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Assessment of visual acuity and bilateral retinal photography with a non mydriatic retinal camera, including analysis and reporting of the images for initial or repeat assessment for presence or absence of diabetic retinopathy, in a patient with medically diagnosed diabetes, if:

(a)    the patient is of Aboriginal and Torres Strait Islander descent; and

(b)    the assessment is performed by the medical practitioner (other than an optometrist or ophthalmologist) providing

    the primary glycaemic management of the patient's diabetes; and

(c)    this item and item 12326 have not applied to the patient in the preceding 12 months; and

(d)    the patient does not have:

    (i)    an existing diagnosis of diabetic retinopathy; or

    (ii)    visual acuity of less than 6/12 in either eye; or

    (iii) a difference of more than 2 lines of vision between the 2 eyes at the time of presentation

Fee: $59.75 Benefit: 75% = $44.85 85% = $50.80

(See para DN.1.19 of explanatory notes to this Category)

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Assessment of visual acuity and bilateral retinal photography with a non-mydriatic retinal camera, including analysis and reporting of the images for initial or repeat assessment for presence or absence of diabetic retinopathy, in a patient with medically diagnosed diabetes, if:

(a)    the assessment is performed by the medical practitioner (other than an optometrist or ophthalmologist) providing

    the primary glycaemic management of the patient's diabetes; and

(b)    this item and item 12325 have not applied to the patient in the preceding 24 months; and

(c)    the patient does not have:

    (i)    an existing diagnosis of diabetic retinopathy; or

    (ii)    visual acuity of less than 6/12 in either eye; or

    (iii)    a difference of more than 2 lines of vision between the 2 eyes at the time of presentation

Fee: $59.75 Benefit: 75% = $44.85 85% = $50.80

(See para DN.1.19 of explanatory notes to this Category)

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Hyperbaric oxygen therapy, for treatment of decompression illness, gas gangrene, air or gas embolism, diabetic wounds (including diabetic gangrene and diabetic foot ulcers) or necrotising soft tissue infections (including necrotising fasciitis or Fournier’s gangrene), or for the prevention and treatment of osteoradionecrosis, performed in a comprehensive hyperbaric medicine facility, under the supervision of a medical practitioner qualified in hyperbaric medicine, for a period in the hyperbaric chamber of at least 1 hour 30 minutes and not more than 3 hours, including any associated attendance (H)

Fee: $309.80 Benefit: 75% = $232.35

(See para TN.1.1 of explanatory notes to this Category)

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Amputation of one or more toes of one foot, or amputation at midfoot or hindfoot of one foot, for diabetic or other microvascular disease;

(a) including any of the following (if performed):

(i) resection of bone;

(ii) excision of neuromas;

(iii) excision of one or more bones of the foot;

(iv) treatment of underlying infection;

(v) skin cover or recontouring with homodigital flaps; and

(b) excluding aftercare;

—applicable only once per foot per occasion on which the service is performed (H)

Multiple Operation Rule

Fee: $315.85 Benefit: 75% = $236.90

(See para TN.8.199 of explanatory notes to this Category)

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