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Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2011 (No. 2)

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Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2011 (No. 2)1
Select Legislative Instrument 2011 No. 99
I, QUENTIN BRYCE, Governor-General of the Commonwealth of Australia, acting with the advice of the Federal Executive Council, make the following Regulations under the Health Insurance Act 1973.
Dated 16 June 2011
QUENTIN BRYCE
Governor-General
By Her Excellency’s Command
NICOLA ROXON
Minister for Health and Ageing
1              Name of Regulations
                These Regulations are the Health Insurance (Diagnostic Imaging Services Table) Amendment Regulations 2011 (No. 2).
2              Commencement
                These Regulations commence on 1 July 2011.
3              Amendment of Health Insurance (Diagnostic Imaging Services Table) Regulations 2010
                Schedule 1 amends the Health Insurance (Diagnostic Imaging Services Table) Regulations 2010.
Schedule 1        Amendments
(regulation 3)
 
[1]           Schedule 1, item 55600
omit
transrectal
[2]           Schedule 1, item 55600, paragraph (a)
omit
a transducer probe
insert
1 or more transducer probes
[3]           Schedule 1, item 55600, subparagraph (a) (i)
omit
has
insert
have
[4]           Schedule 1, item 55600, paragraph (a)
after
paragraph (c))
insert
or a participating nurse practitioner
[5]           Schedule 1, item 55600, paragraph (c)
omit
or a participating nurse practitioner,
[6]           Schedule 1, item 55603
omit
transrectal
[7]           Schedule 1, item 55603, paragraph (a)
omit
a transducer probe
insert
1 or more transducer probes
[8]           Schedule 1, item 55603, subparagraph (a) (i)
omit
has
insert
have
[9]           Schedule 1, item 55836, paragraph (b)
omit
medical practitioner or participating nurse practitioner;
insert
medical practitioner, participating nurse practitioner or podiatrist;
[10]         Schedule 1, item 55840, paragraph (b)
omit
medical practitioner or participating nurse practitioner;
insert
medical practitioner, participating nurse practitioner or podiatrist;
[11]         Schedule 1, item 55844, paragraph (b)
omit
medical practitioner or participating nurse practitioner;
insert
medical practitioner, participating nurse practitioner or podiatrist;
[12]         Schedule 1, Part 2, Division 2.2, heading
substitute
Division 2.2           Group I2 — Computed tomography — Examination
[13]         Schedule 1, clause 2.2.2
substitute
2.2.2       CT services — eligible services
         (1)   Items in this Division (other than items 57360 and 57361) apply to a CT service that is:
                (a)    performed under the professional supervision of a specialist in the specialty of diagnostic radiology who is available:
                          (i)    to monitor and influence the conduct and diagnostic quality of the examination; and
                         (ii)    if necessary, to attend on the patient personally; and
               (b)    reported by a specialist in the specialty of diagnostic radiology.
         (2)   Items 57360 and 57361 apply to a CT service that is:
                (a)    performed under the professional supervision of a specialist or consultant physician who is recognised by the Conjoint Committee for the Recognition of Training in CT Coronary Angiography and available:
                          (i)    to monitor and influence the conduct and diagnostic quality of the examination; and
                         (ii)    if necessary, to attend on the patient personally; and
               (b)    reported by a specialist or consultant physician who is recognised by the Conjoint Committee for the Recognition of Training in CT Coronary Angiography.
         (3)   However, items in this Division apply to a CT service that does not comply with the requirements mentioned in subclause (1) or (2) if the service is performed:
                (a)    in an emergency; or
               (b)    because of medical necessity, in a remote location.
[14]         Schedule 1, after item 57356
insert
57360
Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner if:
   (a)  the request is made by a specialist or consultant physician; and
  (b)  1 of the following applies to the patient:
         (i)   the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography;
        (ii)   the patient requires exclusion of coronary artery anomaly or fistula;
       (iii)   the patient will be undergoing non-coronary cardiac surgery (R) (K) (Anaes.)
700.00

57361
Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner if:
   (a)  the request is made by a specialist or consultant physician; and
350.00

 
  (b)  1 of the following applies to the patient:
         (i)   the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography;
 

 
        (ii)   the patient requires exclusion of coronary artery anomaly or fistula;
       (iii)   the patient will be undergoing non-coronary cardiac surgery (R) (NK) (Anaes.)
 

[15]         Schedule 1, after item 61529
insert
61538
FDG PET study of the brain for evaluation of suspected residual or recurrent malignant brain tumour based on anatomical imaging findings, after definitive therapy (or during ongoing chemotherapy) in patients who are considered suitable for further active therapy (R)
901.00
[16]         Schedule 1, item 61544
omit
[17]         Schedule 1, item 61556
omit
[18]         Schedule 1, item 61568
substitute
61571
Whole body FDG PET study for the further primary staging of patients with histologically proven carcinoma of the uterine cervix, at FIGO stage IB2 or greater by conventional staging, prior to planned radical radiation therapy or combined modality therapy with curative intent (R)
953.00

61575
Whole body FDG PET study for the further staging of patients with confirmed local recurrence of carcinoma of the uterine cervix considered suitable for salvage pelvic chemoradiotherapy or pelvic exenteration with curative intent (R)
953.00

[19]         Schedule 1, item 61580
omit
[20]         Schedule 1, after item 61613
insert
61616
Whole body FDG PET study for the initial staging of indolent non-Hodgkin’s lymphoma if:
   (a)  clinical, pathological and imaging findings indicated that the stage is I or IIA; and
  (b)  the proposed management is definitive radiotherapy with curative intent (R)
953.00

61620
Whole body FDG PET study for the initial staging of newly diagnosed or previously untreated Hodgkin’s or non‑Hodgkin’s lymphoma (excluding indolent non‑Hodgkin’s lymphoma) (R)
953.00

61622
Whole body FDG PET study to assess response to first line therapy either during treatment or within 3 months of completing definitive first line treatment for Hodgkin’s or non-Hodgkin’s lymphoma (excluding indolent non‑Hodgkin’s lymphoma) (R)
953.00

61628
Whole body FDG PET study for restaging following confirmation of recurrence of Hodgkin’s or non‑Hodgkin’s lymphoma (excluding indolent non‑Hodgkin’s lymphoma) (R)
953.00

61632
Whole body FDG PET study to assess response to second‑line chemotherapy if stem cell transplantation is being considered for Hodgkin’s or non-Hodgkin’s lymphoma (excluding indolent non-Hodgkin’s lymphoma) (R)
953.00

61640
Whole body FDG PET study for initial staging of a patient with biopsy-proven bone or soft tissue sarcoma (excluding gastrointestinal stromal tumour) considered by conventional staging to be potentially curable (R)
999.00

61646
Whole body FDG PET study for the evaluation of patients with suspected residual or recurrent sarcoma (excluding gastrointestinal stromal tumour) after the initial course of definitive therapy to determine suitability for subsequent therapy with curative intent (R)
999.00

[21]         Schedule 1, item 64991, sub-subparagraph (e) (iii) (E)
after
East Metropolitan
insert
Perth
[22]         Schedule 1, item 64991, sub-subparagraph (e) (iii) (V)
after
South West Metropolitan
insert
Perth
Note
1.       All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See http://www.frli.gov.au.