Health Insurance (Bone Densitometry) Determination HS/02/2006
__________________________________________________________________
I, TONY ABBOTT, Minister for Health and Ageing, make this Determination under subsection 3C (1) of the Health Insurance Act 1973.
Dated 30/10/2006
_________Tony Abbott_______________________
Minister for Health and Ageing
Contents
1. Name of Determination 3
2. Commencement 3
3. Revocation of Health Insurance Determination HS/4/1999 3
4. Interpretation 3
5. Treatment of a relevant service 4
Schedule Specified health services 5
1. Name of Determination
This Determination is the Health Insurance (Bone Densitometry) Determination HS/02/2006.
2. Commencement
This Determination commences on 1 November 2006.
3. Revocation of Health Insurance Determination HS/4/1999
This Determination revokes Health Insurance Determination HS/4/1999.
4. Interpretation
(1) In this Determination:
relevant service means a health service, as defined in subsection 3C(8) of the Act, that is specified in the Schedule.
the Act means the Health Insurance Act 1973.
the Schedule means the Schedule to this Determination.
Note Unless the contrary intention appears, expressions used in this Determination have the same meanings as in the Act—see section 13 of the Legislative Instruments Act 2003.
(2) Unless the contrary intention appears, in this Determination a reference to a provision of the Act or the National Health Act 1953 or regulations made under the Act or under the National Health Act 1953 as applied, adopted or incorporated in relation to specifying a matter is a reference to those provisions as in force from time to time and any other reference to provisions of an Act or regulations is a reference to those provisions as in force from time to time.
5. Treatment of a relevant service
A relevant service shall be treated as if:
(a) it were both a professional service and a medical service for the purposes of the provisions of the Act, the National Health Act 1953, the Health Insurance Regulations 1975 and the National Health Regulations 1954 that make provision in respect of professional services or medical services; and
(b) there were an item in the general medical services table that related to the relevant service and specified in respect of the service a fee in relation to a State, being the fee specified in the Schedule in relation to the State specified.
Schedule Specified health services
Item
Health Service
Fee for all States
12306
Bone densitometry (performed by a specialist or consultant physician where the patient is referred by another medical practitioner), using dual energy X‑ray absorptiometry, for:
• the confirmation of a presumptive diagnosis of low bone mineral density made on the basis of 1 or more fractures occurring after minimal trauma; or
• for the monitoring of low bone mineral density proven by bone densitometry at least 12 months previously.
Measurement of 2 or more sites ‑ 1 service only in a period of 24 months ‑ including interpretation and report; not being a service associated with a service to which item 12309, 12312, 12315, 12318 or 12321 applies (Ministerial Determination).
$90.45
12309
Bone densitometry (performed by a specialist or consultant physician where the patient is referred by another medical practitioner), using quantitative computerised tomography, for:
• the confirmation of a presumptive diagnosis of low bone mineral density made on the basis of 1 or more fractures occurring after minimal trauma; or
• for the monitoring of low bone mineral density proven by bone densitometry at least 12 months previously.
Measurement of 2 or more sites ‑ 1 service only in a period of 24 months ‑ including interpretation and report; not being a service associated with a service to which item 12306, 12312, 12315, 12318 or 12321 applies (Ministerial Determination).
$90.45
12312
Bone densitometry (performed by a specialist or consultant physician where the patient is referred by another medical practitioner), using dual energy X‑ray absorptiometry, for the diagnosis and monitoring of bone loss associated with 1 or more of the following conditions:
• prolonged glucocorticoid therapy;
• conditions associated with excess glucocorticoid secretion;
• male hypogonadism; or
• female hypogonadism lasting more than 6 months before the age of 45.
Where the bone density measurement will contribute to the management of a patient with any of the above conditions ‑ measurement of 2 or more sites ‑ 1 service only in a period of 12 consecutive months – including interpretation and report; not being a service associated with a service to which item 12306, 12309, 12315, 12318 or 12321 applies (Ministerial Determination).
$90.45
Item
Health Service
Fee for all States
12315
Bone densitometry (performed by a specialist or consultant physician where the patient is referred by another medical practitioner), using dual energy X‑ray absorptiometry, for the diagnosis and monitoring of bone loss associated with 1 or more of the following conditions:
• primary hyperparathyroidism;
• chronic liver disease;
• chronic renal disease;
• proven malabsorptive disorders;
• rheumatoid arthritis; or
• conditions associated with thyroxine excess.
Where the bone density measurement will contribute to the management of a patient with any of the above conditions ‑ measurement of 2 or more sites ‑ 1 service only in a period of 24 consecutive months – including interpretation and report; not being a service associated with a service to which item 12306, 12309, 12312, 12318 or 12321 applies (Ministerial Determination).
$90.45
12318
Bone densitometry (performed by a specialist or consultant physician where the patient is referred by another medical practitioner), using quantitative computerised tomography, for the diagnosis and monitoring of bone loss associated with 1 or more of the following conditions:
• prolonged glucocorticoid therapy;
• conditions associated with excess glucocorticoid secretion;
• male hypogonadism;
• female hypogonadism lasting more than 6 months before the age of 45;
• primary hyperparathyroidism;
• chronic liver disease;
• chronic renal disease;
• proven malabsorptive disorders;
• rheumatoid arthritis; or
• conditions associated with thyroxine excess.
Where the bone density measurement will contribute to the management of a patient with any of the above conditions ‑ measurement of 2 or more sites ‑ 1 service only in a period of 24 consecutive months – including interpretation and report; not being a service associated with a service to which item 12306, 12309, 12312, 12315 or 12321 applies (Ministerial Determination).
$90.45
Item
Health Service
Fee for all States
12321
Bone densitometry (performed by a specialist or consultant physician where the patient is referred by another medical practitioner), using dual energy X‑ray absorptiometry, for the measurement of bone density 12 months following a significant change in therapy for:
• established low bone mineral density; or
• the confirmation of a presumptive diagnosis of low bone mineral density made on the basis of 1 or more fractures occurring after minimal trauma.
Measurement of 2 or more sites ‑ 1 service only in a period of 12 consecutive months ‑including interpretation and report; not being a service associated with a service to which item 12306, 12309, 12312, 12315 or 12318 applies (Ministerial Determination).
$90.45
Note Section 3C(7) of the Act deems an internal territory to form part of the State of New South Wales.
