Health Insurance (Pathologist-determinable Services) Determination 2005 (No. 2)
I, TONY ABBOTT, Minister for Health and Ageing, make this Determination under section 4BA of the Health Insurance Act 1973. Dated 14 October 2005 TONY ABBOTT Minister for Health and Ageing
1 Name of Determination This Determination is the Health Insurance (Pathologist-determinable Services) Determination 2005 (No.2).
2 Commencement This Determination commences on 1 November 2005.
3 Revocation of previous Determination The Health Insurance (Pathologist-determinable Services) Determination 2005 made under section 4BA of the Health Insurance Act 1973 on 5 April 2005 is revoked.
4 Interpretation (1) In this Determination: Act means the Health Insurance Act 1973. Regulations means the Health Insurance Regulations 1975. recognised pathologist means a medical practitioner recognised as a specialist in pathology by a determination under section 3D or subsection 61(3) of the Act. (2) Unless the contrary intention appears, an expression that is used in this Determination and in the Act or the Regulations has the same meaning in this Determination as it has in the Act or the Regulations.
5 Pathologist-determinable services For paragraph 4BA (b) of the Act, the following classes of pathology services are pathologist-determinable services: (a) a pathology service that: (i) is mentioned in an item in the pathology services table; and (ii) is rendered, by or on behalf of, an approved pathology practitioner to a patient of that practitioner; (b) a pathology service that: (i) is rendered, by or on behalf of, an approved pathology practitioner; and (ii) the approved pathology practitioner considers to be necessary, on the basis of information learned from another service: (A) that was rendered to the patient by, or on behalf of, that practitioner; and (B) the request for which complied with paragraph 16A (4) (a) or (b) of the Act; and (iii) is an item in the pathology services table that is mentioned in column 1 in the following table and, in relation to which, the pathology service originally requested was an item in the pathology services table that is mentioned in column 2 of the following table:
Column 1 Pathology service
Column 2 Originally requested service
72846, 72847, 72848
72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830, 72836
73059, 73060, 73061
73045, 73047, 73049, 73051
72851, 72852
72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72830, 72836
73305
73300
(c) a pathology service that is mentioned in items 69364 or 69365 of the pathology services table and: (i) is rendered, by or on behalf of, an approved pathology practitioner who is a recognised pathologist; and (ii) is a service that the approved pathology practitioner determines to be necessary on the basis of: (A) information provided by a treating practitioner in relation to a pathology service mentioned in items 69303, 69306, 69312, 69318, 69321 or 69345 of the pathology services table, that was rendered to the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4)(a) or (b) of the Act; or (B) the nature or appearance of the pathology specimen collected for a pathology service mentioned in items 69303, 69306, 69312, 69318, 69321 or 69345 of the pathology services table, that was rendered to the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4)(a) or (b) of the Act; or (C) information learned from a pathology service mentioned in items 69303, 69306, 69312, 69318, 69321 or 69345 of the pathology services table, that was rendered to the patient by, or on behalf of, the approved pathology practitioner pursuant to a request that complied with paragraph 16A(4)(a) or (b) of the Act.
