Health Insurance (Pathology Services Table) Regulations 2006

metal toxicity testing group means items 66672 and 66673.

nutritional metals testing group means items 66669 and 66670.

(2) An item in the nutritional metals testing group or the metal toxicity testing group does not apply in relation to a service performed if medicare benefits are paid or payable for tests that are performed for the same patient in 3 patient episodes requested within 6 months before the request for that service, under any of:

(a) that item; or

(b) the other item in the same group; or

(c) an item in the other group.

23 Antineutrophil cytoplasmic antibody tests

For subsection 16A (3) of the Act, a request for an antineutrophil cytoplasmic antibody immunofluorescence test is taken to include a request for an antineutrophil proteinase 3 antibody test and an antimyeloperoxidase antibody test if:

(a) the immunofluorescence test performed as a result of the request is abnormal; or

(b) a previous immunofluorescence test was abnormal; or

(c) those antibodies have been previously detected.

24 Satisfying requirements described in pathology service

Unless the contrary intention appears, a requirement contained in the description of a pathology service in Part 3 is satisfied if:

(a) in the case of a requirement for information, the information:

(i) is included in the request for the service; or

(ii) was supplied in writing on an earlier occasion to the approved pathology authority that rendered the service, and has been kept by the approved pathology authority; or

(b) in the case of a requirement for laboratory test results, the results are:

(i) included in the request for the service; or

(ii) obtained from another laboratory test performed in the same patient episode; or

(iii) included in results from an earlier laboratory test that have been kept by the approved pathology authority.

25 Limitation on certain items

(1) For any particular patient, items 66539, 69442, 71075, 71127, 71135 and 71137 are applicable not more than twice in a 12 month period.

(2) For any particular patient, item 66626 is applicable not more than 36 times in a 12 month period.

(3) For any particular patient, items 66655, 66659, 69443 and 69444 are applicable not more than once in a 12 month period.

(4) For any particular patient, item 66750 is applicable not more than once in a pregnancy.

(5) For any particular patient, item 69336 is applicable not more than once in each period of 7 days.

(6) For any particular patient, items 69445, 71079, 73314 and 73523 are applicable not more than 4 times in a 12 month period.

(7) For any particular patient, item 71077 is applicable not more than 6 times in a 12 month period.

(8) For any particular patient, item 69486 is applicable not more than twice in a 24 month period.

26 Antigen detection

If a pathology service described in item 69364, 69365 or 69367 is rendered as a pathologist determinable service, the amount specified in the item is not payable for the service unless the recognised pathologist who renders the service records, in writing, the reasons for rendering the service.

27 HLA B27 typing

If a pathology service described in item 73320 is rendered as a pathologist determinable service, the amount specified in the item is not payable for a pathology service described in the item unless the recognised pathologist who renders the service records, in writing, the reasons for rendering the service and the result of the pathology service described in item 71147.