Health Insurance (Pathology Services Table) Regulations 2010



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Part 1 Preliminary

Division 1.1 Interpretation



1.1.1 Abbreviations

(1) The abbreviations in Part 3 may be used to identify particular pathology services or groups of pathology services.

(2) The names of services or drugs not listed in Part 3 must be written in full.

Division 1.2 General application provisions



1.2.1 Precedence of items

(1) If a service is described:

(a) in an item in general terms; and

(b) in another item in specific terms;

only the item that describes the service in specific terms applies to the service.

(2) Subject to subclause (3), if:

(a) subclause (1) does not apply; and

(b) a service is described in 2 or more items;

only the item that provides the lower or lowest fee for the service applies to the service.

(3) If an item is expressed to include a pathology service that is described in another item, the other item does not apply to the service in addition to the first mentioned item, whether or not the services described in the 2 items are requested separately.



1.2.2 Circumstances in which services rendered following 2 requests to be taken to have been rendered following 1 request

(1) In subclause (2):



service includes assay, estimation and test.

(2) Two or more pathology services (other than services to which, under clause 1.2.3, this clause does not apply) rendered for a patient following 2 or more requests are taken to have been rendered following a single request if:

(a) the services are listed in the same item; and

(b) that item is not item 74990 or 74991; and

(c) the patient’s need for the services was determined under subsection 16A (1) of the Act on the same day even if the services are rendered by an approved pathology practitioner on more than 1 day.


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