Health Insurance (Pathology Services Table) Regulations 2010

1.2.3 Services to which clause 1.2.2 does not apply

(1) Clause 1.2.2 does not apply to a pathology service described in subclause (2) if:

(a) under a request for a service, other than a request for a service described in paragraph (3) (a), no more than 6 tests are requested; and

(b) the tests are performed within 6 months of the request; and

(c) the account for the service is endorsed ‘Rule 3 Exemption’.

Note   Rule 3 in the Health Insurance (Pathology Services Table) Regulations 2009 has been replaced by clause 1.2.2.

(2) For subclause (1), the pathology services are:

(a) estimation of prothrombin time (INR) for a patient undergoing anticoagulant therapy; and

(b) quantitative estimation of lithium for a patient undergoing lithium therapy; and

(c) a service described in item 65070 in relation to a patient undergoing chemotherapy for neoplastic disease or immunosuppressant therapy; and

(d) a service described in item 65070 in relation to clozaril, ticlopidine hydrochloride, methotrexate, gold, sulphasalazine or penicillamine therapy of a patient; and

(e) a service described in any of items 66500 to 66512, in relation to methotrexate or leflunomide therapy of a patient; and

(f) quantitative estimation of urea, creatinine and electrolytes in relation to:

(i) cis platinum or cyclosporin therapy of a patient; or

(ii) chronic renal failure of a patient being treated in a dialysis program conducted by a recognised hospital; and

(g) quantitative estimation of albumin and calcium in relation to therapy of a patient with vitamin D, its metabolites or analogues; and

(h) quantitative estimation of calcium, phosphate, magnesium, urea, creatinine and electrolytes for a cancer patient receiving bisphosphonate infusions.