Appendix D Index of MBS items and recommendation numbers

Item #

Descriptor

Recommendation

number

Type

(change, unchanged, delete or obsolete)

11700

Twelve-lead electrocardiography, tracing and report

19

change

11701

Twelve-lead electrocardiography, report only where the tracing has been forwarded to another medical practitioner, not in association with a consultation on the same occasion

20

change

11702

Twelve-lead electrocardiography, tracing only

19

change

11708

Continuous ECG recording of ambulatory patient for 12 or more hours (including resting EECG and the recording of parameters), not in association with ambulatory blood pressure monitoring, involving microprocessor based analysis equipment, interpretation and report of recordings by a specialist physician or consultant physician. Not being a service to which item 11709 applies. The changing of a tape or batteries does not constitute a separate service.  Where a recording is analysed and reported on and a decision is made to undertake a further period of monitoring, the second episode is regarded as a separate service.

21

obsolete

11709

Continuous ECG recording (Holter) of ambulatory patient for 12 or more hours (including resting ECG and the recording of parameters), not in association with ambulatory blood pressure monitoring, utilising a system capable of superimposition and full disclosure printout of at least 12 hours of recorded ECG data, microprocessor based scanning analysis, with interpretation and report by a specialist physician or consultant physician. The changing of a tape or batteries does not constitute a separate service.  Where a recording is analysed and reported on and a decision is made to undertake a further period of monitoring, the second episode is regarded as a separate service.

22

change

11710

Ambulatory ECG monitoring, patient activated, single or multiple event recording, utilising a looping memory recording device which is connected continuously to the patient for 12 hours or more and is capable of recording for at least 20 seconds prior to each activation and for15 seconds after each activation, including transmission, analysis, interpretation and report — payable once in any 4 week period

23

change

11711

Ambulatory ECG monitoring for 12 hours or more, patient activated, single or multiple event recording, utilising a memory recording device which is capable of recording for at least 30 seconds after each activation, including transmission, analysis, interpretation and report — payable once in any 4 week period

24

obsolete

11712

Multi-channel ECG monitoring and recording during exercise (motorised treadmill or cycle ergometer capable of quantifying external workload in watts) or pharmacological stress, involving the continuous attendance of a medical practitioner for not less than 20 minutes, with resting ECG, and with or without continuous blood pressure monitoring and the recording of other parameters, on premises equipped with mechanical respirator and defibrillator

2

change

11713

Signal averaged ECG recording involving not more than 300 beats, using at least 3 leads with data acquisition at not less than 1000Hz of at least 100 QRS complexes, including analysis, interpretation and report of recording by a specialist physician or consultant physician

35

obsolete

11715

Blood dye — dilution indicator test

37

obsolete

11718

Implanted pacemaker testing involving electrocardiography, measurement of rate, width and amplitude of stimulus, including reprogramming when required, not being a service associated with a service to which item 11700,   11719, 11720, 11721, 11725 or 11726 applies

32.2

obsolete

11719

Implanted pacemaker (including cardiac resynchronisation pacemaker) remote monitoring involving reviews (without patient attendance) or arrhythmias, lead and device parameters, if at least one remote review is provided in a 12 month period. Payable only once in any 12 month period

32.1

unchanged

11720

Implanted pacemaker testing, with patient attendance, following detection of abnormality by remote monitoring involving electrocardiography, measurement of rate, width and amplitude of stimulus including reprogramming when required, not being a service associated with a service to which item 11718 or 11721 applies.

32.1

unchanged

11721

Implanted pacemaker testing of atrioventricular (AV) sequential, rate responsive, or antitachycardia pacemakers, including reprogramming when required, not being a service associated with a service to which item 11700, 11718 11719, 11720, 11725 or 11726 applies

32.3

change

11722

Implanted ECG loop recording for the investigation of recurrent unexplained syncope if: (a) a diagnosis has not been achieved through all other available cardiac investigations; and (b) a neurogenic cause is not suspected; and (c) the patient to whom the service is provided does not have a structural heart defect associated with a high risk of sudden cardiac death; including reprogramming when required, retrieval of stored data, analysis, interpretation and report, not being a service to which item 38285 applies

25

change

11724

Up-right tilt table testing for the investigation of syncope of suspected cardiothoracic origin, including blood pressure monitoring, continuous ECG monitoring and the recording of the parameters, and involving an established intravenous line and the continuous attendance of a specialist or consultant physician — on premises equipped with a mechanical respirator and defibrillator

36

unchanged

11725

Implanted defibrillator (including Cardiac Resynchronisation Defibrillator) remote monitoring involving reviews (without patient attendance) of arrhythmias, lead and device parameters, if at least 2 remote reviews are provided in a 12 month period.  Payable only once in any 12 month period

30.4

unchanged

11726

Implanted defibrillator testing with patient attendance following detection of abnormality by remote monitoring involving electrocardiography, measurement of rate, width and amplitude of stimulus, not being a service associated with a service to which item 11727 applies.

30.4

unchanged

11727

Implanted defibrillator testing involving electrocardiography, assessment of pacing and sensing thresholds for pacing and defibrillation electrodes, download and interpretation of stored events and electrograms, including programming when required, not being a service associated with a service to which item 11700, 11718,  11719, 11720, 11721, 11725 or 11726 applies

30.3

change

13400

Restoration of cardiac rhythm by electrical stimulation (cardioversion), other than in the course of cardiac surgery (Anaes.)

34

change

38200

Right heart catheterisation, with any one or more of the following: fluoroscopy, oximetry, dye dilution curves, cardiac output measurement by any method, shunt detection or exercise stress test (Anaes.)

12.3

unchanged

38203

Left heart catheterisation by percutaneous arterial puncture, arteriotomy or percutaneous left ventricular puncture with any one or more of the following fluoroscopy, oximetry, dye dilution curves, cardiac output measurements by any method, shunt detection or exercise stress test (Anaes.)

12.3

unchanged

38206

Right heart catheterisation with left heart catheterisation via the right heart or by any other procedure with any one or more of the following: fluoroscopy, oximetry, dye dilution curves, cardiac output measurements by any method, shunt detection or exercise stress test (Anaes.)

12.3

unchanged

38209

Cardiac electrophysiological study  up to and including 3 catheter investigation of any 1 or more of  syncope, atrioventricular conduction, sinus node function or simple ventricular tachycardia studies, not being a service associated with a service to which item 38212 or 38213 applies (Anaes.)

29.1

unchanged

38212

Cardiac electrophysiological study  4 or more catheter supraventricular tachycardia investigation; or complex tachycardia inductions, or multiple catheter mapping, or acute intravenous antiarrhythmic drug testing with pre and post drug inductions; or catheter ablation to intentionally induce complete AV block; or intraoperative mapping; or electrophysiological services during defibrillator implantation or testing  not being a service associated with a service to which item 38209 or 38213 applies (Anaes.)

29.2

change

38213

Cardiac electrophysiological study, for follow-up testing of implanted defibrillator - not being a service associated with a service to which item 38209 or 38212 applies (Anaes.)

29.2

change

38215

Selective coronary angiography, placement of catheters and injection of opaque material into the native coronary arteries, not being a service associated with a service to which item 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38218

Selective coronary angiography, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography, not being a service associated with a service to which item 38215, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38220

Selective coronary graft angiography placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38222

Selective coronary graft angiography, placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38225, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38225

Selective coronary angiography, placement of catheters and injection of opaque material into the native coronary arteries and placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38228, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38228

Selective coronary angiography, placement of catheters and injection of opaque material into the native coronary arteries and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38231, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38231

Selective coronary angiography, placement of catheters and injection of opaque material into the native coronary arteries and placement of catheter(s) and injection of opaque material into the free coronary graft(s) attached to the aorta (irrespective of the number of grafts), and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38234, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38234

Selective coronary angiography, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38237, 38240 or 38246 applies (Anaes.)

12.2

change

38237

Selective coronary angiography, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38240 or 38246 applies (Anaes.)

12.2

change

38240

Selective coronary angiography, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography and placement of catheter(s) and injection of opaque material into free coronary graft(s) attached to the aorta (irrespective of the number of grafts) and placement of catheter(s) and injection of opaque material into direct internal mammary artery graft(s) to one or more coronary arteries (irrespective of the number of grafts), not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237 or 38246 applies (Anaes.)

12.2

change

38241

Use of a coronary pressure wire during selective coronary angiography to measure fractional flow reserve (ffr) and coronary flow reserve (cfr) in one or more intermediate coronary artery or graft lesions (stenosis of 30-70%), to determine whether revascularisation should be performed where previous stress testing has either not been performed or the results are inconclusive (Anaes.)

12.2

unchanged

38243

Placement of catheter(s) and injection of opaque material into any coronary vessel(s) or graft(s) prior to any coronary interventional procedure, not being a service associated with a service to which item 38246 applies (Anaes.)

12.2

changed

38246

Selective coronary angiography, placement of catheters and injection of opaque material with right or left heart catheterisation or both, or aortography followed by placement of catheters prior to any coronary interventional procedure, not being a service associated with a service to which item 38215, 38218, 38220, 38222, 38225, 38228, 38231, 38234, 38237, 38240 or 38243 applies (Anaes.)

12.2

changed

38256

Temporary transvenous pacemaking electrode, insertion of (Anaes.)

32.1

unchanged

38270

Balloon valvuloplasty or isolated atrial septostomy, including cardiac catheterisations before and after balloon dilatation (Anaes.) (Assist.)

15.3

unchanged

38272

Atrial septal defect closure, with septal occluder or other similar device, by transcatheter approach (Anaes.) (Assist.)

15.2

change

38273

Patent ductus arteriosus, transcatheter closure of, including cardiac catheterisation and any imaging associated with the service (Anaes.) (Assist.)

15.3

unchanged

38274

Ventricular septal defect, transcatheter closure of, with imaging and cardiac catheterisation (Anaes.) (Assist.)

15.1  

change

38275

Myocardial biopsy, by cardiac catheterisation (Anaes.)

15.3  

unchanged

38285

Implantable ecg loop recorder, insertion of, for diagnosis of primary disorder in patients with recurrent unexplained syncope where: - a diagnosis has not been achieved through all other available cardiac investigations; and - a neurogenic cause is not suspected; and - it has been determined that the patient does not have structural heart disease associated with a high risk of sudden cardiac death. Including initial programming and testing, as an admitted patient in an approved hospital (Anaes.)

26

change

38286

Implantable ecg loop recorder, removal of, as an admitted patient in an approved hospital (Anaes.)

27  

change

38287

Ablation of arrhythmia circuit or focus or isolation procedure involving 1 atrial chamber (Anaes.) (Assist.)

31  

unchanged

38290

Ablation of arrhythmia circuits or foci, or isolation procedure involving both atrial chambers and including curative procedures for atrial fibrillation (Anaes.) (Assist.)

31

unchanged

38293

Ventricular arrhythmia with mapping and ablation, including all associated electrophysiological studies performed on the same day (Anaes.) (Assist.)

31

unchanged

38300

Transluminal balloon angioplasty of 1 coronary artery, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.)

13.2  

obsolete

38303

Transluminal balloon angioplasty of more than 1 coronary artery, percutaneous or by open exposure, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.)

13.1

change

38306

Transluminal stent insertion including associated balloon dilatation for coronary artery, percutaneous or by open exposure, excluding associated radiological services and preparation, and excluding after transluminal insertion of stent or stents into 1 occlusional site, including associated balloon dilatation for coronary artery, percutaneous or by open exposure, excluding associated radiological services and preparation, and excluding aftercare care (Anaes.) (Assist.)

13.2

obsolete

38309

Percutaneous transluminal rotational atherectomy of 1 coronary artery, including balloon angioplasty with no stent insertion where:- no lesion of the coronary artery has been stented; and- each lesion of the coronary artery is complex and heavily calcified; and- balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.)

13.1

change

38312

Percutaneous transluminal rotational atherectomy of 1 coronary artery, including balloon angioplasty with insertion of 1 or more stents, where no lesion of the coronary artery has been stented; and each lesion of the coronary artery is complex and heavily calcified; and balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.)

13.2

obsolete

38315

Percutaneous transluminal rotational atherectomy of more than 1 coronary artery, including balloon angioplasty with no stent insertion where:- no lesion of the coronary arteries has been stented; and- each lesion of the coronary arteries is complex and heavily calcified; and- balloon angioplasty with or without stenting is not suitable; excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.)

13.2

obsolete

38318

Percutaneous transluminal rotational atherectomy of more than 1 coronary artery, including balloon angioplasty, with insertion of 1 or more stents, where: - no lesion of the coronary arteries has been stented; and- each lesion of the coronary arteries is complex and heavily calcified; and- balloon angioplasty with or without stenting is not suitable, excluding associated radiological services or preparation, and excluding aftercare (Anaes.) (Assist.)

13.2

obsolete

38350

Single chamber permanent transvenous electrode, insertion, removal or replacement of, including cardiac electrophysiological services where used for pacemaker implantation (Anaes.)

32.1  

unchanged

38353

Permanent cardiac pacemaker, insertion, removal or replacement of, not for cardiac resynchronisation therapy, including cardiac electrophysiological services where used for pacemaker implantation (Anaes.)

32.1

unchanged

38356

Dual chamber permanent transvenous electrodes, insertion, removal or replacement of, including cardiac electrophysiological services where used for pacemaker implantation (Anaes.)

32.1

unchanged

38358

Extraction of chronically implanted transvenous pacing or defibrillator lead or leads, by percutaneous method where the leads have been in situ for greater than six months and require removal with locking stylets, snares and/or extraction sheaths in a facility where cardiac surgery is available, in association with item 61109 or 60509 (Anaes.) (Assist.)

15.3

unchanged

38359

Pericardium, paracentesis of (excluding aftercare) (Anaes.)

15.3

unchanged

38362

Intra-aortic balloon pump, percutaneous insertion of (Anaes.)

15.3

unchanged

38365

Permanent cardiac synchronisation device (including a cardiac synchronisation device that is capable of defibrillation), insertion, removal or replacement of, for a patient who: (a) has: (i) moderate to severe chronic heart failure (new york heart association (nyha) class iii or iv) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and (iv) a qrs duration greater than or equal to 120 ms; or (b) satisfied the requirements mentioned in paragraph (a) immediately before the insertion of a cardiac resynchronisation therapy device and transvenous left ventricle electrode (Anaes.)

28.1 &2

change

38368

Permanent transvenous left ventricular electrode, insertion, removal or replacement of through the coronary sinus, for the purpose of cardiac resynchronisation therapy, including right heart catheterisation and any associated venogram of left ventricular veins, other than a service associated with a service to which item 35200 or 38200 applies, for a patient who: (a) has: (i) moderate to severe chronic heart failure (new york heart association (nyha) class iii or iv) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and(iv) a qrs duration greater than or equal to 120 ms; or (b) has: (i) mild chronic heart failure (new york heart association (nyha) class ii) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and(iv) a qrs duration greater than or equal to 150 ms; or (c) satisfied the requirements mentioned in paragraph (a) or (b) immediately before the insertion of a cardiac resynchronisation therapy device and transvenous left ventricle electrode (Anaes.)

28.1 & 28.2

change

38371

Permanent cardiac synchronisation device capable of defibrillation, insertion, removal or replacement of, for a patient who:(a) has:(i) moderate to severe chronic heart failure (new york heart association (nyha) class iii or iv) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and (iv) a qrs duration greater than or equal to 120 ms; or (b) has:(i) mild chronic heart failure (new york heart association (nyha) class ii) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and(iv) a qrs duration greater than or equal to 150 ms (Anaes.)

28.3

delete

38384

Automatic defibrillator, insertion of patches for, or insertion of transvenous endocardial defibrillation electrodes for, primary prevention of sudden cardiac death in:   - patients with a left ventricular ejection fraction of less than or equal to 30% at least one month after a myocardial infarct when the patient has received optimised medical therapy; or   - patients with chronic heart failure associated with mild to moderate symptoms (nyha ii and iii) and a left ventricular ejection fraction less than or equal to 35% when the patient has received optimised medical therapy.  Not being a service associated with a service to which item 38213 applies (Anaes.) (Assist.)

30.1

change

38387

Automatic defibrillator generator, insertion or replacement of for, primary prevention of sudden cardiac death in:   - patients with a left ventricular ejection fraction of less than or equal to 30% at least one month after a myocardial infarct when the patient has received optimised medical therapy; or   - patients with chronic heart failure associated with mild to moderate symptoms (nyha ii and iii) and a left ventricular ejection fraction less than or equal to 35% when the patient has received optimised medical therapy.  Not being a service associated with a service to which item 38213 applies, not for defibrillators capable of cardiac resynchronisation therapy (Anaes.) (Assist.)

30.3

change

38390

Automatic defibrillator, insertion of patches for, or insertion of transvenous endocardial defibrillation electrodes for - not for patients with heart failure or as primary prevention for tachycardia arrhythmias. Not being a service associated with a service to which item 38213 applies (Anaes.) (Assist.)

30.1

change

38393

Automatic defibrillator generator, insertion or replacement of for - not for patients with heart failure or as primary prevention for tachycardia arrhythmias. Not being a service associated with a service to which item 38213 applies. (Anaes.) (Assist.)

30.3

change

38470

Permanent myocardial electrode, insertion of, by thoracotomy or sternotomy (Anaes.) (Assist.)

28.3

change

38473

Permanent pacemaker electrode, insertion by open surgical approach (Anaes.) (Assist.)

28.3

change

38475

Valve annuloplasty without insertion of ring, not being a service associated with a service to which item 38480 or 38481 applies (Anaes.) (Assist.)

42.3

delete

38477

Valve annuloplasty with insertion of ring not being a service to which item 38478 applies (Anaes.) (Assist.)

42.3

change

38478

Valve annuloplasty with insertion of ring performed in conjunction with item 38480 or 38481 (Anaes.) (Assist.)

42.3

delete

38480

Valve repair, 1 leaflet (Anaes.) (Assist.)

42.3

delete

38481

Valve repair, 2 or more leaflets (Anaes.) (Assist.)

42.3

delete

38483

Aortic valve leaflet or leaflets, decalcification of, not being a service to which item 38475, 38477, 38480, 38481, 38488 or 38489 applies (Anaes.) (Assist.)

42.3

obsolete

38485

Mitral annulus, reconstruction of, after decalcification, when performed in association with valve surgery (Anaes.) (Assist.)

42.2

unchanged

38487

Mitral valve, open valvotomy of (Anaes.) (Assist.)

42.2

unchanged

38488

Valve replacement with bioprosthesis or mechanical prosthesis (Anaes.) (Assist.)

42.2

delete

38489

Valve replacement with allograft (subcoronary or cylindrical implant), or unstented xenograft (Anaes.) (Assist.)

42.2

delete

38490

Sub-valvular structures, reconstruction and re-implantation of, associated with mitral and tricuspid valve replacement (Anaes.) (Assist.)

42.2

change

38493

Operative management of acute infective endocarditis, in association with heart valve surgery (Anaes.) (Assist.)

42.3

unchanged

38496

Artery harvesting (other than internal mammary), for coronary artery bypass (Anaes.) (Assist.)

39

change

38497

Coronary artery bypass with cardiopulmonary bypass, using saphenous vein graft or grafts only, including harvesting of vein graft material where performed, not being a service associated with a service to which item 38498, 38500, 38501, 38503 or 38504 apply (Anaes.) (Assist.)

39

change

38498

Coronary artery bypass with the aid of tissue stabilisers, performed without cardiopulmonary bypass, using saphenous vein graft or grafts only, including harvesting of vein graft material where performed, either via a median sternotomy or other minimally invasive technique and where a stand-by perfusionist is present, not being a service associated with a service to which items 38497, 38500, 38501, 38503, 38504 or 38600 apply (Anaes.) (Assist.)

39

change

38500

Coronary artery bypass with cardiopulmonary bypass, using single arterial graft, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, not being a service associated with a service to which items 38497, 38498, 38501, 38503 or 38504 apply (Anaes.) (Assist.)

39

change

38501

Coronary artery bypass with the aid of tissue stabilisers, performed without cardiopulmonary bypass, using single arterial graft, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, either via a median sternotomy or other minimally invasive technique and where a stand-by perfusionist is present, not being a service associated with a service to which items 38497, 38498, 38500, 38503, 38504 or 38600 apply (Anaes.) (Assist.)

39

change

38503

Coronary artery bypass with cardiopulmonary bypass, using 2 or more arterial grafts, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, not being a service associated with a service to which items 38497, 38498, 38500, 38501 or 38504 apply (Anaes.) (Assist.)

39

change

38504

Coronary artery bypass with the aid of tissue stabilisers, performed without cardiopulmonary bypass, using 2 or more arterial grafts, with or without vein graft or grafts, including harvesting of internal mammary artery or vein graft material where performed, either via a median sternotomy or other minimally invasive technique and where a stand-by perfusionist is present, not being a service associated with a service to which items 38497, 38498, 38500, 38501, 38503 or 38600 apply (Anaes.) (Assist.)

39

change

38505

Coronary endarterectomy, by open operation, including repair with 1 or more patch grafts, each vessel (Anaes.) (Assist.)

41

obsolete

38506

Left ventricular aneurysm, plication of (Anaes.) (Assist.)

61

change

38507

Left ventricular aneurysm resection with primary repair (Anaes.) (Assist.)

61

change

38508

Left ventricular aneurysm resection with patch reconstruction of the left ventricle (Anaes.) (Assist.)

61

change

38509

Ischaemic ventricular septal rupture, repair of (Anaes.) (Assist.)

62

unchanged

38512

Division of accessory pathway, isolation procedure, procedure on atrioventricular node or perinodal tissues involving 1 atrial chamber only (Anaes.) (Assist.)

50  

unchanged

38515

Division of accessory pathway, isolation procedure, procedure on atrioventricular node or perinodal tissues involving both atrial chambers and including curative surgery for atrial fibrillation (Anaes.) (Assist.)

50

unchanged

38518

Ventricular arrhythmia with mapping and muscle ablation, with or without aneurysmeotomy (Anaes.) (Assist.)

50  

unchanged

38550

Ascending thoracic aorta, repair or replacement of, not involving valve replacement or repair or coronary artery implantation (Anaes.) (Assist.)

43.2  

changed

38553

Ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, without implantation of coronary arteries (Anaes.) (Assist.)

43.2  

changed

38556

Ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, and implantation of coronary arteries (Anaes.) (Assist.)

43.2

changed

38559

Aortic arch and ascending thoracic aorta, repair or replacement of, not involving valve replacement or repair or coronary artery implantation (Anaes.) (Assist.)

45  

change

38562

Aortic arch and ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, without implantation of coronary arteries (Anaes.) (Assist.)

45  

change

38565

Aortic arch and ascending thoracic aorta, repair or replacement of, with aortic valve replacement or repair, and implantation of coronary arteries (Anaes.) (Assist.)

45

change

38568

Descending thoracic aorta, repair or replacement of, without shunt or cardiopulmonary bypass, by open exposure, percutaneous or endovascular means (Anaes.) (Assist.)

44.1  

unchanged

38571

Descending thoracic aorta, repair or replacement of, using shunt or cardiopulmonary bypass (Anaes.) (Assist.)

44.1  

unchanged

38572

Operative management of acute rupture or dissection, in conjunction with procedures on the thoracic aorta (Anaes.) (Assist.)

43.2  

changed

38577

Cannulation for, and supervision and monitoring of, the administration of retrograde cerebral perfusion during deep hypothermic arrest (Assist.)

48.1  

delete

38588

Cannulation of the coronary sinus for, and supervision of, the retrograde administration of blood or crystalloid for cardioplegia, including pressure monitoring (Assist.)

42.1  

change

38600

Central cannulation for cardiopulmonary bypass excluding post-operative management, not being a service associated with a service to which another item in this Subgroup applies (Anaes.) (Assist.)

48.4  

unchanged

38603

Peripheral cannulation for cardiopulmonary bypass excluding post-operative management (Anaes.) (Assist.)

48.3  

change

38609

Intra-aortic balloon pump, insertion of, by arteriotomy (Anaes.) (Assist.)

48.4  

unchanged

38612

Intra-aortic balloon pump, removal of, with closure of artery by direct suture (Anaes.) (Assist.)

48.4  

unchanged

38613

Intra-aortic balloon pump, removal of, with closure of artery by patch graft (Anaes.) (Assist.)

48.5  

delete

38615

Insertion of a left or right ventricular assist device, for use as:(a) a bridge to cardiac transplantation in patients with refractory heart failure who are: (i) currently on a heart transplant waiting list, or (ii) expected to be suitable candidates for cardiac transplantation following a period of support on the ventricular assist device; or (b) acute post cardiotomy support for failure to wean from cardiopulmonary transplantation; or (c) cardio-respiratory support for acute cardiac failure which is likely to recover with short term support of less than 6 weeks; not being a service associated with the use of a ventricular assist device as destination therapy in the management of patients with heart failure who are not expected to be suitable candidates for cardiac transplantation (Anaes.) (Assist.)

53  

unchanged

38618

Insertion of a left and right ventricular assist device, for use as:(a) a bridge to cardiac transplantation in patients with refractory heart failure who are: (i) currently on a heart transplant waiting list, or (ii) expected to be suitable candidates for cardiac transplantation following a period of support on the ventricular assist device; or (b) acute post cardiotomy support for failure to wean from cardiopulmonary transplantation; or (c) cardio-respiratory support for acute cardiac failure which is likely to recover with short term support of less than 6 weeks; not being a service associated with the use of a ventricular assist device as destination therapy in the management of patients with heart failure who are not expected to be suitable candidates for cardiac transplantation (Anaes.) (Assist.)

53  

unchanged

38621

Left or right ventricular assist device, removal of, as an independent procedure (Anaes.) (Assist.)

53  

unchanged

38624

Left and right ventricular assist device, removal of, as an independent procedure (Anaes.) (Assist.)

53  

unchanged

38627

Extra-corporeal membrane oxygenation, bypass or ventricular assist device cannulae, adjustment and re-positioning of, by open operation, in patients supported by these devices (Anaes.) (Assist.)

48.4

unchanged

38637

Patent diseased coronary artery bypasses vein graft or grafts, dissection, disconnection and oversewing of (Anaes.) (Assist.)

40  

unchanged

38640

Re-operation via median sternotomy, for any procedure, including any divisions of adhesions where the time taken to divide the adhesions is 45 minutes or less (Anaes.) (Assist.)

47.1  

change

38643

Thoracotomy or sternotomy involving division of adhesions where the time taken to divide the adhesions exceeds 45 minutes (Anaes.) (Assist.)

47.1  

change

38647

Thoracotomy or sternotomy involving division of extensive adhesions where the time taken to divide the adhesions exceeds 2 hours (Anaes.) (Assist.)

47.1  

change

38650

Myomectomy or myotomy for hypertrophic obstructive cardiomyopathy (Anaes.) (Assist.)

65.1  

change

38653

Open heart surgery, not being a service to which another item in this Group applies (Anaes.) (Assist.)

65.2  

unchanged

38654

Permanent left ventricular electrode, insertion, removal or replacement of via open thoracotomy, for the purpose of cardiac resynchronisation therapy, for a patient who:(a) has:(i) moderate to severe chronic heart failure (new york heart association (nyha) class iii or iv) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and (iv) a qrs duration greater than or equal to 120 ms; or(b) has:(i) mild chronic heart failure (new york heart association (nyha) class ii) despite optimised medical therapy; and (ii) sinus rhythm; and (iii) a left ventricular ejection fraction of less than or equal to 35%; and (iv) a qrs duration greater than or equal to 150 ms; or (c) satisfied the requirements mentioned in paragraph (a) or (b) immediately before the insertion of a cardiac resynchronisation therapy device and transvenous left ventricle electrode (Anaes.) (Assist.)

28.3  

change

38656

Thoracotomy or median sternotomy for post-operative bleeding (Anaes.) (Assist.)

47.2  

unchanged

38670

Cardiac tumour, excision of, involving the wall of the artrium or inter-atrial septum, without patch or conduit reconstruction (Anaes.) (Assist.)

51  

unchanged

38673

Cardiac tumour, excision of, involving the wall of the atrium or inter-atrial septum, requiring reconstruction with patch or conduit (Anaes.) (Assist.)

51  

unchanged

38677

Cardiac tumour arising from ventricular myocardium, partial thickness excision of (Anaes.) (Assist.)

51  

unchanged

38680

Cardiac tumour arising from ventricular myocardium, full thickness excision of including repair or reconstruction (Anaes.) (Assist.)

51

unchanged

38700

Patent ductus arteriosus, shunt, collateral or other single large vessel, division or ligation of, without cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

58  

unchanged

38703

Patent ductus arteriosus, shunt, collateral or other single large vessel, division or ligation of, with cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

58  

unchanged

38706

Aorta, anastomosis or repair of, without cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

46.1

unchanged

38709

Aorta, anastomosis or repair of, with cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

46.1  

unchanged

38712

Aortic interruption, repair of, for congenital heart disease (Anaes.) (Assist.)

46.2  

delete

38715

Main pulmonary artery, banding, debanding or repair of, without cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

59

unchanged

38718

Main pulmonary artery, banding, debanding or repair of, with cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

59  

unchanged

38721

Vena cava, anastomosis or repair of, without cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

60  

unchanged

38724

Vena cava, anastomosis or repair of, with cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

60

unchanged

38727

Intrathoracic vessels, anastomosis or repair of, without cardiopulmonary bypass, not being a service to which item 38700, 38703, 38706, 38709, 38712, 38715, 38718, 38721 or 38724 applies, for congenital heart disease (Anaes.) (Assist.)

54.1

change

38730

Intrathoracic vessels, anastomosis or repair of, with cardiopulmonary bypass, not being a service to which item 38700, 38703, 38706, 38709, 38712, 38715, 38718, 38721 or 38724 applies, for congenital heart disease (Anaes.) (Assist.)

54.1

change

38733

Systemic pulmonary or cavo-pulmonary shunt, creation of, without cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

63   

unchanged

38736

Systemic pulmonary or cavo-pulmonary shunt, creation of, with cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

63   

unchanged

38739

Atrial septectomy, with or without cardiopulmonary bypass, for congenital heart disease (Anaes.) (Assist.)

55  

unchanged

38742

Atrial septal defect, closure by open exposure direct suture or patch, for congenital heart disease (Anaes.) (Assist.)

55  

change

38745

Intra-atrial baffle, insertion of, for congenital heart disease (Anaes.) (Assist.)

57

unchanged

38748

Ventricular septectomy, for congenital heart disease (Anaes.) (Assist.)

56

unchanged

38751

Ventricular septal defect, closure by direct suture or patch (Anaes.) (Assist.)

56  

unchanged

38754

Intraventricular baffle or conduit, insertion of, for congenital heart disease (Anaes.) (Assist.)

57  

unchanged

38757

Extracardiac conduit, insertion of, for congenital heart disease (Anaes.) (Assist.)

64  

unchanged

38760

Extracardiac conduit, replacement of, for congenital heart disease (Anaes.) (Assist.)

64  

unchanged

38763

Ventricular myectomy, for relief of ventricular obstruction, right or left, for congenital heart disease (Anaes.) (Assist.)

65.1

change

38766

Ventricular augmentation, right or left, for congenital heart disease (Anaes.) (Assist.)

65.2

unchanged

55113

M-mode and two-dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain:

(a) with: (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave doppler techniques; and (ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and

(b) not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 3, or another item in this subgroup (except items 55118 and 55130), applies (R)

1.2  

change

55114

M-mode and two-dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic or embolic disease or heart tumour:

(a) with: (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave doppler techniques; and

(ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and

(b) not being a service associated with a service to which an item in subgroup 1 (except item 55054) or 3, or another item in this subgroup (except items 55118 and 55130), applies (R)

1.2

change

55115

M-mode and two-dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows for the investigation of symptoms or signs of congenital heart disease:

(a) with: (i) measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave doppler techniques; and (ii) real time colour flow mapping from at least 2 acoustic windows; and (iii) recordings on video tape or digital media; and

(b) not being a service associated with a service to which an item in subgroup 1 (except item 55054) or 3, or another item in this subgroup (except items 55118 and 55130), applies (r)

1.2  

change

55116

Exercise stress echocardiography performed in conjunction with item 11712:

(a) with: (i) two-dimensional recordings before exercise (baseline) from at least 3 acoustic windows; and (ii) matching recordings from the same windows at, or immediately after, peak exercise; and (iii) recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and (b) not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 3, or another item in this subgroup (except items 55118 and 55130), applies (R)

4  

change

55117

Pharmacological stress echocardiography performed in conjunction with item 11712:

(a) with: (i) two-dimensional recordings before drug infusion (baseline) from at least 3 acoustic windows; and (ii) matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose; and (iii) recordings on digital media with equipment permitting display of baseline and matching peak images on the same screen; and

(b) not being a service associated with a service to which an item in Subgroup 1 (except item 55054) or 3, or another item in this subgroup (except items 55118 and 55130), applies (R)

4  

change

55118

Heart, two-dimensional real time transoesophageal examination of, from at least 2 levels, and in more than1 plane at each level: (a) with: (i) real time colour flow mapping and, if indicated, pulsed wave doppler examination; and (ii) recordings on video tape or digital medium; and (b) not being an intra-operative service or a service associated with a service to which an item in Subgroup 1 (except item 55054) or 3 applies (R) (Anaes.) (Anaes.)

49.1  

change

55119

M-mode and 2 dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of symptoms or signs of cardiac failure, or suspected or known ventricular hypertrophy or dysfunction, or chest pain (r) (nk)

49.1  

change

55120

M-mode and 2 dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of suspected or known acquired valvular, aortic, pericardial, thrombotic, or embolic disease, or heart tumour (r) (nk)

49.1  

change

55121

M-mode and 2 dimensional real time echocardiographic examination of the heart from at least 2 acoustic windows, with measurement of blood flow velocities across the cardiac valves using pulsed wave and continuous wave doppler techniques, and real time colour flow mapping from at least 2 acoustic windows, with recordings on video tape or digital medium, not being a service associated with a service to which an item in subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this subgroup (with the exception of items 55118, 55125, 55130 and 55131), applies, for the investigation of symptoms or signs of congenital heart disease (r) (nk)

49.1

change

55122

Exercise stress echocardiography performed in conjunction with item 11712, with two-dimensional recordings before exercise (baseline) from at least three acoustic windows and matching recordings from the same windows at, or immediately after, peak exercise, not being a service associated with a service to which an item in subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this subgroup applies (with the exception of items 55118, 55125, 55130 and 55131). recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (r) (nk)

4  

change

55123

Pharmacological stress echocardiography performed in conjunction with item 11712, with two-dimensional recordings before drug infusion (baseline) from at least three acoustic windows and matching recordings from the same windows at least twice during drug infusion, including a recording at the peak drug dose not being a service associated with a service to which an item in subgroups 1 (with the exception of items 55026 and 55054) or 3, or another item in this subgroup, applies (with the exception of items 55118, 55125, 55130 and 55131). recordings must be made on digital media with equipment permitting display of baseline and matching peak images on the same screen (r) (nk)

4

change

55125

Heart, 2 dimensional real time transoesophageal examination of, from at least two levels, and in more than one plane at each level:(a) with: (i) real time colour flow mapping and, if indicated, pulsed wave doppler examination; and (ii) recordings on video tape or digital medium; and(b) not being an intra-operative service or a service associated with a service to which an item in subgroups 1 (with the exception of items 55026 and 55054) or 3, applies (r) (nk)  (Anaes.)

49.1

change

55130

Intra-operative 2 dimensional real time transoesophageal echocardiography incorporating doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure, not being a service associated with a service to which item 55135 applies (R)(Anaes.) (Anaes.)

49.1  

change

55131

Intra-operative 2 dimensional real time transoesophageal echocardiography incorporating doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac surgery incorporating sequential assessment of cardiac function before and after the surgical procedure - not associated with items 55135 and 55136 (r) (nk)  (Anaes.)

49.1  

change

55135

Intra-operative 2 dimensional real time transoesophageal echocardiography incorporating doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (replacement or repair) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure, not being a service associated with a service to which item 55130 applies (R)(Anaes.) (Anaes.)

49.1& 49.2

change

55136

Intra-operative 2 dimensional real time transoesophageal echocardiography incorporating doppler techniques with colour flow mapping and recording onto video tape or digital medium, performed during cardiac valve surgery (repair or replacement) incorporating sequential assessment of cardiac function and valve competence before and after the surgical procedure - not associated with items 55130 and 55131 (r) (nk)  (Anaes.)

49.1& 49.2  

change

57360

Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and: the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or the patient requires exclusion of coronary artery anomaly or fistula; or the patient will be undergoing non-coronary cardiac surgery (r) (k)   (Anaes.)

14  

change

57361

Computed tomography of the coronary arteries performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and: the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or the patient requires exclusion of coronary artery anomaly or fistula; or the patient will be undergoing non-coronary cardiac surgery (r) (nk)  (Anaes.)

14

change

59903

Angiocardiography, including the service mentioned in item 59970, 59974, 61109 or 61110, not being a service to which item 59912 or 59925 applies (R) (K) (Anaes.))

12.2  

delete

59912

Selective coronary arteriography, including the service mentioned in item 59970, 59974, 61109 or 61110, not being a service to which item 59903 or 59925 applies (R) (K) (Anaes.)

12.2  

delete

59925

Selective coronary arteriography and angiocardiography, including a service mentioned in item 59903, 59912, 59970, 59974, 61109 or 61110 (R) (K) (Anaes.))

12.2  

delete

59970

Angiography and/or digital subtraction angiography with fluoroscopy and image acquisition using a mobile image intensifier, one or more regions including any preliminary plain films, preparation and contrast injection (R) (K) (Anaes.)

12. 2

change

59971

Angiocardiography, including the service mentioned in item 59970, 59974, 61109 or 61110, not being a service to which item 59972 or 59973 applies (R) (NK) (Anaes.)

12. 2  

change

59972

Selective coronary arteriography, including the service mentioned in item 59970, 59974, 61109 or 61110, not being a service to which item 59971 or 59973 applies (R) (NK) (Anaes.)

12.2  

delete

59973

Selective coronary arteriography and angiocardiography, including a service mentioned in item 59970, 59971, 59972, 59974, 61109 or 61110 (R) (NK) (Anaes.))

12.2

delete

61302

Single stress or rest myocardial perfusion study - planar imaging(R)

5.1

change

61303

Single stress or rest myocardial perfusion study - with single photon emission tomography and with planar imaging when undertaken (R)

5.1  

change

61306

Combined stress and rest, stress and re-injection or rest and redistribution myocardial perfusion study, including delayed imaging or re-injection protocol on a subsequent occasion - planar imaging (R)

5.1

change

61307

Combined stress and rest, stress and re-injection or rest and redistribution myocardial perfusion study, including delayed imaging or re-injection protocol on a subsequent occasion - with single photon emission tomography and with planar imaging when undertaken (R)

5.1  

change

61651

Single stress or rest myocardial perfusion study - planar imaging (r) (nk)

5.1

change

61652

Single stress or rest myocardial perfusion study - with single photon emission tomography and with planar imaging when undertaken (r) (nk)

5.1

change

61653

Combined stress and rest, stress and re-injection or rest and redistribution myocardial perfusion study, including delayed imaging or re-injection protocol on a subsequent occasion - planar imaging (r) (nk)

5.1

change

61654

Combined stress and rest, stress and re-injection or rest and redistribution myocardial perfusion study, including delayed imaging or re-injection protocol on a subsequent occasion - with single photon emission tomography and with planar imaging when undertaken (r) (nk)

5.1  

change





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