Appendix A Endocrine-related pathology test items– Recommendations list

Table A1: Endocrine pathology MBS items considered by the committee

Item Current descriptor Recommendation

66539

Electrophoresis of serum for demonstration of lipoprotein subclasses, if the cholesterol is > 6.5 mmol/L and triglyceride >4.0 mmol/L or in the diagnosis of types iii and iv hyperlipidaemia — (Item is subject to rule 25).

Delete

66542

Oral glucose tolerance test for the diagnosis of diabetes mellitus that includes: (a) administration of glucose; (b) at least 2 measurements of blood glucose; and if performed (c) any test described in item 66695.

Change

66545

Oral glucose challenge test in pregnancy for the detection of gestational diabetes that includes: (a) administration of glucose; and (b) 1 or 2 measurements of blood glucose; and (c) (if performed) any test in item 66695.

Delete

66548

Oral glucose tolerance test in pregnancy for the diagnosis of gestational diabetes that includes:

Change

66551

Quantitation of glycated haemoglobin performed in the management of established diabetes – (item is subject to rule 25).

Change

66554

Quantitation of glycated haemoglobin performed in the management of pre-existing diabetes where the patient is pregnant – including a service in item 66551 (if performed) – (Item is subject to rule 25).

Change

66557

Quantitation of fructosamine performed in the management of established diabetes – each test to a maximum of 4 tests in a 12 month period.

Change

66560

Microalbumin – quantitation in urine.

Change

66686

Performance of 1 or more of the following procedures: (a) growth hormone suppression by glucose loading; (b) growth hormone stimulation by exercise; (c) dexamethasone suppression test; (d) sweat collection by iontophoresis for chloride analysis; (e) pharmacological stimulation of growth hormone.

No change

66695

Quantitation in blood or urine of hormones and hormone binding proteins – ACTH, aldosterone, androstenedione, C-peptide, calcitonin, cortisol, DHEAS, 11-deoxycortisol, dihydrotestosterone, FSH, gastrin, glucagon, growth hormone, hydroxyprogesterone, insulin, LH, oestradiol, oestrone, progesterone, prolactin, PTH, renin, sex hormone binding globulin, somatomedin C (IGF-1), free or total testosterone, urine steroid fraction or fractions, vasoactive intestinal peptide, – 1 test. (Item is subject to rule 6.)

No change

66696

A test described in item 66695, if rendered by a receiving APP – where no tests in the item have been rendered by the referring APP. (Item is subject to rule 6 and 18.)

Pending

66697

Test described in item 66695, other than that described in 66696, if rendered by a receiving APP – each test to a maximum of 4 tests. (Item is subject to rule 6 and 18.)

Pending

66698

2 tests described in item 66695. (Item is subject to rule 6.)

Pending

66701

3 tests described in item 66695. (Item is subject to rule 6.)

Pending

66704

4 tests described in item 66695. (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 4 tests specified on the request form or performs 4 tests and refers the rest to the laboratory of a separate APA.) (Item is subject to rule 6.)

Pending

66707

5 or more tests described in item 66695. (Item is subject to rule 6.)

Pending

66711

Quantitation in saliva of cortisol in: (a) the investigation of Cushing's syndrome; or (b) the management of children with congenital adrenal hyperplasia. (Item is subject to rule 6.)

No change

66712

Two tests described in item 66711. (Item is subject to rule 6.)

No change

66714

A test described in item 66711, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP. (Item is subject to rule 6 and 18.)

No change

66715

Tests described in item 66711, other than that described in 66714, if rendered by a receiving APP, each test to a maximum of 1 test. (Item is subject to rule 6 and 18.)

No change

66716

TSH quantitation

Change

66719

Thyroid function tests (comprising the service described in item 66716 and 1 or more of the following tests – free thyroxine, free t3, for a patient, if at least 1 of the following conditions is satisfied: (a) the patient has an abnormal level of TSH; (b) the tests are performed: (i) for the purpose of monitoring thyroid disease in the patient; or (ii) to investigate the sick euthyroid syndrome if the patient is an admitted patient; or (iii) to investigate dementia or psychiatric illness of the patient; or (iv) to investigate amenorrhoea or infertility of the patient; (c) the medical practitioner who requested the tests suspects the patient has a pituitary dysfunction; (d) the patient is on drugs that interfere with thyroid hormone metabolism or function. (Item is subject to rule 9.)

Change

66722

TSH quantitation described in item 66716 and 1 test described in item 66695. (This fee applies where 1 laboratory or more than 1 laboratory belonging to the same APA, performs the only 2 tests specified on the request form or performs 2 tests and refers the rest to the laboratory of a separate APA.) (Item is subject to rule 6.)

Change

66723

Tests described in item 66722, that is, TSH quantitation and 1 test described in 66695, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP – 1 test. (Item is subject to rule 6 and 18.)

Change

66724

Tests described in item 66722, if rendered by a receiving APP, other than that described in 66723. It is to include a quantitation of TSH – each test to a maximum of 4 tests described in item 66695. (Item is subject to rule 6 and 18.)

Change

66725

TSH quantitation described in item 66716 and 2 tests described in item 66695. (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 3 tests specified on the request form or performs 3 tests and refers the rest to the laboratory of a separate APA.) (Item is subject to rule 6.)

Change

66728

TSH quantitation described in item 66716 and 3 tests described in item 66695. (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 4 tests specified on the request form or performs 4 tests and refers the rest to the laboratory of a separate APA.) (Item is subject to rule 6.)

Change

66731

TSH quantitation described in item 66716 and 4 tests described in item 66695. (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs the only 5 tests specified on the request form or performs 5 tests and refers the rest to the laboratory of a separate APA.) (Item is subject to rule 6.)

Change

66734

TSH quantitation described in item 66716 and 5 tests described in item 66695. (This fee applies where 1 laboratory, or more than 1 laboratory belonging to the same APA, performs 6 or more tests specified on the request form.) (Item is subject to rule 6.)

Change

66773

Quantitation of products of collagen breakdown or formation for the monitoring of patients with proven low bone mineral density, and if performed, a service described in item 66752 – 1 or more tests. (Low bone densitometry is defined in the explanatory notes to Category 2 – Diagnostic Procedures and Investigations of the Medicare Benefits Schedule.)

No change

66776

Quantitation of products of collagen breakdown or formation for the monitoring of patients with metabolic bone disease or Paget's disease of bone, and if performed, a service described in item 66752 – 1 or more tests.

No change

66779

Adrenaline, noradrenaline, dopamine, histamine, hydroxyindoleacetic acid (5HIAA), hydroxymethoxymandelic acid (HMMA), homovanillic acid (HVA), metanephrines, methoxyhydroxyphenylethylene glycol (MHPG), phenylacetic acid (PAA) or serotonin quantitation – 1 or more tests.

Pending

66780

A test described in item 66779 if rendered by a receiving APP – 1 or more tests. (Item is subject to rule 18.)

Pending

66835

1, 25-dihydroxyvitamin D – quantification in serum, if the request for the test is made by, or on advice of, the specialist or consultant physician managing the treatment of the patient.

No change

66836

1, 25-dihydroxyvitamin D—quantification in serum, if: (a) the patient has hypercalcaemia; and (b) the request for the test is made by a general practitioner managing the treatment of the patient.

No change

66837

A test described in item 66835 or 66836 if rendered by a receiving APP. (Item is subject to rule 18.)

No change

66841

Quantitation of HbA1c (glycated haemoglobin) performed for the diagnosis of diabetes in asymptomatic patients at high risk. (Item is subject to rule 25.)

Change

71165

Antibodies to tissue antigens (acetylcholine receptor, adrenal cortex, heart, histone, insulin, insulin receptor, intrinsic factor, islet cell, lymphocyte, neuron, ovary, parathyroid, platelet, salivary gland, skeletal muscle, skin basement membrane and intercellular substance, thyroglobulin, thyroid microsome or thyroid stimulating hormone receptor) – detection, including quantitation if required, of 1 antibody. (Item is subject to rule 6.)

Pending

71166

Detection of 2 antibodies described in item 71165. (Item is subject to rule 6.)

Pending

71167

Detection of 3 antibodies described in item 71165. (Item is subject to rule 6.)

Pending

71168

Detection of 4 or more antibodies described in item 71165. (Item is subject to rule 6.)

Pending

71169

A test described in item 71165, if rendered by a receiving APP, where no tests in the item have been rendered by the referring APP 1 test. (Item is subject to rule 6 and 18.)

Pending