Appendix A                     PE and DVT items: Recommendations list

Item

Item Description

Recommendation

Page reference

55221

DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)

(See para DIQ of explanatory notes to this Category)

Change

14

55222

DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroups 1 (with the exception of items 55026 and 55054) or 4 of this Group applies (R) (NK)

(See para DIQ of explanatory notes to this Category)

Change

16

55244

DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for acute venous thrombosis, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 4 of this Group applies - (R)

(See para DIQ of explanatory notes to this Category)

Change

14

55246

DUPLEX SCANNING, unilateral, involving B mode ultrasound imaging and integrated Doppler flow measurements by spectral analysis of veins in the lower limb, below the inguinal ligament, for chronic venous disease, not being a service associated with a service to which an item in Subgroups 1 (with the exception of item 55054) or 4 of this Group applies - (R)

(See para DIQ of explanatory notes to this Category)

Change

16


Item

 Item Description

Recommendation

Page reference

61328

 LUNG PERFUSION STUDY, with planar imaging and single photon emission tomography OR planar imaging, or single photon emission tomography (R)

Fee: $227.65 Benefit: 75% = $170.75 85% = $193.55

Change

20

57351

COMPUTED TOMOGRAPHY - spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection - 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:

(a) the service is not a service to which another item in this group applies; and
(b) the service is performed for the exclusion of acute or recurrent pulmonary embolism; acute symptomatic arterial occlusion; post operative complication of arterial surgery; acute ruptured aneurysm; or acute dissection of the aorta, carotid or vertebral artery; and
(c) the services to which 57350 or 57355 apply have been performed on the same patient within the previous 12 months; and
(d) the service is not a study performed to image the coronary arteries (R) (K) (Anaes.)

Change

20

57356

COMPUTED TOMOGRAPHY - spiral angiography with intravenous contrast medium, including any scans performed before intravenous contrast injection - 1 or more spiral data acquisitions, including image editing, and maximum intensity projections or 3 dimensional surface shaded display, with hardcopy recording of multiple projections, where:
a) the service is not a service to which another item in this group applies; an
b) the service is performed for the exclusion of acute or recurrent pulmonary embolism; acute symptomatic arterial occlusion; post operative complication of arterial surgery; or acute ruptured aneurysm; acute dissection of the aorta, carotid or vertebral artery; and
(c) the services to which 57350 or 57355 apply have been performed on the same patient within the previous 12 months; and
(d) the service is not a study performed to image the coronary arteries (R) (NK) (Anaes.)

Change

20

61340

LUNG VENTILATION STUDY using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography OR planar imaging or single photon emission tomography (R)

Fee: $253.00 Benefit: 75% = $189.75 85% = $215.05

Change

20

61348

LUNG PERFUSION STUDY AND LUNG VENTILATION STUDY using aerosol, technegas or xenon gas, with planar imaging and single photon emission tomography, OR planar imaging, or single photon emission tomography (R)

Fee: $443.35 Benefit: 75% = $332.55 85% = $376.85

Change

20