Allied Health Guide to Medicare

X-Ray

Chest

57706 – Clavicle

58500 – Chest (Thoracic region)

Hand/ Wrist/ Arm/ Shoulder

57506 – Hand, wrist, forearm, elbow and humerus

57512 – Hand and wrist, hand wrist and forearm, forearm and elbow or elbow and humerus

57700 – Shoulder or scapula

Hip/ Pelvis

57712 – Hip joint

57715 – Pelvic girdle

Foot/ Ankle/ Knee/ Leg

57518 – Foot, ankle, leg, knee or femur

57524 – Foot and ankle, ankle and leg, leg and knee or knee and femur

Spine/ Neck

58100 – Cervical spine

58103 – Thoracic spine

58106 – Lumbosacral spine

58109 – Sacrococcygeal spine

58112 – Spine

• Two examinations of the kind referred to in items 58100, 58103, 58106 and 58109

58120 – Spine, four regions (cervical, thoracic, lumbosacral and sacrococcygeal)

• Limitation is one per calendar year

58121 – Spine

• Three examinations of the kind mentioned in items 58100, 58103, 58106 and 58109.
• Limitation is one per calendar year.

X-Ray

Chest

57706 – Clavicle

58500 – Chest (Thoracic region)

Hand/ Wrist/ Arm/ Shoulder

57506 – Hand, wrist, forearm, elbow and humerus

57512 – Hand and wrist, hand wrist and forearm, forearm and elbow or elbow and humerus

57700 – Shoulder or scapula

Hip/ Pelvis

57712 – Hip joint

57715 – Pelvic girdle

Foot/ Ankle/ Knee/ Leg

57518 – Foot, ankle, leg, knee or femur

57524 – Foot and ankle, ankle and leg, leg and knee or knee and femur

Spine/ Neck

58100 – Cervical spine

58103 – Thoracic spine

58106 – Lumbosacral spine

58109 – Sacrococcygeal spine

58112 – Spine

• Two examinations of the kind referred to in items 58100, 58103, 58106 and 58109

Ultrasound

55836 – ankle or hind foot

55840 – mid foot or fore foot

X-Ray

57521 – Foot/ ankle

57527 – Foot/ ankle

X-Ray

Chest

58503 – Chest

58506 – Chest with fluoroscopy

58509 – Thoracic inlet/ trachea

58521 – Left ribs, right ribs or sternum

57709 – Clavicle

58524 – Ribs

• Both ribs; or
• Right ribs & sternum; or
• Left ribs & sternum

58527 – Both ribs & sternum

Hand/Wrist/ Arm/ Shoulder

57509 – Hand, wrist, forearm, elbow, upper arm

57515 – Combination upper extremity

57703 – Shoulder/scapula

Hip/Pelvis

57712 – Hip

57715 – Pelvis

Foot/ Ankle/ Knee/ Leg

57521 – Foot, ankle, lower leg, upper leg (femur)

57523 – Knee

57527 – Combination lower extremity

57721 – Femur

• Internal fixation of neck or intertrochanteric fracture

Ultrasound

Chest

55070 – Breast x 1

55076 – Breast x 2

55812 – Chest/abdominal wall

Hand

55800 – Hand

Abdomen

55036 – Abdomen

55768 – Multiple pregnancy 22+ weeks

Hip/ Pelvis

55816 – Hip

Foot/Ankle/ Knee/ Leg

55824 – Buttock/ thigh

55828 – Knee apply

55832 – Lower leg

55836 – Ankle/hindfoot

55840 – Midfoot/forefoot

Paediatric

55820 – Paediatric hip

55852 – Paediatric spine

Other

55844 – Assessment of mass

55848 – MSK pre-operative

• Aspiration or injection

55850 – MSK pre-operative including diagnostic scan

• Aspiration or injection

55700 – Dating Scan (Pregnancy < 12 weeks only)

Pelvis or abdomen, pregnancy related or pregnancy complication, ultrasound scan of, by any or all approaches, for determining the gestation, location, viability or number of foetuses, if the dating of the pregnancy (as confirmed by ultrasound) is less than 12 weeks of gestation

55704 – Early anatomy scan (Pregnancy 12 – 16 weeks only)

Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, for determining the structure, gestation, location, viability or number of foetuses, if the dating of the pregnancy (as confirmed by ultrasound) is 12 to 16 weeks of gestation

55706 – Anatomy scan (Pregnancy 17-22 weeks only.)

Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, if:

• The dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
• The service is not performed in the same pregnancy as item 55709

Item can only be claimed once per pregnancy.

55707 – Nuchal translucency scan (Crown rump length of 45 to 84 mm)

Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, if:

• The pregnancy (as confirmed by ultrasound) is dated by a foetal crown rump length of 45 to 84 mm; and
• Nuchal translucency measurement is performed to assess the risk of foetal abnormality; and
• The service is not performed with item 55700, 55703, 55704 or 55705 on the same patient within 24 hours

55718 – Pregnancy >22 weeks only

Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, if:

• The dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
• The service is not performed in the same pregnancy as item 55723

Item can only be claimed once per pregnancy.

Dental Practitioner

57901 – Skull

57969 – Skull

58300 – Bone age study and skeletal surveys

59733 – Sialography, one side

• With preparation and contrast injection, not being a service associated with a service to which item 57918 applies (R)

59739 – Sinogram or fistulogram, one or more regions

• With or without preliminary plain films and with preparation and contrast injection (R)

Oral & Maxillofacial Surgeon

55028 – Ultrasound – Head

55030 – Ultrasound – Orbital contents

55032 – Ultrasound – Neck, one or more structures

56001 – CT Scan – Brain

• Without intravenous contrast medium, not being a service to which item 57001 applies (R) (Anaes.)

56224 – CT Scan – Spine, cervical region

• With intravenous contrast medium and with any scans of the cervical region of the spine before intravenous contrast injection when undertaken (R) (Anaes.)

56801 – CT Scan –  CT Scan – Chest, abdomen and pelvis

• With or without scans of soft tissues of neck without intravenous contrast medium
• Not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

57007 – CT Scan – Chest, abdomen and pelvis

• With or without scans of soft tissues of neck without intravenous contrast medium
• Not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.)

57341 – Interventional techniques

• Computed tomography, in conjunction with a surgical procedure using interventional techniques (R) (Anaes.)

57362 – Cone Beam CT Scan – Dental and temporo mandibular joint imaging

• Without contrast medium for diagnosis and management of any of the following:
  • Mandibular and dento alveolar fractures;
  • Dental implant planning;
  • Orthodontics;
  • Endodontic conditions;
  • Periodontal conditions;
  • Temporo mandibular joint conditions
• Applicable once per patient per day, not being for a service to which any of items 57960 to 57969 apply, and not being a service associated with another service in Group I2 (R) (Anaes.)

57703 – Shoulder or scapula (R)

57709 – Clavicle (R)

57712 – Hip joint (R)

57715 – Pelvic girdle (R)

58103 – Spine—thoracic (R)

58306 – Skeletal survey (R)

58506 – Chest (lung fields) by direct radiography

• With fluoroscopic screening (R)

58521 – Left ribs, right ribs or sternum (R)

58909 – Examination Of alimentary tract and biliary system

• Barium or other opaque meal of one or more of pharynx, oesophagus, stomach or duodenum
• With or without preliminary plain films of pharynx, chest or duodenum
• Not being a service associated with a service to which item 57939, 57942 or 57945 applies (R)

59103 – Localisation of foreign body

• If provided in conjunction with a service described in Subgroups 1 to 12 of Group I3 (R)

59703 – Dacryocystography, one side

• With or without preliminary plain film and with preparation and contrast injection (R)

60000 – Digital subtraction angiography

• Examination of head and neck with or without arch aortography—1 to 3 data acquisition runs (R) (Anaes.)

60506 – Fluoroscopy using a mobile image intensifier in conjunction with a surgical procedure lasting less than 1 hour

• Not being a service associated with a service to which another item in this Group applies (R)

60509 – Fluoroscopy using a mobile image intensifier, in conjunction with a surgical procedure lasting 1 hour or more

• Not being a service associated with a service to which another item in this Group applies (R)

61109 – Fluoroscopy in an angiography suite with image intensification

• In conjunction with a surgical procedure using interventional techniques
• Not being a service associated with a service to which another item in this Group applies (R)

61372 – Nuclear medicine (non-PET) – Salivary study (R)

61421 – Bone study – Whole body

• With, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R)

61425 – Bone study – Whole body and single photon emission tomography

• With, when undertaken, blood flow, blood pool and delayed imaging on a separate occasion (R)

61429 – Whole body study using gallium (R)

61430 – Whole body study using gallium with single photon emission tomography (R)

61433 – Whole body study using cells labelled with technetium (R)

61434 – Whole body study using cells labelled with technetium, including single photon emission tomography (R)

61446 – Regional scintigraphic study using an approved bone scanning agent, including when undertaken, blood flow imaging, blood pool imaging and repeat imaging on a separate occasion (R)

61449 – Regional scintigraphic study using an approved bone scanning agent and single photon emission tomography, including when undertaken, blood flow imaging, blood pool imaging and repeat imaging on a separate occasion (R)

61450 – Localised study using gallium (R)

61453 – Localised study using gallium, with single photon emission tomography (R)

61454 – Localised study using cells labelled with technetium (R)

61457 – Localised study using cells labelled with technetium, with single photon emission tomography (R)

61462 – Repeat planar and single photon emission tomography imaging, or repeat planar imaging or single photon emission tomography imaging

• On an occasion subsequent to the performance of item 61364, 61426, 61429, 61430, 61442, 61450, 61453, 61469 or 61485
• If there is no additional administration of radiopharmaceutical and if the previous radionuclide scan was abnormal or equivocal (R)

63007 – MRI – Head

• Including MRA, if performed for skull base or orbital tumour (R) (Anaes.) (Contrast)