Specialist Guide to Medicare

Head

63001 – Tumour of the brain or meninges

63004 – Inflammation of the brain or meaninges

63007 – Skull base or orbital tumor

63010 – Stereotactic scan of brain, with Fiducials in place, for planning for stereotactic neurosurgery

63040 – Acoustic neuroma

63043 – Pituitary tumour

63046 – Toxic or metabolic or ischaemic encephalopathy

63049 – Demyelinating disease of the brain

63052 – Congenital malformation of the brain or meninges

63055 – Venous sinus thrombosis

63058 – Head trauma

63061 – Epilepsy

63064 – Stroke

63067 – Carotid or vertebral artery dissection

63070 – Intracranial aneurysm

63073 – Intracranial arteriovenous malformation

Head and neck vessels

63101 – Stroke

Head and cervical spine

63111 – Tumour of the central nervous system or meninges

63114 – Inflammation of the central nervous system or meninges

63125 – Demyelinating disease of the central nervous system

63128 – Congenital malformation of the central nervous system or meninges

63131 – Syrinx (congenital or acquired)

Spine – one region or two contiguous regions

63151 – Infection

63154 – Tumour

63161 – Demyelinating disease

63164 – Congenital malformation of the spinal cord or the cauda equina or the meninges

63167 – Myelopathy

63170 – Syrinx (congenital or acquired)

63173 – Cervical radiculopathy

63176 – Sciatica

63179 – Spinal canal stenosis

63182 – Previous spinal surgery

63185 – Trauma

Spine – three contiguous regions or two non-contiguous regions

63201 – Infection

63204 – Tumour

63219 – Demyelinating disease

63222 – Congenital malformation of the spinal cord or the cauda equina or the meninges

63225 – Myelopathy

63228 – Syrinx (congenital or acquired)

63231 – Cervical radiculopathy

63234 – Sciatica

63237 – Spinal canal stenosis

63240 – Previous spinal surgery

63243 – Trauma

55712 – Anatomy Scan – Pregnancy 17-22 weeks only – Specialist referral 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 service is requested by a medical practitioner who:
    • Is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or
    • Has a Diploma of Obstetrics; or
    • Has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or
    • Has obstetric privileges at a non-metropolitan hospital; and
  • The dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
  • Further examination is clinically indicated after performance, in the same pregnancy, of a scan mentioned in item 55706 or 55709

55721 – Pregnancy >22 weeks only – Specialist referral only

• Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, if:
  • The service is requested by a medical practitioner who:
    • Is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or
    • Has a Diploma of Obstetrics; or
    • Has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or
    • Has obstetric privileges at a non-metropolitan hospital; and
  • The dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
  • Further examination is clinically indicated in the same pregnancy to which item 55718 or 55723 applies (R)

55764 – Anatomy scan for multiple pregnancy – Pregnancy 17-22 weeks only – Specialist referral 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 service is requested by a medical practitioner who:
  • Is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or
  • Has a Diploma of Obstetrics; or
  • Has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or
  • Has obstetric privileges at a non-metropolitan hospital; and
• Ultrasound of the same pregnancy confirms a multiple pregnancy; and
• The dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and
• Further examination is clinically indicated in the same pregnancy in which item 55759 or 55762 has been performed; and
• The service mentioned in item 55706, 55709, 55712 or 55715 is not performed in conjunction with the scan during the same pregnancy (R)

55772 – Pregnancy >22 weeks only – Specialist referral only

• Pelvis or abdomen, pregnancy related or pregnancy complication, foetal development and anatomy, ultrasound scan of, by any or all approaches, if:
  • Dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
  • The service is requested by a medical practitioner who:
    • Is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists; or
    • Has a Diploma of Obstetrics; or
    • Has a qualification recognised by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists as equivalent to a Diploma of Obstetrics; or
    • Has obstetric privileges at a non-metropolitan hospital; and
  • Further examination is clinically indicated in the same pregnancy to which item 55768 or 55770 has been performed; and
  • The pregnancy as confirmed by ultrasound is a multiple pregnancy; and
  • The service mentioned in item 55718, 55721, 55723 or 55725 is not performed in conjunction with the scan during the same pregnancy