Items |
Descriptions |
Limitations |
55700 |
the pregnancy is dated at less than 12 weeks gestation and one or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
(iv) toxaemia of pregnancy;
(v) liver or renal disease;
(vi) autoimmune disease;
(vii) cardiac disease;
(viii) alloimmunisation;
(ix) maternal infection;
(x) inflammatory bowel disease;
(xi) bowel stoma;
(xii) abdominal wall scarring;
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
(xv) thrombophilia;
(xvi) significant maternal obesity;
(xvii) advanced maternal age;
(xviii) abdominal pain or mass;
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality
|
Pregnancy < 12 weeks only
|
55707 |
the pregnancy (as confirmed by ultrasound) is dated by a crown rump length of 45 to 84mm; and nuchal translucency measurement is performed to assess the risk of fetal abnormality; and one or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
(iv) toxaemia of pregnancy;
(v) liver or renal disease;
(vi) autoimmune disease;
(vii) cardiac disease;
(viii) alloimmunisation;
(ix) maternal infection;
(x) inflammatory bowel disease;
(xi) bowel stoma;
(xii) abdominal wall scarring;
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
(xv) thrombophilia;
(xvi) significant maternal obesity;
(xvii) advanced maternal age;
(xviii) abdominal pain or mass;
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality
|
Pregnancy nuchal translucency only |
55704 |
PELVIS or ABDOMEN dating of the pregnancy (by ultrasound) is 12 - 16 weeks and one or more of the following conditions are present:
(i) hyperemesis gravidarum;
(ii) diabetes mellitus;
(iii) hypertension;
(iv) toxaemia of pregnancy;
(v) liver or renal disease;
(vi) autoimmune disease;
(vii) cardiac disease;
(viii) alloimmunisation;
(ix) maternal infection;
(x) inflammatory bowel disease;
(xi) bowel stoma;
(xii) abdominal wall scarring;
(xiii) previous spinal or pelvic trauma or disease;
(xiv) drug dependency;
(xv) thrombophilia;
(xvi) significant maternal obesity;
(xvii) advanced maternal age;
(xviii) abdominal pain or mass;
(xix) uncertain dates;
(xx) high risk pregnancy;
(xxi) previous post dates delivery;
(xxii) previous caesarean section;
(xxiii) poor obstetric history;
(xxiv) suspicion of ectopic pregnancy;
(xxv) risk of miscarriage;
(xxvi) diminished symptoms of pregnancy;
(xxvii) suspected or known cervical incompetence;
(xxviii) suspected or known uterine abnormality;
(xxix) pregnancy after assisted reproduction;
(xxx) risk of fetal abnormality
|
Pregnancy 12 -16 weeks only
|
55706 |
PELVIS or ABDOMEN pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where
(a) the patient is referred by a medical practitioner; and
(b) the dating for the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(e) the service is not performed in the same pregnancy as item 55709
|
Pregnancy 17 -22 weeks only and only 1 per pregnancy
|
55712
Specialist Referral Only
|
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a) the patient is referred by a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or has a qualification recognised by the Royal Australian and New
Zealand College of Obstetricians and Gynaecologists as being equivalent to a Diploma of Obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(b) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks of gestation; and
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(e) further examination is clinically indicated in the same pregnancy to which item 55706 applies
|
Pregnancy 17-22 weeks only
|
55718 |
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:
(a) the patient is referred by a medical practitioner; and
(b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(e) the service is not performed in the same pregnancy as item 55723; and
(f) one or more of the following conditions are present:
(i) known or suspected fetal abnormality or fetal cardiac arrhythmia;
(ii) fetal anatomy (late booking or incomplete mid-trimester scan);
(iii) malpresentation;
(iv) cervical assessment;
(v) clinical suspicion of amniotic fluid abnormality;
(vi) clinical suspicion of placental or umbilical cord abnormality;
(vii) previous complicated delivery;
(viii) uterine scar assessment;
(ix) uterine fibroid;
(x) previous fetal death in utero or neonatal death;
(xi) antepartum haemorrhage;
(xii) clinical suspicion of intrauterine growth retardation;
(xiii) clinical suspicion of macrosomia;
(xiv) reduced fetal movements;
(xv) suspected fetal death;
(xvi) abnormal cardiotocography;
(xvii) prolonged pregnancy;
(xviii) premature labour;
(xix) fetal infection;
(xx) pregnancy after assisted reproduction;
(xxi) trauma;
(xxii) diabetes mellitus;
(xxiii) hypertension;
(xxiv) toxaemia of pregnancy;
(xxv) liver or renal disease;
(xxvi) autoimmune disease;
(xxvii) cardiac disease;
(xxviii) alloimmunisation;
(xxix) maternal infection;
(xxx) inflammatory bowel disease;
(xxxi) bowel stoma;
(xxxii) abdominal wall scarring;
(xxxiii) previous spinal or pelvic trauma or disease;
(xxxiv) drug dependency;
(xxxv) thrombophilia;
(xxxvi) significant maternal obesity;
(xxxvii) advanced maternal age;
(xxxviii) abdominal pain or mass
|
Pregnancy >22 weeks only and only 1 per pregnancy
|
55721
Specialist
Referral Only
|
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of by any or all approaches, where:
(a) the patient is referred by a medical practitioner who is a Member or a Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a Diploma of Obstetrics or has qualifications recognised by the Royal Australian and New
Zealand College of Obstericians and Gynaecologists as being equivalent to a Diploma of obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(b) the dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(c) the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(d) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(e) further examination is clinically indicated in the same pregnancy to which item 55718 applies
|
Pregnancy >22 weeks only
|
55759 |
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a) the patient is referred by a medical practitioner; and
(b) ultrasound of the same pregnancy confirms a multiple pregnancy; and
(c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and
(d) the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(e) the referring practitioner is not a member of a group of practitioners to which the providing practitioner is a member; and
(f) the service is not performed in conjunction with item 55706 or 55712 during the same pregnancy
|
Multiple Pregnancy 17-22 weeks only and only 1 per pregnancy
|
55764
Specialist
Referral Only
|
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, with measurement of all parameters for dating purposes, where:
(a) the patient is referred by a medical practitioner who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has a
Diploma of Obstetrics or has a qualification recognised by the Royal Australian and New
Zealand College of Obstericians and Gynaecologists as equivalent to a Diploma of obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(b) ultrasound of the same pregnancy confirms a multiple pregnancy; and
(c) the dating of the pregnancy (as confirmed by ultrasound) is 17 to 22 weeks gestation; and
(d) the service is not associated with a service to which an item in Subgroup 2 or 3 of this group applies; and
(e) the referring practitioner is not a member of a group of practitioners to which the providing practitioner is a member; and
(f) further examination is clinically indicated in the same pregnancy to which item 55759 has been performed; and
(g) not performed in conjunction with item 55706 or 55712 during the same pregnancy
|
Multiple Pregnancy 17-22 weeks only
|
55768 |
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:
(a) dating of the pregnancy (as confirmed by ultrasound) is after 22 weeks of gestation; and
(b) the ultrasound confirms a multiple pregnancy; and
(c) the patient is referred by a medical practitioner; and
(d) the service is not performed in the same pregnancy as item 55770; and
(e) the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies; and
(f) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(g) the service is not performed in conjunction with item 55718 or 55721 during the same pregnancy
|
Multiple Pregnancy >22 weeks only and only 1 per pregnancy
|
55772
Specialist Referral Only
|
PELVIS or ABDOMEN, pregnancy related or pregnancy complication, fetal development and anatomy, ultrasound scan of, by any or all approaches, where:
(a) dating of the pregnancy as confirmed by ultrasound is after 22 weeks of gestation; and
(b) the patient is referred by a medical practitioner who is a Member or Fellow of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists or who has
a Diploma of Obstetrics or has a qualification recognised by the Royal Australian and New
Zealand College of Obstericians and Gynaecologists as equivalent to a Diploma of obstetrics or has obstetric privileges at a non-metropolitan hospital; and
(c) further examination is clinically indicated in the same pregnancy to which item 55768 or 55770 has been performed; and
(d) the pregnancy as confirmed by ultrasound is a multiple pregnancy; and
(e) the service is not associated with a service to which an item in Subgroups 2 or 3 of this group applies; and
(f) the referring practitioner is not a member of a group of practitioners of which the providing practitioner is a member; and
(g) the service is not performed in conjunction with item 55718 or 55721 during the same pregnancy
|
Multiple Pregnancy >22 weeks only
|
