Document ID: chunk:federal_register_of_legislation:F2025C00214:clause:1_55895:p2
Version: federal_register_of_legislation:F2025C00214
Segment Type: clause
Provision Reference: sch 1 cl 55895 (pt 2/4)
Character Range: 134944–137907

stenosis or regurgitation.

2.1.12  Restriction on item 55126—timing
  Item 55126 does not apply to a service provided to a patient if, in the previous 24 months, a service associated with a service to which item 55127, 55128, 55129, 55132, 55133 or 55134 applies has been provided to the patient.

2.1.13  Restriction on items for stress echocardiograms—patients, requests and requirements
 (1) Items 55141, 55143, 55145 and 55146 apply to a service performed on a patient only if:
 (a) one or more of subclauses 2.1.14(1), (2) and (3) apply to the patient; and
 (b) the request for the service identifies any symptoms or clinical indications mentioned in those subclauses that apply to the patient; and
 (c) the service is performed in accordance with clause 2.1.15; and
 (d) subclause (2) does not apply to the patient.
 (2) This subclause applies to a patient if:
 (a) stress echocardiography would not provide adequate information about the patient because of:
 (i) the patient's body habitus, or other physical conditions (including heart rhythm disturbance); or
 (ii) the patient's inability to exercise to the required extent; or
 (b) the results of a previous imaging service indicate that a stress echocardiogram service would not provide adequate information.

2.1.14  Stress echocardiograms—patients
 (1) This subclause applies to a patient if:
 (a) the patient displays symptoms of typical or atypical angina, including constricting discomfort of one or more of the following:
 (i) the front of the chest;
 (ii) the neck;
 (iii) the shoulders;
 (iv) the jaw;
 (v) the arms; or
 (b) the patient's symptoms are:
 (i) precipitated by physical exertion; or
 (ii) relieved within 5 minutes or less by rest or glyceryl trinitrate.
 (2) This subclause applies to a patient if:
 (a) the patient has known coronary artery disease; and
 (b) the patient displays one or more symptoms that are suggestive of ischaemia; and
 (c) the symptoms:
 (i) are not adequately controlled with medical therapy; or
 (ii) have evolved since the last functional study undertaken of the patient.
 (3) This subclause applies to a patient if one or more of the following clinical indications apply to the patient:
 (a) assessment of myocardial ischaemia with exercise is required because the patient has congenital heart lesions, has undergone surgery and reversal of ischemia is considered possible;
 (b) the patient does not have a known coronary artery disease but assessment indicates that resting twelve‑lead electrocardiogram changes are consistent with coronary artery disease or ischaemia;
 (c) coronary artery disease related lesions, of uncertain functional significance, have previously been identified on a computed tomography coronary angiography or invasive coronary angiography;
 (d) an assessment by a specialist or consultant physician indicates that the patient has potential non‑coronary artery disease, where a stress echocardiography study is likely to assist