Document ID: chunk:federal_register_of_legislation:F2024C01086:clause:1_35414:p2
Version: federal_register_of_legislation:F2024C01086
Segment Type: clause
Provision Reference: sch 1 cl 35414 (pt 2/4)
Character Range: 1775861–1778741

diaphoresis or syncope occurring at a low threshold; or
 (c) either of the following, detected on computed tomography coronary angiography:
 (i) significant left main coronary artery disease with greater than 50% stenosis or a cross‑sectional area of less than 6 mm2;
 (ii) severe proximal left anterior descending coronary artery disease (with stenosis of more than 70% or a cross‑sectional area of less than 4 mm2 before the first major diagonal branch).

5.10.17B  Items 38248 and 38249—patient eligibility
 (1) A patient is eligible for a service to which item 38248 or 38249 applies if:
 (a) subclause (2) applies to the patient; or
 (b) the patient is recommended for coronary angiography as a result of a heart team conference that meets the requirements of subclause (3).
 (2) This subclause applies to a patient who has:
 (a) limiting angina or angina equivalent, despite an adequate trial of optimal medical therapy; or
 (b) high risk features, including at least one of the following:
 (i) myocardial ischaemia demonstrated on functional imaging;
 (ii) ST segment elevation, sustained ST depression, hypotension or a Duke treadmill score of minus 11 or less, demonstrated by stress electrocardiogram testing;
 (iii) computed tomography coronary angiography evidence of one or more coronary arteries with stenosis of 70% or more; or
 (iv) left ventricular dysfunction with an ejection fraction of less than 40% or segmental wall motion abnormality at rest.
 (3) For the purposes of paragraph (1)(b), the requirements for a heart team conference are as follows:
 (a) the conference must be conducted by a team of specialists or consultant physicians practising in the speciality of cardiology or cardiothoracic surgery, including each of the following:
 (i) an interventional cardiologist;
 (ii) a non‑interventional cardiologist;
 (iii)  a specialist or consultant physician; and
 (b) the team must:
 (i) assess the patient's risk and technical suitability to receive the service; and
 (ii) make a recommendation about whether or not the patient is suitable for invasive coronary angiography; and
 (c) a record of the conference must be created, and must include the following:
 (i) the particulars of the assessment of the patient during the conference;
 (ii) the recommendations made as a result of the conference;
 (iii) the names of the members of the team making the recommendations.

5.10.17C  Items 38311, 38313, 38314, 38320, 38322 and 38323—patient eligibility
 (1) A patient is eligible for a service to which item 38311, 38313, 38314, 38320, 38322 or 38323 applies if:
 (a) subclause (2) applies to the patient; or
 (b) the patient is recommended for the service as a result of a heart team conference that meets the requirements of subclause (4).
 (2) This subclause applies to a patient if:
 (a) the patient has any of the following:
 (i) limiting angina or