Document ID: chunk:federal_register_of_legislation:F2025C00183:clause:1_71203:p1
Version: federal_register_of_legislation:F2025C00183
Segment Type: clause
Provision Reference: sch 1 cl 71203 (pt 1/2)
Character Range: 237545–240717

71203                Determination of HLAB5701 status by flow cytometry or cytotoxity assay prior to the initiation of Abacavir therapy including item 73323 (if performed)                                                                                                                                                                                                                                                                                                                                         40.55

Division 2.5—Group P5: tissue pathology

2.5.1  Restrictions on items—services performed using material submitted for a Group P6 service
  An item in Group P5 (other than items 72858 and 72859) does not apply to a service performed using material submitted for a test in Group P6, including if a cell block is prepared from the material.

2.5.2  Restrictions on items—certain biopsy examinations performed in a single patient episode
  If more than one of the services described in items 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 and 72838 are performed in a single patient episode, only the item with the highest specified fee for a service performed in the episode applies.

2.5.3  Restrictions on items—certain histopathological examinations performed on specimens from a single patient episode
  If more than one histopathological examination is performed on separate specimens, of different complexity levels, from a single patient episode, only the item with the highest specified fee for any of the examinations performed applies.

2.5.4  Restriction on items—certain services in Groups P5 and P6 performed in a single patient episode
  If more than one of the services described in items 72846, 72847, 72848, 72849, 72850, 73059, 73060, 73061, 73064 and 73065 are performed in a single patient episode, only the item with the highest specified fee for a service performed in the episode applies.
Note: Items 73059, 73060, 73061, 73064 and 73065 are in Group P6.

2.5.5  Restrictions on items 72858 and 72859
 (1) Items 72858 and 72859 apply:
 (a) only to a service that is covered by:
 (i) item 65084 or 65087; or
 (ii) item 72813, 72816, 72817, 72818, 72823, 72824, 72825, 72826, 72827, 72828, 72830, 72836 or 72838; or
 (iii) an item in Group P6 (other than item 73070, 73071, 73072, 73074, 73075 or 73076); and
 (b) only if the treating practitioner and the approved pathology practitioner who provided the original opinion on the patient specimen agree that a second opinion is reasonably necessary for diagnostic purposes.
 (2) Items 72858 and 72859 do not apply if the accredited pathology laboratory in which the second opinion is provided is the same laboratory in which the original opinion was provided.

2.5.5A  Application of item 72860
  Item 72860 applies to a service (the relevant service) for a patient if:
 (a) the relevant service is subsequent to one or more earlier patient episodes involving:
 (i) the rendering of services to which one or more items in Groups P5, P6 or P7 apply (other than item 72860); and
 (ii) the collection of tissue material (either biopsy material or samples submitted