CHANGES TO MEDICARE BENEFITS SCHEDULE Among changes to the Pathology Services Table, effective 1st November 2001, are the following:
1. HDL Cholesterol
Previous restrictions for ordering HDL cholesterol have been removed [i.e. relating to total cholesterol and fasting triglyceride levels, clinical / drug history].
2. CARDIAC ENZYMES
Previously, LDH, AST and CK were the tests allowed under requests for cardiac enzymes. These tests are no longer part of the cardiac enzyme screen. If a request is now received for cardiac enzymes our laboratory will only be able to test for Troponin I . It is recommended that Troponin I and CK be requested individually to assess cardiac muscle damage.
ADDITIONAL TESTS FOR SPECIMENS AT THE LABORATORYAdditional tests that are required can only be added to the original request for a period of two working days after the completion of the original tests. Our pathology accounts are forwarded to patients / Medicare two days after completion of all tests. Additional pathology tests cannot be charged if requested after the account has been generated.
SHORT SYNACTHEN STIMULATION TESTThe short Synacthen test is used as part of the investigation of suspected adrenal hypo-function. Over recent years several studies have investigated the appropriateness of the dose of Synacthen used [250?g I.M.], it is considered supra-physiologic and a much lower dose [1?g I.V.] has been shown to have higher sensitivity in the assessment of abnormalities of the hypothalamic – pituitary – adrenal axis.In consultation with local endocrinologists our testing protocol for all requests will be:
• Basal cortisol level
• 1?g I.V. Synacthen
• 30 minute cortisol level
Patients are required to make an appointment by telephoning the laboratory.
GLUCOSE TOLERANCE TESTINGPatients are required to make an appointment for the two hour glucose tolerance test by telephoning the laboratory. The glucose challenge test done during pregnancy requires no appointment. The patient needs to be informed that this test takes one hour and they do not need to fast.
TESTING FOR COELIAC DISEASE
Changes to the Pathology Services Table of Medicare Benefits Schedule effective from 1st November 2002.
1. ITEM 71162 – NEW ITEM FOR DIAGNOSIS OF COELIAC DISEASEIn order to charge under this item we require the following on your request form that this request is for “the diagnosis of Coeliac Disease”. Antibody to tissue transglutaminase [TGA] and IgA and IgG Gliadins will be performed on all requests under this item number.
2. ITEM 71161 – NEW ITEM FOR THE MONITORING OF ESTABLISHED COELIAC DISEASEIn order to charge under this item we require the following on your request form that this request is for “monitoring purposes of established Coeliac Disease”. IgA antibodies to Coeliac Disease ie. TGA and IgA Gliadin antibodies will be performed on all requests under this item number.If you require any additional information please contact Dr Michael Beamish on 63 34 3636.