Diagnostic procedures and investigations assessing rules in Medicare 011-42050000
Expand allExternal websites
Services Australia - MBS billing for diagnostic audiology items
MBS Notes
DN.1.17 – Investigations for sleep disorders in adults (Items 12203 to 12208 and 12250)
DN.1.18 - Bone densitometry (Items 12306 to 12322)
DN.1.23 - Multiple sleep latency testing and maintenance of wakefulness testing
DN.1.37 - Investigations for sleep disorders in children and adolescents (Items 12210 to 12219)
MN.15.5 - Provision of diagnostic audiology services by audiologists (Items 82300 to 82332)
Overview of Diagnostic Procedures and Investigations
Table 1: summarises the MBS Category 2 services and provides a brief description and examples of each.
| Subgroup | Description | Examples | Item range |
| 1 - Neurology | Tests the brain, nerves and muscles to help diagnose neurological conditions, such as seizures or nerve damage. |
| 11000–11027 |
| 2 - Ophthalmology | Tests eye function and structures, including vision, retina and optic nerve health. |
| 11200–11244 |
| 3 - Otolaryngology | Includes ear, nose and throat (ENT) investigations, such as hearing and balance testing. |
| 11300–11345 |
| 4 - Respiratory | Assesses lung function and breathing capacity to identify respiratory problems including asthma and emphysema. |
| 11503–11512 |
| 5 - Vascular | Examines blood flow and circulation in arteries and veins to detect blockages or poor blood supply. |
| 11600–11627 |
| 6 - Cardiovascular | Tests heart rhythm, function and exercise tolerance to assess heart health. |
| 11704–11737 |
| 7 - Gastroenterology & Colorectal | Investigates digestive and bowel function, including swallowing and gut motility issues. |
| 11800–11833 |
| 8 - Genito/Urinary Physiological Investigations | Tests that assess how the bladder, kidneys and urinary tract are functioning. These investigations are often used to help diagnose problems with continence, urine flow or bladder emptying. |
| 11900–11919 |
| 9 - Allergy Testing | Investigates allergic and immune system responses. |
| 12000–12024 |
| 10 - Other Diagnostic Procedures and Investigations | Includes specialised tests that do not fit into the other groups but are still used to diagnose or monitor health conditions. These services may assess body systems, organ function or specific clinical concerns. |
| 12200–12326 |
| Group D2 - Nuclear Medicine (Non-Imaging) | Includes specialised tests that use small amounts of radioactive material to measure how certain organs or body systems are functioning, rather than producing diagnostic images. These investigations are used to assess physiological function, detect abnormalities and support diagnosis where standard pathology or diagnostic imaging may not provide enough information. These tests can help measure kidney performance, blood volume, absorption or metabolic activity. |
| 12500–12533 |
Bone densitometry items
Table 2: summarises the bone densitometry items, including their descriptions, item restrictions and time dependencies.
| Item number | Description | Item restrictions | Time dependency |
| 12306 | Bone densitometry for confirmation of a presumptive diagnosis or monitoring of low bone mineral density | 12312, 12315, 12321 | 1 service in 24 months |
| 12312 | Bone densitometry for diagnosis and monitoring of bone loss associated with specified conditions | 12306, 12315, 12321 | 1 service in 12 months |
| 12315 | Bone densitometry for diagnosis and monitoring of bone loss associated with specific conditions | 12306, 12312, 12321 | 1 service in 24 months |
| 12320 | Bone densitometry for measurement of bone density for a patient aged over 70 years | 12306, 12312, 12315, 12321, 12322 | 1 service in 5 years |
| 12321 | Bone densitometry at least 12 months after a significant change in therapy | 12306, 12312, 12315 | 1 service in 12 months |
| 12322 | Bone densitometry for measurement of bone density for a patient aged over 70 years | 12306, 12312, 12315, 12320, 12321 | 1 service in 2 years |
Sleep study items
Table 3: summarises the sleep study items, including the item number, service type, age requirements and time dependencies.
| Item number | Service type | Age requirement | Time dependency |
| 12203 | Adult sleep study - attended | 18 years or more | 1 service in 12 months |
| 12204 | Adult overnight assessment of positive airway pressure - attended | 18 years or more | 1 service in 12 months |
| 12205 | Adult follow up study for a sleep-related breathing disorder - attended | 18 years or more | 1 service in 12 months |
| 12207 | Adult overnight investigation for a sleep-related breathing disorder - attended | 18 years or more | 1 service in 12 months |
| 12208 | Adult overnight investigation for sleep apnoea - attended | 18 years or more | 1 service in 12 months |
| 12210 | Paediatric overnight investigation - attended | Less than 12 years | 3 services in 12 months |
| 12213 | Paediatric overnight investigation - attended | At least 12 years but less than 18 years | 3 services in 12 months |
| 12215 | Paediatric overnight investigation - attended | Less than 12 years | 1 service in 12 months |
| 12217 | Paediatric overnight investigation - attended | At least 12 years but less than 18 years | 1 service in 12 months |
| 12218 | Paediatric overnight investigation - unattended | At least 3 years but less than 12 years | 3 services in 12 months |
| 12219 | Paediatric overnight investigation - unattended | At least 12 years but less than 18 years | 3 services in 12 months |
| 12250 | Adult overnight investigation to confirm diagnosis of obstructive sleep apnoea - unattended - unattended | 18 years or more | 1 service in 12 months |
| 12254 | Multiple sleep latency test for the assessment of unexplained hypersomnolence | 18 years or more | 1 service in 12 months |
| 12258 | Maintenance of wakefulness test for the assessment of the ability to maintain wakefulness | 18 years or more | 1 service in 12 months |
| 12261 | Multiple sleep latency test for the assessment of unexplained hypersomnolence | At least 12 years but less than 18 years | 1 service in 12 months |
| 12265 | Maintenance of wakefulness test for the assessment of the ability to maintain wakefulness | At least 12 years but less than 18 years | 1 service in 12 months |
| 12268 | Multiple sleep latency test for the assessment of unexplained hypersomnolence | Less than 12 years | 1 service in 12 months |
| 12272 | Maintenance of wakefulness test for the assessment of the ability to maintain wakefulness | Less than 12 years | 1 service in 12 months |
Electrocardiography items
Table 4: summarises the electrocardiography (ECG) items, including their descriptions, item restrictions and time dependencies.
| Item | Description | Service type | Item restrictions | Time dependency |
| 11704 | Twelve‑lead ECG, trace and formal report | Trace and formal report provided by a specialist or consultant physician | 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | Cannot be claimed on the same day as an attendance item by the same practitioner |
| 11705 | Twelve‑lead ECG, formal report only | Formal report only, where the ECG has not already been reported | 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 2 services in 1 day |
| 11707 | Twelve‑lead ECG, trace only | Trace-only service for forwarding to a specialist or consultant physician for a formal report. Can be provided by any medical practitioner, including a GP | 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 2 services in 1 day |
| 11713 | Signal averaged ECG recording | Specialised ECG recording using at least 3 leads. Includes analysis, interpretation and a report by a specialist or consultant physician. | 12218, 12219 | N/A |
| 11714 | Twelve-lead ECG, trace and clinical note | Trace and clinical note service. Can be provided by any medical practitioner, including a GP | 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 2 services in 1 day |
Ambulatory electrocardiogram items
Table 5: summarises the ambulatory electrocardiogram (AECG) items, including the item number, description, recording duration and whether a report is required.
| Item | Description | Item restrictions | Time dependency |
| 11716 | Continuous AECG recording of a patient for 12 or more hours | 11704, 11705, 11707, 11714, 11717, 11723, 11735, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 1 service in 28 days |
| 11717 | AECG recording of a patient for 12 or more hours - report | 11716, 11723, 11735, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 1 service in 90 days |
| 11723 | AECG monitoring for up to 7 days | 11716, 11717, 11735, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 1 service in 90 days |
| 11735 | Continuous AECG recording of a patient for 7 days | 11716, 11717, 11723, 12203, 12204, 12205, 12207, 12208, 12210, 12213, 12215, 12217, 12218, 12219, 12250 | 4 services in 12 months |