Current htis schedule 1 August 2019.pdf

link to page 9 SERVICE SCHEDULE FOR HIGH TECH IMAGING SERVICES
CONTRACT NO: HTISXXXX
A.  QUICK REFERENCE INFORMATION
1.
TERM FOR PROVIDING HIGH TECH IMAGING SERVICES
1982
The Term for the provision of High Tech Imaging Services is the period from 1 August 2018
(“Commencement Date”) until the close of 31 July 2021 (the “Date of Expiry”) or such earlier
date upon which the period is lawfully terminated or cancelled.
Act
Prior to the End Date, the parties may agree in writing to extend the Term of this Service
Schedule for a further term of three years.  Any decision to extend the Term of this Service
Schedule will be based on:
1.1.1  The parties reaching agreement on the extension in writing prior to the End Date; and
1.1.2  ACC being satisfied with the performance of the Services by the Supplier; and
1.1.3  All  other  provisions  of  this  Service  Schedule  either  continue  to  apply  during  such
extended Term or are re-negotiated to the satisfaction of both parties.
There is no obligation on the part of ACC to extend the Term of the Service Schedule, even if
Information
the Supplier has satisfactorily performed all the Services.
2.
SPECIFIED AREA AND SERVICE LOCATION (PART B, CLAUSE 4)
<<Facilities>>
Official
3.
SERVICE ITEMS AND PRICES (PART B, CLAUSE 16)
Service Item  Service Item
Service Item Definition
Price
the
Code
Description
(excl. GST)
X82
Day Bed Stay Rate
Day Stay is defined as the patient not being
in a hospital bed at midnight of the day of
$160.29
procedure.
X30
IV Sedation/ General
High Tech Imaging Services requiring
Actual and
Anaesthetic
Anaesthesia and IV sedation.
reasonable
cost
under

The procedures which can be provided under this Agreement are those set out in Table 1 below:

Table 1 – Service Items and Prices
Primary
2018-19 Primary  Secondary
Secondary
Procedure Description
Service
Service Item
Service Item
Service Item
Item Code
Price (Excl.
Price (Excl.
GST)
Code
GST)
MRI Brain
R01
$771.81
R01A
$617.45
Released
MRI Internal Auditory
Meatis
R03
$771.81
R03A
$617.45
MRI Face
R11
$771.81
R11A
$617.45
MRI Neck
R12
$771.81
R12A
$617.45
HTIS Service Schedule 1 August 2019
Page 1 of 18

Primary
2018-19 Primary Secondary
Secondary
Procedure Description
Service
Service Item
Service Item
Service Item
Item Code
Price (Excl.
Price (Excl.
GST)
Code
GST)
MRI Upper Arm
R15
$771.81
R15A
$617.45
MRI Elbow
R16
$771.81
R16A
$617.45
MRI Forearm
R17
$771.81
R17A
$617.45
MRI Wrist
R18
$771.81
R18A
$617.45
MRI Hand
R19
$771.81
R19A
$617.45
MRI Chest
R20
$771.81
R20A
$617.45
1982
MRI Breast
R26
$771.81
R26A
$617.45
MRI Abdomen
R30
$771.81
R30A
$617.45
MRI Pelvis
R36
$771.81
R36A
$617.45
Act
MRI Cervical Spine
R41
$771.81
R41A
$617.45
MRI Cervical Spine – GP
referred
R41GP
$771.81

$617.45
MRI Thoracic Spine
R42
$771.81
R42A
$617.45
MRI Lumbar Spine
R43
$771.81
R43A
$617.45
MRI Lumbar Spine – GP
referred
R43GP
$771.81

$617.45
MRI Sacrum
R44
$771.81
R44A
$617.45
MRI Thigh
R52
$771.81
R52A
$617.45
MRI Knee
R53
$771.81
R53A
$617.45
Information
MRI Knee – GP referred
R53GP
$771.81

$617.45
MRI Lower Leg
R54
$771.81
R54A
$617.45
MRI Shoulder Girdle
R55
$771.81
R55A
$617.45
MRI Shoulder Girdle – GP
Referred
R55GP
$771.81

$617.45
MRI Hip
R57
$771.81
R57A
$617.45
MRI Ankle
R58
$771.81
R58A
$617.45
Official
MRI Foot
R59
$771.81
R59A
$617.45
MR Arthrogram Shoulder
R62
$1,051.09
R62A
$840.87
MR Arthrogram Elbow
R63
$1,051.09
R63A
$840.87
the
MR Arthrogram Wrist
R64
$1,051.09
R64A
$840.87
MR Arthrogram Hand
R66
$1,051.09
R66A
$840.87
MR Arthrogram Hip
R67
$1,051.09
R67A
$840.87
MR Arthrogram Knee
R68
$1,051.09
R68A
$840.87
MR Arthrogram Ankle
R69
$1,051.09
R69A
$840.87
under
MR Arthrogram Foot
R85
$1,051.09
R85A
$840.87
MR Angiography
Unspecified
R70
$1,051.09
R70A
$840.87
MR Angiography Head
R71
$1,051.09
R71A
$840.87
MR Angiography Face or
Neck
R72
$1,051.09
R72A
$840.87
MR Angiography Chest
R73
$1,051.09
R73A
$840.87
MR Angiography Upper
Limbs
R74
$1,051.09
R74A
$840.87
Released
MR Angiography
Abdomen/Pelvis
R75
$1,051.09
R75A
$840.87
MR Angiography Pelvis and
Lower Extremities
R76
$1,051.09
R76A
$840.87
MR – Venography
R78
$1,051.09
R78A
$840.87
HTIS Service Schedule 1 August 2019
Page 2 of 18

Primary
2018-19 Primary Secondary
Secondary
Procedure Description
Service
Service Item
Service Item
Service Item
Item Code
Price (Excl.
Price (Excl.
GST)
Code
GST)
MR Interventional
Procedure
R80
$1,051.09
R80A
$840.87
MRI Other Region
(Not Otherwise included)
R90
$771.81
R90A
$617.45
MR Arthrogram Other
region
R91
$1,051.09
R91A
$840.87
(Not otherwise specified)
1982
CT Brain
T01
$431.61
T01A
$345.29
CT Sinuses
T11
$431.61
T11A
$345.29
CT Orbits
T13
$492.54
T13A
$394.03
Act
CT Face
T14
$492.54
T14A
$394.03
CT Neck
T15
$492.54
T15A
$394.03
CT Chest
T20
$578.86
T20A
$463.09
CT High Resolution Lungs
T21
$578.86
T21A
$463.09
CT Abdomen
T30
$578.86
T30A
$463.09
CT Abdomen and Pelvis
T31
$578.86
T31A
$463.09
CT Pelvis
T35
$492.54
T35A
$394.03
CT Cervical Spine
T41
$578.86
T41A
$463.09
CT Thoracic Spine
T42
$578.86
T42A
$463.09
CT Lumbar Spine
T43
$578.86
T43A
$463.09
Information
CT Sacrum
T44
$578.86
T44A
$463.09
CT Myelogram
(sole charge – includes
T45
$919.07
T45A
$735.25
fluoroscopy)
CT Discogram
(sole charge – includes
T46
$1,071.40
T46A
$857.12
fluoroscopy)
Official
CT Upper Arm
T47
$492.54
T47A
$394.03
CT Elbow
T48
$492.54
T48A
$394.03
CT Forearm
T49
$492.54
T49A
$394.03
the
CT Shoulder/Thoracic
Outlet
T51
$492.54
T51A
$394.03
CT Wrist
T52
$492.54
T52A
$394.03
CT Hand
T53
$492.54
T53A
$394.03
CT Thigh
T54
$492.54
T54A
$394.03
CT Hips
T55
$431.61
T55A
$345.29
under
CT Knee
T56
$492.54
T56A
$394.03
CT Lower Leg
T57
$492.54
T57A
$394.03
CT Ankle
T58
$492.54
T58A
$394.03
CT Foot
T59
$492.54
T59A
$394.03
CT Arthrogram
T60
$634.72
T60A
$507.77
CT Arthrogram Upper
Extremity
T61
$634.72
T61A
$507.77
CT Arthrogram Lower
Released
Extremity
T65
$634.72
T65A
$507.77
CT Angiography unspecified
T70
$919.07
T70A
$735.25
CT Angiography Intracranial
T71
$919.07
T71A
$735.25
CT Angiography Neck
T72
$919.07
T72A
$735.25
HTIS Service Schedule 1 August 2019
Page 3 of 18

Primary
2018-19 Primary  Secondary
Secondary
Procedure Description
Service
Service Item
Service Item
Service Item
Item Code
Price (Excl.
Price (Excl.
GST)
Code
GST)
CT Angiography Upper
Extremities
T73
$919.07
T73A
$735.25
CT Angiography Chest
T75
$919.07
T75A
$735.25
CT Angiography  Abdomen
and/or Pelvis
T77
$919.07
T77A
$735.25
CT Angiography Pelvis and
Lower Limbs
T78
$919.07
T78A
$735.25
1982
CT Guided Injection/
Aspiration (price includes
CT scan and the
injection/aspiration)
T80
$919.07
T80A
$735.25
Act
Prior approval required for
third or subsequent use of
this procedure.
CT Digital Radiograph/
Scanogram
T91
$299.59
T91A
$239.67
CT Leg Lengths
T92
$299.59
T92A
$239.67
CT Rotational Profile
T94
$299.59
T94A
$239.67
CT Additional 3D
reconstruction
T97
$299.59
T97A
$239.67
CT Other region
(not otherwise specified)
T98
$578.86
T98A
$463.09
Information
Nuclear Scan Brain
N01
$863.21
N01A
$690.57
Nuclear Scan Lung
N10
$609.33
N10A
$487.46
Nuclear Scan – Bone
Triphasic
N20
$411.30
N20A
$329.04
Nuclear Scan Bone – Whole
Body
N21
$482.38
N21A
$385.91
Nuclear Scan Bone –
Official
SPECT
N22
$497.62
N22A
$398.09
NaF PET Scan
Prior approval required
N23
$1,076.63
N23A
$861.30
Nuclear Scan SPECT-CT
N24
$710.97
N24A
$568.78
the
Nuclear Scan Renal Tracts
N30
$497.62
N30A
$398.09
Nuclear Scan Liver- Sulphur
Colloid
N40
$462.07
N40A
$369.66
Nuclear Scan  Biliary Tree
N41
$497.62
N41A
$398.09
Nuclear Scan Cardiac
(myocardial perfusion)
N50
$944.46
N50A
$755.57
under
Nuclear Scan Blood Pool
N60
$497.62
N60A
$398.09
Nuclear Scan Thyroid
N80
$365.60
N80A
$292.48
Nuclear Scan Other Region/
At 80% of the
Miscellaneous
N90
At cost
N90A
primary codes
cost
N/A
Nuclear Scan Additional
secondary
N/A secondary
Region SPECT
procedure
procedure only
N91A
$152.33
only
Released
Duplex/Doppler US of
Carotid arts
U50
$248.81
U50A
$199.05
Duplex/Doppler US of Chest
U51
$248.81
U51A
$199.05
Duplex/Doppler US of
Abdomen/Pelvis
U52
$248.81
U52A
$199.05
HTIS Service Schedule 1 August 2019
Page 4 of 18

Primary
2018-19 Primary Secondary
Secondary
Procedure Description
Service
Service Item
Service Item
Service Item
Item Code
Price (Excl.
Price (Excl.
GST)
Code
GST)
Duplex/Doppler US of Limb
Veins for DVT (one limb)
U53
$208.19
U53A
$166.55
Duplex/Doppler Vein
Mapping Lower Extremity
U54
$309.74
U54A
$247.79
(one limb)
Duplex/Doppler US of Limb
Arteries (one limb)
U55
$248.81
U55A
$199.05
1982
Duplex/Doppler US of
Additional Limb Arterial or
U56
$198.03
U56A
$158.43
Venous
Duplex/Doppler
Act
Echocardiography
U58
$248.81
U58A
$199.05
Duplex/Doppler US
Miscellaneous
U59
$248.81
U59A
$199.05
Bone densitometry
S12
$142.18
N/A
N/A
Fluoroscopy (per half hour)
S20
$253.89
N/A
N/A
Sinogram
S41
$299.59
N/A
N/A
Arthrogram
S70
$299.59
N/A
N/A
Tenogram
S76
$299.59
N/A
N/A
Injection or Aspiration under
fluoroscopy
Information
Prior approval required for
S79
$299.59
N/A
N/A
third or subsequent use of
this procedure
Herniagram
S83
$517.93
N/A
N/A
IVP incl plain film + tomos.
D40
$299.59
N/A
N/A
Urethrogram
D45
$517.93
N/A
N/A
Micturating
Official
Cystourethrogram
D46
$517.93
N/A
N/A
Injection of steroid and/or
local anaesthetic into joint
under imaging – specialist the
referred only, approval
S85
$446.41
N/A
N/A
required for the third and
subsequent injections

Note
1.
All plain film performed as part of a High Tech Imaging investigation is included in
under
the contract price of that investigation.
2.
All contrasts are included in the price of imaging.

Price Review

ACC will review pricing when, at ACC’s sole discretion, we consider a review necessary. The
factors ACC may take into account during a review include, but are not limited to:
•
general inflation
•
changes in service component costs
Released
•
substantial changes in the market

If ACC finds that the factors we take into account have not had a significant impact on price,
the prices will remain unchanged.
HTIS Service Schedule 1 August 2019
Page 5 of 18

If ACC provides a price increase, the supplier must agree any adjustment in writing. The price
increase will take effect from a date specified by ACC.
4.
RELATIONSHIP MANAGEMENT
Level
ACC
Supplier
Frequency
Client
ACC Client Service Staff
Individual staff or

operational contact
Branch
Branch Manager
Operational contact

1982
Region
Designated Engagement and

Performance Manager
Act
5.
ADDRESSES FOR NOTICES (PART 1, SCHEDULE 2)
NOTICES FOR ACC TO:
ACC Health Procurement
(for deliveries)
Justice Centre
19 Aitken Street
Wellington 6011
ACC Health Procurement
(for mail)
P O Box 242
Wellington 6140
Information
Marked: “Attention: Procurement Specialist”
Phone: 0800 400 503
Email: [email address]

NOTICES FOR SUPPLIER TO:
«Vendor_Name_Legal»
(for deliveries)
Official
«Physical_Address_1»
«Physical_Address_2»
«Physical_City»
the
«Vendor_Name_Legal»
(for mail)
«Postal__Address_1»
«Postal_Address_2»
«Postal_City» «Postal_Code»
Marked: “Attention: «Contractual_First_Name» «Contractual_Surname»”
Phone: «Contractual_Phone»
under
Mobile: «Alternative_Number»
Email: «Contractual_Email»
Released
HTIS Service Schedule 1 August 2019
Page 6 of 18

B.
SERVICE SPECIFICATIONS FOR HIGH TECH IMAGING
1.
PURPOSE
1.1.
ACC wishes to purchase High Tech Imaging (HTIS) Services.
1.2.
The purpose of the Service is to provide ACC clients requiring HTIS Services, their treatment
providers  and  ACC  with  necessary,  appropriate,  quality  diagnostic  imaging,  interventional
radiology  and  reporting  services  which  represent  value  for  money  and  positively  contribute  to
effective and appropriate treatment and rehabilitation of clients with ACC covered injuries.
1982
2.
SERVICE OBJECTIVES
Act
2.1.
ACC will measure the success of this service based on the following service philosophies and
objectives:
2.1.1.  Clinical Protocols – the Supplier will have written and applied protocols and policies which
outline the standards for Imaging Services provided under this Agreement.
2.1.2.  Provision  of  Services  – all  Imaging  Services  provided  must  be  necessary,  appropriate,
timely, of the required quality and not excessive in number or duration.
2.1.3.  Cultural Appropriateness – Imaging Services will be provided in a culturally appropriate
manner.
2.1.4.  Accessible Information for the Client – The Supplier will provide information (in writing
where applicable) to the Client to assist in decision making, and to give informed consent.
Information
2.1.5.  Access  for  People  with  Disabilities  –  All  facilities  will  be  accessible  to  people  with
disabilities.
2.1.6.  Client Centred Approach – Each person receiving the Imaging Services will be treated
with dignity and respect at all times.
2.1.7.  Minimised Travel – Service delivery will be aimed at minimising the number of times that
a Client must travel to the Supplier, particularly for Clients who have to travel from outside
Official
the location in which the Supplier is located.
2.1.8.  Financial Access to Services – No Client will be charged for the Services provided under
this Agreement. the
2.1.9.  Consistent Messages – Information provided to Clients or the public will be consistent with
the aims, objectives and Service requirements of this Agreement.
2.1.10.  Reporting  –  The  Supplier  will  provide  ACC  with  an  Imaging  Report  following  the
completion of imaging service/s provided to the Client.
under
3.
SERVICE COMMENCEMENT
3.1.
Eligibility for Service
3.1.1.  A person is eligible for this Service if the person has suffered a personal injury for which a
claim for cover has been made and accepted by ACC; and the Supplier has received a
clinically appropriate referral from a Specialist.
3.1.2.  Imaging services may commence on the receipt, by the Supplier, of:
3.1.2.1.  A clinically appropriate referral from a Specialist;
Released 3.1.2.2.  A referral from a General Practitioner specifically authorised by ACC to make
such referrals for particular stated procedures, and
HTIS Service Schedule 1 August 2018
Page 8 of 18

3.1.2.3.  A  notification  of  approval  and  purchase  order  number  from  ACC  for  those
services which require prior approval as specified in this Service Schedule or
that may be specified by ACC from time to time by notice and/or on the ACC
website as Imaging Services that require prior approval in accordance with Part
B, Clause 6.
3.2.
ACC prior approval is required for the procedures specified below.  Provision of the following
services must not commence before prior approval has been received from ACC:
3.2.1.  NaF PET Scan (see Clause 6.1)
1982
3.2.2.  Third or subsequent CT Guided Injection/Aspiration (see Clause 6.1) – prior approval is
not required for the first two CT Guided Injections/Aspirations provided for a claim, but is
required prior to undertaking a third or subsequent CT Guided Injection/Aspiration.
3.2.3.  Third or subsequent Injection or Aspiration under Fluoroscopy (see Clause 6.1) – prior
Act
approval is not required for the first or second Injection or Aspiration under Fluoroscopy
provided for a claim, but is required prior to undertaking a third or subsequent Injection or
Aspiration under Fluoroscopy.
3.2.4.  Third or subsequent injection of steroid and/or local anaesthetic into joint under imaging –
3.3.
In addition to the procedures above, ACC may, from time to time, specify by notice and/or on the
ACC  website  that  particular  procedures  also  require prior approval in accordance  with  Part  B,
Clause 6.
3.4.
Where ACC approval is required the referring provider must submit the required documentation to
ACC in accordance with Part B, Clause 6. The Radiology Supplier will be advised on the decision.
Information
3.5.
Where ACC approval or cover is uncertain
3.5.1.  If the Supplier is uncertain prior to providing the Imaging Services whether or not:
3.5.1.1.  The particular Service in the Referral is needed by a Client; or
3.5.1.2.  The  Service  required  for  the  particular  patient  or  Client  is  covered  by  this
Agreement; or Official
3.5.1.3.  The patient is an ACC Client with a covered claim; or
3.5.1.4.  Where required, prior approval has been granted by ACC.
the
3.5.2.  The Supplier will immediately (and prior to providing Services) confirm eligibility by, as
appropriate:
3.5.2.1.  Contacting the referring Specialist for the claim details; or
3.5.2.2.  Requiring the Client to provide evidence of their accepted claim; or
3.5.2.3.  Contacting the ACC Helpline on 0800 222 070;
to  confirm  that  the  Client  has  an  accepted  claim  (and  prior  approval  where
under required) before commencing Services.
4.
SPECIFIC SITE (PART A, CLAUSE 2)
4.1.
The Supplier will provide Services only at the location(s) specified in Part A, Clause 2, and in a
facility which is listed in Part A, Clause 2 as providing the appropriate specified modality.
5.
SERVICE REQUIREMENTS
Released
5.1.
“Imaging Services” include:
5.1.1.  Arranging an appointment for an investigation of the Client, and providing the investigation
(unless the Supplier advises against investigation, in accordance with Clause 5.1.2 below);
HTIS Service Schedule 1 August 2018
Page 9 of 18

5.1.2.  Advising  the  Referrer  and  ACC  prior  to  investigating  the  Client  if,  in  the  Supplier’s
reasonable opinion, the investigation will not assist with diagnosis of any personal injury
or suspected personal injury of the Client, or with the rehabilitation of the Client;
5.1.3.  Provision of associated reports in accordance with Clause 13 below, and any necessary
follow-up services;
5.1.4.  Any administrative matters and account management time associated with the provision of
the Services and this Agreement; and
5.1.5.  All supplies, pharmaceutical items, and other associated items used during the Services. 1982
5.2.
All Imaging Services provided by the Supplier must be necessary and appropriate.
5.3.
Client Management
5.3.1.  The Supplier will have and follow documented procedures for the reception, advice and
Act
counselling,  physical  handling,  examination,  and,  where  necessary,  the  medication  of
patients. Procedures will include the following:
5.3.1.1.  Positive  identification  of  the  Client  and  confirmation  of  relevant  patient
information;
5.3.1.2.  The effective instruction of the Client in the imaging process to be performed;
5.3.1.3.  The pre-imaging preparation of the Client including the consideration of any
Client abnormalities or conditions which may affect the imaging process, e.g.
prosthetic  implants,  pregnancy,  claustrophobic  tendencies,  known  contrast
media reactions etc;
5.3.1.4.  Administration of any intravenous or other patient medication;
Information
5.3.1.5.  The in-process communication with the patient;
5.3.1.6.  The use of any necessary protective or shielding equipment on the Client;
5.3.1.7.  The post-imaging treatment of the Client, including counselling, prior to the
Client leaving the Service.
5.4.
Arranging Appointments
Official
5.4.1.  The Supplier will arrange the appointment for the investigation with the Client.  If the
Client fails to show for the appointment, the Supplier may not charge ACC, but the Supplier
will notify ACC of the failure to attend.
the
6.
FUNDING APPROVAL PROCESS
6.1.
Prior Approval for Imaging Services
under
Where  ACC  approval  is  required  to  undertake  an  Imaging  Service  the  referring  Specialist  is
responsible for requesting prior approval, although the radiology provider may action this process.
The  referring  Specialist  will submit  or instruct the  radiology  provider  to  submit  a  copy  of the
referral along with all supporting notes from the consultation, to ACC.
6.2.
Decision making process
ACC  will  consider  the  Client’s  cover  and  entitlement  upon  receipt  of  a  request  for  funding
approval.
Released
ACC will advise the Client, the referring provider and the radiology supplier (specified on the
referral) of the decision.
HTIS Service Schedule 1 August 2018
Page 10 of 18

6.3.
If funding is approved
On receiving ACC’s advice that funding has been approved, the Radiology Supplier will promptly
contact the Client to arrange for the Services to be undertaken within 10 days of receipt of an
approved purchase order from ACC.
Where the Supplier has been advised of approval and the approved treatment has not commenced
within three months of the date of the approval, the approval will lapse and a new application for
approval will be required. The referring specialist will make this request.
1982
Where the approval has lapsed ACC will not pay the Radiology Supplier for any services provided
to the Client unless a new approval has been received.
6.4.
If funding is declined
Act
Where funding is declined, the Client will not be eligible for the Service/s, and payment will not
be made to the Radiology Supplier if services are undertaken.
7.
SERVICE SPECIFIC QUALITY REQUIREMENTS
In addition to the requirements specified in Part 1 of this Agreement, the Supplier will meet the
following Service specific requirements:
7.1.
The Supplier will:
Information
7.1.1.  Meet all legislative and regulatory requirements for the use of radiation equipment in New
Zealand.
7.1.2.  Hold IANZ accreditation for each modality and site of HTI service provided.
7.1.3.  Provide  the  Services  in  accordance  with  the  Maximum  Waiting  Time  requirements
described in Clause 8 below.
7.1.4.  Provide the Services in accordance with all reasonable instructions and directions of ACC.
Official
7.2.
The Supplier will only utilise the services of Radiologists who, as a minimum, have and maintain
EITHER:
the
7.2.1.  Vocational registration as a radiologist with the New Zealand Medical Council; and
7.2.2.  Fellowship of, or education affiliation to, the Royal Australia and New Zealand College of
Radiologists; and
7.2.3.  Who  are  Nuclear  Physicians  who  are  members  of  the  Australian  and  New  Zealand
Association of Physicians in Nuclear Medicine.
under
7.3.
The Supplier must have:
7.3.1.  A  team  of  qualified  registered  radiologists  with  the  appropriate  level  of  training  and
experience;
7.3.2.  Sufficient skilled assistance available during Procedures to maintain safe clinical practice;
7.3.3.  Anaesthetists,  technical  staff  and  allied  staff  with  appropriate  specialty  experience  and
qualifications;
7.3.4.  Ongoing staff education programmes or access to education programmes aimed at keeping
staff up to date with developments in the field.
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7.4.
The  Supplier  will  have  a  contingency  plan  to  maintain  continuity  of  Service  in  the  event  of
temporary or permanent loss to the Supplier of any key personnel.
7.5.
The Supplier will have appropriate equipment and consumables to provide the Services.
HTIS Service Schedule 1 August 2018
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7.6.
The  Supplier  will  ensure  that  all  equipment  is  adequately  controlled,  capable  of  achieving  the
accuracy required and complies with the specifications relevant to the examinations concerned.
7.7.
Equipment will be operated by competent and authorised personal.  Up-to-date instructions on the
use and maintenance of equipment (including relevant manuals provided by the manufacturer of
the equipment) shall be readily available for use by the service personal.
7.8.
Equipment  will  be  protected  from  deterioration  and  abuse  and  will  be  maintained  regularly  to
ensure proper functioning.  Maintenance procedures shall be established.  Equipment that has been
subject to overloading or mishandling, or gives suspect results, or has been shown by verification
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or use to be defective, shall be taken out of service, clearly labelled or marked and appropriately
stored until it has been repaired and shown by calibration, verification or test to perform correctly.
The  Supplier  will  examine  the  effect  of  this  defect  on  previous  examinations  and  advise  any
Referrer and ACC of any Reports which may have been affected.
Act
7.9.
Equipment will be subjected to periodical intermediate checks to a defined procedure between
calibrations  and/or  verifications  if  checks  are  needed  to  maintain  confidence  in  the
calibration/verification status of the equipment.
7.10.  When, for any reason, equipment has been outside the direct control of the Supplier for any period,
the Supplier will ensure that the function and calibration status of the equipment are checked and
shown to be satisfactory before the equipment is returned to service.
7.10.1.  Where calibrations give rise to a set of correction factors, the Supplier will have procedures
to ensure that any copies, e.g. in computer software, are correctly updated.
Information
7.11.  Where such systems are available, and from a date notified by ACC, referrals must be received or
made using electronic referral forms.
8.
MAXIMUM WAITING TIMES
8.1.
Imaging Services
Official
8.1.1.  Imaging Services for a Client must be commenced within 10 Working Days of the Supplier
receiving the Specialist’s Referral or, for services requiring prior approval, an approved
purchase order from ACC.
the
8.2.
Notification of Failure to Meet Waiting Time Requirements
8.2.1.  Where  the  Supplier  is  not  able  to  meet,  or  foresees  that  it  may  be  unable  to  meet,  a
Maximum  Waiting  Time  requirement  for  a  particular  Client  or  group  of  Clients,  the
Supplier will immediately notify the Case Manager responsible for each particular Client.
under
ACC may, in its sole discretion, either endeavour to agree with the Supplier and the relevant
Client  an  extension  of  the  Maximum  Waiting  Time,  or  require  that  the  Supplier  make
alternative arrangements for the proposed investigation of the Client.  If ACC chooses the
latter alternative, the Supplier shall make the necessary clinical Referral to another Supplier
as approved by ACC.
9.
SERVICE EXIT
9.1.
This Service is complete for a Client when:
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9.1.1.  The  Supplier  has  performed  the  requested  imaging  procedure  and  forwarded  the
imaging/films and/or CD and any Imaging Report to the person(s) specified in Clause 13
below.
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10.
EXCLUSIONS
10.1.  No  payment  will  be  claimed  by  the  Supplier  or  made  by  ACC  under  this  Agreement  for  any
services:
10.1.1.  Requiring prior approval from ACC, unless a purchase order has been approved for the
service before the service has been provided;
10.1.2.  Which are not related to a valid claim for personal injury which has been accepted by ACC
under the Accident Compensation Act 2001;
10.1.3.  Which are funded or obliged to be funded by the Ministry of Health or a District Health
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Board, including Public Health Acute Services; or
10.1.4.  For which a claim for payment has been, or will be, made against ACC under any other
contract.
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11.
LINKAGES
11.1.  The Supplier will ensure that linkages are maintained with the following Services:
11.1.1.  ACC Client Service Staff;
11.1.2.  Health Professionals;
11.1.3.  Other Services as appropriate to meet the Client’s needs.
12.
PERFORMANCE REQUIREMENTS
Information
12.1.  The Supplier’s performance will be measured as shown in Table 2 – Performance Measurement
Table 2 – Performance Measurement
Objective
Performance measure
Target
Data Source
1.  Quality Intervention
Facilities are accredited
IANZ accreditation  Copy of IANZ
in the modalities
held for each
certification
provided under this
modality and site of
Official
Agreement.
HTI service
provided.
2.  Cost effective
Services are necessary,
100% of Imaging
Imaging Reports
the appropriate and not  Services performed
excessive in number or
are clinically
duration (see Clause 3
necessary and
for Service eligibility).
appropriate.
3.  Early intervention
Imaging Services are
100% of Clients
Imaging Reports
performed within
will have their
necessary time to allow
Imaging Services
under  for maximum
commenced within
rehabilitation.
10 Working Days
after the Supplier
receives the
Specialist’s
Referral, or, for
services requiring
prior approval, an
approved purchase
order from ACC.
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4.  Prompt and accurate
Complete and accurate
100% of
Imaging Reports
information submitted to
information provided to
documentation
Invoice
ACC
enable assessment of
received within
quality service received.
scheduled
timeframes.
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12.2.  Service Improvement Process
12.2.1.  ACC and the Supplier will consider the information reported under Clause 12 and other
relevant information on a regular basis.
12.2.2.  Discussion between the Supplier and ACC will occur to better understand the information
and decide if performance could be expected to change or if there are other factors that
provide a reasonable basis for the identified performance.
12.2.3.  If a change in performance is deemed appropriate then further analysis and a follow-up
discussion will be undertaken three months after the initial discussion between the Supplier
and ACC.
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12.2.4.  If a change is observed such that performance is within appropriate parameters then the
performance monitoring process will provide feedback to the Supplier.
12.2.5.  If a change in performance is still deemed appropriate a performance improvement plan
Act
will be documented that includes the required action(s) by either party and the timeframes
for this to occur.
12.2.6.  Further analysis and discussion will occur at the end of the period stated in the performance
improvement plan.  If no change is observed ACC may issue a notice of breach of contract
in accordance with Part 1 Schedule 2 Clause 9.1.
13.
REPORTING REQUIREMENTS
13.1.  Imaging Report
13.1.1.  Following the provision of any Imaging Service for a Client under this Agreement, the
Information
Supplier will forward an Imaging Report containing the following details:
13.1.1.1.  Name, claim number, contact address and phone number of Client.
13.1.1.2.  HPI number and name of the radiologist who performed the investigation.
13.1.1.3.  Type/s of imaging undertaken.
13.1.1.4.  Date of examination performed.
13.1.1.5.  Relevant clinical history.
Official
13.1.1.6.  Any limitations which might adversely affect accuracy of diagnosis.
13.1.1.7.  Any contrast given – name, amount and route.
13.1.1.8.  Any adverse patient reaction.
the
13.1.1.9.  Positive  and  pertinent  negative  radiographic  findings  and  correlation  with
previous or other examinations.
13.1.1.10.  Differential diagnosis of significant positive findings.
13.1.1.11.  Clinical  opinion  detailing  the  most  likely  cause  of  the  significant  positive
findings, and any recommendations.
under
13.1.2.  Where an ‘additional region’ has been imaged, the Imaging Report must provide details of
the specific region imaged. This also applies to ‘miscellaneous’ and ‘unspecified’ regions
as contained in Table 1 – Service Items and Prices.
13.2.  Imaging Reports – To Whom and By When
13.2.1.  Imaging Reports will be forwarded to the Client’s Referrer, and must be electronically
copied  to  ACC  as  arranged  with  the  ACC  eBusiness  (ie  HealthLink  EDI  account  or
MMEx).
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13.2.2.  Imaging Reports will be forwarded to the Client’s Referrer and ACC within 5 working days
of completion of the investigation.
13.2.3.  Imaging relating to a Client’s examination will be forwarded to:
13.2.3.1.  The Client’s Referrer, on request, on completion of the investigation; and
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13.2.3.2.  Where requested, ACC (copies only at no extra cost).
13.3.  Change in an Imaging Report
13.3.1.  To  avoid  confusion  over  which  is  the  “correct”  report  if  the  content  of  an  originally
distributed Imaging Report is subsequently changed in any way, the following procedures
will apply.
13.3.2.  Any change in a previously distributed report must include:
13.3.2.1.  Clear indication that this is an amended or supplementary report;
13.3.2.2.  Reference to the original report (including the date of the original report);  1982
13.3.2.3.  Clear indication of the change(s);
13.3.2.4.  Date of the amended or supplementary report; and
13.3.2.5.  Name of the radiologist providing the amended or supplementary report.
Act
13.3.3.  Any changed Imaging Report will be distributed to all recipients of the original report.
13.3.4.  ACC will not be charged any additional fee for amended or supplementary reports, which
are due to an error associated with the original report.
13.4.  Change in Imaging Procedure
13.4.1.  Radiologists are not authorised to provide additional or alternative imaging Procedures to
those specified in the Referral, unless the radiologist believes it is likely to achieve a more
useful  result,  and  if  s/he  has  obtained  the  approval  of  the  Referring  Specialist.  Where
approval  has  been  received  from  the  Referring  Specialist  for  additional  or  alternative
imaging, the Imaging Report must indicate this. However, such approval is not required
Information
where:
13.4.1.1.  The incorrect body part has been requested for imaging. The correct body part
should be imaged.  The Referral should be noted and the Imaging Report must
reflect why a different body part was imaged.
13.4.1.2.  An abnormality likely to be related to the injury is noted at the edge of the
imaging field.  In this case the examination may be expanded to include the full
Official
site of abnormality.  The reason for extending the examination must be indicated
in the Imaging Report.
13.4.1.3.  A medical emergency has occurred necessitating urgent medical investigation
before the Referring Specialist can be contacted.  The nature of the emergency,
the
the resultant activity, findings and outcome must be recorded in the Imaging
Report.
13.4.1.4.  It is apparent that imaging enhancement (for example with gadolinium) would
result  in  significant  additional  data  which  would  significantly  influence  the
medical  arrangement  of  the  Client.    The  reason  for  enhancement  must  be
under included in the body of the Imaging Report as well as any adverse effects
suffered by the Client.
13.5.  Films
13.5.1.  Every  effort  should  be  made  to  obtain  and  use  currently  existing  films  for  correlation
purposes.  If correlative plain film imaging is unavailable, or too old to be of use, but plain
film imaging is considered necessary to define the level or extent of an abnormality, it may
be carried out (but this should not be a routine procedure).  The reason for adding the films
must be included in the Imaging Report. This can include, but is not limited to, weight
Released bearing films for knee injuries.
13.5.2.  If hard copy films or digital images are not kept on file by the Supplier, the Supplier will
keep a record of where the films have been sent.
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13.6.  Image Quality
13.6.1.  If an imaging procedure is incomplete, or technically inadequate for interpretation, ACC
will not be charged for the procedure until a technically satisfactory examination has been
completed or a reasonable explanation has been provided.
13.7.  Reporting Quality
13.7.1.  The Supplier shall supply the Imaging Report in accordance with ACC’s requirements set
out in Clause 13.1 of this Service Schedule. Within 12 months of receiving the Imaging
Report, ACC may inspect and examine it to ensure that it meets the requirements in Clause
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13.1.
13.7.2.  If ACC informs the Supplier in writing that ACC reasonably believes that any part of the
Imaging Report does not meet the requirements under Clause 13.1 or differs in any way
from those requirements, and this is other than as a result of a default on the part of ACC
Act
or  the  Client,  the  Supplier  shall  at  its  own  expense  re-issue  the  Imaging  Report  in
accordance with the requirements of Clause 13.1 within such reasonable time as may be
specified by ACC.
13.7.3.  If the Supplier has not re-issued an Imaging Report within the timeframes specified by
ACC that meets the requirements under Clause 13.1, then ACC may at its sole discretion:
13.7.3.1.  Dispute the validity of the invoice to which the Imaging Report relates; and/or
13.7.3.2.  Recover  the  sum  of  money  paid  to  the  Supplier  for  the  Imaging  Report  by
deducting that sum from any sum then due, or at any later time may become due
to ACC under this Service Schedule.
13.7.4.  If an invoice is disputed by ACC under Clause 13.7 then both parties must continue to
Information
perform their other obligations under this Service Schedule.
13.8.  The Supplier will provide reports and invoices to ACC in accordance with Table 3 – Reporting
Requirements:
Table 3 – Reporting and Invoicing Requirements
Information
Frequency
When
Responsibility
Official
Imaging Reports
Following completion of  Within 5 working days of
Supplier
service
completion of service
Invoice
Following completion of  Within 1 month of the service
Supplier
the
service
provision
14.
OPERATIONAL CONTACT
14.1.  During the Term of this Agreement the Supplier will nominate a person (as specified in Clause 5
of the Quick Reference Information in Part A of this Service Schedule) to be the main contact for
under
ACC who will:
14.1.1.  Have primary responsibility for relationships with ACC and the operation of this Service
on a day to day basis;
14.1.2.  Be proactive in informing ACC of issues with provision of Services as outlined;
14.1.3.  Raise issues and suggest solutions regarding this Service;
14.1.4.  Ensure that the Service is operated in accordance with this Service Schedule;
14.1.5.  Represent the Supplier in discussions on performance; and
14.1.6.  Ensure that ACC is advised promptly when the person’s contact details change.
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15.
RELATIONSHIP MANAGEMENT
15.1.  To ensure the continuing effective operation of the service, formal working relationships are to be
maintained as defined in Table 2 - Relationship Management at Clause 4 of Part A.
16.
PAYMENT AND INVOICING
16.1.  Service prices are defined for this Service in Table 1 Service Items and Prices at Clause 3 of Part
A.
1982
16.2.  ACC agrees to pay the prices set out in Table 1 – Service Items and Prices for Services provided in
accordance with this Agreement.
16.3.  Prices of Two or More Procedures performed on the Same Day using the same modality.
Act
16.3.1.  Most procedures have a ‘primary’ and a ‘secondary’ service item code. The secondary
codes are differentiated with a suffix of ‘A’.
16.3.2.  When more than one procedure from the same modality is undertaken on the same day on
a client (against the same or multiple claim numbers), no more than one procedure shall be
invoiced using a primary code (unless Clause 16.3.4 applies). All additional procedures
must be invoiced using the appropriate secondary code.
16.3.3.  If more than one procedure from the same modality is carried out on the same day on a
client, the total price will be:
16.3.3.1.  The price of the most expensive Procedure (or if the prices of all the Procedures
Information
are equal, the price of the first Procedure carried out); plus
16.3.3.2.  The price  of  each  of the  other  Procedure(s)  calculated  using  the ‘secondary
code’ for the procedure.
16.3.4.  Procedures that do not have a ‘secondary’ service item code should always be invoiced
using the primary code.
16.3.5.  Where more than one procedure from different modalities is undertaken on the same day
Official
on a client, both procedures can be invoiced at the full price (using the primary code).
16.4.  No Additional Charge to ACC for After Hours Attendance
16.4.1.  Services under this Agreement are not deemed to be acute. ACC expects that Services will
the
be provided to Clients within the hours of 8.30am – 5.00pm, Monday to Friday.  ACC will
not pay for any after hours charge.
16.5.  No Additional Fees
16.5.1.  The prices set out are the entire amount chargeable to ACC in relation to the Services and
under
no additional amount may be charged to ACC, the Client or other person for Services under
this agreement, except in the following circumstance:
16.5.1.1.  If a Client wishes to receive Services outside the hours specified in Clause 16.4
above, the Supplier may charge that Client a reasonable co-payment if, and only
if, the Supplier has obtained the Client’s agreement to the co-payment prior to
the provision of the Services.
16.5.1.2.  ACC will not have any liability to the Supplier for failure of any Client to pay
any such co-payment charged by the Supplier.
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16.6.  Work Related Gradual Process Injury
16.6.1.  Where a Work-Related Gradual Process Injury (WRGPI) claim is made, a decision about
cover will be made following an investigation. Prior to a WRGPI cover decision, ACC will
cover  the  costs  of  investigating  and  deciding  cover.  This  will  include  any  diagnostic
imaging required (provided it does not require prior approval).
16.6.2.  If as a result of investigation, cover for the WRGPI claim is declined, payment of treatment
costs ends. ACC will only contribute towards the cost of treatment that does not require
prior approval and was incurred from the time the ACC45 was completed to the time the
decline cover decision was made (this timeframe may be extended at ACC’s discretion). 1982
16.7.  GST Invoice
16.7.1.  In addition to the invoicing requirements outlined in Clause 10 of the Standard Terms and
Conditions the Supplier will provide an invoice that:
Act
(a)
is  provided  on  an  applicable  bulk  billing  schedule  for  all  High  Tech  Imaging
Services provided under this Service Schedule, and
(b)
specify  the  Service  Provider  who  was  primarily  responsible  for  the  Services
provided to the Client
16.7.2.  The Supplier must invoice ACC directly for High Tech Imaging Services provided, and
ACC will not accept invoices from subcontractors of the Supplier or from Service Providers
(other than the Supplier).
Information
(a)
Payments of complying schedules and invoices will be made in accordance with
this Service Schedule and will be direct credited into the Supplier’s nominated bank
account  provided  the  Supplier  has  complied  with  all  its  obligations  under  this
Service Schedule.
17.
DEFINITIONS AND INTERPRETATION
Official
“Maximum Waiting Times” means the maximum period of time within which certain Service
components are to be provided, as specified in Part B, Clause 8;

the
“Modality” means one form of radiology therapy as opposed to another, for example, MRI, CT or
Bone Scintigraphy;

“Procedure” means a radiological procedure or service;

“Radiologist”  means  a  registered  medical  practitioner  who  holds  a  licence,  appropriate  to  the
under
treatment for which payment is sought, under the Radiation Protection Act 1965;

“Referrer” means the Specialist who requests the service for the Client, and

“Referrer” and “Referral” have a corresponding meaning;

“Specialist”  means  a  Medical  Practitioner  (other  than  a  General  Practitioner)  who  holds  or  is
deemed  to  hold  vocational  registration  relevant,  (or,  in  the  reasonable  opinion  of  a  General
Practitioner, likely to be relevant), to the injury suffered or apparently suffered by the Client.  In
Released
the  context  of  this  Agreement,  a  Specialist  includes  a  vocationally  registered  Sports  Medicine
practitioner or musculoskeletal practitioner.
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