Referral guidelines

Shoulder & knee ultrasound

Item	Description
55808	Shoulder or upper arm Where the service is provided, for the assessment of one or more of the following conditions or suspected conditions: evaluation of injury to tendon, muscle or muscle/tendon junction; or rotator cuff tear/calcification/tendinosis (biceps, subscapular, suspraspinatus, infraspinatus); or biceps subluxation; or capsulitis and bursitis; or evaluation of mass including ganglion; or occult fracture; or acromioclavicular joint pathology. Benefits are not payable when referred for non-specific pain alone.
55828	Knee Where the service is provided for the assessment of one or more of the following conditions or suspected conditions: abnormality of tendons or bursae about the knee; or meniscal cyst, popliteal fossa cyst, mass or pseudomass; or nerve entrapment, nerve or nerve sheath tumour; or injury of collateral ligaments. Benefits are not payable when referred for non-specific pain alone and including meniscal or cruciate ligament tears and assessment of chondral surfaces.

Item

Description

55808

Shoulder or upper arm

Where the service is provided, for the assessment of one or more of the following conditions or suspected conditions:

evaluation of injury to tendon, muscle or muscle/tendon junction; or
rotator cuff tear/calcification/tendinosis (biceps, subscapular, suspraspinatus, infraspinatus); or
biceps subluxation; or
capsulitis and bursitis; or
evaluation of mass including ganglion; or
occult fracture; or
acromioclavicular joint pathology.

Benefits are not payable when referred for non-specific pain alone.

55828

Knee

Where the service is provided for the assessment of one or more of the following conditions or suspected conditions:

abnormality of tendons or bursae about the knee; or
meniscal cyst, popliteal fossa cyst, mass or pseudomass; or
nerve entrapment, nerve or nerve sheath tumour; or
injury of collateral ligaments.

Benefits are not payable when referred for non-specific pain alone and including meniscal or cruciate ligament tears and assessment of chondral surfaces.