PHI 57/12

This circular issued by the Private Health Insurance Branch contains information about the August 2012 Prostheses List

Page last updated: 29 August 2012

Printable version of 57/12 (PDF 103 KB)

29 August 2012

Amendment to the Private Health Insurance (Prostheses) Amendment Rules 2012(No. 3)

Purpose

The purpose of this Circular is to inform stakeholders of an amendment to the Private Health Insurance (Prostheses) Rules (No. 2). The amended Private Health Insurance (Prostheses) Amendment Rules (No. 3) will commence on 30 August 2012. The amended rules will be available on the departments website.

Amendments to Part A

The Amendment Rules amend Part A of the Schedule to the Rules as follows:
  • Add one (1) new item:
    Billing Code
    Sponsor
    Product Name
    Description
    Size
    Minimum
    Benefit
    AC082
    Atrium Australia – Pacific Rim Pty LtdInterflow Ultrathin Radially SupportedePTFE vascular graft with radial support6-8mm x 40cm$1,520
  • Reinstate two (2) items:
    Billing Code
    Sponsor
    Product Name
    Description
    Size
    Minimum
    Benefit
    SJ288
    St Jude Medical Australia Pty LtdAnchor (Butterfly)Lead Anchor (Butterfly)One size only$168
    SY249
    Synthes Australia Pty LtdAO/ASIF K Wires, Pins, Washers – Steel/Ti Sterile & Non SterileHybrid Pins – Spade point wires/reduction wires1.5, 2.0mm Diameter$129
  • Delete four (4) billing codes:
    Billing Code
    SponsorProduct Name
    SJ228St Jude Medical Australia Pty LtdInterflow Ultrathin Radially Supported
    AC081Atrium Australia – Pacific Rim Pty LtdAnchor (Butterfly)
    SP051Surgiplas MedicalCONTOUR Hand Screws
    SP052Surgiplas MedicalCONTOUR Hand
  • Change the ‘Minimum Benefit’ from $4,100 to $3,700 for one (1) item:
    Billing CodeSponsorProduct Name
    GO007Global Orthopaedic TechnologyRBK Total Knee System Femoral Component
  • Change ten (10) billing codes from National Surgical Corporation Pty Ltd to National Surgical Pty Ltd due to incorrect transfer:
    Previous Billing Code
    New
    Billing Code
    Product Name
    Description
    Size
    Minimum

    Benefit
    NI159NK006Fortex Pedicle Screw System – Pedicle ScrewPolyaxial pedicle screw4.75, 5.5, 6.5, 7.5, 8.25mm diameter. 30, 35, 40, 45, 50, 55mm lengths.$1,330
    NI160NK007Spider Cervical Plating System – Spider ScrewTitanium, Self Tapping and Self Drilling4.0 – 4.25mm, lengths 12-16mm$200
    NI161NK008Calix Interbody SpacerCervical cage, PEEKHeights 5-12mm. Lordotic and Convex$2,503
    NI162NK009Calix Peek Lumbar SystemPeek lumbar interbody spacer for fusion of the lumbar spine using an anterior, posterior or transverse approach.36mm x 24mm x 8mm x 8deg, 36mm x 24mm x 10mm x 8deg, 36mm x 24mm x 12mm x 8deg, 36mm x 24mm x 14mm x 8deg, 36mm x 24mm x 16mm x 8deg, 36mm x 24mm x 18mm x 8deg, 36mm x 24mm x 20mm x 8deg, 36mm x 24mm x 8mm x 12deg, 36mm x 24mm x 10mm x 12deg, 36mm x 24mm x 12mm x 12deg, 36mm x 24mm x 14mm x 12deg, 36mm x 24mm x 16mm x 12deg, 36mm x 24mm x 18mm x 12deg, 36mm x 24mm x 20mm x 12deg, 28mm x 10mm x 6mm, 28mm x 10mm x 7mm, 28mm x 10mm x 8mm, 28mm x 10mm x 9mm, 28mm x 10mm x 10mm, 28mm x 10mm x 11mm, 28mm x 10mm x 12mm, 28mm x 10mm x 13mm, 28mm x 10mm x 14mm, 28mm x 10mm x 15mm, 28mm x 10mm x 16mm, 22mm x 10mm x 6mm, 22mm x 10mm x 7mm, 22mm x 10mm x 8mm, 22mm x 10mm x 9mm, 22mm x 10mm x 10mm, 22mm x 10mm x 11mm, 22mm x 10mm x 12mm, 22mm x 10mm x 13mm, 22mm x 10mm x 14mm, 22mm x 10mm x 15mm, 22mm x 10mm x 16mm, 26mm x 10mm x 6mm, 26mm x 10mm x 8mm, 26mm x 10mm x 10mm, 26mm x 10mm x 12mm, 26mm x 10mm x 14mm, 26mm x 10mm x 6mm x 5o, 26mm x 10mm x 8mm x 5o, 26mm x 10mm x 10mm x 5o, 26mm x 10mm x 12mm x 5o, 26mm x 10mm x 14mm x 5o$3,000
    NI163NK010Fortex Pedicle Screw Set Screw Pedicle Screw Set3.1mm height$170
    NI164NK011Capless LI Pedicle screw system – X Link cross connector – FixedTitanium, lowprofile transverse crossconnectorLow profile, multiple sizes, 25-35mm$400
    NI165NK012Capless LI Pedicle screw system – X Link cross connector – VariableTitanium, lowprofile transverse dual articulation crossconnectorLow profile, Multiple sizes, 37-80mm$1,350
    NI166NK013Spider Cervical Plating System – Spider PlateTitanium, Anterior Cervical Plate System22-54mm$1,400
    NI167NK014Spider Cervical Plating System – Spider PlateTitanium, Anterior Cervical Plate System56-77mm$1,700
    NI168NK015Capless Li Pedicle screw system – rodTitanium rod. Straight and pre-bentStraight and pre-bent, multiple sizes, 40-300mm$443
If you require further information please telephone: (02) 6289 9853/24 hr answering machine or email the enquiry to Private Health Insurance Branch

For more information visit 2012 Private Health Insurance (PHI) Circulars.

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