Attachment A

Schedule - Amendments

Page last updated: 21 February 2014

Printable version of Attachment A (PDF 136 KB)

Schedule – Amendments

Private Health Insurance (Prostheses) Rules 2014 (No. 1)

1. Schedule, Part A, billing codes, BX296, BX297, BX298, BX299, BX300, BX301, BX302, BX303, BX304, BX305, BX306 and BX307

delete the contents of items 1 to 12 of the table from the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1BX296Actifuse Shape 1.6ml–Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft1.6mL
$760.00
2BX297Actifuse Shape 2.6ml–Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft2.6mL
$760.00
3BX305Actifuse Microgranules 2.5ml–Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft2.5mL
$760.00
4BX306Actifuse Microgranules 5ml–Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft5mL
$760.00
5BX299Actifuse Shape 8.0ml –Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft8.0mL
$1,200.00
6BX301Actifuse Granules 10ml–Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft10mL
$1,200.00
7BX304Actifuse Easy Prep –Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft10ml
$1,200.00
8BX307Actifuse Microgranules –Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft10mL
$1,200.00
9BX298Actifuse Granules –Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft20mL
$1,500.00
10BX300ACTIFUSE SHAPE15.8ml –BONE MATRIX IMPLANT ARTIFICIALA silicate substituted synthetic bone graft15.8mL
$1,500.00
11BX302Actifuse Granules –Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft5mL
$1,500.00
12BX303Actifuse Granules 40ml–Bone Matrix Implant ArtificialA silicate substituted synthetic bone graft40mL
$1,560.00

2. Schedule, Part A, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153 and MI141, after entry for billing code WC295

delete the subheadings:
8.14.01 – Implantable Cardiac Event Recorders
Biotronik Australia Pty Ltd
i
Medtronic Australasia Pty Ltd
delete the contents of item 1 of the table from the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1BT153BioMonitorImplantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope53.3mm x 42.7mm x 7.1mm, 26 grams$3,900.00
2MI141Reveal LINQInsertable Cardiac Monitor45 x 7 x 3.5mm, 1.18cc$3,900.00

3. Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After subheading 8.14.01 – Implantable Cardiac Event Recorders,

insert the subheading “Biotronik Australia Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1BT153BioMonitorImplantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope53.3mm x 42.7mm x 7.1mm, 26 grams$3,900.00

4. Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After entry for billing code BT153,


insert the subheading “i”
insert the subheading “Medtronic Australasia Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1MI141Reveal LINQInsertable Cardiac Monitor45 x 7 x 3.5mm, 1.18cc$3,900.00

5. Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,

delete the subheading “Orthopaedic Solutions Pty Ltd”
delete the contents of item 1 of the table from the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1OE029BIOProfile Pyrocarbon Carpometacarpal ImplantsLow Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)Small, Medium, Large & Extra Large$884.00

5. Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,


insert the subheading “Tornier Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1TO149BIOProfile Pyrocarbon Carpometacarpal ImplantsLow Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)Small, Medium, Large & Extra Large$884.00

6. Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO044,

insert the contents of item 1 of the table in the columns indicated:
ItemBilling CodeProduct DescriptionSizeMinimum benefit
1SO049FCI MasterkaSelf-retaining monocanalicular nasal intubation WITHOUT nasal retrieval30mm to 40mm$180.00