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PHI 66/11

This circular issued by the Private Health Insurance Branch contains information on Amendment to the Private Health Insurance (Prostheses) Rules 2011 (No.2)

Printable version of 66/11 (PDF 29 KB)

12 September 2011

Amendment to the Private Health Insurance (Prostheses) Rules 2011 (No.2)

Purpose

The purpose of this Circular is to inform stakeholders of an amendment to the Private Health Insurance (Prostheses) Amendment Rules (No. 2). The amended Private Health Insurance (Prostheses) Amendment Rules (No. 2) was registered on 2 September 2011 and commenced on 5 September 2011.

Amendments to Part A

The Amendment Rules amend Part A of the Schedule to the Rules as follows:

adding two (2) new items:

Billing Code	Product Name	Description	Size	Group	Sub-Group	Suffix	Min Benefit	Max Benefit
SM079	TC (Tri Compartment) PLUS Knee System Femoral and Tibial Stems	Femoral and Tibial Stems, Cemented, CoCr	80-150	12.11.10 - Stems - straight or offset	-	-	$1,258.00	-
BS198	Uphold™ LITE Vaginal Support System	Synthetic polypropylene mesh assemblies and fixation device	One Configuration	Group 4 - Urogenital - Reconstructive Material	Group 4a - Reconstructive Material : synthetic	k	$1,322.00	$1,333.00

changing the ‘Group’ (Group, Sub-Group or Suffix) of thirteen (13) items:

Billing Code	Product Name
OO035	Bi-polar head
OH398	Furlong Hemi Range
GO019	UniSyn Hip Connecting Nut
EA006	Buechel-Pappas Ultracoat Total Knee Replacement System (Primary and Revision)
EA013	Buechel-Pappas Ultracoat Total Knee Replacement System Femoral Component
EA023	Buechel-Pappas Ultracoat Total Knee Replacement System Femoral and Tibial Stems
EA024	Buechel-Pappas Ultracoat Total Knee Replacement System Rebar Screws
EA008	Buechel-Pappas Ultracoat Total Knee Replacement System Tibial Baseplate
EA015	Buechel-Pappas Ultracoat Total Knee Replacement System Tibial Baseplate
EA010	Buechel-Pappas Ultracoat Total Knee Replacement System Tibial Insert
EA012	Buechel-Pappas Ultracoat Total Knee Replacement System Patellar Component
EA011	Buechel-Pappas Ultracoat Total Knee Replacement System Patellar Component
JJ736	Confidence Spinal cement system

deleting the ‘Maximum Benefit’ of $1,800.00 for one (1) item:

Billing Code	Product Name
SX051	OsseoFix+ System

changing the ‘Size’ of three (3) items:

Billing Code	Product Name
SN273	Echelon/Spectron
SN271	Echelon
DY556	Expedium Spine System

changing the ‘Description’ of four (4) items:

Billing Code	Product Name
SN271	Echelon
JJ833	Delta Shoulder System
JJ834	Delta Shoulder System
DP956	Delta Shoulder system

changing the ‘Product Name’ of one (1) item:

Billing Code	Amendment
WR132	Product Name changed to 'Profemur R Hip System'

deleting seven (7) Smith & Nephew Surgical Pty Ltd items:

Billing Code	Product Name
SN814	Genesis II Knee System Femoral Component
SN356	Genesis Knee System Tibial Baseplate
SN335	Genesis Uni Tibial Baseplate
SN852	Gen II Mobile Bearing PS Insert
SN371	MOD III Patella Femoral Knee System Trochlear Component
SN063	TC 100 2.7mm Small Fragment (Compression) plates
SM048	UC (Unicompartment) PLUS Solution Knee System Uni Tibial Baseplate

changing the ‘Sponsor Name’ to Smith & Nephew Surgical Pty Ltd for four (4) items:

Billing Code	Product Name
SL002	Genesis II Knee System Tibial Insert
SL003	Profix Knee System Tibial Insert
SL004	VKS (Vario) Knee System Tibial Insert
SL005	Genesis II Knee System Tibial Insert

changing the ‘Suffix’ associated with Sub Group – 12.1.3.3 – Totally Constrained:

Old Suffix	New Suffix
REV	Revision

Further information relating to the Private Health Insurance (Prostheses) Amendment Rules (No. 2) is available at the ComLaw website.

The updated Private Health Insurance (Prostheses) Rules 2011 (No.2) is available at the Health and Ageing's Prostheses List webpage.

Enquiries

If you have any enquiries about the application forms or the applications process, please contact the Prostheses Section, Department of Health and Ageing, on (02) 6289 9463 or via email to Prostheses.

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 2011 Private Health Insurance (PHI) Circulars.

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