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)

Page last updated: 02 November 2012

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
SM079TC (Tri Compartment) PLUS Knee System Femoral and Tibial StemsFemoral and Tibial Stems, Cemented, CoCr80-15012.11.10 - Stems - straight or offset--$1,258.00-
BS198Uphold™ LITE Vaginal Support SystemSynthetic polypropylene mesh assemblies and fixation deviceOne ConfigurationGroup 4 - Urogenital - Reconstructive MaterialGroup 4a - Reconstructive Material : synthetick$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
REVRevision
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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