PHI 19/12

This circular issued by the Private Health Insurance Branch contains information about the Amendment to the Private Health Insurance (Prostheses) Rules 2012 (No. 1)

Page last updated: 22 March 2012

Printable version of 19/12 (PDF 67 KB)

22 March 2012

Amendment to the Private Health Insurance (Prostheses) Rules 2012 (No. 1)

Purpose

The purpose of this Circular is to inform stakeholders of:
  • Errors identified on the Private Health Insurance (Prostheses) Rules 2012 (No. 1) that commenced on 3 March 2012. These errors include the inadvertent removal of one billing code, inaccurate description of fifteen items; five omissions from the deletion report, and omission of transfer of sponsorship for one product for the February 2012 Prostheses List. An Amendment to the Private Health Insurance (Prostheses) Rules 2012 (No. 1) is currently being drafted and is scheduled to commence on 9 April 2012.
Amendment to Part A

The Amendment Rules will amend Part A of the Schedule to the Rules by:
  • Reinstating billing code:
  • DY 538 Healix Anchor System, Johnson and Johnson (due to a publishing error).
  • Changes (noted in bold) to the descriptions of the items in the table below:
Billing Code
Assessment Body
Product Group
Product Sub-Group
Suffix
Product Name
Description
Size
Benefit Amount
SN801
6.3 - SKELETAL RECONSTRUCTION
6.3.3 - Plates
6.3.3.4 - Small (screw size 2.71mm – 4.49mm)(including blade) ≤ 6 holes
COM
Peri-Loc3.5mm Recon Plates > 7 to < 15 holes$625
EO072
6.3 - SKELETAL RECONSTRUCTION
6.3.4 Screws
6.3.4.4 Micro (< 2.0mm)
DT,LK
APTUS ScrewsAPTUS locking Screws1.5mm – 2.0mm Diameter$297
EO073
6.3 - SKELETAL RECONSTRUCTION
6.3.4 Screws
6.3.4.3 Mini (2.01 – 2.7mm)
DT,LK
APTUS ScrewsAPTUS locking Screws2.5mm Diameter$423
EO074
6.3 - SKELETAL RECONSTRUCTION
6.3.4 Screws
6.3.4.2 Small (2.71mm – 4.49mm)
DT,LK
APTUS ScrewsAPTUS locking Screws2.8mm – 3.5mm Diameter$351
SK538
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.4.4 - Small (screw size 2.71mm – 4.49mm)(including blade)> 6 holes.
LK
Stryker Plating SystemLocking Compression Anatomical Shape2 to 6 hole$495
SK539
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.3.5 - Small (screw size 2.71mm – 4.49mm)(including blade)> 7 holes to < 15 holes.
LK
Stryker Plating SystemLocking Compression Anatomical Shape7 to 14 holes$564
SK540
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.4.4 - Small (screw size 2.71mm – 4.49mm)(including blade)> 6 holes
LK
Stryker Plating SystemLocking Reconstruction Plate4.0mm, 4-6 hole$495
SK541
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.3.5 - Small (screw size 2.71mm – 4.49mm)(including blade)> 7 holes to < 15 holes.
LK
Stryker Plating SystemLocking Reconstruction Plate4.0mm,7 - 14 hole$564
SK542
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.4.4 - Small (screw size 2.71mm – 4.49mm)(including blade)> 6 holes
LK
Stryker Plating SystemLocking One Third Tubular Plates3.0mm,2 - 6 hole$495
SK543
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.3.5 - Small (screw size 2.71mm – 4.49mm)(including blade)> 7 holes to < 15 holes.
LK
Stryker Plating SystemLocking One Third Tubular Plates3.0mm,2 - 6 hole$564
DY020
11.4 ACCESORIES
11.4.18 - Screw
SCROM Trochanteric Washer ScrewTitanium, attaches washer to calcar replacement stem42mm,52mm and 62mm$200
JJ712
6.3 - SKELETAL RECONSTRUCTION
6.3.3 -Plates
6.3.3.5 - Small (screw size 2.71mm – 4.49mm)(including blade)> 7 holes to < 15 holes.
LK
ALPS – Anatomic Locked Plating System3.5mm titanium plates7 to 15 holes$564
DY400
6.2 – UPPER LIMB
6.2.2 Finger Joint Articulations
6.2.2.4 – Other fingers, interphalangealNeuflex FingerNeuflex PIP1 to 20$1600
DP868
6.3 - SKELETAL RECONSTRUCTION
6.3.4 Screws
6.3.4.2 Small (2.71mm – 4.49mm)
CN, DT
Barouk Screw SystemBarouk Screw - Titanium10 – 34mm Length$421
DE370
6.3 - SKELETAL RECONSTRUCTION
6.3.4 Screws
6.3.4.2 Small (2.71mm – 4.49mm)
CN
Cannulated Titanium Low Profile Screws, SmallCannulated Titanium Low Profile Screws, Small3 - 3.75mm$91
  • Correcting the deletion report with an additional 5 deletions as follows:
    Billing CodeDeletion
    SN146 Requested by sponsor
    SN708Requested by sponsor
    SN709Requested by sponsor
    SN032Requested by sponsor
    SN437Requested by sponsor
  • One transfer
    Billing CodeTransfer
    DY550Transfer sponsorship from Johnson & Johnson Medical Pty Ltd to Finsbury Orthopaedics Australia Pty Ltd
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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