Addition of cardiac and vascular drug eluting balloon catheters
The Minister for Health and Aged Care has given in-principle approval to the addition of two new groups for the cardiac and vascular drug eluting balloon catheters to the Part C criteria for listing stated in the Private Health Insurance (Prostheses) Rules (the Prostheses Rules).
Cardiac and vascular drug eluting balloon catheters are not-implantable devices and therefore are not eligible for listing on Part A, but they are considered to be interchangeable with and deliver similar outcomes to implantable drug eluting stents and therefore expansion of the PL Part C criteria for listing for these devices has been agreed.
The Department is also working on assessment of the benefits for these devices.
Sponsors of cardiac and vascular drug eluting balloon catheters may now submit Prostheses List applications for listing their devices on the Prostheses List, and such applications will undergo assessment of the comparative clinical effectiveness as per the usual practice before any decisions may be made regarding the listing on the PL.
Sponsors can apply via the Prostheses List Management System (PLMS).
Deletion of billing codes from part B
Billing codes appearing in Part B of the March 2023 Prostheses List under The Eye Bank of South Australia [SAE01 (Cornea), SAE02 (Sclera) and SAE03 (Cornea for Endothelial Keratoplasty] are redundant and stakeholders are advised not to use them.
The Department has become aware about the technical glitch in the Prostheses List Management System (PLMS) and will be processing a deletion of these billing codes from the PL in July 2023.
The Southern Adelaide Local Health Network Incorporated has now listed the human tissue items under the billing codes SAA01 (Cornea), SAA03 (Sclera) and SAA02 (Cornea for Endothelial Keratoplasty) with the correct benefits.
Stakeholders are advised to contact the Southern Adelaide Health Network Incorporated if they have any questions concerning these human tissue items.