Private Health Insurance (Prostheses) Rules 2012 (No. 2) (Cth)

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Private Health Insurance (Prostheses) Rules 2012 (No. 2)

As amended

Made under item 4 of the table in section 333-20 of the Private Health Insurance Act 2007.

This compilation was prepared on 18 February 2013 taking into account amendments up to and including the Private Health Insurance (Prostheses) Amendment Rules 2013 (No.2).

Prepared by the Department of Health and Ageing, Canberra

Contents

Part 1 Preliminary 3

1. Name of Rules 3

2. Commencement 3

3. Revocation 3

4. Definitions 3

Part 2 Benefit requirements 5

5. Listing of, and benefits for, prostheses 5

5A. Circumstances in which a prosthesis is provided other than circumstances in which a medicare benefit is payable 6

5B. Conditions in relation to provision of listed prostheses 6

6. Benefits for prostheses provided as part of hospital treatment 6

7. Benefits for prostheses provided as part of hospital-substitute treatment 7

Part 3 Other 8

8. Timing of applications to have a prosthesis listed 8

9. Minister may have regard to recommendations and advice 8

10. Listing criteria for prostheses to be listed in Part C of the Schedule 8

Part 1Preliminary

  1. 1.

    Name of Rules

These Rules are the Private Health Insurance (Prostheses) Rules 20 12 (No.2).

2.

Commencement

These Rules commence on 30 August 2012.

3.

Revocation

These Rules revoke the Private Health Insurance (Prostheses) Rules 2012 (No. 1).

  1. 4.

    Definitions

In these Rules:

accredited podiatrist means a podiatric surgeon who holds specialist registration in the specialty of podiatric surgery under the National Law.

Note: The registration requirements for an accredited podiatrist for the purposes of these Rules are the same registration requirements for podiatric surgeons as set out in rule 8 of the Private Health Insurance (Accreditation) Rules.

Act means the Private Health Insurance Act 2007.

certified overnight Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.

certified Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.

consultant physician has the same meaning as in subsection 3(1) of the Health Insurance Act 1973.

gap permitted prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and a different amount is set out in the column under the heading 'Maximum Benefit'.

implantable cardiac event recorderincludes a component of an implantable cardiac event recorder.

insulin infusion pump includes a component of an insulin infusion pump.

listed prosthesis means a kind of prosthesis listed in the Schedule to these Rules.

listing application has the same meaning as in subsection 72-10(6) of the Act.

listing criteriahas the same meaning as in subsection 72-10(6) of the Act.

National Law means:

(a) for a State or Territory other than Western Australia — the Health Practitioner Regulation National Law set out in the Schedule to the Health Practitioner Regulation National Law Act 2009 (Qld)as it applies (with or without modification) as law of the State or Territory; or

(b) for Western Australia — the legislation enacted by the Health Practitioner Regulation National Law (WA) Act 2010 that corresponds to the Health Practitioner Regulation National Law.

Note: The Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions that was made on 26 March 2008 provides for the enactment of the State and Territory legislation mentioned in this definition.

no gap prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and no amount is set out in the column under the heading 'Maximum Benefit'.

private hospital means a hospital in respect of which there is in force a statement under subsection 121-5 (8) of the Act that the hospital is a private hospital.

Note: Section 15 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals withthe status ofcertainhospitals for which a declaration had been made before the commencement of the Act.

professional attendance has the same meaning as in clause 1.2.3 of the General Medical Services Table being the table prescribed under section 4 of the Health Insurance Act 1973.

professional service has the same meaning as in subsection 3(1) of the Health Insurance Act 1973.

public hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a public hospital.

Note: Section 15 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals withthe status ofcertainhospitals for which a declaration had been made before the commencement of the Act.

Schedule means the Schedule in these Rules.

Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the Legislative Instruments Act 2003. These terms include:

complying health insurance policy

hospital-substitute treatment

hospital treatment

medicare benefit

Part 2Benefit requirements

  1. 5.

    Listing of, and benefits for, prostheses

For item 4 of the table in subsection 72-1 (2) of the Act:

  1. (a)

    the Schedule lists the kinds of prostheses:

    1. (i)

      in relation to which the Minister has granted an application for listing under subsection 72-10 (5) of the Act; or

    2. (ii)

      which are listed in accordance with section 12 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007; and

      Note: Section 12 of the Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals with the listing of a prosthesis that was a no gap prosthesis or a gap permitted prosthesis for the purposes of the National Health Act 1953 immediately before the commencement of the Act.

(aa) circumstances in which a listed prosthesis is provided for the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5A; and

(ab) conditions that must be satisfied in relation to the provision of a listed prosthesis for the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5B; and

  1. (b)

    rule 6 sets out the method for working out the minimum benefit and maximum benefit for hospital treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis; and

  2. (c)

    rule 7 sets out the method for working out the minimum benefit and maximum benefit for hospital-substitute treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis.

5A.Circumstances in which a prosthesis is provided other than circumstances in which a medicare benefit is payable

For the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) of the Act, the following circumstances are set out:

(a) the provision of a listed prosthesis which is associated with podiatric treatment by an accredited podiatrist.

Note: Paragraph (c) of Item 4 of subsection 72-1(2) deals with the provision of a listed prosthesis in circumstances in which a medicare benefit is payable.

5B.Conditions in relation to the provision of listed prostheses

For the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) of the Act, conditions that must be satisfied in relation to the provision of a listed prosthesis in the circumstances covered by paragraph (c) or (d) of that item, as the case may be, are:

(a) in relation to any kind of prosthesis where there is a statement of a requirement under the heading 'Condition' in the Schedule under the listing for that kind of prosthesis, that requirement; and

(b) in relation to a listed prosthesis that is an insulin infusion pump, also:

(i) the professional service associated with the provision of the insulin infusion pump must be a professional attendance by a consultant physician in the practice of his or her specialty; and

(ii) the professional service must be provided as a certified Type C procedure or certified overnight Type C procedure; and

(iii) the insulin infusion pump must be provided for the purpose of administering insulin.

Note: Item 4 of the table in subsection 72-1(2) of the Act states other requirements in relation to benefits for the provision of prostheses that a policy that covers hospital treatment must meet. These requirements relate to benefits for hospital treatment and, if the policy covers hospital-substitute treatment, to the benefits of that coverage as well.

6.Benefits for prostheses provided as part of hospital treatment

(1) For a no gap prosthesis provided as part of an episode of hospital treatment by a private hospital, the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.

(2) For a gap permitted prosthesis provided as part of an episode of hospital treatment by a private hospital:

  1. (a)

    the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and

(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.

(3) For a no gap prosthesis provided as part of an episode of hospital treatment by a public hospital:

  1. (a)

    the minimum benefit is the lesser of the following amounts:

    (i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or

    (ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and

    (iii) the maximum benefit is the amount for that prosthesis listed in the column under the heading 'Minimum Benefit'.

(4) For a gap permitted prosthesis provided as part of an episode of hospital treatment by a public hospital:

  1. (a)

    the minimum benefit is the lesser of the following amounts:

    (i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or

    (ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and

    (iii) the maximum benefit is the amount for that prosthesis listed in the column under the heading ‘Maximum Benefit’ in the Schedule.

Note: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.

7.Benefits for prostheses provided as part of hospital-substitute treatment

  1. (1)

    For a no gap prosthesis provided as part of an episode of hospital-substitute treatment the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.

(2) For a gap permitted prosthesis provided as part of an episode of hospital-substitute treatment:

(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and

(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.

Note 1: Private health insurers cannot cover, as part of hospital-substitute treatment, a service for which medicare benefit is payable unless the service is specified in the Private Health Insurance (Health Insurance Business) Rules ― see paragraph 121-10 (3) (a) of the Act.

Note 2: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.

Part 3Other

8.Timing of applications to have a prosthesis listed

As a matter of normal administrative practice, applications made under subsection 72-10 (2) of the Act will be considered after they have been received and, if the Minister decides to grant the application, the kind of prosthesis will be listed in the Schedule the next time the Minister makes or varies the Rules.

Note 1: Under subsection 72-10 (5) of the Act the Minister must list the kind of prosthesis, set out the minimum benefit and, if the Minister considers it appropriate, the maximum benefit for the prosthesis in these Rules on the next occasion that the Minister makes or varies the Rules after he or she grants an application and the applicant has paid to the Commonwealth any initial listing fee within 14 days of being informed of the Minister's decision to grant the application.

Note 2: Under subsection 72-15 (3) of the Act, the Minister may remove a kind of prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee. Minister may have regard to recommendations and advice

  1. 9.

    Note 2:Under subsection 72-15 (3) of the Act, the Minister may remove a kind of prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee. Minister may have regard to recommendations and advice

In making the decision under subsection 72-10 of the Act, the Minister may have regard to a recommendation from the Prostheses List Advisory Committee.

10.

Listing criteria for prostheses to be listed in Part C of the Schedule

For a listing application to be granted to list a kind of prosthesis in Part C of the Schedule, the listing criterion is that the kind of prosthesis is an:

(i) insulin infusion pump; or

(ii) implantable cardiac event recorder.

  1. Note:

    1. The power to make listing criteria is in subsection 72-10(6) of the Act.

  2. 2.

    Under subsection 72-10(7) of the Act the Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.

  3. 3.

    Under the Act the Minister may refuse to grant a listing application even if the listing criteria are satisfied. See Note to subsection 72-10(7) of the Act.

Part A - Prostheses List February 2013

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.1.1 - Aphakic

1.1.1.1 - Rigid

Alcon Laboratories (Aust.) Pty Ltd

AL003 MTA2UO - MTA6UO PMMA +5 to +30 D $156.00

Bausch & Lomb (Australia) Pty Ltd

BL005 Storz (Coburn) Intraocular Lens PMMA Anterior Chamber Intraocular 13.75mm length. 6.0mm $156.00

121UV; L122UV PMMA Anterior lens 1 piece optic size, diopter range 3-

Chamber Lens 30d. L122UV: 6.0mm optic,

13.75mm length, power

range; 5.0 to 30.0 Diopters

Emagin Pty Ltd

EG009 Artisan Anterior Chamber Aphakia ModelComposition: PMMA 5.00mm Optic Diameter x $156.00

Intraocular Lens 8.5 in overall length

ifc

AMO Australia Pty Ltd

AO019 Verisyse AC IOL Aphakic Model 5mm Optic Diameter x 8.5 $250.00

overall length

m

AMO Australia Pty Ltd

AO001 Intraocular Lens: Model AC 51L Duralens PMMA, Anterior Chamber 6.00 mm Optic Diameter x $198.00

IOL 13.0mm in overall length

1.1.2 - Phakic

1.1.2.1 - Rigid

AMO Australia Pty Ltd

AO016 Verisyse AC IOL Phakic Intraocular Lens: Model 5mm Optic Diameter x 8.5 $680.00

Myopia.

Composition: PMMA overall length; 6mm Optic

Diameter x 8.5 overall

AO017 Verisyse AC IOL Phakic Intraocular Lens: Model 5mm Optic Diameter x 8.5 $680.00

Hyperopia.

Composition: PMMA overall length

Prostheses List by Category, Groups and Sponsor Page 1 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Emagin Pty Ltd

EG012 Artisan Anterior Chamber IOL Phakic Intraocular Lens Myopic / 5.00mm Optic Diameter x $680.00

Hyperopic 8.5 in overall length;

t1

AMO Australia Pty Ltd

AO030 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x $1,056.00

7.5mm overall length

Emagin Pty Ltd

EG008 Artisan Anterior Chamber Phakic Intraocular Lens: Model Toric 5.00mm Optic Diameter x $1,056.00

Intraocular Lens Composition: PMMA 7.5 in overall length

t2

AMO Australia Pty Ltd

AO029 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x $1,358.00

7.5mm overall length

1.1.2.2 - Foldable

Alcon Laboratories (Aust.) Pty Ltd

AL034 AcrySof Cachet Phakic Lens Anterior chamber foldable, acrylic, -6.0 to -16.5 diopters, in 0.5 $723.00

single piece phakic lens diopter increments

AMO Australia Pty Ltd

AO025 VeriFlex Foldable Phakic IOL Anterior chamber foldable phakic -2 to -14.5d in 0.5d $723.00

silicone intraocular lens increments. Overall

diameter 8.5mm. Optic

6.0mm

Emagin Pty Ltd

EG010 Artiflex Anterior Chamber Optic: Hydrophobic Polysiloxane. 6mm optic diameter x 8.5 in $723.00

Intraocular Lens Haptic: PMMA overall length

1.2.1 - Rigid

Alcon Laboratories (Aust.) Pty Ltd

AL002 Models MZ60BD, MC50BD, CZ70BD Other:PMMA Range of Powers:-10 to +34 $156.00

D

Prostheses List by Category, Groups and Sponsor Page 2 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Bausch & Lomb (Australia) Pty Ltd

BL006 Posterior chamber IOLS model PMMA Posterior Chamber lens 1 12.25mm to 13.75mm $156.00

P359 UV, P399 UV, 68 UV, 95 length. 5.5mm to 7mm optic

BUV, or lolab PC One Piece, model size, diopter range -4.5 -

6741B, 8591B, 8191B; Model EZE- 45d to 10 - 34d; EZE-Fit

65: 6.5mm optic, 13.35mm

length, Power range: 10.0

to 30.0 Diopter

1.2.2 - Foldable

1.2.2.1 - Microincision

at

Carl Zeiss Pty Ltd

CZ016 CT ASPHINA 409M ZEISS Micro Incision Aaspheric 6mm optic, 11mm overall $364.00

(aberration neutral) IOL: Foldable, diameter. Diopter range 0.0

square-edged, single piece IOL for to +32.0D (0.5D steps from

capsular bag fixation 10.0 to 30.0D, 1.0D outside

this range)

CZ017 CT ASPHINA 509M ZEISS Micro Incision Aspheric 6mm Optic, 11mm overall $364.00

(aberration correcting) IOL: Foldable, diameter. Diopter range 0.0

square-edged, single piece IOL for to +32.0D (0.5D steps from

capsular bag fixation 10.0 to 30.0D, 1.0D outside

this range)

at, pl

Bausch & Lomb (Australia) Pty Ltd

BL026 Akreos AO Micro Incision Lens Micro Incision, posterior chamber, 6mm optic overall diameter $374.00

foldable acrylic, aphakic, anterior & 11.0mm(10D-15D), 10.7mm

posterior edge modification, (15.50-22D), 10.5mm

preloaded, with aberration contro, (22.50-30D)

Carl Zeiss Pty Ltd

CZ028 CT ASPHINA 409MP Preloaded, micro incision, aspheric Diopter range: 0.0 to $374.00

(aberration neutral), foldable square- 32.0D; Optic size: 6.0mm;

edged single piece inraocular lens for Overall length: 11.0mm

capsular bag fixation.

CZ037 CT ASPHINA 509MP Preloaded, micro incision, aspheric Diopter range: 0.0 to + $374.00

(aberration correcting), foldable 32.0D; Optic Size: 6.0mm;

square-edged single-piece intraocular Overall length: 11.0mm

lens for capsular bag fixation

Prostheses List by Category, Groups and Sponsor Page 3 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, pl, t1

Carl Zeiss Pty Ltd

CZ031 AT TORBI 709MP (Standard Bitoric, preloaded, micro incision, Diopter range: Sph -10.0 to $760.00

aspheric (aberration neutral), foldable, 32.0, Cyl +1.0 to 6.5

square-edged, single-piece IOL for Optic size: 6.0mm, Overall

capsular bag fixation length: 11.0mm

at, pl, t2

Carl Zeiss Pty Ltd

CZ032 AT TORBI 709MP (high cyl) Bitoric, preloaded, micro incision, Diopter range: Sph -10.0 to $1,061.00

aspheric (aberration neutral), foldable, 32.0, Cyl +7.0 to 12.0,

square-edged, single-piece IOL for Optic size: 6.0mm. Overall

capsular bag fixation Length 11.0mm

at, t1

Carl Zeiss Pty Ltd

CZ020 AT TORBI 709M STANDARD RANGE BITORIC - 6mm optic, 11mm overall $740.00

ZEISS Micro Incision Aspheric diameter. Diopter range:

(abberation neutral) IOL: Foldable, Sph -10.0 to +32.0D, Cyl

square-edged, single piece IOL for +1.0 to 6.5D (all 0.5D

capsular bag fixation

t2, at

Carl Zeiss Pty Ltd

CZ027 AT TORBI 709M HIGH CYLINDER BITORIC - ZEISS 6mm optic, 11mm overall $1,041.00

Micro Incision Aspheric (aberration diameter. Diopter range:

neutral) IOL: Foldable square edged, Sph -10.0 to +32.0D, +7.0

single piece IOL for capsular bag to 12.0D (all 0.5D steps)

fixation

1.2.2.2 - No edge modification

Ellex Australia Pty Ltd

XE002 Staar foldable silicone intraocular Polyimide haptics 6.3mm optic - low 14.0mm length $281.00

lens: Model AQ 5010V diopters

t1

Ellex Australia Pty Ltd

XE001 Staar Toric foldable silicone Plate haptics 6.0mm optic 10.8mm - 11.2mm length $579.00

intraocular lens: Model AA4203TF;

Model AA4203TL

Prostheses List by Category, Groups and Sponsor Page 4 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.2.2.3 - Edge modification

Alcon Laboratories (Aust.) Pty Ltd

AL004 Acrysof Multipiece Models Foldable Acrylic Multi-piece Lens -5 D to +30 D $322.00

MA50BM, MA60AC

AL011 Acrysof Model SA60AT Foldable Acrylic Single-piece Lens, Range of Powers: +6 to +40 D $322.00

asymmetric optic/consistent edge

AMO Australia Pty Ltd

AO002 Sensar AR40 Monofocal Acrylic Soft Acrylic, Foldable, UV 6 mm Optic Diameter x $322.00

IOL,

Sensar OptiEdge AR40e Absorbing, Posterior 13mm in overall length.

Foldable Acrylic IOL

AO006 Clariflex, Model CLRFLXB Foldable Silicone IOL with OptiEdge One size only $322.00

Posterior Chamber Intraocular Lens design

Bausch & Lomb (Australia) Pty Ltd

BL020 Akreos Adapt acrylic foldable Composition: Hydrophilic acrylic 10.0 to 15.0 Diopter in 1.0 $322.00

posterior chamber intraocular lens polymer. Packaged in lens folding Diopter increments15.0 to

device in a sterile vial.

Four haptic 25.0 Diopter in 0.5 Diopter

design increments25.0 to 30.0

Diopter in 1.0 Diopter

increments

BL021 SoflexSE, Intraocular lenses, Composition: silicone, Lenses - Range of powers: 5.0 to $322.00

Posterior Chamber foldable, posterior chamber 30.0 Diopter - Optic

intraocular lenses diameter 6.0mm; 13.0mm

Carl Zeiss Pty Ltd

CZ029 CT 53N Foldable, 3-piece, monofocal, square- Diopter range: 0.0 to 40.0, $322.00

edged, hydrophilic acrylic (with Optic size: 6.0mm, Overall

hydrophobic surface properties) length: 13.0mm

intraocular lens for capsular bag or

sulcus fixation.

Device Technologies Australia Pty Ltd

DE398 Oculentis LENTIS L-302-1 Foldable one-piece monofocal C loop Optic Size 6.0mm, Overall $322.00

acrylic IOL. Length 12.00mm. +-0.0D to

+35.0D (1.0D steps) and

+15.5D to +26.5D (0.5D

steps).

Prostheses List by Category, Groups and Sponsor Page 5 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Ellex Australia Pty Ltd

XE003 Staar foldable silicone IOLs: Plate haptics 6.0mm; Polymide 10.8mm 0 13.5mm length $322.00

Models AQ2010V, AQ2017V and haptics 5.5 or 6.3mm optic;

Kevin Grundy (IBD) Pty Ltd

KG001 Rayner C-Flex Hydrophilic HEMA-MMA 5.75mm dia optic, 12.00mm $322.00

copolymer, foldable with injector dia overall

KG002 Superflex Hydrophilic HEMA-MMA 6.25mm dia optic, 12.5mm $322.00

copolymer, foldable with injector dia overall

at

AMO Australia Pty Ltd

AO014 TECNIS™ Intraocular Lens (Z9002 Foldable Intraocular Lenses - 5-10 dioptre in 1.0 dioptre $364.00

& ZA9003) Ultraviolet light absorbing posterior increments; 10.5 - 30

chamber intraocular lenses, dioptre in 0.5 increments

Silicone/Acrylic

AO024 Tecnis™ One Piece (ZCB00) One piece intraocular lens with edge +5 diopters to +34 diopters $364.00

modification and 360 degree square in 0.5d increments

edge

Bausch & Lomb (Australia) Pty Ltd

BL022 SofPort Advanced Optic (AO) Posterior chamber, foldable silicone 0 D to 30.0 D $364.00

IOL with anterior optic-haptic square

edge, posteriof optic-haptic square

edge, 360-degree optic square edge

and asperic optic for aberration control

BL023 Akreos Advanced Optic Posterior chamber, foldable acrylic 0 D to 30.0 D $364.00

IOL, with anterior optic-haptic square

edge, posterior optic-haptic square

edge, 360 degree optic square edge

and aspheric optic for aberration

BL030 enVista The enVista, Model MX60, is an ultra- Overall diameter 12.5mm, $364.00

violet-absorbing, posterior chamber, optic body diameter 6.0mm

hydrophobic acrylic one-piece in dioptric powers ranging

intraocular lens (IOL)

Has an from +0.0 to +34D

aspheric lens optic, square posterior 0.0D to 10.0D in 1 Diopter

edge, modified C haptics and available increments

in dioptric powers ranging from +0.0 11.0D to 30.0D in 0.5

to +34.0D. Diopter increments

31.0D to 34.0D in 1

Diopter increments

Prostheses List by Category, Groups and Sponsor Page 6 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Carl Zeiss Pty Ltd

CZ030 CT ASPHINA 404 Small incision, foldable, single piece, Diopter range: -10.0 to $364.00

monofocal, aspheric (aberration 42.0, Optic size: 6.0mm,

neutral), square-edged, hydrophilic Overall length: 11.0mm

acrylic (with hydrophobic surface

properties) intraocular lens for

capsular bag fixation. (Monofocal lens

for powers outside standard 409MP

MICS range).

Device Technologies Australia Pty Ltd

DE399 Oculentis LENTIS L-312 Foldable one-piece monofocal acrylic Optic size 6.0mm, Overall $364.00

C Loop IOL Length 12.00mm. Central

Thickness 1.02mm

(+22.0D). Available

Diopters: -10.0D to35.0D

(1.0D steps). +10.5D to

DE400 Oculentis LENTIS L-313 Foldable one-piece monofocal acrylic Optic size 6.0mm, Overall $364.00

plate haptic

IOL Length 11.00mm. Available

Diopters: +-0.0D to 35.0D

(1.0D steps). +10.5D to

29.5D (0.5D steps)

DE401 Oculentis LENTIS L-402 Foldable three piece monofocal acrylic Optic Size 6.0mm, Overall $364.00

IOL. Length 13.00mm. +-0.0D to

+35.0D (1.0D) + 15.5D to

+26.5D (0.5D). Minus range

on demand.

IQ Medical

IQ004 Softec Acrylic, single piece, foldable Available in dioptric $364.00

intraocular lens with anterior and powers from -5.0 to +36.0,

posterior optic-haptic square edge, 1D steps: -5.0 to +10.0 and

360 degree optic square edge design, +31.0 to +36.0; 0.5D steps:

precision power calculation and +10.5 to +18.0 and +25.0 to

aberration technology +29.5; 0.25D steps: +18.0

to +25.0

IQ010 PreciSAL 302AC Acrylic, single piece, foldable Available in dioptric $364.00

intraocular lens with anterior and powers from 0.0 to +30.0.

posterior optic-haptic square edge, 1D steps: 0.0 to +10.0;

360 degree optic square edge design, 0.5D steps: +10.5 to + 17.5

precision power calculation, and +28.5 to +30.0; 0.25D

aberration technology and UV light steps: +18.0 to +28.0

Prostheses List by Category, Groups and Sponsor Page 7 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Kevin Grundy (IBD) Pty Ltd

KG012 Rayner "C-Flex" and Superflex" Aspheric Intra Ocular Lenses with C-Flex -970C + 22.5D to $364.00

Aspheric IOL Amon-Apple enhanced 360 Degree +34D Superflex-920H - 10D

square edge, Anti-vaulting Haptics to +22D

at, pl

AMO Australia Pty Ltd

AO034 TECNIS® 1-Piece Pre-Loaded IOL 1-piece IOL Posterior Chamber +5.0 to +34.0 diopter $374.00

Intraocular lens, incorporates a powers in 0.5 diopter

proprietary wavefront-designed increments. Overall

aspheric optic with a squared diameter 13mm, Optic size

posterior optic edge designed to

provide a 360 degree barrier. The edge

of the optic has a frosted design to

reduce potential edge glare effects.

Supplied pre-loaded in a screw style

disposable injector.

Ellex Australia Pty Ltd

XE004 Preloaded Aspheric Intraocular Silicone intraocular lens 6.0mm $374.00

at, pl, t1, vblf

Design for Vision Pty Ltd

DV253 HOYA AF-1 351 Toric Preloaded injector system, correct IOL Power: + 10.0 to 30.0 $800.00

T3/T4/T5/T6/T7/T8/T9 corneal astigmatism micro-incision, (0.5 steps), IOL Cylinder

ashperic, blue-blocker, single piece power: 1.50D (351T3),

hydophobic. 2.25D (351T4), 3.00D

(351T5), 3.75D (351T6),

4.50D (351T7), 5.25D

(351T8), 6.00D (351T9)

at, pl, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL024 AcrySert model SN60WS Foldable Acrylic Single-piece Lens +6 to +30 D $405.00

with Blue light protection and

aspheric correction, in cartridge.

AL031 AcrySert C Model SN6CWS Posterior chamber, UV absorbing, +6.0 to +30.0 D $405.00

foldable, acrylic, single piece lens

with blue light protection and

aspheric correction, in cartridge

Prostheses List by Category, Groups and Sponsor Page 8 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Design for Vision Pty Ltd

DV250 Hoya-PS AF-1 (UY) PY-60AD Preloaded in cartridge, Aspheric, Blue +6.0D to +30.0D (0.5D $405.00

blocker, Foldable, Single-Piece,

Hydrophobic Acrylic

DV252 HOYA iSert® 251 Preloaded injector system, Micro- +6.0D to 30.0D (5 steps) $405.00

incision, Aspheric, Blue-Blocker,

Single Piece, Hydrophobic

at, t1

AMO Australia Pty Ltd

AO031 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber +5.0 to +34.0 diopter $740.00

Intraocular lens, incorporates a powers in 0.5 diopter

proprietary wavefront designed toric increments. Cylinder

aspheric optic with a squared power: 1.00 diopter, 1.50

posterior optic edge designed to diopter, 2.25 diopter, 3.00

provide a 360 degree barrier. The edge diopter and 4.00 diopter (as

of the optic has a frosted design to measured at the IOL plane).

reduce potential edge glare effects. Overall diameter 13mm,

Optic size 6mm.

Bausch & Lomb (Australia) Pty Ltd

BL032 enVista Toric The enVista toric (Model MX60T) is a Overall diameter is 12.5mm $740.00

one-piece glistening-free for the entire lens power

hydrophobic IOL. The enVista Toric, range, with spherical

model MX60T IOL has a Toric equivalent powers from +6.0

aspheric lens optic, a square posterior to +30.0 Diopters in 0.5

edge and modified C haptics, an Diopter steps and cylinder

overall diameter of 12.5mm and an powers from +1D to 6D

optic body of 6.0mm.

It is available in Diopters (at the IOL plane).

multiple spherical and cylindrical

powers.

Device Technologies Australia Pty Ltd

DE390 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size 6.0mm, overall $740.00

monofocal toric acrylic IOL length 11.0mm. Sph +/-0.0D

to +35.0D (in 0.01D

increments) Cyl +0.25 to

+6.99D cyl (in 0.01D

increments)

Prostheses List by Category, Groups and Sponsor Page 9 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

DE397 Oculentis LENTIS Tplus LS-313 Foldable one-piece monofocal toric Optic Size 6.0mm, Overall $740.00

T1-T6 acrylic IOL. Length 11.00mm. Available

diopters: +10.0D to +30.0D

(0.5D). Cyl: (T1 +1.5D) (T2

+2.25D) (T3 +3.0D) (T4

+3.75D) (T5 +4.5D) (T6

+5.25D)

at, t1, vblf

Device Technologies Australia Pty Ltd

DE392 Oculentis LENTIS LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall $780.00

monofocal toric acrylic IOL. Violet length 11.00mm. Sph +/-

Light Filter 0.0D to +35.0D (in 0.01D

increments) Cyl +0.25D to

+6.99D cyl (in 0.01D

increments)

at, t2

Device Technologies Australia Pty Ltd

DE391 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall $1,042.00

monofocal toric acrylic IOL length 11.00mm. Sph +/-

0.0D to +35.0D (in 0.01D

increments) Cyl +6.99D to

+12.0D cyl (in 0.01D

increments)

at, t2, vblf

Device Technologies Australia Pty Ltd

DE393 Oculentis LENTIS T plus LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall $1,084.00

monofocal toric acrylic IOL. Violet length 11.00mm. Available

Light Filter. diopters: Cyl +7.00D to

+12.0D inclusive in 0.01D

increments.

at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL021 Alcon AcrySof SN60WF Foldable Acrylic Single-piece Lens + 6.0 D to +30.0 D $385.00

with Blue Light Protection and

Aspheric Correction

Prostheses List by Category, Groups and Sponsor Page 10 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Bausch & Lomb (Australia) Pty Ltd

BL025 SofPort Advanced Optic (AO) Posterior chamber, aphakic, foldable 6mm optic 13mm overall $385.00

Violet Shield silicone, anterior & posterior edge lengthModified C 5

modification intraocular lens with degree angulation 0-30D,

aberration technology, a violet light 0.5D steps

Design for Vision Pty Ltd

DV247 HOYA AF-1 iMics1 NY-60 Mini Incision, Aspheric, Blue- +6.0D to 30.0D (0.5 steps) $385.00

blocker, Single-piece, Hydrophobic

Device Technologies Australia Pty Ltd

DE402 Oculentis LENTIS LS-312Y Foldable one-piece monofocal C Loop Optic Size 6.0mm, Overall $385.00

Acrylic IOL. Violet Light filter. Length 12.0mm. Available

Diopters: +-0.0D to 35.0D

(1.0D steps) +15.5D to

26.5D (0.5D steps).

DE403 Oculentis LENTIS LS-313Y Foldable one-piece monofocal acrylic Optic Size 6.0mm, Overall $385.00

plate haptic IOL. Violet Light Filter Length 11.00mm. Available

Diopters: +-0.0D to 35.0D

(1.0D steps). +15.5D to

26.5D (0.5D steps).

IQ Medical

IQ009 Softec HDY Acrylic, single piece, foldable Available in dioptric $385.00

intraocular lens with anterior and powers from -5.0 to + 36.0,

posterior optic-haptic square edge, 1D steps: -5.0 to +10.0 and

360 degree optic square edge design, +31.0 to +36.0; 0.5D steps:

precision power calculation, +10.5 to +18.0 and +25.0 to

aberration technology and blue light 29.5; 0.25D steps: + 18.0 to

+25.0

IQ011 PreciSAL 302A Acrylic, single piece, foldable Available in dioptric $385.00

intraocular lens with anterior and powers from 0.0 to +30.0.

posterior optic-haptic square edge, 1D steps: 0.0 to +10.0;

360 degree optic square edge design, 0.5D steps: +10.5 to +17.5

precision power calculation, and +28.5 to +30.0; 0.25D

aberration technology and blue light steps: +18.0 to +28.0

pl

Ellex Australia Pty Ltd

XE005 Staar KS-Xs Preloaded Acrylic Preloaded acrylic lens with anterior Optic diameter 6.0mm, $332.00

Intraocular Lens and posterior edge modification overall length 12.5mm,

diopter range +10 to +28.0

Prostheses List by Category, Groups and Sponsor Page 11 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

t1

Bausch & Lomb (Australia) Pty Ltd

BL028 Akreos Toric Astigmatism- Single piece, foldable, acrylic The overall diameter is 11 $698.00

Correcting Lens intraocular lens with a toric optic on millimetres for the entire

the posterior surface and axis marks on lens power range (spherical

the posterior optic's flat meridian. equivalent powers from

+10.0 to +30.0 diopters in

0.5 diopter steps and

cylinder powers of +1.25,

+2.00 & +2.75 diopters).

Kevin Grundy (IBD) Pty Ltd

KG003 Rayner Standard Toric C-Flex Hydrophilic HEMA-MMA 5.00mm dia optic, 12.00mm $698.00

copolymer, foldable with injector dia overall, cyls 2.0D to

6.0D in 2D increments

t1, at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL032 AcrySof IQ Toric IOL Posterior chamber, UV absorbing, +6 to +30 D spherical; 1.00 $780.00

foldable, acrylic, toric, single piece to 6.00 D cylinder.

lens with blue light protection and

aspheric correction

Design for Vision Pty Ltd

DV251 HOYA AF - 1 311 Toric T3/T4/T5 Correct Corneal Astigmatism, Micro- lOL Power: 6.0D to 30.0D $780.00

incision,Aspheric, Blue-Blocker, (0.5 steps)lOL Cylinder

Single Piece, Hydrophobic Power: 1.50D (311T3),

2.25D (311T4), 3.00D

(311T5)

t1, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL023 Alcon AcrySof Toric PC IOL Models Posterior chamber, UV absorbing, +6 to +34 D spherical; 1.50 $740.00

foldable, acrylic, toric, single piece to 6.00 D cylinder

lens with blue light protection

t2

Kevin Grundy (IBD) Pty Ltd

KG004 Rayner Premium Toric C-Flex HEMA-MMA copolymer, foldable 5.75mm dia optic, 12.00mm $1,000.00

with injector dia overall, cyls 1.5D to

11.0D in 0.5D increments

Prostheses List by Category, Groups and Sponsor Page 12 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

KG013 Rayner Super Premium Toric I.O.L. Acrylic foldable toric single piece -10.0D to 0.00D Sphere: 1D $1,000.00

to 11.00D Cylinder in 0.25

steps

+31.00D to +35.00

Spit: 1D to 11.00D

Cylinder in 0.25steps

vblf

Alcon Laboratories (Aust.) Pty Ltd

AL016 Alcon Acrysof Natural Model Foldable Acrylic Single-piece Lens, +6 to +40D $364.00

SN60AT asymmetric optic/consistent edge,

with blue light protection

AL025 AcrySof Multipiece Models Foldable Acrylic multi-piece Lens - 5 D to + 30 D $364.00

MN60MA, MN60AC with Blue light Protection

1.2.2.4 - Multifocal or bifocal

AMO Australia Pty Ltd

AO020 ReZoom Acrylic Multifocal Acrylic, foldable, posterior chamber, 6.0mm Optic Diameter x $780.00

Intraocular Lens intraocular lens 13.0mm overall length

at

AMO Australia Pty Ltd

AO026 TECNIS™ Multifocal Intraocular Posterior chamber lens with UV light- +5 diopters to +34 diopters $822.00

Lens (ZMA00) absorbing, foldable acrylic, 3-piece in 0.5d increments

with a diffractive posterior optic and a

modified anterior surface technology

with edge modification and 360

degree square edge.

AO027 Tecnis Multifocal 1-Piece Lens, A multifocal posterior chamber lens 6.0mm Optic Diameter x $822.00

Model ZMB00 with UV-blocking, foldable acrylic, 1- 13.0mm in overall length.

piece with a diffractive posterior optic +5.0 Diopter to +34.0

and a modified anterior surface Diopter in 0.5 Diopter

technology with edge modification increments.

and a 360 degree square edge.

Carl Zeiss Pty Ltd

CZ015 AT LISA 809M ZEISS micro incision, aspheric 6mm optic, 11mm diameter. $822.00

multifocal IOL.

Diffractive bifocal Diopter range 0.0D to

anterior surface with asymmetric light +32.0D (0.5D steps)

distribution (65% distance / 35%

near), 3.75D addition for near focus.

Prostheses List by Category, Groups and Sponsor Page 13 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Device Technologies Australia Pty Ltd

DE396 Oculentis LENTIS Mplus LS-313 Foldable one-piece multifocal plate Overall Length 11.0mm and $822.00

haptic acrylic IOL. Optic Size 6.0mm Available

diopters +-0.0D to +36.0D

(0.05D steps)

Kevin Grundy (IBD) Pty Ltd

KG009 Rayner "M-Flex" Mulitfocal Acrylic, Foldable, Single piece multi- 6.5mm Optic-Overall $822.00

Foldable IOL zoned refractive aspheric multifocal diameter 12.5mm: +3D or +

with Amon-Apple 360 Degree Square 4D Addition: +14D to

edge, Anti Vaulting Haptics +25D in 1.0D increments:

+8.5D to +23.5D in 0.5D

at, pl

Carl Zeiss Pty Ltd

CZ033 AT LISA 809MP Preloaded, micro incision, aspherical Diopter range: 0.0 to 32.0 $842.00

bifocal, square edged, single-piece Optic size: 6.0mm. Overall

IOL for capsular bag fixation. The length: 11.0mm

anterior aspheric bifocal surface has an

asymmetric light distribution 65/35

for distance/near vision, and 3.75D

add for the near focus.

CZ034 AT LISA tri 839MP Trifocal (aspheric) micro incision, Diopter range: 0.0 to $842.00

single-piece IOL for capsular bag +32.0D (0.5D increments).

fixation, implantable with preloaded Optic size: 6.0mm. Overall

injector system.

The trifocal (anterior) Length: 11.0mm

optic provides two diffractive focal

points (+3.33D near focus and +1.66D

intermediate focus) with asymmetric

light distribution 50% distance / 20%

intermediate / 30% near vision.

at, pl, t1

Carl Zeiss Pty Ltd

CZ035 AT LISA toric 909MP ZEISS pre-loaded, micro incision, 6mm optic, 11mm diameter. $1,218.00

multifocal toric IOL. Aspheric toric Diopter range: Sph +6.0D

anterior surface, diffractive bifocal to 24.0D, Cyl +1.0 to 4.0D

posterior surface with asymmetric (all 0.5D steps)

light distribution (65% distance/ 35%

near), and 3.75D addition for near

Prostheses List by Category, Groups and Sponsor Page 14 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, t1

AMO Australia Pty Ltd

AO033 Tecnis Multifocal Toric Toric Multifocal Intraocular Lens +5.0 Diopters to +34.0 $1,198.00

Diopters in 0.5 Diopter

increments.

Cylinder

powers 1.50D, 2.25D,

3.00D and 4.00D

Device Technologies Australia Pty Ltd

DE388 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal- Overall Length 11.0mm and $1,198.00

313MFT toric plate haptic acrylic IOL Optic Size 6.0mm + 0.0D to

+36.0D inclusive in 0.01D

increments. Cyl +0.25 to

+6.99D inclusive in 0.01D

increments

at, t1, vblf

Device Technologies Australia Pty Ltd

DE394 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal- Overall Length 11.0mm and $1,240.00

313 MF30TY toric plate haptic acrylic IOL. Optic Size 6.0mm, +-0.0D to

+36.0D inclusive in 0.01D

increments. Cyl +0.25D to

+6.99D inclusive in 0.01D

increments.

at, t2

Device Technologies Australia Pty Ltd

DE389 Oculentis LENTIS Mplus LU- Patient specific one-piece multifocal- Overall Length 11.0mm and $1,500.00

313MFT toric acrylic plate haptic IOL Optic size 6.0mm +-0.0D to

+36.0D inclusive in 0.01D

increments. Cyl +6.99D to

+12.0D inclusive in 0.01D

increments

at, t2, vblf

Device Technologies Australia Pty Ltd

DE395 Oculentis LENTIS Mplus LU-313 Patient specific one-piece multifocal Overall Length 11.00mm $1,542.00

MFTY toric plate haptic acrylic IOL. Violet and Optic Size 6.0mm +-

Light Filter 0.0D to +36.0D inclusive in

0.01D increments.

Cyl

+7.00D to +12.0D inclusive

in 0.01D increments.

Prostheses List by Category, Groups and Sponsor Page 15 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL028 AcrySof IQ ReSTOR SN6AD3 Posterior Chamber, UV absorbing, +6 D to + 34 D $864.00

foldable, acrylic, single piece lens

with apodised diffractive optic and

blue light protection

AL030 AcrySof IQ ReSTOR SN6AD1, Posterior Chamber, UV absorbing, +6 D to + 34 D $864.00

SV25T0 and MN6AD1 foldable, acrylic, single piece lens

with apodised diffractive optic and

blue light protection

Design for Vision Pty Ltd

DV248 HOYA PY-60MV Preloaded in cartridge, Multifocal, +14.0D to 27.0D (0.5 steps) $864.00

Aspheric, Blue-blocker, Single Piece,

Hydrophobic

at,pl,t1

Carl Zeiss Pty Ltd

CZ036 AT LISA tri Toric 939MP Trifocal (aspheric), bitoric, micro Diopter range: + 6.00 to $1,218.00

incision, single-piece IOL for 24.0 DS and + 1 to +4 DC;

capsular bag fixation, implantable Optic size: 6.0mm; Overall

with preloaded injector system. The length: 11.0mm

trifocal (anterior) optic provides two

diffractive focal points (+3.33D near

focus and + 1.66D intermediate focus)

with asymmetric light distribution

50% distance / 20% intermediate /

30% near vision,

t1, at

Carl Zeiss Pty Ltd

CZ025 AT LISA toric 909M ZEISS micro incision, multifocal toric 6mm optic, 11mm diameter. $1,198.00

IOL (standard cyl range). Aspheric Diopter range: Sph -10.0D

toric anterior surface, diffractive to +32.0D, Cyl +1.0 to 6.5D

bifocal posterior surface with (all 0.5D steps)

asymmetric light distribution (65%

distance / 35% near), 3.75D addition

for near focus.

Prostheses List by Category, Groups and Sponsor Page 16 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Kevin Grundy (IBD) Pty Ltd

KG010 Rayner M-Flex Toric (Standard) Acrylic, Foldable, Single Piece, 5.75mm / 12.0mm: 6.25mm / $1,198.00

Multi-zoned Refractive Aspheric 12.5mm +3.00D or +4.00D

Toric Mulitfocal with Amon-Apple Addition FAR: +14.0D to

enhanced 360 degree Square edge, +32.00D in 0.5 STEPS:

Anti Vaulting Haptics +2.00D +3.00D +4.00D

Cylinder. NEAR: +14.0D to

27.0D in 0.5 STEPS:

+2.00D +3.00D

+4.00D

Cylinder

KG011 Rayner "M-Flex" Toric (Non Acrylic, Foldable, Single Piece, Muli- 5.75/12.0mm: 6.25/12.5mm $1,198.00

Standard) Zoned Refractive, Toric Multifocal +3.00D to +4.00D Addition

with Amon-Apple enhanced 360 FAR: +14.0D to +32.0D in

Degree square edge, Anti-vaulting 0.5D Increments: NEAR:

Haptics, Patient Specific. +14.0D to +27.0D in 0.50D

Increments Cylinder: 1.0D

to 1.5D and 2.5D to 6.00D

in 0.5 increments

t1, at, vblf

Alcon Laboratories (Aust.) Pty Ltd

AL033 AcrySof IQ ReSTOR multifocal toric Posterior chamber UV absorbing +6 to +34 D spherical; 1.00 $1,240.00

IOL (SND1T2-5; SV25T2-6) foldable, acrylic, aspheric, toric single to 3.00 D cylinder

piece lens with apodised diffractive

optic and blue light protection.

t2, at

Carl Zeiss Pty Ltd

CZ024 AT LISA toric 909M ZEISS micro incision, multifocal toric 6mm optic, 11mm diameter. $1,500.00

IOL (high cyl range). Aspheric toric Diopter range: Sph -10.0D

anterior surface, diffractive bifocal to +32.0D, Cyl +7.0 to

posterior surface with asymmetric 12.0D (all 0.5D steps)

light distribution (65% distance /

35% near), 3.75D addition for near

Prostheses List by Category, Groups and Sponsor Page 17 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.2.2.5 - Accommodative

at, pa, pl

AMO Australia Pty Ltd

AO035 Synchrony Vu Accommodating IOL Synchrony Vu Dual Optic 5.50mm Anterior Optic, $822.00

Accommodating Posterior Chamber 6.00mm Interior Optic,

IOL 9.80mm Overall Length,

Diopter Range: +16.00 to

+28.00 in 0.5D Increments

at, pa, t1

Bausch & Lomb (Australia) Pty Ltd

BL031 Crystalens Toric The Crystalens Toric IOL, Models Overall diameter is 11.5mm $1,198.00

BL1AT/BL2AT and BL1UT/BL2UT (BL1AT/BL1UT) or 12.0mm

is an accommodating IOL (BL2AT/BL2UT) for the

incorporating a toroidal posterior entire lens power range.

surface. The Crystalens toric IOL has a Spherical equivalent

square posterior edge with polyimide powers range from +5.0 to

footplates and is available in multiple +33.0 Diopters in 0.5

spherical and cylindrical powers. Diopter steps and cylinder

powers of +1.25, +2.00 and

+2.75 Diopters (at the IOL

plane).

pa

Bausch & Lomb (Australia) Pty Ltd

BL027 Crystalens HD Accommodating lens with > 3 10.0 to 33.0 Dioptres in .05 $780.00

Dioptres of accommodation with dual Dioptre steps

mechanism of action: (1) forward axial

movement of lens and (2)

accommodative arching of optic.

Posterior chamber, polyspheric

optics, 3-piece, plate haptic, foldable

UV light filtering, bic

IQ Medical

IQ003 Tetraflex Acrylic single piece, foldable Available in dioptric $780.00

accommodating intraocular lens with powers from +5.0 to +36.0,

sqare edge design, custom control 1D steps: +31.0 to +36.0;

precision and closed loop haptic 0.5D steps: +5.0 to +18.0

and +25.0 to +30.0; 0.2D

steps; +18.0 to +25.0

Prostheses List by Category, Groups and Sponsor Page 18 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

pa, at

Bausch & Lomb (Australia) Pty Ltd

BL029 Crystalens AO Accommodating lens designed to 10.0 to 33.0 D in 0.50 $822.00

provide > 3 Diopters of Diopter steps. 10.0 - 16.5

accommodation with dual mechanism Diopters (12mm length) and

of action: (1) forward axial movement 17.0 - 33.0 Diopters

of lens and (2) accommodative arching (11.5mm length).

of optic.

Posterior chamber, aspheric,

aberration free optics, 3-piece, plate

haptic, fol

pa, pl

AMO Australia Pty Ltd

AO028 Synchrony Accommodating IOL Synchrony Dual Optic 5.50mm Anterior Optic, $800.00

Accommodating Posterior Chamber 6.00mm Interior Optic,

9.80mm Overall Length,

Diopter Range: +16.00 to

+28.00 in 0.5D Increments

1.2.3 - Pseudo-phakic, piggy-back

1.2.3.1 - Monofocal

Design for Vision Pty Ltd

DV246 Rayner Sulcoflex Ashperic Pseudophakic Supplementary -10.0D to -5.50D in 0.5D $323.00

(Premium) I.O.L. I.O.L.O.L. increments. +5.50D

to 10.00D in 0.5D

at

Kevin Grundy (IBD) Pty Ltd

KG008 Rayner "Sulcoflex" Pseudophakic Sulcoflex Aspheric Pseudophakic I.O.L -5D to +5D $365.00

I.O.L.

t1, at

Kevin Grundy (IBD) Pty Ltd

KG005 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric SE -3 to +3 in 0.5 D steps $698.00

Pseudophakic Secondary I.O.L - Pseudophakic Secondary IOL: Cyl +1 to +3 in 1D steps

Standard Sulcus fixated with undulating

Haptics and Posterior Haptic

Prostheses List by Category, Groups and Sponsor Page 19 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

KG007 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric SE -6.00 to +6.00 in 0.5 D $698.00

Pseudophakic Secondary IOL Pseudophakic Secondary IOL: Sulcus steps Syl +1.00 to +6.00 in

(Premium) fixated with undulating Haptics and 0.5D steps

Posterior Haptic Angulation

1.2.3.2 - Multi-focal

at

Kevin Grundy (IBD) Pty Ltd

KG006 Rayner "Sulcoflex" Aspheric Multi- Acrylic, Aspheric Multi-focal 6.5mm / 13.5mm - $822.00

focal Pseudophakic Secondary IOL Pseudophakic Secondary IOL: 5.00D+5.00D sphere with

Sulcus-Fixated with Undulating + 3.00 Addition

Haptics and Posterior Haptic

at, t1

Design for Vision Pty Ltd

DV254 Rayner Premium Sulcoflex 653Z-Premium Multifocal Toric -7D to +7D (Spherical $1,198.00

Multifocal Toric Supplementary IOL Supplementary IOL Equivalent) Cylinder 1D,

4D, 5D, 6D Addition 3.5D

DV255 Rayner Standard Sulcoflex 653Z-Standard Multifocal Toric -3D to +3D (Spherical $1,198.00

Multifocal Toric Supplementary IOL Supplementary IOL Equivalent) Cylinders 2D

and 3D Addition 3.5D

1.3.1 - Viscoelastic

Alcon Laboratories (Aust.) Pty Ltd

AL006 PROVISC VISCOELASTIC PROVISC contains sodium 0.85mL pack $80.00

SOLUTION

AL007 VISCOAT Viscoelastic Fluid Chondroitin sulfate and sodium 0.75mL $80.00

hyaluronate

AL015 Cellugel viscoelastic fluid Hypromellose 2%. $80.00

AL029 DisCoVisc Ophthalmic Sodium hyaluronate 17 mg/mL and 0.5 mL and 1.0 mL $80.00

Viscosurgical Device chondroitin sulfate 40mg/mL

AMO Australia Pty Ltd

AO008 Healon, Intraocular Viscoelastic Sodium Hyaluronate 10mg/ml Healon 0.4ml, 0.55ml & $80.00

0.85ml

AO032 Healon Endocoat Viscoelastic 0.85ml $80.00

Prostheses List by Category, Groups and Sponsor Page 20 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Bausch & Lomb (Australia) Pty Ltd

BL008 Ocucoat Intraocular Fluid 20mg/mL hydroxypropylmethyl 1ml and 2ml Sterile $80.00

cellulose for intraocular use

BL015 Amvisc Plus injection 15mg/mL Sodium Hyaluronate for 0.5mL and 0.8mL $80.00

intraocular use

Carl Zeiss Pty Ltd

CZ012 Z-HYALIN Viscoelastic Cohesive Viscoelastic Solution - Volume 1.0ml $80.00

sodium hyaluronate 10mg/ml.

(previously called Ophthalin)

CZ013 Z-HYALIN Plus Viscoelastic Cohesive Viscoelastic Solution - Volume 1.0ml $80.00

sodium hyaluronate 15mg/ml.

(previously called Opthalin Plus)

CZ022 VISTHESIA 1.5% VISCOANAESTHETIC syringe 0.8ml syringe & 2x0.3ml $80.00

contains sodium hyaluronate (NaHA, ampoules

1.5%) and lidocaine hydrochloride

(1%). Also contains two topical

ampoules with NaHA (0.3%) and

lidocaine (2%)

IQ Medical

IQ002 Ocuvis and Ocumax 2% 20mg/mL hydroxypropylmethyl 2mL sterile $80.00

Hydroxypropylmethylcellulose cellulose for intraocular use. Pre-

loaded in a sterile syringe with one

cannula for injection, in a sterile

Tyvek pouch

hmw

AMO Australia Pty Ltd

AO009 Healon 5, Intraocular Viscoelastic HEALON5- Sodium hyaluronate 0.6ml $85.00

Fluid 23mg/ml .

AO010 Healon GV Intraocular Viscoelastic Sodium Hyaluronate 14mg/mL 0.5mm and 0.85ml $85.00

Fluid

1.3.1.1 - Dual Fluids

Alcon Laboratories (Aust.) Pty Ltd

AL005 DUOVISC VISCOELASTIC SYSTEM PROVISC contains sodium Small & large packs $110.00

hyaluronate, VISCOAT contains

chondroitin sulfate and sodium

hyaluronate

Prostheses List by Category, Groups and Sponsor Page 21 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Carl Zeiss Pty Ltd

CZ019 TWINVISC Viscoelastic TWINVISC includes a cohesive and a Total volume 1.4 ml $110.00

dispersive viscoelastic in one

syringe, separated by a valve.

Dispersive: sodium hyaluronate

(2.2%).

Cohesive: sodium

1.3.2 - Non Viscous

Design for Vision Pty Ltd

DV231 Vision Blue Trypan blue dye for ophthalmic 0.5ml syringe $48.00

applications

1.4.1 - Simple

Alcon Laboratories (Aust.) Pty Ltd

AL001 Capsular Tension Rings - 10.0 - 12.0 compressed, $159.00

12.3 - 14.5 uncompressed

AMO Australia Pty Ltd

AO021 Stabileyes Capsular Tension Ring Polymethylmethacrylate (PMMA) 12mm ring, and 13mm ring $159.00

Implant

Carl Zeiss Pty Ltd

CZ002 Tensiobag: Capsular Tension Ring PMMA Diameter 10 - 14mm $159.00

Design for Vision Pty Ltd

DV009 Morcher Capsular Tension Ring PMMA Implant 14, 14A, 14C $159.00

Emagin Pty Ltd

EG001 Capsular Tension Rings Clear PMMA Implant 10/08, 12/10, 13/11mm $159.00

pl

Design for Vision Pty Ltd

DV029 Eyejet CRT Capsular tension ring made of PMMA 14 (10mm), 14C (11mm), $243.00

per-load on disposable injector 14A (12mm)

Prostheses List by Category, Groups and Sponsor Page 22 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Insight Surgical Pty Ltd

IS001 Preloaded Capsulan Tension Ring Capsular tension ring preloaded 13/11mm $243.00

(acrylic)

1.4.2 - Complex

Design for Vision Pty Ltd

DV010 Morcher Coloboma Diaphram PMMA Implant 96G, 96L $334.00

1.5.1 - Long Tube

AMO Australia Pty Ltd

AO012 Baerveldt Glaucoma Implant BG Non-valved artificial drainage device, Surface area 250, 350, $425.00

101-350, Baerveldt Glaucoma composition silicone - smooth, 425mm2

Implant BG 103-425, Baerveldt tumble-polished finish

Glaucoma Implant BG 103-250

Design for Vision Pty Ltd

DV020 Molteno Implant Double plate - dual chamber One size only $425.00

DV242 Molteno Implant Glaucoma Drainage Device - Single N/A $425.00

Plate/Single Plate-Dual

Chamber/Double Plate

v

Design for Vision Pty Ltd

DV230 Molteno 3 Drainage implant for glaucoma, made 2 Sizes: *230 mm square $625.00

of silicon *175mm square

1.5.2 - Short Tube

1.5.2.1 - Cannulated

Alcon Laboratories (Aust.) Pty Ltd

AL037 ExPress Minature Glaucoma Shunt Miniature Glaucoma Shunt 50 & 200 microns $715.00

Prostheses List by Category, Groups and Sponsor Page 23 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.6.1 - Spacers

Spectrum Surgical

SO017 FCI Ptose-up Expanded PTFE 15cm long x 2 or 3mm wide $348.00

x 0.35mm thick

1.6.2 - Weights

1.6.2.1 - Gold <1.8 grams

Device Technologies Australia Pty Ltd

DE183 Lid Load Gold Eyelid Weights; Gold 0.6, 0.8, 1.0, 1.2, 1.4, 1.6 $425.00

grams

1.6.2.2 - Gold ≥1.8 grams

Device Technologies Australia Pty Ltd

DE182 Lid Load Gold Eyelid Weights; Gold 1.8, 2.0, 2.2, 2.4, 2.6, 2.8 $800.00

grams

1.6.2.3 - Platinum

CoreMed Pty Ptd

RC001 LIDCHAIN Platinum Eyelid Implant Platinum Weights - 0.8, 1.0, 1.2, 1.4, $1,300.00

1.6, 1.8 grams

1.7.1 - Intracanalicular

Design for Vision Pty Ltd

DV022 Eyetec DCR Tubes Stainless steel, silicone tubing, 30cm $135.00

Bodkin lacrimal intubation set

DV241 Eyetec DCR Tubes Crawford and Cannaliculus N/A $135.00

Intubation Sets

DV256 LIS 052 "StenTube" Large Diameter Lachrymal Intubation 1.32mm Tube diameter $135.00

Set

Prostheses List by Category, Groups and Sponsor Page 24 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Device Technologies Australia Pty Ltd

DE191 Canaliculus Intubation Sets Silicone, SS & Nylon 17.7 x .064 x 29cm, 15.5 x $135.00

.051 x 33cm

DE278 BD Visitec Lacrimal Intubation Sets Stainless steel probes with solid 1. Probes 0.90mm x 4.5cm, $135.00

silicone rods or silicone tubing - rod 40cm x 0.80mm. 2.

packaged sterile Probes 0.40mm x 11cm,

tubing 35cm x 0.64mm.

Probes 0.60mm x 11mm,

tubing 35cm x 0.30mm.

Spectrum Surgical

SO021 FCI Lacrimal Intubation Set PVP Coated Silicone Tubing/PVP PVP Bika: 0.64mm O.D. $135.00

Coated Silicone Plug/Metal Tube/80 x 0.8mm probes,

Probes/Polypropylene Thread PVP Differential Bika: 0.64

& 1.18mm O.D. Tube/40 x

1.2mm probes, PVP Bika for

DCR: 0.94mm O.D. Tube/50

x 0.8mm probes, PVP Infant

Bika 0.64mm O.D. Tube/55

x 0.7mm probes, PVP Infant

Bika II: 0.64mm O.D. Tube/

SO043 FCI Bi-Canalicular Lacrimal Silicone tubing swaged, imbedded Probes: 40mm to 120mm x $135.00

Intubation Set into or around malleable and flexible 0.7mm to 1.2mm. Tube:

stainless steel probes. PEEK thread. 0.64mm to 1.18mm x 25mm

to 400mm.

PEEK Thread:

0.2mm to 0.4mm x 500mm.

mc

Spectrum Surgical

SO044 FCI Mono-Canalicular Lacrimal Silicone tubing with plug swaged, Probes: 40mm to 120mm x $180.00

Intubation Set imbedded into or around malleable or 0.7mm to 1.2mm. Tube:

flexible stainless steel probes or 0.64mm to 1.18mm x 30mm

guides. PEEK thread. Introducer. to 350mm. PEEK Thread:

0.2mm to 0.4mm x 500mm.

Plug Collar: 2mm to 4mm.

Prostheses List by Category, Groups and Sponsor Page 25 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.7.2 - Extracanalicular

Device Technologies Australia Pty Ltd

DE177 Lester Jones Tear Duct Tubes Glass 3 x 9 to 16mm, 3.5 x 9 to $84.00

18mm, 4.0 x 9 to 24mm, 5.0 x

9mm

1.7.3 - Balloon Dilatation Catheters

Design for Vision Pty Ltd

DV258 Lacricath Lachrymal Duct Balloon Unilateral Lachrymal Duct Balloon 2mm, 3mm & 5mm $485.00

Catheter Catheter system including inflation

device

bilateral

Design for Vision Pty Ltd

DV257 Lacricath Lachrymal Duct Balloon Bilateral Lachrymal Duct Balloon 2mm, 3mm and 5mm $879.00

Catheter Catheter System including inflation

device.

1.8.1 - Intrascleral

Device Technologies Australia Pty Ltd

DE188 Acrylic Implant Acrylic 12, 14, 16, 18, 20mm. $55.00

DE202 John Weiss Glass Mule Globes Glass No: 12, 14, 16, 18, 20mm $55.00

Spectrum Surgical

SO040 FCI Orbital Implants Silicone - Sterile 12mm to 22mm $55.00

vp

Spectrum Surgical

SO006 FCI Orbital Implants Orbital Implant, Bioceramic Bioceramic diameter, 12, 14, $1,200.00

(Aluminium Oxide)/Hydroxyapatite 16, 18, 20, 21, 22mm;

(Synthetic) Synthetic Diameter, 10, 12,

14, 16, 18, 20, 22mm

Prostheses List by Category, Groups and Sponsor Page 26 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.8.2 - Extrascleral

1.8.2.1 - Complex and permeable

Stryker Australia Pty Ltd

SK521 Sphere Orbital Sphere Models 6316, 6326, Orbital Sphere Models $785.00

6327, 6317 and 6322 8702-8704. 6316: 14mm, 6326: 16mm,

COI implant, models 7222, 7223 & 6327: 18mm, 6317: 20mm,

80026. MCOI implant, models 7207 - 6322: 22mm, 8702: 19mm,

7209 Quad Motility Implants 9866 - 8703: 21mm, 8704: 23mm,

9868 & 80022 COI Implants 7222: Approx

4ml, 7223: Approx 5ml,

80026: Approx 6ml, MCOI

7207: Approx 3ml, 7208:

Approx 4.2ml,

7209:

Approx 5.6ml, QUAD

Motility Small 16ml,

Medium: 18ml, Large: 20ml,

Extra Large: 22ml.

ha

Spectrum Surgical

SO007 FCI Orbital Implants Mesh wrapped orbital implant: mesh Bioceramic diameter: 16, 18, $1,600.00

wrapped bioceramic (aluminium 20, 22mm; Synthetic

oxide), mesh wrapped hydroxyapatite Hydroxyapatite diameter:

(synthetic), mesh wrap (polyglycolic 16, 18, 20, 22mm

acid)

vp

Medical Vision Australia Plastic and Cosmetic Pty Ltd

MW002 Biopore Sphere An implantable device made of high- 14mm, 16mm, 18mm, 20mm, $1,930.00

density polyethylene material with an 22mm, 24mm (diameter)

interconnecting pore structure that

supports tissue ingrowth. The device

is available in sizes to meet the

patient's specific needs.

Used for

orbital reconstruction following

enucleation and evisceration

procedure.

Prostheses List by Category, Groups and Sponsor Page 27 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.8.2.2 - Multi-component

Spectrum Surgical

SO019 FCI Orbital Implants Peg & Sleeve Standard Large $863.00

1.8.3 - Fascial - solid and permeable

Device Technologies Australia Pty Ltd

DE277 Frontalis Suspension Set Stainless steel needles with solid needles 0.90mm x 6.5cm, rod $315.00

silicone rods and silicone tubing - 40cm - 0.80mm, sleeve 10 x

packaged sterile 2mm

Spectrum Surgical

SO045 FCI Ptosis Probes Stainless steel needle probes swaged 80mm x 0.8mm needle $315.00

with silicone tubing. probes, 280mm 0.64mm

tubing.

1.9.1 - Buckles, bands, tyres and sponges

Austmed Pty Limited

AP003 Mira: Scleral Implants Solid Silicone- Tires-Mira 286 Wendel $45.00

Tire/Meridional/Wedge/Pad. Retinal Symmetrical Oval Tire 6mm,

Implant used in Scleral Buckling Mira Symmetrical Oval Tire

(Dimethylmethylvinyl Siloxane 7mm, Mira 287WG Murray

Copolymer) wide (3.5mm) grooved

symmetrical tire, 10mm

wide, Mira 288 ross

symmetrical grooved tire,

low profile 10mm wide by

2.5mm, Mira 289

Symmetrical oval tire 10m

AP004 Mira: Scleral Implants Solid Silicone-Sleeve. Retinal Implant Sleeves-Mira 70 Sleeve 1mm $45.00

used in Scleral Buckling I.D., Mira 71 Sleeve 1mm

(Dimethylmethylvinyl Siloxane I.D., Mira 72 McNutt Sleeve

Copolymer) 1.57mm I.D., Mira 270

Sleeve 0.76mm I.D.

Prostheses List by Category, Groups and Sponsor Page 28 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

AP006 Mira: Scleral Implants Solid Silicone-Band/Strip/Boat/Clip. Bands-Mira 40 Circling $45.00

Retinal Implant used in Scleral Band 2mm, Mira 240

Buckling (Dimethylmethylvinyl Circling Band 2.5mm.

Siloxane Copolymer) Strips-Mira 41 Strip 3.5mm,

Mira 42 Strip 4mm, Mira 20

Strip 4mm, Mira 219 Strip

4.5mm, Mira 31 Strip 4.5mm,

Mira 32 Strip 5mm, Mira

225 Oval Strip 5mm, Mira

220 Strip 6mm. Boats-Mira

60 Boat

Device Technologies Australia Pty Ltd

DE179 Silicon Retinal Implant Tire 7.0, 9.0, 12.5, 6.0, 8.5, 10.0mm $45.00

DE181 Silicon Retinal Implant Band 0.75 x 2.0 x 125mm, 0.60 x $45.00

2.5 x 125mm, 0.75 x 2.5 x

125mm

Spectrum Surgical

SO009 FCI Scleral Buckling Devices Band/strip: solid silicone Band - 2.0 x 0.75mm Type $45.00

40, 3.5 x 0.75mm Type 41,

4.0 x 1.25mm Type 42, 2.5 x

0.6mm Type 240, Morin 3.5

x 0.6mmStrip - 5.7mm Type

20, 7.2mm Type 31, 9.2mm

Type 32, 6mm Type 219,

7.5mm Type 220, 8mm Type

225

SO011 FCI Scleral Buckling Devices Tire: Solid Silicone Symmetrical: (2.5 mm $45.00

Groove, 7 to 9mm wide),

Biconvex: (2.5mm Groove, 7

to 10mm wide),

Asymetrical: (2.5mm

Groove, 7 to 10mm wide)

SO013 FCI Scleral Buckling Devices Strip: Solid Silicone Strip: 1.4 x 4.4 x 100mm, $45.00

Morin Strip: 7mm wide x

100mm long, Caputo Zip

Strip: 7 to 9mm wide x

120mm long, Korobelnik

Oval Strip: 2 x 5mm

Prostheses List by Category, Groups and Sponsor Page 29 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.9.1.1 - Sponges

Austmed Pty Limited

AP002 Mira: Scleral Implants Silicone Sponge- Retinal Implant Sponge- Mira 502 Cylinder $90.00

Used in Scleral Buckling (Silicone 2mm, Mira 5025 Cylinder

Elastomer Sponge) 2.5mm, Mira 503 Cylinder

3mm, Mira 504 Cylinder

4mm, Mira 505 Cylinder

5mm, Mira 505G Grooved

cylinder 5mm, Mira 505T

Packer tunnel cylinder 5mm,

Mira 510 Half cylinder

5mm, Mira 515 Brucker two-

thirds cyl

Device Technologies Australia Pty Ltd

DE178 Silicon Retinal Implant Sponge 2.5 x 4.0 x 80mm, 3.0 x 5.0 x $90.00

100mm, 3.25 x 7.0 x 80mm,

5.5 x 7.5 x 80mm, 1.5 x

80mm, 2.0 x 80mm, 2.5 x

80mm, 3.0 x 80mm, 4.0 x

80mm, 5.0 x 80mm, 7.0 x 80mm

Spectrum Surgical

SO012 FCI Scleral Buckling Devices Sponge/Cord: Silicone Cord: 1.0 to 5.0mm O.D. x $90.00

150mm length; Half Cord:

3.0mm to width x1.5mm to

2.5mm height x150mm;

Circular Sponge: 3 to 5mm;

Oval Sponge: 2 to 5.5mm x

4 to 12mm; Half Sponge: 2

to 3.1mm x 4 to 7.5mm;

Grooved Sponge: 3 to 5mm

x 5 to

12mm; Gain Sponge:

6 x

Prostheses List by Category, Groups and Sponsor Page 30 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.9.2 - Clips and tacks

Device Technologies Australia Pty Ltd

DE201 Labtician Tantalum Clips Tantalum 2, 2.5mm $50.00

1.9.3 - Sleeves

Device Technologies Australia Pty Ltd

DE180 Silicon Retinal Implant Sleeve 1mm, .76mm, 1.5mm $25.00

Spectrum Surgical

SO010 FCI Scleral Buckling Devices Fixation Sleeve: Solid silicone O.D: 1.65 to 2.41mm, $25.00

Length 30mm

1.9.4 - Intraocular Gases

Alcon Laboratories (Aust.) Pty Ltd

AL035 ISPAN Retinal Gases for Tamponade gases for retinal surgery 125g cylinder, dispensed in $75.00

Constellation® Vision System C3F8 and SF6 single dose syringe

AL036 ISPAN retinal gases Tamponade gases for retinal surgery 125 g cylinder, dispensed $75.00

C3F8 and SF6 in single dose syringe

Device Technologies Australia Pty Ltd

DE284 Single Dose Ophthalmic Gases Single dose tamponading gas for 30ml $75.00

retinal surgery

IQ Medical

IQ012 EasyGas Endotamponade Gases for Retinal 60ml dispensed in a single $75.00

Surgery, EasyGas SF6, C2F6 or C3F8, dose, sterile syringe

each supplied in a 60ml syringe,

Prostheses List by Category, Groups and Sponsor Page 31 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

1.9.5 - Intraocular Heavy Liquids

Alcon Laboratories (Aust.) Pty Ltd

AL013 Perfluoron Kits Perfluoro-n-octane for use as a retinal 5mL $240.00

surgery additive

AL014 Perfluoron Kits Perfluoro-n-octane for use as a retinal 7mL $240.00

surgery additive

Bausch & Lomb (Australia) Pty Ltd

BL017 Perfluo-octane (Oktaline) Okta- Perfluorocarbon Liquid for use as a 5mL $240.00

retinal surgery additive

BL018 DK Line 100% purified Perfluorodecalin 7ml $240.00

perfluorodecalin

Design for Vision Pty Ltd

DV244 D.O.R.C. Eftiar Eftiar Decaline and Octane 5ml 5ml $240.00

Device Technologies Australia Pty Ltd

DE204 Arcaline (Perfluorodecaline) Liquid perfluorocarbon aid for retinal 3ml, 5ml, 7ml $240.00

surgery, operative device for retinal

surgery, in particular retinal

detachment (RD), RD with giant tear

etc.

DE205 Arcotane (Perfloro-N-Octane) Liquid perfluoro-N-Octane aid for 5ml, 7ml $240.00

retinal surgery, pre-operative device

for retinal surgery, in particular retinal

detachment (RD), RD with giant tear,

RD with proliferative vitreal

retinopathy (PVR) etc.

IQ Medical

IQ005 Densiron Heavy Tamponade Liquid Medium, 10 ml, Sterile $240.00

Postoperative

IQ008 Octane & Decalin Perfluorocarbon retinal tamponade 5ml & 7ml, Sterile $240.00

medium, intraoperative

Spectrum Surgical

SO023 FCI - DECA, FCI - OCTA FCI - DECA: Purified 5ml $240.00

perfluorodecalin, FCI - OCTA:

Purified perfluoro-N-octane

Prostheses List by Category, Groups and Sponsor Page 32 of 1011

1 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

SO024 FCI - DECA, FCI - OCTA FCI - DECA: Purified 7ml $240.00

perfluorodecalin, FCI - OCTA:

Purified perfluoro-N-Octane

1.9.6 - Intraocular Silicone Oils

Bausch & Lomb (Australia) Pty Ltd

BL016 Oxane LMWC Fractioned Silicone Purified fractioned silicone oil 10mL $195.00

Oil

BL024 Oxane HD Silicone oil - RMN3 mixture 10ml $195.00

Design for Vision Pty Ltd

DV243 D.O.R.C. Silicon Oil D.O.R.C. Silicon Oil 1000/5000CS 10ml $195.00

Device Technologies Australia Pty Ltd

DE228 LSO Silicone Oil Silicone oil for tamponade use in 10ml, vial or syringe $195.00

vitreoretinal surgery

IQ Medical

IQ006 Siluron 1000 & Siluron 5000 Silicone Oils 10 ml, Sterile $195.00

Spectrum Surgical

SO022 FCI Purified Silicone Oil (Solvent Viscosity: 1000 cst/5000 cst: solvent 10ml $195.00

Free) free purified silicone oil

Prostheses List by Category, Groups and Sponsor Page 33 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

10.1.1 - Bare Metal Stents

10.1.1.1 - Balloon Expandable

Abbott Australasia Pty Ltd

AY022 Cobalt Chromium Balloon Cobalt Chromium Diameter 4-10mm, Length $1,800.00

Expandable Peripheral Stent 12-58mm

AY024 Omnilink Stainless Steel Balloon Stainless Steel Balloon Expandable 018 & 035 system: 5-10mm $1,800.00

Deployable Peripheral Stent Peripheral Stent on 018/035 system diameter by 12, 16, 18, 28,

38, 58mm length

B Braun Australia Pty Ltd

BB244 Coroflex Blue Cobalt Chromium Alloy L605 2-4mm diameter, 8-25mm $1,800.00

length

Bard Australia Pty Ltd

BA218 Lifestent Valeo Stainless Steel Balloon Expandable 6-10mm diameter 17-56mm $1,800.00

Peripheral Stent length

Biotronik Australia Pty Ltd

BT094 Dynamic PTA Balloon Expandable Stent Diameters: 5-10mm, $1,800.00

Lengths: 15, 25, 38, 56mm

Boston Scientific Australia Pty Ltd

BS059 Express Vascular LD Stent; Express Stainless Steel, Balloon Expanding Stent Diameters up to 10mm $1,800.00

Vascular SD Stent Stent and lengths up to 60mm

Cook Medical Australia Pty Ltd

WC234 Formula 414 Rx Renal Stent System Balloon Expandable Vasc/Biliary Rapid exchange 014/018, $1,800.00

80-135cm delivery system.

Diameters 4-10mm, lengths

0.8 - 4cm

Johnson & Johnson Medical Pty Ltd

JJ057 Palmaz Balloon Expandable Stent Stainless steel stent Diameter 4-12mm, length $1,800.00

20-30mm

JJ058 Palmaz Balloon Expandable Stent Stainless steel stent Extra-large $1,800.00

JJ305 Palmaz Genesis Peripheral Stent Stainless steel balloon expandable Diameter 4-8mm, length 12- $1,800.00

and Delivery System on Opta Pro stent mounted on an Opta Pro 39mm

JJ306 Palmaz Genesis Peripheral Stent Stainless steel peripheral stent Diameter 4-12mm, length $1,800.00

11-79mm

Prostheses List by Category, Groups and Sponsor Page 34 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

JJ567 PALMAZ® BLUE™ .018 L605 Cobalt Chromium Alloy 12, 15, 18, 24mm length 4, $1,800.00

Peripheral Stent System Balloon Expandable Stent 5, 6, 7mm diameter

JJ688 Palmaz Blue .014 Renal Stent CoCr balloon expandable stent 12, 15, 18, 24mm Lengths $1,800.00

System (on Aviator Plus) 40, 50,

60, 70mm diameters

80, 142cm shaft

lengths

MD Solutions Pty Ltd

MB009 ArchStent Ostial System The ArchStent Ostial System is a 7Fr: 5mm x 16mm x 135mm. $1,800.00

0.14" guidewire-compatible, rapid 7Fr: 6mm x 16mm x 135mm

exchange balloon expandable stent

system for the treatment of

atherosclerotic stenosis at the renal-

ostial junction. It consists of a 316L

stainless steel stent with flaring of the

proximal 1/5 segment, and a dual

balloon delivery catheter featuring a

Locator balloon that enables the

operator to precisely position and

conform the stent to aorto-ostial

anomalies.

Medtronic Australasia Pty Ltd

MC328 Racer Renal Stent System Cobalt Alloy Diameter: 4-7mm; Lengths: $1,800.00

12 &18mm

MC773 Assurant Cobalt Stent Iliac balloon expandable stent system Diameter: 6 - 10mm, $1,800.00

Length:

20 - 80mm

MC959 Hippocampus Renal Stent System Hippocampus Renal Rapid Exchange Diameter 4.0mm - 7.00mm $1,800.00

Stainless Steel Stent system, 5F Length: 10mm - 24mm

sheath, 0.014" guide wire compatible

MC977 Chromis deep cobalt Chromium, Chromis deep - Cobalt Chromium, pre- Diameter: 2.0 mm 4.0mm $1,800.00

infrapopliteal OTW stent mounted balloon expandable, 0.014" Length: 10mm - 76mm

compatable stent

10.1.1.2 - Self Expandable, <150mm

Abbott Australasia Pty Ltd

AY015 Xact/ Xact Flex Carotid Stent Nitinol Self-Expanding stent on rapid Diameter 7-10mm Length 20 $1,800.00

exchange delivery system + 30mm Straight; Diameter

8-6, 9-7, 10-8mm Length 20

+ 30mm Tapered

Prostheses List by Category, Groups and Sponsor Page 35 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

AY021 Nitinol Self Expanding Peripheral Nitinol Diameter 3-10mm $1,800.00

Stent

AY031 Xpert Xpert is a laser cut nitinol self 3 - 8mm in diameter, 20 - $1,800.00

expanding stent, used to treat 80mm in length

peripheral vessel disease, Xpert is a

low profile system designed for small

vessels and is 4 french.

AY032 ACCULINK Peripheral Stent Nickel-Titanium Intra-vascular stent 4-10mm diameter, 13-56mm $1,800.00

length

AY035 Absolute Pro (Long Length) Laser cut nitinol self expanding stent Diameter 5mm to 10mm; $1,800.00

<150mm length 120mm

Bard Australia Pty Ltd

BA178 Luminex Vascular Stent Luminex nitinol self-expanding stent 4mm - 20mm diameters, 2cm - $1,800.00

12cm lengths

BA199 Lifestent Laser cut nitinol self expanding stent, Diameter: 6-8mm, Length: $1,800.00

used to treat peripheral disease 120mm

BA216 Lifestent Lifestent cut nitinol self expanding 6-10mm diameter 20mm- $1,800.00

120mm length

Biotronik Australia Pty Ltd

BT072 Astron Peripheral self expanding nitinol, Diameters: 6 - 12mm, $1,800.00

coated stent Lengths: 30 - 100mm

BT103 Astron Pulsar Astron Pulsar is a 4F compatible, 4-7mm by 20-80mm $1,800.00

Nitinol self expanding stent (OTW

design) used to treat peripheral vessel

disease.

BT126 Pulsar 18 Peripheral self expanding Pulsar 18 self expanding Nitinol Stent: Ø 4- 7mm length: 20- $1,800.00

Nitinol stent system stent system 120mm Catheter length: 90-

135mm

BT133 Pulsar 35 Peripheral self-expanding Pulsar 35 Peripheral self-expanding Diameter: 5-7mm; Length: $1,800.00

Nitinol stent system Nitinol stent system 30-120mm; Catheter length:

90cm

Boston Scientific Australia Pty Ltd

BS035 Expandable Endoprosthesis Biomedical superalloy, self expanding Stent Diameters up to 30mm $1,800.00

stent and lengths up to 100mm

BS056 Carotid Wall Stent Elgiloy self expanding stent Stent diameters up to 10mm $1,800.00

and lengths up to 40mm

Prostheses List by Category, Groups and Sponsor Page 36 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

BS137 EPIC Nitinol Stent Nitinol self expanding stent Stent diameters up to 14mm $1,800.00

and lengths up to 120mm

BS167 Placehit Wallstent Biomedical cobalt-based alloy, self Stent diameters up to 19mm $1,800.00

expanding stent and lengths up to 100mm

BS168 Wallstent RP Tracheobronchial, Iliac, Biomedical 20-24mm; length 18-90mm $1,800.00

Superalloy Wire, Braided Mesh,

Stainless Steel Stent with Unistep

Delivery System

BS189 Adapt Monorail Carotid Stent System Nitinol self expanding stent 21-40mm length, 4-9mm $1,800.00

diameter

BS196 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, $1,800.00

lengths less than 150mm

Cook Medical Australia Pty Ltd

WC168 Cook Vascular/Biliary Stent Vascular/Biliary stent 5/6 Fr delivery system, 4 - $1,800.00

14mm diameter, 2 - 8cm

length

WC278 Zilver Vascular Stent with Rapid Zilver Stent Vascular Design, self- Delivery System 5Fr, $1,800.00

Exchange Delivery System expandable nitinol stent. Preloaded in 125cm. Stent diameter 4mm-

a 5.0 French Rapid Exchange delivery 10mm. Stent length 2cm-8cm.

catheter.

WC287 Zilver® Flex 35™ Vascular Stent The Zilver® Flew 35™ Stent (ZFV) is The Zilver® Flex 35™ $1,800.00

a self-expandable stent made of Stent is available in the

nitinol.

The special laser-cut pattern following sizes: stent outer

of the nitinol tube provides a diameters of 5 -10mm and

construction with a strong radial force stent lengths of 20 -140mm.

and high flexibility.

The stent has

radiopaque markers at both ends.

The

stent is supplied preloaded in a 6.0

French inducer catheter. A radiopaque

marker on the distal tip of the sheath

is used to visualize deployment of the

stent. Stent deployment is controlled

by means of a hand held device.

WC290 Zilver® Vena ™ Venous Stent The Zilver® Vena™ Venous Stent is a 14mm and 16mm diameters, $1,800.00

self-expanding, flexible, slotted-tube and 60mm/100mm/140mm

nitinol stent. Post-deployment, the lengths.

stent is designed to impart an outward

radial force upon the inner lumen of

the vessel, establishing patency in the

stented region.

Prostheses List by Category, Groups and Sponsor Page 37 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Device Technologies Australia Pty Ltd

DE376 Supra Veritas Peripheral Vascular Interwoven Self-Expanding Nitnol 20mm x 4,5,6,7mm $1,800.00

Stent 30mm x 4,5,6,7mm

60mm x 4,5,6,7mm

80mm x 4,5,6,7mm

100mm x 4,5,6,7mm

120mm x 4,5,6,7mm

Endotherapeutics Pty Ltd

ET037 SX-Ella Endovascular Stent Uncovered, self-expanding nitinol Dia 6-16mm, length 22-77mm $1,800.00

ev3 Australia Pty Ltd

EE006 Protégé GPS Peripheral Stent Protégé RX Peripheral Stent Diameter 6-10mm Length $1,800.00

20-60mm

EE024 Protégé EverFlex Peripheral Stent Protégé EverFlex is a self expanding Diameter 5-8, Length 20- $1,800.00

Nitinol stent premounted on an OTW 120mm

delivery system.

Johnson & Johnson Medical Pty Ltd

JJ419 SMART Control Peripheral Stent SMART Control is a laser cut nitinol Dia 6 – 14mm; Length 20 – $1,800.00

System self expanding stent, used to treat 100mm

peripheral vessel disease.

JJ592 SMART Nitinol Stent System Long 120mm Stent, 6F compatible 6-8mm diameter, 120mm $1,800.00

stent length, 120cm

delivery system

JJ646 Precise Pro Rx Nitinol Stent System Nitinol self expanding stent Diameter: 5, 6, 7, 8, 9, $1,800.00

10mm;

Length: 20, 30, 40mm

Medtronic Australasia Pty Ltd

MC743 Complete SE Stent Nitinol 20mm - 80mm $1,800.00

MC744 Complete SE Stent Nitinol 100mm - 120mm $1,800.00

MC978 Cristallo Ideale Carotid Self Cristallo Ideale Nitinol, Carotid Self Cylinder Diameter: 7.0mm - $1,800.00

Expanding Stent System Expanding Hybrid Stent system, 5F 11.0 mm. Taper Diameter

introducer sheath compatible, Rapid 6.0/9.0 - 7.0/10.0. Length

Exchange design, .014" guide wire 20mm - 40 mm.

compatible.

MI010 Maris Plus Peripheral Self- Nitinol, self expanding, peripheral Diameter: 6.0-12.0mm; $1,800.00

Expanding Stent System stent system Length: 30-120mm

Prostheses List by Category, Groups and Sponsor Page 38 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Pyramed Pty Limited

PY028 Sinus-XL Stent Self-expanding Nitinol stent Diameter: 16mm, 18mm. $1,800.00

Length: 40-100mm

nominal; 41-100 expanded.

PY031 Optimed Sinus Stents Sinus-wave nitinol stent 3-14mm Diameter x 20- $1,800.00

130mm Length

PY036 sinus-Venous Stents sinus-Venous Stent used for treating 12-18mm Diameter, 60- $1,800.00

venous insufficiency, occlusion and 150mm Length

stenosis

LD

Pyramed Pty Limited

PY029 Sinus-XL Stent ≥20mm Self-expanding Nitinol stent Diameter: 20mm, 22mm, $2,970.00

24mm, 26mm, 28mm, 30mm,

32mm, 34mm. Length: 30-

100mm nominal; 32-102

expanded.

10.1.1.3 - Self Expandable, ≥150mm

Abbott Australasia Pty Ltd

AY036 Absolute Pro (Long Length) Laser cut nitinol self expanding stent Diameter 5mm to 10mm; $2,970.00

≥150 length 150mm, 170mm,

200mm

Bard Australia Pty Ltd

BA217 Lifestent Laser cut nitinol self expanding stent Diameter 5mm to 10mm; $2,970.00

length 150mm - 200mm

Biotronik Australia Pty Ltd

BT127 Pulsar 18 Peripheral self expanding Pulsar 18 self expanding Nitinol Stent: 4-7mm Stent length: $2,970.00

Nitinol stent system stent system 150-200mm Catheter

length: 90-135mm

BT132 Pulsar 35 Peripheral self-expanding Pulsar 35 Peripheral self-expanding Diameter: 5-7mm; Length: $2,970.00

Nitinol stent system Nitinol stent system 150-200mm; Catheter

length: 90cm, 135cm

Boston Scientific Australia Pty Ltd

BS197 Innova Self-Expanding Stent Nitinol, self expanding stent Diameters up to 8mm, $2,970.00

Lengths greater than 150mm

Prostheses List by Category, Groups and Sponsor Page 39 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Cook Medical Australia Pty Ltd

WC285 Zilver® Flex35™ Vascular Stent The Zilver® Flex35™ Stent (ZFV) is a Diameter: 5-8mm; $2,970.00

self-expandable stent made of nitinol. Length:170mm and 200mm

The special laser-cut pattern of the

nitinol tube provides a construction

with a strong radial force and high

flexibility.

The stent has radiopaque

markers at both ends.

Device Technologies Australia Pty Ltd

DE375 Supera Verita Peripheral Vascular Interwoven Self-Expanding Nitnol 150mm x 4,5,6mm $2,970.00

System 180mm x 4,5,6mm

200mm x 4,5,6mm

ev3 Australia Pty Ltd

EE025 Protégé EverFlex Peripheral Stent Protégé EverFlex is a self expanding Diameter 5-8mm, Length $2,970.00

Nitinol stent premounted on an OTW 150-200mm

delivery system.

Johnson & Johnson Medical Pty Ltd

JJ617 SMART Nitinol Stent System Long 150mm stent, 6F compatible 6-8mm diameter, 150mm $2,970.00

length, 120cm delivery

system

Medtronic Australasia Pty Ltd

MC760 Complete SE Stent Nitinol 150mm $2,970.00

MI011 Maris Plus Peripheral Self- Nitinol, self expanding, peripheral Diameter: 6.0-12.0mm; $2,970.00

Expanding Stent System stent system Length: 150mm

Pyramed Pty Limited

PY016 Optimed Iliac Sinus Stent - extra long Sinus-wave nitinol stent - extra long 6-8 mm x 150-200mm $2,970.00

PY037 sinus-Venous Stent sinus-Venous stent used for treating 18mm diameter, 150mm $2,970.00

venous insufficiency, occlusion and Length

stenosis

Prostheses List by Category, Groups and Sponsor Page 40 of 1011

10 - VASCULAR

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

10.1.1.4 - Self-Expanding, large diameter for treatment of aortic dissection disease

Cook Medical Australia Pty Ltd

WC288 Zenith Dissection Endovascular The Zenith Dissection Endovascular Diameter: 46mm (designed $4,650.00

Stent with the H&L-B One-Shot for vessel diameters 24-

Introduction System is indicated for 38mm). Length: 82, 123,

the endovascular treatment of patients 164mm

with aortic dissection distal to the left

subclavian artery.

10.1.2 - Drug Eluting Stents

Cook Medical Australia Pty Ltd

WC289 Zilver PTX The Zilver PTX Drug Eluting 6French: 5, 6, 7, 8, 9, 10mm $2,400.00

Model 4600; Classic Annuloplasty Composition: Elgiloy Bands;

Polyester Film Strips; Silicone

Rubber; Polyester Cloth, Cosgrove-

Edwards

Medtronic Australasia Pty Ltd

MC005 Medtronic Duran Annuloplasty Annuloplasty Devices - Models 610R Model 610R 25-35mm & $2,200.00

Ring; Duran Ancore Ring 620R; & 620R Silicone / Barium Sulphate, Model 620R 23-35mm

Duran Ancore Chordal Model 620RG Dacron.

Sorin Group Australia Pty Ltd

SA127 AnnuloFlo Annuloplasty System Annuloflex Ring or AnnuloFlo Ring 26-36mm $2,200.00

St Jude Medical Australia Pty Ltd

SJ035 SJM Tailor Annuloplasty Ring Fully Flexible 25mm - 35mm $2,200.00

9.4.2 - Ring, with modification

Edwards Lifesciences Pty Ltd

EL049 McCarthy-Edwards IMR Etlogix Rigid mitral annuloplasty ring with 24mm, 26mm, 28mm, 30mm, $2,400.00

Annuloplasty Ring (Model: 4100) an assymetric design 32mm, 34mm, 36mm

EL050 Edwards MC3 Tricuspid Ring 3D rigid annuloplasty ring with a 26mm, 28mm, 30mm, 32mm, $2,400.00

Annuloplalsty System (Model: tricuspid specific design 34mm, 36mm

Prostheses List by Category, Groups and Sponsor Page 1002 of 1011

9 - CARDIOTHORACIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

EL057 Geoform Geoform annuloplasty ring Model 26, 28, 30 and 32mm $2,400.00

4200 with Holder

EL059 Carpentier-Edwards PHYSIO ll PHYSIO II is a semi rigid mitral 24, 26, 28, 30, 32, 34, 36, $2,400.00

Mitral Annuloplasty Ring annuloplasty ring, with an improved 38, 40mm

saddle shape and global disease based

design

EL061 Carpentier-Edwards Physio The Carpentier-Edwards Physio 24, 26, 28, 30, 32, 34, 36mm $2,400.00

Tricuspid Annuloplasty Ring Tricuspid annuloplasty ring, model

6200 is intended for use in patients

with tricuspid valvular insufficiency.

Designed with selective flexibility

and 3D waveform shape.

Medtronic Australasia Pty Ltd

MC745 CG Future Composite Ring Semi-rigid mitral annuloplasty ring, 24, 26, 28, 30, 32, 34, 36 & $2,400.00

with anterior flexibility 38mm

MC844 Profile 3D Annuloplasty Ring 3D, rigid annuloplasty ring with Diameter (mm) 24 - 40mm $2,400.00

physiologic mitral valve shape

Sorin Group Australia Pty Ltd

SA150 MEMO 3D Memo 3D Semirigid Mitral 24-38mm $2,400.00

Annuloplasty Ring, with 3D

flexibility and coasted with Carbofilm

St Jude Medical Australia Pty Ltd

SJ087 St Jude Medical Rigid Saddle Ring Rigid Annuloplasty Ring 24 - 34mm $2,400.00

SJ195 Attune Flexible Adjustable Flexible annuloplasty ring 25mm - 43mm $2,400.00

Annuloplasty Ring

SJ316 Seguin Annuloplasty Ring Semi-rigid annuloplasty ring 24-40mm $2,400.00

Prostheses List by Category, Groups and Sponsor Page 1003 of 1011

9 - CARDIOTHORACIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

9.4.3 - Band, with modification

Medtronic Australasia Pty Ltd

MC709 Posterior Annuloplasty Band; Annuloplasty - Model 610B & 620B Model 610B: 25-35mm; $2,200.00

Colvin - Galloway Future Band Silicone / Barium Sulphate, Dacron. Models 620B & 620BG:

Model 638B; Duran Ancore Band Models 638B semi-regid metal alloy 23-35mm, Model 638B - 26-

620B; Duran Ancore Chordal core, silicone coating, polyester knit 38mm

Model 620BG fabric, kit includes-band, malleable

handle, template with suture markers,

sizers

St Jude Medical Australia Pty Ltd

SJ088 SJM Tailor Annuloplasty Band Flexible double-velour, polyester 25 - 35mm $2,200.00

9.5.1 - Tissue

9.5.1.1 - < 25cm²

Baxter Healthcare Pty Ltd

BX292 Supple Peri-Guard (4 x 4cm) Model No PC0404SN - 4 x 4cm 4 x 4cm $350.00

Bovine pericardium patch

9.5.1.2 -

25-75cm²

Baxter Healthcare Pty Ltd

BX293 Supple Peri-Guard (6 x 8cm) Model No PC0608SN -6 x 8cm 6 x 8cm $550.00

Bovine pericardium patch

9.5.1.3 - >75cm²

Baxter Healthcare Pty Ltd

BX294 Supple Peri-Guard (10 x 16cm) Model No PC1016SN - 10 x 16 10 x 16cm $760.00

Bovine pericardium patch

BX295 Supple Peri-Guard (8 x 14cm) Nodel No PC0814SN - 8 x 14 Bovine 8 x 14cm $760.00

pericardium patch

Prostheses List by Category, Groups and Sponsor Page 1004 of 1011

9 - CARDIOTHORACIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Edwards Lifesciences Pty Ltd

EL033 Baxter Augmentation / Substitution Edwards Pericardial Patch. Bovine 10cm x 16cm $760.00

Material, Human or Animal Origin, Pericardium.

Sterile Pericardial Patch.

9.5.2 - Synthetic

9.5.2.1 - Cardiovascular < 75cm²

W L Gore & Associates

GT117 Gore-Tex - Cardiovascular Patch ePTFE 0.4mm Thickness 2 x 9cm $240.00

GT118 Gore-Tex - Cardiovascular Patch ePTFE 0.4mm - 3 x 6cm0.6mm - $240.00

2.5cm x 15cm & 5cm x 7.5cm

GT126 Acuseal Cardiovascular Patch ePTFE 0.5mm Thickness 1 x 9cm; $240.00

Vascular 0.8 x 7.5cm

GT127 Acuseal Cardiovascular Patch ePTFE 0.5mm Thickness 3 x 6cm & $240.00

5 x 7.5cm

9.5.2.2 - Cardiovascular ≥ 75cm²

Tag Medical

TM040 Repel - CV Bioresorbable Adhesion Barrier 18cmx13.5cmx137 microns $521.00

W L Gore & Associates

GT120 Gore-Tex Cardiovascular Patch ePTFE 0.6mm Thickness 5 x 15cm $521.00

GT121 Gore-Tex Cardiovascular Patch ePTFE 0.6mm Thickness 10 x 15cm $521.00

9.6.1 - Non-cardiovascular < 100cm²

W L Gore & Associates

GT122 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 6 x 12cm $360.00

Prostheses List by Category, Groups and Sponsor Page 1005 of 1011

9 - CARDIOTHORACIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

9.6.2 - Non-cardiovascular ≥100cm² and <200cm²

W L Gore & Associates

GT123 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 8 x 16cm $643.00

GT124 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 12 x 12cm $643.00

9.6.3 - Non-cardiovascular

≥200cm²

W L Gore & Associates

GT125 Preclude Pericardial Membrane ePTFE 0.1mm Thickness 15 x 20cm $1,455.00

9.9.1 - Modified Tube (end modified eg valsalva)

Terumo Corporation Australia

TU036 Gelweave Valsalva Graft Woven vascular prosthesis, polyester, Diameter 24 - 34 mm, $3,320.00

gelatin sealed Overall length 18.4 -

9.9.2 - Tube with one side branch

Terumo Corporation Australia

TU038 Gelweave Graft Straight Thoracic Graft, with antiflo 20 -34 mm x 20-40 cm $1,715.00

side branch, Polyester, woven, gelatin

sealed

9.9.3 - Tube with multiple side branches (more than 1)

Terumo Corporation Australia

TU037 Gelweave Plexus Graft Multi Branched, for Aortic Arch 20 - 34 mm x 40 cm $2,150.00

reconstruction, Polyester, Woven,

gelatin sealed

Prostheses List by Category, Groups and Sponsor Page 1006 of 1011

ORTHOPAEDIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

6.7.1 Trauma and general accessories

6.7.1.3.1 End Cap

titanium

Biomet Australia Pty Ltd

BH175 Supacondylar Nail System Solid End Cap Titanium Unsterile or One size only $57.00

Sterile

6.7.10 Soft Tissue Fixation Devices

6.7.10.4 Other

Device Technologies Australia Pty Ltd

DE301 Suture Button Multiple hole button for fixation of 2.6mm - 7.5mm $248.00

bone to bone or soft tissue to bone,

and are intended as fixation posts, a

distribution bridge, or for

distributing suture tension over areas

of ligament or tendon repair

6.7.2 External Fixator

6.7.2.5.3 External Fixator, Bone Fixation Pin

Peg

Biomet Australia Pty Ltd

BH219 Ace External Fixator Peg, titanium 5mm $81.00

6.7.2.6.1 External Fixator, Olive wire

Biomet Australia Pty Ltd

BH202 Ace External Fixator Wire bayonet point - stainless steel 1.8mm $41.00

packet of 3

Biomet Australia Pty Ltd

BH201 Ace External Fixator Olive wire bayonet point - stainless 1.5 or 1.8mm $260.00

steel, packet of 3

Prostheses List by Category, Groups and Sponsor Page 1007 of 1011

ORTHOPAEDIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

6.7.3.1 Internal Fixation, other Fixation

6.7.3.2.1.1.1 Intramedullary Nail, femur

Cannulated

Synthes Australia Pty Ltd

SY123 AO/ASIF Intermedullary Nails Femoral reamed, tibial nail 9 - 19mm, length 200 - $649.00

500mm.

6.7.3.2.1.1.4 Intramedullary Nail, tibia

titanium

Biomet Australia Pty Ltd

BI286 Uniflex Tibial Nail Tibial Nail, Titanium 8-14mm x 240-420mm $950.00

6.7.3.5.7.1 Fixation screw, cortical or bone, otherwise unspecified, 4mm to 7 mm diameter or size

Biomet Australia Pty Ltd

BH334 Small / Large Fragment Set S/S CHS Compression Screw - Stainless Neutral to +2 $35.00

Steel

6.7.3.5.7.3 Fixation screw, cortical or bone, otherwise unspecified, < 4mm diameter

Medical & Optical Instruments Australia Pty Ltd

MO195 Acumed Congruent Plate System Screw - titanium 2.7, 3.5, 4.0mm dia, 30 - 65 $120.00 $147.00

length

6.7.3.6.1.3 Cable System, Cable and Sleeve

Johnson & Johnson Medical Pty Ltd

DP364 Control Cable with Sleeve Control Cable with sleeve One size only $350.00

6.7.5 Orthopaedic reconstruction, general

Global Orthopaedic Technology

GO183 Actifuse ABX MIS Actifuse ABX MIS, Applicator and 7.5ml $2,300.00

Cartridge, 7.5ml

GO184 Actifuse ABX MIS Actifuse ABX MIS, Refill Cartridge, 7.5ml $1,560.00

7.5ml

Prostheses List by Category, Groups and Sponsor Page 1008 of 1011

ORTHOPAEDIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

6.7.5.2.2 Bone Substitute, >1cc or 1gm, to <= 5cc or 5gm

Global Orthopaedic Technology

GO162 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A 5ml $1,300.00 $1,540.00

silicate substituted synthetic bone

< = 3cc

Global Orthopaedic Technology

GO161 Actifuse ABX Easyfill Actifuse ABX Easyfill - A silicate 1.5mL to 4mL $1,080.00 $1,200.00

substituted synthetic bone graft

6.7.5.2.3 Bone Substitute, >5cc or 5gm, <=12cc or 12gm

Global Orthopaedic Technology

GO163 Actifuse ABX Easyfill Putty Actifuse ABX Easyfill Putty - A 10ml $2,300.00

silicate substituted synthetic bone

6.7.7 Limb preservation, resection and lengthening systems

6.7.7.2.2 Limb preservation and lengthening, proximal femur

cementless

Johnson & Johnson Medical Pty Ltd

DY187 Limb Preservation System Beaded, 'Porocoat' Standard & Neutral, 15deg Left & Right $6,990.00

Trochanter Replacement in both styles

Bone matrix implant, artificial

Global Orthopaedic Technology

GO177 ACTIFUSE ABX Putty Actifuse AVX Putty - A silicated 20ml $4,600.00

substituted synthetic bone graft.

Grafts, Bone

Zimmer Pty Ltd

ZI265 Continuum hip system Hedrocel AVN Rod 3mm - 12mm block $3,208.00

Prostheses List by Category, Groups and Sponsor Page 1009 of 1011

ORTHOPAEDIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Hip F - Accessory

Group 30h - Mesh

Stryker Australia Pty Ltd

HW044 Exeter Hip System X-Change Revision Mesh - Stainless Acetabular, Femoral and $889.00

Steel Flat Mesh

HW045 Exeter Hip System X-Change Revision Mesh -Rim - Small $886.00

Stainless Steel

HW046 Exeter Hip System X-Change Revision Mesh - Rim - Large $855.00

Stainless Steel

Zimmer Pty Ltd

ZI329 CPT Impaction Grafting Mesh Titanium Femoral or acetabular mesh 6 sizes acetabular rim (small $3,367.00

and large), medial wall

(small and large), flat and

femoral meshes

Prostheses List by Category, Groups and Sponsor Page 1010 of 1011

PLASTIC AND RECONSTRUCTIVE

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Bone Matrix Implants, Artificial

Biomet Australia Pty Ltd

BI487 Mimix Calcium Phosphate Bone Calcium Phosphate 5 grams $1,004.00

Void Filler

BI488 Mimix Calcium Phosphate Bone Calcium Phosphate 10 grams $1,900.00

Void Filler

BI489 Mimix Calcium Phosphate Bone Calcium Phosphate 20 grams $2,300.00

Void Filler

Grand Total: 9851 Records

Prostheses List by Category, Groups and Sponsor Page 1011 of 1011

PART B - Human Tissue List February 2013

Billing Code Facility Minimum Benefit Maximum Benefit

1 - OPHTHALMIC

Amniotic Membrane

LEM03 Lions Eye Donation Service $770.00

Cornea

LEM01 Lions Eye Donation Service $2,000.00

LEN01 Lions NSW Eye Bank $2,026.00

LEW01 Lions Eye Bank of Western Australia $2,500.00

QEB01 Queensland Eye Bank $2,100.00

SAE01 The Eye Bank of South Australia $1,838.00

Cornea for Endothelial Keratoplasty

LEW03 Lions Eye Bank of Western Australia $3,000.00

Cornea for Endothelial Lamellar Keratoplasty

LEM04 Lions Eye Donation Service $2,660.00

Cornea For Lamellar

LEN03 Lions NSW Eye Bank $1,216.00

Sclera

LEM02 Lions Eye Donation Service $150.00

LEN02 Lions NSW Eye Bank $304.00

LEW02 Lions Eye Bank of Western Australia $250.00

QEB02 Queensland Eye Bank $298.00

SAE02 The Eye Bank of South Australia $196.00

CARDIO-THORACIC

Conduit - Aortic

TBV56 Donor Tissue Bank of Victoria $1,117.00

Conduit - Aortic + Valve

QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $6,300.00

Conduit - Arterial

SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $987.00

Conduit - Pulmonary

TBV03 Donor Tissue Bank of Victoria $1,116.00

Page 1 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Conduit - Pulmonary + Valve

QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00

Conduit - Pulmonary large

QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00

Patch - Mitral

QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,743.00

Patch - Pericardium

QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00

Patch - Tricuspid

QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,743.00

Pericardium

TBV50 Donor Tissue Bank of Victoria $540.00

Thoracic Aorta

QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $1,915.00

Valve - Aortic

QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00

RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00

SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $5,350.00

TBV01 Donor Tissue Bank of Victoria $7,278.00

Valve - Mitral

QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $6,300.00

Valve - Pulmonary

QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $6,600.00

RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00

SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $5,350.00

TBV02 Donor Tissue Bank of Victoria $7,278.00

DERMATOLOGIC

Skin 100cm² - frozen skin graft from human origin

QBB72 The Queensland Bone Bank $477.00

Skin 200cm² - frozen skin graft from human origin

QBB73 The Queensland Bone Bank $705.00

Skin 50cm² - frozen skin graft from human origin

Page 2 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

QBB71 The Queensland Bone Bank $248.00

ORTHOPAEDIC

Autologous Skull Flap

MVS23 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,396.00

QBB60 The Queensland Bone Bank $1,568.00

RNB02 Hunter New England Bone Bank $1,470.00

Autologous Skull Flap - processed

QBB56 The Queensland Bone Bank $1,986.00

Bone - Cancellous Bone Matrix, Lyophilised 40cc

TBV52 Victorian Institute of Forensic Medicine $683.00

Bone - Cancellous Bone Matrix, Lyophilised 80cc

TBV53 Victorian Institute of Forensic Medicine $1,364.00

Bone - Cancellous Crunch 15cc

NBB62 New South Wales Bone Bank $903.00

Bone - Cancellous Crunch 30cc

NBB61 New South Wales Bone Bank $1,647.00

Bone - Cancellous Crunch 60cc

NBB60 New South Wales Bone Bank $2,498.00

Bone - Cancellous Cubes (6) Freeze Dried

QBB09 The Queensland Bone Bank $1,609.00

Bone - Cancellous Strips (2) Freeze Dried

QBB10 The Queensland Bone Bank $680.00

Bone - Chips/cubes 40cc

TBV09 Donor Tissue Bank of Victoria $1,073.00

Bone - Chips/cubes 80cc

TBV10 Donor Tissue Bank of Victoria $2,044.00

Bone - Cortico-Cancellous Crunch (40/60) 15cc

NBB65 New South Wales Bone Bank $903.00

Bone - Cortico-Cancellous Crunch (40/60) 30cc

NBB64 New South Wales Bone Bank $1,647.00

Bone - Cortico-Cancellous Crunch (40/60) 60cc

NBB63 New South Wales Bone Bank $2,498.00

Page 3 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Bone – Cortico-Cancellous Crunch <20g Sterile

AUB08 Australian Biotechnologies $2,215.00

Bone – Cortico-Cancellous Crunch <30g

AUB04 Australian Biotechnologies $2,070.00

Bone - Demineralised Bone Matrix, Lyophilised 10g

TBV55 Donor Tissue Bank of Victoria $1,157.00

Bone - Demineralised Bone Matrix, Lyophilised 5g

TBV54 Donor Tissue Bank of Victoria $578.00

Bone - Milled <30g Freeze Dried

PBT37 Perth Bone and Tissue Bank $750.00

Bone - Milled <30gr (60cc equivalent)

PBT08 Perth Bone and Tissue Bank $2,409.00

Bone - Milled >50gr (100cc equivalent)

PBT10 Perth Bone and Tissue Bank $3,445.00

Bone - Milled 20g

QBB45 The Queensland Bone Bank $1,993.00

Bone - Milled 20g Freeze Dried

QBB03 The Queensland Bone Bank $2,524.00

Bone - Milled 30 - 50gr (60 - 100cc equivalent)

PBT09 Perth Bone and Tissue Bank $3,030.00

Bone - Milled 30-50g Freeze Dried

PBT38 Perth Bone and Tissue Bank $900.00

Bone - Milled 40cc

TBV11 Donor Tissue Bank of Victoria $1,285.00

Bone - Milled 80cc

TBV12 Donor Tissue Bank of Victoria $2,299.00

Bone - Milled Femoral Head

AUB02 Australian Biotechnologies $2,457.00

Bone - Ronguered Chips

QBB68 The Queensland Bone Bank $2,022.00

Bone - Ronguered Chips Freeze Dried

QBB67 The Queensland Bone Bank $2,524.00

Page 4 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Bone Plug/Dowel - Cancellous

NBB05 New South Wales Bone Bank $1,224.00

PBT03 Perth Bone and Tissue Bank $500.00

TBV07 Donor Tissue Bank of Victoria $762.00

Bone Plug/Dowel - Tricortical

TBV08 Donor Tissue Bank of Victoria $827.00

Cartilage - costal segments

PBT11 Perth Bone and Tissue Bank $300.00

QBB12 The Queensland Bone Bank $210.00

TBV17 Donor Tissue Bank of Victoria $430.00

Cortical Strut

AUB05 Australian Biotechnologies $2,451.00

QBB52 The Queensland Bone Bank $441.00

TBV14 Donor Tissue Bank of Victoria $842.00

Cortical Strut >15 - 20cm

PBT07 Perth Bone and Tissue Bank $2,364.00

Cortical Strut >20cm

PBT48 Perth Bone and Tissue Bank $2,732.00

Cortical Struts 10-15cm

PBT06 Perth Bone and Tissue Bank $1,981.00

Disc - Freeze Dried

QBB04 The Queensland Bone Bank $713.00

Elbow - joint

QBB14 The Queensland Bone Bank $2,205.00

TBV18 Donor Tissue Bank of Victoria $5,787.00

Fascia Lata

NBB09 New South Wales Bone Bank $922.00

TBV21 Donor Tissue Bank of Victoria $889.00

Fascia Lata - Large (15cm x 10cm)

PBT15 Perth Bone and Tissue Bank $1,590.00

Fascia Lata - per sq cm

QBB11 The Queensland Bone Bank $5.00

Page 5 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Fascia Lata - Small (10cm x 5cm)

PBT16 Perth Bone and Tissue Bank $854.00

Femoral Head

ACT01 ACT Bone Bank $2,432.00

APH01 The Avenue Private Hospital Bone Bank $1,131.00

AUB03 Australian Biotechnologies $2,354.00

CSA01 Rachel Forster Bone Bank $802.00

DHR01 Barwon Health Bone Bank $3,028.00

HBB01 The Hobart Private Hospital Bone Bank $2,113.00

LPH01 Lingard Private Hospital Bone Bank $1,103.00

MMH01 Mater Misericordiae Hospital Bone Bank Theatres $400.00

MVS05 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,370.00

NBB16 New South Wales Bone Bank $2,354.00

PBT22 Perth Bone and Tissue Bank $2,632.00

QBB27 The Queensland Bone Bank $2,163.00

RNB01 Hunter New England Bone Bank $2,250.00

SVN01 Mater Hospital $731.00

TBV26 Donor Tissue Bank of Victoria $2,596.00

Femoral Head - Autologous

QBB61 The Queensland Bone Bank $2,163.00

Femoral Head - Freeze Dried

QBB28 The Queensland Bone Bank $2,163.00

Femoral Hemi-condyle

NBB59 New South Wales Bone Bank $2,271.00

PBT21 Perth Bone and Tissue Bank $2,295.00

TBV46 Donor Tissue Bank of Victoria $1,330.00

Femoral Rings

NBB17 New South Wales Bone Bank $1,606.00

PBT24 Perth Bone and Tissue Bank $1,662.00

QBB30 The Queensland Bone Bank $1,591.00

Femoral Rings - Freeze Dried

QBB31 The Queensland Bone Bank $670.00

Femoral Shaft

Page 6 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

QBB23 The Queensland Bone Bank $2,247.00

Femoral Shaft - Freeze Dried

QBB66 The Queensland Bone Bank $2,811.00

Femoral Shaft - Half

NBB57 New South Wales Bone Bank $2,778.00

Femoral Shaft - Middle Third

NBB13 New South Wales Bone Bank $2,507.00

TBV24 Donor Tissue Bank of Victoria $2,357.00

Femoral Shaft - Segment

NBB56 New South Wales Bone Bank $1,687.00

Femoral Shaft - Third

NBB55 New South Wales Bone Bank $1,687.00

Femoral Shaft/Tibial Shaft - Middle third

PBT19 Perth Bone and Tissue Bank $2,791.00

Femur - Distal (Shaft & Condyles)

MVS02 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT17 Perth Bone and Tissue Bank $3,471.00

TBV22 Donor Tissue Bank of Victoria $4,251.00

Femur - Distal Half

NBB10 New South Wales Bone Bank $2,778.00

QBB20 The Queensland Bone Bank $2,800.00

Femur - Distal third

NBB11 New South Wales Bone Bank $2,606.00

Femur - Entire

MVS03 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB12 New South Wales Bone Bank $6,200.00

QBB22 The Queensland Bone Bank $4,268.00

TBV23 Donor Tissue Bank of Victoria $7,120.00

Femur - Entire head removed

PBT18 Perth Bone and Tissue Bank $5,882.00

Femur - Proximal (shaft, trochanter, neck)

MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

Page 7 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

PBT20 Perth Bone and Tissue Bank $3,471.00

TBV25 Donor Tissue Bank of Victoria $4,220.00

Femur - Proximal half

NBB15 New South Wales Bone Bank $2,921.00

QBB25 The Queensland Bone Bank $3,020.00

Femur - Proximal third

NBB14 New South Wales Bone Bank $1,306.00

Femur - Proximal with femoral head

TBV51 Donor Tissue Bank of Victoria $4,095.00

Fibula - Entire

MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB18 New South Wales Bone Bank $6,041.00

PBT25 Perth Bone and Tissue Bank $2,667.00

QBB32 The Queensland Bone Bank $2,651.00

TBV27 Donor Tissue Bank of Victoria $6,863.00

Fibula - Segment

NBB54 New South Wales Bone Bank $2,359.00

PBT28 Perth Bone and Tissue Bank $1,472.00

Fibula - Segment (12cm)

MVS14 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

TBV29 Donor Tissue Bank of Victoria $1,164.00

Fibula - Segment (6cm)

MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

TBV28 Donor Tissue Bank of Victoria $762.00

Fibular Shaft

TBV30 Donor Tissue Bank of Victoria $2,419.00

Hemipelvis - Acetabulum

NBB21 New South Wales Bone Bank $2,905.00

PBT29 Perth Bone and Tissue Bank $2,940.00

QBB33 The Queensland Bone Bank $2,762.00

TBV31 Donor Tissue Bank of Victoria $3,300.00

Hemipelvis - Complete

MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

Page 8 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

NBB24 New South Wales Bone Bank $6,500.00

PBT30 Perth Bone and Tissue Bank $5,411.00

QBB37 The Queensland Bone Bank $4,268.00

TBV32 Donor Tissue Bank of Victoria $7,487.00

Hemipelvis - iliac crest

NBB22 New South Wales Bone Bank $2,705.00

PBT31 Perth Bone and Tissue Bank $1,174.00

QBB34 The Queensland Bone Bank $2,478.00

TBV33 Donor Tissue Bank of Victoria $2,984.00

Hemipelvis - Tricortical iliac wedge

NBB23 New South Wales Bone Bank $1,195.00

PBT32 Perth Bone and Tissue Bank $1,067.00

QBB35 The Queensland Bone Bank $1,195.00

TBV34 Donor Tissue Bank of Victoria $1,149.00

Hemipelvis - Tricortical iliac wedge Freeze Dried

QBB36 The Queensland Bone Bank $735.00

Humeral Head

TBV37 Donor Tissue Bank of Victoria $1,823.00

Humeral Head Addition

NBB26 New South Wales Bone Bank $1,545.00

Humeral Shaft

NBB50 New South Wales Bone Bank $3,090.00

QBB39 The Queensland Bone Bank $1,612.00

Humeral Shaft - Half

NBB51 New South Wales Bone Bank $1,671.00

Humerus - Distal

MVS19 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB25 New South Wales Bone Bank $2,359.00

TBV49 Donor Tissue Bank of Victoria $2,472.00

Humerus - Entire

MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB29 New South Wales Bone Bank $3,142.00

QBB43 The Queensland Bone Bank $3,035.00

Page 9 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Humerus - Entire with rotator cuff

NBB30 New South Wales Bone Bank $3,182.00

PBT33 Perth Bone and Tissue Bank $3,343.00

Humerus - Proximal

NBB27 New South Wales Bone Bank $2,769.00

PBT35 Perth Bone and Tissue Bank $1,174.00

TBV36 Donor Tissue Bank of Victoria $3,054.00

Humerus - Proximal half with rotator cuff

NBB28 New South Wales Bone Bank $2,778.00

Humerus - Proximal with rotator cuff

MVS09 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

PBT34 Perth Bone and Tissue Bank $2,886.00

TBV35 Donor Tissue Bank of Victoria $2,919.00

Humerus - Ring

NBB53 New South Wales Bone Bank $1,448.00

Ligament - Medial

NBB31 New South Wales Bone Bank $1,781.00

TBV38 Donor Tissue Bank of Victoria $1,964.00

Meniscal Graft

PBT47 Perth Bone and Tissue Bank $1,921.00

Meniscus

QBB05 The Queensland Bone Bank $1,400.00

TBV40 Donor Tissue Bank of Victoria $1,306.00

Meniscus with Ligaments

TBV39 Donor Tissue Bank of Victoria $2,368.00

Osteotomy Wedge

PBT60 Perth Bone and Tissue Bank $1,267.00

Patella

QBB47 The Queensland Bone Bank $788.00

TBV41 Donor Tissue Bank of Victoria $1,125.00

Patellar unit whole with or without tibial block

PBT40 Perth Bone and Tissue Bank $2,654.00

Page 10 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Radius

MVS18 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB06 New South Wales Bone Bank $3,024.00

PBT13 Perth Bone and Tissue Bank $1,800.00

QBB15 The Queensland Bone Bank $2,258.00

TBV19 Donor Tissue Bank of Victoria $3,436.00

Radius - Ring

NBB49 New South Wales Bone Bank $1,854.00

Radius - Shaft

NBB47 New South Wales Bone Bank $2,975.00

Rib (5cm)

MVS21 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $382.00

PBT41 Perth Bone and Tissue Bank $300.00

TBV43 Donor Tissue Bank of Victoria $537.00

Spinal Ring

AUB07 Australian Biotechnologies $1,854.00

Tendon

AUB10 Australian Biotechnologies $2,184.00

Tendon - Achilles

NBB01 New South Wales Bone Bank $1,922.00

PBT61 Perth Bone and Tissue Bank $1,985.00

QBB62 The Queensland Bone Bank $1,922.00

TBV05 Donor Tissue Bank of Victoria $1,129.00

Tendon - Achilles Hemi

QBB65 The Queensland Bone Bank $1,433.00

Tendon - Achilles with bone block

NBB02 New South Wales Bone Bank $2,228.00

PBT01 Perth Bone and Tissue Bank $2,301.00

QBB01 The Queensland Bone Bank $1,922.00

TBV06 Donor Tissue Bank of Victoria $2,300.00

Tendon - Achilles with bone plug

AUB09 Australian Biotechnologies $2,228.00

Tendon - Achilles with machined conical bone block

Page 11 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

NBB69 New South Wales Bone Bank $2,728.00

Tendon - EHL

QBB69 The Queensland Bone Bank $1,922.00

Tendon - Gracilis

QBB59 The Queensland Bone Bank $1,922.00

Tendon - Patellar

QBB48 The Queensland Bone Bank $2,055.00

Tendon - Patellar Hemi

QBB63 The Queensland Bone Bank $1,570.00

Tendon - Patellar split with bone plugs

PBT02 Perth Bone and Tissue Bank $1,918.00

Tendon - Patellar with bone plugs

NBB33 New South Wales Bone Bank $2,147.00

TBV42 Donor Tissue Bank of Victoria $2,368.00

Tendon - Patellar with machined conical bone plug

NBB68 New South Wales Bone Bank $2,647.00

Tendon - Patellar with Quads

NBB72 New South Wales Bone Bank $2,184.00

Tendon - Peroneus Longus

NBB73 New South Wales Bone Bank $2,184.00

Tendon - Semi tendinosis

NBB70 New South Wales Bone Bank $2,185.00

QBB70 The Queensland Bone Bank $1,922.00

Tendon - Single (ant and post tibilias, FDL, EDL, hamstring, gracilis)

PBT46 Perth Bone and Tissue Bank $2,398.00

Tendon - Tibialis Anterior

NBB67 New South Wales Bone Bank $2,184.00

QBB58 The Queensland Bone Bank $1,922.00

TBV57 Donor Tissue Bank of Victoria $2,300.00

Tendon - Tibialis Posterior

NBB71 New South Wales Bone Bank $2,184.00

QBB57 The Queensland Bone Bank $1,922.00

Page 12 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Tibia - Condyles only

TBV47 Donor Tissue Bank of Victoria $1,832.00

Tibia - Distal

MVS17 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

QBB51 The Queensland Bone Bank $1,892.00

TBV48 Donor Tissue Bank of Victoria $2,401.00

Tibia - Plateau (prox 1/3)

NBB35 New South Wales Bone Bank $2,518.00

Tibia - Proximal

NBB36 New South Wales Bone Bank $2,551.00

PBT45 Perth Bone and Tissue Bank $2,635.00

QBB54 The Queensland Bone Bank $2,365.00

Tibia - Proximal 16-25cm

TBV45 Donor Tissue Bank of Victoria $2,722.00

Tibia - Proximal 7-15cm

TBV44 Donor Tissue Bank of Victoria $2,826.00

Tibia - Proximal half

MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

Tibia – Proximal third

AUB06 Australian Biotechnologies $2,562.00

Tibia - Proximal with Patella

QBB08 The Queensland Bone Bank $2,800.00

Tibia - Proximal with Patella & Tendon

PBT44 Perth Bone and Tissue Bank $4,118.00

Tibia - Proximal with Patellar Tendon

NBB46 New South Wales Bone Bank $3,986.00

Tibia - Ring

NBB45 New South Wales Bone Bank $1,448.00

Tibia - Whole

MVS16 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB37 New South Wales Bone Bank $4,065.00

QBB55 The Queensland Bone Bank $4,248.00

Page 13 of 14

Billing Code Facility Minimum Benefit Maximum Benefit

Tibia - Whole with Patella

QBB64 The Queensland Bone Bank $4,268.00

Tibia - Whole with Patellar Tendon

NBB44 New South Wales Bone Bank $5,455.00

Tibia Shaft

QBB53 The Queensland Bone Bank $992.00

Tibial Shaft

NBB41 New South Wales Bone Bank $3,747.00

Tibial Shaft - half

NBB43 New South Wales Bone Bank $2,450.00

Tibial Shaft - third

NBB42 New South Wales Bone Bank $2,645.00

Tibial Shaft Freeze Dried

QBB02 The Queensland Bone Bank $872.00

Tri Cortical Osteotomy

NBB66 New South Wales Bone Bank $1,208.00

Ulna

MVS15 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00

NBB07 New South Wales Bone Bank $2,787.00

PBT14 Perth Bone and Tissue Bank $1,500.00

QBB16 The Queensland Bone Bank $2,258.00

TBV20 Donor Tissue Bank of Victoria $3,167.00

Ulna - Ring

NBB40 New South Wales Bone Bank $1,854.00

Ulna - Shaft

NBB38 New South Wales Bone Bank $2,450.00

Grand Total: 276 Records

Page 14 of 14

Part C - Other Prostheses February 2013

3 - GENERAL MISCELLANEOUS

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

3.2.3 - Infusion Pumps, Battery Powered

3.2.3.2 - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and

Managing Diabetes Pty Ltd

DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00

DE, SS

Australasian Medical & Scientific Ltd

AN011 Animas Vibe Insulin Pump & CGM Ambulatory insulin infusion pump Pump/Monitor: 8.26 x 5.08 $8,950.00

System with real-time continuous glucose x 2.18cm

monitoring (CGM) capability Sensor/Transmitter: 3.8 x

2.3 x 1.3cm

Managing Diabetes Pty Ltd

DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small 75 x 45 x 19mm, 60grams $8,950.00

device about the size of a pager. It

holds up to 300 units of insulin,

which is delivered continuously

through a small tube to the patient.

The DANAR Insulin Pump also has

an integrated blood glucose meter and

remote control via bluetooth

communication.

Roche Diagnostics Australia Pty Ltd

RO044 Accu-Chek Combo System Insulin delivery device capable of The Accu-Chek Combo $8,950.00

remotely receiving and acting on System is only available in

information about blood glucose one size.

levels, performing bolus calculation

and bolus advice on additional

parameters than what is normally

SS

Australasian Medical & Scientific Ltd

AN005 Animas 2020 Insulin Pump. Ambulatory Insulin Infusion Pump 7.4cm x 5cm x 1.9cm $7,750.00

Medical Specialties Australia Pty Ltd

MS031 Medical Specialties "Deltec Cozmo Ambulatory Insulin Infusion Pump Deltec Cozmo Insulin Pump $7,750.00

Insulin Pump" - each

Page 1 of 3

3 - GENERAL MISCELLANEOUS

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

3.2.3.3 - Device has capability to automatically adjust the insulin delivery based on continuous

DE, SS

Medtronic Australasia Pty Ltd

MC839 Medtronic MiniMed Insulin Paradigm Veo Model MMT-554. 5.1 x 7.6 x 2.0cm $9,500.00

Infusion Pump 'Smart' Insulin Pump with REAL-

Time continuous glucose monitoring

capability, incorporating a low

glucose suspend and with remote

MC840 Medtronic MiniMed Insulin Paradigm Veo Model MMT-754. 5.1 x 9.4 x 2.0cm $9,500.00

Infusion Pump 'Smart' Insulin Pump with REAL-

Time continuous glucose monitoring

capability, incorporating a low

glucose suspend and with remote

Page 2 of 3

8 - CARDIAC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

8.14.1 - Implantable Cardiac Event Recorders

Medtronic Australasia Pty Ltd

MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00

volume of 9cc

MC768 Reveal DX Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00

volume of 9cc

St Jude Medical Australia Pty Ltd

SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with 6.5cc, 12g $3,900.00

atrial fibrillation monitoring.

SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00

Grand Total: 12 Records

Page 3 of 3

Endnotes

Endnote 1 – Legislation history

This endnote sets out the details of the legislation history of the Private Health Insurance (Prostheses) Rules 2012 (No. 2).

Instrument

Date of FRLI registration

Date of commencement

Application, saving or transitional provision

Private Health Insurance (Prostheses) Rules 2012 (No. 2)

21 August 2012

(F2012L01722)

30 August 2012

Private Health Insurance

(Prostheses) Amendment

Rules 2012 (No. 3)

30 August 2013

(F2012L01788)

30 August 2012

_

Private Health Insurance

(Prostheses) Amendment

Rules 2013 (No. 1)

15 February 2013

(F2013L00203)

5 March 2013

_

Private Health Insurance

(Prostheses) Amendment

Rules 2013 (No. 2)

22 February 2013

(F2013L00265)

5 March 2013

_

  1. 11.

Endnote 2 – Amendment history

This endnote sets out the amendment history of the Private Health Insurance (Prostheses) Rules 2012 (No. 2).

  1. ad. = added or inserted

    am. = amended rep. = repealed rs. = repealed and substituted

Provision affected

How affected

Schedule, Part A

Schedule, Part B

Schedule, Part C

am. F2012L01788; rs. F2013L00203; am. F2013L00265

rs. F2013L00203

rs. F2013L00203

Endnote 3—Application, saving and transitional provisions

This endnote sets out application, saving and transitional provisions for amendments of the Private Health Insurance (Prostheses) Rules 2012 (No. 2) .

There are no application, saving or transitional provisions.

Endnote 4—Uncommenced amendments

This endnote sets out amendments of the Private Health Insurance (Prostheses) Rules 2012 (No. 2) that have not yet commenced. For commencement details see Endnote 1.

There are no uncommenced amendments.

Endnote 5—Misdescribed amendments

This endnote sets out amendments of the Private Health Insurance (Prostheses) Rules 2012 (No. 2) that have been misdescribed.

Amending Instrument

Misdescribed amendment

Private Health Insurance (Prostheses) Amendment Rules 2012 (No.3)

at page 56 of 975, after the “Sponsor” column starting “Atrium Australia – Pacific Rim Pty Ltd”, under the heading “Billing Code” insert, “AC082”, under the heading “Product Name” insert, “Interflow Ultrathin Radially Supported”, under the heading “Description” insert, “ePTFE vascular graft with radial support”, under the heading “Size” insert, “6-8mm x 40cm”, under the heading “Minimum Benefit” insert, “$1,520.00”.

Private Health Insurance (Prostheses) Amendment Rules 2012 (No.3)

at page 320 of 975, after the “Sponsor” column starting “National Surgical Pty Ltd

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