Private Health Insurance (Prostheses) Rules 2015 (No. 1) (Cth)

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Private Health Insurance (Prostheses) Rules 2015

(No. 1)

as amended

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

Compilation start date:10 July 2015

Includes amendments up to:Private Health Insurance (Prostheses) Amendment Rules 2015 (No. 2)

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2015 (No. 1) as in force on 10 July 2015. It includes any commenced amendment affecting the legislation to that date.

This compilation was prepared on 3 August 2015.

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of each amended provision.

Uncommenced amendments

The effect of uncommenced amendments is not reflected in the text of the compiled law but the text of the amendments is included in the endnotes.

Application, savings and transitional provisions for provisions and amendments

If the operation of a provision or amendment is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Modifications

If a provision or the compiled law is affected by a modification that is in force, details are included in the endnotes.

Provisions ceasing to have effect

If a provision of the compiled law has expired or otherwise ceased to have effect in accordance with a provision of the law, details are included in the endnotes.

Contents

End Notes10

Schedule15

Part 1Preliminary

1.Name of Rules

These Rules are the Private Health Insurance (Prostheses) Rules 20 15 (No. 1).

2.Commencement and authority

(1) These Rules commence on 18 March 2015.

(2) These Rules are made under item 4 of the table in section 333-20 of the Private Health Insurance Act 2007.

3.Revocation

These Rules revoke the Private Health Insurance (Prostheses) Rules 2014 (No. 2).

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.

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.

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

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

(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

  1. (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 in 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 in a private hospital:

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

  1. (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 in a public hospital:

(a) the minimum benefit is the lesser of the following amounts:

  1. (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

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

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

(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

(b) 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) 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 subsection 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.

Part3Other

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.

9.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.

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

Note 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.

Note 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.

Endnotes

Endnote 1 – About the endnotes

The endnotes provide details of the history of this legislation and its provisions.

The following endnotes are included in each compilation:

Endnote 1 – About the endnotes

Endnote 2 – Abbreviation key

Endnote 3 – Legislation history

Endnote 4 – Amendment history

Endnote 5 – Uncommenced amendments

Endnote 6 – Modifications

Endnote 7 – Misdescribed amendments

Endnote 8 – Miscellaneous

If there is no information under a particular endnote, the word “none” will appear in square brackers after the endnote heading.

Abbreviation key – Endnote 2

The abbreviation key in this endnote sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history – Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended the compiled law.

The information includes commencement information for amending laws and details of application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision level.

It also includes information about any provision s that have expired or otherwise ceased to have effect in accordance with a provision of the compiled law.

Uncommenced amendments – Endnote 5

The effect of uncommenced amendments is not reflected in the text of the compiled law, but the text of the amendment is included in endnote 5.

Modifications – Endnote 6

If the compiled law is affected by a modification that is in force, details of the modification are included in endnote 6.

Misdescribed amendments – Endnote 7

An amendment is a misdescribed amendment if the effect of the amendment cannot be incorporated into the text of the compilation.

Any misdescribed amendment is included in Endnote 7.

Miscellaneous – Endnote 8

Endnote 8 includes any additional information that may be helpful for a reader of the compilation.

Endnote 2 – Abbreviation key

ad = added or inserted

am = amended

c = clause(s)

CH = Chapter(s)

def = definition(s)

Dict = dictionary

disallowed = disallowed by Parliament

Div = Division(s)

exp = expired or ceased to have effect

hdg = heading(s)

LI = legislative instruments

LIA = Legislative Instruments Act 2003

mod = modified/modification

No = Number(s)

o = orders

Ord = Ordinance

orig = original

par = paragraph(s)/subparagraphs(s) /sub‑subparagraph(s)

pres = present

prev = previous

(prev) = previously

Pt = Part(s)

r = regulation(s)/rule(s)

Reg = Regulation/Regulations

reloc = relocated

renum = renumbered

rep = repealed

rs = repealed and substituted

s = section(s)

Sch = Schedule(s)

Sdiv = Subdivisions(s)

SLI = Select Legislative Instrument

SR = Statutory Rules

Sub-Ch = Sub-Chapter(s)

SubPt = Subpart(s)

Endnote 3 – Legislation history

Name

FRLI Registration

Commencement

Application, saving and transitional provisions

Private Health Insurance (Prostheses) Rules 2015 (No. 1)

2 March 2015

F2015L00241

18 March 2015

Private Health Insurance (Prostheses) Amendment Rules 2015 (No. 1)

15 April 2015

F2015L00540

1 May 2015

-

Private Health Insurance (Prostheses) Amendment Rules 2015 (No. 2)

6 July 2015

F2015L01111

10 July 2015

-

Endnote 4 – Amendment history

This endnote sets out the amendment history of the Private Health Insurance (Prostheses) Rules 2015 (No. 1)

ad. = added or inserted am. = amended rep. = repealed rs. = repealed and substituted

Provision affected

How affected

Schedule, Part A

am. F2015L00540

Schedule Part A

am. F2015L01111

Endnote 5 – Uncommenced amendments

There are no uncommenced amendments

Endnote 6 – Modifications

There are no modifications.

Endnote 7 – Misdescribed amendments

There are no misdescribed amendments.

Part A - Prostheses List February 2015

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.01.01 - Aphakic

01.01.01.01 - 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

ifc

AMO Australia Pty Ltd

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

overall length

Emagin Pty Ltd

EG009 Artisan Anterior Chamber Aphakia ModelComposition: PMMA 5.00mm Optic Diameter x $250.00

Intraocular Lens 8.5 in 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

01.01.02 - Phakic

01.01.02.01 - 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 1092

01 - 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

t1, ifc

Emagin Pty Ltd

EG019 Artisan Toric (Custom) T1 AC Iris clip IOL Toric 5.00mm Optic Diameter x $1,150.00

7.5 Overall

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

t2, ifc

Emagin Pty Ltd

EG020 Artisan Toric (Custom) T2 AC Iris clip IOL Toric 5.00mm Optic Diameter x $1,452.00

7.5 Overall

01.01.02.02 - Foldable

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

Prostheses List by Category, Groups and Sponsor Page 2 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.02.01 - Rigid

Alcon Laboratories (Aust.) Pty Ltd

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

D

01.02.02 - Foldable

01.02.02.01 - Microincision

Carl Zeiss Pty Ltd

CZ040 CT SPHERIS 209M Micro incision, aspheric (aberration Diopter range :0.00 to + $322.00

correcting), foldable square-edged 32.0. Optic Size: 6mm

single-piece intraocular lens for Overall Length: 11mm

capsular bag fixation.

at

Carl Zeiss Pty Ltd

CZ016 CT ASPHINA 409M ZEISS Micro Incision Aspheric 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 control, (22.50-30D)

Prostheses List by Category, Groups and Sponsor Page 3 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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 intraocular 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

Designs for Vision Pty Ltd

DV263 Rayner C-flex Advance Aspheric Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 $374.00

dioptres in 0.5 increments

Emagin Pty Ltd

EG016 ARTIS PL E Preloaded Intraocular lens 0 to 35D $374.00

EG017 LUXIOL 60 Preloaded Intraocular lens +10 to +35D $374.00

Insight Surgical Pty Ltd

IS013 Preloaded Monofocal Hydrophilic Posterior chamber IOL, 360° Special Optic diameter: 6.0 mm $374.00

677P without Blue light Filter for Square Edge, Aspheric – Coma ±0.10 mm,

Medjet PL-MA 2.2 single use optimized Overall diameter: 13.0 mm

injection system ±0.20 mm

Powers available:

-10.0 - +9.0 D ±0.25 Dincrement:

1.0 D

+10.0 - +25.0 D ±0.25 Dincrement:

0.5 D

+25.5 - +30.0 D ±0.5 Dincrement:

0.5 D

+31.0 - +45.0 D ±0. D

increment:

1.0 D

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

Emagin Pty Ltd

EG015 ARTIS T PL Preloaded Toric Intraocular lens +18 to +25D / C +1.50D $760.00

Prostheses List by Category, Groups and Sponsor Page 4 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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, pl, vblf

Insight Surgical Pty Ltd

IS017 Preloaded Monofocal Hydrophilic Posterior chamber IOL, 360° Special Optic diameter: 6.0 mm $405.00

677PY with Blue light Filter for Square Edge, Aspheric – Coma ±0.10 mm, Overall diameter:

Medjet PL-MA 2.2 single use optimized 13.0 mm ±0.20 mm

injection system Powers available:

-10.0 - +9.0 D ±0.25 D

increment:

1.0 D

+10.0 - +25.0 D ±0.25 D

increment:

0.5 D

+25.5 - +30.0 D ±0.5 D

increment:

0.5 D

+31.0 - +45.0 D ±0.5

increment:

1.0 D

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

Prostheses List by Category, Groups and Sponsor Page 5 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.02.02.02 - 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

01.02.02.03 - 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 Range available from -10D $322.00

IOL,

Sensar OptiEdge AR40e Absorbing, Posterior to +30D. 6 mm Optic

Foldable Acrylic IOL Diameter x 13mm in overall

length.

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 6 of 1092

01 - 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 to +34 diopter powers in $364.00

modification and 360 degree square 0.5d increments. Overall

edge diameter 13mm, Optic size

6mm

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, posterior 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

foldable intraocular lens (IOL)

Has from +0.0 to +34D

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

posterior edge, modified C haptics and increments

available in dioptric powers ranging 11.0D to 30.0D in 0.5

from +0.0 to +34.0D. Diopter increments

31.0D to 34.0D in 1

Diopter increments

Prostheses List by Category, Groups and Sponsor Page 7 of 1092

01 - 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.

Insight Surgical Pty Ltd

IS010 BiFlex 677AB Hydrophilic Acrylic Posterior chamber IOL, 360° Special Optic diameter: 6.0 mm $364.00

Foldable Aspheric Monofocal Lens Square Edge, Aspheric – Coma ±0.10 mm, Overall diameter:

(without Blue light Filter) optimized 13.0 mm ±0.20 mm

Powers available:

-10.0 - +9.0 D ±0.25 D

increment:

1.0 D

+10.0 - +25.0 D ±0.25 D

increment:

0.5 D

+25.5 - +30.0 D ±0.5 D

increment:

0.5 D

+31.0 - +45.0 D ±0. D

increment:

1.0 D

Prostheses List by Category, Groups and Sponsor Page 8 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IS015 BiFlex 877FAB Hydrophobic Posterior Chamber IOL, special 360° Optic diameter: 6.0 mm $364.00

Acrylic Foldable Aspheric sharp edge, Aspheric - "Aberration ±0.10 mm, Overall diameter:

Monofocal Lens without Blue light Balanced" 13.0 mm ±0.20 mm

Powers available:

-0.0-+9.0 D ± 0.25 D

increment: 1.0 D

+10.0-+ 25.0 D ± 0.25 D

increment: 0.5 D

+25.5-+ 30.0 D ± 0.5 D

increment: 0.5 D

+31.0 - +35.0 D ±0.5 D

increment: 1.0 D

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

IQ013 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

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

Spectrum Surgical

SO074 HumanOptics Aspira Posterior chamber IOL, foldable, UV -6.0 to +40.0 D $364.00

absorber, Aspheric, aberration

technology, 360° LEC barrier, HD

Prostheses List by Category, Groups and Sponsor Page 9 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, pl

AMO Australia Pty Ltd

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

IOL 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

IQ Medical

IQ014 PreciSAL P302AC Preloaded Acrylic, single piece, Available in dioptric $374.00

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

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

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

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

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

Spectrum Surgical

SO075 HumanOptics Aspira Preloaded Preloaded posterior chamber IOL, +10.0 to +40.0 D $374.00

foldable, UV absorber, Aspheric,

aberration technology, 360° LEC

barrier, HD optic

at, pl, t1

Bausch & Lomb (Australia) Pty Ltd

BL032 enVista Toric The enVista toric (Model MX60T) is a Overall diameter is 12.5mm $760.00

one-piece glistening-free for the entire lens power

hydrophobic foldable IOL. The range, with spherical

enVista Toric, model MX60T IOL has equivalent powers from +6.0

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

posterior edge and modified C haptics, Diopter steps and cylinder

an 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.

Prostheses List by Category, Groups and Sponsor Page 10 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ Medical

IQ017 PreciSAL Toric T302AC Acrylic single piece, foldable Available in spherical $760.00

intraocular lens with anterior and dioptric powers from 0.0 to

posterior optic-haptic square edge, +30.0. 1D steps: 0.0 to

360 degree optic square edge design, +10.0; 0.5D steps: +10.5 to

precision power calculation, +17.5 and +28.5 to +30.0;

aberration technology, toric 0.25D steps: +18.0 to

correction on anterior surface with +28.0; Cylinder powers

cylinder marks to indicate flat from 1.0D to 6.0D

meridian plus the cylinder axis to

allow alignment for astigmatic

correction, and UV filter.

IQ018 PreciSAL Toric PT302AC Pre-loaded acrylic single piece, Available in spherical $760.00

foldable intraocular lens with anterior dioptric powers from 0.0 to

and posterior optic-haptic square +30.0. 1D steps: 0.0 to

edge, 360 degree optic square edge +10.0; 0.5D steps: +10.5 to

design, precision power calculation, +17.5 and +28.5 to +30.0;

aberration technology, toric 0.25D steps: +18.0 to

correction on anterior surface with +28.0; Cylinder powers

cylinder marks to indicate flat from 1.0D to 6.0D

meridian plus the cylinder axis to

allow alignment for astigmatic

correction, and UV filter.

at, pl, t1, vblf

Designs 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 11 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Bausch & Lomb (Australia) Pty Ltd

BL035 MICRO+ AY 123 Preloaded, posterior chamber, UV An overall diameter of $405.00

absorbing, foldable, aspheric, acrylic, 10.75mm and optic diamter

single piece lens with blue light of 6.15mm. From 0 to +35

protection. diopters with 0.5 diopter

increments.

Designs 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

DV262 Hoya 751 Intra Ocular Lens Intra Ocular Lens Power +10 dioptres - +26 $405.00

dioptres

IQ Medical

IQ016 PreciSAL P302A Preloaded Acrylic, single piece, Available in dioptric $405.00

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

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

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

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

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

Nvision Surgical Pty Ltd

VI001 Nidek SZ-1 Pre-Loaded IOL Pre-Loaded Intra Ocular Lens Power +11 dioptres to 30+ $405.00

Injector System Implantation system dioptres

Spectrum Surgical

SO067 HumanOptics Aspira Y Preloaded Preloaded posterior chamber IOL, +10.0 to +30.0 D $405.00

foldable, UV absorber, Aspheric,

aberration technology, 360° LEC

barrier, HD optic, Blue light filter

SO071 Mediphacos Easyflex Preloaded posterior chamber IOL, +5.0 to +30.0 D $405.00

foldable, UV absorber, Aspheric,

aberration technology, double square

edge, Blue light filter

Prostheses List by Category, Groups and Sponsor Page 12 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, t1

AMO Australia Pty Ltd

AO039 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, 3.75 diopter, 4.00

of the optic has a frosted design to diopter, 4.50 diopter, 5.25

reduce potential edge glare effects. diopter and 6.00 diopter (as

measured at the IOL plane).

Overall diameter 13mm,

Optic size 6mm.

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)

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)

Spectrum Surgical

SO060 HumanOptics Torica Toric posterior chamber IOL, foldable, Sphere +10D to +30D, $740.00

UV absorber, Aspheric, aberration Cylinder 1D to 6D

technology, 360° LEC barrier, HD

Prostheses List by Category, Groups and Sponsor Page 13 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, t1, pl, vblf

IQ Medical

IQ020 PreciSAL Toric PT302A Pre-loaded acrylic single piece, Available in spherical $800.00

foldable intraocular lens with anterior dioptric powers from 0.0 to

and posterior optic-haptic square +30.0. 1D steps: 0.0 to

edge, 360 degree optic square edge +10.0; 0.5D steps: +10.5 to

design, precision power calculation, +17.5 and +28.5 to +30.0;

aberration technology, toric 0.25D steps: +18.0 to

correction on anterior surface with +28.0; Cylinder powers

cylinder marks to indicate flat from 1.0D to 6.0D

meridian plus the cylinder axis to

allow alignment for astigmatic

correction, and UV and blue light

filters.

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)

Insight Surgical Pty Ltd

IS012 Medicontur BiFlex 677TAY Posterior chamber IOL, 360° Special Optic diameter: 6.0 mm $780.00

Hydrophilic Acrylic Foldable Toric Square Edge, ±0.05 mm, Overall diameter:

Lens with Blue light Filter Aspheric – Coma optimized – Toric 13.0 mm ±0.10 mm

Powers available:

-10.0 - +30.0 D ±0.25 D

increment: 0.5 D

+31.0

- +35.0 D ±0.5 D

increment:

1.0 D

Cylinders available:

+1.5 D - +9.0 D

increment:

0.75 D

+9.0 D - +10.0 D

increment:

1.0 D

Prostheses List by Category, Groups and Sponsor Page 14 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ Medical

IQ019 PreciSAL Toric T302A Acrylic single piece, foldable Available in spherical $780.00

intraocular lens with anterior and dioptric powers from 0.0 to

posterior optic-haptic square edge, +30.0. 1D steps: 0.0 to

360 degree optic square edge design, +10.0; 0.5D steps: +10.5 to

precision power calculation, +17.5 and +28.5 to +30.0;

aberration technology, toric 0.25D steps: +18.0 to

correction on anterior surface with +28.0; Cylinder powers

cylinder marks to indicate flat from 1.0D to 6.0D

meridian plus the cylinder axis to

allow alignment for astigmatic

correction, and UV and blue light

filters.

Spectrum Surgical

SO057 HumanOptics Torica Y Toric posterior chamber IOL, foldable, Sphere +10D to +30D, $780.00

UV absorber, Aspheric, aberration Cylinder 1D to 6D

technology, 360° LEC barrier, HD

optic, Blue light filter

SO072 Mediphacos Miniflex Toric Toric posterior chamber IOL, foldable, Sphere +5.0 to +30.0 D, $780.00

UV absorber, Aspheric, aberration Cylinder < 7D

technology, double square edge, Blue

light filter

at, t2

AMO Australia Pty Ltd

AO040 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber +5.0 to +34.0 diopter $1,042.00

Intraocular lens, incorporates a powers in 0.5 diopter

proprietary wavefront designed toric increments. Cylinder

aspheric optic with a squared power: 7.00 diopter, 8.00

posterior optic edge designed to diopter (as measured at the

provide a 360 degree barrier. The edge IOL plane). Overall

of the optic has a frosted design to diameter 13mm, Optic size

reduce potential edge glare effects.

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)

Prostheses List by Category, Groups and Sponsor Page 15 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Spectrum Surgical

SO059 HumanOptics Torica Toric posterior chamber IOL, foldable, Sphere +10D to +30D, $1,042.00

UV absorber, Aspheric, aberration Cylinder 7D to 12D

technology, 360° LEC barrier, HD

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.

Spectrum Surgical

SO058 HumanOptics Torica Y Toric posterior chamber IOL, foldable, Sphere +10D to +30D, $1,084.00

UV absorber, Aspheric, aberration Cylinder 7D to 12D

technology, 360° LEC barrier, HD

optic, Blue light filter

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

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

Designs 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).

Prostheses List by Category, Groups and Sponsor Page 16 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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).

Insight Surgical Pty Ltd

IS014 BiFlex 877FABY Hydrophobic Posterior Chamber IOL, special 360° Optic diameter: 6.0 mm $385.00

Acrylic Foldable Aspheric sharp edge, Aspheric - "Aberration ±0.10 mm, Overall diameter:

Monofocal Lens with Blue light Balanced" 13.0 mm ±0.20 mm

Powers available:

-0.0-+9.0 D ±0.25 D

increment: 1.0 D

+10.0 - +25.0 D ±0.25 D

increment: 0.5 D

+25.5- +30.0 D ±0.5 D

increment: 0.5 D

+31.0- +35.0 D ±0.5 D

increment: 1.0 D

IS016 BiFlex 677ABY Hydrophilic Posterior chamber IOL, 360° Special Optic diameter: 6.0 mm $385.00

Acrylic Foldable Aspheric Square Edge, Aspheric – Coma ±0.10 mm, Overall diameter:

Monofocal Lens with Blue light optimized 13.0 mm ±0.20 mm

Powers available:

-10.0 - +9.0 D ±0.25 D

increment:

1.0 D

+10.0 - +25.0 D ±0.25 D

increment:

0.5 D

+25.5 - +30.0 D ±0.5 D

increment:

0.5 D

+31.0 - +45.0 D ±0. D

increment:

1.0 D

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

Prostheses List by Category, Groups and Sponsor Page 17 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

IQ015 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

Spectrum Surgical

SO055 HumanOptics Aspira Y Posterior chamber IOL, foldable, UV -6.0 to +40.0 D $385.00

absorber, Aspheric, aberration

technology, 360° LEC barrier, HD

optic, Blue light filter

SO073 Mediphacos Miniflex/Mediflex Posterior chamber IOL, foldable, UV +5.0 to +30.0 D $385.00

absorber, Aspheric, aberration

technology, double square edge, Blue

light filter

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

t1

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

Designs 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)

Prostheses List by Category, Groups and Sponsor Page 18 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

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

01.02.02.04 - Multifocal or bifocal

at

AMO Australia Pty Ltd

AO026 TECNIS® Multifocal Intraocular Posterior chamber lens with UV light- +5 to +34 diopter powers in $822.00

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

with a diffractive posterior optic and a diameter 13mm, Optic size

modified anterior surface technology 6mm

with edge modification and 360

degree square edge.

Prostheses List by Category, Groups and Sponsor Page 19 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

Models ZMB00, ZKB00, ZLB00 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. ZMB00 +4.00

and a 360 degree square edge. Diopter add, ZKB00 +2.75

add,

AO037 TECNIS® Symfony Extended Range Extended Range of Vision Posterior +5.0 to 34.0 diopter powers $822.00

of Vision (ZXR00) Chamber IOL in 0.5 diopter increments

Overall diamter 13mm,

Optic size 6mm

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.

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)

IQ Medical

IQ023 PreciSAL Multifocal M302AC Acrylic single piece, foldable Available in spherical $822.00

intraocular lens with anterior and dioptric powers from 0.0D

posterior optic-haptic edge, 360 to +30.0D. 1D steps: 0.0D

degree optic square edge design, to+10.0D; 0.5D steps:

precision power calculation, +10.5 to +17.5 and +28.5 to

abreration technology, pupil +30.0; 0.25D steps: +18.0

independent diffractive anterior to +28.0; near sight

surface with a near sigh correction correction addition up to

addition of up to +3.5D, and UV +3.5D on all spherical

Filter. dioptric powers.

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

Prostheses List by Category, Groups and Sponsor Page 20 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Spectrum Surgical

SO063 HumanOptics Diffractiva Multifocal posterior chamber IOL, Sphere: +10D to +30D, $822.00

foldable, UV absorber, Aspheric, Near addition +3.5D

aberration technology, 360° LEC

barrier, HD optic

at, pl

AMO Australia Pty Ltd

AO036 TECNIS® Multifocal 1-Piece IOL Preloaded 1-Piece Multifocal +5.0 to 34.0 diopter powers $842.00

with iTec Preloaded delivery system posterior chamger IOL in 0.5 diopter increments

Overall diamter 13mm,

Optic size 6mm

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.

IQ Medical

IQ024 PreciSAL Mulitfocal PM302AC Pre-loaded acrylic single piece, Available in spherical $842.00

foldable intraocular lens with anterior dioptric powers from 0.0 to

and posterior optichaptic square +30.0. 1D steps: 0.0 to

edge, 360 degree optic square edge +10.0; 0.5D steps: +10.5 to

design, precision power calculation, +17.5 and +28.5 to +30.0;

aberration technology, pupil 0.25D steps: +18.0 to

independent diffractive anterior +28.0; near sight correction

surface with a near sight correction addition up to +3.5D on all

addition of up to +3.5D, and UV filter. spherical dioptric powers.

Prostheses List by Category, Groups and Sponsor Page 21 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Spectrum Surgical

SO065 HumanOptics Diffractiva Preloaded Preloaded Multifocal posterior Sphere: +10D to +30D, $842.00

chamber IOL, foldable, UV absorber, Near addition +3.5D

Aspheric, aberration technology,

360° LEC barrier, HD optic

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

CZ036 AT LISA tri Toric 939MP Trifocal (aspheric), bitoric, micro Diopter range -10.00 to $1,218.00

incision, single-piece IOL for +28.0 and +1 to +4.0 DC

capsular bag fixation, implantable Optic size: 6..00mml;

with preloaded injector system. The Overall length: 11.mm

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,

at, pl, vblf

IQ Medical

IQ025 PreciSAL Multifocal PM302A Pre-loaded acrylic single piece, Available in spherical $884.00

foldable intraocular lens with anterior dioptric powers from 0.0 to

and posterior optichaptic square +30.0. 1D steps: 0.0 to

edge, 360 degree optic square edge +10.0; 0.5D steps: +10.5 to

design, precision power calculation, +17.5 and +28.5 to +30.0;

aberration technology, pupil 0.25D steps: +18.0 to

independent diffractive anterior +28.0; near sight correction

surface with a near sight correction addition up to +3.5D on all

addition of up to +3.5D, and UV and spherical dioptric powers.

blue filter powers.

Spectrum Surgical

SO066 HumanOptics Diffractiva Y Preloaded Multifocal posterior Sphere: +10D to +30D, $884.00

chamber IOL, foldable, UV absorber, Near addition +3.5D

Aspheric, aberration technology,

360° LEC barrier, HD optic, Blue

Prostheses List by Category, Groups and Sponsor Page 22 of 1092

01 - 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 Available +5.0 Diopters to $1,198.00

+34.0 Diopters in 0.5

Diopter increments.

Cylinder powers 1.50D,

2.25D, 3.00D and 4.00D (as

measured on the IOL

AO038 TECNIS Symfony Toric Extended Extended Range of Vision Toric +6 to +30 in 0.5d steps $1,198.00

Range of Vision (ZXT00) Multifocal Posterior Chamber IOL Available Cyl powers

+1.0d, 1.5d, 2.25d, 3.00d,

Carl Zeiss Pty Ltd

CZ038 AT LISA tri toric 939M low cylinder Trifocal (aspheric), bitoric, micro Diopter range: -10.00 to + $1,198.00

incision, single-piece IOL for 32.0 DS and +1 to +6.5DC

capsular bag fixation.

The trifocal Optic Size: 6.0mm. Overall

(anterior) optic provides two Length: 11.0mm

diffractive focal points (+3.33D near

focus and +1.66D intermediate focus)

with asymmetric light distribution

50% distance / 20% intermediate /

30% near vision.

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

Bausch & Lomb (Australia) Pty Ltd

BL036 FineVision Toric POD FT Posterior chamber, toric, trifocal An overall diameter of $1,240.00

diffractive (aspheric), UV and blue 11.40mm and optic diameter

light blocker, single piece acrylic of 6.00mm. From 0 to +35

Diopters with 0.5 diopter

increments.

Prostheses List by Category, Groups and Sponsor Page 23 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

Carl Zeiss Pty Ltd

CZ039 AT LISA tri toric 939M high Trifocal (aspheric), bitoric, micro Diopter range: -10.00 to + $1,500.00

powered cylinder incision, single-piece IOL for 32.0 DS and +7 to +12 DC

capsular bag fixation. The trifocal Optic Size: 6.0mm. Overall

(anterior) optic provides two Length: 11.0mm

diffractive focal points (+3.33D near

focus and +1.66D intermediate focus)

with asymmetric light distribution

50% distance / 20% intermediate /

30% near vision.

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.

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

Prostheses List by Category, Groups and Sponsor Page 24 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

Bausch & Lomb (Australia) Pty Ltd

BL033 FineVision POD F Posterior chamber, UV absorbing, An overall diameter of $864.00

foldable, aspheric, acrylic, single 11.40mm and optic diameter

piece lens with apodised diffractive, of 6.00mm. From 0 to +35

trifocal optic and blue light diopters with 0.5 diopters

with 0.5 diopter increments.

BL034 FineVision Micro F Posterior chamber, UV absorbing, An overall diameter of $864.00

foldable, aspheric, acrylic, single 10.75mm and optic diameter

piece lens with apodised diffractive, of 6.15mm. From 0 to +35

trifocal optic and blue light dopters with 0.5 diopter

increments.

Designs 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

Insight Surgical Pty Ltd

IS011 Medicontur BiFlex 677MY Posterior chamber IOL, 360° Special Optic diameter: 6.0 mm $864.00

Hydrophilic Acrylic Foldable Square Edge, ±0.10 mm, Overall diameter:

Multifocal Lens with Blue light Aspheric – Coma optimized – 13.0 mm ±0.20 mm

Multifocal – Diffractive Powers available:

+0.0 - +30.0 D ±0.25

D increment: 0.5 D

Add:

+3.5 D ±0.5 D

IQ Medical

IQ022 PresiSAL Multifocal M302A Acrylic single piece, foldable Available in sperical $864.00

intraocular lens with anterior and dioptric powers from 0.0D

posterior optic-haptic square edge, to +30.0D. 1D steps: 0.0D

360 degree optic square edge design, to +10.0D; 0.5D steps:

precision power calculation. +10.5 to +17.5 and +28.5 to

Aberration technology, pupil +30.0; 0.25D steps: +18.0.0

independent diffractive anterior to +28.0; near sight

surface with a near sight correction correction addition up to

addition of up to +3.5D, and UV and +3.5D on all spherical

blue light fliters. dioptric powers.

Prostheses List by Category, Groups and Sponsor Page 25 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

Spectrum Surgical

SO064 HumanOptics Diffractiva Y Multifocal posterior chamber IOL, Sphere: +10D to +30D, $864.00

foldable, UV absorber, Aspheric, Near addition +3.5D

aberration technology, 360° LEC

barrier, HD optic, Blue light filter

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.

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.

Prostheses List by Category, Groups and Sponsor Page 26 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

01.02.02.05 - Accommodative

at, pa, t1

Bausch & Lomb (Australia) Pty Ltd

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

BL1AT/BL2AT and BL1UT/BL2UT (BL1AT,BL1UT,AT50T) or

is an accommodating IOL 12.0mm (BL2AT/BL2UT)

incorporating a toroidal posterior for the entire lens power

surface. The foldable IOL has a square range. Spherical equivalent

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 27 of 1092

01 - 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

01.02.03 - Pseudo-phakic, piggy-back

01.02.03.01 - Monofocal

Designs 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.

at, t1, vblf

Spectrum Surgical

SO061 HumanOptics Torica Add-On IOL Toric Add-On IOL for sulcus fixation Sphere: -4.0 to +1.5 in 0.5D $740.00

in pseudophakic eyes, 3-piece, steps, Cylinder < 7D

foldable, UV absorber, blue light

filter, Iris protection, safety profile

technology and undulated haptics

at, vblf

Spectrum Surgical

SO062 HumanOptics Secura Add-On IOL Add-On IOL for sulcus fixation in -6.0 to +6.0 in 0.5D steps $385.00

pseudophakic eyes, 3-piece, foldable,

UV absorber, blue light filter, Iris

protection and safety profile

Prostheses List by Category, Groups and Sponsor Page 28 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

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

01.02.03.02 - Multi-focal

Emagin Pty Ltd

EG014 REVERSO Multifocal Intraocular lens -3 to +3 $780.00

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

Designs 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

at, t1, vblf

Spectrum Surgical

SO056 HumanOptics ToricaDiffractiva Toric Multifocal Add-On IOL for -2.0 to +0.5 in 0.5D steps, $1,240.00

Add-On IOL sulcus fixation in pseudophakic eyes, Cylinder < 7D, Near

3-piece, foldable, UV absorber, blue addition 3.5D

light filter, Iris protection, safety

profile technology and undulated

Prostheses List by Category, Groups and Sponsor Page 29 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

at, vblf

Spectrum Surgical

SO068 HumanOptics Diffractiva Add-On Multifocal Add-On IOL for sulcus -6.0 to +6.0 in 0.5D steps, $864.00

IOL fixation in pseudophakic eyes, 3- Near addition 3.5D

piece, foldable, UV absorber, blue

light filter, Iris protection and safety

profile technology.

01.03.01 - 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

AO032 Healon Endocoat Viscoelastic 0.85ml $80.00

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)

Prostheses List by Category, Groups and Sponsor Page 30 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

AMO Australia Pty Ltd

AO008 Healon, Intraocular Viscoelastic Sodium Hyaluronate 10mg/ml Healon 0.55ml & 0.85ml $80.00

01.03.01.01 - 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

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

Prostheses List by Category, Groups and Sponsor Page 31 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.03.02 - Non Viscous

Designs for Vision Pty Ltd

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

applications

Emagin Pty Ltd

EG013 Retidyne Tissue staining in Ophthalmic 0.5ml Syringe Vial $48.00

01.04.01 - 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

Designs 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

Designs 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)

Insight Surgical Pty Ltd

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

(acrylic)

Prostheses List by Category, Groups and Sponsor Page 32 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

pl

Emagin Pty Ltd

EG018 RINGJECT Preloaded Capsular tension ring 12/10, 13/11 $243.00

01.04.02 - Complex

Designs for Vision Pty Ltd

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

01.05.01 - 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

Designs 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

Designs for Vision Pty Ltd

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

of silicon *175mm square

01.05.02 - Short Tube

01.05.02.01 - 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 33 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.05.03 - Ab Interno Glaucoma Drainage Device

RQSolutions Medical Devices Distribution Support

RQ072 iStent Trabecular Micro-Bypass The iStent GTS100R and GTS100L 1.0mm in length, 0.33mm in $800.00

are micro-invasive glaucoma surgical height with a snorkel

devices which are implanted in an "ab length of 0.25mm

interno" procedure into the trabecular

meshwork to create a bypass through

the trabecular meshwok to Schlemm's

Canal to improve aqueous outflow

through the natural physiologic

pathway.

01.06.01 - Spacers

Spectrum Surgical

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

x 0.35mm thick

01.06.02 - Weights

01.06.02.01 - Gold <1.8 grams

Designs for Vision Pty Ltd

DV260 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Gold Thin 0.6, 0.8, 1.0, 1.2, $425.00

patients with facial palsy 1.4, 1.6g

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

Spectrum Surgical

SO047 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Gold Thin 0.6, 0.8, 1.0, 1.2, $425.00

patients with facial palsy 1.4, 1.6g

Prostheses List by Category, Groups and Sponsor Page 34 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

01.06.02.02 - Gold ≥1.8 grams

Designs for Vision Pty Ltd

DV259 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Contour Gold 0.6, 0.8, 1.0, $800.00

patients with facial palsy. 1.2, 1.4, 1.6, 1.8g

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

Spectrum Surgical

SO046 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Contour Gold 0.6, 0.8, 1.0, $800.00

patients with facial palsy. 1.2, 1.4, 1.6, 1.8g

01.06.02.03 - 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

Designs for Vision Pty Ltd

DV261 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Platinum Thin 0.6, 0.8, 1.0, $1,300.00

Platinum patients with facial palsy 1.2, 1.4, 1.6g

Contour Platinum 0.6, 0.8,

1.0, 1.2, 1.4, 1.6, 1.8g

Spectrum Surgical

SO048 Meddev Eyelid Weight, Implantable Thin Profile eyelid implants for Platinum Thin 0.6, 0.8, 1.0, $1,300.00

Platinum patients with facial palsy 1.2, 1.4, 1.6g

Contour Platinum 0.6, 0.8,

1.0, 1.2, 1.4, 1.6, 1.8g

01.07.01 - Intracanalicular

Designs 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

Prostheses List by Category, Groups and Sponsor Page 35 of 1092

01 - OPHTHALMIC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Condition

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

Set

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:

SYN05 Synthes Australia Pty Ltd $5,700.00

OPHTHALMIC

Amniotic Membrane

LEM03 Lions Eye Donation Service $770.00

Cornea

LEM01 Lions Eye Donation Service $2,000.00

LEN01 Lions NSW Eye Bank $2,287.00

LEW01 Lions Eye Bank of Western Australia $2,500.00

QEB01 Queensland Eye Bank $2,321.00

SAE01 The Eye Bank of South Australia $1,890.00

Page 2 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

Cornea for Endothelial Keratoplasty

LEN04 Lions NSW Eye Bank $2,695.00

LEW03 Lions Eye Bank of Western Australia $3,000.00

SAE03 The Eye Bank of South Australia $2,849.00

Cornea for Endothelial Lamellar Keratoplasty

LEM04 Lions Eye Donation Service $2,660.00

Cornea For Lamellar

LEN03 Lions NSW Eye Bank $1,372.00

Sclera

LEM02 Lions Eye Donation Service $150.00

LEN02 Lions NSW Eye Bank $343.00

LEW02 Lions Eye Bank of Western Australia $250.00

QEB02 Queensland Eye Bank $329.00

SAE02 The Eye Bank of South Australia $230.00

ORTHOPAEDIC

Autologous Skull Flap

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

QBB60 The Queensland Bone Bank $1,733.00

RNB02 Hunter New England Bone Bank $1,470.00

Autologous Skull Flap - processed

QBB56 The Queensland Bone Bank $2,195.00

Bone - Cancellous Bone Matrix, Lyophilised 40cc

TBV52 Donor Tissue Bank of Victoria $683.00

Bone - Cancellous Bone Matrix, Lyophilised 80cc

TBV53 Donor Tissue Bank of Victoria $1,364.00

Bone - Cancellous Crunch 15cc

NBB62 New South Wales Bone Bank $1,169.00

Bone - Cancellous Crunch 30cc

NBB61 New South Wales Bone Bank $2,131.00

Bone - Cancellous Crunch 60cc

NBB60 New South Wales Bone Bank $3,232.00

Bone - Cancellous Cubes (6) Freeze Dried

Page 3 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

QBB09 The Queensland Bone Bank $1,778.00

Bone - Cancellous Strips (2) Freeze Dried

QBB10 The Queensland Bone Bank $751.00

Bone - Chips/cubes 40cc

TBV09 Donor Tissue Bank of Victoria $1,254.00

Bone - Chips/cubes 80cc

TBV10 Donor Tissue Bank of Victoria $2,247.00

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

NBB65 New South Wales Bone Bank $1,169.00

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

NBB64 New South Wales Bone Bank $2,131.00

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

NBB63 New South Wales Bone Bank $3,232.00

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, DBX Putty, 10cc

SYN02 Synthes Australia Pty Ltd $3,400.00

Bone - Demineralised Bone Matrix, DBX Putty, 5cc

SYN01 Synthes Australia Pty Ltd $2,650.00

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 <5 gr (<10cc equivalent)

PBT62 Perth Bone and Tissue Bank $550.00

Bone - Milled >50gr (100cc equivalent)

PBT10 Perth Bone and Tissue Bank $4,050.00

Bone - Milled 10-19 gr (20-38cc equivalent)

Page 4 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

PBT64 Perth Bone and Tissue Bank $2,050.00

Bone - Milled 20-29gr (40-58cc equivalent)

PBT08 Perth Bone and Tissue Bank $2,950.00

Bone - Milled 20g

QBB45 The Queensland Bone Bank $2,202.00

Bone - Milled 20g Freeze Dried

QBB03 The Queensland Bone Bank $2,789.00

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

PBT09 Perth Bone and Tissue Bank $3,550.00

Bone - Milled 30-50g Freeze Dried

PBT38 Perth Bone and Tissue Bank $900.00

Bone - Milled 40cc

TBV11 Donor Tissue Bank of Victoria $1,471.00

Bone - Milled 5-9 gr (10-18cc equivalent)

PBT63 Perth Bone and Tissue Bank $1,150.00

Bone - Milled 80cc

TBV12 Donor Tissue Bank of Victoria $2,508.00

Bone - Milled Femoral Head

AUB02 Australian Biotechnologies $2,457.00

Bone - Ronguered Chips

QBB68 The Queensland Bone Bank $2,235.00

Bone - Ronguered Chips Freeze Dried

QBB67 The Queensland Bone Bank $2,789.00

Bone Plug/Dowel - Cancellous

NBB05 New South Wales Bone Bank $1,584.00

PBT03 Perth Bone and Tissue Bank $1,200.00

TBV07 Donor Tissue Bank of Victoria $935.00

Bone Plug/Dowel - Tricortical

TBV08 Donor Tissue Bank of Victoria $1,002.00

Cartilage - costal segments

PBT11 Perth Bone and Tissue Bank $300.00

QBB12 The Queensland Bone Bank $232.00

Page 5 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

TBV17 Donor Tissue Bank of Victoria $596.00

Cortical Strut

AUB05 Australian Biotechnologies $2,451.00

QBB52 The Queensland Bone Bank $487.00

TBV14 Donor Tissue Bank of Victoria $1,017.00

Cortical Strut >15 - 20cm

PBT07 Perth Bone and Tissue Bank $2,664.00

Cortical Strut >20cm

PBT48 Perth Bone and Tissue Bank $3,032.00

Cortical Struts 10-15cm

PBT06 Perth Bone and Tissue Bank $1,981.00

DBX Putty - 1.00cc

SYN08 Synthes Australia Pty Ltd $1,450.00

DBX Putty - 2.5cc

SYN09 Synthes Australia Pty Ltd $1,800.00

Disc - Freeze Dried

QBB04 The Queensland Bone Bank $788.00

Elbow - joint

QBB14 The Queensland Bone Bank $2,437.00

TBV18 Donor Tissue Bank of Victoria $6,076.00

Fascia Lata

NBB09 New South Wales Bone Bank $1,193.00

TBV21 Donor Tissue Bank of Victoria $1,065.00

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 $6.00

Fascia Lata - Small (10cm x 5cm)

PBT16 Perth Bone and Tissue Bank $854.00

Femoral Head

ACT01 ACT Bone Bank $2,432.00

AUB03 Australian Biotechnologies $2,354.00

Page 6 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

CSA01 Rachel Forster Bone Bank $802.00

DHR01 Barwon Health Bone Bank $3,028.00

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 $2,932.00

QBB27 The Queensland Bone Bank $2,390.00

RNB01 Hunter New England Bone Bank $2,500.00

TBV26 Donor Tissue Bank of Victoria $2,812.00

Femoral Head - Autologous

QBB61 The Queensland Bone Bank $2,390.00

Femoral Head - Freeze Dried

QBB28 The Queensland Bone Bank $2,390.00

Femoral Hemi-condyle

NBB59 New South Wales Bone Bank $2,939.00

PBT21 Perth Bone and Tissue Bank $2,900.00

TBV46 Donor Tissue Bank of Victoria $1,517.00

Femoral Rings

NBB17 New South Wales Bone Bank $2,078.00

PBT24 Perth Bone and Tissue Bank $1,800.00

QBB30 The Queensland Bone Bank $1,758.00

Femoral Rings - Freeze Dried

QBB31 The Queensland Bone Bank $740.00

Femoral Shaft

QBB23 The Queensland Bone Bank $2,483.00

Femoral Shaft - Freeze Dried

QBB66 The Queensland Bone Bank $3,106.00

Femoral Shaft - Half

NBB57 New South Wales Bone Bank $3,595.00

Femoral Shaft - Middle Third

NBB13 New South Wales Bone Bank $3,244.00

TBV24 Donor Tissue Bank of Victoria $2,567.00

Femoral Shaft - Segment

NBB56 New South Wales Bone Bank $2,183.00

Page 7 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

Femoral Shaft - Third

NBB55 New South Wales Bone Bank $2,183.00

Femoral Shaft/Tibial Shaft - Middle third

PBT19 Perth Bone and Tissue Bank $3,200.00

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 $4,220.00

TBV22 Donor Tissue Bank of Victoria $4,505.00

Femur - Distal Half

NBB10 New South Wales Bone Bank $3,595.00

QBB20 The Queensland Bone Bank $3,094.00

Femur - Distal third

NBB11 New South Wales Bone Bank $3,372.00

Femur - Entire

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

NBB12 New South Wales Bone Bank $8,023.00

QBB22 The Queensland Bone Bank $4,717.00

TBV23 Donor Tissue Bank of Victoria $7,440.00

Femur - Entire head removed

PBT18 Perth Bone and Tissue Bank $8,000.00

Femur - Proximal (shaft, trochanter, neck)

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

PBT20 Perth Bone and Tissue Bank $4,220.00

TBV25 Donor Tissue Bank of Victoria $4,473.00

Femur - Proximal half

NBB15 New South Wales Bone Bank $3,780.00

QBB25 The Queensland Bone Bank $3,337.00

Femur - Proximal third

NBB14 New South Wales Bone Bank $1,690.00

Femur - Proximal with femoral head

TBV51 Donor Tissue Bank of Victoria $4,345.00

Fibula - Entire

Page 8 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

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

NBB18 New South Wales Bone Bank $7,817.00

PBT25 Perth Bone and Tissue Bank $3,500.00

QBB32 The Queensland Bone Bank $2,930.00

TBV27 Donor Tissue Bank of Victoria $7,177.00

Fibula - Segment

NBB54 New South Wales Bone Bank $3,053.00

PBT28 Perth Bone and Tissue Bank $2,000.00

Fibula - Segment (12cm)

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

TBV29 Donor Tissue Bank of Victoria $1,347.00

Fibula - Segment (6cm)

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

TBV28 Donor Tissue Bank of Victoria $935.00

Fibular Shaft

TBV30 Donor Tissue Bank of Victoria $2,631.00

Hemipelvis - Acetabulum

NBB21 New South Wales Bone Bank $3,759.00

PBT29 Perth Bone and Tissue Bank $2,940.00

QBB33 The Queensland Bone Bank $3,052.00

TBV31 Donor Tissue Bank of Victoria $3,532.00

Hemipelvis - Complete

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

NBB24 New South Wales Bone Bank $8,411.00

PBT30 Perth Bone and Tissue Bank $7,000.00

QBB37 The Queensland Bone Bank $4,717.00

TBV32 Donor Tissue Bank of Victoria $7,815.00

Hemipelvis - iliac crest

NBB22 New South Wales Bone Bank $3,500.00

PBT31 Perth Bone and Tissue Bank $2,000.00

QBB34 The Queensland Bone Bank $2,738.00

TBV33 Donor Tissue Bank of Victoria $3,209.00

Hemipelvis - Tricortical iliac wedge

Page 9 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

NBB23 New South Wales Bone Bank $1,546.00

PBT32 Perth Bone and Tissue Bank $1,500.00

QBB35 The Queensland Bone Bank $1,321.00

TBV34 Donor Tissue Bank of Victoria $1,331.00

Hemipelvis - Tricortical iliac wedge Freeze Dried

QBB36 The Queensland Bone Bank $812.00

Humeral Head

TBV37 Donor Tissue Bank of Victoria $2,021.00

Humeral Head Addition

NBB26 New South Wales Bone Bank $1,999.00

Humeral Shaft

NBB50 New South Wales Bone Bank $3,998.00

QBB39 The Queensland Bone Bank $1,781.00

Humeral Shaft - Half

NBB51 New South Wales Bone Bank $2,162.00

Humerus - Distal

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

NBB25 New South Wales Bone Bank $3,053.00

TBV49 Donor Tissue Bank of Victoria $2,685.00

Humerus - Entire

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

NBB29 New South Wales Bone Bank $4,066.00

QBB43 The Queensland Bone Bank $3,354.00

Humerus - Entire with rotator cuff

NBB30 New South Wales Bone Bank $4,118.00

PBT33 Perth Bone and Tissue Bank $3,343.00

Humerus - Proximal

NBB27 New South Wales Bone Bank $3,583.00

PBT35 Perth Bone and Tissue Bank $2,800.00

TBV36 Donor Tissue Bank of Victoria $3,280.00

Humerus - Proximal half with rotator cuff

NBB28 New South Wales Bone Bank $3,595.00

Humerus - Proximal with rotator cuff

Page 10 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

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

PBT34 Perth Bone and Tissue Bank $4,200.00

TBV35 Donor Tissue Bank of Victoria $3,142.00

Humerus - Ring

NBB53 New South Wales Bone Bank $1,874.00

Ligament - Medial

NBB31 New South Wales Bone Bank $2,305.00

TBV38 Donor Tissue Bank of Victoria $2,165.00

Meniscal Graft

PBT47 Perth Bone and Tissue Bank $1,921.00

Meniscus

QBB05 The Queensland Bone Bank $1,547.00

TBV40 Donor Tissue Bank of Victoria $1,492.00

Meniscus with Ligaments

TBV39 Donor Tissue Bank of Victoria $2,578.00

Osteotomy Wedge

PBT60 Perth Bone and Tissue Bank $2,000.00

Patella

QBB47 The Queensland Bone Bank $871.00

TBV41 Donor Tissue Bank of Victoria $1,307.00

Patellar unit whole with or without tibial block

PBT40 Perth Bone and Tissue Bank $2,954.00

Proximal Femur with Femoral Head

PBT65 Perth Bone and Tissue Bank $6,300.00

Radius

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

NBB06 New South Wales Bone Bank $3,913.00

PBT13 Perth Bone and Tissue Bank $1,800.00

QBB15 The Queensland Bone Bank $2,495.00

TBV19 Donor Tissue Bank of Victoria $3,671.00

Radius - Ring

NBB49 New South Wales Bone Bank $2,399.00

Page 11 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

Radius - Shaft

NBB47 New South Wales Bone Bank $3,850.00

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 $705.00

Spinal Ring

AUB07 Australian Biotechnologies $1,854.00

Tendon

AUB10 Australian Biotechnologies $2,184.00

Tendon - Achilles

NBB01 New South Wales Bone Bank $2,487.00

PBT61 Perth Bone and Tissue Bank $1,985.00

QBB62 The Queensland Bone Bank $2,124.00

TBV05 Donor Tissue Bank of Victoria $1,311.00

Tendon - Achilles Hemi

QBB65 The Queensland Bone Bank $1,584.00

Tendon - Achilles with bone block

NBB02 New South Wales Bone Bank $2,883.00

PBT01 Perth Bone and Tissue Bank $2,800.00

QBB01 The Queensland Bone Bank $2,124.00

TBV06 Donor Tissue Bank of Victoria $2,509.00

Tendon - Achilles with bone plug

AUB09 Australian Biotechnologies $2,228.00

Tendon - Achilles with machined conical bone block

NBB69 New South Wales Bone Bank $3,530.00

Tendon - EHL

QBB69 The Queensland Bone Bank $2,124.00

Tendon - Gracilis

QBB59 The Queensland Bone Bank $2,124.00

Tendon - Patellar

QBB48 The Queensland Bone Bank $2,271.00

Page 12 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

Tendon - Patellar Hemi

QBB63 The Queensland Bone Bank $1,735.00

Tendon - Patellar split with bone plugs

PBT02 Perth Bone and Tissue Bank $2,500.00

Tendon - Patellar with bone plugs

NBB33 New South Wales Bone Bank $2,778.00

TBV42 Donor Tissue Bank of Victoria $2,578.00

Tendon - Patellar with machined conical bone plug

NBB68 New South Wales Bone Bank $3,425.00

Tendon - Patellar with Quads

NBB72 New South Wales Bone Bank $2,826.00

Tendon - Peroneus Longus

NBB73 New South Wales Bone Bank $2,826.00

Tendon - Semi tendinosis

NBB70 New South Wales Bone Bank $2,827.00

QBB70 The Queensland Bone Bank $2,124.00

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

PBT46 Perth Bone and Tissue Bank $2,800.00

Tendon - Tibialis Anterior

NBB67 New South Wales Bone Bank $2,826.00

QBB58 The Queensland Bone Bank $2,124.00

TBV57 Donor Tissue Bank of Victoria $2,509.00

Tendon - Tibialis Posterior

NBB71 New South Wales Bone Bank $2,826.00

QBB57 The Queensland Bone Bank $2,124.00

Tibia - Condyles only

TBV47 Donor Tissue Bank of Victoria $2,030.00

Tibia - Distal

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

QBB51 The Queensland Bone Bank $2,091.00

TBV48 Donor Tissue Bank of Victoria $2,612.00

Tibia - Plateau (prox 1/3)

Page 13 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

NBB35 New South Wales Bone Bank $3,258.00

Tibia - Proximal

NBB36 New South Wales Bone Bank $3,301.00

PBT45 Perth Bone and Tissue Bank $2,635.00

QBB54 The Queensland Bone Bank $2,614.00

Tibia - Proximal 16-25cm

TBV45 Donor Tissue Bank of Victoria $2,941.00

Tibia - Proximal 7-15cm

TBV44 Donor Tissue Bank of Victoria $3,047.00

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 $3,094.00

Tibia - Proximal with Patella & Tendon

PBT44 Perth Bone and Tissue Bank $5,000.00

Tibia - Proximal with Patellar Tendon

NBB46 New South Wales Bone Bank $5,158.00

Tibia - Ring

NBB45 New South Wales Bone Bank $1,874.00

Tibia - Whole

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

NBB37 New South Wales Bone Bank $5,260.00

QBB55 The Queensland Bone Bank $4,694.00

Tibia - Whole with Patella

QBB64 The Queensland Bone Bank $4,717.00

Tibia - Whole with Patellar Tendon

NBB44 New South Wales Bone Bank $7,059.00

Tibia Shaft

QBB53 The Queensland Bone Bank $1,096.00

Tibial Shaft

Page 14 of 15

Billing Code Facility Minimum Benefit Maximum Benefit

NBB41 New South Wales Bone Bank $4,849.00

Tibial Shaft - half

NBB43 New South Wales Bone Bank $3,170.00

Tibial Shaft - third

NBB42 New South Wales Bone Bank $3,423.00

Tibial Shaft Freeze Dried

QBB02 The Queensland Bone Bank $964.00

Tri Cortical Osteotomy

NBB66 New South Wales Bone Bank $1,563.00

Ulna

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

NBB07 New South Wales Bone Bank $3,606.00

PBT14 Perth Bone and Tissue Bank $1,500.00

QBB16 The Queensland Bone Bank $2,495.00

TBV20 Donor Tissue Bank of Victoria $3,396.00

Ulna - Ring

NBB40 New South Wales Bone Bank $2,399.00

Ulna - Shaft

NBB38 New South Wales Bone Bank $3,170.00

Grand Total: 286 Records

Page 15 of 15

Part C - Other Prostheses February 2015

03 - GENERAL MISCELLANEOUS

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

03.02.03 - Infusion Pumps, Battery Powered

03.02.03.02 - 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

Page 1 of 3

03 - GENERAL MISCELLANEOUS

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

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

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

MI150 MiniMed 640G Insulin Pump MiniMed 640G Insulin Pump with 1.8ml and 3.0ml $9,500.00

SmartGuard Technology and

continuous glucose monitoring

capability, designed to automatically

suspend insulin delivery before

dangerous lows occur, and

automatically resume after levels

recover.

Page 2 of 3

08 - CARDIAC

Minimum Maximum

Billing Code Product Description Size Benefit Benefit Notations

08.14.01 - 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

i

Biotronik Australia Pty Ltd

BT153 BioMonitor Implantable cardiac monitor for 53.3mm x 42.7mm x 7.1mm, $3,900.00

continuous remote monitoring of 26 grams

patients with Atrial Fibrillation (AF)

or unexplained syncope

Medtronic Australasia Pty Ltd

MI141 Reveal LINQ Insertable Cardiac Monitor 45 x 7 x 3.5mm, 1.18cc $3,900.00

Grand Total: 14 Records

Page 3 of 3

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