Private Health Insurance (Prostheses) Amendment Rules 2014 (No. 1)
I, Shane Porter, delegate of the Minister for Health, make these Rules under item 4 of the table in section 333-20 of the Private Health Insurance Act 2007.
Dated 17 February 2014
Shane Porter
Shane Porter
Assistant Secretary
Private Health Insurance Branch
Medical Benefits Division
Department of Health
Contents
PART 1 PRELIMINARY
1. Name of Rules 3
2. Commencement 3
3. Authority 3
4. Schedules 3
SCHEDULE – AMENDMENTS 4
Part 1 Preliminary
1. Name of Rules
These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2014
(No. 1).
2. Commencement
These Rules commence on 28 February 2014.
3. Authority
These Rules are made under the Private Health Insurance Act 2007.
4. Schedules
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Schedule – Amendments
Private Health Insurance (Prostheses) Rules 2014 (No. 1)
1 Schedule, Part A, billing codes, BX296, BX297, BX298, BX299, BX300, BX301, BX302, BX303, BX304, BX305, BX306 and BX307
delete the contents of items 1 to 12 of the table from the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
BX296
ACTIFUSE SHAPE 1.6mL–BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
1.6mL
$760.00
2
BX297
ACTIFUSE SHAPE 2.6mL–BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
2.6mL
$760.00
3
BX305
ACTIFUSE MICROGRANULES2.5mL–BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
2.5mL
$760.00
4
BX306
ACTIFUSE MICROGRANULES 5mL–BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
5mL
$760.00
5
BX299
ACTIFUSE SHAPE 8.0mL –BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
8.0mL
$1,200.00
6
BX301
ACTIFUSE GRANULES 10mL–BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
10mL
$1,200.00
7
BX304
ACTIFUSE EASY PREP –BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
10ml
$1,200.00
8
BX307
ACTIFUSE MICROGRANULES –BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
10mL
$1,200.00
9
BX298
ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
20mL
$1,500.00
10
BX300
ACTIFUSE SHAPE15.8mL –BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
15.8mL
$1,500.00
11
BX302
ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
5mL
$1,500.00
12
BX303
ACTIFUSE GRANULES 40mL–BONE MATRIX IMPLANT ARTIFICIAL
A silicate substituted synthetic bone graft
40mL
$1,560.00
2 Schedule, Part A, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153 and MI141, after entry for billing code WC295
delete the subheadings:
8.14.01 – Implantable Cardiac Event Recorders
Biotronik Australia Pty Ltd
i
Medtronic Australasia Pty Ltd
delete the contents of item 1 of the table from the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
BT153
BioMonitor
Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope
53.3mm x 42.7mm x 7.1mm, 26 grams
$3,900.00
2
MI141
Reveal LINQ
Insertable Cardiac Monitor
45 x 7 x 3.5mm, 1.18cc
$3,900.00
3 Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After subheading 8.14.01 – Implantable Cardiac Event Recorders,
insert the subheading “Biotronik Australia Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
BT153
BioMonitor
Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope
53.3mm x 42.7mm x 7.1mm, 26 grams
$3,900.00
4 Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After entry for billing code BT153,
insert the subheading “i”
insert the subheading “Medtronic Australasia Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
MI141
Reveal LINQ
Insertable Cardiac Monitor
45 x 7 x 3.5mm, 1.18cc
$3,900.00
5 Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,
delete the subheading “Orthopaedic Solutions Pty Ltd”
delete the contents of item 1 of the table from the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
OE029
BIOProfile Pyrocarbon Carpometacarpal Implants
Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)
Small, Medium, Large & Extra Large
$884.00
5 Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,
insert the subheading “Tornier Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
TO149
BIOProfile Pyrocarbon Carpometacarpal Implants
Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty)
Small, Medium, Large & Extra Large
$884.00
6 Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO044,
insert the contents of item 1 of the table in the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
SO049
FCI Masterka
Self-retaining monocanalicular nasal intubation WITHOUT nasal retrieval
30mm to 40mm
$180.00
7 Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO043,
insert the contents of item 1 of the table in the columns indicated:
Item
Billing Code
Product
Description
Size
Minimum benefit
1
SO050
FCI Nunchaku
Self-retaining bicanalicular nasal intubation WITHOUT nasal retrieval
90mm to 105mm
$135.00
