Private Health Insurance (Prostheses) Amendment Rules 2012 (No. 1)
I, RICHARD MAGOR, delegate of the Minister for Health and Ageing, make these Rules under item 4 of the table in section 333-20 of the Private Health Insurance Act 2007.
Dated 3 April 2012
________________________
Richard Magor
Assistant Secretary
Private Health Insurance Branch
Medical Benefits Division
Department of Health and Ageing
Contents
PART 1 PRELIMINARY
1. Name of Rules 3
2. Commencement 3
3. Amendment of the Private Health Insurance (Prostheses) Rules 2012 (No.1) 3
SCHEDULE – AMENDMENTS 4
Part 1 Preliminary
1. Name of Rules
These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2012
(No. 1).
2. Commencement
These Rules commence on 9 April 2012.
3. Amendment of the Private Health Insurance (Prostheses) Rules 2012 (No.1)
The Schedule amends the Private Health Insurance (Prostheses) Rules 2012 (No.1).
Schedule – Amendments
[1] Schedule - Part A – Prostheses List – February 2012
[1.1] at page 127 of 944, after billing code DD052, in the sponsor column insert “Finsbury Orthopaedics Australia Pty Ltd”.
[1.2] at page 127 of 944, after the sponsor column starting “Finsbury Orthopaedics Australia Pty Ltd”, under the heading “Billing Code” insert “FI061”, under the heading “Product name” insert “Adept MoM Modular Head”, under the heading “Description” insert “Metal on Metal modular head, CoChr, 12/14 Eurocone”, under the heading “Size” insert “38-58mm going up in 2mm increments. 4 different neck lengths”, under the heading “Minimum Benefit” insert “$2,400.00”.
[1.3] at page 128 of 944, delete Billing Code DY550 and the contents of all fields associated with it.
[1.4] at page 173 of 944, after Billing Code GO175, under the sponsor column insert “Johnson & Johnson Medical Pty Ltd”.
[1.5] at page 173 of 944, after the sponsor column starting “Johnson & Johnson Medical Pty Ltd”, under the heading “Billing Code” insert “DY020”, under the heading “Product Name” insert “SROM Trochanteric Washer Screw”, under the heading “Description” insert “Titanium, attaches washer to calcar”, under the heading “Size” insert “42mm, 52mm, 62mm”, under the heading “Minimum Benefit” insert “$200.00”.
[1.6] at page 341 of 944, delete Billing Code DY020 and the contents of all fields associated with it.
[1.7] at page 529 of 944, delete sponsor “Johnson & Johnson Medical Pty Ltd” and the contents of all fields associated with it.
[1.8] at page 529 of 944, delete Billing Code DP868 and the contents of all fields associated with it.
[1.9] at page 538 of 944, delete Billing Code DY400 and the contents of all fields associated with it.
[1.10] at page 539 of 944, after the line starting 6.2.2.4, under the sponsor column insert “Johnson & Johnson Medical Pty Ltd”.
[1.11] at page 539 of 944, after the sponsor column starting “Johnson & Johnson Medical Pty Ltd”, under the heading “Billing Code” insert “DY400”, under the heading “Product Name”, insert “Neuflex Finger”, under the heading “Description” insert “Neuflex PIP”, under the heading “Size” insert “1 to 20”, under the heading “Minimum Benefit” insert “$1,600.00”.
[1.12] at page 576 of 944, delete line starting “Smith & Nephew Surgical Pty Ltd” and the contents of all fields associated with it.
[1.13] at page 576 of 944, delete Billing Code SN032 and the contents of all fields associated with it.
[1.14] at page 579 of 944, delete Billing Code SN146 and the contents of all fields associated with it.
[1.15] at page 579 of 944, delete Billing Code SN708 and the contents of all fields associated with it.
[1.16] at page 579 of 944, delete Billing Code SN709 and the contents of all fields associated with it.
[1.17] at page 638 of 944, delete Billing Code SK538 and the contents of all fields associated with it.
[1.18] at page 638 of 944, delete Billing Code SK540 and the contents of all fields associated with it.
[1.19] at page 638 of 944, delete Billing Code SK542 and the contents of all fields associated with it.
[1.20] at page 638 of 944, delete Billing Code SN801 and the contents of all fields associated with it.
[1.21] at page 640 of 944, after Billing Code SN800, under the heading “Billing Code” insert “SN801”, under the heading “Product Name” insert “Peri-Loc”, under the heading “Description” insert “3.5mm Recon Plates”, under the heading “Size” insert “> 7 to < 15 holes”, under the heading “Minimum Benefit” insert “$625.00”
[1.22] at page 642 of 944, after Billing Code SN979, under the Sponsor Column, insert “Stryker Australia Pty Ltd”.
[1.23] at page 642 of 944, after the sponsor column starting “Stryker Australia Pty Ltd”, under the heading “Billing Code” insert “SK538”, under the heading “Product Name” insert “Stryker Plating System”, under the heading “Description” insert “Locking Compression Anatomical Shape”, under the heading “Size” insert “2-6 hole”, under the heading “Minimum Benefit” insert “$495.00”.
[1.24] at page 642 of 944, after the Billing Code SK538, under the heading “Billing Code” insert “SK540”, under the heading “Product Name” insert “Stryker Plating System”, under the heading “Description” insert “Locking Reconstruction Plates”, under the heading “Size” insert “4.0mm, 4-6 hole”, under the heading “Minimum Benefit” insert “$495.00”.
[1.25] at page 642 of 944, after the Billing Code SK540, under the heading “Billing Code” insert “SK542”, under the heading “Product Name” insert “Stryker Plating System”, under the heading “Description” insert “Locking One Third Tubular Plates”, under the heading “Size” insert “3.0mm, 2-6 hole”, under the heading “Minimum Benefit” insert “$495.00”.
[1.26] at page 647 of 944, delete Billing Code SK539 and the contents of all fields associated with it.
[1.27] at page 647 of 944, delete Billing Code SK541 and the contents of all fields associated with it.
[1.28] at page 647 of 944, delete Billing Code SK543 and the contents of all fields associated with it.
[1.29] at page 647 of 944, delete Billing Code JJ712 and the contents of all fields associated with it.
[1.30] at page 649 of 944, after Billing Code SN980, under the Sponsor Column, insert “Stryker Australia Pty Ltd”.
[1.31] at page 649 of 944, after the sponsor column starting “Stryker Australia Pty Ltd”, under the heading “Billing Code” insert “SK539”, under the heading “Product Name” insert “Stryker Plating System”, under the heading “Description” insert “Locking Compression Anatomical Shape”, under the heading “Size” insert “7-14 hole”, under the heading “Minimum Benefit” insert “$564.00”.
[1.32] at page 649 of 944, after the Billing Code SK539, under the heading “Billing Code” insert “SK541”, under the heading “Product Name” insert “Stryker Plating System”, under the heading “Description” insert “Locking Reconstruction Plates”, under the heading “Size” insert “4.0mm, 7-14 hole”, under the heading “Minimum Benefit” insert “$564.00”.
[1.33] at page 649 of 944, after the Billing Code SK541, under the heading “Billing Code” insert “SK543”, under the heading “Product Name” insert “Stryker Plating System”, under the heading “Description” insert “Locking One Third Tubular Plates”, under the heading “Size” insert “3.0mm, 7-14 hole”, under the heading “Minimum Benefit” insert “$564.00”.
[1.34] at page 649 of 944, after the line starting LK, under the sponsor column insert “Johnson & Johnson Medical Pty Ltd”.
[1.35] at page 649 of 944, after the sponsor column starting “Johnson & Johnson Medical Pty Ltd”, under the heading “Billing Code” insert “JJ712”, under the heading “Product Name”, insert “ALPS – Anatomic Locked Plating System”, under the heading “Description” insert “3.5mm Titanium plates”, under the heading “Size” insert “7 to 15 holes”, under the heading “Minimum Benefit” insert “$564.00”.
[1.36] at page 667 of 944, delete Billing Code DE370 and the contents of all fields associated with it.
[1.37] at page 672 of 944, after the line starting LV075, under the sponsor column insert “Device Technologies Australia Pty Ltd”.
[1.38] at page 672 of 944, after the sponsor column starting “Device Technologies Australia Pty Ltd”, under the heading “Billing Code” insert “DE370”, under the heading “Product Name”, insert “Cannulated Titanium Low Profile Screws, Small”, under the heading “Description” insert “Cannulated Titanium Low Profile Screws, Small”, under the heading “Size” insert “3 – 3.75mm”, under the heading “Minimum Benefit” insert “$231.00”.
[1.39] at page 673 of 944, after the line starting IG109, under the sponsor column insert “Johnson & Johnson Medical Pty Ltd”.
[1.40] at page 673 of 944, after the sponsor column starting “Johnson & Johnson Medical Pty Ltd”, under the heading “Billing Code” insert “DP868”, under the heading “Product Name”, insert “Barouk Screw System”, under the heading “Description” insert “Barouk Screw - Titanium”, under the heading “Size” insert “10 – 34mm length”, under the heading “Minimum Benefit” insert “$421.00”.
[1.41] at page 676 of 944, after the line starting DY573, under the sponsor column insert “Medartis”.
[1.42] at page 676 of 944, after the sponsor column starting “Medartis”, under the heading “Billing Code” insert “EO074”, under the heading “Product Name”, insert “APTUS Screws”, under the heading “Description” insert “Aptus Locking Screws”, under the heading “Size” insert “2.8mm – 3.5mm Diameter”, under the heading “Minimum Benefit” insert “$351.00”.
[1.43] at page 678 of 944, under sponsor column delete “Medartis” and the contents of all fields associated with it.
[1.44] at page 678 of 944, delete Billing Code EO074 and the contents of all fields associated with it.
[1.45] at page 681 of 944, delete Billing Code EO073 and the contents of all fields associated with it.
[1.46] at page 685 of 944, after the line starting EO057, under the suffix column insert “DT, LK”.
[1.47] at page 685 of 944, after the suffix column starting “DT, LK”, under the sponsor column insert “Medartis”.
[1.48] at page 685 of 944, after the sponsor column starting “Medartis”, under the heading “Billing Code” insert “EO073”, under the heading “Product Name”, insert “APTUS Screws”, under the heading “Description” insert “Aptus Locking Screws”, under the heading “Size” insert “2.5mm Diameter”, under the heading “Minimum Benefit” insert “$423.00”.
[1.49] at page 687 of 944, delete Billing Code EO072 and the contents of all fields associated with it.
[1.50] at page 689 of 944, after the line starting MO367, under the suffix column insert “DT, LK”.
[1.51] at page 689 of 944, after the suffix column starting “DT, LK”, under the sponsor column insert “Medartis”.
[1.52] at page 689 of 944, after the sponsor column starting “Medartis”, under the heading “Billing Code” insert “EO072”, under the heading “Product Name”, insert “APTUS Screws”, under the heading “Description” insert “Aptus Locking Screws”, under the heading “Size” insert “1.5mm – 2.0mm Diameter”, under the heading “Minimum Benefit” insert “$297.00”.
[1.53] at page 703 of 944, after the line starting BH118, under the sponsor column insert “Johnson & Johnson Medical Pty Ltd”.
[1.54] at page 703 of 944, after the sponsor column starting “Johnson & Johnson Medical Pty Ltd”, under the heading “Billing Code” insert “DY538”, under the heading “Product Name”, insert “Healix Anchor System”, under the heading “Description” insert “Titanium anchor with suture”, under the heading “Size” insert “4.5– 6.5mm”, under the heading “Minimum Benefit” insert “$435.00”, under the heading “Maximum Benefit” insert “$493.00”.
[1.55] at page 730 of 944, delete line starting with “Smith & Nephew Surgical Pty Ltd” and the contents of all fields associated with it.
[1.56] at page 730 of 944, delete Billing Code SN437 and the contents of all fields associated with it.
Note
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