Private Health Insurance (Prostheses) Amendment Rules 2009 (No. 2)
I, PENNY SHAKESPEARE, 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    12 August 2009
 
 
________________________
Penny Shakespeare
 
Assistant Secretary
Private Health Insurance Branch
Acute Care Division
Department of Health and Ageing
 
 
 
 
 

1.                      Name of Rules
These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2009 (No. 2).
2.                      Commencement
These Rules commence on 15 August 2009.
3.                      Amendment of the Schedule to the Private Health Insurance (Prostheses) Rules 2009 (No. 2)
These Rules amend the Schedule to the Private Health Insurance (Prostheses) Rules 2009 (No. 2) dated 24 July 2009 and effective on 15 August 2009, as set out below:
3.1         Part A – Prostheses, at page 250 of 870, for the Billing Code DV230, under the heading “Minimum Benefit” delete “$425.00” and insert “$600.00”.
3.2         Part A – Prostheses, at page 263 of 870, for the Billing Code DV029, under the heading “Minimum Benefit” delete “$159.00” and insert “$243.00”.
3.3         Part A – Prostheses, at page 263 of 870, for the Billing Code DV029, under the heading “Maximum Benefit” delete “$243.00”.
3.4         Part A – Prostheses, at page 263 of 870, for the Billing Code IS001, under the heading “Minimum Benefit” delete “$243.00” and insert “$255.00”.
3.5         Part A – Prostheses, at page 263 of 870, for the Billing Code DV010, under the heading “Minimum Benefit” delete “$247.00” and insert “$334.00”
3.6         Part A – Prostheses, at page 263 of 870, for the Billing Code DV010, under the heading “Maximum Benefit” delete “$334.00”.
3.7         Part A – Prostheses, at page 295 of 870, after the Billing Code JJ561, delete  the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete  “OH084” and insert “LC036”.
3.8         Part A – Prostheses, at page 296 of 870, after the heading “6.6.1.7 Shoulder joint, Accessory, Adaptor”, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH088” and insert “LC037”.
3.9         Part A – Prostheses, at page 299 of 870, after the subheading “cementless”, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH114” and insert “LC038”.
3.10     Part A – Prostheses, at page 299 of 870, after the Billing Code JJ553, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH115” and insert “LC039”.
3.11     Part A – Prostheses, at page 305 of 870, after the Billing Code MA449, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”;  after the subheading, under the heading “Billing Code” delete “OH086” and insert “LC040”.
3.12     Part A – Prostheses, at page 305 of 870, after the Billing Code “LC040”, delete “OH089” and insert “LC041”.
3.13     Part A – Prostheses, at page 305 of 870, after the Billing Code “LC041”, delete “OH090” and insert “LC042”.
3.14     Part A – Prostheses, at page 306 of 870, after the Billing Code JJ612, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH085” and “LC043”.
3.15     Part A – Prostheses, at page 306 of 870, after the subheading “tumour”, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH083” and insert “LC044”.
3.16     Part A – Prostheses, at page 311 of 870, after the Billing Code MA448, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH087” and insert “LC045”.
3.17     Part A – Prostheses, at page 314 of 870, after the subheading “tumour”, delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH082” and insert “LC046”.
3.18     Part A – Prostheses, at page 669 of 870, after the heading “Nails, Bone” delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH138” and insert “LC047”.
3.19     Part A – Prostheses, at page 671 of 870, after the heading “Prostheses, Joint, Shoulder” delete the subheading “Orthotech Pty Ltd” and insert “Lima Orthopaedics Australia Pty Ltd”; after the subheading, under the heading “Billing Code” delete “OH327” and insert “LC048”.
3.20     Part A – Prostheses, at page 678 of 870, for the Billing Code MO298, under the heading “Maximum Benefit” delete “$350.00”.
3.21     Part A – Prostheses, at page 678 of 870, for the Billing Code MO303, under the heading “Maximum Benefit” delete “$644.00”.
3.22     Part A – Prostheses, at page 679 of 870, for the Billing Code MO299, under the heading “Maximum Benefit” delete “$450.00”.
3.23     Part A – Prostheses, at page 680 of 870, for the Billing Code MO304, under the heading “Maximum Benefit” delete “$725.00”.
3.24     Part A – Prostheses, at page 684 of 870, for the Billing Code MO300, under the heading “Maximum Benefit” delete “$600.00”.
3.25     Part A – Prostheses, at page 684 of 870, for the Billing Code MO301, under the heading “Maximum Benefit” delete “$650.00”.
3.26     Part A – Prostheses, at page 702 of 870, for the Billing Code MO296, under the heading “Maximum Benefit” delete “$170.00”.
3.27     Part A – Prostheses, at page 702 of 870, for the Billing Code MO297, under the heading “Maximum Benefit” delete “$170.00”.
3.28     Part A – Prostheses, at page 738 of 870, for the Billing Code MO295, under the heading “Maximum Benefit” delete “$770.00”.
3.29     Part A – Prostheses, at page 776 of 870, for the Billing Code SY517, under the heading “Maximum Benefit” delete “$75.00”.
3.30     Part A – Prostheses, at page 777 of 870, for the Billing Code SY518, under the heading “Maximum Benefit” delete “$500.00”.
3.31     Part A – Prostheses, at page 795 of 870, after the Billing Code SP029,  under the heading “Billing Code” insert “SP032”; under the heading “Product Name” insert “OsteoMed Plating & Fixation System”; under the heading “Description” insert “Lag Screws - Maxi, MMF, 3.0mm”; under the heading “Size” insert “2.4mm x (8 – 42)mm; 2.4 x (12 – 18)mm; 3.0mm x (12 – 36)mm”; under the heading “Minimum Benefit” insert “$80.00”; and under the heading “Notations” insert “Only to be funded where used in a service for which a Medicare Benefit is payable”.    
3.32     Part A – Prostheses, at page 796 of 870, after the Billing Code MP011, insert the heading “Reconstruction Sheeting, Plastic Surgery”; under the heading, insert the subheading “Medical Vision Australia Pty Ltd”; after the subheading, under the heading “Billing Code” insert MF034; under the heading “Product Name” insert “Sphere”; under the heading “Description” insert “Orbital Sphere Models 6316, 6326, 6327, 6317 and 6322 8702-8704.  COI implant, models 7222, 7223 & 80026.  MCOI implant, models 7207 – 7209 Quad Motility Implants 9866 – 9868 & 80022”; under the heading “Size” insert “Orbital Sphere Models 6316: 14mm, 6326: 16mm, 6327: 18mm, 6317: 20mm, 6322: 22mm, 8702: 19mm, 8703: 21mm, 8704: 23mm, COI Implants 7222: Approx 4ml, 7223: Approx 5ml, 80026: Approx 6ml, MCOI 7207: Approx 3ml, 7208: Approx 4.2ml, 7209: Approx 5.6 ml, QUAD Motility Small 16ml, Medium: 18ml, Large: 20ml”; under the heading “Minimum Benefit” insert “$713.00”; and under the heading “Notations” insert “Only to be funded where used in a service for which a Medicare Benefit is payable”.