Changed Items for Prostheses List
Billing Code Product Name
Further Description
Explanation of Change
Size
Abbott Australasia Pty Ltd
Cardio-thoracic
AY012
AY023
AY025
JoStent Coronary Stent Graft
Xience Everolimus Eluting Stent System
Stents
Stainless Steel/PTFE
9 - 26 mm x 2.5 - 5 mm
Everolimus Eluting Stent System
2.25mm to 4.0mm widths, 8mm to 28mm lengths
ACS Multilink Coronary Stent; ACS Megalink Peripheral Stent; ACS
RX Herculink Peripheral Stent. Stainless steel
Detail Change
Detail Change
1.5mm - 8.0mm
AY026
AY027
AY028
Multilink Coronary Stent System
Multilink Coronary Stent System - Frontier
Multilink Coronary Stent System - Vision
Stainless Steel
316L Stainless steel stent
Cobalt chrome stent
Detail Change
Detail Change
Detail Change
Length 1.5mm - 8.0mm
Length 1.5 - 8.0mm
Length 1.5 - 8.0mm
Detail Change
Vascular
AY007
Jostent SelfX Expanding Stent
AY008
Jostent Renal Premounted
AY010
JOStent Peripheral Stent Graft
AY015
Xact/ Xact Flex Carotid Stent
Diameter 8-6, 9-7,
AY017
Starclose
AY018
wire lengths:
Emboshield
Detail Change
Nitinol
Shaft length 15 - 180cm, stent length 32 - 92mm
Balloon expandable
Stent length 12 - 17mm, diameter 5 - 7 mm
Stainless Steel/PTFE
4 - 12 mm x 12 - 58m mm
Nitinol Self-Expanding stent on rapid exchange delivery system
Detail Change
10-8mm Length 20 + 30mm Tapered
6 Fr Exchange Sheath, Dilator, Guidewire, implantable nitinol clip
pre-mounted on a Clip Applier
Embolic Protection Device, including delivery system, device
specific procedural wire, filter for capturing embolic matter and
retrieval system
Detail Change
Detail Change
Detail Change
Diameter 7-10mm Length 20 + 30mm Straight;
6 Fr
Detail Change
Filters 3, 4, 5, and 6mm, Large and Small.. Two
190cm for Monorail systems and 315cm for Over the Wire Systems
Advanced Medical Optics Australia Pty Ltd
Ophthalmic
AO001
Intraocular Lens: Model AC 51L
Duralens PMMA, Anterior Chamber IOL
AO002
Sensar AR40 Monofocal Acrylic IOL, Sensar OptiEdge AR40e
Detail Change
Foldable Acrylic IOL
AO006
Clariflex, Model CLRFLXB Posterior Chamber Intraocular Lens
AO007
AO008
AO009
AO010
AO014
dioptre in 0.5
6.00 mm Optic Diameter x 13.0mm in overall length
Soft Acrylic, Foldable, UV Absorbing, Posterior
Detail Change
6 mm Optic Diameter x 13mm in overall length.
Foldable Silicone IOL with OptiEdge design
One size only
Viscoelastic Fluid: AMO Vitrax (sodium hyaluronate) 30mg/mL,
Surgically Implanted Intraocular Viscoelastic
0.65mL
Healon, Intraocular Viscoelastic Fluid
Sodium Hyaluronate 10mg/ml
Healon 0.4ml, 0.55ml & 0.85ml
Healon 5, Intraocular Viscoelastic Fluid
HEALON5- Sodium hyaluronate 23mg/ml .
0.6ml
Healon GV Intraocular Viscoelastic Fluid
Sodium Hyaluronate 14mg/mL
0.5mm and 0.85ml
TECNIS™ Intraocular Lens
Foldable Intraocular Lenses - Ultraviolet light absorbing posterior
Detail Change
chamber intraocular lenses, Silicone/Acrylic
increments
Changed Items for Prostheses List Report
Detail Change
0.65mL Gap removed, Detail Change
Detail Change
Detail Change
Detail Change
5-10 dioptre in 1.0 dioptre increments; 10.5 - 30
Page 1 of 99
Billing Code Product Name
Further Description
AO021
Stabileyes Capsular Tension Ring
Polymethylmethacrylate (PMMA) Implant
AO022
Posterior Chamber IOL; Pharmacia Heparin Surface Modified AC
722C: +8.0 to +30.0 diopter
Detail Change
IOL Model 352C
piece, biconvex. 812C, 722C, 757C, 808C CeeOn
AO024
Tecnis One Piece (ZCB00)
Gap removed, Detail Change
Size
Explanation of Change
12mm ring, and 13mm ring
Gap removed
CeeOn Posterior chamber, heparin coated , PMMA lenses, One
812C:+8.0 to +40.0 diopter increments,
increments, 757C: -10.0 to +7.0 diopter increments
One piece intraocular lens with edge modification and 360 degree
+6 diopters to +30 diopters in 0.5d increments
square edge
Advanced Surgical Design & Manufacture Ltd
Orthopaedic
AE104
FMP Acetabular System - Metal on Metal Heads
CoCro femoral heads in 28mm, 34mm and 38mm diameters to fit
with FMP metal on metal acetabular liners and FMP Acetabular
Shells. The 34 mm and 38mm heads need to be used in conjunction
with Encore Unipolar Sleeves, which provide -3.5mm, 0mm,
+3.5mm, +7.0
28mm and 38mm diameters
Detail Change
Plastic and Reconstructive
AE007
AE053
AE054
MF-Cortex Screw
ASDM Bone Plates
ASDM Bone Plates
Titanium
Custom Skull Mesh Plate, Titanium
Titanium 1.0mm MF Bone Plate
1.0 - 2.7mm dia, length 2 - 40mm
Benefit Review, Detail Change
One size only
Benefit Review, Detail Change
Small, Single square plate 2x2 holes, T-shape, 90 deg, 5 holes
Benefit Review, Detail Change
AE055
ASDM Bone Plates
Titanium 1.0mm MF Bone Plate
Medium, Double square plate, 3x2 holes; Double Y-shape, 6 or 7 Benefit Review, Detail Change
holes; Y-shape, 6 hole; Double T-shape, 9 hole;T-shape, 90 deg, 7
holes;L-shape, right or left, 5 hole;Straight Plate, 8 hole
AE056
ASDM Bone Plates
Titanium 1.0mm MF Bone Plate
Large, Triple square plate, 4x2 holes;Curved plate, 8 hole;Straight Benefit Review, Detail Change
plate, 24 hole;L-shape plate, right or left, 8 holes
AE057
ASDM Bone Plates
Titanium 1.7mm MF Bone Plate, Titanium
AE058
ASDM Bone Plates
Tiranium 1.7mm MF Bone Plate, Titanium
Small, Straight plate, 6-8mm, 4 hole;L-Shape, right or left, 6mm, 4
Benefit Review, Detail Change
hole;Curved plate, 6mm, 4 hole
Medium, L-Shape, right or left, 8mm, 4 hole;Y-Shape, 8mm, 5
Benefit Review, Detail Change
hole;T-Shape, 10mm, 5 hole;L-shape, right or left, 10-12mm, 4-5
holes;Straight Plate, 8 hole;Double Y-Shape, 6-7 holes;Curved plate,
6-8 holes;Single square plate, 2x2 holes
AE059
ASDM Bone Plates
Titanium 1.7mm MF Bone Plate, Titanium
Large, Triple square plate, 4x2 holes;Straight plate, 16 hole
AE060
ASDM Bone Plates
Titanium 2.0mm MF Bone Plate, Titanium
AE061
ASDM Bone Plates
Titanium 2.0mm MF Bone Plate, Titanium
Small, Straight plate, 9-13mm, 4 holes;Staright plate, 4 holes;L- Benefit Review, Detail Change
shape, right or left, 4 holes
Medium, Y-Shape, 8 hole;Double Y-Shape, 6 hole;L-Shape, right or
Benefit Review, Detail Change
left, 5 holes;L-Shape, right or left, 9-13mm, 4 holes;Straight Plate, 6
hole;Curved plate, 6 hole
AE062
ASDM Bone Plates
Titanium 2.0mm MF Bone Plate, Titanium
Changed Items for Prostheses List Report
Benefit Review, Detail Change
Large, Double square plate, 3x2 holes;Curved plate, 10 hole;Straight
plate, 16 hole;L-shape plate, right or left, 9 holes
Benefit Review, Detail Change
Page 2 of 99
Billing Code Product Name
Further Description
Size
AE063
ASDM Bone Plates
Titanium 2.2mm MF Bone Plate, Titanium
Small, Straight plate, 8-14mm, 4 holes;Curved plate, 11mm, 4 holes
Explanation of Change
AE064
AE065
ASDM Bone Plates
ASDM Bone Plates
Titanium 2.2mm MF Bone Plate, Titanium
Titanium 2.2mm MF Bone Plate, Titanium
Medium, Straight plate, 8-14mm, 6 holes
Benefit Review, Detail Change
Large, Straight plate, 11mm, 8 holes;Straight plate, 14 holes;Angled
Benefit Review, Detail Change
plate, 6 holes
Benefit Review, Detail Change
Advanced Surgical Technologies
Orthopaedic
AD114
AD212
Transcend/Lineage Articulation System
CONSERVE Total hip head
Metal femoral head CoCr
CoCr SLT Taper Femoral Head
28 and 32mm, 4 lengths
Detail Change
Sizes 38mm-54mm in 2mm increments, -3.5 to +3.5 Neck Detail Change
AD236
Profemur Total Hip System
Titanium Femoral Necks
Length 27 - 38.5mm; Neutral to Ante/Retro - Varus Valgus 2
AD286
BFH Total, A-class
3.5mm, 0mm, + Detail Change
Cobalt Chrome super finished femoral head. Size range from 36mm
Detail Change
36mm to 56mm in 2mm increments each with -
to 56mm in 2mm increments with 3 head lengths per size 3.5mm head lengths
AD288
AD308
AD332
Transcend/Lineage Articulation System
Transcend/Lineage Articulation System
Procotyl L Delta Ceramic Liner
Metal femoral head CoCr
Metal femoral head CoCr
Delta ceramic liners
36mm, 4 lengths
32mm, 4 lengths
28, 32, 36ID
Detail Change
Detail Change
Detail Change
Alcon Laboratories (Aust.) Pty Ltd
Ophthalmic
AL004
AL005
AL006
AL007
AL011
Detail Change
Acrysof Multipiece Models MA60BM, MA30BA, MA50BM,
Foldable Acrylic Multi-piece Lens
-5 D to +30 D
Detail Change
MA60MA, MA30AC, MA60AC
DUOVISC VISCOELASTIC SYSTEM
PROVISC contains sodium hyaluronate, VISCOAT contains
Small & large packs Detail Change
chondroitin sulfate and sodium hyaluronate
PROVISC VISCOELASTIC SOLUTION
PROVISC contains sodium hyaluronate
0.55mL & 0.85mL packs
Detail Change
VISCOAT Viscoelastic Fluid
Chondroitin sulfate and sodium hyaluronate
0.75mL
Detail Change
Intraocular Lens: Alcon Acrysof Model SA30AL, Alcon Acrysof
Foldable Acrylic Single-piece Lens, asymmetric optic/consistent edge
Range of Powers: +6 to +40 D
Model SA60AT, SA30AT Intraocular Lens; Alcon Acrysof PC IOL
Model SA65AT
AL015
Cellugel viscoelastic fluid
Hypromellose 2%
.
Detail Change
AL016
Alcon Acrysof Natural Model SN60AT
Foldable Acrylic Single-piece Lens, asymmetric optic/consistent
+6 to +40D
Detail Change
edge, with blue light protection
AL019
AcrySof Model SN60AS
Foldable Acrylic Single-piece lens, in cartridge, with blue light
+6 to +40 D
Detail Change
protection
AL021
Alcon AcrySof SN60WF
Foldable Acrylic Single-piece Lens with Blue Light Protection and
+ 6.0 D to +30.0 D Detail Change
Aspheric Correction
AL023
Alcon AcrySof Toric PC IOL Models
Posterior chamber, UV absorbing, foldable, acrylic, toric, single
SN60T3 (1.50 D cylinder), SN60T4 (2.25 D
cylinder), SN60T5
Detail Change
piece lens with blue light protection
(3.00 D cylinder), SN60T6 (3.75 D cylinder), SN60T7 (4.50 D
cylinder), SN60T8 (5.25 D cylinder), SN60T9 (6.00 D cylinder)
Changed Items for Prostheses List Report
Page 3 of 99
Billing Code Product Name
Further Description
AL024
AcrySert model SN60WS
+6 to +36 D
Detail Change
AL025
AcrySof Multipiece Models MN60MA, MN60AC
Foldable Acrylic Single-piece Lens with Blue light protection and
aspheric correction, in cartridge.
Foldable Acrylic multi-piece Lens with Blue light Protection
- 5 D to + 30 D
Detail Change
AL029
DisCoVisc Ophthalmic Viscosurgical Device
Sodium hyaluronate 17 mg/mL and chondroitin sulfate 40mg/mL
0.5 mL and 1.0 mL Detail Change
AL031
AcrySert C Model SN6CWS
Posterior chamber, UV absorbing, foldable, acrylic, single piece lens
with blue light protection and aspheric correction, in cartridge
+6.0 to +30.0 D
Detail Change
AL032
AcrySof Toric Aspheric IOL
Posterior chamber, UV absorbing, foldable, acrylic, toric, single
piece lens with blue light protection and aspheric correction
+6.0 to +30.0 D
Detail Change
Size
Explanation of Change
Anatomics Pty Ltd
Plastic and Reconstructive
AT051
AT053
E-POR Biomaterial/ Sheet - Porous Polyethylene
Sheet - Porous Polyethylene
E-POR Biomaterial/ Midface Contour Porous Polyethylene
30mm - 50mm x 0.4mm - 3mm
Midface Contour Porous Polyethylene
AT055
Detail Change
E-POR Biomaterial/ Orbital Wall and Floor Porous Polyethylene
Orbital Wall and Floor Porous Polyethylene Titanium Mesh
Titanium Mesh Composite (large)
Composite
E-POR Biomaterial/ Craniotomy Gap Wedge Porous Polyethylene
Craniotomy Gap Wedge Porous Polyethylene
E-POR Biomaterial/ Transsphenoidal Sellar Contourable Porous
Transphenoidal Sellar Contourable Porous Polyethylene 2.5mm x 20mm - 40mm
AT056
Detail Change
AT058
Detail Change
Polyethylene
AT059
E-POR Biomaterial/ Mastoid, Pterional, Contourable Porous
Benefit Review, Detail Change
Polyethylene
AT061
E-POR Biomaterial/ Contour Porous Polyethylene
Contour Porous Polyethylene
AT062
E-POR Biomaterial/ Temporal Fossa Implant Porous Polyethylene
Review, Detail Change
AT063
Detail Change
E-POR Biomaterial/ Patient Specific Cranial Implant, Porous
Polyethylene
AT064
E-POR Biomaterial/ Cranial Temporal, Porous Polyethylene Titanium
Review, Detail Change
Mesh Composite
AT067
E-POR Biomaterial/ Burr Hole Cover, Porous Polyethylene
Benefit Review, Detail Change
Benefit Review, Detail Change
One size Benefit Review, Detail Change
41 x 42 x 0.6-1.0mm Benefit Review,
One Size - V and T shape
Benefit Review,
Benefit Review,
Mastoid, Pterional, Contourable Porous Polyethylene
Left, Right, 43mm - 57mm x 0.6mm, 1.5mm
One Size 56mm x 91mm
Temporal Fossa Implant Porous Polyethylene
Benefit Review, Detail Change
61mm - 105mm x 18mm - 20mm
Patient Specific Cranial Implant, Porous Polyethylene
Cranial Shape - Customised
Benefit Review,
Cranial Temporal, Porous Polyethylene Titanium Mesh Composite Left, Right, 130mm x 130mm
Burr Hole Cover, Porous Polyethylene
Benefit
Benefit
15mm x 3mm x 5mm; 29mm x 7mm x 14mm
AstraZeneca Pty Ltd
Plastic and Reconstructive
AZ001
Astra Tech Cover Screws
Cover Screw
AZ002
Astra Tech MicroThread Fixtures and MicroThread Osseospeed
Review, Detail Change
Fixtures
Diameter 3.5mm, 4.0mm, 4.5/5.0mm Short, 4.5/ 5.0mm Long
Titanium fixture with microthreaded cervical neck
Benefit Review, Detail Change
Diameter 3.5 - 5.0mm, Length 8-19mm
Benefit
Changed Items for Prostheses List Report
Page 4 of 99
Billing Code Product Name
Further Description
Size
AZ003
Astra Tech Healing Abutments
Healing Abutments, Healing Abutments Zebra
Zebra 1.5, 3.0, 4.5, 6.0mm; Healing Abutment 5.5mm Ultra, Short,
Long; 7.0mm Short, Long; ST Short, Long; ST 5.5mm Short,
Long; ST 7.0mm Short, Long; Temporary Abutment 3.5, 4.0
4.0/5.0mm
Explanation of Change
AZ004
AZ005
AZ006
AZ007
AZ008
AZ009
Astra Tech Abutments
Astra Tech Abutments
Astra Tech Abutments
Astra Tech Abutments
AstraTech Cast to Abutment
AstraTech Profile BI Abutment
Temporary Abutment
PreFab Titanium Abutment, BiAbutment/Abutment Kit
UniAbutment, Angled Abutment, Ball Abutment
Ceramic Abutment
Diam 3.5 - 5.0mm
Diam 3.5 - 5.0mm
Diam 3.5 - 7.0mm
Diam 4.5 - 5.0mm
.
.
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Stainless Steel Coronary Stent
Dia 2-5mm, Length 6-40mm
Detail Change
Atrium polypropolene mesh - surgical mesh
Atrium polypropolene mesh - surgical mesh
Atrium polypropolene mesh - surgical mesh
Atrium polypropolene mesh - surgical mesh
Atrium polypropolene mesh - surgical mesh
Atrium polypropolene mesh - surgical mesh
Atrium polypropolene mesh - surgical mesh
Polypropolene
Polypropolene
Polypropolene
Polypropolene
Polypropolene - Pre-shaped with hole
Polypropolene
Polypropolene mesh plug
7.5 x 15cm
30 x 30cm
15cm x 15cm
26 x 36cm
6.5 x 12.5cm
5 x 10cm
Small, Medium, Large and Extra Large
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium PTFE Vascular Graft
Atrium Ultramax PET Grafts
Atrium Ultramax PET Grafts
Atrium Ultramax PET Grafts
Atrium Ultramax PET Grafts
Advanta SST, VXT, AFT GDS
Radially Supported (Ringed) PTFE Standard Wall
Straight PTFE Standard Wall
Tapered PTFE Standard Wall
Vascular Access Graft PTFE Standard Wall
Radially Supported (Ringed) PTFE Thin Wall
Straight PTFE Thin Wall
Tapered PTFE Thin Wall
Vascular Access Graft PTFE Thin Wall
Bifurcate Polyster Graft
Axillo-bifemoral Polyster Graft
Straight Polyster Graft
Straight Polyster Graft
PTFE Vascular Graft
4mm x 10cm - 10mm x 100cm
6mm x 10cm - 10mm x 90cm
4-6mm x 30cm - 6-8mm x 90cm
4mm x 10cm - 10mm x 100cm
4mm x 10cm - 10mm x 100cm
6mm x 10cm - 10mm x 90cm
4-6mm x 30cm - 6-8mm x 90cm
4mm x 10cm - 10mm x 100cm
12mm x 24mm - 6mm x 12mm x 40cm
8mm - 10mm 100 x 60cm
6mm x 15cm - 24mm x 30cm
6mm x 40cm - 8mm x 100cm
4mm x 10cm - 24mm x 100cm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review, Detail Change
Atrium Australia - Pacific Rim Pty Limited
Cardio-thoracic
AC022
Flyer RX Coronary Stent System
General/Miscellaneous
AC005
AC006
AC007
AC008
AC009
AC010
AC011
Vascular
AC001
AC002
AC003
AC004
AC012
AC013
AC014
AC015
AC016
AC017
AC018
AC019
AC020
Changed Items for Prostheses List Report
Page 5 of 99
Billing Code Product Name
Further Description
AC025
Atrium Ultramax Patches
Detail Change
Knitted Double Velour Vascular Patch. Composition is polyester
Size
Explanation of Change
Size range 8mm x 75mm to 50mm x 152mm
impregnated with absorbable gelatin
Aus Systems Pty Ltd
Plastic and Reconstructive
AU002
AU005
AU006
AU007
AU014
AU018
AU019
AU022
AU035
AU043
AU055
AU056
AU057
AU058
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Bone Screws
Aus Systems Titanium Bone Screws
Aus Systems Titanium Miniplates (Bone Plates)
Aus Systems Titanium Miniplates (Bone Plates)
Titanium Surgical Mesh
Titanium Surgical Mesh
Low profile 2 & 4 hole
Low profile condensed
Low profile
Low profile pre-shaped - Square, T, L, Y, Y Double & X
Low profile burr hole cover
Strip plates, Titanium (M10 series)
16 & 19 hole
Pre-shaped - L
Screws 2mm & 2.3mm diameter
Screws 1.5mm & 1.8mm diameter
Pre-shaped - T, T Double, Y
Pre-shaped - Y Double
Titanium Surgical Mesh
Titanium Surgical Mesh
Short, medium, long
8 hole
19 hole
Short, medium, Long, 4 & 5 hole
10mm, 14mm, 18mm, 22mm
1mm profile, 4 holes
0.7mm & 1mm profile
Small, Medium, Long
4mm - 15mm length
3mm - 11mm length
Small, Medium, Long, 4 & 5 hole
Small, Medium, Long
Mesh to suit 2mm screw
Mesh to suit 1.5mm screw
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Ausponsor Pty Ltd
Ophthalmic
AQ003
Hoya-PS AF-1 (UY) PY-60AD
Preloaded in cartridge, Aspheric, Blue blocker, Foldable, SinglePiece, Hydrophobic Acrylic
+6.0D to +30.0D (0.5D steps) Detail Change
Plate
Mesh
Custom Mesh
Screw
Straight, Left, Right, X, T and Y shaped
.
.
Width 1.0 - 3.0mm. Length 3.0 - 25mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Set Screw for Polyaxial Pedicle Screw System
Rotatable posterior lumbar interbody fusion cage
One size
Detail Change
Heights: 10mm, 11mm, 12mm, 14mm, 16mm and Lengths: 24mm Detail Change
and 26mm
Australian Surgical Innovations Pty Ltd
Plastic and Reconstructive
AI004
AI005
AI006
AI007
ASI Plates and Screws
ASI Plates and Screws
ASI Plates and Screws
ASI Plates and Screws
Austspine Pty Ltd
Neurosurgical
AJ002
AJ020
Preference II Pedicle screw system
Vigor PEEK Lumbar Interbody Fusion Cage
Changed Items for Prostheses List Report
Page 6 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Auto Suture Company, Australia T/A Tyco Healthcare Pty Ltd
General/Miscellaneous
AS055
Mesh Polyproplene; Monofilament Polyproplylene.
Benefit Review, Detail Change
Multifilament Polypropylene; Monofilament Polypropylene.
7.6cm x 12.7cm Surgipro* mesh (3 x 5 inch)
AS056
Mesh Polyproplene; Monofilament Polyproplylene.
Benefit Review, Detail Change
Multifilament Polypropylene; Monofilament Polypropylene.
35.6cm x 22.9cm Surgipro* mesh (14 x 9 inch).
AS057
Mesh Polyproplene; Monofilament Polyproplylene.
Benefit Review, Detail Change
Multifilament Polypropylene; Monofilament Polypropylene.
2.5cm x 10.2cm Surgipro* mesh (1 x 4 inch)
AS068
Surgipro Non Absorbable Polypropylene Hernia Mate Plug System
AS122
Parietene-Monofilament Polypropylene mesh
Parietene-Monofilament Polypropylene standard mesh / light mesh
20 x 20 cm
AS123
Detail Change
Parietene-Monofilament Polypropylene mesh
Parietene-Monofilament Polypropylene standard mesh / light mesh/
30 X 30 cm, 30 x 32 cm
AS124
Parietene-Monofilament Polypropylene mesh
X-shaped mesh
Parietene-Monofilament Polypropylene mesh Plug and Patch
06 x 12 cm
Parietex-Multifilament Polyester Anatomical Mesh Standard / With
13 x 09 cm, 15 x 10 cm, 16 x 12cm
AS128
Parietex-Multifilament Polyester Mesh
Review, Detail Change
Polypropylene
Medium and Large Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review,
Benefit Review, Detail Change
Benefit
Slit and Folding / With Slit and No Touch System
AS130
AS139
Parietex-Multifilament Polyester Mesh
Parietex Composite 9F
AS140
Parietex Composite 12F
AS141
Parietex Composite 15F
AS142
Parietex Composite 20F
AS143
Parietex Composite 1510F
AS144
Parietex Composite 2015F
AS145
Parietex Composite 2520F
AS146
Parietex Composite 3020F
AS147
Parietex Composite 3728F
AS148
Parietex Composite 1510OS
AS149
Parietex Composite 2015OS
Changed Items for Prostheses List Report
Parietex-Multifilament Polyester Mesh Plug
6 cm, 8 cm
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophlic film
Dual sided Polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion -prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Benefit Review, Detail Change
9cm round
Benefit Review, Detail Change
12cm round
Benefit Review, Detail Change
15cm round
Benefit Review, Detail Change
20cm round
Benefit Review, Detail Change
15x10cm square
Benefit Review, Detail Change
20x15cm square
Benefit Review, Detail Change
25x20cm Oval
Benefit Review, Detail Change
30x20cm oval
Benefit Review, Detail Change
37x28cm oval
Benefit Review, Detail Change
15x10cm square
Benefit Review, Detail Change
20x15cm square
Benefit Review, Detail Change
Page 7 of 99
Billing Code Product Name
Further Description
AS150
Parietex Composite 2520OS
25x20cm Square
AS151
AS152
Parietex Composite Hiatal Hernia Mesh
Parietene Composite 12
AS153
Parietene Composite 1510
AS154
Parietene Composite 1515
AS155
Parietene Composite 2015
AS156
Parietene Composite 2520
AS157
Parietene Composite 3020
AS161
Parietene ProGrip Mesh (PRE-SHAPED)
Dual sided polyester meshes with a resorbable adhesion-prevention
hydrophilic film
Composite Mesh
8x8cm, 9x8cm, 8.5x8cm
Dual sided polypropylene mesh with resorbable adhesion-prevention
hydrophilic film
Dual sided polypropylene mesh with resorbable adhesion-prevention
hydrophilic film
Dual sided polypropylene mesh with resorbable adhesion-prevention
hydrophilic film
Dual sided polypropylene mesh with resorbable adhesion-prevention
hydrophilic film
Dual sided polypropylene mesh with resorbable adhesion-prevention
hydrophilic film
Dual sided polypropylene mesh with resorbable adhesion-prevention
hydrophilic film
Pre-Cut, slit mesh with self gripping overlapping flap - right or left
AS162
Parietene ProGrip Mesh (FLAT)
Mesh with self gripping FLAT
15 x 9cm RECTANGLE
Benefit Review, Detail Change
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Polypropylene
Self Forming Plug
Polypropylene Mesh
3x10cm
4.5x10cm
4.5x10cm
4.5x10cm
5x30cm
6x14cm
6x13.5cm
7.5x7.5cm
4.5x105cm
7.5x15cm
10x10cm
6x14cm
10x15cm
15x15cm
26x36cm
30x30cm
All sizes, small, medium, large
5x30cm, 5 pieces
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Size
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
12cm round
Benefit Review, Detail Change
15x10cm Square
Benefit Review, Detail Change
15x15cmBenefit Review, Detail Change
20x15cm Oval
Benefit Review, Detail Change
25x20cm Oval
Benefit Review, Detail Change
30x20cm Oval
Benefit Review, Detail Change
12 x 8cm elliptic
Benefit Review, Detail Change
B Braun Australia Pty Ltd
General/Miscellaneous
BB088
BB089
BB090
BB091
BB092
BB093
BB094
BB095
BB096
BB097
BB098
BB099
BB100
BB101
BB102
BB103
BB104
BB181
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
Premilene Mesh
OPTILENE MESH
Changed Items for Prostheses List Report
Page 8 of 99
Billing Code Product Name
Further Description
BB182
OPTILENE MESH
BB183
OPTILENE MESH
BB184
OPTILENE MESH
BB185
OPTILENE MESH
BB186
OPTILENE MESH
BB187
OPTILENE MESH
BB188
OPTILENE MESH
BB189
OPTILENE MESH
BB190
OPTILENE MESH
BB191
OPTILENE MESH
BB192
Premilene Mesh
Review, Detail Change
Polypropylene Mesh
20x30cm, 5 pieces
Polypropylene Mesh
7.5x7.5cm, 5 pieces
Polypropylene Mesh
15x15cm, 5 pieces
Polypropylene Mesh
30x30cm, 5 pieces
Polypropylene Mesh
5 x 10cm, 5 pieces
Polypropylene Mesh
10 x 15cm, 5 pieces
Polypropylene Mesh
4.5x10cm, 5 pieces
Polypropylene Mesh.
7.5 x 15cm, 5 pieces
Polypropylene Mesh
4.5x10cm
Polypropylene Mesh
6x14cm, 5 pieces
Premilene Nonabsorbable Polypropylene Surgical Suture Material
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Self-Forming Plug-Small, 5 pieces
Benefit
Low Profile.
Premilene Nonabsorbable Polypropylene Surgical Suture Material
Self-Forming Plug-Medium, 5 pieces
Benefit
Low Profile.
Premilene Nonabsorbable Polypropylene Surgical Suture Material
Self-Forming Plug-Large, 5 pieces
Benefit
Low Profile.
Polypropylene Mesh
Benefit Review, Detail Change
BB193
Premilene Mesh
Review, Detail Change
BB194
Premilene Mesh
Review, Detail Change
BB195
OPTILENE MESH
Size
Self-Forming Plug-Large, 5 pieces
Explanation of Change
Neurosurgical
BB064
BB135
BB140
BB153
BB158
BB213
Socon Spinal System
Aesculap Cervical System
Aesculap Cervical System
Aesculap Cervical System
Aesculap Cervical System
CO Posterior Lumbar Cage System
Socon Clamps
Titanium, rigid
Titanium, rigid
Titanium, rigid
Titanium with locking mechanism
Posterior Lumbar Cage - PEEK
One size only
Detail Change
Medium 34 - 64mm length
Benefit Review
Large 67 - 103mm length
Benefit Review, Detail Change
Small 20 - 32mm Length
Benefit Review
Dia 4 - 4.5mm, length 10 - 28mm
Detail Change
L23.5 x 9mm x h8mm, L23.5 x 9mm x h9mm, L23.5 x 10mm x
Detail Change
h10mm, L23.5 x 10.7mm x h11mm, L23.5 x 11.7mm x h12mm,
L23.5 x 12.7mm x h13mm, L23.5 x 13.7mm x h14mm, L23.5 x
14.7mm x h15mm, L23.5 x 9mm x h9mm
BB214
CC Posterior Lumbar Cage System
Posterior Lumbar Cage - PEEK
L23.5 x 10-12.5mm x h8mm, L23.5 x 10-12.5mm x h9mm, L23.5 Detail Change
x 10-12.5mm x h10mm, L23.5mm x 11-13.5mm x h11mm, L23.5
x 11-13.5mm x h12mm, L23.5mm x 11-13.5mm x h13mm, L23.5
x 11-13.5mm x 14mm, L23.5mm x 10-12.5mm x h6mm
BB215
Adonys Posterior Lumbar Cage System
Posterior Lumbar Cage - PEEK - Standard
BB216
Adonys Posterior Lumbar Cage System
Posterior Lumbar Cage - Short
8mm x 4 degrees, 12mm x 4 degrees, 8mm x 10 degrees, 12mm x Detail Change
10 degrees
8mm x 4 degrees, 10mm x 4 degrees, 12mm x 4 degrees, 8mm x Detail Change
10 degrees, 10mm x 10 degrees, 12mm x 10 degrees
BB230
S4 Spinal System
Set Screw - titanium
one size
Detail Change
Orthopaedic
Changed Items for Prostheses List Report
Page 9 of 99
Billing Code Product Name
Further Description
Size
BB067
BB296
Titanium and Steel
Modular neck adaptors made from CoCr
24mm-90mm
Benefit Review
CCD - 130°, 135 °, 140°; Offset - 0mm, -5mm ,+5mm; Version - Detail Change
7.5° left ante/right retro, 0 °, 7.5 ° left retro/right ante
Caspar Cervical Plate
Metha - Modular neck adaptors
Explanation of Change
Plastic and Reconstructive
BB072
Craniofix Titanium Clamps
Titanium
11mm
Benefit Review, Detail Change
BB073
Craniofix Titanium Clamps
Titanium
16mm
Benefit Review, Detail Change
BB168
Craniofix
Titanium skull fixation clamp
20mm
Benefit Review, Detail Change
BB289
CranioFix Absorbable
Double sided Cranial clamp, absorbable polyester
11mm
Benefit Review, Detail Change
BB304
Aesculap CranioPlate System/ Plate Neuro, 2 hole straightCranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 2 hole 11 & 16mm straight Benefit
Review, Detail Change
Consists of screws, plates
BB305
Aesculap CranioPlate System/Plate Neuro, 6 hole rectangular
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 6 hole 10 x 17 mm
rectangular
Benefit Review, Detail Change
Consists of screws, plates.
BB306
Aesculap CranioPlate System/ Plate Neuro, 4 hole square Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 4 hole 10mm square
Benefit
Review, Detail Change
Consists of screws, plates.
BB307
Aesculap CranioPlate System/ Plate Neuro, 4 hole straightCranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 4 hole 17 & 20 mm straight Benefit
Review, Detail Change
Consists of screws, plates.
BB308
Aesculap CranioPlate System/ Plate Neuro, 6 hole double Y
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 6 hole 15 & 17mm, double Y
shape
Benefit Review, Detail Change
Consists of screws, plates.
BB309
Aesculap CranioPlate System/ Plate neuro, 5 hole Y
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 5 hole 17mm, Y shape
Benefit
Review, Detail Change
Consists of screws, plates
BB310
Aesculap CranioPlate System/ Plate Neuro, 8 hole rectangular
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 8 hole 10 x 24 mm
rectangular
Benefit Review, Detail Change
Consists of screws, plates.
BB313
Aesculap CranioPlate System/ Plate Neuro, Burr hole cover 12 &
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 6 hole x 16 & 20mm Burr
hole cover
Benefit Review, Detail Change
16mm
Consists of screws, plates.
BB314
Aesculap CranioPlate System/ Screws Neuro Emergency, self
Cranial fixation system, internal fracture, non biodegradable.
Screws Neuro, Emergency, self tapping,
magazine of 8, 1.8mm x 3
Benefit Review, Detail Change
tapping, 1.8mm x 3 & 5mm
Consists of screws, plates.
& 5mm lengths
BB315
Aesculap CranioPlate System/Plate Neuro, 65 x 90mm, 0.6mm
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 65 x 90 mm, 0.6mm Mesh
Benefit Review, Detail Change
mesh
Consists of screws, plates.
BB316
Aesculap CranioPlate System/Screws Neuro, self-drilling, 1.5 x 3, 4
Cranial fixation system, internal fracture, non biodegradable.
screws neuro, self drilling, magazine of 8,
1.5mm x 3, 4 & 5 mm
Benefit Review, Detail Change
& 5mm
Consists of screws, plates.
lengths
BB317
Aesculap CranioPlate System/ Plate Neuro, 16 hole straight
Cranial fixation system, internal fracture, non biodegradable.
Plate Neuro, 16 hole 63mm straight
Benefit Review, Detail Change
Consists of screws, plates.
Vascular
BB170
Celsite Access Port for pain relief
Dimension: 25.8 x
Composition - polysulphone. Kit includes tunnelling rod, filter,
Detail Change
connectors, needles, syringe, tuohy needle
37.8mm
Diameter of septum:11.7mm. Height: 11.5mm.
Bard Australia Pty Ltd
General/Miscellaneous
BA061
BA062
Bard Mesh
Bard Mesh
Changed Items for Prostheses List Report
PerFix Plug
Visilex Laparoscopic mesh
Small, Medium, Large
3 x 6" & 4.5 x 6"
Benefit Review, Detail Change
Benefit Review, Detail Change
Page 10 of 99
Billing Code Product Name
Further Description
Size
BA063
BA064
BA065
BA066
BA067
BA068
BA069
BA070
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Composix Ventral mesh
Composix Ventral mesh
Composix Ventral mesh
Composix Ventral mesh
Composix Ventral mesh
Composix Ventral mesh
Composix Ventral mesh
Flat mesh
BA071
BA072
BA073
BA074
BA083
BA084
BA085
BA086
BA087
BA096
BA097
BA098
BA099
BA100
BA101
BA102
BA103
BA104
BA105
BA106
BA107
BA108
BA109
BA110
BA111
BA112
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Mesh
Bard Composix Kugel Hernia Patch
Bard Composix Kugel Hernia Patch
Bard Composix Kugel Hernia Patch
Bard Composix Kugel Hernia Patch
Bard Composix Kugel Hernia Patch
Bard Composix E/X Mesh
Bard Composix E/X Mesh
Bard Composix E/X Mesh
Bard Composix E/X Mesh
Bard Composix E/X Mesh
Bard Composix E/X Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
3D Mesh
3D Mesh
3D Mesh
3D Mesh
Kugel Patch
Kugel Patch
Kugel Patch
Kugel Patch
Kugel Patch
Small Oval w/e PTFE
Medium Oval w/e PTFE
Large Oval w/e PTFE
Small Circle w/e PTFE
Large Circle w/e PTFE
Elliptical
Elliptical
Elliptical
Elliptical
Elliptical
Rectangle
Oval Shaped
Oval Shaped
Oval Shaped
Oval Shaped
Oval Shaped
Oval Shaped
10"x14"
Benefit Review, Detail Change
12"x12"
Benefit Review, Detail Change
2" x 4"
Benefit Review, Detail Change
3" x 6"
Benefit Review, Detail Change
4" x 8"
Benefit Review, Detail Change
6" x 8"
Benefit Review, Detail Change
8" x 10"
Benefit Review, Detail Change
Small - 1" x 4" / 2" x 4" / 2" x 12" / 3 " x 6" / Pre-shaped 1.8" x 4" /
Benefit Review, Detail Change
Pre-shaped 2.4" x 5.4"
Large Left
Benefit Review, Detail Change
Medium Left
Benefit Review, Detail Change
Large Right
Benefit Review, Detail Change
Medium Right
Benefit Review, Detail Change
Small Oval 8 x 12cm
Benefit Review, Detail Change
Large Oval 14 x 18cm
Benefit Review, Detail Change
Small Circle 8 x 8cm
Benefit Review, Detail Change
Large Circle 12 x 12cm
Benefit Review, Detail Change
Medium Oval 11 x 14cm
Benefit Review, Detail Change
8 x 12 cms
Benefit Review, Detail Change
11 x 14 cms
Benefit Review, Detail Change
14 x 18 cms
Benefit Review, Detail Change
8 x 8cms
Benefit Review, Detail Change
12 x 12cms
Benefit Review, Detail Change
4" x 6" (10 x 15cm)
Benefit Review, Detail Change
6" x 8" (15 x 20cm)
Benefit Review, Detail Change
7" x 9" (18 x 23cm)
Benefit Review, Detail Change
8" x 10" (20 x 25 cm)
Benefit Review, Detail Change
10" x 13" (25 x 33 cm)
Benefit Review, Detail Change
10" x 14" (25 x 36 cm)
Benefit Review, Detail Change
7.5 x 10 cm, 1mm thickness
Benefit Review, Detail Change
8 x 12cm, 1mm thickness
Benefit Review, Detail Change
10 x 15 cm, 1mm thickness
Benefit Review, Detail Change
15 x 19 cm, 1mm thickness
Benefit Review, Detail Change
18 x 24 cm, 1mm thickness
Benefit Review, Detail Change
20 x 30cm, 1mm thickness
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Explanation of Change
Page 11 of 99
Billing Code Product Name
Further Description
BA113
BA114
BA115
BA116
BA117
BA118
BA119
Change
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Bard Dulex Mesh
Avitene Ultrafoam
Oval Shaped
26 x 34 cm, 1mm thickness
Oval Shaped
10 x 15 cm, 2 mm thickness
Oval Shaped
15 x 19 cm, 2 mm thickness
Oval Shaped
18 x 24 cm, 2 mm thickness
Oval Shaped
20 x 30 cm, 2 mm thickness
Oval Shaped
26 x 34 cm, 2 mm thickness
Hemostatic sponge applied directly to the source of surgical bleeding
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
12.5-7 2 cm x 6.25cm x 7mm
BA120
Avitene Ultrafoam
Hemostatic sponge applied directly to the source of surgical bleeding
50
BA121
Avitene Ultrafoam
Hemostatic sponge applied directly to the source of surgical bleeding
100
BA122
Change
Avitene Ultrafoam
Hemostatic sponge applied directly to the source of surgical bleeding
100/Thin
BA123
Avitene Ultrafoam
Hemostatic sponge applied directly to the source of surgical bleeding
200
Extra large oval - w/e PTFE
20cm X 25cm
Extra large oval - w/ePTFE
25cm X 33cm
The Bard Composix Kugel Hernia Patch is a self-expanding, non-
Benefit Review, Detail Change
Benefit Review, Detail Change
Extra Large Oval w/e PTFE 18cm x 23cm Benefit
BA127
Composix Kugel Hernia Patch
BA128
Composix Kugel Hernia Patch
BA131
Bard Composix Kugel Hernia Patch
Review, Detail Change
Size
Explanation of Change
8cm x 6.25cm x 1cm
8cm x 12.5cm x 1cm
Detail Change
Detail Change
8cm x 12.5cm x 3mm
8cm x 25cm x 1cm
Detail
Detail
Detail Change
absorbable, sterile prosthesis. Two layers of monofilament,
polypropylene mesh are stitched to an ePTFE sheet; an extruded
monofilament PET polymer "ring" provides memory, adds stability
to the
BA132
Detail Change
Bard Modified Kugel Hernia Patch
The Bard Modified Kugel Hernia Patch is a self-expanding, non-
7.5 cm (3") diameter
Benefit Review,
absorbable, sterile prosthesis. It consists of two layers of
monofilament, polypropylene mesh; an extruded monofilament PET
polymer "ring" provides memory, adds stability to the device. The p
BA133
Bard Modified Kugel Hernia Patch
The Bard Modified Kugel Hernia Patch is a self-expanding, nonabsorbable, sterile prosthesis. It consists of two layers of
monofilament, polypropylene mesh; an extruded monofilament PET
polymer "ring" provides memory, adds stability to the device. The p
10 cm (4") diameter Benefit Review, Detail Change
BA134
Detail Change
Bard Modified Kugel Hernia Patch
The Bard Modified Kugel Hernia Patch is a self-expanding, non-
11.5 cm (4.5") diameter
Benefit Review,
absorbable, sterile prosthesis. It consists of two layers of
monofilament, polypropylene mesh; an extruded monofilament PET
polymer "ring" provides memory, adds stability to the device. The p
BA135
Detail Change
Bard Composix Kugel Hernia Patch
The Bard Composix Kugel Hernia Patch is a self-expanding, nonabsorbable, sterile prosthesis. Two layers of monofilament,
polypropylene mesh are stitched to an ePTFE sheet; an extruded
monofilament PET polymer "ring" provides memory, adds stability
to the
Oval w/e PTFE 16cm x 31.2cm Benefit Review,
Changed Items for Prostheses List Report
Page 12 of 99
Billing Code Product Name
Further Description
BA136
Detail Change
The Bard Ventralex Patch is a self-expanding, non-absorbable,
Bard Ventralex Hernia Patch
Size
Explanation of Change
4.3 cm x 4.3 cm (1.7" x 1.7")
Benefit Review,
sterile prosthesis. Two layers of monofilament, polypropylene mesh
are stitched to an ePTFE sheet; an extruded monofilament PET
polymer "ring" provides memory, adds stability to the device. The
BA137
Detail Change
Bard Ventralex Hernia Patch
The Bard Ventralex Patch is a self-expanding, non-absorbable,
6.4 cm x 6.4 cm (2.5" x 2.5") Benefit Review,
sterile prosthesis. Two layers of monofilament, polypropylene mesh
are stitched to an ePTFE sheet; an extruded monofilament PET
polymer "ring" provides memory, adds stability to the device. The
BA138
Detail Change
Bard 3DMax Mesh
The Bard 3DMax Mesh is a sterile prosthesis constructed of
Extra Large Left 5" x 7"
Benefit Review,
Extra Large Right 5" x 7"
Benefit Review,
monofilament polypropylene mesh. 3DMax mesh is a threedimensional, anatomically formed prosthesis for use in laparoscopic
hernia repair.
BA139
Detail Change
Bard 3DMax Mesh
The Bard 3DMax Mesh is a sterile prosthesis constructed of
monofilament polypropylene mesh. 3DMax mesh is a threedimensional, anatomically formed prosthesis for use in laparoscopic
hernia repair.
BA157
BA158
BA160
Bard Mesh
Bard Mesh
Bard Crurasoft Patch
BA161
Bard Crurasoft Patch
BA162
BA179
Bard CK Parastomal Patch
Bard Ventralex Hernia Patch
Flat Mesh
Medium - 6" x 6"
Flat Mesh
Large - 10" x 14"
Dual sided mesh with PTFE mesh on one side and ePTFE mesh on
the other side
Dual sided mesh with PTFE mesh on one side and ePTFE mesh on
the other side
Bard CK Parastomal Patch
12.5 x 15.5cm, 15.5 x 20.5cm
Bard Ventrlex Hernia Patch, Large
8cm x 8cm
Benefit Review, Detail Change
Benefit Review, Detail Change
7cm x 6cm Small Benefit Review, Detail Change
11cm x 8cm Large Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Vascular
BA001
BA005
BA009
Change
BA010
BA040
BA048
BA049
BA050
BA051
BA052
BA053
BA054
Memotherm Vascular Stents
Memotherm nitinol self-expanding stent
Encapsulated Carbon Lined Stent Graft
Iliac / SFA PTFE covered nitinol self-expanding stent
Simon Filter Femoral - 2110F, Simon Filter Jugular - 2210J, Simon
4mm - 20mm diameters, 2cm - 12 cm lengths
Detail Change
4mm - 10mm diameter, 3cm - 12cm length
Detail Change
Nitinol self expanding vena cava filter - "Simon Nitinol Filter"
28mm Filter, 7Fr delivery
Filter Anticubital - 2310A
Recovery Filter
VitaCuff, Hickman Catheter
VitaCuff, Broviac Catheters
Broviac Catheters
Hickman Catheters Single
Hickman Catheters Dual
Hickman Catheters Triple
Vitacuff, Hickman Single Lumen Catheters
Vitacuff, Hickman Dual Lumen Catheters
28mm Filter, 7Fr delivery System
36-45cm overall length
2.4 - 6.6 French Catheter
2.4 - 6.6 French Catheter
7 - 14.4F French Catheter
7 - 9 French Catheter
13.5 French Catheter
7 - 14.4F French Catheter
7 - 9 French Catheter
Changed Items for Prostheses List Report
Nitinol self expanding vena cava filter
Dialysis/Apheresis catheter, dual lumen, silicone
Silicone, with VitaCuff
Without VitaCuff, silicone
Without VitaCuff, silicone
Without VitaCuff, silicone
Without VitaCuff, silicone
Silicone, with VitaCuff
Silicone, with VitaCuff
Detail
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Page 13 of 99
Billing Code Product Name
Further Description
BA055
BA056
BA057
BA059
Vitacuff, Hickman Triple Catheters
Subcutaneous Ports
Groshong Subcutaneous Ports
Dual Lumen Subcutaneous Ports
Silicone, with VitaCuff
13.5 French Catheter
Hickman open-ended catheter, single lumen
8 - 9.6 French Catheter
Single or dual lumen catheter
8 - 9.6 French Catheter
Silicone, Polyurethane or ChronoFlex Open-ended Catheter
Detail Change
Detail Change
Detail Change
7 - 10 French Catheter
Detail Change
BA060
BA125
Hickman Subcutaneous Ports
Groshong Catheter
Low-Profile
6 - 6.6 French Catheter
Single Lumen, Sizes 3fr-8fr Groshong Valved-Closed ended catheter
Detail Change
Single Lumen, sizes 3fr-8fr
Detail Change
BA126
Groshong Catheter
Dual Lumen, sizes 5fr-9.5fr
Detail Change
BA129
Vascular Catheter
Single Lumen 3Fr - 6Fr
Detail Change
BA130
Vascular Catheter
Single Lumen, Sizes 5fr-9.5fr Groshong Valved-Closed ended
catheter
PICC - may include a Groshong Valved - Closed ended PICC,
Single Lumen 3Fr-6Fr
PICC- may include a Groshong Valved - Closed ended PICC, Single
Lumen 4Fr-7Fr
Kit contents: 14.5fr catheter, 18g guidewire introducer needle,
Detail Change
0.038" 70cm J-wire guidewire, 15fr PTFE introducer sheath, 8"
& 28cm and 31cm Pre-curved jugular kit.
tunnelling device, 10-12fr dualator vessel dilator, 2 adhesive
dressings, 2 injections caps, silicone attachable suture wing, hep
Dual Lumen 4Fr - 7Fr
Detail Change
HemoSplit is a carbothane long term dual lumen catheter used to
Standard Kit (straight15cm to42cm and pre-curved
BA140
HemoGlide Long Term Haemodialysis Catheter
Pre-curved kit; 19, 24
BA159
19cm to31cm),
HemoSplit Long Term Haemodialysis catheter
Detail Change
Size
Explanation of Change
15, 19, 23 & 27cm straight kit; 19 & 23cm
provide vascular access for haemodialysis. It comprises of a double Microintroducer Kits (straight 19cm to 42cm & pre-curved 19cm to
D lumen configuration catheter each lumen having an ID of 2.3mm) 31cm)
with a fixed split tip (to 7.5cmm) which enables blood flo
BA167
BA168
BA169
BA170
BA177
Fr Catheter
Poly RadPICC Catheters
Poly RadPICC Catheters
Poly RadPICC Catheters
Poly RadPICC Catheters
SlimPort Ultra Low Profile Implanted Port
Detail Change
BA178
Luminex Vascular Stent
Single lumen open-ended Polyurethane
3, 4, 5Fr with 70cm guide wire
Single Lumen open-ended Polyurethane
4, 5Fr with 135cm guide wire
Double Lumen open-ended Polyurethane
4, 5, 6Fr with 70cm guide wire
Double Lumen open-ended Polyurethane
5, 6Fr with 135cm guide wire
Ultra SlimPort Low Profile Plastic/Titanium port with attachable
Detail Change
Detail Change
Detail Change
Detail Change
Port: 16.9 x 22.7mm (W) x 9.2mm (H); 2.9g Wt 6
Chronoflex® single lumen catheter
Luminex nitinol self-expanding stent
Detail Change
4mm - 20mm diameters, 2cm - 12cm lengths
Bausch & Lomb (Australia) Pty Ltd
Ophthalmic
BL008
Ocucoat Intraocular Fluid
20mg/mL hydroxypropylmethyl cellulose for intraocular use
BL015
Amvisc Plus injection
15mg/mL Sodium Hyaluronate for intraocular use
BL019
Akreos Fit acrylic foldable posterior chamber intraocular lens
Diopter increments; 15.0 to 25.0 Diopter
Detail Change
device in a sterile vial. Modified C-Loop design
Changed Items for Prostheses List Report
1mL sterile
Gap removed, Detail Change
0.5mL and 0.8mL
Gap removed, Detail Change
Composition: Hydrophilic acrylic polymer. Packaged in lens folding
10.0 to 15.0 Diopter in 1.0
in 0.5 Diopter increments; 25.0 to 30.0 Diopter in 1.0 Diopter
increments
Page 14 of 99
Billing Code Product Name
Further Description
BL020
Akreos Adapt acrylic foldable posterior chamber intraocular lens
Diopter increments15.0 to 25.0
Detail Change
device in a sterile vial. Four haptic design
BL021
SoflexSE, Intraocular lenses, Posterior Chamber
diameter 6.0mm;
BL022
SofPort Advanced Optic (AO)
BL023
Akreos Advanced Optic
BL025
SofPort Advanced Optic (AO) Violet Shield
degree angulation 0-
BL026
Akreos AO Micro Incision Lens
10.7mm (15.50- Detail Change
Explanation of Change
Size
Composition: Hydrophilic acrylic polymer. Packaged in lens folding
10.0 to 15.0 Diopter in 1.0
Diopter in 0.5 Diopter increments25.0 to 30.0 Diopter in 1.0
Diopter increments
Composition: silicone, Lenses - foldable, posterior chamber
Detail Change
intraocular lenses
13.0mm length
Posterior chamber, foldable silicone IOL with anterior optic-haptic
square edge, posteriof optic-haptic square edge, 360-degree optic
square edge and asperic optic for aberration control
Range of powers: 5.0 to 30.0 Diopter - Optic
0 D to 30.0 D
Detail Change
Posterior chamber, foldable acrylic IOL, with anterior optic-haptic
square edge, posterior optic-haptic square edge, 360 degree optic
square edge and aspheric optic for aberration control
0 D to 30.0 D
Detail Change
Posterior chamber, aphakic, foldable silicone, anterior & posterior
Detail Change
edge modification intraocular lens with aberration technology, a
violet light
6mm optic 13mm overall lengthModified C 5
30D, 0.5D steps
Micro Incision, posterior chamber, foldable acrylic, aphakic,
anterior & posterior edge modification, preloaded, with aberration
contro, intraocular lens
6mm optic overall diameter 11.0mm(10D-15D),
22D), 10.5mm (22.50-30D)
Baxter Healthcare Pty Ltd
General/Miscellaneous
BX214
and 1.0 ml of
TISSEEL Two Component Fibrin Sealant Syringe
Detail Change
BX215
and 2.0 ml of
TISSEEL Two Component Fibrin Sealant Syringe
Detail Change
BX216
TISSEEL Two Component Fibrin Sealant Syringe
Solution and 5.0 ml of
Active ingedients:Sealer Protein Solution & Thrombin Solution -
2.0 ml (containing 1.0 ml of Sealer Protein Solution
deep-frozen
Thrombin Solution)
Active ingedients:Sealer Protein Solution & Thrombin Solution -
4.0 ml (containing 2.0 ml of Sealer Protein Solution
deep-frozen
Thrombin Solution)
Active ingedients:Sealer Protein Solution & Thrombin Solution Detail Change
deep-frozen
Thrombin Solution)
10.0 ml (containing 5.0 ml of Sealer Protein
Biomet 3i Australia Pty Ltd
Plastic and Reconstructive
NW001
NW002
NW003
3i Abutment Complete
3i Self Tapping Threaded Implants and 3i Coverscrew
Biogran
Titanium
Osseotite/Ice
Resorbable Synthetic Bone Graft
3.25 - 6mm diameter
Benefit Review, Detail Change
3.25 - 6mm diameter
Benefit Review, Detail Change
3i Biogran 750mg Glass Syringe 2 pack; 3I Biogran 750mg Glass Benefit Review, Detail Change
Syringe 7 pack; 3I Biogran 500mg Mixing Cup 7 pack; 3I 750mg
Mixing Cup 7 pack; 3I Biogran 1500mg Mixing Cup 7 pack
Head, Chrome Cobalt, Metal on metal
Femoral Stem, Chrome Cobalt, Cemented unpolished
Head, Chrome Cobalt, Metal on metal
28mm, -6mm to +12mm neck
7-17mm
28mm, -6mm to +12mm neck
Biomet Australia Pty Ltd
Orthopaedic
BI045
BI047
BI056
Scientific Hip Prostheses System
Echo FX Stem
Exceed M2A Femoral Head
Detail Change
Detail Change
Detail Change
Changed Items for Prostheses List Report
Page 15 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
BI068
BI070
BI896
BI944
Head, Chrome Cobalt, metal on metal
Head, Chrome Cobalt, metal on metal
Femoral Head, Cobalt Chrome, metal on metal
Metal on Metal Femoral Head, Cobalt Chrome
28mm, -6mm to +12mm neck
28mm or 32mm, -6mm to +12mm neck
38-60mm
38mm
Detail Change
Detail Change
Detail Change
Detail Change
Stanmore Hip System
Biomet Taperloc Hip System
M2A Magnum System
M2a 38 Femoral Head
Plastic and Reconstructive
BI348
BI349
BI351
BI353
BI360
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
L-Plate, 2mm System, Left or Right. Titanium
2 x 2 hole, Mini or Low Profile
Plate, Compression Straight, 2mm System. Titanium
4 hole
L-Plate, 2mm System, Left or Right. Titanium
2 x 2 hole, long
Plate, Burr Hole, 1mm, 1.5mm, 2mm system
13mm, 17mm, 18.5mm
Bone Screw, Cross or Centre Drive, Std or Self Drilling; Titanium
BI365
BI375
BI381
BI385
BI399
Detail Change
W Lorenz Osteosynthesis System
Bone Screw, Cross or Centre Drive; Titanium
W Lorenz Osteosynthesis System
Bone Screw, Cross or Centre Drive; Titanium
W Lorenz Osteosynthesis System
Bone Screw, Cross or Centre Drive; Titanium
W Lorenz Osteosynthesis System
Plate 2mm System
Lactosorb Resorbable Craniomaxillofacial Fixation System
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
2.0mm x (4 - 7) mm Benefit Review, Detail Change
2.0mm x (9 - 19) mm
2.7mm x (8 - 18) mm
2.7mm x (22 - 40) mm
4-7 hole
Panel or Sheet, Solid or Holed, PGA/PLA
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
0.25mm x 25x25mm
Benefit Review,
BI400
Lactosorb Resorbable Craniomaxillofacial Fixation System
Review, Detail Change
Cover, Solid or Holed, PGA/PLA
(0.25, 0.5, 0.75mm) x 38x38mm
BI401
Detail Change
Lactosorb Resorbable Craniomaxillofacial Fixation System
Cover, Solid or Holed, PGA/PLA
0.25mm x 50x50mm
BI415
Lactosorb Resorbable Craniomaxillofacial Fixation System
Bone Screw, 2 Pack, Endobrow, Lactosorb. PGA/PLA 2 x 5mm Benefit Review, Detail Change
BI417
Detail Change
Lactosorb Resorbable Craniomaxillofacial Fixation System
Cover, Solid or Holed, PGA/PLA
(0.5 or 0.8mm) x 25 x 25mm
Benefit Review,
BI418
Detail Change
Lactosorb Resorbable Craniomaxillofacial Fixation System
Panel, Lactosorb. 1.5mm System. PGA/PLA
25 x 50mm (5 x 10hole)
Benefit Review,
BI419
Detail Change
Lactosorb Resorbable Craniomaxillofacial Fixation System
Cover, Solid or Holed, PGA/PLA
(0.5 or 0.8)mm x 50x50mm
Benefit Review,
BI427
Detail Change
Lactosorb Resorbable Craniomaxillofacial Fixation System
Mesh, Mandibular Lactosorb 2.5mm System. PGA/PLA 1.42mm x 42x42mm
BI447
BI448
Lorenz 2.4mm Locking Reconstruction System
Lorenz 2.4mm Locking Reconstruction System
Plate, Curved, Std Thickness, 2.4mm System, Titanium 8 or 15 hole
Plate, curved, std or low profile, 2.4mm system, titanium 16-32 hole
Benefit Review, Detail Change
Benefit Review, Detail Change
BI450
BI452
Lorenz 2.4mm Locking Reconstruction System
Lorenz 2.4mm Locking Reconstruction System
Plate, low profile. Curved. 2.4mm System. Titanium
4-7 hole
Plate, curved. Std or low profile, 2.4mm System, Titanium
Benefit Review, Detail Change
16 hole Benefit Review, Detail Change
BI455
BI457
BI471
Lorenz 2.4mm Locking Reconstruction System
Lorenz 2.4mm Locking Reconstruction System
Lorenz 2.4mm Locking Reconstruction System
Plate, Double Angled, 2.0 or 2.4mm System, Titanium
Screw, Locking Reconstruction Modular. Titanium
Screw Head, Plate Locking Modular
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
5 x (22 or 24) x 5 hole
2.4 x (6-18)mm
2.4mm
Benefit
Benefit Review,
Benefit Review,
Page 16 of 99
Billing Code Product Name
Further Description
BI499
BI559
BI569
BI580
BI591
BI604
BI605
BI617
BI620
BI621
BI622
Small Fragment Titanium System
TMJ System
TMJ System
Distraction Technology System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
Washer, Lag Screw 1.2,1.7, 2.3mm System
0.6mm or 1mm height
Mandibular Component, Left or Right, Titanium
(40 - 60mm), 5-13 hole
Fossa Component, Left or Right; Titanium, UHMWPE Small, Medium Large
Distractor, Midface, Drive Screw with Sleeve. Titanium 20 - 30mm
Chin Plates, Paulus, 2mm System, Titanium
4 - 12mm
Sheet, 1mm System. Titanium
85x50x0.2mm
Plate, Matrix, 1.0 or 1.5mm System, Titanium
6 hole
Plate, Straight, 1mm System. Titanium
4 hole
Plate, Straight, low profile, 2.0mm System, Titanium
4 - 8 hole
Plate, L , 2.5mm or 2m system, Titanium
2 x2 or 3x3 hole
Z-Shape Plate, Left or Right, 1.5mm or 2mm System. Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
2 x 2 hole
Benefit Review, Detail Change
BI623
BI624
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
T-Plate, Left or Right, 1.5mm System. Titanium
3x3 hole, 7x7 hole
T-Plate 90 degrees, Left or Right, 2mm System. Titanium 2x5hole, 3x3hole, 2x3hole
Benefit Review, Detail Change
Benefit Review, Detail Change
BI625
W Lorenz Osteosynthesis System
Plate, Y, Double Y, X, 1.5mm System or 2.0mm System, Titanium
One size only
BI627
BI631
BI633
BI635
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
Plate, Straight, 1.5mm System, Titanium
L Plate, Left or Right, 1mm System. Titanium
T Plate 90 degrees, 1mm System, Titanium
Plate, DoubleT, Double Y; 1mm, 2mm system, Titanium
4 or 6 hole
5x3 hole
5 hole, Regular
6,7,11 hole
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
BI636
BI638
BI639
BI640
BI641
BI644
BI645
BI656
BI658
BI660
BI677
BI681
BI714
BI717
BI718
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
RapidFlap Cranial Clamp
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
Plate, Y-Shape, 1mm System, 2mm System .Titanium
Plate, Orbital. 1mm System, Titanium
Plate, Square. 1mm System. Titanium
Plate, Matrix, 1.0 or 1.5mm System, Titanium
Plate, Matrix. 1mm System, 1.5mm System. Titanium
Mesh panel, 1.5mm System. Titanium
Mesh panel. 1.5mm System Titanium
Plate, Orbital, 1.5mm, 2.0mm System, Titanium
Plate, Orbital. 1.5mm System, 2mm System. Titanium
Plate, H-Shape, 1.5mm System, Titanium
Plate, Neuro Straight, 1.5mm System, Titanium
Bone Screw, Cross or Centre Drive; Titanium
Clamp, Burr Hole or Craniotomy Line, Titanium
Neuro Gap Plate, Titanium
Neuro Gap Plate, Titanium
Regular, medium, long, xlong, nasal. 6 hole
One size only
4 hole
6 hole
2 x 4 hole
83 x 51mm x 0.6mm
83 x 51mm x(0.3 or 0.2mm)
6 hole
8-10 hole
One size only
2 hole (medium or long)
1.0mm x (2 - 7) mm
12, 16, 20mm
6 hole, 45mm length
6 hole 25mm length
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Size
Explanation of Change
Benefit Review, Detail Change
Page 17 of 99
Billing Code Product Name
Further Description
BI719
BI720
BI721
BI723
W Lorenz Osteosynthesis System
W.Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
Mandibular Fracture System
Neuro Sub-Temporal Plate, Titanium
medium
Neuro Gap Plate; titanium
6 hole, 35mm length
Plate, Burr Hole, 1.5mm System, Titanium
22mm, 25mm
Screw, High Torque 2.0/2.4 Mandibular Fracture, Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
2.7 x (6-20)mm
Benefit Review, Detail Change
BI726
Lengths
Mandibular Fracture System
Benefit Review, Detail Change
Screw, High Torque (HT), Emergency, 2.0/2.4 Mandibular Fracture
Dia 2.3mm x 4.0, 5.0, 7.0, 9.0, 11.0, 13.0, 15.0mm
BI728
BI731
W.Lorenz Osteosynthesis System
Mandibular Fracture System
BI733
BI734
BI735
BI738
BI740
W.Lorenz Osteosynthesis System
W.Lorenz Osteosynthesis System
W.Lorenz Osteosynthesis System
W.Lorenz Osteosynthesis System
W.Lorenz Osteosynthesis System
System, Titanium
Neuro Square or Rectangular Plate, titanium
1.5mm system, 4 hole
Washer, for High Torque (HT) Lag Screw, 2.0/2.4 Mandibular
Fracture System, titanium
Bone Screw, Self Drilling, Cross Drive, Titanium
1.5 mm (dia) x 6.0, 7.0mm [lengths]
Bone Screw, Self Drilling, Cross Drive, Titanium
1.5 mm (dia) x 3.5, 4.0, 5.0mm, [lengths]
Bone Screw, Cross or Centre Drive; Titanium
2.3mm x (5 - 9) mm
Orbital Floor Plate; Titanium
1.5mm system, Large
Orbital Floor Plate (Small) or NOE plate, 1.5mm System, Titanium
BI742
BI744
TMJ System
Mandibular Fracture System
Screw, Cross Drive Mandibular Component, Titanium
(2.7 - 3.2mm) x (8 - 12mm)
Screw, High Torque 2.0/2.4 Mandibular Fracture, Titanium
Benefit Review, Detail Change
2.0 x (9-17)mm
Benefit Review, Detail Change
Screw, High Torque (HT), Lag, 2.0/2.4 Mandibular Fracture
Dia 2.0 x 19, 21.0, 23, 25, 27, 29mm Lengths
System, Titanium
Screw, High Torque (HT), 2.0/2.4 Mandibular Fracture System,
Dia 2.4 x 6.0mm, 8.0, 10.0, 12.0, 14.0, 16.0,
Titanium
Screw, High Torque (HT), Lag, 2.0/2.4 Mandibular Fracture,
2.4mm Dia, 24, 28, 32, 36, 40mm Lengths Benefit
Titanium
Plates, Compression, 2.0 Mandibular Fracture System, Titanium
4 hole
BI755
Mandibular Fracture System
Review, Detail Change
Plates, Y Shapek, 2.0 Mandibular Fracture System, Titanium
5 hole long, 5 hole medium, 5 hole regular Benefit
BI756
Mandibular Fracture System
Plates, Compression, 2.0 Mandibular Fracture System, Titanium
4-6 hole Benefit Review, Detail Change
BI761
Mandibular Fracture System
Plates, V Shape, 2.0 Mandibular Fracture System, Titanium
6 hole
BI762
BI764
BI767
Mandibular Fracture System
Mandibular Fracture System
Mandibular Fracture System
Plates, 2.4 Mandibular Fracture System, Titanium
16 - 24 Hole
Plates, 2.0 / 2.4 Mandibular Fracture System, Titanium 4-7 hole
Plates, Straight, 2.0 Mandibular Fracture System, Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
8-15 hole
Benefit Review, Detail Change
BI773
BI774
BI786
BI792
W Lorenz Osteosynthesis System
W Lorenz Osteosynthesis System
Lorenz 2.4mm Locking Reconstruction System
Lorenz 2.4mm Locking Reconstruction System
Neuro sub-temporal plate, 1.5 system, titanium
Lefort plate, 1.5mm system, 0.6mm thickness, titanium
Screw, bending inserts, titanium
Condyle left or right, chrome cobalt (CoCr)
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
BI747
Mandibular Fracture System
Benefit Review, Detail Change
BI748
Mandibular Fracture System
18.0mm Lengths Benefit Review, Detail Change
BI751
Mandibular Fracture System
Review, Detail Change
BI754
Mandibular Fracture System
Changed Items for Prostheses List Report
Size
Small
Flat, 2-11mm
One size only
One size only
Explanation of Change
Benefit Review, Detail Change
2.0 (dia), 2.4 (dia) Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Small or NOE plate Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Page 18 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
BI823
BI824
BI825
BI870
Detail Change
distraction device, single tooth
distraction device, multi tooth
Shim plate, titanium
Plate & screws: Neuro pack Burr cover or multi plate set.
10-20mm
10-20mm
1-3mm
Thinflap
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.5mm or 2mm system
Benefit Review,
Orbital Floor Plate, 1.5mm System, PGA/PLA
Left or right
BI924
BI934
BI949
Detail Change
Alveolar Ridge Distraction System - titanium
Alveolar Ridge Distraction System - titanium
Alveolar Ridge Distraction System - titanium
Neurological Packs
4 hole plus plate sets
Lactosorb Resorbable Craniomaxillofacial Fixation System
Lactosorb Distraction System
Neurological Packs
Benefit Review, Detail Change
Plate, drive screw and distractor, PGA/PLLA, Ti
Small, Medium, Large
Plate & screws: Neuro pack - single plate or thinflip 2 hole plate set
Benefit Review, Detail Change
1.5mm or 2mm system
Benefit Review,
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
53 and 60cm lengths
Detail Change
Detail Change
Detail Change
Detail Change
one size only
Detail Change
Biotronik Australia Pty Ltd
Cardio-thoracic
BT029
BT046
BT047
BT054
BT058
BT060
BT062
BT063
BT064
BT066
Philos DR-A Model 122600 Implantable Pacemaker
Protos VR/CLS
Protos DR/CLS
Lexos VR
Lekton Motion
Philos II DR
Philos II SR
Selox SR
Kentrox SL-S steroid
Selox ST
BT067
BT068
BT070
BT071
BT075
Selox JT
Kentrox RV-S steroid
Corox OTW UP Steroid
Philos II DR-T
Lumos VR-T
Multiprogrammable, rate responsive, DDDR
5mm ports, One size only
Single chamber rate responsive, closed loop system.
One size only
Dual chamber, rate responsive, closed loop system.
One size only.
Single chamber ICD, Rate responsive pacing
One size only.
Coated flexible stent, Balloon mounted
Diameter 2.5mm to 4mm, Length 8 - 30mm
Multiprogrammable, rate responsive, DDDR
One size only
Multiprogrammable, Rate Responsive, SSIR pacemaker One size only
Lead, pacemaker, implantable, endocardial
45, 53, 60cm length
Fractal coated steroid electrode, dual shock coil
16 and 18 cms tip to second shock coil
Transvenous Bipolar Passive Steroid Ventricular Pacing Lead,
fractal coated
Fractal coated steroid electrode
45 and 53cm lengths
Fractal coated steroid electrode, single shock coil
65cm lengths
Coronary Sinus Lead
77, 87cm
Dual Chamber Rate Responsive with Home Monitoring One size only
Single Chamber ICD with home monitoring and IEGM online
BT076
BT077
Lumos DR-T
Kentrox SL steriod
Dual Chamber ICD with home monitoring
one size only
Dual shock coil fractal steroid eluting passive fixation electrode
Detail Change
65, 75cm lengths
Detail Change
BT078
Kentrox RV Steroid
single shock coil fractal steroid eluting passive fixation electrode
65, 75 cm lenghts
Detail Change
BT079
Cylos DR-T
one size Detail Change
BT080
BT082
Cylos VR
PRO-Kinetic
Dual chamber dual sensor rate responsive with home monitoring
system option
single chamber dual sensor rate responsive
one size only
Cobalth Chromium coronary stent system
8-40mm length 2-5mm diameter
Changed Items for Prostheses List Report
Detail Change
Detail Change
Detail Change
Page 19 of 99
Billing Code Product Name
Further Description
BT083
Setrox S
length 45, 53, 60cm Detail Change
BT084
Change
Linox SD
Bipolar active fixation lead with fractal coated and steroid eluting
electrode
Fractal coated and steroid electrode, active fixation quadrapolar
BT085
Stratos LV-T
Multiprogrammable Biventricular DDDRV with Home Monitoring
One size only
Detail Change
BT086
Lumax 340 DR-T
ICD-DR 34 J with bidirectional Home Monitoring. Dual chamber
One Size Only
Detail Change
BT087
Lumax 300 VR-T
ICD-VR with bidirectional Home Monitoring. Single chamber
One Size Only
Detail Change
BT088
BT089
BT090
Lumax 300 HF-T
Lumax 340 HF-T
Lumax 340 VR-T
CRT-D with bidirectional Home Monitoring
One size only
CRT-D 34 J with bidirectional Home Monitoring
One Size Only
ICD-VR 34 J with bidirectional Home Monitoring. Single chamber
Detail Change
Detail Change
One size only
Detail Change
BT091
BT092
spacing
Lumax 300 DR-T
Linox TD
Detail Change
ICD-DR with bidirectional Home Monitoring
One size only
Fractal and steroid coated passive fixation quadripolar ICD lead
Detail Change
65, 74 or 100cm length and 16 or 18mm electrode
BT093
BT095
BT096
BT097
Detail Change
Linox T
Corox OTW BP
Linox S
Dextrus (marketed by Boston Scientific)
Passive fix RV bipolar fractal coated steroid ICD lead
65, 75cm length
Coronary Sinus bipolar steroid
77, 87 cm length
Active fix RV bipolar fractal coated steroid IC lead
65, 75cm length
Bipolar, silicone, active fixation, steroid eluting, pacing lead
Detail Change
Detail Change
Detail Change
7Fr, with 45cm, 53cm and 60cm length options
BT098
Lumax 340 VR-T XL
BT100
LUMAX 540 VR-T
ICD-VR with 40 J output, bidirectional Home Monitoring and High
One Size Only
Detail Change
Longevity
High Energy, Single-Chamber ICD (Implantable Cardiac Diamensions: 66*55*13 mm Volume/Weight : 37.2cc/92g
Detail Change
Defibrillator) with Advanced Patient Management Via unique Home
Monitoring Technology incorporatin Automatic Threshold
Monitoring and Extended Longevity.
BT101
37.2cc/92g
Lumax 540 DR-T
Detail Change
Size
High Energy, Dual-Chamber ICD (Implantable Cardiac Defibrillator)
Explanation of Change
65, 75cm length, 16, 18mm elec dis
Detail
Diamensions: 66*55*13mm, Volume/Weight:
with Advanced Patient Management Via unique Home Monitoring
Technology incorporating Automatic Ventricular Threshold
Monitoring
BT102
Lumax 540 HF-T
High Energy, Three Chamber ICD (Implantable Cardiac Diamensions: 66*59*13 mm, Volume/Weight: 39.8cc/94g
Defibrillator) with Advanced Patient Management Via unique Home
Monitoring Technology incorporating Automatic RV/LV Threshold
Monitoring and Extended Longevity.
Astron
Peripheral self expanding nitinol, coated stent
Detail Change
Vascular
BT072
Dia: 6 - 12mm, Len: 30 - 100mm
Detail Change
Boston Scientific Australia Pty Ltd
Cardio-thoracic
Changed Items for Prostheses List Report
Page 20 of 99
Billing Code Product Name
Further Description
BS069
Express 2/Liberte Coronary Stent System,
diameters: 2.25, Detail Change
Consists of a balloon expandable stent, pre-mounted on a Maverick
Size
Explanation of Change
Stent lengths: 8,12,16,20,24,28 & 32 mm Stent
2 Monorail delivery catheter.
2.5, 2.75, 3.0, 3.5, 4.0, 4.5 & 5.0 mm
BS074
Taxus on Express2 Coronary Stent System Models 38001-0822 to
balloon expandable stent with conformal polymer/drug matrix
Detail Change
0840; 38001-1222 to 1250; 38001-1622 to 1650;38001-2022 to
coating, pre-mounted on high pressure monorail delivery catheter
2050; 38001-2422 to 2450; 38001-2827 to 2850; 38001-3227 to
3250
Length 8 - 32mm; Diameter 2.25 - 5.0mm
BS099
Change
Taxus Liberte Paclitaxel-Eluting Coronary Stent System 316L Stainless Steel Stent with Translute Polymer and Paclitaxel
2.0mm-5.0mm & 8.0mm-38mm
BS112
BS113
BS114
Contak Renewal 4 RF CRT-D
Contak Renewal 4 RF CRT-D
Contak Renewal 4 RF CRT-D
CRT-D with RF telemetry, IS-1 connector H230
39cc, 82g
CRT-D with RF telemetry, IS-1 connector H235
39cc, 82g
CRT-D with RF telemetry, IS-1 connector H239 High Energy
Detail Change
Detail Change
43cc, 90g
VDD Pacemaker
10.0cc, 23.5g
Single chamber pacemaker
10cc, 23.4g
Cobalt chromium alloy stent coated with a blended polymer mixed
Detail Change
Detail Change
2.25mm to 4.0mm diameter, 8mm to 28mm length
BS123
Insignia AVT 882
BS124
Insignia AVT 1192
BS125
Promus Everolimus Coronary Stent System
Detail Change
BS126
BS128
Insignia AVT 1292
Confient RF HE
BS129
BS130
BS132
LIVIAN CRT-D
LIVIAN CRT-D HE
Teligen 100 HE VR 4-SITE
BS133
BS134
Acuity Spiral
TELIGEN 100 HE DR 4-SITE
BS135
BS136
Teligen 100 DR DF-1/IS-1
TELIGEN 100 HE VR DF-1/IS-1
with Everolimus.
Dual chamber pacemaker
10.8cc, 25.4g
Dual chamber, high energy implantable cardioverter defibrillator
with wireless radio frequency capability
CRT-D (IS-1 and LV-1 connectors)
40cc, 79.5g, 14.5mm
CRT_D RF High Energy (IS-1 and LV-1 connectors)
44cc, 87.5g, 14.5mm
High energy single chamber ICD with 4-SITE inline RV connector
(GDT-LLHH)
Transvenous Left Ventricular pacing lead
80, 90 & 100cm
High energy dual chamber ICD with 4 SITE (GDT-LLH) inline RV
connector
High energy dual chamber ICD
31.5cc, 9.9mm
High energy single chamber ICD with DF-1/IS-1 connector
BS138
COGNIS 100 HE 4-SITE
BS139
COGNIS 100 HE (DF-1/IS-1 & DF-1/LV-1)
Detail
Detail Change
Detail Change
44cc, 87.5g
Detail Change
Detail Change
Detail Change
30.5cc, 9.9mm
Detail Change
Detail Change
31.55cc, 9.9mm
Detail Change
Detail Change
31.5cc, 9.9mm
Detail Change
High Energy CRT-D with 4SITE (GDT-LLHH) inline RV connector
32cc, 9.9mm
Detail Change
High Energy CRT-D (DF-1/IS-1 & DF-1/LV-1connectors)
32.5cc, 9.9mm
Detail Change
General/Miscellaneous
BS046
Ultraflex Oesophageal Stent; Ultraflex Oesophageal NG Stent
Detail Change
Nitinol, self expanding stent
Diameters up to 30mm & lengths up to 150mm
BS047
BS049
BS051
BS052
BS053
Diameters up to 25mm & lengths up to 80mm
Diameters up to 30mm & lengths up to 150mm
Diameters up to 10mm & lengths up to 100mm
Diameters up to 10mm & lengths up to 100mm
Diameters up to 30mm & lengths up to 150mm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Ultraflex Tracheobronchial Stent
Wallstent Flamingo Oesophageal Stent
Wallstent Biliary Stent
Wallstent Biliary Stent
Wallstent Enteral Stent
Changed Items for Prostheses List Report
Nitinol, self expanding stent
Monofilament wire, self-expanding stent
Monofilament wire, self-expanding stent
Monofilament wire, self-expanding stent
Monofilament wire, self-expanding stent
Page 21 of 99
Billing Code Product Name
Further Description
BS054
BS055
BS066
BS070
BS071
BS089
BS090
BS101
Detail Change
Polyurethane Biliary Stent
Diameters up to 12Fr & lengths up to 15cm
Polyurethane Biliary Stent
Diameters up to 12Fr & lengths up to 15cm
C-Flex or Polyurethane Biliary Stent
Diameters up to 12Fr & lengths up to 15cm
Monofilament wire, self-expanding stent
Diameters up to 10mm & lengths up to 100mm
Nitinol, self expanding stent
Diameters up to 30mm & lengths up to 150mm
Nitinol, self expanding stent
Diameters up to 30mm & lengths up to 150mm
Nitinol, self expanding stent
Diameters up to 30mm & lengths up to 150mm
Polyester braided material encapsulated with silicone, self expanding
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Diameters up to 25mm & lengths up to 80mm
stent
Polyester braided material encapsulated with silicone, self expanding
Diameters up to 30mm & lengths up to 150mm
stent
Bifurcated Tracheobronchial stent. Bronchial Limbs made of silicone
Diameters up to 25mm & lengths up to 120mm
Flexima Biliary Stent
RX Biliary Stent
Biliary Drainage Stent, Amsterdam Biliary Stent
Wallstent RX Biliary Stent
Ultraflex Precision Colonic Stent
WallFlex Oesophageal Stent
WallFlex Enteral Stent (Duodenal/Colonic)
Polyflex Airway Stent
BS102
Polyflex Oesophageal Stent
Detail Change
BS103
Dynamic (Y) Stent
Detail Change
Size
Explanation of Change
and tracheal stem made of silicone with embedded stainless steel cshape rings.
BS117
WallFlex RX Biliary Stent
Platinol, self-expanding stent
Diameters up to 10mm & lengths up to 100mm
Detail Change
Platinum Coil and Microcatheter Delivery System
Delivery device lengths up to 175cm. Sizes of
Neurosurgical
BS021
Fibred Platinum Coils, Braided Occlusion Device (BOD), Vortx,
coils Diameter 2mm
Detail Change
Vortx Diamond,Interlock Fibered IDC Coils, Excelsior, Tracker,
FasTracker, Turbotracker, Renegade, Spinnaker Elite
BS027
BS081
BS098
Change
Guglielmi Detachable Coil (GDC)
GDC 360 Shaped Detachable Coil
Neuroform Microdelivery Stent System
- 30mm and lengths 2mm - 100mm.
Stretch-Resistant Bare Platinum Coil
2-20mm x 4-30cm
Stretch-Resistant Bare Platinum Coil, 360 Shape
Length: 5cm to 40cm; Diameter: 2mm to 24mm
Nitinol Self-Expanding Stent, 3fr delivery catheter, peelable sheath,
Detail Change
Detail Change
Diameter 2.5 - 4.5 mmLength 10 - 30 mm Detail
2fr stabilising catheter, rotating haemostasis valve (x2)
BS100
BS104
Matrix Detachable Coils
Precision SCS Implantable Pulse Generator
PGLA-Coated, Stretch-Resistant, Platinum Coils
Length: 2cm to 40cm, Diameter: 2mm to 24mm
Rechargeable Neurostimulation System Implantable Pulse Generator.
Detail Change
One Size Only
Detail Change
BS105
Precision SCS External Patient Recharger
One Size Only
Detail Change
BS106
BS107
Precision SCS External Patients Remote Programmer
Precision SCS Clinician Programmer
External Patient Recharging System: Base Station, charger, Cradle
power supply, charger base station
Hand held remote control External Patient Programmer One Size Only
Independent clinician programmer for the precision SCS system
Detail Change
One Size Only
Detail Change
BS108
BS109
BS110
Precision SCS Bionic Navigator
Precision SCS Eight Contact Leads
Precision SCS 16 Point Leads
Remote Control for the Clinician Programmer
One Size Only
Eight contact percutaneous leads.
30cm to 70cm
16 contact point leads with independent current controlled.
Detail Change
Detail Change
50cm - 70cm
Detail Change
BS111
BS119
Precision SCS Lead Extensions
Precision SCS Trial Leads
Lead Extensions
Trial Leads
Detail Change
Detail Change
25cm to 55cm
30cm - 70cm
Urogenital
Changed Items for Prostheses List Report
Page 22 of 99
Billing Code Product Name
BS038
BS078
BS086
BS091
Detail Change
BS092
BS093
BS094
BS095
BS116
BS127
BS131
Further Description
Polaris Ureteral Stents
Dual durometer ureteral stent with attached suture
Advantage Transvaginal Mid-Urethral Sling System
Polypropylene smooth mesh material
Polaris Ultra Ureteral Stent
Dual durometer ureteral stent with attached suture
Percuflex; Percuflex Plus; Percuflex Tail; Percuflex Tail Plus
Ureteral Stents.
Contour Ureteral Stent
Retromax Plus Ureteral Stent
Contour VL; Stretch VL Flexima; Ureteral Stents
Urinary Diversion Stents
Polaris Loop Ureteral Stent
Polyform Synthetic Mesh
Pinnacle PFR Kit
Size
Explanation of Change
Diameters up to 14Fr & lengths up to 40cm
One size only
Diameters up to 14Fr & lengths up to 40cm
Ureteral stent with attached suture
Detail Change
Detail Change
Detail Change
Diameters up to 14Fr & lengths up to 40cm
Ureteral stent with attached suture
Diameters up to 14Fr & lengths up to 40cm
Ureteral stent
Diameters up to 14Fr & lengths up to 40cm
Ureteral stent with attached suture
Diameters up to 14Fr & lengths up to 40cm
Percuflex urinary diversion stent
Diameters up to 14Fr & lengths up to 95cm
Dual durometer ureteral stent with attached suture
Diameters up to 14Fr & lengths up to 40cm
Synthetic Polypropylene mesh
100 sq cm to 500 sq cm.
Synthetic Polypropylene mesh assembly and fixation device
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
One Size Detail Change
Vascular
BS026
BS028
BS031
Braided Occlusion Device (BOD) Fibered Platinum Coil Fibered Platinum Coil, Pushable
GDC Delivery Catheters
Microcatheter Delivery Systems
PVA/Contour SE for embolization and delivery system Polyvinyl alcohol foam and Microcatheter for delivery
Coils 2-30mm x3-60mm
Detail Change
150-175cm/3-25cm
Detail Change
45-150 micron, 150-250 micron, 250-355 micron, 355-500 micron, Detail Change
500-710 micron, 710-1000 micron, 1000-1180 micron, 150175cm/3-25cm
BS034
PVA Particles (contour embolisation, Contour SE
Polyvinyl alcohol foam, Hydrophilic Spherical Shape
45-150 micron, 150-250 micron, 250-355 micron, 355-500 micron, Detail Change
500-710 micron, 710-1000 micron, 1000-1180 micron; 1ml, 2ml
BS035
18-70mm
Expandable Endovascular Wallstent
Detail Change
Wallstent - Self-expanding stent, cylindrical braided structure with
BS056
Carotid Wall Stent
length 22 - 37mm
BS059
Express Vascular LD Stent; Express Vascular SD Stent
BS063
Wallstent RP; 7Fr Placehit Wallstent
Detail Change
core of either tantalum or platinum
Elgiloy (cobalt chromium), Flexible low profile and self expanding
Detail Change
stent
Stainless Steel, Balloon Expanding Stent
Diameter 4mm - 10mm, Length 14mm - 60mm
Tracheobronchial, lliac, Biomedical Superalloy Wire, Braided Mesh,
Stent Diameter x Stent Length: 6-16mm x
Fully open diameter 6.0 - 10.0mm, Fully open
Detail Change
Diameter 6mm - 24mm, Length 18mm - 90mm
Stainless Steel Stent with Unistep Delivery System
BS077
BS085
Sentinol Nitinol Vascular Stent System
Filterwire EZ
Nitinol Stent with Uniflex Delivery System
Embolic Protection Device
Diameter: 5 to 10mm. Length: 20 to 120mm
Detail Change
3.5mm - 5.5mm on 190cm delivery system. 3.5mm - 5.5mm on
Detail Change
300cm delivery systen.
Ventilation tube - Silicone - T-tube, T-tube grommet
Teflon, w/o wire
Teflon w/wire, and titanium w/o wire
Titanium w wire
1.1mm; 1.27mm lumen
1.10mm, 1.25mm, 1.50mm lumen
0.76mm, 1.00mm, 1.25mm, 1.50mm lumen
1.00mm, 1.25mm, 1.50mm lumen
BR & CT Enterprises Pty Ltd
Ear, Nose & Throat
BC010
BC011
BC012
BC013
Ventilation tube
Ventilation Tubes - Collar Button
Ventilation Tubes - Collar Button
Ventilation Tubes - Collar Button
Changed Items for Prostheses List Report
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Page 23 of 99
Billing Code Product Name
Further Description
BC014
BC015
BC016
BC017
Detail Change
Teflon, w or w/o wire
1.15mm lumen
Titanium, w/o wire
1.00mm, 1.25mm lumen
Titanium with wire
1.00mm, 1.25mm lumen
Armstrong Grommet, Donaldson w & w/o Tab, Paparella 1 and
Ventilation Tubes - Shepherd
Ventilation Tubes - Shepherd
Ventilation Tubes - Shepherd
Ventilation Tubes - Silicone
Size
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.1mm & 1.5mm lumen
Benefit Review,
Paparella 2 (1.5mm)
Cardinal Health
Orthopaedic
CI002
CI003
AVAmax Plus
AVAmax
Radiopaque bone cement system
Radiopaque bone cement system
11G & 13G
11G & 13G
Detail Change
Detail Change
Carl Zeiss Pty Ltd
Ophthalmic
CZ003
Detail Change
Intraocular Lens: Model Bigbag
Hydrophilic acrylic, foldable, PC, single piece, Tri-haptic, square
6.5mm optic diameter x 10.35 overall diameter
edge design, UV blocker
CZ006
Intraocular Lens, Model Stabibag RTU, Model XL Stabi RTU/Sky
Hydrophilic acrylic, foldable, CP, single piece, square edge design,
10.5mm to 10.75mm overall diameter
Detail Change
UV blocker, Tri-haptic, Ready to use single use pre-loaded
5.5mm to 6.0mm optic x
CZ008
Change
Hydromax
Hydrophobic Acrylic, Foldable, PC, 3-Piece, Square Edge Design,
6.0mm Optic x 12.5mm Overall Diameter Detail
CZ009
Change
Ethos
UV Blocker
Hydrophobic Acrylic, Foldable, PC, 3-Piece, Square Edged Design,
6.0mm Optic x 12.5mm Overall Diameter Detail
CZ010
Change
XL Stabi ZO, Invent ZO
UV Blocker, Pre-Loaded
Hydrophilic Acrylic, Foldable, PC, Single Piece, Square Edge
6.0mm Optic x 10.5mm Overall Diameter Detail
Design, UV Blocker, Tri-haptic, Quad Haptic, Aspheric Optic
CZ011
Change
XL Stabi ZO Sky, Invent ZO Sky
Hydrophilic Acrylic, Foldable, PC, Single Piece, Square Edge
6.0mm Optic X 10.5mm Overall Diameter Detail
Design, UV Blocker, Trihaptic, Quad Haptic, Aspheric Optic, PreLoaded
CZ012
Ophthalin Viscoelastic
Ophthalin; Viscoelastic Solution - sodium hyaluronate 10mg/ml.
Preloaded in sterile syringe with a 27G cannula for injection
Volume 1.0ml
Detail Change
CZ013
Ophthalin Plus Viscoelastic
Ophthalin Plus; Viscoelastic Solution - sodium hyaluronate 15mg/ml.
Preloaded in sterile syringe with a 27G cannula for injection
Volume 1.0ml
Detail Change
CZ016
Change
ZEISS - Acri.Smart 46LC
Aberration corrected, optimized aspheric foldable square-edged
Overall length 11.0mm Optic size 6.0mm Detail
single-piece intraocular lens for cpasular bag fixation MICS
CZ018
Change
Acri.Comfort 646TLC
ZEISS - Acri.Confort 646TLC (MICS Bitoric Aspheric Foldable
IOL)
Cochlear Limited
Overall length 11.00mm Optic size 6.0mm Detail
Ear, Nose & Throat
Changed Items for Prostheses List Report
Page 24 of 99
Billing Code Product Name
Further Description
CO013
Nucleus 24k Cochlear Implant
CO014
Nucleus 24 Contour Advance Cochlear Implant
Model CI24R (ST) coclear implant. A Nucleus 3 system cochlear
implant with straight electrode array
Model CI24R (CA) coclear implant. A Nucleus 3 system cochlear
implant with the Contour Advance electrode array
Size
CO019
ESPrit 3G Speech Processor - Replacement
Speech processor, Generation 3
Cable lengths: 6, 8, 10, 20, 28cm
CO020
Nucleus Cochlear Implant Accessory Kit - ESPrit 3G Speech
Accessory set consists of accessory adapter cable, lapel
Benefit Review, Detail Change
Processor
microphone & lapel clip, battery cover set and accessory case
CO021
Detail Change
Nucleus Freedom Implant with Contour Advance Electrode
Explanation of Change
One size only
Benefit Review, Detail Change
One size only
Benefit Review, Detail Change
Benefit Review, Detail Change
Lapel microphone comes in lengths of 40-150cm
Model C124RE (CA), Generation 4 Cochlear implant with
one size only
Benefit Review,
perimodiolar electrode array. Titanium casing, removable magnet,
22 half-banded platinum electrodes, moulded in a durable silicone
seal
CO022
CO023
CO024
CO025
Detail Change
Nucleus Freedom Speech Processor - Initial
Nucleus Freedom Speech Processor
Nucleus Freedom Implant with Straight Electrode
Baha Abutment Snap Coupling
Speech processor (modular) and accessories
One size only
Speech processor, and accessories - REPLACEMENT
one size only
Speech processor and accessories - Initial
One size only
Titanium abutment delivered with a gold screw and holder,
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
5.5mm - 9035, 8.5mm - 90410 Benefit Review,
individually packaged and sterile. The 5/5mm is for standard use
and the 8.5mm for patients that have persistent regrowth of
subcutaneous tissue
CO028
BAHA - Cover screw unigrip
Titanium coverscrews, individually packaged and delivered sterile.
The cover screws are used to prevent bone overgrowth of the
implant.
One size only
Benefit Review, Detail Change
CO030
Detail Change
Self tapping fixture with pre-mounted fixture mount
Self tapping titanium flange fixture premounted with a disposable
Self Tapping 4mm and 3mm
Benefit Review,
fixture mount. Available in two sizes: 3mm and 4mm. Used in two
stage surgical procedures.
CO032
Abutment
CO033
Flange fixture - self tapping fixture with pre-mounted abutment
Self tapping titanium flange fixture with abutment in two sizes:
Self Tapping 4mm and 3mm with BAHA
Benefit Review, Detail Change
3mm and 4mm
Baha Cordelle II sound processor
A powerful sound processor for the Baha hearing system with a
One Size Benefit Review, Detail Change
bodyworn unit and a head worn transducer. Available in three
colours. Body worn sound processor for the Baha hearing system.
CO040
Baha Divino sound processor
Review, Detail Change
Head worn digital sound processor for the Baha hearing system.
One Size But Left/Right Ear Orientations Benefit
Available in four colours and left and right side orientations.
CO041
Baha Intenso sound processor
Head worn digital sound processor for the Baha hearing system.
Available in four colours.
One size Benefit Review, Detail Change
Plastic and Reconstructive
CO035
CO036
Face to Face
Standard Abutments
Cover Screw with Internal Hexagon
Abutment Complete - Titanium
One Size Only
Benefit Review, Detail Change
3.0mm - 90780, 4.0mm - 90778, 5.5mm - 90776, 7.0mm - 90774 Benefit Review, Detail Change
CO037
CO038
Face to Face
Face to Face
Console Abutment Unigrip - Titanium
Healing Abutment Unigrip - Titanium
30, 60, 90, 110 Degrees
7mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Page 25 of 99
Billing Code Product Name
Further Description
CO042
Titanium self-tapping fixtures for the retention of midface and
orbital prostheses.
Vistafix™ Fixture ST
Size
Explanation of Change
3mm and 4mm
Benefit Review, Detail Change
ConceptVision Australia Pty Ltd
Ophthalmic
CS002
CS005
Change
CS007
Change
CS008
Staar Toric foldable silicone intraocular lens: Model AA4203TF;
Model AA4203TL
Staar foldable silicone intraocular lens: KS-3 Model AS310NV
Plate haptics 6.0mm optic
10.8mm - 11.2mm length
Silicone, foldable, polyamide haptics
6mm Optic, 12.5mm overall length
Staar foldable silicone IOLs: Models AQ2010V, AQ2017V and
Plate haptics 6.0mm; Polymide haptics 5.5 or 6.3mm optic;
AO2003V
Preloaded Aspheric Intraocular Lens
6.0mm
Silicone intraocular lens
Detail Change
10.8mm 0 13.5mm length
Detail
Detail
Detail Change
Corin Australia Pty Ltd
Orthopaedic
CR016
CR020
CR101
CR114
CR137
Optimom Modular Head
Metalok Femoral Head
Modular Neck for Acor & Integrale Femoral Stems
Extreme Hip System Extended Neck
METS Proximal Tibia Fixed Hinge
Metal on metal, CoCr
>32mm
Metal on metal, CoCr
Head 28mm (short/med/long neck)
Titanium neck, with varying alignments & tapers
4 sizes
Femoral neck with extension for locking screw for stem 4 sizes
CoCr-Molybdenum proximal tibial component including bumper
Detail Change
Detail Change
Detail Change
Detail Change
Small and standard Detail Change
CR138
METS Proximal Tibia Fixed Hinge Coated
Small and standard Detail Change
CR144
METS Proximal Tibia Rotating Hinge Coated
CR151
METS Proximal Tibia Rotating Hinge
CoCr-Molybdenum with HA coated patella tendon reattachment
mechanism and bumper
Titanium with UHMWPE bearing and HA coated patella tendon
reattachment mechanism
Titanium with UHMWPE bearing
Small and standard
Nitinol spiral coil and delivery system for transcatheter occlusion of
Distal x Proximal Coil Diameter: 4x4mm, 5x4mm,
Small and standard Detail Change
Detail Change
Denward Dell Pty Ltd TA Surimex
Cardio-thoracic
DW001
6x5mm,
Nit-Occlud PDA Occlusion System
Detail Change
PDA
DW002
Nit-Occlud PDA Occlusion System (Medium)
6mm, 11 x 6mm, 12
10x6mm, 12x6mm, 14x6mm; Introducer Sheath: 4F, 5F; Length
Introducer: 85cm, 105cm; Coil Length configurated +-0.5mm:
3.5mm, 6.0mm, 6.5mm
Nitinol spiral coil and delivery system for transcatheter occlusion of
Distal x Proximal Coil Diameter: 7 x 6mm, 9 x
Detail Change
PDA
x 6mm, 14 x 6mm; Introducer Sheath: 5F; Length Introducer:
85cm, 105cm; Coil Length configurated +-0.5mm: 4.5; 5.0; 6.0
Design for Vision Pty Ltd
General/Miscellaneous
DV024
Haemorrhage Occluder Pin with applicator
Changed Items for Prostheses List Report
Designed to control severe presacral bleeding during pelvic surgery.
Two sizes: 10mm and 14mm
Detail Change
Page 26 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Ophthalmic
DV010
Morcher Coloboma Diaphram
DV029
Eyejet CRT
Review, Detail Change
DV230
DV231
DV232
Molteno 3
Vision Blue
HOYA-PS AF-1 (UV) PC-60AD
DV240
10D to +22D
Rayner "C-Flex" and Superflex" Aspheric IOL
Detail Change
PMMA Implant
96G, 96L
Capsular tension ring made of PMMA per-load on disposable
injector
Drainage implant for glaucoma, made of silicon
2 Sizes: *230 mm square *175mm square
Trypan blue dye for ophthalmic applications
0.5ml syringe
Preloaded in cartridge, aspheric, foldable, single-piece, hydrophobic
acrylic
Aspheric Intra Ocular Lenses with Amon-Apple enhanced 360
Benefit Review
14 (10mm), 14C (11mm), 14A (12mm)
Benefit
Benefit Review, Detail Change
Detail Change
+6.0D to +30.0D (0.5D steps) Detail Change
C-Flex -970C + 22.5D to +34D Superflex-920H -
Degree square edge, Anti-vaulting Haptics
Device Technologies Australia Pty Ltd
Ophthalmic
DE253
Change
MicroSil Toric IOL
Silicone Lens (MS6116TU) Standard Range -3.00 to 31.00 Dioptres
Lens Dia =6.00mm Haptics Dia =11.6mm Detail
in 0.5 steps with cylinder from 2.00 to 12.00 Dioptres
DE254
MicroSil Toric IOL
Detail Change
Silicone Lens (MS6116TU) Semi-Custom Range -3.00 to 31.00
Lens Diameter = 6.00mm Haptics Dia = 11.6mm
Dioptres with 1.0 steps, Cylinder from 3.0 - 14.0 Dioptres
DE255
MicroSil Toric IOL
Detail Change
Silicone Lens (MS6116TU) Custom made range: -28 to +31 Sphere
Lens Dia = 6.00mm Haptics Dia = 11.6mm
DE260
Change
ICU Akkomodative® IOL
and up to 30D cylinder
ICU Akkomodative IOL- Acrylic lens Range 15-35 Dioptres in 0.5
Lens Dia =5.5mm Haptics Dia =9.8mm
DE264
MicroCryl Acrylic Introcular lenses
steps
Foldable Monobloc Posterior Chamber LensMCX11ASP 6.0D-40.0D
Detail Change
Metal Head
40/14 - 54/23
Detail Change
Round: low, medium, high & extra high profile
110 - 800 grams
Detail
Orthopaedic
DE171
Univers 3D Shoulder Prostheses
Plastic and Reconstructive
DE104
DE106
DE109
DE110
Allergan Style 40, 45, SSL, SSM, SSF, SSX Intrashiel Gel-Filled
Round Mammary Implant
Allergan Type MLP, MHP, TRL, TRM, TRF, TRX Low, Medium,
High & Extra High Profile Gel-Filled Mammary Implant
Low, Medium, High & Extra High profile, textured surface
Allergan styles CML, CMH, TSL, TSM, TSF, TSX
Silicone Cohesive Gel-Filled Breast Implant
80 - 800 grams
Allergan Type SLD, SHD, SRL, SRM, SRF, SRX Smooth Silicone
Low, Medium, High or Extra High Profile
Gel-filled Mammary Implant
DE274
Style 510 Dual Gel Breast Prosthesis
Anatomical textured implant with dual gel for projection of
145-600 grams, FX
Benefit Review
nipple/areola complex, concave base and tapered edges for
sizes from 165-630 grams
minimisation of edge/thoracic wall palpability.
Detail Change
80 - 800 grams
Detail Change
100 - 800 grams
Detail Change
Detail Change
LX sizes from 130-575 grams, MX sizes from
Diabetes Australia - New South Wales
Changed Items for Prostheses List Report
Page 27 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Continuous insulin infusion pump
75mm x 45mm x 19mm
Detail Change
General/Miscellaneous
DB001
DANAIIS Insulin Pump
Edwards Lifesciences Pty Ltd
Cardio-thoracic
EL030
CE Supra Annular Aortic Valve Model 2650 Carpentier-Edwards
Carpentier-Edwards SAV Bioprosthesis. Composition: Porcine
S.A.V Bioprosthesis Model 6650 Mitral Valve
Valve; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene
19mm-33mm
EL031
Carpentier-Edwards Perimount Pericardial Bioprosthesis - Models
Carpentier-Edwards Pericardial Bioprosthesis. Composition: Bovine
Model 6900P 25, 27, 29, 31, 33mm
Detail Change
2900/6900 Carpentier-Edwards Perimount Plus Pericardial
Pericardium; Elgiloy Alloy; Silicone Rubber, Polytetrafluoroethylene
Bioprosthesis Mitral - Model 6900P
EL039
Edwards Perimount Magna Model 3000
Aortic Pericardial
Detail Change
Models 2900/6900 19-33mm,
Carpentier-Edwards Perimount Magna composition: Glutaraldehyde
19MM Aortic Pericardial Tissue Valve; 21MM
Detail Change
treated bovine pericardium/elgiloy wireform stent/polyester
Tissue Valve; 23MM Aortic Pericardial Tissue Valve; 25MM Aortic
band/silicone rubber suture ring/polytetrafluoroethylene Pericardial Tissue Valve; 27MM Aortic Pericardial Tissue Valve;
cloth/polyester cloth.
29MM Aortic Pericardial Tissue Valve
Emagin Pty Ltd
Ophthalmic
EG008
Artisan Anterior Chamber Intraocular Lens
Detail Change
Phakic Intraocular Lens: Model ToricComposition: PMMA
5.00mm Optic Diameter x 7.5 in overall length
EMT Healthcare Pty Ltd
General/Miscellaneous
EM007
Detail Change
Biomesh P1/P3 Reinforcement Mesh
Macro porous 100% polypropylene mesh for laproscopic and open
25 x 36cm; 30 x 30cm
EM008
Intramesh Reinforcement Mesh
surgical approaches
Reinforcement mesh made from two surfaces for intra-peritoneal
visceral surgery (Polypropylene/ePTFE or Polyester/Silicone)
20 x 20cm
Benefit Review, Detail Change
EM009
Intramesh Reinforcement Mesh
Reinforcement mesh made from two surfaces for intra-peritoneal
visceral surgery (Polypropylene/ePTFE or Polyester/Silicone)
15 x 15cm
Benefit Review, Detail Change
EM010
Intramesh Reinforcement Mesh
Reinforcement mesh made from two surfaces for intra-peritoneal
visceral surgery (Polypropylene/ePTFE or Polyester/Silicone)
30 x 30cm
Benefit Review, Detail Change
EM015
BIOMESH HERNIA REINFORCING MESH KIT
Laparoscopic Hernia Repair Kit with 15cm x 15cm mesh EMT-KIT2BT2PMX2 (bilateral)
Benefit Review, Detail Change
EM016
BIOMESH HERNIA REINFORCING MESH KIT
Laparoscopic Hernia Repair Kit with 15cm x 15cm mesh EMT -KIT2NM (Unilateral)
Benefit Review, Detail Change
EM018
EM019
EM020
Abdominal Wall Reinforcement Implant
BIOMESH HERNIA REINFORCING MESH KIT
BIOMESH HERNIA REINFORCING MESH KIT
Polyester combined with polymerised silicone
Laparoscopic Hernia Repair Kit with Shape Mesh
Laparoscopic Hernia Repair Kit with Shape Mesh
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
12cm x 14cm & 12cm x 16cm
EMT-KIT2BT2PMX (Bilateral)
EMT-KIT2NM (Unilateral)
Benefit Review,
Page 28 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Endocorp Pty Ltd
Ear, Nose & Throat
EC018
Exmoor Plastics Ear Vent Drains - Reuter Bobbin
Without hole, teflon
1.14 mm lumen dia x 2.54 mm inner flange dia x 2.54 mm outer
flange dia x 0.76 inter flange. 1.52mm total length
Benefit Review, Detail Change
EC019
Exmoor Plastics Ear Vent Drains - Collar Button
Teflon
1.14 mm lumen dia x 2.24 mm inner flange dia x 2.24 mm outer
flange dia x 1.27 inter flange. 1.78 mm total length
Benefit Review, Detail Change
EC020
Exmoor Plastics Ear Vent Drains - Collar Button
Teflon
1.14 mm lumen dia x 3.0 mm inner flange dia x 3.0 mm outer flange
dia x 1.27 inter flange. 1.78 mm total length
EC021
Exmoor Plastics Ear Vent Drains - Collar Button
Teflon
1.4 mm lumen dia x 2.55 mm inner flange dia x 2.55 mm outer
flange dia x 0.85 inter flange. 1.35 mm total length
Benefit Review, Detail Change
EC022
Exmoor Plastics Ear Vent Drains - Collar Button
Teflon
1.75 mm lumen dia x 2.85 mm inner flange dia x 2.85 mm outer
flange dia x 0.95 inter flange. 1.46 mm total length
Benefit Review, Detail Change
EC024
Exmoor Plastics Ear Vent Drains - Shepards Drain
Teflon Shephards Drain
1.14 mm lumen dia x 2.36 mm inner flange dia x 2.36 mm outer
flange dia x 1.42 inter flange. 2.41 mm total length
Benefit Review, Detail Change
EC026
2.08 mm outer
Exmoor Plastics Ear Vent Drains - Teflon Shephards Drain with
Benefit Review, Detail Change
wire grasping feature
Teflon Shephards Drain with wire
Exmoor Plastics Ear Vent Drains - Donaldson Grommet With tab, silicone rubber
1.1 mm lumen dia x 2.25 mm inner flange dia x 2.25 mm outer
flange dia x 0.76 inter flange. 2.25 mm total length
EC031
Benefit Review, Detail Change
0.97 mm lumen dia x 2.08 mm inner flange dia x
flange dia x 1.42 inter flange. 2.41 mm total length
Benefit Review, Detail Change
Endotherapeutics Pty Ltd
Ear, Nose & Throat
ET040
Vox Implants
Vox Implants are solid, irregularly textured, medical grade
Polydimethylsiloxane Elastomer implants suspended in a hydrogel
carrier
One size only
Embospheres
Embospheres
Embospheres
-
Detail Change
Detail Change
Detail Change
Benefit Review, Detail Change
Vascular
ET006
ET007
ET008
2ml per implant
1ml per implant
.5ml per implant
Enta Surgical
Ear, Nose & Throat
Changed Items for Prostheses List Report
Page 29 of 99
Billing Code Product Name
Further Description
ES001
Myringotomy Tube with Trocar - Gold Coated Silver; Myringotomy
Tube with Trocar - Titanium; Myringotomy Tube with Trocar,
with wire - Gold Coated Silver; Myringotomy Tube with Trocar,
with wire - Titanium
One Size Only
Benefit Review, Detail Change
Total femoral implant
various sizes
Distal femoral implant
various sizes
CoCr, varying versions & offsets
One Size
4mm, 6mm, 8mm
Nail TiNb
3 x 30, 40, 50mm length
Peg TiNb
6 x 30, 40, 50mm length
CoCr, metal on metal, dimpled, large
36mm - 48mm
CoCr, non polished, long stem
200mm - 350mm
CoCr, metal on metal, can be used with any ESKA stem 36mm - 48mm
Co Cr, Titanium Spray, 3 Dimensional Metal,
Femoral Stem 1 - 7
CoCr, Titanium Spray, 3 Dimensional Metal, HA
Femoral Stem 1 - 7
CoCr, Titanium Spray, 3 Dimensional Metal, Variable Screw Holes,
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
44-68mm
Detail Change
Self expanding, nitinol stent
Detail Change
Trocar Myringotomy Tube
Size
Explanation of Change
ESKA Australia
Orthopaedic
EK017
EK018
EK034
EK043
EK054
EK055
EK064
EK081
EK084
EK086
EK087
EK088
ESKA Tumor Revision System MML
ESKA Tumor Revision System MML
Adapter Femoral Neck
PE Articular Surface Component Ankle Joint
Nail TiNb
Profi Peg Nail TiNb
Silver Surf Large Metal Head
Adapter GHE Femoral Long Stem Cemented
BS Femoral Head
Adapter Uncemented Femoral Stem
Adapter Uncemented Femoral Stem
2000 Plus Acetabular Metal Shell
ev3 Australia Pty Ltd
Vascular
EE006
Peripheral Stent
Tapered (8-6, 9-6, 10-7mm) Straight (5-14mm)
Finsbury Orthopaedics Australia Pty Ltd
Orthopaedic
FI002
ADEPT MoP Acetabular Component
Detail Change
FI003
ADEPT MoP Acetabular Component
Detail Change
FI004
Delta motion acetabular cup
- 102 Acetabular
FI005
ADEPT CoC Acetabular component
Detail Change
FI015
Adept MoM Modular Head
Changed Items for Prostheses List Report
Titanium, plasma with HA cup with presembleed with unmodified
44-66 outer diameter going up in 2mm increments
UHMPE
Titanium, plasma with HA cup with presembleed with unmodified
44-66 Outer diameter going up in 4mm increments
UHMPE with dysplasia flange
Titanium, plasma with HA cup with presembleed delta ceramic liner
42 - 66 going in 2 mm Increments
Detail Change
Cup - 42 OD 32 bore, 168 - 104Acetabular Cup - 44 OD 32 bore,
168 - 106 Acetabular Cup - 46 OD 36 bore, 168 - 108 Acetabular
Cup - 48 OD 36 Bore, 168 - 110 Acetabular Cup - 50 Od 40
Titanium, plasma with HA cup with presembleed delta ceramic liner
with dysplasia flange
Metal on Metal modular head, CoChr, 12/14 Eurocone
168
44-66 Outer diameter going up in 4mm increments
38 - 58mm going up in 2mm increments. 4 different neck lengths
Detail Change
Page 30 of 99
Billing Code Product Name
Further Description
FI034
FI038
Change
Delta ceramic modular head
36-40-44-48mm
Metal on Metal Articulating Femoral Heads for Adler Stems
Delta modular head
Adler Metal on Metal Head
FI042
Modula SC Neck
9C, 9AA, 9BB, 9CC
Size
32,36,40mm OD
The complete series of MODULA SC necks, all patented, consists
Detail Change
of 15 sizes and makes it possible to optimise the reciprocal position
of the stem and neck cup on the basis of the articular needs of the
patient, by restoring the physiological off-set and le
Explanation of Change
Detail Change
Short, Medium, Long in 32,36 and 40 mm Detail
OX, OY, OZ, OA, OB, OC, 9X, 9Y, 9Z, 9A, 9B,
Global Manufacturing Technology Pty Ltd
Neurosurgical
GM026
GM032
GM062
GM072
GM080
Maxima/Optima Anterior Cervical Plate System
Optimal Spinal System
Maxima/Optima Anterior Cervical Plate System
BacFix (Thoracolumbar System)
AcuFix
Anterior Cervical Plates
24mm to 108mm
Set Screw
9 x 1.5 to 10 x 1.5mm
Set Screw
One Size
Non-threaded wedge with serrated teeth - Titanium alloy 5.5 - 6mm
1 segment SlimLine plate - Anterior cervical plate system - Titanium
Benefit Review
Detail Change
Detail Change
Detail Change
20 - 34mm
Benefit Review
GM081
AcuFix
2 segment SlimLine plate - Anterior cervical plate system - Titanium
34 - 54mm
Benefit Review
GM082
AcuFix
3 segment SlimLine plate - Anterior cervical plate system - Titanium
47 - 71mm
Benefit Review
GM083
AcuFix
4 segment SlimLine plate - Anterior cervical plate system - Titanium
68 - 92mm
Benefit Review, Detail Change
GM084
AcuFix
34 - 54mm
Benefit Review
GM085
AcuFix
53 - 77mm
Benefit Review
GM086
AcuFix
68 - 101mm
Benefit Review, Detail Change
GM098
AcuFix
2 segment Corpectomy plate - Anterior cervical plate system Titanium
3 segment Corpectomy plate - Anterior cervical plate system Titanium
4 segment Corpectomy plate - Anterior cervical plate system Titanium
2 segment SlimLine plate - Anterior cervical plate system - Titanium
34 - 54mm
Benefit Review
GM099
AcuFix
3 segment SlimLine plate - Anterior cervical plate system - Titanium
47 - 71mm
Benefit Review
Orthopaedic
GM066
GM091
GM108
GM110
BioBall Femoral Head
Apex Global & K2 Femoral Neck
BioBall Delta Femoral Head
OsteoBridge
Femoral Head Vivium > 32mm
Titanium with lateral extension for stem connection
Femoral Head Biolox Delta
Nail
36mm to 58mm
Detail Change
25mm - 35mm to 35mm - 50mm
Detail Change
36mm, 38mm, 40mm, 44mm, 48mm
Detail Change
7mm, 8mm, 9mm, 10mm, 12mm, 14mm, 16mm & 18mm Detail Change
GM111
GM133
OsteoBridge
K2 Global Modular Femoral Stem
OsteoBridge Spacer
K2 Mid Stem
20mm, 25mm & 30mm
Size 2 to 12
Changed Items for Prostheses List Report
Detail Change
Benefit Review
Page 31 of 99
Billing Code Product Name
Further Description
Size
GM134
K2 Global Modular Femoral Stem
K2 Stem
GM135
GM136
Edinburgh Ceramic Femoral Head
Edinburgh Ceramic Femoral Head
Ceramic, Biolox Forte
Ceramic, Biolox Forte
GM137
GM138
GM139
GM140
GM141
GM142
GM143
Edinburgh Head
Edinburgh Femoral Head CoCr
Bio Ball Femoral Head Biolox Forte
Bio Ball Femoral Head Biolox Forte
Edinburgh Femoral Stem Distal Centraliser
Edinburgh Femoral Stem Distal Centraliser
SMR Femoral Stem
Femoral Head Stainless Steel
Femoral Head CoCr 28mm to 32mm
BioBall Femoral Head Biolox Forte
Bio Ball Femoral Head Biolox Forte
PMMA - Distal Centraliser
PMMA - Distal Centraliser
SMR Distal Component 240mm
K2 Stem Size 2, K2 Stem Size3, K2 Stem Size 4, K2 Stem Size 5, Benefit Review
K2 Stem Size 6 , K2 Stem Size 7, K2 Stem Size 8, K2 Stem Size 10,
K2 Stem Size 11,
36mm, -4.0mm to +8.00mm
Benefit Review
28mm Small, Medium, Long
32mm Benefit Review
Small, Medium, Long
36mm, -4.0mm to +8.00mm
Benefit Review, Detail Change
Small, Medium, Long
Benefit Review
36mm
Benefit Review
28mm, 32mm
Benefit Review, Detail Change
35 x 10mm
Benefit Review
25 x 10mm
Benefit Review
SMR distal component 14x 240mm, SMR distal component 16 x Benefit Review
240mm, SMR distal component 17x240mm, SMR distal component
18 x 240mm, SMR distal component 19 x 240mm, SMR distal
component 20 x 240mm, SMR distal component 22 x 240mm
Explanation of Change
GM144
SMR Femoral Stem
SMR Distal Component <200mm
SMR Distal Component 14 x 160mm, SMR Distal Component 16 x
160mm, SMR Distal Component 17 x 160mm, SMR Distal
Component 18 x 160mm, SMR Distal Component 19 x 160mm,
SMR Distal Component 20 x 160mm, SMR Distal Component 22 x
160mm, SMR Distal Component 14 x 200m, SMR Distal
Component 16 x 200m SMR Distal Component 18 x 200mm, SMR
Distal Component 20 x 200mm, SMR Distal Component 22 x 200mm
GM145
GM146
BioBall Femoral Head
BioBall Femoral Head
Femoral Head Vivium > 32mm
Femoral Head Vivium < 32mm
36mm to 58mm
28mm, 32mm
Benefit Review
Benefit Review, Detail Change
Benefit Review, Detail Change
Global Medical Solutions Australia Pty Ltd
General/Miscellaneous
GL007
Advantage I-125 Pre-load
and 4.5 mm in length
Advantage I-125 seeds are sealed radioactive sources containing
Gap removed
Iodine-125. They are intended to interstitial brachytherapy.
Advantage I-125 Pre-load consists of
Advantage I-125 seeds pre-loaded as linked or 'stranded'
seeds(similar to RAPID Strand RX ) on prescription into
brachytherapy needles specifically for treatment of an individual
patient. They arrive sterile and pre-packaged ready for use in theatre.
Advantage I-125 seeds are 0.8 mm in diameter
Spinal Fixation System, Open Screw Closure
Spinal Fixation System, Closed Screw Set Screw
Detail Change
Detail Change
Global Orthopaedic Technology
Neurosurgical
GO078
GO079
Nex-Link
Nex-Link
Changed Items for Prostheses List Report
4.00mm
4.0mm
Page 32 of 99
Billing Code Product Name
Further Description
GO085
Incompass
Thoracolumbar Fixation System, Closed Implant Set Screw
5.5mm Detail Change
GO093
GO094
GO095
GO096
GO097
GO098
AcuFix
AcuFix
AcuFix
AcuFix
AcuFix
AcuFix
1 segment ThinLine plate
2 segment ThinLine plate
1 segment Ant-Cer dynamic plate
2 segment Ant-Cer dynamic plate
3 segment Ant-Cer dynamic plate
4 segment Ant-Cer dynamic plate
Benefit Review
Benefit Review
Benefit Review
Benefit Review
Benefit Review
Benefit Review, Detail Change
Size
20 - 36mm
34 - 54mm
24 - 32mm
34 - 54mm
50 - 71mm
68 - 96mm
Explanation of Change
Orthopaedic
GO014
Change
UniSyn Hip Complex Neck
Titanium, with lateral extension for stem connection, includes calcar
30-36mm non calcar, 45-55mm for calcar Detail
& non calcar replacement necks, separate locking bolt
GO036
GO037
GO047
GO074
GO132
GO139
GO185
GO186
GO187
GO188
Absolut Cemented Femoral Stem
Paragon Femoral Stem
ICON Femoral Head
Paragon Femoral Stem, Non HA
FMP Femoral Head
R120 Femoral Neck
R120 Metal Femoral Head
R120 Metal Femoral Head
R120 Ceramic Femoral Head
R120 Ceramic Femoral Head
CoCr, highly polished, tapered, with neck
Titanium, proximal plasma & HA
CoCr, metal on metal, large diameter
Titanium, proximal plasma, non HA
CoCr, metal on metal
CoCr, varying offsets & versions
R120 Metal Femoral Head >32mm
R120 Metal Femoral Head <32mm
R120 Ceramic, Biolox Femoral Head > 32mm
R120 Ceramic, Biolox Femoral Head <32mm
1 to 14
1 to 14
38-58mm
1-14
28 to 38mm
32-38mm length, varying degrees
36mm
28mm, 32mm
36mm
28mm - 3.5mm to +3.5mm
4.0mm to +4.0mm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review
Benefit Review
Benefit Review
32mm -
Benefit Review
Global Scientific Pty Ltd
Neurosurgical
GS010
Heyer-Schulte Connectors for Neurosurgical Use
Pudenz straight, Pudenz right angled, Pudenz three-way (Y)
Threaded straight, Threaded right angled, Double threaded straight
Each in one size
Detail Change
Plastic and Reconstructive
GS285
Integra Artificial Skin (IDRT) Terminally Sterile
INTEGRA Dermal Regeneration Template is a bilayer membrane
system for skin replacement made of a porous matrix of fibers of
cross-linked bovine tendon collagen and glycosaminoglycan and
polysiloxane layer.
5cm x 5cm
Benefit Review, Detail Change
GS286
Integra Artificial Skin (IDRT) Terminally Sterile
INTEGRA Dermal Regeneration Template is a bilayer membrane
system for skin replacement made of a porous matrix of fibers of
cross-linked bovine tendon collagen and glycosaminoglycan and
polysiloxane layer.
10cm x 12.5cm
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Page 33 of 99
Billing Code Product Name
Further Description
GS287
Integra Artificial Skin (IDRT) Terminally Sterile
INTEGRA Dermal Regeneration Template is a bilayer membrane
system for skin replacement made of a porous matrix of fibers of
cross-linked bovine tendon collagen and glycosaminoglycan and
polysiloxane layer.
10cm x 25cm
Benefit Review, Detail Change
GS288
Integra Artificial Skin (IDRT) Terminally Sterile
INTEGRA Dermal Regeneration Template is a bilayer membrane
system for skin replacement made of a porous matrix of fibers of
cross-linked bovine tendon collagen and glycosaminoglycan and
polysiloxane layer.
20cm x 25cm
Benefit Review, Detail Change
Size
Explanation of Change
Guidant Australia Pty Ltd
Cardio-thoracic
GU009
GU011
GU012
GU013
GU016
GU023
Fineline II Sterox IROX Lead
Fineline II Sterox IROX Lead
Fineline II Sterox IROX Lead
Fineline II EZ Sterox IROX Lead
Fineline II EZ Sterox IROX Lead
Guidant Aust Selute Picotip Steroid Eluting Bipolar Lead
Model 4458, Model 4459
52cm, 58cm
Model 4456, Model 4457
52cm, 58cm
Model 4479, Model 4480
45cm, 52cm
Model 4472, Model 4473 & Model 4474
45cm, 52cm, 58cm
Model 4469, Model 4470 & Model 4471
45cm, 52cm, 58cm
Model 4033, Model 4034, Model 4035, Model 4063, Model 4064
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
45cm , 52cm, 59cm Detail Change
GU028
GU037
GU056
Guidant Aust Selute Picotip VDD Lead
Myocardial Pacing Lead
Easytrak Lead
Detail Change
Detail Change
65cm, 72cm, 80cm Detail Change
GU079
GU107
Pulsar Model VDD 870
Ventak Prizm HE DR
Model 4340, Model 4341, Model 4342 & Model 4343
.
Model 4312 and 4316
54cm and 35cm
Model 4510, Model 4511, Model 4512 Transvenous Coronary Sinus
Lead
Titanium
3.2mm/IS-1
Model 1853 & Model 1858, titanium, dual chamber, adaptive rate
Detail Change
One size only
Detail Change
GU110
GU111
GU112
Ventak Prizm II VR
Ventak Prizm II DR
Endotak Reliance S Lead
Model 1860, titanium, single chamber, adaptive rate
One size only
Model 1861, titanium, dual chamber, adaptive rate
One size only
Model 0127 & Model 0128, defibrillation lead, 9fr introducer
(silicone coated), steroid eluting, high impedence
Detail Change
Detail Change
59cm, 64cm
Detail Change
GU115
Endotak Reliance Lead
Model 0147, Model 0148 & Model 0149, defibrillation lead, 9fr
introducer (silicone coated), steroid eluting, high impedence
59cm, 64cm, 90cm Detail Change
GU118
Change
Endotak Endurance EZ Leads Model 0154, Model 0155, Model 0156
Defibrillation lead, steroid eluting, trilumen lead body contains one
64, 70, 100cm
Detail
conductor for pacing/sensing and two conductors for defibrillation.
The helix is composed of platinum iridium.
GU120
Insignia Plus DR Model 1297, Insignia Plus DR Model 1298
GU121
GU122
Insignia Entra DR Models 1294,1295,1296
Flextend Lead Models 4086, 4087 & 4088
Changed Items for Prostheses List Report
Dual Chamber Rate Responsive Permanent Pacemaker
Dual Chamber Rate Responsive Permanent Pacemaker One size only
Bipolar, steroid eluting, transvenous silicon pace/sense leads with an
extendable/retractable active fixation for implantation into the atrium
or ventricle
One size only
Detail Change
Detail Change
45,52,59cm
Detail Change
Page 34 of 99
Billing Code Product Name
Further Description
GU123
Endotak SQ Array XP Lead Model 0085
70 cm
GU124
GU126
GU129
Insignia Entra SR Models 1195 & 1198
Insignia Plus SR Model 1194
LV-1 Lead Adaptor to IS-1
Endotak SQ Array XP Lead Model 0085 is used in addition to an
Endotak endocardial leads for patients with a high DFT
(Defibrillation Threshold)
Single Chamber Rate Responsive Permanent Pacemaker One size only
Single Chamber Rate Responsive Permanent Pacemaker One size only
Connects Left ventricular leads to IS-1 ports in pacemakers and
defibrillators to replace abnormal cardiac excitation
Detail Change
Detail Change
One size only
Detail Change
GU130
Y Adaptor
Connects multiple defibrillator electrodes to a common port,
enabling the use of shocks to revert Ventricular Tachycardia and
normal cardiac function to return
One size only
Detail Change
GU132
Responsive
Vitality DR Model 1871
Detail Change
This device acts to defibrillate the heart chambers when the patient
Model 1871 Vitality DR Dual Chamber Rate
Size
Explanation of Change
Detail Change
enters into an arrhythmia or uses shocks or anti tachy pacing to
Pacemaker/Defibrillator
revert Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF).
While also acting as a dual chamber pacemaker.
GU133
Responsive
Vitality VR Model 1870
Detail Change
This device acts to defibrillate the heart chambers when the patient
Model 1870 Vitality VR Single Chamber Rate
enters into an arrhythmia or uses shocks or anti tachy pacing to
Pacemaker/Defibrillator
revert Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF).
While also acting as a single chamber pacemaker.
GU134
Contak Renewal 2
This device acts to defibrillate the heart chambers when the patient
enters into an arrhythmia or uses shocks or anti tachy pacing to
revert Ventricular Tachycardia (VT) or Ventricular Fibrillation (VF).
While also acting as a biventricular pacemaker.
One Size Only
Detail Change
GU137
Vitality AVT
Dual chamber defibrillator, with atrial and ventricular therapy
One size only
Detail Change
GU138
Easytrak 2, Model 4514,4515, 4516, 4517, 4518, 4519, 4520
The Easytrak 2 lead is a dual electrode version of the Easytrak lead.
The Easytrak 2 lead is a coronary sinus lead, steroid eluting, dual
electrode, pace/sense lead. The lead provides chronic pacing and
sensing of the left ventricle by placement in the
GU139
GU140
GU141
GU142
Insignia Ultra SR Lodel 1190
Implantable Cardiac Pacemaker
Insignia Ultra DR Model 1291
Implantable Cardiac Pacemaker
Insignia Ultra DR Model 1290
Implantable Cardiac Pacemaker
Contak Renewal TR2 CRT - P Model H140, Model H145 Implantable Cardiac pacemaker
One size only
One size only
One size only
45x54x8.5mm, 14cc, 26gm
Detail Change
Detail Change
Detail Change
Detail Change
GU143
GU144
Contak Renewal TR CRT -P Model H120, Model H125 Implantable cardiac pacemaker
Contak Renewal 4 HE CRT-D Model H197, Model H199 Implantable dual-chamber defibrillator
45x54x8.5mm, 14cc, 26gm
one size only
Detail Change
Detail Change
GU145
Endotak Reliance G Lead Model 0164, Model 0165, Model 0166,
Model 0167
Endotak Reliance SG Lead Model 0160, Model 0161, Model 0162,
Model 0163
Implantable defibrillator/pacemaker lead
Lead Lengths: 59 - 90cm
Detail Change
Implantable defibrillator/pacemaker lead
Lead Lengths: 59 - 90cm
Detail Change
GU146
Changed Items for Prostheses List Report
.
Detail Change
Page 35 of 99
Billing Code Product Name
GU147
GU148
GU149
GU150
GU151
GU152
GU153
GU154
GU155
GU156
GU157
GU158
Further Description
Size
Explanation of Change
Contak Renewal 4 CRT-D Model H190, Model H195
Implantable dual-chamber defibrillator
One size only
Detail Change
Vitality 2 EL VR - Model T177
Implantable Cardiac Defibrillator
35cc 90g
Detail Change
Vitality 2 DR - Model T165
Implantable Cardiac Defibrillator
30cc ; 82g
Detail Change
Vitality 2 EL DR - Model T167
Implantable cardiac Defibrillator
35cc ; 90g
Detail Change
Vitality 2 VR - Model T 175
Implantable cardiac defibrillator
30cc; 82g
Detail Change
Easytrak IS-1 Lead, Models 4535 to 4538
Implantable left ventricular pacemaker lead
80 - 90cm
Detail Change
Easytrak 2 Is-1 Lead - Models 4542, 4543 & 4544
Implantable left ventricular pacemaker lead
80 to 100cm
Detail Change
Contak Renewal 4 AVT CRT -D - Model M170 and M175
Implantable Cardioverter Defibrillator with Cardiac
37cc; 89g
Detail Change
Resynchronisation Therapy
Contak Renewal 4 AVT HE CRT - D - Model M177, M179
Implantable Cardioverter Defibrillator with cardiac resynchronisation
40cc; 89g Detail Change
Therapy
Easytrak 3 Lead - Models 4521, 4522, 4523, 4524, 4525, 4526 and
Implantable left ventricular pacemaker lead
80 to 100cm
Detail Change
4527
Vitality AVT - Model A155
Implantable cardiac defibrillator with both Atrial and Ventricular
30cc
Detail Change
tachyarrhythmia therapy
Endotak Reliance SG Passive Fixation Lead
Endotak Reliance SG Passive Fixation Lead: Models 0170, 0171,
54cm - 90cm
Detail Change
0172, and 0173 Implantable cardioverter defibrillator lead with
GORE ™ ePTFE covered coils.
GU159
Endotak Reliance G Passive Fixation Lead
Endotak Reliance G Passive Fixation Lead: Models 0174, 0175,
0176 and 0177. Implantable Cardioverter defibrillator lead with
GORE ™ ePTFE covered coils
54cm -90cm
Detail Change
GU160
Endotak Reliance Active Fixation Lead
Endotak Reliance Active Fixation Lead: Models 0157, 0158 and
0159 Implantable cardioverter defibrillator lead
54cm - 90cm
Detail Change
GU161
Endotak Reliance S Active Fixation Lead
54cm - 90cm
Detail Change
GU162
Easytrak 3 IS-1 Lead
Endotak Reliance S Active Fixation Lead: Models 0137, 0138 and
0139
Models 4548, 4549 and 4550. Silicone and polyurethane insulation
and polyurethane protective sleeve
GU163
ENDOTAK RELIANCE G Lead 018 Series
Endotak Reliance G Lead: Models 0184 to 0187. Implantable
cardioverter defribrillator lead. Active fixation.
59-90cm Detail Change
GU164
ENDOTAK RELIANCE SG Lead 018 Series
Endotak Reliance SG Lead: Models 0180 to 0183. Implantable
cardioverter defibrillator lead. Active fixation.
59-90cm Detail Change
GU165
Acuity Steerable Lead
Steerable IS-1 bipolar CS LV LeadModels 4554, 4555, 4556
80cm, 90 cm, 100cm
Grote, HA
Goldenberg Footplate - HA
Attic Defect Plate, HA
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Sizes 80 to 100cm Detail Change
Detail Change
Gyrus Australasia Pty Ltd
Ear, Nose & Throat
GY001
GY002
GY003
Canal Wall Prosthesis
Ossicular Prosthesis Malleus, Incus and Stapes
Ossicular Prosthesis
Changed Items for Prostheses List Report
Small - Large
One size only
7-14mm
Page 36 of 99
Billing Code Product Name
Further Description
GY004
long, d) 7-
a) Applebaum HA, b) Goldenberg HA, c) Kartusch HA , d) Grote
Ossicular Prosthesis Incus
Benefit Review, Detail Change
HA, e) Wehrs (single & double notched) HA
GY005
Ossicular Prosthesis - PORP
GY006
Ossicular Prosthesis - PORP/TORP
GY008
Piston: Stapes Prosthesis
0.3x0.8x3.5-0.3x0.8x6mm, c)
GY009
Ossicular Prosthesis -TORP
Review, Detail Change
GY010
Ossicular Prosthesis -TORP
GY011
Ossicular Prosthesis -TORP
GY012
Piston: Stapes Prosthesis
0.4x4-0.4x5mm Benefit Review, Detail Change
Size
Explanation of Change
a) small - large, b) one size only, c) short, medium,
10mm, e) short, average, medium, long
Sheehy plastipore, Drum to stapes, Grote Malleus to stapes,
One size only
Benefit Review, Detail Change
modified, centered or offcentered
Goldenberg Malleable/HA
One Size Only
Benefit Review, Detail Change
a) Schuknecht Malleus att Piston. Stainless steel, b) Cawthorne.
a) 0.6x5.5mm-0.8x6.5, b)
Benefit Review, Detail Change
Fluoroplastic, c) Fluoroplastic, d) Schuknecht. Stainless steel, e)
0.6x0.6x3.5-0.8x0.6x6mm, d) 0.4x3.5-0.5x5mm, e) one size only
Causse. Fluoroplastic
a) black spanner strut HA, b) black oval top TORP HA, c) black
a) one size only, b) 7-10mm, c) 0.5-0.7mm Benefit
oval top PORP, universal, HA/fluoroplastic
Fisch plastipore, Causse modified plastipore, Shea modified
plastipore/ fluoroplastic, Austin modified plastipore, Tilt top plastipore
One size only
a) Shea malleable, HA/plastipore, b) Shea plastipore
a) one size only, b) 4-8mm
a) Armstrong. Platinum, b) McGee. Stainless steel, c) Richards.
Benefit Review, Detail Change
a) 0.6x3.5-0.8x5mm, b) 0.6x3.25-0.8x5.5mm, c)
Benefit Review, Detail Change
GY013
GY015
GY016
GY018
GY019
Piston: Stapes Prosthesis
Piston: Stapes Prosthesis
Piston: Stapes Prosthesis
Septal Button
Ventilation Tube
Teflon & platinum
Fisch-Type Platinum or Stainless Steel
0.4mm x 6mm
Platinum Fluoroplastic
0.6x3.5mm - 0.8x5mm
Platinum Fluoroplastic
0.6x3mm - 0.8x5.75mm
Plastipore
One size only
Shepard grommet, fluoroplastic or silicon, vent tube w/wire.
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.02 -1.14mm
Benefit Review, Detail Change
GY020
GY021
GY027
GY028
GY029
GY030
GY032
GY033
GY034
GY035
GY036
GY037
GY038
GY039
GY040
GY041
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Shepard, fluoroplastic, w/Tab & wire
Shepard, Ultrasil Silicon & Blue Poly
T-Tube Richards Silicon, Soft Silicon, Ultrasil
T-Tube Richards Modified Silicon & Ultrasil
T-Tube Richards Modified Soft Silicon
Butterfly T-Tube Silicon & Ultrasil
Armstrong Beveled Grommet Ultrasil Silicon w/Tab
Grommet - Sha Mini. Teflon
Shah. Teflon, Silicon
Shah. Teflon, Fluorplastic w/Wire
Shah. Teflon, Fluorplastic without Wire
Armstrong Beveled Plain End Fluoroplastic
Armstrong Beveled Plain End Silcon
Bobbin - Reuter Stainless Steel
Bobbin - Reuter Stainless Steel
Bobbin - Reuter Fluoroplastic 1mm I.F Without Holes
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
1.02 -1.14mm
1.02 - 1.14mm
1.14mm
1.32mm
1.32mm
Silicon - one size only. Ultrasil - one size only.
1.14mm
0.76mm
5.1mm
1.14mm
1.14mm
One size only
One size only
1mm
Without Wire 1.14-1.27mm, w/wire 1mm
1mm
Page 37 of 99
Billing Code Product Name
Further Description
GY042
GY043
GY044
GY045
GY048
GY049
GY050
GY051
GY052
GY053
GY054
GY055
GY056
GY057
GY058
GY059
GY060
GY061
GY062
GY063
GY064
GY065
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Bobbin - Reuter Fluoroplastic 1mm I.F Without Holes
1.14mm
Bobbin - Reuter Fluoroplastic 1mm I.F w/wire
1.14mm
Bobbin - Reuter Fluoroplastic 1mm I.F
1.14mm
Bobbin - Reuter Fluoroplastic 0.5mm I.F
1.27mm
Collar Bobbin Fluoroplastic
1.27mm
Collar Bobbin Fluoroplastic
0.75mm
Collar Bobbin Fluoroplastic
1.14mm
Collar Bobbin Fluoroplastic
1.27x0.5mm
Collar Button Ultrasil Silicon
1.27mm
Collar Button Fluoroplastic Blue
1.27mm
Collar Button Fluoroplastic w/Wire
1.27mm
Collar Button Silicon
1.27mm
Collar Button Titanium
1.14mm
Collar Button Titanium
1.27mm
Donaldson Silicon
1.14mm
Donaldson Soft Silicon
1.14mm
Donaldson Silicon w/Tab
1.14mm
Donaldson Fluoroplastic
1.14mm
Donaldson Ultrasil Silicon
1.14mm
Duravent Silicon
1.27mm
Duravent Blue Ultrasil
1.27mm
Paparella w/tab Fluoroplastic, Silicon, Soft Silicon, Ultrasil
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.02 - 2.03mm
Benefit Review, Detail Change
GY067
GY068
GY069
GY070
GY071
GY072
GY073
GY078
GY080
GY081
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Ventilation Tube
Vocal Cord Medialisation Implant
Vocal Cord Medialisation Implant
Dornhoffer Prostheses
Ossicular Chain Prosthesis
Piston: Stapes Prosthesis
Shea w/Tab - Silicone
Shea Parasol w/Tab Small Flange - Silicone
Shea Parasol w/Tab - Silicone
Shea Parasol w/Tab - Silicone
Straight Fluoroplastic or Polyethylene
Vocom Larynx Medial Implant - Hydroxylapatite
Vocom Shim for Medial Implant - Hydroxylapatite
Hydroxyapetite head/HAPEX shaft PORP and TORP
Micron adjustable TORP/PORP. Titanium
Smart: Nitinol/Flouroplastic
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Size
0.76mm
1.02mm
1.02mm
1.52mm
0.89 x 12mm, 0.86 x 7mm, 1.14 x 12mm, 1.14 x 7mm
3 - 7mm Head
1mm - 3mm Offset
0.8mm Shaft Dia TORP, 1.3mm Shaft Diameter PORP
2-10mm, 2-5mm
0.5, 0.6, 0.8 x 3.75-4.75mm
Explanation of Change
Henry Schein/Halas Pty Ltd
Plastic and Reconstructive
Changed Items for Prostheses List Report
Page 38 of 99
Billing Code Product Name
Further Description
HD006
Dental Implants
HD007
Bio-Oss Collagen
collagen, block Benefit Review, Detail Change
Titanium type 4 and 5
3.25 to 6.0mm diameter, 6.0 to 52.5mm length
The product consists of Bio-Oss grannules, embedded in 10%
Size
Explanation of Change
Benefit Review, Detail Change
1 preformed block of cancellous-bone granulate and
porcine collagen. The collagen component is resorbed within a few sizes 500mg
weeks. The properties of the Bio-Oss granules remain unchanged.
The collagen component of Bio-Oss Collagen facilitates the hand
HD008
Bio-Oss Collagen
collagen, block Benefit Review, Detail Change
The product consists of Bio-Oss grannules, embedded in 10%
1 preformed block of cancellous-bone granulate and
porcine collagen. The collagen component is resorbed within a few size 250mg
weeks. The properties of the Bio-Oss granules remain unchanged.
The collagen component of Bio-Oss Collagen facilitates the hand
HD009
Bio-Oss
Review, Detail Change
The material consists of anorganic bovine bone matrix sterilized by
Cancellous Bone Block - 1cm x1cm x2cm Benefit
gamma-irradiation. Bio-Ossis a natural bone mineral for filling of
bone defects in maxillfacial surgery, implantology, and
periodontology, eg. Preparation of implant sites, ridge reconst
HD010
Bio-Gide
Bio-Gide & Bio-Gide Perio are collagen membranes containing
porcine collagen in a bilayer structure. They are used for guided
bone regeneration and peridontal tissue regeneration in oral and
maxillofacial surgery.
30mm x 40mm
Benefit Review, Detail Change
HD011
Bio-Gide
Bio-Gide & Bio-Gide Perio are collagen membranes containing
porcine collagen in a bilayer structure. They are used for guided
bone regeneration and peridontal tissue regeneration in oral and
maxillofacial surgery.
25mm x 25mm
Benefit Review, Detail Change
HD012
Bio-Gide
Bio-Gide & Bio-Gide Perio are collagen membranes containing
porcine collagen in a bilayer structure. They are used for guided
bone regeneration and peridontal tissue regeneration in oral and
maxillofacial surgery.
13 x 25mm
Benefit Review, Detail Change
Bio-Gide & Bio-Gide Perio are collagen membranes containing
Bio-Gide perio - 16mm x 22mm
HD013
Bio-Gide Perio
Review, Detail Change
Benefit
porcine collagen in a bilayer structure. They are used for guided
bone regeneration and peridontal tissue regeneration in oral and
maxillofacial surgery.
HD014
Bio-Oss Collagen
collagen, block Benefit Review, Detail Change
The product consists of Bio-Oss grannules, embedded in 10%
1 preformed block of cancellous-bone granulate and
porcine collagen. The collagen component is resorbed within a few size 100mg
weeks. The properties of the Bio-Oss granules remain unchanged.
The collagen component of Bio-Oss Collagen facilitates the hand
Insight Surgical Pty Ltd
Ophthalmic
IS001
IS008
Preloaded Capsulan Tension Ring
Capsular tension ring preloaded (acrylic)
13/11mm
Quatrix Aspheric Micro-Incision 2.2mm Intraocular Lens Posterior chamber IOL, acrylic, single piece with 360 degree square
edge includign the optic haptic junction, 8 point stability, evolutive
aspheric, packaged with disposable syringe and cartridge.
Benefit Review, Detail Change
+10 to +30
Detail Change
Changed Items for Prostheses List Report
Page 39 of 99
Billing Code Product Name
Further Description
IS009
Preloaded posterior chamber IOL, acrylic, single piece with 360
degree square edge including the optic haptic junction, 8 point
stability, evolutive aspheric, packaged in a preloaded syringe.
+10 to +30
The ALNA Vena Cava Filter is impanted into the SVC via the
Benefit Review
femoral, brachial or jugular vein to prevent pulmonary emboli (PEs). mm.
The ALN vena cava is one size, suitable for a
Acrylic, single piece, rollable, refractive multifocal with monofocal
Dioptric powers from 10.0 to 30.0 D
Quatrix Aspheric Preloaded Intraoular Lens
Explanation of Change
Size
Detail Change
Interventional Dynamics
Vascular
ID001
ALN Permanent or Retrievable Vena Cava Filter
diameter up to 32
IQ Medical
Ophthalmic
IQ001
Change
UltraChoice 1.0 Rollable Thinlens Model PHC001
Detail
function meniscus optic, accommodating intraocular lens with 50
micron edge
IQ002
Ocuvis and Ocumax 2% Hydroxypropylmethylcellulose 20mg/mL hydroxypropylmethyl cellulose for intraocular use. Preloaded in a sterile syringe with one cannula for injection, in a sterile
Tyvek pouch
2mL sterile
IQ004
steps: -5.0 to
Softec
Detail Change
Available in dioptric powers from -5.0 to +36.0, 1D
Acrylic, single piece, foldable intraocular lens with anterior and
posterior optic-haptic square edge, 360 degree optic square edge
design, precision power calculation and aberration technology
IQ007
Blueron
Detail Change
+10.0 and +31.0 to +36.0; 0.5D steps: +10.5 to +18.0 and +25.0 to
+29.5; 0.25D steps: +18.0 to +25.0
Eye Dye
0.5 ml, Sterile
Detail Change
Hertra Polypropylene Mesh
4.5cm x 10cm
Benefit Review, Detail Change
Jecoli Pty Ltd
General/Miscellaneous
JO006
Herniamesh Polypropylene Mesh
Johnson & Johnson Medical Pty Ltd
Cardio-thoracic
JJ026
JJ200
JJ239
Change
BX Velocity with Hepacoat System
BX Velocity Stent and Delivery System
BX Sonic
Balloon expandable, stainless steel, heparin coated
.
Stainless steel stent
Diameter: 2.25-5.0 mm; Length 8 - 33 mm
Stainless steel coronary stent mounted on a balloon delivery system
JJ302
Change
CYPHER Sirolimus-Eluting Stent & Delivery System Model CRS 23300, 08225, 08250, 08275, 08300, 28225, 28250, 28275, 28300,
33225, 33250, 33275, 33300, 13225, 13250, 13275, 18225, 18250,
18275, 18300, 23225, 23250, 23275, 23350, 23400, 08350, 08400,
2835
Stainless steel coronary stent with Rapamycin (an
immunosuppressive and antiproliferative drug) bound to the stent
struts
Detail Change
Detail Change
Dia 2.25 - 4.0mm, lengths 8 - 33mm
Detail
Diameter 2.25 - 5.0mm, length 8-33mm
Detail
Changed Items for Prostheses List Report
Page 40 of 99
Billing Code Product Name
JJ481
8 - 33mm
JJ587
CYPHER Select Plus Sirolimus Eluting Coronary Stent
Detail Change
JJ670
Further Description
Size
Explanation of Change
CYPHER SELECT Sirolimus-Eluting Stent & Delivery System
Stainless steel coronary stent with Sirolimus (an immunosuppressive
Detail Change
and anti-proliferative drug) bound to the stent by a polymer. Model
CRA-23300, 08225, 08250, 08275, 08300, 28225, 28250, 28275,
28300, 33225, 33250, 33275, 33300, 13225, 13250, 13275, 182
Presillion CoCr Coronary Stent on RX System
Stainless steel coronary stent with Sirolimus bound to the stent by a
polymer
Cobalt Chromium, bare metal coronary stent
Diameter 2.25 - 5.0mm, length
Diameter 2.25 - 5.00mm, Length 8 - 33mm
Stent Length (mm) x Stent Diameter (mm) 8 x 2.50, 2.75, 3.0,
3.50, 4.0; 12 x 2.50, 2.75, 3.0, 3.50, 4.0; 17 x 2.50, 2.75, 3.0,
3.50, 4.0; 24 x 2.75, 3.0, 3.50, 4.0; 33 x 2.75, 3.0, 3.50, 4.0; 33 x
2.75, 3.0, 3.50, 4.0, 20 x 2.50, 2.75, 3.0, 3.50, 4.0
Detail Change
General/Miscellaneous
JJ003
JJ004
JJ005
JJ006
JJ007
JJ008
Spongostan Absorbable Haemostat
Spongostan Absorbable Haemostat
Spongostan Absorbable Haemostat
Spongostan ORIGINAL Absorbable Haemostat
Spongostan ORIGINALAbsorbable Haemostat
Surgicel Nu-Knit Absorbable Haemostat
JJ009
Surgicel Fibrillar Absorbable Haemostat
JJ012
Surgicel ORIGINAL Absorbable Haemostat
JJ013
Surgicel ORIGINAL Absorbable Haemostat
JJ014
Surgicel ORIGINAL Absorbable Haemostat
JJ015
JJ019
JJ020
JJ023
Spongostan Absorbable Haemostat
Vypro Mesh
Vicryl Mesh
Surgicel Nu-Knit Absorbable Haemostat
JJ029
Surgicel Fibrillar Absorbable Haemostat
JJ030
Surgicel Fibrillar Absorbable Haemostat
JJ172
JJ173
JJ174
Mersilene Mesh
VICRYL Mesh
Prolene Mesh
Changed Items for Prostheses List Report
Standard (Box of 20)
70 x 50 x 10mm
Film (Box of 20)
200 x 70 x 0.5mm
Special (Box of 20)
70 x 50 x 1mm
Anal 20s (Box of 20)
80 x 30mm
Anal 5s (Box of 5)
80 x 30mm
High density, oxidised regenerated cellulose, the material is
biocompatible and also bactericidal
Fibrous fleece, oxidised regenerated cellulose, the material is
biocompatible and also bactericidal
Oxidised regenerated cellulose gauze, the material is biocompatible
and also bactericidal
Oxidised regenerated cellulose gauze, the material is biocompatible
and also bactericidal
Oxidised regenerated cellulose gauze, the material is biocompatible
and also bactericidal
Dental (Box of 24)
10 x 10 x 10mm
Vicryl/Prolene Composite Mesh
Medium - 15cm x 15cm
1 sheet/box
Large - 30cm x 30cm
High density, oxidised regenerated cellulose, the material is
biocompatible and also bactericidal
Fibrous fleece, oxidised regenerated cellulose, the material is
biocompatible and also bactericidal
Fibrous fleece, oxidised regenerated cellulose, the material is
biocompatible and also bactericidal
Non-absorbable polyester mesh
30cm x 30cm
Polyglactin 910 - synthetic absorbable mesh.
15cm x 15cm
Small polypropylene monofilament non absorbable mesh 2.5cm x 10cm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
7.5 x 10cm
Detail Change
2.5 x 5.1cm
Detail Change
5-10.2 x 20-35cm
Detail Change
5 x 7.5cm
Detail Change
1.25 x 5cm
Detail Change
Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
2.5 x 2.5cm
Detail Change
10.2 x 10.2cm
Detail Change
5.1 x 10.2cm
Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Page 41 of 99
Billing Code Product Name
Further Description
JJ175
Prolene Mesh
Medium polypropylene monofilament non absorbable mesh
7.6cm x 15cm
JJ176
Prolene Mesh
Large polypropylene monofilament non absorbable mesh 30cm x 30cm
Benefit Review, Detail Change
JJ177
Prolene Mesh
Small keyhole polypropylene monofilament non absorbable mesh
4.6cm x 10.2cm
Benefit Review, Detail Change
JJ178
Prolene Mesh
Large keyhole polypropylene monofilament non absorbable mesh
6cm x 13.7cm
Benefit Review, Detail Change
JJ179
VYPRO Mesh
Vicryl (polyglactin 910) / Prolene (polypropylene) composite mesh
30cm x 30cm
Benefit Review, Detail Change
JJ180
JJ222
Prolene Hernia System
Prolene Mesh - medium
BI-LAYER POLYPROPYLENE NON ABSORBABLE MEDIUM TO EXTENDED
Constructed of knitted filaments of extruded polypropylene identical
to that used in Prolene suture. Material is approx. 0.027mm thick.
Non-absorbable mesh for tension free-inguinal hernia techniques.
Benefit Review, Detail Change
Medium - 6" x 6" Benefit Review, Detail Change
JJ240
VYPRO II Mesh
Composition - equal part Vicryl polyglactin yarn - non-absorbable
Prolene polypropylene yarn. Partly absorbable lightweight mesh for
tension free-inguinal hernia techniques
Small 6 x 11cm
JJ241
VYPRO II Mesh
Composition - equal part Vicryl polyglactin yarn - non-absorbable
Prolene polypropylene yarn. Partly absorbable lightweight mesh for
tension free-inguinal hernia techniques
Medium 12 x 10cm Benefit Review, Detail Change
JJ242
VYPRO II Mesh
Composition - equal part Vicryl polyglactin yarn - non-absorbable
Prolene polypropylene yarn. Partly absorbable lightweight mesh for
tension free-inguinal hernia techniques
Large 15 x 10cm
JJ243
Detail Change
VYPRO II Mesh
Composition - equal part Vicryl polyglactin yarn - non-absorbable
Extra large 15 x 15cm
Size
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review,
Prolene polypropylene yarn. Partly absorbable lightweight mesh for
tension free-inguinal hernia techniques
JJ412
JJ413
overlay
Swedish Adjustable Gastric Band
Prolene *3D Patch Polypropylene Mesh
Benefit Review, Detail Change
Silicone
One size only
Sterile Three-dimensional device consisting of a flat mesh onlay
Detail Change
5.49cm x 12.50cm 3DPatch large with preshaped
patch secured to a formed expandable diamond-shaped mesh patch
component.
JJ414
Prolene *3D Patch Polypropylene Mesh
preshaped overlay
Sterile Three-dimensional device consisting of a flat mesh onlay
Benefit Review, Detail Change
patch secured to a formed expandable diamond-shaped mesh patch
component.
5.49cm x 12.50cm 3D Patch with medium
JJ415
overlay
Sterile Three-dimensional device consisting of a flat mesh onlay
5.49cm x 12.50cm 3D Patch medium with extended
Prolene *3D Patch Polypropylene Mesh
Benefit Review, Detail Change
patch secured to a formed expandable diamond-shaped mesh patch
component.
JJ416
overlay
Prolene *3D Patch Polypropylene Mesh
Benefit Review, Detail Change
Sterile Three-dimensional device consisting of a flat mesh onlay
5.49cm x 12.50cm 3D Patch large with extended
patch secured to a formed expandable diamond-shaped mesh patch
component.
JJ432
SURGICEL Nu knit Absorbable Haemostat
High density , oxidised regenerated cellulose, the material is
biocompatible and also bactericidal.
2.5 x 8.75cm
Detail Change
Changed Items for Prostheses List Report
Page 42 of 99
Billing Code Product Name
Further Description
JJ433
SURGICEL Nu knit Absorbable Haemostat
JJ446
JJ447
JJ448
JJ449
JJ450
JJ451
JJ452
JJ453
JJ454
JJ455
JJ456
JJ465
JJ466
JJ467
JJ468
JJ469
JJ470
JJ566
JJ585
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
PROCEED Surgical Mesh
ULTRAPRO Mesh
ULTRAPRO Mesh
ULTRAPRO Mesh
ULTRAPRO Mesh
ULTRAPRO Mesh
ULTRAPRO Mesh
PROLENE Mesh
Ultrapro Hernia System
JJ602
ULTRAPRO Plug
High density , oxidised regenerated cellulose, the material is
15.2 x 22.9cm
Detail Change
biocompatible and also bactericidal.
PROCEED Surgical Mesh B1
2x4 (inches)
Benefit Review, Detail Change
PROCEED Surgical Mesh R1
3x6 inches
Benefit Review, Detail Change
PROCEED Surgical Mesh N1
4x6 inches oval
Benefit Review, Detail Change
PROCEED Surgical Mesh D1
4x8 inches
Benefit Review, Detail Change
PROCEED Surgical Mesh M1
6x6 inches
Benefit Review, Detail Change
PROCEED Surgical Mesh G1
6x8 inches oval
Benefit Review, Detail Change
PROCEED Surgical Mesh H1
8x10 inches oval
Benefit Review, Detail Change
PROCEED Surgical Mesh J1
8x12 inches
Benefit Review, Detail Change
PROCEED Surgical Mesh T1
10x13 inches oval
Benefit Review, Detail Change
PROCEED Surgical Mesh W1
10x14 inches
Benefit Review, Detail Change
PROCEED Surgical Mesh L1
12x12 inches
Benefit Review, Detail Change
ULTRAPRO Mesh S3
6 x 11cm
Benefit Review, Detail Change
ULTRAPRO Mesh P3
10 x 12cm
Benefit Review, Detail Change
ULTRAPRO Mesh N3
10 x 15cm
Benefit Review, Detail Change
ULTRAPRO Mesh M3
15 x 15cm
Benefit Review, Detail Change
ULTRAPRO Mesh T1
15x30cm
Benefit Review, Detail Change
ULTRAPRO Mesh L1
30x30cm
Benefit Review, Detail Change
Polypropylene Mesh
10 x 15cm
Benefit Review, Detail Change
Ultrapro Hernia System. Mesh Made From Composite of Monocryl
Small to Large Oval Benefit Review, Detail Change
& Prolene
Partially Absorbable Synthetic Surgical Mesh Device
Small- Onlay patch plug: 12cm x 7.5cm, 5cm rim diameter, 3cm Benefit Review, Detail Change
anchor diameter; Medium- Onlay patch plug: 12cm x 7.5cm, 5cm
rim diameter, 4cm anchor diameter; Large- Onlay patch plug: 12cm
x 7.5cm, 5cm rim diameter, 5cm anchor diameter
Size
Explanation of Change
Neurosurgical
DP301
DP449
DP453
Moss Miami (Stainless Steel)
Kaneda SR (Smooth Rod) Anterior (TI)
Isola Paediatric System (Stainless Steel)
Transverse Connector - Complete
One size only
Closed Screw
1/4" - 6.25mm x 25 - 60mm
Threadless TRC - Closed or Open Body without or with Rod
Detail Change
Detail Change
3/16"
Detail Change
DP463
DP470
DP473
DP489
DP501
Isola System (Titanium)
Isola System (Stainless Steel)
Isola System (Stainless Steel)
Isola Paediatric System (Stainless Steel)
Isola System (Stainless Steel)
Set Screw
Transverse Rod Connector or Dual Rod Connector
Iliac Screw
Cable Wire Screw
Set Screw
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Changed Items for Prostheses List Report
6.35mm
1/4" & 3/16"
6.25 & 7.0mm
4.75 - 5.50mm x 25 - 30mm
One size only
Page 43 of 99
Billing Code Product Name
Further Description
DP577
DP580
DP832
DY078
DY103
DY106
DY107
DY108
DY109
DY293
DY299
DY303
DY311
DY337
DY345
DY356
DY432
DY444
DY450
Kaneda Anterior Scoliosis System S/S
Kaneda Anterior Scoliosis System S/S
Profile Anterior Thoracolumbar Plate System
Kaneda SR Anterior
Isola System (Stainless Steel)
Isola System (Titanium)
Carbon Fibre Cages
Isola System
Carbon Fibre Cages
Crossover System (Titanium)
Slim-loc Anterior Cervical Plate System
Monarch Spinal System
Frontier Anterior Scoliosis System (Titanium)
Summit Cervical Rod System
Summit Cervical Rod System
In Motion Lumbar Artificial Disc
Expedium Spine System
Summit SI System
Swift Spine System
Closed Screw - Standard or Blunt
3/16" - 6.25mm x 25 - 60mm
Radiused Caps for Open Screws
3/16"
Locking Inner Screw
One size only
Kaneda SR Anterior Open Screw
1/4"-6.25mm x 25-60mm, 3/16"
Modular Cross Connector Set Screw
One Size Only
Modular Cross Connector Set Screw
One size only
Stackable Cage Titanium Interface Screw Nuts
One size only
Titanium, Locking Screw
60-120mm
Stackable Cage Titanium Protective Sleeve
5-15mm
Crossover Nut or Ball Screw
One size only
Plates - three level
56-78mm
Typhoon Cap and Domed Nuts
One size only
Twist on Internal Cap
One size only
Open Cable Connector
One size only
Transverse Connector Screw
One size only
End Plates Parallel & Oblique
Small, medium, large
Si Screw Set
4.35 - 7.5mm
Inner Set Screw
one size
Titanium Anterior Cervical Plate System - various size Plates
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review, Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
56-115mm
Benefit Review, Detail Change
JJ594
JJ599
JJ600
JJ609
JJ647
JJ656
JJ736
Mountaineer OCT Spinal System
Mountaineer OCT Spinal System
Mountaineer Oct Spinal System
Vertebroplasty System
Expedium Spine System - Dual Innie Set Screw
SI Set Screw - Expedium Anterior Spine System
Confidence Spinal cement system
CT Inner Set Screw
One size only
Transverse Connector Plate
21 - 56mm
Transverse Connector Inner Screw
One size only
Vertobroplasty System
One size only
DI Set Screw
one size only
Single Innie Set Screw - Titanium
one size only
Spinal Bone Cement PMMA and Percutaneous Administration Kit
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
11 cc
Benefit Review, Detail Change
JJ766
JJ767
JJ772
JJ773
Expedium SFX Cross Connector System
Expedium SFX Cross Connector System
Anterior Isola System
Anterior Isola System
Fixed Length Cross Connector
Variable Length Cross Connector
Open Monoaxial Screw
Closed Monoaxial Screw
15mm - 36mm Length, 4.5, 5.5, 6.35mm rod diameter
26mm - 100 mm Length, 4.5, 5.5, 6.35mm rod diameter
1/4" x 5.5 - 7mm x 20 - 55mm
1/4" x 5.5 - 7mm x 20 - 55mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Detail Change
Detail Change
Modular Cross Connector J-Hooks
Modular Cross Connector Plates
1/4 & 3/16"
0 - 70mm
Detail Change
Detail Change
Size
Explanation of Change
Orthopaedic
DP072
DP073
Isola System (Titanium)
Isola System (Titanium)
Changed Items for Prostheses List Report
Page 44 of 99
Billing Code Product Name
DP254
Further Description
Size
Explanation of Change
SROM Noiles Knee System femoral component
DP268
Rotating Hinge, cemented, CoCr, SROM & LPS knee systems, with
Sizes xxsmall-large Detail Change
Hinge Pin
SROM Noiles Posterior Stabilised Revision femoral component
Posterior stabilised, CoCr, cemented, femoral component Sizes xxsmall-large Detail Change
DP426
DP427
Surgical Titanium Mesh System
Surgical Titanium Mesh System
Mesh - Long/Oval
Mesh - Curved or Long/Oval
DP436
Surgical Titanium Mesh System
Mesh - Oval or Flat or Long/Round
DP438
DP854
Surgical Titanium Mesh System
Songer Cable System - Titanium
17-22 x 22-28mm - 10-15mm Hgt or 90mm x 90mm or 10 - 16mm Detail Change
x 30 - 100mm Hgt
Mesh - Oblong
12 - 13 x 15 -17mm x 10 - 20mm
Benefit Review, Detail Change
Flex Bar - Large/Small or Flanged Crimp 2 Hole Bar /Flat Bar (Pk 2)
35mm/30mm
Benefit Review, Detail Change
DP860
DP862
DY064
Songer Cable System - Stainless Steel
Songer Cable System - Titanium
Protrusio Acetabular Reconstruction Cage
Double Loop Cable with 2 Crimps
One size only
Double Loop Cable with 2 Crimps
One size only
Titanium, grit blast, proximal distal flange, left & right sided
Benefit Review, Detail Change
Benefit Review, Detail Change
49-57 ID and 52-60 OD
Detail Change
DY151
MBT Knee System Revision Tibial base Plate
Sizes 1-7 Detail Change
DY215
DY330
DY416
Pinnacle Femoral Head
ASR Large Femoral Head
Total Shoulder System
Tibial baseplate, cemented, CoCr, for rotating platform, also usable
with specific hinged insert
CoCr , metal on metal,
28, 36, 40, 44, 48 mm
CoCr, large diameter, metal on metal
39-63mm
Global CAP Conserv Head PC, Global CAP Conserv Head HA
DY417
Total Shoulder System
Global CAP Conserv Head PC, Global CAP Conserv Head Porous
Coated
Titanium, fluted, distal polished femoral long stem & neck, bowed
40 x 15 to 56 x 21 Detail Change
DY510
SROM Femoral Calcar Replacement Stem, long
Benefit Review
DY511
SROM Femoral Stem Long
Benefit Review
DY512
DY513
DY514
DY515
DY516
Review
Pinnacle Acetabular Cup System
Pinnacle Acetabular Cup System
Kar Femoral Stem
Kar Femoral Stem
Solution Implantable Hip System
26 x 33mm x 50 - 90mm
Detail Change
14mm x 130mm or 17 - 22 x 22 - 28mm x 50 - 150mm Hgt
Benefit Review, Detail Change
Detail Change
Detail Change
40 x 15 to 56 x 21 Detail Change
9 -21mm diameter, greater than 200mm length
and straight with Calcar Replacement
Titanium, fluted, distal polished femoral long stem & neck, bowed
9 -21mm diameter, greater than 200mm length
and straight
Pinnacle ceramic liner
44 - 66mm
Pinnacle Ultamet metal liner
44 - 66mm
Titanium, grit blast, full HA coating, fluted distally
Sizes ≤12, (length less than 200mm)
Titanium, grit blast, full HA coating, fluted distally
Sizes 14 - 20, (length 200mm & greater)
Revision Standard & MMA 8 straight or bowed porous coated
Benefit Review
Benefit Review
Benefit Review
Benefit Review
6 inch (150mm) size 10.5 - 22.5
Benefit
8 inch (200mm) size 10.5 - 22.5
Benefit
collarless, coxa vara or high offset uncemented stem
DY517
Review
Solution Implantable Hip System
Revision Standard & MMA 8 straight or bowed porous coated
collarless, coxa vara or high offset uncemented stem
DY520
Pinnacle Acetabular Shell
Changed Items for Prostheses List Report
Titanium, beaded (Duofix), multiple holes, variable spike
arrangements, can be used with ceramic, metal and UHMWPE liners
38 - 80mm
Benefit Review
Page 45 of 99
Billing Code Product Name
Further Description
DY521
Pinnacle Acetabular Shell
Titanium, beaded (Porocoat), not HA, multiple holes, variable spike
arrangements, can be used with ceramic, metal and UHMWPE liners
38 - 80mm
JJ524
JJ527
JJ574
VIPER Spine System
Eagle/Eagle Plus Anterior Cervical Plate
ASR XLAnatomic Femoral Head
Detail Change
Benefit Review, Detail Change
39-63 Detail Change
JJ584
JJ605
Femoral Prep Kit
ASR 300 Acetabular Cup
Viper Single Innie Set Screw
One size
Anterior Cervical Plate
56-60mm
CoCr, metal on metal, large diameter with large offset taper, used
with XLAnatomic sleeve (JJ575)
Femoral Preparation Kit
One size only
CoCr, beaded, with HA, (duofix) & 3 additional spikes for fixation
Detail Change
44 - 70mm
Detail Change
JJ713
JJ749
JJ750
ALPS SFS
SROM Femoral Stem
SROM Calcar Replacement Femoral Stem
Detail Change
Benefit Review
Sizes 6-21
Benefit Review
JJ751
DePuy Ceramic Heads
Cancellous Titanium Bone Screws
10-150MM
Titanium, fluted, distal polished femoral stem & neck
Sizes 6-21
Titanium, fluted, distal polished femoral stem & neck, with calcar
replacement
Ceramic (Biolox Forte) Femoral head various tapers & neck lengths
JJ752
JJ753
JJ754
JJ755
JJ756
DePuy Delta Heads
Hardinge Cement Restrictor
DePuy Femoral Cement Restrictor
OGEE Cemented Cup
Wroblewski Cemented Cup
Delta femoral head various tapers & neck lengths
UHMWPE cement restrictor
UHMWPE cement restrictor
UHMWPE cup, cemented
UHMWPE cup, cemented
≤32mm
Benefit Review
One size only
Benefit Review
Size 0 to 10
Benefit Review
22 - 32mm inner diameter, 40-53mm outer diamter
Benefit Review
22mm inner diamter, 40 - 53mm outer diameter and angled bored Benefit Review
JJ757
LPW Cemented Cup
UHMWPE cup, cemented
28mm inner diameter, 40 - 53mm outer diameter
Benefit Review
Titanium cranial fixation system
Titanium cranial fixation system - straight plate, 2 hole
Titanium cranial fixation system - straight plate, 4 hole
Titanium cranial fixation system - Y plate, 5 hole
Titanium cranial fixation system - X plate, 6 hole
Titanium cranial fixation system - T plate, 5 hole
Titanium cranial fixation system - burr hole, 6 hole
Titanium cranial fixation system - burr hole, 6 hole
Titanium cranial fixation system - box car, 4 hole
Titanium cranial fixation system - box car 6 hole
Titanium cranial fixation system - box car, 8 hole
Titanium cranial fixation system
Titanium cranial fixation system, 2 hole
1.5mm diam, 3-10 6mm length; pack of 5
1.5mm diam, 11mm length; pack of 5
1.5mm - 1.9mm diam, 19mm length
1.5mm diam, 17mm length
1.5mm -1.9 diam, 17 - 18mm length
1.5mm diam, 15mm length
1.5mm - 1.9 diam, screw 12 - 18mm diam plate
1.5mm diam, 18mm plate
1.5mm - 1.9mm diam, 10 x 10mm
1.5mm diam, 8 x 17mm
1.5mm diam, 10 x 24mm
1.9 mm diam; 15mm length pack of 5
1.9mm diam; 15mm length pack of 5
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Size
Explanation of Change
Benefit Review
≤32mm Benefit Review
Plastic and Reconstructive
JJ201
JJ204
JJ205
JJ206
JJ207
JJ208
JJ209
JJ210
JJ211
JJ212
JJ213
JJ215
JJ216
Bioplate Bone Screw
Bioplate Bone Plate
Bioplate Bone Plate
Bioplate Bone Plate
Bioplate Bone Plate
Bioplate Bone Plate
Bioplate Burr Hole Cover
Bioplate Burr Hole Cover
Bioplate Bone Plate
Bioplate Bone Plate
Bioplate Bone Plate
Bioplate Bio-100 Screw
Bioplate Bio-100 Plate
Changed Items for Prostheses List Report
Page 46 of 99
Billing Code Product Name
Further Description
JJ244
Detail Change
BIOPLATE Bone screw
Titanium alloy self-drilling screws, 5 per pack, packaged non-sterile
Dia 1.9mm, length 3 - 5mm
Benefit Review,
JJ245
Detail Change
BIOPLATE Bone screw
Titanium alloy self-drilling screws, 5 per pack, packaged non-sterile
Dia 1.9mm, length 4mm
Benefit Review,
JJ248
Detail Change
BIOPLATE Bone screw
Titanium alloy self-drilling screw, 5 per pack, packaged non-sterile
Dia 1.5mm, length 3 - 5mm
Benefit Review,
JJ251
BIOPLATE Bone screw
Review, Detail Change
Titanium alloy long screws, 5 per pack, packaged non-sterile
Dia 1.9mm, length 3, 4, 5, 6, 8, 10mm
Benefit
JJ252
BIOPLATE Bone screw
Review, Detail Change
Titanium alloy long screw, 1 per pack, packaged non-sterile
Dia 1.5mm, length 3, 4, 5, 6, 8, 10mm
Benefit
JJ253
BIOPLATE Bone screw
Benefit Review, Detail Change
Titanium alloy emergency screws, 5 per pack, packaged non-sterile
Dia 1.8, length 6mm; Dia 2.3mm, length 5mm
JJ254
BIOPLATE Bone screw
Benefit Review, Detail Change
Titanium alloy emergency screw, 1 per pack, packaged non-sterile
Dia 1.8, length 6mm; Dia 2.3mm, length 5mm
JJ255
JJ256
JJ257
JJ258
JJ260
JJ270
Titanium, lattice, 48 hole, packaged non-sterile
32 x 44mm
Titanium cranial biomesh, packaged non-sterile
0.45mm thickness, 60 x 60mm
Titanium cranial biomesh, packaged non-sterile
0.45mm thickness, 85 x 90mm
Titanium cranial biomesh, packaged non-sterile
0.65mm thickness, 65 x 65mm, 90 x 92mm
Titanium cranial biomesh 3ME, packaged non-sterile
20 x 20cm
Titanium straight plate, 2 hole, 5 per pack, packaged non-sterile
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
12mm in length
Benefit Review, Detail Change
JJ271
BIOPLATE Bone plate
JJ272
BIOPLATE Bone plate
JJ273
BIOPLATE Bone plate
JJ274
BIOPLATE Bone plate
JJ275
BIOPLATE Bone plate
Review, Detail Change
Titanium Y plate, 5 hole, packaged non-sterile
1.9mm diam, 19mm length
Titanium T-plate, 5 hole, packaged non-sterile
1.9mm diam, 16mm length
Titanium boxcar plate, 6 hole, packaged non-sterile
1.9mm diam, 9 x 18mm
Titanium boxcar plate, 8 hole, packaged non-sterile
1.9mm diam, 11 x 25mm
Titanium cranial straight plate, 2 hole, packaged non-sterile
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.5mm - 1.9mm diam, 14 - 15mm length Benefit
JJ276
BIOPLATE Bone plate
JJ278
BIOPLATE Bone plate
Review, Detail Change
Titanium curved plate, 8 hole, packaged non-sterile
1.5mm, 30mm length
Titanium cranial straight plate, 16 hole, packaged non-sterile
Benefit Review, Detail Change
1.5mm and 1.9mm diam, 63 - 86 length
JJ280
Titanium large boxcar plate, 4 hole, packaged non-sterile 1.5mm diam, 14 x 14mm length
Benefit Review, Detail Change
JJ281
BIOPLATE Bone plate
Review, Detail Change
Titanium BIO100, 2 hole plate, 5 per pack, packaged non-sterile
1.5mm - 1.9mm Diam, 14mm length
JJ284
BIOPLATE Burr hole cover
Benefit Review, Detail Change
1.9mm, titanium, flexible contoured burr hole cover, packaged non-
1.5 - 1.9mm diam hole, 12-18mm diam plate
BIOPLATE Biomesh
BIOPLATE Biomesh
BIOPLATE Biomesh
BIOPLATE Biomesh
BIOPLATE Biomesh
BIOPLATE Bone plate
BIOPLATE Bone plate
Size
Explanation of Change
JJ290
Burr hole button
sterile
Sterile, 10 per package, silicone rubber
Button length 35mm, cover diameter 29mm, stem thickness 4.1mm Benefit Review, Detail Change
JJ291
JJ441
JJ489
Burr hole cover
Titanium Mesh
Bioplate ZIP
Burr hole cover, sterile, 10 per package, silicone rubber
Titanium Mesh Sterile
Titanium Alloy Implant
Seat diameter 10mm, seat depth 6mm
0.2mm thickness, 15cm x 15cm
11 - 12mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit
Benefit
Changed Items for Prostheses List Report
Page 47 of 99
Billing Code Product Name
JJ490
JJ491
JJ492
JJ493
JJ494
JJ497
JJ498
JJ499
JJ500
JJ501
JJ502
JJ505
JJ506
JJ507
JJ534
JJ535
JJ537
JJ538
JJ539
JJ540
JJ541
JJ542
JJ543
JJ544
JJ638
JJ687
Detail Change
Further Description
Bioplate ZIP
Titanium Alloy Implant
Bioplate ZIP
Titanium Alloy Implant
BIOPLATE Sterile Packs
813573, 2-Hole straight plate and screws - 1.5mm
BIOPLATE Sterile Packs
813574, 2-Hole compression plate and screws - 1.5mm
BIOPLATE Sterile Plates
813575, 2-Hole straight plate and screws - 1.5mm
BIOPLATE Sterile Packs
813578, X-plate and screws - 1.5mm
BIOPLATE Sterile Packs
813579, 4-Hole plate and screws - 1.5mm
BIOPLATE Sterile Packs
813580, 6-Hole Burr Hole cover and screws - 1.5mm
BIOPLATE Sterile Packs
813581, 2-Hole straight plate and screws - 1.9mm
BIOPLATE Sterile Packs
813582, 2-Hole compression plate and screws - 1.9mm
BIOPLATE Sterile Packs
813583, 2-Hole compression plate and screws - 1.9mm
BIOPLATE Sterile Packs
813586, X-plate and Screws - 1.9mm
BIOPLATE Sterile Packs
813587, Boxcar plate and screws - 1.9mm
BIOPLATE Sterile Packs
813588, 6-Hole Burr Hole Cover and Screws - 1.9mm
BIOPLATE Low Profile
Low Profile Titanium Screw
BIOPLATE Low Profile
Low Profile 2-hole Straight Plate
BIOPLATE Low Profile
Low Profile 4-hole Straight Plate
BIOPLATE Low Profile
Low Profile 5-hole Y Plate
BIOPLATE Low Profile
Low Profile 6-hole X Plate
BIOPLATE Low Profile
Low Profile 5-hole T Plate
BIOPLATE Low Profile
Low Profile 4-hole Boxcar Plate
BIOPLATE Low Profile
Low Profile 6-hole Narrow Boxcar Plate
BIOPLATE Low Profile
Low Profile 8-hole Boxcar Plate
BIOPLATE Low Profile
Low Profile Flex Contoured Burr Hole Cover
BIOPLATE Neurosurgery Fixation System - BIOPLATE Low
Profile Plate and Screw Sterile Packs
PDS Plates
Absorbable synthetic (poly-p-dioxanone) plate/foil
Size
Explanation of Change
15 - 16mm
18 - 20mm
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1 kit
1.5mm diam, 3-5mm length
11mm - 14mm length
19mm length
18mm length
17mm length
15mm length
10 x 10mm
8 x 17mm
10 x 24mm
18mm diam plate
Five Hole T-Plate with Screws - Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.5mm Benefit Review, Detail Change
0.25mm x 30mm x 40mm
30mm x 40mm
50mm
JJ732
Bioplate - Biomesh 1MC
1MC (0.3mm) thick titanium malleable mesh
JJ733
Bioplate - Biomesh 3MC
3MC (0.6mm) thick titanium malleable mesh
JJ734
Bioplate - Two hole straight plate with 2 self drilling screws sterile
Benefit Review, Detail Change
kit
JJ735
Bioplate - 2 x two hole straight plate with 4 self-drilling screws
screws
Benefit Review, Detail Change
sterile kit
and 4 x self-drilling screws
0.5mm x
Benefit Review,
0.25mm x 40mm x
0.5mm x 40mm x 50mm
36 x 43mm
36 x 52mm
Sterile low profile kit -2 hole plate w/ 2 self drill scews
Benefit Review, Detail Change
Benefit Review, Detail Change
11-19mm plates and 3-5mm self-drilling screws
Sterilised low profile kit containing 2 x 2 hole compression plates 11 - 19mm plates and 3-5mm self drilling
Vascular
Changed Items for Prostheses List Report
Page 48 of 99
Billing Code Product Name
Further Description
JJ057
Palmaz Balloon Expandable Stent
JJ224
TruFill Pushable coil
length 2 - 100mm
Stainless steel stent
Diameter 4-12mm, length 20-30mm
Platinum pushable coil of 1. Straight, 2. C, 3. Flat spiral and 4.
Detail Change
Complex shapes. Embolic coil and delivery tube.
JJ304
12-39mm
Palmaz Genesis Peripheral Stent and Delivery System on Slalom
Detail Change
Size
Explanation of Change
Detail Change
Size .014" outer diameter. Size 2 - 10mm and
Stainless steel balloon expandable stent mounted on a slalom balloon
Diameter 3-8mm, length
JJ305
Palmaz Genesis Peripheral Stent and Delivery System on Opta Pro
Stainless steel balloon expandable stent mounted on an Opta Pro Diameter 4-8mm, length 12-39mm
Detail Change
Balloon
JJ306
Palmaz Genesis Peripheral Stent
Stainless steel peripheral stent
Diameter 4-12mm, length 11-79mm
Detail Change
JJ419
SMART Control Peripheral Stent System
SMART Control is a laser cut nitinol self expanding stent, used to
Dia 6 – 14mm; Length 20 – 100mm
Detail
Change
treat peripheral vessel disease.
JJ423
OPTEASE retrievable vena cava filter
OPTEASE is a laser cut nitinol vena cava filter, used to treat patients
Suitable for vessels up to 30mm
Detail
Change
at high risk of pulmonary embolisation
JJ463
PRECISE RX Nitinol Stent System
Nitinol self expandable stent and repid exchange delivery system
Stent Lengths 20, 30, 40mm; Stent Diameter: 5, 6,
7, 8, 9, 10mm
Detail Change
JJ479
PALMAZ GENESIS on CORDIS AMIIA RX .014 Delivery System
Peripheral balloon expandable stent and rapid exchange delivery Lengths: 12, 15, 18, 24mm. Diameter: 4,
4.5, 5, 5.5, 6, 6.5, 7mm
Detail Change
system
JJ567
PALMAZ® BLUE™ .018 Peripheral Stent System
L605 Cobalt Chromium Alloy Balloon Expandable Stent 12, 15, 18, 24mm length 4, 5, 6, 7mm diameter
Detail Change
JJ592
SMART Nitinol Stent System
Long 120mm Stent, 6F compatible
6-8mm diameter, 120mm stent length, 120cm delivery system
Detail Change
JJ617
SMART Nitinol Stent System
Long 150mm stent, 6F compatible
6-8mm diameter, 150mm length, 120cm delivery system Detail Change
Kevin Grundy (IBD) Pty Ltd
Ophthalmic
KG001
Change
Rayner C-Flex
Hydrophilic HEMA-MMA copolymer, foldable with injector
5.75mm dia optic, 12.00mm dia overall
Detail
KG002
Change
Superflex
Hydrophilic HEMA-MMA copolymer, foldable with injector
6.25mm dia optic, 12.5mm dia overall
Detail
KG003
to 6.0D in 2D
Rayner Standard Toric C-Flex
Detail Change
Hydrophilic HEMA-MMA copolymer, foldable with injector
5.00mm dia optic, 12.00mm dia overall, cyls 2.0D
KG004
Rayner Premium Toric C-Flex
HEMA-MMA copolymer, foldable with injector
increments
5.75mm dia optic, 12.00mm dia overall, cyls 1.5D to 11.0D in 0.5D
increments
Detail Change
Lifehealthcare Pty Ltd
Ear, Nose & Throat
LH404
NeoZoline Otological Ventilation Tubes
Benefit Review, Detail Change
Armstrong, Collar Button, Shepard, Reuter, Donaldson, Paparella,
Shah
General/Miscellaneous
1.10mm, 1.14mm, 1.27mm, 1.40mm, 0.76mm
Changed Items for Prostheses List Report
Page 49 of 99
Billing Code Product Name
Further Description
LH408
Geli Putty is a single- use, water insoluble, fully bioabsorbable
gelatin powder comprising milled sponges( Gelita-Spon) made from
100% pharmacuetical grade porcine gelatin mixed with sterile liquid
(e.g. saline or antibiotic solution) prior to use to for
Geli Putty(Powder, 1g)
Size
Explanation of Change
1 gram Benefit Review, Detail Change
Neurosurgical
LH192
LH193
LH240
Blackstone Medical Inc Anterior Cervical Plate System
Blackstone Top Locking Plate
Spinal Fixation System
Titanium alloy plate L3
Holds bone screws and anterior cervical plate in place
Multi screw - Titanium
LH243
LH247
and 6.5mm x
Spinal Fixation System
Set screw spinal system
Blackstone - Spinal Fixation System - Mono Axial Screws
Detail Change
LH280
LH281
LH283
LH293
LH310
LH311
LH313
LH365
LH382
Change
Blackstone - Posterior Cervical System
Blackstone Set Screw
Blackstone - Standard Ring Screw
Wafer Cartridge Assemby,
ICON Modular Spinal Fixation System
ICON Modular Spinal Fixation System
ICON Modular Spinal Fixation System
Unity Lumbar Plate
Signus Anterior Cervical Plate - Bone Screws
56mm - 90mm
Benefit Review, Detail Change
One size only
Detail Change
5.5 x 35mm up to 55mm in 5mm increments; 6.5 x 35mm up to
Detail Change
60mm in 5mm increments; 7.5 x 35mm up to 60mm in 5mm
increments
One size only
Composition - Titanium
45mm
Mini-Multi-Axial Screw
3.5-4mmx10-30mm (2mm increments)
Titanium
One size only
Titanium
One size only
Composition: Peek
8 x 20/25/30mm
Screw
4.5mm - 8.5mm x 25-80mm
Multi-axial body assembly
5.5mm
Set Screw
one size only
Unity Cover Plate
17-28mm
Provides stability in patients undergoing anterior cervical spine
Detail Change
5.5mm x 40mm, 5.5mm x 45mm, 6.5mm x 40mm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
4.0 & 4.5mm diameter x 12-16mm length Detail
fusion procedures. It consists of a pre-contoured titanium plate,
secured onto the spinal vertebrae by either fixed or variable angle
colour coded screws. These screws have an integral lock
LH386
Blackstone Medical ACP - 3 Level
Titanium Alloy Anterior Cervical Plate - 3 Level
56mm - 90mm
Benefit Review, Detail Change
Orthopaedic
LH184
Modular U Necks
Cobalt chrome
LH304
HemiCAP Contoured Articular Knee System Resurfacing
0.5mm x 0.5mm to 2.0mm x 2.0mm
Detail Change
Component
Standard, varus, valgus, antiverted right, antiverted left Detail Change
Articular resurfacing component - CoCr with titanium plasma spray
LH305
HemiCAP Contoured Articular Knee System Fixation component
Components Screw
Detail Change
component - Titanium with titanium plasma spray
Proximal Morse taper, fully cannulated, tapered, threaded fixation Component for 15mm & 20mm Articular
Articular Component 15mm -
offset; Articular Component 20mm - 1.0mm x 1.0mm to 4.0mm x
4.0mm offset; 6 x 2mm to 10 x 3mm Offset
9.5mm Dia x 20mm; 11mm x 22mm
Link Orthopaedics Australia
Orthopaedic
Changed Items for Prostheses List Report
Page 50 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
LO009
LO010
Saddle Component
Saddle Base Component
One size only
Sizes 1-7
Detail Change
Detail Change
LINK Endo - model Saddle Prosthesis
LINK Endo - Model Saddle Prosthesis
LMA PacMed Pty Ltd
Ear, Nose & Throat
PM028
PM032
PM033
PM057
PM065
Stapes
K-Piston
Montgomery Thyroplasty Implant System
Provox Voice Prosthesis
Tympo Vent
PM066
PM068
Tympo Vent
Tympo Vent
PM072
Tympo Vent
PM074
PM075
Tympo Vent
Tympo Vent
PM079
PM083
Tympo Vent
Tympo Vent
PM086
Tympo Vent
PM088
Detail Change
Tympo Vent
PM089
Tympo Vent
PM090
PM091
Tympo Vent
Tympo Vent
PM102
Tracheal Cannula System
PM103
Tracheal Cannula System
PM104
Montgomery Safe-T-Tube
Review, Detail Change
PM106
159, 163mm
Montgomery Safe-T-Tube
Benefit Review, Detail Change
Bell/Aerial/Angular Prosthesis/Piston - Gold/Titanium 1.75 - 7.00mm
Gold/Titanium
ID 0.4,0.6mm
Silicone
6,7,8,9,10,11,12
Long term indwelling; Silicone
4.5,6,8,10,12.5mm
Otological ventilation tubes, short medium term, Donaldson
fluoroplastic/blue
Otological ventilation tubes, straight tube
Length 7.0 - 7.2mm
Otological ventilation tubes, short medium term, star tube, silicone
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Length 2.2
Benefit Review, Detail Change
Otological ventilation tubes, short medium term, shepard with tail,
silicone/blue
Otological ventilation tubes, paparella with tab
Length 2.2mm
Otological ventilation tubes, collar button, tubingen type gold, gilded
silver
Otological ventilation tubes, t-tube
Length 6 - 12mm
Otological ventilation tubes, long term, collar button - tubingen type,
titanium
Otological ventilation tubes, short medium term, reuter bobbin
without holes, titanium
Otological ventilation tubes, donaldson, reuter bobbin, shepard
Length 12.4
Otological ventilation tubes, short medium term, bevel bobbin,
fluoroplastic/blue
Otological ventilation tubes, armstrong
Length 3.8 - 10.0mm
Otological ventilation tubes, short medium term, collar button,
fluoroplastic/blue
Short and long term Cannula (Medical Grade Silicone) Diameter 9-13mm; Length 37m & 101mm
Cannula Speaking Valves (Medical Grade Plastic)
4-10
Paediatric, Standard, Thoracic, Extra-Long, Tapered and Hebeler in
Length 1.8
clear and radiopaque
Paediatric, Standard, Thoracic, Extra-Long, Tapered, Hebeler and
Benefit Review, Detail Change
Length 2.8
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Length 1.5mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Length 1.5
Benefit Review, Detail Change
Length 1.6
Benefit Review, Detail Change
Length 1.5mm - 9.8mm
Benefit Review,
Benefit Review, Detail Change
Benefit Review, Detail Change
Length 2.0
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Paediatric/Standard - Clear/Radioplaque
Benefit
ID 8/10, 10/13, 12, 15, 18mm; Length 76, 77, 79,
HMS, in clear and radiopaque
PM107
Laryngeal Keel
PM115
Montgomery Safe-T-Tube
Review, Detail Change
PM117
Passy-Muir Speaking Valve
Changed Items for Prostheses List Report
12-16mm Keel
Paediatric, Standard, Thoracic, Extra-Long, Tapered, Hebeler and
Benefit Review, Detail Change
ID 7, 9, 11mm; Length 100, 110mm
HMS
Tracheostomy and Ventilator
Benefit Review, Detail Change
15mm I.D./ 22 & 23mm O.D.
Benefit
Page 51 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
A bioresorbable tension-less Nerve repair guide
1.5mm x 3cm to 10.0mm x 3cm
Detail Change
LMT Surgical Pty Ltd
General/Miscellaneous
LM080
Ascension Neurolac
Orthopaedic
LM005
LM018
LM028
LM068
LM077
LM078
Change
TriMed Fixation Systems
Ascension Silicone Finger joint replacement
Ascension pyrocarbon carpal implant
Normed fracture fixation plates
Memometal Memory Staples
Ascension HRA - Humeral Resurfacing Arthroplasty
Multiple stainless steel wire forms
various sizes
MCP/PIP moulded silicone finger joint
Various
Pyrocarbon carpal prostheses
Multiple sizes
Titanium plates, various sizes and shapes
Various
Heat Activated Compression Staple
10 mm to 25 mm
A anatomic semi constrained, monobody device intended for
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
40mm x 16mm to 56mm x21mm
LM082
Fixos Screws
resurfacing of the humeral head.
Bone Fixation Screws
2mm diam. X11mm length to 2mm x 16mm
Benefit Review, Detail Change
High Density polyethylene (ring); Stainless Steel (pins)
Diameter 1-3mm
Benefit Review, Detail Change
Detail
Plastic and Reconstructive
LM030
Synovis Coupler
LSS Surgical Pty Limited
Neurosurgical
LS003
LS020
LS023
Solas Spinal System
SOCORE Spinal System- Locking Screw
DIVA PEEK Lumbar Cage
Set Screw
Locking Screw
PEEK Lumbar Cage Posterior & Anterior
One Size
Detail Change
Standard & Mini
Detail Change
Posterior Cages 0, 4 & 8 degrees Length 20mm & 25mm T8 to
Detail Change
T14. Anterior Cages 4 & 8 degrees T9 to T16
LS024
LS025
Solas Spinal System
Solas Spinal System
Hooks open, Pedicle and Lamina
Hooks closed, Pedicle and Lamina
4mm -11mm
4mm - 11mm
Benefit Review
Benefit Review
Mathys Orthopaedics Pty Ltd
Orthopaedic
MA023
RM Classic Acetabular Cup, Metal on Metal
MA029
MA031
MA472
MA473
Metamys Metal on Metal Femoral Head
RM Classic Acetabular Cup
RM Pressfit Cup
RM Pressfit Acetabular Cup, Metal on Metal
MA484
28, 32
Ceramys Ceramic Revision Femoral Head
Detail Change
MA485
Ceramys Large Ceramic Revision Femoral Head
Changed Items for Prostheses List Report
Titanium with lugs and CoCr bonded bearing surface plus
UHMWPE sandwich
CoCr, metal on metal
28mm, 32mm, 36mm
Titanium with lugs bonded bearing surface UHMWPE
46mm - 68mm
Titanium bonded bearing surface UHMWPE
46-64mm
Titanium and CoCr bonded bearing surface plus UHMWPE sandwich
46mm - 68mm
Detail Change
Detail Change
Detail Change
Detail Change
46-64mm
Detail Change
Ceramic, zirconia alumina combination, supplied with titanium taper
28 L, 28 M, 28 S, 28 XL, 32 L, 32 M, 32 S, 32 XL,
sleeve
Ceramic, zirconia alumina combination, large diameters, supplied
with titanium taper sleeve
36 L, 36 M, 36 S, 36 XL, 36
Detail Change
Page 52 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
MA499
MA500
MA501
Femoral body, Titanium, non HA
Titanium, grit blast, non HA
Titanium, grit blast, non HA
50 - 110mm
14, 16, 18
20, 22, 24
Detail Change
Detail Change
Detail Change
Lima Revision Total Hip System
Lima Revision Total Hip System
Lima Revision Total Hip System
Medacta Australia Pty Ltd
Orthopaedic
MU056
ROMAX Resurfacing System - Large Femoral Head Adaptor
Adaptor necessary to combine the ROMAX large femoral head with
Adaptor 12/14: size S, size M,
size L and size XL
Detail Change
a MEDACTA hip stem
MU057
ROMAX Resurfacing System - Large Femoral Head
Large femoral head for metal-metal articulation
From diameter 38mm to diameter 60mm, every 2mm
Detail Change
MU059
GMK Posterior Stabilised fixed tibial insert
Posterior Stabilised fixed polyethylene insert
size 1 to 6, 10/12/14/17/20mm thickness
Benefit Review
MU060
Unicompartmental femoral component
cemented unicompartmental femoral component
1 to 4
Benefit Review
MU061
GMK Inset Patella
Inset cemented polyethylene patella
sizes 1-2; 3-4; 5-6 (20/24/28mm diameter)
Benefit Review
MU062
GMK Unicompartmental fixed tibia insert
cemented unicompartmental polyethylene fixed tibial insert
1 to 5, left and right, 8/9/10/11/12/14mm thiknesses
Benefit Review
MU063
MU064
MU065
GMK cemented standard femur
GMK posterior stabilised cemented femur
GMK Unicompartmental fixed tibial baseplate
MU066
GMK Uncemented Standard Femur
MU067
MU068
MU069
MU070
thicknesses
GMK Uncemented Fixed Tibia Tray
GMK Standard mobile tibial insert
GMK Tibial Extension Stem
GMK Unicompartmental Full - PE Tibia Component
Benefit Review
MU071
MU072
MU073
MU074
MU075
MU077
MU078
GMK Standard Fixed Tibial Insert
GMK Resurfacing Patella
GMK Ultracongruent Mobile Tibial Insert
GMK ultracongruent Fixed tibial Insert
GMK Cemented fixed Tibia Tray
GMK Mobile Cemented Tibia Tray
GMK Uncemented Posterior stabilised femur
cemented standard femoral component
sizes 1to 6, left to right
cemented posterior stabilised femoral component
sizes 1 to 6, left to right
cemented unicompartmental fixed tibial component with peg and
fixation keel
Uncemented standard femoral component with titanium porous
covered by an hydroxyapatite coating
Asymmetric uncemented fixed tibial component
1 to 6, left and right
posterior cruciate retaining mobile polyethylene insert
size 1 to 6, 10/12/14/17/20mm thickness
Tibial Baseplate extension stem
diameter 11mm, length 65mm
cemented unicompartmental all polyethylene fixed component
Benefit Review
Benefit Review
1 to 5, left and right Benefit Review
Posterior cruciate retaining fixed polyethylene insert
size 1 to 6, 10/12/14/17/20mm thickness
resurfacing three pegged cemented polyethylene patella size 1- 2, 3-4, 5-6
Ultracongruent Mobile Polyethylene Insert
size 1 to 6, 10/12/14/17/20mm thickness
Ultracongruent fixed polyethylene insert
1 to 6, 10/12/14/17/20mm thickness
Asymmetric polished cemented fixed tibial component 1 to 6, left to right
Asymmetric mobile cemented tibial component
1 to 6, left to right
uncemented posterior stabilised femoral component with titanium
porus coating covered by an hydroxyapatite coating
Benefit Review
Benefit Review
Benefit Review
Benefit Review
Benefit Review
Benefit Review
1 to 6, left to right Benefit Review
1 to 6, left and right Benefit Review
Benefit Review
Benefit Review
Benefit Review
1 to 5, left and right, 8/9/10/11/12/14mm
Medical & Optical Instruments Australia Pty Ltd
Plastic and Reconstructive
MO002
Martin Mandibular Fracture System
Review, Detail Change
Changed Items for Prostheses List Report
2.7mm Threadlock System, angled and straight plates, titanium
=>3mm thick, 2.7mm threadlock system
Benefit
Page 53 of 99
Billing Code Product Name
Further Description
MO004
MO023
MO024
MO054
MO121
MO127
MO129
MO135
MO185
Martin Mandibular Fracture System
Martin Microplate Osteosynthesis System
Martin Mandibular Fracture System
Martin Miniplate Osteosynthesis System
Martin Micro Plate Osteosynthesis System
Titan Mesh
Titan Mesh
Martin Internal Distraction System
Resorb-X Plates
Threadlock 2.7mm System, angled and straight plates
16 - 32 hole =>3mm thick, 2.7mm threadlock system
Lindorf Plate
0 to11mm
Condylar Implant - left or right
5cm
Straight Plate Titanium
2 hole, 1mm profile
1.5mm system Burr Hole Cover Titanium
12 to 22mm, 0.3 - 0.6mm profile
Mesh Sheet Titanium
13 hole 1, 1.5, 2mm
Mesh Plates Titanium
1 x 2 holes 1, 1.5, 2mm
Titanium Distractor
10 to 20mm
Resorb-X Osteosynthesis System, Resorbable straight plate
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
4 - 8 hole
Benefit Review, Detail Change
MO186
MO188
Martin Level One Fixation Resorb x & SonicWeld
Resorb-X Mesh Plate
51 x 51mm
Plate PDLLA (resorbable)
1.0 to 1.99mm thick,8 to 15 holes
Resorb-X Osteosynthesis System, Resorbable mesh plate 51 x 51mm - 0.3, mm profile
Benefit Review, Detail Change
Benefit Review, Detail Change
MO204
Resorb-X Plates
Resorb-X Osteosynthesis System, Resorbable Mesh Plate 125 x 125mm
Benefit Review, Detail Change
MO224
MO231
MO233
MO234
MO236
Martin Fixation Device Internal - Plate
Resorb X Plates Various Sizes
Internal Distraction Device
Martin Rigid External Distraction System II (REDII)
Martin Rigid External Distraction System II (RED II)
Lindorf chin plate. 1.0 0 1.99 thick. 4 - 7 hole
1.5mm diameter system
Resorb Osteosynthesis System resorbable mesh plate
11 x 126mm
Titanium
1.5mm
RED II Titanium Cranial Fixation Screws
45-55mm
RED II Aluminium Cranium Frame and Carbon Fibre Rods
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
One Size Only
Benefit Review, Detail Change
MO239
Detail Change
Intra-Oral Distraction System
Titanium Distraction Device. Complex Midface and Reconstructive
15 - 60mm distraction length
MO240
MO242
MO246
Martin Rigid External Distraction Device II (REDII)
Martin Rigid External Distraction Device II (REDII)
Martin Rigid External Distraction System II (REDII)
RED II Titanium Maxillary Fixation
1.5mm - 1.8mm
RED II Titanium Fixation Plate
1.5mm
REDII Aluminium and Carbon Fibre Cross-Bar Assembly One size only
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
MO250
MO251
Martin Microplate Osteosynthesis system
OSTEOSYNTHESIS SYSTEM MESH PLATE
1.5mm Titanium Plate
3 D Mesh
2-6 Hole
0.6mm Profile
Size
80x80
Benefit Review,
Benefit Review, Detail Change
Benefit Review, Detail Change
Medical Device Alliance Pty Ltd
Plastic and Reconstructive
MP003
MP005
MP007
MP008
Facial Implant Nasal "L" Shaped
Calf Implants
Facial Implant Malar
Calf Implant
White, pink
Asymmetrical shape, silicone gel smooth surface
Malar
Silicone elastomer - smooth surface, asymmetrical shape,
1.9 x 4.1 x 2.8cm, 1.8 x 4 x 2.9cm
85-180cc
Small, medium, large/left or right
70-175cc
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
MP009
Facial Implant Nasal
Nasal dorsum
Small, large
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Page 54 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
MP010
MP012
MP013
MP014
MP016
MP017
MP018
MP019
MP020
MP021
MP022
MP023
MP024
MP025
MP026
MP027
MP028
MP029
MP030
MP031
MP032
MP034
MP035
MP036
MP037
MP048
MP049
MP051
Anotomical chin
Chin
Zygomatic
Silicone elastomer - smooth surface, symmetrical shape
Symmetrical shape, silicone gel
Oval Shape, Silicone Gel, Smooth
Oval Shape, Silicone Gel, Textured Surface
Round Shape, Silicone Gel, Smooth Surface
Oval Shape, Silicone Elastomer, Smooth Surface
Oval Shape, Silicone Elastomer, Textured Surface
Round Shape, Silicone Elastomer, Smooth Surface
Sheet standard-small with reinforcement
Sheet standard - large with reinforcement
Sheet standard - small without reinforcement
Sheet standard - large without reinforcement
Sheet extra strength small
Sheet extra strength large
Block standard super soft
Block coloured, single consistency, white/pink
Block coloured, double consistency, white/pink
Silicone sheet - textured
Small, medium, large/left, right
Small, medium, large/left, right
Right, left
15-105cc
12-140cc
100-300cc
200-400cc
200-300cc
95-260cc
225-420cc
250-340cc
100mm
200mm
100mm
200mm
100mm
200mm
Soft, Medium, Hard
One size only
One size only
0.3mm, 29cm x 17cm;
One size only
Small, medium, large/left or right
14cc; 20cc; 38cc; 63cc; 122cc
190cc - 300cc
3-60ml
16-55ml
1-5ml
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Facial Implant Chin
Facial Implant Chin
Facial Implant Nasal
Calf Implant
Calf Implants
Gluteal Implants filled with Gel
Gluteal Implants filled with Gel
Gluteal Implants filled with Gel
Gluteal Implants filled with Elastomer
Gluteal Implants filled with Elastomer
Gluteal Implants filled with Elastomer
Silicone Sheets
Silicone Sheets
Silicone Sheets
Silicone Sheets
Silicone Sheets
Silicone Sheets
Silicone Sheets
Silicone Sheets
Silicone Sheets
Suspension Sheet for Mammoplasty
Facial Implant - Ear
Facial Implant Malar
Infraclavicular Implant
Pectoral Implants
Silimed Tissue Expanders
Silimed Tissue Expanders
Silimed Tissue Expanders
Malar Anatomical
Infraclavicular Implant
Gel - Smooth surface
Ball Shaped Orbital Model # 741, 747
Auricular Model # 841, 847
Finger Syndactylism Model # 851, 857
Medical Specialties Australia Pty Ltd
General/Miscellaneous
MS030
Detail Change
TiMESH light
Prosthetic warp-knitted fabric made of monofil polypropylene
10 x15 cm TiMESH light
Benefit Review,
threads with an encapsulating titanic coating
MS032
Detail Change
TiMESH extralight
Prosthetic warp-knitted fabric made of monfil polypropylene threads
10 x 15cm TiMESH extralight Benefit Review,
with an encapsulating titanic coating
Changed Items for Prostheses List Report
Page 55 of 99
Billing Code Product Name
Further Description
MS033
Detail Change
Prosthetic warp-knitted fabric made of monofil polypropylene
TiMESH light
Size
Explanation of Change
15 x 15cm TiMESH light
Benefit Review,
threads with an encapsulating titanic coating
MS034
Detail Change
TiMESH extralight
Prosthetic warp-knitted fabric made of monofil polypropylene
15 x15cm TiMESH extralight Benefit Review,
threads with an encapsulating titanic coating
MS035
Detail Change
TiMESH light
Prosthetic warp-knitted fabric made of monofil polypropylene
20 x 15cm TiMESH light
Benefit Review,
threads with an encapsulating titanic coating
MS036
Detail Change
TiMESH extralight
Prosthetic warp-knitted fabric made of monofil polypropylene
20 x 15cm TiMESH extralight Benefit Review,
threads with an encapsulating titanic coating
MS038
Detail Change
TiMESH Extra Large
Prosthetic warp-knitted fabric made of monofil polypropylene
Extra Large TiMESH
Benefit Review,
threads with an encapsulating titanic coating
MS043
TiPLUG/TiPATCH System
MS044
TiPLUG/TiPATCH System
Titanized polypropylene composite. Prosthetic warp-knitted fabric
made of monofilament polypropylene threads with an encapsulating
titanic coating.
Titanized polypropylene composite. Prosthetic warp-knitted fabric
made of monofilament polypropylene threads with an encapsulating
titanic coating.
TiPLUG Benefit Review, Detail Change
TiPATCH
Benefit Review, Detail Change
Plastic/magnetic. Programmable valve. Programmer kit and shunts
kit.
3, 8 settings
Detail Change
Silicone tracheal and bronchial stents - Dumon
Nitinol wire - tracheal and bronchial stenets - Dumon
Benefit Review, Detail Change
Benefit Review, Detail Change
Neurosurgical
MS003
Sterile Hydrocephalic Shunts
Medical Vision Australia Pty Ltd
Ear, Nose & Throat
MF001
MF002
Endoxane
Tracheobronxane Silmet
10 - 20mm diameter, 20 - 60mm length
12 - 20mm diameter, 20 - 90mm length
Plastic and Reconstructive
MF020
Enophthalmos Wedge
Benefit Review, Detail Change
Regular left and right. Large left and right. (Models 9541 - 9544)
Regular: 22 x 31 x 7mm. Large: 28 x 40 x 7.5mm
MF021
Rim Onlay
Orbital Rim
Benefit Review, Detail Change
Orbital rims, left and right extended. Models 9539, 9540 Orbital Rim
Left & right extended models 47 x 40mm Oribtal
MF022
Complete Orbital Shape
MF023
x 47 x 3mm,
Chins
Benefit Review, Detail Change
Onlay Implants 81001, 81002
Implants left & right 40 x 40mm
Porus Polyethylene. Complete and 2 / 3 orbit shapes. Inferior 2 / 3
left and right. Models 9567, 9568
Extended chin implants: Round RZ (Models 8313 - 8315) and
Inferior: 83 x 78mm Benefit Review, Detail Change
Extended chin Implants design RZ round small: 45
extended square RZ (Models 8316, 8318). Two piece chin design
medium 45 x 47 x 5mm, large 45 x 47 x 7mm; Extneded Chin
(Models 8320 - 8322). Single piece chin design, contoured (Models Implants square small 45 x 47 x3mm; Medium 45 x 47 x 5mm;
7520 - 7522). Additional chin shapes (Models 6341 - 6344)
Large 45 x 47 x 7mm; Two piece design small 46 x 33 x 5mm;
Contoured t
Medium 56 x 36 x 7mm
MF024
large 60 x 25 x
Genioplasty Wedge
Benefit Review, Detail Change
Porus Polyethylene. Genioplasty wedges, models 8340 - 8343
Small 60 x 25 x 5mm, medium 60 x 25 x 7.5mm,
10mm
Changed Items for Prostheses List Report
Page 56 of 99
Billing Code Product Name
Further Description
MF025
Prejowl Shape
MF026
Malar Shape
50 x 19 x 3mm, Benefit Review, Detail Change
Porus Polyethylene. Model 8319
45 x 41 x 4mm
Porus Polyethylene. Design RZ malar shapes, super petite and petite,
Size
Explanation of Change
Benefit Review, Detail Change
Design RZ malar shapes: super petite left and right
left and right (Models 9501 - 9504). Design M malar shapes, left
Design RZ malar shapes petite left and right 50 x 19 x 5mm. Design
and right (Models 9507 - 9512). Additional malar shapes, extended
malar shapes: small left and right 64 x 19 x 3mm, left and right
contoured left and right (Models 9513 - 9518) Contoured medium 64 x 19 x 4.5mm, Left and right large 64 x 19 x
MF027
Nasal Shape or Rhinoplasty Shape
70 x 15 x 2mm, Benefit Review, Detail Change
Porus Polyethylene. Nasal Arch shapes, nasal arch and nasal sheet
Nasal arch shapes: small 70 x 13 x 2mm, medium
(Models 9533 - 9536). Nasal dorsum shapes, design A and design B large 70 x 15 x 2mm, sheet 40 x 9 x 1.1mm. Nasal dorsum shapes:
(Models 7516 - 7518). Nasal valve support, lateral nasal valve
design A small 53 x 5mm, design A large 66 x 8mm, design B 67 x
support and ext.
6.5mm. Nasal valve support: lateral nasal valve 13 x 0.85 x 3.5mm
MF028
Micro Thin Sheet
MF029
Ultra Thin Sheet
MF030
Sheet
1.5mm, 8662: 76 x
Model/s 8438, 83020, 83022, 83029
8438: 30 x 50 x 0.4mm, 83020: 38 x 50 x 0.25mm, 83022: 38 x 50
Benefit Review, Detail Change
x 0.35mm, 83029: 38 x 50 x 0.45mm
Porus Polyethylene. Models 7210
38 x 50 x 0.85mm
Benefit Review, Detail Change
Porus Polyethylene. Models 6330, 6331, 8662, 9562. Micro single
Sheets 6330: 38 x 50 x 1.5mm, 6331: 50 x 76 x
Benefit Review, Detail Change
channel sheet, model 9528. Barrier microplate single channel sheet, 127 x 1.5mm, 9862: 38 x 50 x 3mm. Microplate single channel
model 9527 Medpor Titan Implant Sheets Plain, Barrier & Double Sheet 9528: 38 x 50 x 0.85mm. Barrier microplate single channel
Barrier, and Medpor Titan Orbital floor and wall sheets 8102
Sheet 9527: 38 x 50 x 0.85mm. Titan implant sheets 81020: 76 x 50
x
MF031
Barrier Sheet: Barrier Sheet - Orbital Floor
76 x 1.6mm: 50 x
Porus Polyethylene. Barrier sheet - Rectangle, models 8312 and
Barrier sheet - Rectangle: 50 x 76 x 1mm, 50 x
Benefit Review, Detail Change
9312. Orbital floor implants, models 8305 and 9305
76 x 1mm, 50 x 76 x 1.6mm. Orbital Floor: 38 x 50 x 1mm, 38 x
50 x 1.6mm
MF032
Block
Models 6332 - 6340 & 6359
MF033
Medium left &
Flexblock TF2
Benefit Review, Detail Change
Flexblock TF2 implant, left and right, models 9857 - 9860, 9861 9862
6332: 13 x 38 x 3mm, 6333: 13 x 38 x 6mm, 6334: 13 x 38 x
Benefit Review, Detail Change
9.5mm, 6335: 25 x 50 x 3 mm, 6336: 25 x 50 x 6mm, 6337: 25 x
50 x 9.5mm, 6338: 38 x 63 x 3mm, 6339: 38 x 63 x 6mm, 6340: 38
x 63 x 9.5mm 6359: 150 x 201mm
Flexblock TF2: small left & right 61 x 78 x 18mm,
right 74 x 93 x 20mm, large left & right 82 x 105 x 20mm
MF035
Ear Reconstruction
MF036
Complete Orbital Shape
MF037
Mandibular angle
3mm, 65 x 35 x 7 x
Porus Polyethylene. Helical rim, models 8328 and 8329 Helical rim: 37 x 62mm
Benefit Review, Detail Change
Complete left and right. Models 9569, 9570
Complete 61 x 76mm
Benefit Review, Detail Change
Porus Polyethylene. RZ mandibular angles left and right (Models
RZ mandibular angles: 65 x 35 x 3 x 6.5 x 3 x
Benefit Review, Detail Change
9955 - 9960); Porus Polyethylene. Contoured mandibular angles left 6.5 x 3 x 3mm, 65 x 35 x 11 x 6.5 x 3 x 3mm. Contoured
and right (Models 88037 - 88038)
mandibular angles left and right:59 x 29 x 7 x 11mm.
MF038
5 x 5 x 45mm,
Porus Polyethylene. Petite Nasal Dorsum ( Models 84000 - 84004).
Nasal Shape. Petite Nasal Dorsum.
Benefit Review, Detail Change
MF039
Nasal Valve Support.
Nasal Valve Batten:
MF040
Nasal Sheet (Strut).
Petite Nasal Dorsum: 4 x 4 x 45mm, 4 x 4 x 55mm,
5 x 5 x 55mm, 6 x 9 x 55mm.
Lateral Nasal Valve, Model 7545. External Nasal Valve Batten,
Lateral Nasal Valve:13 x 3.5 x 0.85mm, External
Benefit Review, Detail Change
Model 7546. External Nasal Valve Batten - Thin, Model 7167
25 x 11 x 0.85mm, External Nasal Valve Batten - Thin: 24 x 11.5 x
0.6mm.
Nasal Sheet (Strut). Model 9536
Nasal Sheet (Strut): 40 x 9 x 1.1mm
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Page 57 of 99
Billing Code Product Name
Further Description
MF041
Nasal Shell Shapes.
9mm, Insert Large
Nasal Shell Shapes, Regular and Large with Inserts Small and Large
Regular: 38 x 21 x 17mm, Insert Small 30 x 4 x
Benefit Review, Detail Change
(included). Models 9553 - 9554. Thin Nasal Shell 84006 38 x 2.5 x 9mm. Large: 40 x 20 x 18mm, Insert Small 32 x 4 x
9mm, Insert Large 41 x 3 x 9mm. Thin Nasal Dorsal Shell 42.7mm
x 16.4mm x 21.8mm
MF042
Ultra Thin Sheet
MF043
Ultra Thin Sheet
MF044
Ultra Thin Sheet
MF045
Sheet - Multi Channel, Barrier Channel.
channel: 40 x 52 x
Porus Polyethylene. Model 7212
50 x 76 x 0.85mm
Benefit Review, Detail Change
Porus Polyethylene. Model 7214
76 x 127 x 0.85mm
Benefit Review, Detail Change
Porus Polyethylene. Model 7216
127 x 178 x 0.85mm
Benefit Review, Detail Change
Porus Polyethylene. Miniplate channel sheet, model 9529.
Miniplate channel: 40 x 52 x 2.3mm. Mircoplate
Benefit Review, Detail Change
Microplate channel sheet, model 9530. Barrier Miniplate and
2.3mm. Barier Miniplate and Microplate Channel Sheets: 40 x 52 x
Microplate Channel Sheets, Models 9531 and 9532.
2.3mm, 40 x 52 x 2.3mm
MF046
Sheet - Barrier Single Channel Sheet.
Review, Detail Change
Porus Polyethylene. Barrier Single Channel Sheet, Model 9527.
Barrier Single Channel: 38 x 50 x 0.85mm Benefit
MF047
Flexblock TF2
Review, Detail Change
Porus Polyethylene. Flexblock TF2 implant, left and right, models
Flexblock TF2: large 82 x 105 x 20mm.
9861 - 9862
Porus Polyethylene. Flexblock TF implant, models 9521 - 9522.
Flexblock TF: small 70 x 70 x 10mm, medium 88 x
MF049
Flexblock TF
MF050
Flexblock, Cranial Grid
Review, Detail Change
Porus Polyethylene. Flexblock TF implant, model 9523. Flexblock TF: large 98 x 95 x 18mm.
Porus Polyethylene.Flexblock cranial grid implant, model 9524.
Benefit Review, Detail Change
Flexblock cranial grid: 97 x 107 x 6mm.
MF051
Flexblock
MF052
Ear Reconstruction
base extended: 30
Porus Polyethylene. Flexblock, model 6314.
Flexblock: 56 x 91 x 4mm.
Porus Polyethylene. Ear base left and right, models 7542 and 7525
Benefit Review, Detail Change
- 7527. Ear base extended left and right, models 8330 and 8331.
x 60mm.
Benefit Review, Detail Change
Ear base: 29 x 55 x 13mm, 32 x 65 x 16mm. Ear
Amplatzer Duct Occluder
Amplatzer Septal Occluder
Amplatzer Muscular VSD Occluder
Amplatzer PFO Occluder
Amplatzer Membranous VSD Occluder
Nitinol Wire Mesh
5 - 24mm
Nitinol Wire Mesh
4mm - 40mm
Nitinol Wire Mesh
4 - 24mm
Nitinol Wire Mesh
25mm & 35mm
Nitinol wire mesh, double disc occluder and delivery system
Detail Change
Detail Change
Detail Change
Detail Change
4-24mm, Length 7-10mm
Superstitch
Amplatzer Vascular Plug
Suture Mediated Closure Device
Self expandable nitinol wire mesh
Detail Change
Detail Change
MF048
86 x 15mm,
Flexblock TF
Benefit Review, Detail Change
Size
Explanation of Change
Benefit
Benefit
Medtel Australia Pty Ltd
Cardio-thoracic
ME065
ME066
ME067
ME068
ME074
Detail Change
Vascular
ME107
ME182
Sheath sizes: 6F and 8F
Diameter 4mm - 16mm, Length 7 & 8mm
Medtronic Australasia Pty Ltd
Cardio-thoracic
Changed Items for Prostheses List Report
Page 58 of 99
Billing Code Product Name
Size
Explanation of Change
MC002
Medtronic Sprint Quattro Lead Model 6944RV/SVC 65cm; Model
6944RV/SVC 75cm; or Model 6944RV/SVC 100cm; Medtronic
Sprint Quattro Lead Model 6944RV/SVC 58cm
Silicone and polyurethane
65-100cm
Detail Change
MC008
MC009
MC010
Medtronic Capsurefix Model 5568 Pacing Leads
Silicone Polyurethane
Medtronic Epicardial Pacing Leads IS-1 Model 5071
Silicone
Medtronic Capsure SP Novus Model 5092; Capsure SP Novus Lead
Model 5592; Medtronic Capsure Model 4023 Lead; Medtronic
Capsure Model 4024 Lead (med.dexamethasone) Medtronic Capsure
Model 4523(MED) Medtronic Capsure Model 4524 Lead;
Medtronic Capsure Model
30 - 85cm
35 - 53cm
Silicone Polyurethane
Detail Change
Detail Change
45 -110cm
Detail Change
MC011
Capsure EPI steroid eluting bipolar epicardial lead Model 4968 Silicone
ventricle
Freestyle bioprosthesis
Models 995xx, 995MSxx
19 - 35mm
Medtronic Transvene SVC Lead Model 6937;
Model 6937-35, Model 6937-52, Model 6937-58, Model 6937-110;
Silicone;
Model 6721 Unipolar Epicardial Patch Leads S/M/L
Model 6721S-50, Model 6721M-50, Model 6721L-50; Silicone
25 - 60cm
Detail Change
MC015
MC026
MC027
MC036
Change
Further Description
Medtronic Lead End Cap Kit Model: 5867-3M; Medtronic DF-1 Port
Pin Plug Kit: Model 6719, Medtronic IS-1 Port Pin Plug Kit: Model
6725; Medtronic Upsizing Sleeve: Model 5866-45, Model 5866-46
Detail Change
35 - 110cm x 660mm
370, 660, 840mm
Pin Plug Kits to Seal Unused Pacemaker or Defibrillator Port; Sizing
Detail Change
Detail Change
One Size Per Model Detail
Sleeve - Silicone or Polyurethane
MC052
Medtronic Capsure VDD2 Model 5038 AV Pacing Lead Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1
x vein lifter, 2 x fixation tools, extra stylets
11.5cm, 13.5cm, 15.5cm
MC053
Capsure EPI steroid eluting unipolar epicardial lead Model 4965
ventricle
Medtronic AVE S660 Coronary Stents, S670 Coronary Stents, S7
Detail Change
Coronary Stents, BeStent2,
Silicone
25 - 50cm
Stainless Steel
S660 Coronary Stent - Diameter (2.5mm-2.75mm),
MC208
Medtronic Sprint Quattro Secure Lead Model 6947 58cm; Model
6947 65cm; Model 6947 75cm; Model 6947 100cm
tantalum coils, steroid eluting tip
Leads, Defibrillator, Implantable, Silicone, polyurethane, platinized
58-100cm Detail Change
MC225
MC226
Attain Over the Wire Model 4193
Titanium, polyurethane
Medtronic Insync III Triple Chamber Pacemaker Model 8042
78-88cm
Titanium
Detail Change
One size only
Detail Change
MC229
MC246
MC251
Medtronic Capsure SP Novus Model 5594 Lead 30cm
Silicone, platinum
DF-I Y-Adaptor/Extender Model 6726 25cm & 37cm
Silicone
Implantable Subcutaneous Defibrillator Lead Model 6996SQ 41cm,
58cm, 85cm
CapSure Sense pacemaker lead Models 4073
Titanium Nitride
30-100cm
Lengths 25cm, 37cm
Silicone and Platinum Alloy
Detail Change
Detail Change
Lengths 41-85cm inclusive
30 - 85cm
Detail Change
MC197
Length (9mm-
MC254
Changed Items for Prostheses List Report
Detail Change
Detail Change
24mm); S670 & S7 Coronary Stent - Diameter (3mm-4mm),
Length (9mm-30mm); BeStent2 - Diameter (2.5mm-4mm), Length
(9mm-30mm);
Detail Change
Page 59 of 99
Billing Code Product Name
Further Description
MC301
Model 3830 PACING LEADS
MC329
Medtronic Driver, Micro Driver Coronary Stent System
Active fixation pacemaker leadComposition: Insulation is
59 - 75 cm
Detail Change
polyurethane, Electrodes are Titanium Nitride coated Platinum, the
screw is steriod-coated
Cobalt Alloy
Driver Stent: diameter (2.25 - 4.5mm), length (8-30mm); Micro- Detail Change
Driver Stent: diameter (2.25 - 2.75mm), length (8 - 24mm)
MC336
Medtronic Capsure Z Novus Model 5054 Pacing Lead
Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1
x vein lifter, 2 x fixation tools, extra stylets
45-58cm Detail Change
MC337
Medtronic Capsure Z Novus Model 5554 Pacing Lead
Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1
x vein lifter, 2 x fixation tools, extra stylets
45-58cm Detail Change
MC338
Medtronic Capsurefix Novus Model 5076 Pacing Lead
Silicone; Contents: 1 x lead with anchoring sleeve, stylet & guide, 1
x vein lifter, 2 x fixation tools, extra stylets
45-85cm Detail Change
MC360
EnRhythm
MC371
Size
Model P150 1DR, Rate Responsive dual chamber pacemaker with
Anti-Tachycardia functions: DDDRP
Medtronic Capsurefix Model 6940 Pacing Lead; Medtronic Tined
Silicone Polyurethane
IS-1 Model 4557M; Medtronic Capsurefix Model 4067/8/4568
Pacing Leads; Medtronic Capsurefix Model 5067 Pacing Leads;
Medtronic Capsurefix Model 5068 Pacing Leads; Capsure SP Novus
Pacing Lead
Explanation of Change
21g, 13cc
Detail Change
30 - 85cm
Detail Change
MC372
CapSure Sense pacemaker lead Models 4074 & 4574
Titanium Nitride
MC699
MC701
MC713
MC720
Attain OTW Model 4194 Lead
Mosaic Cinch, Aortic, Mitral
Adapta Pacemaker
Concerto CRT-D
MC721
Virtuoso
Model 4194
Models 305cxx, 310cxx
VDDR PacemakerModels ADVDD01
Implantable Cardioverter Defibrillator with Cardiac
Resynchronisation Therapy
DR ModelImplantable Cardioverter Defibrillator, Dual Chamber
37cc, 68g
Detail Change
MC722
Virtuoso
VR ModelImplantable Cardioverter Defibrillator, Single Chamber
37cc, 68g
Detail Change
MC726
Adapta Pacemaker
11.1-14.2cc23.6g-31.3g
MC728
MC730
MC732
MC765
MC769
MC771
MC772
Adapta Pacemaker
Attain StarFix LV Lead
Endeavour Drug Eluting Coronary Stent System
U-Clips
Endeavor Sprint Drug Eluting Stent System
Mosaic Ultra
U-Clips
DR PacemakerModels ADDR01, ADDRS1, ADDRL1, ADDR06,
ADDR03
SR PacemakerModels ADSR01, ADSR06, ADSR03
9.7 - 11.0cc21.5 - 22.5g
Over the wire left Ventrucular Lead
78, 88, 103cm
Cobalt Alloy, ABT - 578
Diameter: 2.25mm-4.5mm; Length: 8.00mm-38.0mm
Nitinol Clips, 8-pack
Needle Lengths: 6.5mm - 9.5mm, 8-pack
Cobals Alloym ABT - 578
Diameter: 2.25mm-4.0mm; Length: 8.0mm-30.0mm
Small Aortic Root Bioprosthesis
19mm-29mm
Nitinol Clips, 2-pack
Needle Lengths: 6.5mm - 9.5mm, 2-Pack
Changed Items for Prostheses List Report
CapSure Sense Lead Model 4074 - 30cm to 85cm; CapSure Sense Detail Change
Lead Model 4574 - 30cm to 53cm
78cm, 88cm
Detail Change
19mm - 35mm
Detail Change
11.1cc23.6g
Detail Change
38cc
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Page 60 of 99
Billing Code Product Name
Further Description
MC778
MC811
MC812
Oscor Adaptor
Attain Ability 4196 LV Lead
Consulta CRT-D
Adaptor for LV-1 lead to unipolar and bipolar IS-1
10cm, 17cm and 40cm
Over the wire dual electrode left ventricular lead
78, 88, and 103 cm
Fully Automatic, Wireless Implantable cardioverter defibrillator with
cardiac resynchronization therapy (CRT), and therapies for
ventricular and atrial tachyarrhythmia
Detail Change
Detail Change
38cc
Detail Change
MC813
Secura VR
Fully Automatic, Wireless Implantable cardioverter defibrillator with
high energy capability and therapies for ventricular tachyarrhythmia
37cc
Benefit Review, Detail Change
MC814
Secura DR
Fully Automatic, Wireless Implantable cardioverter defibrillator with
high energy capability and therapies for ventricular and atrial
tachyarrhythmia
37cc
Benefit Review, Detail Change
MC816
MC831
Endeavor Resolute Drug Eluting Coronary Stent System Cobalt Alloy, ABT - 578, BioLinx Polymer
Medtronic Lead Extender Kit Model: 6984M, 6981M, 6985M,6986m
Diameter:2.25mm-4.0mm; Length: 8.00mm-30.0mm
Silicone
Detail Change
37 - 50cm
MC832
Adaptor Kit Model 5866-24M, 5866-40M, 5866-37M, Bipolar Lead
Adaptor Kit Model 2872
Silicone
14cm
Size
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Ear, Nose & Throat
MC255
0.6cm x 20cm
Medtronic Xomed Australia Material Implantable Sterile - Gore
ePTFE - expanded polytetrafluroethyelene
Benefit Review, Detail Change
Thyroplasty
x 0.6mm
MC260
Middle Ear Prosthesis
Total Ossicular Reconstruction Implants
0.6 - 0.8mm x 3.0 - 4.0mm x 7.0 - 8.0mm
MC261
Universal Ossicular Reconstruction Implants - Titanium Malleus + Incus + Stapes
0.6 - 1.17mm x 0.3 - 4.0mm x 4.75 - 8.0mm
MC262
Partial Ossicular Reconstruction Implant
Malleus + Incus
0.4 - 1.17mm x 2.2 - 8.8mm x 3.5 - 10.0mm
MC263
Total Ossicular Reconstruction Implant
Malleus + Incus + Stapes
0.5 - 0.6mm x 3.5 - 6.0mm and One Size Only
MC264
Septal Button
Silicone
3cm
MC265
Silicone Blocks
Netterville Phonoform Block - Right, Left, Wedge & Strip
- One size only Benefit Review, Detail Change
& Strip - One size only
MC268
Medtronic Vent Tubes
Fluoroplastic
0.76 - 1.52mm x 2.1 - 9.5mm x 1.0 - 12.0mm
MC269
Medtronic Vent Tubes
Activent Antimicrobial Ventilation Tube
1.02 - 1.27mm x 0.9 - 2.4mm
MC270
Medtronic Vent Tubes
Antibacterial/Antimicrobial
1.27 x 2.9 x 1.3mm
MC271
Medtronic Vent Tubes
Stainless Steel
1.02 - 1.27mm, 1.58 - 2.7mm
MC272
Medtronic Vent Tubes
Titanium
1.02 - 1.52mm x 0.9 - 4.45mm
MC273
Medtronic Vent Tubes
Fluoroplastic
1.02 - 1.27mm x 1.3 - 3.0mm
MC276
Medtronic Vent Tubes
Silicone
0.76 - 1.27mm x 1.0 - 7.5mm
MC277
Medtronic Vent Tubes
Fluoroplastic, C-Flex
0.89 - 1.52mm x 2.3 - 12.0mm
MC278
Medtronic Vent Tubes
Silicone
0.76 - 1.27mm x 1.5 - 12.0mm
MC279
Medtronic Vent Tubes
Antimicrobial Ventilation Tube
1.02 - 1.27mm x 2.7 - 9.1mm
MC280
Medtronic Vent Tube
Antibacterial/Antimicrobial
1.02 - 1.52mm x 1.3 - 12.0mm
0.75cm x 40cm x 0.6mm; 0.4cm x 20cm x 0.6mm;
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Right - One size only, Left - One size only, Wedge
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
General/Miscellaneous
Changed Items for Prostheses List Report
Page 61 of 99
Billing Code Product Name
Further Description
MC353
Change
Paradigm Model MMT-722. 'Smart' Insulin Pump with REAL-Time
Medtronic MiniMed Insulin Infusion Pump
Size
Explanation of Change
Pump dimensions: 5.1 x 9.4 x 2.0cm
Detail
Pump Dimensions: 5.1 x 7.6 x 2.0cm
Detail
continuous glucose monitoring capability and with remote control
MC354
Change
Medtronic MiniMed Insulin Infusion Pump
Paradigm Model MMT-522. 'Smart' Insulin Pump with REAL-Time
continuous glucose monitoring capability and with remote control
Neurosurgical
MC294
MC299
MC307
MC308
MC309
MC346
MC377
MC384
MC394
MC418
MC419
MC432
MC433
MC434
MC456
MC457
MC462
MC504
MC546
MC584
Vertex Spinal System
Centerpiece
Vertex Spinal System
Centerpiece
Centerpiece
Venture Anterior Cervical Plate
Colorado Spinal System
Colorado 2
CD Horizon
Atlantis Anterior Cervical Plate
Atlantis Anterior Cervical Plate
Colorado Spinal System
Colorado Spinal System
Colorado Spinal System
Interfix
LordoTec Cage (LT-Cage)
Zephir
CD Horizon
Vertex Spinal System
CSF - Distal Catheters
MC608
MC609
MC645
TSRH
Connector
Small, Medium, Large
Detail Change
CD Horizon Spinal System
Percutaneous Set Screw
25 - 60mm
Detail Change
Strata Valve Unitised NSC (non siphon control) PSM range
Adjustable CSF valve with five symmetric performance level steps.
Includes a strata valve, pre-attached ventricular catheter, and a preattached peritoneal catheter. Right Angle Clip. Disposable Quick
Release Ventricular Catheter Introducer.
Changed Items for Prostheses List Report
Occipital Buttons
TiMesh LP
Occipital Buttons
TiMesh LP
TiMesh LP
Single or multi level plate, titanium alloy and Nitinol
Colorado 2 Clamp
Pedicle Screw
Set screw
Plate
Anterior Cervical Plate
Sacral Plate
Ilio-Sacral Plate
Connector for Sacral & Ilio-Sacral Plate
Titanium Cage
Titanium, PEEK
Cancellous Screw
Breakoff Set Screw
Set screw
Non metallic and latex free, Models
43418,43103,43111,43209,43522,43551,27211
Bolt 6 - 30 mm Length
Detail Change
Open Door (OD) Plate
Benefit Review
Nut 12mm Diameter
Detail Change
Open Door Graft (GP) Plate
Benefit Review
French Door (FD) Plate
Benefit Review
20mm - 50mm
Benefit Review
.
Detail Change
Diameter 5.5 - 7.5 Lengths 30 - 70mm
Detail Change
Each in one size
Detail Change
19.0mm - 47.5mm
Benefit Review
50mm - 55mm
Benefit Review, Detail Change
Left/right
Benefit Review, Detail Change
Left/right
Benefit Review, Detail Change
One size only
Detail Change
12 x 20mm - 24 x 50mm
Detail Change
18-28mm
Detail Change
13-17mm
Detail Change
25 - 55mm
Detail Change
One size only
Detail Change
Distal cardiac/peritoneal catheters ID 1.3mm OD 2.5mm Length Detail Change
90cm, 96cm, 110cm, 120cm, ID 1.2mm, OD 2.1mm, Length
90cm, 75cm, 58cm
8-120cm Detail Change
Page 62 of 99
Billing Code Product Name
Further Description
MC651
Delta Valve Assembly with Bioglide PSM range
CSF Flow Valves. Polypropylene and acetal plastic base. Silicone
elastomer dome. Assembly system includes the valve, integral
peritoneal catheter, female luer adapter and prefill tubing. Surface of
the valve bonded with hydrogel (Bioglide surface modification
90-120cm (0.5, 1.0, 1.5, 2.0)
MC654
MC657
MC667
MC674
MC706
MC821
MC822
MC823
Engage
Pyramid
SiLo
CD Horizon
Venture Anterior Cervical Plate
T2
CD Horizon
CD Horizon
Breakoff Set Screw
Pyramid Cover Plate and Set Screw
Set Screw
Legacy set Screw
Single or multi level plate, titanium alloy and Nitinol
End Cap
Legacy Multiaxial Iliac Screw
Legacy Fixed Iliac Screw
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review, Detail Change
Detail Change
Benefit Review
Benefit Review
Size
one size only
17mm - 35mm length in 2 mm increments
One Size only
one size only
52.5mm - 55mm
13-31 mm, 0, 4, 8, 15 degree lordosis
6.5mm to 8.5mm Diameter
6.5mm to 8.5mm Diameter
Explanation of Change
Detail Change
Orthopaedic
MC806
Infuse Bone Graft
Recombinant human bone morphogenetic protein rhBMP-2
Extra Small 1.4mg Detail Change
MC807
Infuse Bone Graft
Recombinant human bone morphogenetic protein rhBMP-2
Mini 0.7mg
Detail Change
MC808
Infuse Bone Graft
Recombinant human bone morphogenetic protein rhBMP-2
Small 4.2mg
Detail Change
Plastic and Reconstructive
MC387
TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Square Grid Mesh
Large
Benefit Review, Detail Change
MC389
TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Square Grid Mesh
Small
Benefit Review, Detail Change
MC393
TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Z Plate Left and Right
4 hole - 5mm, 9.5mm
Benefit Review, Detail Change
MC512
MC513
MC514
MC515
MC516
MC517
MC519
MC520
MC521
MC522
MC524
MC525
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
TiMesh
One size only
One size only
One size only
One size only
One size only
One size only
4 holes x 1mm - 4 holes x 2.2mm
4 holes x 1mm - 4 holes x 2.2mm
1mm - 2.2mm; Complex 1, Complex 2, Complex 3
1mm x 12 holes
One size only
11 x 7.5cm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Maxillary Prosthesis
Full Mandible
Mandibular Angle, Left/Right
Hemimandible, Left/Right
Mandibular Symphysis
Mandibular "J" Plate
Squareplate
X Plate
Naso-Orbital-Ethmoid
Curved Plate: Standard, Rigid, Left, Right
Isogrid Panel
Sugar Mesh Panel / Grid
Page 63 of 99
Billing Code Product Name
Size
Explanation of Change
MC526
MC527
MC528
MC547
MC548
MC550
MC551
MC553
MC554
MC559
MC560
MC562
MC563
MC564
MC565
MC566
MC567
MC568
MC570
MC571
MC574
MC576
MC580
MC581
MC582
MC620
Detail Change
TiMesh
Surgical Mesh: Anterior, Posterior, Modified
TiMesh
Lateral Mesh: Left, Right
TiMesh
Cranial Custom Mesh
Macropore
Z Plates
Macropore
Cranial Recon
Macropore
Rectangle Plates
Macropore
Protective Disc
Macropore
Oblong Plates
Macropore
CraniDisk
Macropore
L Plates
Macropore
Protective Sheets
Macropore
Y Plates
Macropore
Straight Plates
Macropore
Straight Plates
Macropore
Straight Plates
Macropore
C Plates
Macropore
Clover Leaf Plates
Macropore
Bur Hole Cover
Macropore
Tacks
Timesh
12 Point Screws
Timesh
X-Drive Screws
Timesh
Double Y Plates
Macropore
Locks
Invisx Locks
Invisx polymer cranial fixation system
Invisx Locks
Invisx polymer cranial fixation system
TiMesh Titanium Rigid Fixation Bone Grafting and Plating System
One size only
One size only
121mm x 72mm - 152 x 152mm
10 hole
29 - 165mm
4-8 hole
25mm
6 - 8 hole
23 - 28mm
8 hole, Left & Right
60 x 80 x 0.5mm - 60 x 80 x 1.0mm
7 hole
4 hole
8 hole
20 hole
8 hole
4 hole
25mm
1.5 x 4mm - 2.0 x 6mm
3 - 20mm
2 - 15mm
3 Hole - 2.5mm - 7mm
2 - 20mm
Single pack
2 pack
FlexMesh 1.5mm System
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
148mm x 148mm, 0.6mm
Benefit Review,
MC623
Detail Change
TiMesh Titanium Rigid Fixation Bone Grafting and Plating System
FlexMesh 2.2mm System. Composition: Titanium.
114mm x 82mm, 0.6mm
Benefit Review,
MC624
Detail Change
TiMesh Titanium Rigid Fixation Bone Grafting and Plating System
FlexMesh 2.2mm System. Composition: Titanium.
154mm x 154mm, 0.6mm
Benefit Review,
MC625
Modified Dual TiMesh
Review, Detail Change
MC626
MC627
MC628
MC629
Macropore FRP (fast resorbing polymer)
Macropore FRP (fast resorbing polymer)
Macropore FRP (fast resorbing polymer)
Macropore FRP (fast resorbing polymer)
Changed Items for Prostheses List Report
Further Description
TiMesh Surgical Mesh Modified, includes two cranial plates.
121mm x 77mm. 152mm x 152mm.
Composition: Titanium
Polylactide and Polyglycolide polymer
Polylactide and Polyglycolide polymer
Polylactide and Polyglycolide polymer
Polylactide and Polyglycolide polymer
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.8mm x 3-8mm
100mm x 100mm x 0.75mm
60mm x 80mm x 0.75mm
50mm x 50mm 0.75mm
Benefit
Page 64 of 99
Billing Code Product Name
MC630
MC631
MC678
Further Description
Macropore FRP (fast resorbing polymer)
Polylactide and Polyglycolide polymer
Macropore FRP (fast resorbing polymer) screw
Polylactide and Polyglycolide polymer
TiMesh Rigid Fixation Bone Grafting and Plating System Titanium, Universal Plate
Size
Explanation of Change
25mm x 25mm x 0.75mm
2.1mm x 3-8mm
12h
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Vascular
MC160
MC203
Talent lliac Extension Graft
Talent Occluder System
Talent Endoluminal Stent Graft - lliac Extension
8 - 26mm x 60 - 200mm
Nitinol stents attached to polyester graft sealed both ends Standard Sizes, 8 - 24mm x 31 - 35mm
Detail Change
Detail Change
MC206
Talent Thoracic Stent Graft
Talent Endoluminal Stent Graft - Thoracic Stent Graft System
22 - 46mm x 130mm
MC328
MC743
MC744
MC747
MC748
MC760
Racer Renal Stent System
Complete SE Stent
Complete SE Stent
Valiant Endovascular Stent Graft
Valiant Endovasculat Stent Graft
Complete SE Stent
Cobalt Alloy
Nitinol
Nitinol
Nitinol and polyester system
Nitinol and polyester system
Nitinol
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Diameter: 4-7mm; Lengths: 12 &18mm
20mm - 80mm
100mm - 120mm
22-46mm diameter, 110mm length
22-46mm diameter, 150mm length
150mm
Detail Change
Mentor Medical Systems
Plastic and Reconstructive
MN003
Terino Malar Shell Implants
MN020
Implantech Facial Implants - Chin Prostheses
Benefit Review, Detail Change
Solid-silicone, Implantech
Small, medium, large, xlarge
Implantech Anatomical Chin;Flowers Mandibular Glove;Terino
Benefit Review, Detail Change
Extra small, Small, Medium, Large, Extra Large
Extended Anatomical Chin;Terino Square Chin Style I;Mittleman
Pre-Jowl;Glasgold Wafer for Pre-Jowl Chin;Mittleman Pre-Jowl
Chin;Glasgold Wafer for Extended Anatomical Chin;Silicone
Chin;Terino Squ
MN021
Implantech Facial Implants - Nasal Prostheses
Benefit Review, Detail Change
Implantech Shirakabe Nasal Implant; Implantech Flowers Dorsal
Extra Small, Small, Medium, Large, Extra Large
Nasal Implant; Implantech Dorsal Columella Implant; Implantech
Brink Peri-Pyriform Implant; Implantech Rizzo Dorsal Nasal
Implant; Composition: Implant Grade Silicone Elastomer
Mondeal Medical Systems Pty Ltd
Plastic and Reconstructive
MD002
MD004
MD005
MD007
Detail Change
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Plate
Straight 2-6 hole
Benefit Review, Detail Change
Plate
Straight 8 hole
Benefit Review, Detail Change
Plate
Straight 16 hole
Benefit Review, Detail Change
Plate
L Shape Right & Left
Benefit Review,
Reconstruction System
Changed Items for Prostheses List Report
Page 65 of 99
Billing Code Product Name
Further Description
MD008
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD009
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD011
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD015
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD019
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Review, Detail Change
Reconstruction System
MD021
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD022
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD024
Mondeal Medical Systems Implant & Prostheses, Mini 2000
Reconstruction System
MD029
Mondeal Medical Systems Implant & Prostheses
Screw 2000
MD035
Mondeal Medical Systems Implant & Prostheses
Screw 2000
MD038
Mondeal Medical Systems Implant & Prostheses, Mini 1700
Reconstruction System
MD041
Mondeal Medical Systems Implant & Prostheses, Mini 1700
Detail Change
Reconstruction System
MD042
Mondeal Medical Systems Implant & Prostheses, Mini 1700
Reconstruction System
MD043
Mondeal Medical Systems Implant & Prostheses, Mini 1700
Reconstruction System
MD047
Mondeal Medical Systems Implant & Prostheses, Mini 1700
Detail Change
Reconstruction System
MD051
Mondeal Medical Systems Implant & Prostheses
Screw 1700
MD058
Mondeal Medical Systems Implant & Prostheses, Micro 1200
Reconstruction System
MD059
Mondeal Medical Systems Implant & Prostheses, Micro 1200
Reconstruction System
MD062
Mondeal Medical Systems Implant & Prostheses, Micro 1200
Reconstruction System
MD066
Mondeal Medical Systems Implant & Prostheses
Screw 1000/1200
MD070
Mondeal Medical Systems Implant & Prostheses
Mesh
MD071
Mondeal Medical Systems Implant & Prostheses
Mesh
MD072
Mondeal Medical Systems Implant & Prostheses
Mesh
MD104
Mondeal Medical Systems Implant & Prostheses
Chin Plate
Size
Explanation of Change
Plate
T Shape Benefit Review, Detail Change
Plate
Y Shape Benefit Review, Detail Change
Plate
T Shape Benefit Review, Detail Change
Plate
Straight 4-6 hole
Plate
Straight 8 hole & L Shape - Right & Left Benefit
Plate
T Shape Benefit Review, Detail Change
Plate
Y Shape Benefit Review, Detail Change
Plate
T, Y, Orbital Shape Benefit Review, Detail Change
Standard 4mm - 19mm
Cross Fit, Lock Drive 4mm - 19mm
Plate
Benefit Review, Detail Change
Benefit Review, Detail Change
Straight 4 - 6 hole Benefit Review, Detail Change
Plate
Straight 16 hole, Y Shape
Plate
Orbital Shape
Benefit Review, Detail Change
Plate
T, Y, Z Shape
Benefit Review, Detail Change
Plate
L Shape Right & Left
Cross Fit, Lock Drive 3mm - 17mm
Plate
Benefit Review, Detail Change
L, T Shape
Benefit Review, Detail Change
Plate
L, Y Shape
Plate
H Shape Benefit Review, Detail Change
Cross Fit, Lock Drive 3mm - 15mm
Micro 50 x 30mm
Micro 100 x 60mm
Micro 100 x 30mm, 50 x 60mm
4mm - 12mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review,
Benefit Review,
Benefit Review, Detail Change
Morton Surgical Pty Ltd t/a Matrix Surgical Company
Changed Items for Prostheses List Report
Page 66 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Ear, Nose & Throat
MG003
Micromedics Ventilation Tubes
Micromedics;Shepard;1.0mm / 1.14mm lumen;Fluroplastic /
Silicone;w.tab / w.wire;box of 6 / box of 50
Benefit Review, Detail Change
MG011
Micromedics Ventilation Tubes
MG012
Micromedics Ventilation Tubes
MG013
Micromedics Ventilation Tubes
Micromedics; Donaldson; 1.14mm lumen; Silicone / Fluroplastic; Benefit Review, Detail Change
w.tab; box of 6 / box 50
Micromedics; Paparella-I / Paparella-II; 1.14mm / 1.42mm lumen; Benefit Review, Detail Change
Silicone; box of 6 / box of 50
Micromedics; T-tubes; (12x10)/(5x8)/(5x4)/(8x5.5); 1.14mm /
Benefit Review, Detail Change
1.27mm / 1.4mm lumen ; silicone; box of 6 / box of 50;
MG014
Micromedics Ventilation Tubes
Micromedics; Armstrong; bevelled straight / grommit / w.wire; Benefit Review, Detail Change
7mm / 7.5mm / 1.14mm; silicone / fluroplastic; box of 6 / box of 50
MG015
Micromedics Ventilation Tubes
MG016
Micromedics Ventilation Tubes
MG017
Micromedics Ventilation Tubes
Micromedics; Collar Button; 1.27mm lumen; fluroplastic; box of 6 /
Benefit Review, Detail Change
box of 50
Micromedics;Reuter Bobbin;1.0mm / 1.14mm lumen; fluroplastic; Benefit Review, Detail Change
box of 6 / box of 50
Micromedics; Shah with wire; mini 0.76mm lumen; fluroplastic; Benefit Review, Detail Change
box of 6 / box of 50
General/Miscellaneous
MG001
MG004
MG005
MG006
MG007
MG008
MG009
MG010
MG019
MG020
MG021
MG022
Aspide Surgimesh
Aspide Surgimesh
Aspide Surgimesh
Aspide Surgimesh
Aspide Surgimesh
Aspide Surgimesh
Aspide Surgimesh
Aspide Surgimesh
Surgimesh XB non-adherent
Surgimesh XB non-adherent
Surgimesh XB non-adherent
Surgimesh XB non-adherent
Monofilament polypropylene
Monofilament polypropylene
Monofilament polypropylene
Monofilament polypropylene
Monofilament polypropylene
Monofilament polypropylene
Monofilament polypropylene
Monofilament polypropylene
Intra-abdominal implant biface
Intra-abdominal implant biface
Intra-abdominal implant biface
Intra-abdominal implant biface
6x11cm thread 0.14mm
8 x 12cm Thread 0.14mm
10 x 13cm Thread 0.14mm
10 x 15cm Thread 0.14mm
15 x 15cm Thread 0.14mm
Easyplug Large
Easyplug Medium
Easyplug Small
Tintra S 14x15cm
Tintra R 12.5cm, 15cm
Tintra M 22x15x10cm
Tintra L 30x30x20cm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Haemostatic Ligating Clips
Haemostatic Ligating Clips
Titanium Ligating Clips
Titanium Ligating Clips
Small - Large (6 Clips per cartridge)
Small, medium (24 clips per pouch)
Detail Change
Detail Change
Vascular
MG030
MG031
N Stenning & Co Pty Ltd
Neurosurgical
Changed Items for Prostheses List Report
Page 67 of 99
Billing Code Product Name
Further Description
NG053
Leo Plus Self-Expanding Intracranial Stent
18 mm, 25 mm, Benefit Review
The Leo Plus is a Self-Expanding Intracranial Stent constructed
Size
Explanation of Change
D 2.5 L 12 mm, 18 mm, 25 mm. D 3.5 L 12 mm,
from braided Nitinol wire. The Leo Plus is pre loaded onto its on
35 mm, D 4.5 L 15 mm, 20 mm, 25 mm, 30 mm, 40 mm, 50 mm.
quidewire an introducer.
D 5.5 L 25 mm, 30 mm, 35 mm, 50 mm, 75 mm.
Neoss Australia Pty Ltd
Plastic and Reconstructive
NJ001
Neoss Implant System
Titanium Dental Implant
NJ003
NJ004
NJ009
Neoss Titanium Abutment
Neoss Gold Abutment
Neoss Implant
Neoss Abutment Titanium
Neoss Abutment Gold
Healing Abutment with Screw
Diameters 3.5, 4.0, 4.5, 5.0 & 5.5mm in Lengths: 7, 9, 11, 13, 15, Benefit Review, Detail Change
17mm
Universal
Benefit Review, Detail Change
Universal
Benefit Review, Detail Change
universal
Benefit Review
Nobel Biocare
Plastic and Reconstructive
NR001
NR002
NR003
NR004
NR006
NR007
NR009
Detail Change
Nobel Biocare Abutments
Nobel Biocare Cover Screws
Branemark Fixtures
Healing Abutment Complete
Branemark Novum System
Branemark Titanium Fixture
NobelDirect Implant
Abutment, complete
3.5, 3.6, 4.0, 4.5, 5.0, 5.3, 6.0, 7.0mm Diameter
Cover screw
NP, RP, WP, 6.0mm
Titanium Fixture
3, 4, 5mm
Abutment Coping
One Size Only
Titanium - Kit Fixture System
One size only
Zygomaticus Fixture
30, 35, 42.5, 40, 45, 47.5, 50, 52.5mm Length
Dental Implant Endosseous incorporating abutment, Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
10mm, 13mm, 16mm
Benefit Review,
NR010
Replace Implant
Dental Implant Endosseous, Titanium
NR011
NobelPerfect Implant
Dental Implant Edosseous, Titanium
NR012
Groovy Implants (NobelReplace Straight Groovy, NobelReplace
Benefit Review, Detail Change
Tapered Groovy, NobelSpeedy Replace, Branemark System Mk III
Groovy, NobelSpeedy Groovy)
10mm, 13mm, 16mm
10mm, 13mm, 16mm
Dental Implants, endosseous
Benefit Review, Detail Change
Benefit Review, Detail Change
Diameter 3.5 - 6.0mm; Length 8.0 - 18.0mm
NR013
Dental implants, endosseous
Diameter 3.5 - 5.0mm; Length 8.5 - 18.0mm
Benefit Review, Detail Change
Cannulated Lock Screw
Cannulated
Bone Screw
Titanium Anterior Plate
one size
3.5 - 4.5mm diameter20-70mm length
4.0 - 4.7mm diameter10 - 20mm length
11 - 110mm
Detail Change
Detail Change
Detail Change
Benefit Review
NobelActive implants
Nuvasive Australia and NZ Pty Ltd
Neurosurgical
NV002
NV005
NV007
NV008
SpheRx
Triad Facet Screw
Gradient Cervical Plates
Gradient Cervical Plates
O R Paradigm Pty Ltd
Ear, Nose & Throat
Changed Items for Prostheses List Report
Page 68 of 99
Billing Code Product Name
Further Description
OS001
8.0mm; Distal
Adjustable Length Titanium Ossicular Chain Reconstruction
ALTO Prosthesis
Benefit Review, Detail Change
Prosthesis
Size
Explanation of Change
Head Size 2.5mm x 3.5mm; Length 2.0mm -
Diameter 0.8mm - 1.2mm
Oncura Pty Limited
General/Miscellaneous
ON003
RAPID Strand Rx Kit
Pre-loaded, variable per patient prescription version of RAPID Strand
Custom size up to 100 seeds
Detail Change
NM003
R Stent Evolution 2 Coronary Delivery System
Detail Change
316LVM Stainless Steel Balloon Expandable Stent (Tubular)
Lengths - 9-33mm; Diameters - 2.5-4.0mm
NM004
Blazer Coronary Stent Delivery System
Length 9 to 33mm
L605 Cobalt Chromium alloy balloon expandable vascular prosthesis
Detail Change
Expanded Stent Diameter 2.5 to 4.0mm, Stent
Titanium
7 - 12
Unique low profile stainless steel locking screw for use with NexFix
Benefit Review, Detail Change
3.2mm x 12mm, 14mm, 16mm, 18mm, 20mm
OrbusNeich Medical Pty Ltd
Cardio-thoracic
Orthopaedic Solutions Pty Ltd
Orthopaedic
OE005
Futura Conical Subtalar Implant
OE007
NexFix MTP Fusion System
Benefit Review
MTP Fusion plates, indicated for use in osteoporotic bone
OE008
NexFix MTP Fusion System
A bendable stainless steel bone plate and screw system with unique
low profile locking screw option. Indicated for use in primary MTP
fusion
Left 2 + 3; Right 2 + 3
Benefit Review
OE009
NexFix MTP Fusion System
Left: 2+3; Right: 2+3
Detail Change
OE010
24mm, 28mm
NexFix MTP Fusion System
Detail Change
A bendable stainless steel bone plate and screw system with unique
low profile locking screw option. Indicated for use in primary and
revision MTP fusion
Unique low profile stainless steel locking screw for use with NexFix
2.7mm x 12mm, 14mm, 16mm, 18mm, 20mm,
MTP Fusion plates, indicated for use in normal bone
Orthotech Pty Ltd
Neurosurgical
OH035
OH043
OH048
OH050
OH054
OH063
OH131
OH166
Synergy/Polaris Spinal System
Synergy Spinal System
Synergy/Polaris Spinal System
Synergy/Polaris Spinal System
Interpore Bone Plate System
Anterior Cervical Plate System
Anterior Cervical Cage
Mendec Spine
Changed Items for Prostheses List Report
Sliders
Point/Double Hex Set Screw
Variable Locking Screw Seat
Variable Locking Screw Reduction Seat
TPS Locked Nut
Titanium Locking Plate
Peek
Bone Cement
4.75 - 6.35mm dia
4.75 - 6.35mm
5.5-6.35mm
4.75-6.35mm
3mm
20 - 140mm
12 x 15, 12 x 17, 14 x 17, 14 x 19
Cement
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review
Detail Change
Detail Change
Page 69 of 99
Billing Code Product Name
Further Description
OH171
OH195
OH196
OH204
OH211
Mendec Spine
Array/Ballista Spinal System
Array/Ballista Spinal System
Altius Occipito-Cervico-Thoracic (OCT) System
Array/Ballista Spinal System
Bone Cement
Cement Kit
Titanium Alloy Modular Spinal System - Pre-Bent Rod 5.5mm x 30 - 100mm
Titanium Alloy Modular Spinal System - set screws
one size
Locking and CAP Nuts
one size only
Titanium Alloy Modular Spinal System - multiaxial screw5.5 - 7.5mm x 30 - 55mm
OH240
OH254
Vuelock (Anterior Cervical Plate)
Intext Cervical Plate/Intext Screws
Vuelock (Anterior Cervical Plate)
Intext cervical plate, including (2-part) fixation screws
OH263
Intext Cervical Plate/Intext Screws
Intext cervical plate, including (2 - part) fixation screws
OH305
ADD / ADDplus
Detail Change
Size
Explanation of Change
Benefit Review, Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Level 1-4, 12mm - 92mm
Benefit Review
Screws/Revision Screws - dia 4.4mm, length 11 - 18mm - Pack of 3
Detail Change
Plates - width 13mm, Height 4mm - 9mm, width 17mm, height
Benefit Review
4mm - 9mm
Osmium Screw including bolt, titanium. The osmium screw is a
length = 14, 16, 18mm with outer diameter of 5mm
two-component system consisting of a screw and a bolt. Expansion
of the screw is achieved by inserting the bolt. Hyper-expansion of
the screw is not possible.
OH309
OH310
OH351
Cosmic implant system
Cosmic implant system
Novel set screw
Cosmic Locking Screw - titanium
Cosmic Cap - titanium
Set screw
one size
one size
4-10mm
Detail Change
Detail Change
Detail Change
Titanium, complex neck segment
Spacer
Acetabular reconstruction shell
Modular neck
32 - 49mm, -5 - +30mm
S-M-L
50 - 58mm
1-6
Detail Change
Detail Change
Detail Change
Detail Change
Polyester Fibre optic catheter
Polyester Fibre optic fibre catheter
Tubular Stent, Stainless steel 316L, Gold markers
2.5 and 2.2mm
0.457mm, 0.9mm, 1.4mm, 1.7mm and 2.0mm
Dia 5 - 9mm length: 20 - 100mm
Detail Change
Detail Change
Detail Change
Orthopaedic
OH061
OH110
OH112
OH349
Exactech M Series body
Lima Total Hip Replacement System
Lima Bilobo Hemisphere bone revision shell
H-Max Femoral neck
Pacing Importers Pty Ltd - Life Systems
Cardio-thoracic
PI001
PI002
PI003
Excimer Laser Stent
Excimer Laser Stent
Med-X-Flexy Stent
Ear, Nose & Throat
PI005
PI006
PI007
(one size only)
Combi C40+ Implantable Auditory Stimulator
Tempo+ Auditory Implant Speech Processor
Duet EAS Hearing System
Benefit Review, Detail Change
PI009
OPUS 2 Speech Processor
Changed Items for Prostheses List Report
Cochlear Implant
One Size Only
Tempo+ Auditory Implant Speech Processor
One Size Only
Cochlear implant speech processor and accoustic hearing aid
Benefit Review, Detail Change
Benefit Review, Detail Change
Length 53.5mm, width 8.5mm, Height 58.4mm
combined in one device
Cochlear implant speech processor, fine structure speech 54.0mm x 35.1mm x 8.7mm
processing, remote control, interface for assistive listening devices
according to the international hearing aid standard (initial patient kit)
Benefit Review, Detail Change
Page 70 of 99
Billing Code Product Name
Further Description
PI010
Cochlear implant speech processor, fine structure speech 54.0mm x 35.1mm x 8.7mm
processing, remote control, interface for assistive listening devices
according to the international hearing aid standard (replacement kit)
Opus 2 Speech Processor Replacement
Size
Explanation of Change
Benefit Review, Detail Change
PI011
Sonata Ti 100 Cochlear Implant
stimulator 24.8mm,
Cochlear implant, titanium casing, 24 independent current sources,
45.7mm length, width at coil 29.0mm, width at
Benefit Review, Detail Change
sequential and parallel stimulation modes up to 50,074 pulses per
thickness at coil 3.7mm, thickness at stiulator 5.9mm. Standard
sec, 19 or 24 oval-shaped platinium electrodes, different sizes
Electrode - length 31.5mm, spacing 2.4mm; Medium - length:
20.9mm, Spacing 1.9mm; Compressed (short) - length 12.1mm,
Electro
PI012
PULSAR CI 100
Benefit Review, Detail Change
Cochlear implant, ceramic casing, 24 independent current sources,
Length: 31.5mm, Electrode Spacing: 2.4mm
sequential and parallel stimulation modes up to 50,074 pulses per
sec, 24 oval-shaped platinium electrodes. Stimulator with standard
length electrode array (contact extent 26.4mm)
PI013
PULSAR CI 100
Benefit Review, Detail Change
Cochlear implant, ceramic casing, 24 independent current sources,
Length: 20.9mm, Electrode Spacing: 1.9mm
sequential and parallel stimulation modes up to 50,074 pulses per
sec, 24 oval-shaped platinium electrodes. Stimulator with medium
length electrode array (contact extent 20.9mm)
PI014
PULSAR CI 100
Benefit Review, Detail Change
Cochlear implant, ceramic casing, 24 independent current sources,
Length: 12.1mm, Electrode Spacing: 1.1mm
sequential and parallel stimulation modes up to 50,074 pulses per
sec, 24 oval-shaped platinium electrodes. Stimulator with short
length electrode array (contact extent 12.1mm)
PI015
1.1mm
PULSAR CI 100
Benefit Review, Detail Change
Cochlear implant, ceramic casing, 24 independent current sources,
Length: 4.4mm & 6.6mm, Electrode Spacing
sequential and parallel stimulation modes up to 50,074 pulses per
sec, 24 oval-shaped platinium electrodes. Stimulator with double
electrode array (contact extent 4.4mm and 6.6mm)
PI016
PULSAR CI 100
Benefit Review, Detail Change
Cochlear implant, ceramic casing, 24 independent current sources,
Length: 26.4mm, Electrode Spacing: 2.4mm
sequential and parallel stimulation modes up to 50,074 pulses per
sec, 19 oval-shaped platinium electrodes. Stimulator with standard
length electrode array (contact extent 26.4mm) with incr
PI017
PULSAR CI 100
Benefit Review, Detail Change
Cochlear implant, ceramic casing, 24 independent current sources,
Length: 20.9mm, Electrode Spacing: 1.9mm
sequential and parallel stimulation modes up to 50,074 pulses per
sec,19 oval-shaped platinium electrodes. Stimulator with medium
length electrode array (contact extent 20.9mm) with increas
Pharmacia Australia Pty Ltd (Pfizer Australia Pty Ltd)
General/Miscellaneous
PU056
100 - 80mm x
Gelfoam Sterile Sponge
Detail Change
Sterile, pliable, nonantigenic surgical sponge prepared from specially
Size 12 - 20mm x 60mm x 7mm, packet of 4; Size
treated purified gelatin solution
125mm x 10mm in individual packet
Portland Orthopaedics (Aust) Pty Ltd
Orthopaedic
Changed Items for Prostheses List Report
Page 71 of 99
Billing Code Product Name
Further Description
Size
PD005
Femoral Modular Neck
Y, Z, AZ, A, B, C, BA, CA, CB, B+4, C+6, CB+6; 31mm to 52mm
lateral offset; 23mm to 35mm vertical height
Margron DTC Hip Replacement
PD022
M-COR Femoral Neck
vertical height, 3
Explanation of Change
Detail Change
Titanium Neck for M-COR System with lateral extension for stem
Detail Change
connection. Contains threaded sealing plug.
lengths
31mm to 47mm lateral offset, 23mm to 33mm
Monoaxial Screw
Polyaxial Screw
Nut
Clamp
Plate
Screw
Anterior cervical plate - titanium
Straddler - titanium alloy
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review
Detail Change
Benefit Review
Detail Change
Scient'x Australia
Neurosurgical
SX001
SX002
SX004
SX005
SX008
SX009
SX011
SX016
Isobar TTL
Isobar TTL
Isobar TTL
Isobar TTL
Antelys
Antelys
Stella
Easys
D: 4.5 - 8mm, L: 25 - 50mm
D: 4.5 - 8mm, L: 30 - 55mm
Blocker, Hemispherical
Snap-on, Short, Long and Monobloc
H: 19-23mm
D: 5mm, L: 32.5 to 50mm
L: 21-121mm
one size
Sherwood Davis & Geck
General/Miscellaneous
SG002
Dexon Mesh Danbury 7979-00
Beige polyglycolic acid absorbable surgical mesh fabric 18 x 23cm
Benefit Review, Detail Change
Smith & Nephew Surgical Pty Ltd
Orthopaedic
SM047
SN263
SN264
SN359
SN693
SN703
SN741
SN888
Toefit - Plus
Buck
Buck
Invis
Hip Component
Absorbable Suture Anchor
Birmingham Modular Femoral Head
PROMOS Reverse Modular Shoulder System
Chromium Cobalt
Cement Restrictor
IM Prep Kit
Distal Centraliser PMMA
Femoral or acetabular custom component
Preloaded PLLA Suture Anchor
Cobalt Chrome
PE Insert - UHMWPE
SN893
SN894
SN898
Promos Reverse Modular Shoulder System
Anthology HAC
MDF Revision System
Body
36/mm, 36/10mm, 36/15mm, 42/5, 42/10mm, 42/15mm Detail Change
Femoral Stem - Titanium grit blasted HA coated
01-18 90mm-122mm
Detail Change
Modular Neck - CoCr highly polished trapezoidal for MDF
24mm - 36.5mm
stem/MIS stem multiple options of version height and neck length
Changed Items for Prostheses List Report
Proximal Insert 6, 7, 8
Detail Change
18.5 - 35mm
Detail Change
One size only
Detail Change
7 - 21mm
Detail Change
Size 0 - 20
Detail Change
2.9mm, 5.0mm & 6.5mm
Detail Change
38 - 58mm
Detail Change
36/6mm, 36/9mm, 36/12mm, 42/6mm, 42/9mm, 42/12mm
Detail Change
Detail Change
Page 72 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Sorin Group
Cardio-thoracic
SA136
SA137
SA138
SA139
SA140
SA141
6.1mm
Symphony DR 2550
Symphony SR
OVATIO CRT-D 6750
OVATIO VR 6250
OVATIO DR 6550
REPLY TM DR
Detail Change
Active Implantable pacemaker
1 size only
Titanium
one size only
Titanium, dual chamber ICD with CRT
30cc
Titanium, single chamber, sterile, VR 6250, 34J
29cc
Titanium dual chamber ICD, 29 cc
29cc
Dual Chamber permanent Pacemaker with Rate Response Modulation
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
8cc, Weight: 20grams, Dimensions:41.2 x 41.5 x
Peg & Sleeve
Detail Change
Spectrum Surgical
Ophthalmic
SO019
FCI Orbital Implants
Standard Large
St. Jude Medical Australia Pty Ltd
Cardio-thoracic
SJ011
Atlas DR Model V-240
SJ012
Atlas VR Model V-199
37cc
Detail Change
36cc
Detail Change
SJ023
Single chamber implantable cardioverter defibrillator with rate
response
Riata Transvenous Tachyarrhythmia Lead Model 1570, Model 1571
Quadripolar, dual-coil, steroid eluting, active fixation
tachyarrhythmia leads
TENDRIL SDX 1488T, 1388T
Single, Active Fixation, Steroid Eluting, Low Polarisation Lead, IS-1
SJ024
PASSIVE PLUS DX 1342T, 1343K, 1345K, 1346T
46-58cm Detail Change
SJ027
St Jude Medical Microny II SR+ Model 2525T Pacemaker
SJ016
Dual chamber implantable cardioverter defibrillator with rate response
Single, passive fixation, steroid eluting, low polarisation lead;
Models: Bipolar Atrial Lead, IS-1 Unipolar Atrial Lead, IS-1 Unipolar
Ventricular Lead, IS-1 or Bipolar Ventricular Lead, IS-1
One size only
Detail Change
46cm-58cm
Detail Change
Single Chamber Rate Responsive Pacemaker
Volume 5.9cc, Weight 12.8gm Detail Change
SJ033
Aescula LV Model 1055K
Left Ventricular Pacing Lead
SJ038
St Jude Medical Toronto SPV Valve Model SPA-101, St Jude
Bioimplant Mitral:
Detail Change
Medical Bioimplant Heart Valve
SJ048
Epic Plus VR Model V-196 Implantable Cardioverter Defibrillator
75cm
Tissue Heart Valves, Bioimplant
Detail Change
TSPV: 21 - 29mm, Bioimplant Aortic: 21-27mm,
27-32mm
Single Chamber sensing and bradycardia pacing
32cc
SJ049
Dual Chamber sensing, bradycardia pacing with atrial fibrillation
33cc
Dual Chamber multi-programmable rate-adaptive pacing devices
11cc, 23.5g
SJ050
SJ051
Detail Change
Epic Plus DR Model V-236 Implantable Cardioverter Defibrillator
suppression
Verity ADx Model XL DC 5256 Dual - Chamber pacemaker
with extended longevity
Verity Adx Implantable Pacemaker, Models XL DR 5356 and XL
DR 5357M/S
Changed Items for Prostheses List Report
Detail Change
Detail Change
Detail Change
Dual - Chamber, multi-programmable, rate-responsive pacemaker 45x52x6mm,11cc, 23g, 5mm or 6mm M/S
withAF suppression
Page 73 of 99
Billing Code Product Name
Further Description
SJ053
Verity Adx Model XL SC 5056 implantable pacemaker
10.5cc, 23g
SJ054
Identity ADx Model VDR 5480 implantable pacemaker
SJ055
Integrity ADx Model SR 5160 implantable pacemaker
Single Chamber multi-programmable rate-adaptive pacing device
with extended longevity
Single Chamber multi-programmable rate-adaptive pacing device
with extended longevity
Single Chamber multi-programmable rate-adaptive pacing device
SJ056
11cc, 23.5g
Integrity ADx Model DR 5360 and XL DR 5366
Detail Change
Dual-Chamber, multi-programmable, rate-responsive pacemaker
Model DR 5360 - 8cc, 18g, Model XL DR 5366 -
SJ057
SJ059
DR 5386:
SJ060
Size
with AF suppression
Verity ADx Model XL VDR 5456 implantable pacemaker Single Chamber multi-programmable rate-adaptive pacing device
with extended longevity
Identity ADx Models DR 5380 and XL DR 5386
Dual-Chamber, multi-programmable, rate-adaptive pacing devices
Detail Change
with AF suppression
44x52x6mm, 23.5g and 11cc
Identity ADx Model SR 5180 implantable pacemaker
Single Chamber multi-programmable rate-adaptive pacing device
Explanation of Change
Detail Change
8cc, 18g Detail Change
8cc, 17g Detail Change
11cc, 23.5g
Detail Change
ADx DR 5380: 43x44x6mm, 18g and 8ccADx XL
8cc, 18g Detail Change
SJ061
Identity Adx Model XL DC 5286 Dual Chamber Pacemaker
Identity ADx Model XL DC Model 5286 is an implantable, multi- 11cc, 23.5g
programmable rate-adaptive pacing device with AF suppression
SJ062
Epic HF Model V-339 Implantable Cardiac Defibrillator Cardioverter/defibrillator with dual chamber (atrial and RV) sensing
and bradycardia pacing with ventricular resynchronisation
SJ063
SJ064
Atlas DR Model V-242 ICD
Implantable Dual Chamber Cardio-verter Defibrillator
38cc/78g
Detail Change
Atlas + HF Model V - 341 ICD - Defibrillator, Implantable,
Atlas + HF ICD is a cardioverter defibrillator with dual chamber 40cc/81g Detail Change
automatic, dual-chamber
(atrial and RV) sensing and bradycardia Pacing with ventricular
resynchronisation therapy.
SJ065
SJ066
SJ067
Atlas + VR Model V-193 ICD
Atlas + VR - C Model V-193C ICD
Epic + HF Model V-350 ICD
Single chamber implantable cardio-verter defibrillator
38cc, 77g
Single chamber implantable cardio-verter defibrillator
38cc, 77g
Epic + HF V-350 ICD is a cardioverter defibrillator with dual
chamber (atrial and RV) sensing and bradycardia pacing with
ventricular resynchronisation therapy.
One size only
Detail Change
Detail Change
36cc / 73g
Detail Change
Detail Change
Detail Change
SJ068
Atlas + DR Model V-243 ICD
SJ069
St Jude Medical Biocor Porcine Prosthetic Heart Valve
21-29mm, Implant
Implantable Dual Chamber Cardio-verter Defibrillator
38cc, 78g
Detail Change
St Jude Medical Biocor Porcine Prosthetic Heart Valve is
Aortic Valves - Tissue Annulus Diameter Detail Change
manufactured from selected procine aortic valve cusps that have
Height - 11-15c; Mitral Valves - Tissue Annulus Diameter - 25been cross-linked with a glutaraldehyde solution
35mm, Implant Height - 8-10mm
SJ070
SJ071
SJ072
Epic + DR Model V-233 ICD
Epic + DR Model V-239 ICD
Frontier II - Model 5596
SJ073
Tendril SDX Models 1688T and 1688TC
Dual Chamber Implantable Cardio-verter Defibrillator
Dual chamber implantable cardio-verter defibrillator
Biventricular Cardiac Resynchronisation Device with AF
suppression algorithm - Titanum
Endocardial Steroid-Eluting Active Fixation Pacing Lead
SJ074
Riata Transvenous tachyarrhythmia Leads Model 1582
Changed Items for Prostheses List Report
33cc 70g
33cc 70g
49mm(h) x 52(1) x 6(t), 25g
Detail Change
Detail Change
Detail Change
100cm, 25cm, 34cm, 40cm, 46cm, 52cm, 58cm, 85cm, 7F Detail Change
Tri-polar Active - Fixation, Steroid-Eluting, Single shock Coil
Tachyarrhythmia; Lead
60cm, 65cm, 8F introducer
Detail Change
Page 74 of 99
Billing Code Product Name
SJ075
SJ076
SJ077
SJ078
Detail Change
Further Description
Size
Explanation of Change
Riata Transvenous Tachyarrhythmia Lead Model 1580, Model 1581
Quadripolar, dual-coil, steroid eluting, active fixation
One size only
Detail Change
tachyarrhythmia leads
Verity Adx Model XL SR 5157 M/S implantable pacemaker
Single Chamber multi-programmable rate-adaptive pacing devices
11cc, 23g Detail Change
with extended longevity
Verity Adx Models XL SR 5156 implantable pacemaker Single Chamber multi-programmable rate-adaptive pacing devices
11cc, 23g
Detail Change
with extended longevity
IsoFlex S, Models 1645K, 1643K, 1635K
Endocardial, Steroid Eluting, Silicone, Passive Fixation Leads with
34cm, 40cm, 46cm, 52cm, 58cm, 85cm, 7F
Fast-Pass Coating
Unipolar, Steroid Eluting, Titanium Nitride Electrode,
75cm, 6F and 86cm, 6F
Guidewire/Stylet-placed Left Heart Lead with Fast-Pass Coating
SJ079
QuickSite Model 1056K
SJ081
introducer
Riata i Transvenous Tachyarrhythmia Leads Model 1590/1591
Active fixation leads, Steroid Eluting, Dual Shock Coil Defibrillation
60cm, 65cm, 75cm, 8F
Detail Change
Lead
Isoflex S, Models 1646T, 1642T and 1636T
endocardial, Steroid Eluting, Silicone, Passive Fixation Pacing Leads
34cm, 40cm, 46cm, 52cm, 58cm, 85cm, 7F, 120cm
Detail Change
with Fast-Pass Coating
Riata Transvenous Tachyarrhythmia Lead Model 1572 Tri-polar Passive-Fixation, Steroid Eluting, Single Shock Coil
60cm, 65cm, 8F introducer
Detail Change
Tachyarrhythmia Lead
Riata i Transvenous Tachyarrhythmia Lead Model 1592 Active Fixation, Steroid Eluting, Single Shock Coil Defibrillation Lead
60cm, 65cm, 75cm, 8F introducer
Detail
SJ082
8F
SJ083
SJ084
Change
Detail Change
SJ085
introducer
Riata iTransvenous Tachyarrhythmia Leads Models 1560 and 1561
Detail Change
Passive Fixation, Steroid-Eluting, Dual Shock Coil Defibrillation Lead
60cm, 65cm, 70cm, 8F
SJ086
Change
Riata i Transvenous Tachyarrhythmia Lead Model 1562 Passive Fixation, Steroid Eluting, Single Shock Coil Defibrillation
SJ089
SJ090
SJ091
30mm
Victory XL DR 5816 and DR 5810
Victory SR 5610
Premere PFO Closure System
Detail Change
SJ092
Epic II + DR V-258
SJ093
SJ096
Epic II VR V-158 Implantable Cardiac Defibrillator
Riata ST 7000/7001/7002
Single Chamber Cardioverter Defibrillator
34cc, 70g
Active-Fixation True-Bipolar, Dual-Coil, (7002 - Single-Coil)
Steroid-Eluting Steroid Eluting, Endocardial Defibrillation Leads
Detail Change
60, 65cm 7F introducer
SJ097
Change
Isoflex P 1644T and 1648T
Endocardial, Steroid Eluting, Polyurethane, Passive-Fixation Bipolar
1648T - 34-85cm 1644T - 34-42cm
SJ098
Epic II+ HF V-357
SJ099
QuickSite 1056T
SJ100
Epic II HF V-355
SJ101
Epic II DR V-255
60cm, 65cm, 70cm, 8F introducer
Detail
Lead
Dual Chamber Rate Responsive Pacemakers
44x52x6mm; 23.5g; 11cc
single chamber rate responsive pacemaker
41x44x46mm 17g 8cc
Percutaneous, transcatheter, self-expanding, dual anchor, occlusion
Detail Change
Detail Change
Left Atrial Anchor diameter 20mm, 25mm and
device
Epic II + DR V-258 Implantable Cardioverter Defibrillator
35cc, 72g
Pacing Leads with Fast-Pass Coating
Epic II + HF V-357 Cardiac Resynchronisation Therapy Defibrillator
with V-V Timing programmability
Bipolar Steroid-Eluting, Titanium Nitride Coated Electrodes
Guidewire/Stylet-Placed Keft Heart Lead with Fast-Pass Coating
Epic II HF V-355 Cardiac resynchronisation Therapy Defibrillator
with V-V Timing programmability
Epic II DR V-255 Implantable Cardioverter Defibrillator 34cc, 72g
36cc, 74g
Detail Change
Detail
Detail Change
75cm, 6F and 86cm, 6F
36cc,73g Detail Change
Detail Change
Detail Change
Detail Change
Changed Items for Prostheses List Report
Page 75 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
SJ102
Introducer
Riata ST Transvenous Tachyarrhythmia Leads 7010/7011/7012
Riata ST 7010/7011 Active-Fixation Integrated-Biopolar, Dual-Coil,
Detail Change
Steroid-eluting, Endocardial Defibrillation Leads, 7012 - Single Coil
SJ103
SJ105
SJ106
Zephyr XL DR 5826 and DR 5820
Zephyr SR 5620
Riata Transvenous Tachyarrhythmia Leads 1940/41/42
Dual Chamber Rate-Responsive Pacemaker
5826 - 23.5g, 11cc and 5820 - 18g, 8.5cc
Single Chamber Rate-Responsive Pacemaker
8cc, 17g
Riata 1940/41 Active-Fixation True-bipolar, Dual-Coil, Steroideluting, Endocardial Defibrillation Leads, 1942 - Single Coil
Detail Change
Detail Change
60-75cm Detail Change
SJ108
Riata i Transvenous Tachyarrhythmia Leads 1962
Riata i 1962 - Active Fixation Integrated-Bipolar, Single-Coil,
Steroid-Eluting, Endocardial Defibrillation Leads
60 - 75cm
Detail Change
SJ109
Atlas II+ HF V-367
Detail Change
SJ110
Introducer
Cardiac Resynchronisation Therapy Defibrillator with V-V Timing
41cc, 79g
Programmability
Riata ST Transvenous Tachyarrhythmia Leads 7040/41/42 and
Riata ST 7040/41 Passive-Fixation True-Bipolar, Dual-Coil, SteroidDetail Change
7050/51/52
eluting, Endocardial Defibrillation Leads, 7042 - Single Coil, 7050/51
- Integrated Bipolar, Dual Coil, 7052 - Integrated Bipolar, Single Coil
SJ113
Riata i TransvenousTachyarrhythmia Leads 1950/51
Riata i 1950/51 - Passive-Fixation Integrated-Bipolar, Dual-Coil,
Steroid-Eluting, Endocardial Defibrillation Leads
60 - 75cm
Detail Change
SJ114
SJ115
SJ117
SJ118
Atlas II VR-168
Atlas II+ DR V-268
Promote CRT-D 3107
OptiSense 1699T/1699TC
Detail Change
Detail Change
Detail Change
40-58cm Detail Change
SJ120
Current DR RF 2207
Single chamber cardioverter defibrillator
38cc, 77g
Dual Chamber Cardioverter Defibrillator
39cc, 78g
Cardiac Resynchronisation Therapy Defibrillator
41cc, 80g
Endocardial, Bi-polar Active-fixation Pacing Leads with Optim
Insulation
Dual Chamber Cardioverter Defibrillator with RF Telemetry
SJ121
SJ122
Change
Current VR 1107-36
Riata ST Optim 7020/1/2 and 7030/1
Single Chamber Cardioverter Defibrillator
38cc 76g
7020/1 - Active fixation, true bipolar, 7022 - Active fixation, true
Detail Change
60, 65 and 75cm length and 7Fr introducer Detail
80g, 42cc
60 - 75cm 6.3Fr, 7 Fr
60 - 75cm, 6.3 Fr, 7 Fr
Detail Change
bipolar - single coil, 7030/1 - Active fixation, integrated bipolar, dual
coil steroid eluting endocardial defibrillation leads with Optim
insulation overlay
SJ123
SJ124
SJ125
Change
Current DR 2107
Current RF VR 1207-36
Tendril ST 1788T/TC and 1782TC
Dual Chamber Cardio-verter Defibrillator
39cc 78g
Single Chamber Cardioverter Defibrillator with RF Telemetry
Detail Change
79g, 41cc
Endocardial Bipolar Steroid-Eluting Active Fixation Pacing Leads
40cm, 46cm, 52cm, 58cm, 65cm
Detail Change
SJ126
QuickSite XL 1058T
Bipolar, Steroid-Eluting, Titanium Nitride Coated Electrodes,
Guidewire/Stylet-Placed Left Heart Lead with Fast-Pass Coating
75-86cm Detail Change
SJ128
Promote RF CRT-D 3213
Cardiac Resynchronisation Therapy Defibrillator with RF Telemetry
43cc, 82g
Changed Items for Prostheses List Report
Detail
Detail Change
Page 76 of 99
Billing Code Product Name
Further Description
SJ129
Tendril ST 1888TC and 1882TC
Endocardial Bi-polar Steroid-Eluting Active Fixation Pacing Leads
46-65cm Detail Change
SJ130
Change
Riata ST Optim 7070/1
Passive Fixation, True bipolar, Dual Coil, Steroid Eluting,
60, 65 and 70cm length, 7Fr introducer
Size
Explanation of Change
Detail
Endocardial Defibrillation Leads with Optim insulation overlay
SJ131
SJ132
Zephyr XL SR 5626
Myodex 1084T
Single-Chamber Rate-Responsive Pacemaker
23.5g and 10.4cc
Steroid-Eluting Bipolar Sutureless Myocardial Pacing Lead with
Titanium Nitride Electrodes
Stented Porcine tissue valve
Aortic Valves - Tissue Annulus Diameter - 21 - 29mm
Detail Change
35cm and 54cm
SJ136
SJM Biocor Heart Valve
SJ139
Quickflex 1156T and XL 1158T
Annulus Diameter - 25-35mm
Bipolar, Steroid-Eluting, Titanium Nitride Coated Elextrodes,
Guidewire/Stylet-Placed Left Heart Lead with Fast-PassTM Coating
Length 75 and 86cm
SJ140
Change
Myodex 1084T and FasTac Flex Lead Implant Tool
Steroid -Eluting Bipolar Sutureless Myocardial Pacing Lead with
35cm and 54cm, Lead implant tool - 44cm Detail
Detail Change
Detail Change
Mitral Valves - Tissue
Detail Change
Titanium Nitride Electrodes and Lead implant tool with articulating
distal end.
Neurosurgical
SJ133
Eon Mini Neurostimulation System - Implantable Pulse Generator
3788
3788
Lamitrode Lead - Tripole 16C
Tripole 16C (3214)
Eon Mini Neurostimulation System - Implantable Pulse Generator 18cc, 29g Benefit Review
Angio-Seal Haemostatic Puncture Closure Device, Models 6F-STS
6F
Detail Change
Angio-Seal Haemostatic Puncture Closure Device, Models 8F-STS
8F
Detail Change
SJ041
SJ042
SJ043
Angio-Seal Vascular Closure Device - STS Platform and STS Plus
Platform and 6F STS Plus
Angio-Seal Vascular Closure Device - STS Platform and STS Plus
Platform and 8F STS Plus
Intergard W
Woven Straight
Intergard W
Woven Bifurcated
Intergard W
Woven Aortic Arch
SJ044
SJ045
SJ046
SJ047
Intergard K
Intergard K
Intergard K
Intergard K
Knitted Straight
Knitted Bifurcated
Knitted Radially Supported
Knitted Axillobifemoral
SJ107
SJ111
SJ112
InterGard HemaBridge
InterGard Knitted UltraThin
InterGuard UltraThin Knitted
Aortic Graft
Straight
Radially Supported Straight
SJ138
Length 60cm
Benefit Review
Vascular
SJ014
SJ015
6mm x 30cm - 38mm x 30cm
Detail Change
18mm x 9mm - 24mm x 12mm
Detail Change
24mm x 10mm x 8mm x 8mm x 50cm - 30mm x 10mm x 8mm x Detail Change
8mm
6mm x 40cm - 24mm x 40cm
Detail Change
12mm x 6mm - 24mm x 12mm
Detail Change
6mm x 70cm - 8mm x 60cm
Detail Change
Diameter (mm) Length (cm) 8 x 8 100/60; 10 x 10 100/60; 8 x 6 x Detail Change
6 85/55; 8 x 8 85/55; 8 x 8 100/55
20 x 10mm - 36 x 10mm diameter, 35 x 40cm length
Detail Change
6mm x 40cm to 8mm x 70mm
Detail Change
6mm - 70cm to 8mm - 70cm
Detail Change
Straumann Pty Ltd
Plastic and Reconstructive
Changed Items for Prostheses List Report
Page 77 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
SB001
SB002
Straumann Dental Implant NNI/RN/WNI
Straumann Healing Cap NNI/RN/WNI
Diameter 3.3 - 4.8mm Length 6 - 16mm
Height 1.5 - 4.5 mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Fisch Incus Prostheses: short, medium, large, Titanium
Fisch Neomalleus Prostheses, Titanium
Fisch Total Prostheses: with foot, Titanium
All Sizes
1.1x5mm
0.6x10mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Straumann Pty Ltd
Straumann Pty Ltd
Stryker Australia Pty Ltd
Ear, Nose & Throat
ST795
ST796
ST798
Titanium Middle Ear Prostheses
Titanium Middle Ear Prostheses
Titanium Middle Ear Prostheses
Neurosurgical
SK112
SK226
SK250
Change
XIA/Oasys Spine System
Oasys-Occipito Cervico Thoracic System
Trio Spinal Fixation System
SK426
Cortoss Vertebral Augmentation Kit
SK492
SK493
SK494
SK495
SK496
SR042
DuraMatrix
DuraMatrix
DuraMatrix
Dura Matrix
DuraMatrix
Xia Precision System
Buttress thread locking nut
3.5mm - 6mm
Occipital Plate
100 and 130 degree
Titanium - Offset Connector, Two Step Locking Connector,
Variable Offset Connector
Cortoss Cement 10cc, Delivery Gun, Mix Tips, Percutaneous
Administration Kit
Resorbable Collagen Dura Substitute Membrane
1" x 1" (2.5cm x 2.5cm)
Resorbable Collagen Dura Substitute Membrane
1" x 3" (2.5cm x 7.5cm)
Resorbable Collagen Dura Substitute Membrane
4" x 5" (10cm x 12.5cm)
Resorbable Collagen Dura Substitute Membrane
3" x 3" (7.5cm x 7.5cm)
Resorbable Collagen Dura Substitute Membrane
2" x 2" (5cm x 5cm)
Screw, Cannulated, Multi Axial, Titanium
5.5mm - 7.5mm x 35mm - 55mm
Detail Change
Benefit Review, Detail Change
Offset Connector - Small, Medium, Large Detail
10cc
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Orthopaedic
HW001
HW188
SK381
SK444
SK446
SR051
Hardinge Cement Restrictor
Howmedica Modular Resection System
Stryker Plating System
ABG II Modular Hip System
Rejuvinate SPT Femoral Hip System
Mitch Hip System
PMMA
Growing Prosthesis - Vitallium
Stryker locked plating system
Neck for the ABGII stem
Neck for Rejuvinate SPT Stem
Femoral Head Metal on Metal
6,9 and 12 Leaf
Expandable prostheses - Custom made to child
Distal Humerus, Lateral and Medial, 1-8 holes
Long & Short
30-38mm
38mm - 60mm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Plastic and Reconstructive
SK129
4-6 Holes
Leibinger Titanium Implant System - Universal Mandible
Benefit Review, Detail Change
Compression Plate
and tumour resection.
SK130
Leibinger Titanium Implant System - Universal Mandible Fracture
Holes
Benefit Review, Detail Change
Plate
and tumour resection.
SK131
Leibinger Titanium Implant System - Universal Mandible Fracture
C-shaped, 4 holes
Benefit Review, Detail Change
Plate
and tumour resection.
SK132
Leibinger Titanium Implant System - Universal Mandible Fracture
Angled Shaped, 6 holes, 115-140
Benefit Review, Detail Change
Plate
and tumour resection.
Changed Items for Prostheses List Report
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Compression Plate,
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Fracture Plate, 14
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Fracture Plate,
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Fracture Plate,
deg
Page 78 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
SK133
Leibinger Titanium Implant System - Universal Mandible Fracture
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Fracture Plate, 4-6
holes with/without Bar
Benefit Review, Detail Change
Plate
and tumour resection.
SK134
Leibinger Titanium Implant System - Universal Mandible Mini Plate
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Mini Plate, 4-6 holes
with/without Bar Benefit Review, Detail Change
and tumour resection.
SK135
Leibinger Titanium Implant System - Universal Mandible Mini Plate
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Mini Plate, 16 holes
Benefit Review, Detail Change
and tumour resection.
SK136
Leibinger Titanium Implant System - Universal Mandible Primary
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Primary
Reconstruction Plate, (Hemi) Left and
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection.
Right 5+17 holes, with template
SK137
Leibinger Titanium Implant System - Universal Mandible Primary
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Primary
Reconstruction Plate, 11-17 holes, with
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection.
template
SK138
Leibinger Titanium Implant System - Universal Mandible
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Reconstruction Plate,
(Full), 6 + 13 + 6 holes,
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection.
with template
SK139
Leibinger Titanium Implant System - Universal Mandible 3D Plate
Items used for reconstruction and fixation of mandibular fractures Universal Mandible 3D Plate, (Full), 6 x 2
Hole, Curved, Square
Benefit Review, Detail Change
and tumour resection.
SK140
Leibinger Titanium Implant System - Universal Mandible
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Reconstruction Plate,
11 - 17 holes, straight
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection.
with template
SK141
Leibinger Titanium Implant System - Universal Mandible
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Reconstruction Plate,
(Hemi), Right and Left, 6
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection
+ 17 holes with template
SK142
Leibinger Titanium Implant System - Universal Mandible
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Reconstruction Plate,
(Full), 6 + 17 + 6 holes,
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection
with template
SK143
Leibinger Titanium Implant System - Universal Mandible
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Reconstruction Plate,
(Full), 6 + 15 + 6 holes,
Benefit Review, Detail Change
Reconstruction Plate
and tumour resection
with template
SK144
Leibinger Titanium Implant System - Universal Mandible 3D Plate
Items used for reconstruction and fixation of mandibular fractures Universal Mandible 3D Plate, 4 x 2 Hole
Square
Benefit Review, Detail Change
and tumour resection
SK145
Leibinger Titanium Implant System - Universal Mandible 3D Plate
Items used for reconstruction and fixation of mandibular fractures Universal Mandible 3D Plate, 3 x 2 Hole
Rectangle
Benefit Review, Detail Change
and tumour resection
SK146
Leibinger Titanium Implant System - Universal Mandible Biconcave
Items used for reconstruction and fixation of mandibular fractures Universal Mandible Bi-concave Washer
Benefit Review, Detail Change
Washer
and tumour resection
SK147
Leibinger Screw - Universal Mandibular Screws
Items used for reconstruction and fixation of mandibular fractures
Universal Mandible Smartlock Emergency Screws,
2.7mm
Benefit Review, Detail Change
and tumour resection
Diameter, 8mm - 20mm length
SK148
Leibinger Screw - Universal Mandibular Screws
Items used for reconstruction and fixation of mandibular fractures
Universal Mandible Screws, Emergency, 2.7mm
Diameter, 8-20mm
Benefit Review, Detail Change
and tumour resection
Length
SK149
Leibinger Screw - Universal Mandibular Screws
Items used for reconstruction and fixation of mandibular fractures
Universal Mandible Screws, 2.0mm Dia, 4-14mm
Length; Universal
Benefit Review, Detail Change
and tumour resection
Mandible Screws, 2.3mm Dia, 4-14mm Length
SK150
Leibinger Screw - Universal Mandibular Screws
Diameter, 16mm-
Items used for reconstruction and fixation of mandibular fractures
Universal Mandible Smartlock Screws, 2.0mm
Benefit Review, Detail Change
and tumour resection
20mm Length; Universal Mandible Smartlock Screws, 2.3mm
Diameter, 18mm-20mm Length
SK151
16mm-20mm
Items used for reconstruction and fixation of mandibular fractures
Leibinger Screw - Universal Mandibular Screws
Benefit Review, Detail Change
Universal Mandible Screws, 2.0mm Diameter,
and tumour resection
SK152
24mm-42mm
Leibinger Screw - Universal Mandibular Screws
Benefit Review, Detail Change
Length; Universal Mandible Screws, 2.3mm Diameter, 16mm20mm Length
Items used for reconstruction and fixation of mandibular fractures
Universal Mandible Lag Screws, 2.0mm Diameter,
and tumour resection
Changed Items for Prostheses List Report
Length
Page 79 of 99
Billing Code Product Name
Further Description
SK153
Leibinger Screw - Universal Mandibular Screws
Diameter, 4mm- Benefit Review, Detail Change
Items used for reconstruction and fixation of mandibular fractures
and tumour resection
SK183
Leibinger Intraoral Distractor (Multiguide II)
mm length Auto -
SK218
and Right
Size
Explanation of Change
Universal Mandible Smartlock Screws, 2.0mm
14mm Length; Universal Mandible Smartlock Screws, 2.3mm
Diameter, 4mm-16mm Length
Manufactured from stainless steel, allows gradual, independent, and
Benefit Review, Detail Change
simultaneous distraction of the mandible in 3 planes.
Pilot Pins
Frame 20mm - 35mm, 2.0mm diameter, 50 - 90
Leibinger Titanium Implant System - Universal Mandible Condylar
Items used for reconstruction following trauma or tumor resection Universal Mandible Condylar Device Left
Benefit Review, Detail Change
Device
of the mandible. Included are 2x cross pin fixation screw.
SK255
Leibinger Titanium Implant System - Universal CMF Plate
condensed; 24 Hole
Benefit Review, Detail Change
SK257
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
SK258
Leibinger Titanium Implant System - Universal CMF Plate
condensed; 10 hole
Benefit Review, Detail Change
SK259
Leibinger Titanium Implant System - Universal CMF Plate
Hole Double Y Plate,
Benefit Review, Detail Change
SK260
3-D Plate,
Leibinger Titanium Implant System - Universal CMF Plate
Benefit Review, Detail Change
SK261
3-D Plate,
Leibinger Titanium Implant System - Universal CMF Plate
Benefit Review, Detail Change
SK262
Leibinger Titanium Implant System - Universal CMF Plate
Plate 90 Degree Benefit Review, Detail Change
Upperface Fixation Plates
24 Hole Straight Plate Upperface, malleable
Straight Plate Upperface
Upperface Fixation Plates
18 Hole Straight, Upperface, Malleable
Upperface Fixation Plates
10 Hole Curved Plate Upperface, malleable
Curved plate, Upperface
Upperface Fixation Plates
7 Hole Double Y Plate Upperface, malleable; 7
Upperface
Upperface Fixation Plates
2x2 Hole 3-D Plate Upperface, malleable; 2x2 Hole
Upperface
Upperface Fixation Plates
6x2 Hole 3-D Plate Upperface, malleable; 6x2 Hole
Upperface
Uppeface Fixation Plates
8 Hole L Plate 90 Degree Left, Upperface; 8 Hole L
Benefit
SK263
Detail Change
Leibinger Titanium Implant System - Universal CMF Plate
Right, Upperface
Upperface Fixation Plates
7 Hole T Plate, Upperface
SK264
Detail Change
Leibinger Titanium Implant System - Universal CMF Plate
Upperface Fixation Plates
4 Hole Orbita Plate, Upperface Benefit Review,
SK265
Upperface,
Leibinger Titanium Implant System - Universal CMF Plate
Benefit Review, Detail Change
Upperface Fixation Plates
6x6 Hole 3-D Plate, Upperface; 6x6 Hole 3-D Plate
malleable
Upperface Fixation Plates
10x10 Hole 3-D plate Upperface, malleable; 10x10
Upperface
Diameter 7, 10, 14 & 20mm
Midface Fixation Plates
Benefit Review, Detail Change
24 Hole Straight Plate Midface, malleable
SK266
Leibinger Titanium Implant System - Universal CMF Plate
Hole 3-D plate, Benefit Review, Detail Change
SK267
Leibinger Titanium Implant System
Burr Hole Cover 1.0mm - 2.3mm
SK269
Leibinger Titanium Implant System - Universal CMF Plate
condensed; 20 Hole
Benefit Review, Detail Change
Benefit Review,
Straight Plate Midface, malleable; 24 Hole Straight Plate Midface
SK270
Leibinger Titanium Implant System - Universal CMF Plate
Midface Fixation Plates
4 Hole Straight Plate with Bar, Midface; 4 Hole
Curved Plate with
Benefit Review, Detail Change
SK271
Detail Change
Leibinger Titanium Implant System - Universal CMF Plate
Bar, Midface
Midface Fixation Plates
10 Hole Curved Plate, Midface Benefit Review,
SK272
Detail Change
Leibinger Titanium Implant System - Universal CMF Plate
Midface Fixation Plates
5 Hole T Plate, Midface
SK273
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Midface Fixation Plates
5 Hole Y Plate with 4mm Bar, Midface
Changed Items for Prostheses List Report
Benefit Review,
Benefit
Page 80 of 99
Billing Code Product Name
Size
Explanation of Change
SK274
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Midface Fixation Plates
7 Hole Double Y Plate, Midface
SK280
Leibinger Titanium Implant System - Universal CMF Plate
L Plates 100 Degree, Advancement 2 - 10mm
5 - 6 Hole
Benefit Review, Detail Change
SK282
Leibinger Titanium Implant System - Universal CMF Plate
L Plate 100 Degree Advancement 12mm
5 - 6 Holes
Benefit Review, Detail Change
Graduated Stability L Plates
5 Hole L Plate 2mm Advancement 100 Degree
Further Description
SK283
Leibinger Titanium Implant System - Universal CMF Plate
Left, Midface, GSP;
Benefit Review, Detail Change
Benefit
5 Hole L Plate 2mm Advancement 100 Degree Right, Midface, GSP
SK287
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Mid-Face Fixation Plates, Locking
16 Hole Straight Plate, Midface, locking
Benefit
SK288
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Mid-Face Fixation Plates, Locking
8 Hole Curved Plate, Midface, locking
Benefit
SK289
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Mid-Face Fixation Plates, Locking
2x2 Hole 3-D Plate, Midface, Locking
Benefit
SK290
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Mid-Face Fixation Plates, Locking
2x6 Hole 3-D Plate, Midface, Locking
Benefit
SK291
Hole Y Plate
Mid-Face Fixation Plates, Locking
5 Hole Y Plate with 4mm Bar, Midface, Locking; 5
with 8mm Bar, Midface, locking
Mid-Face Fixation Plates, Locking
7 Hole Double Y Plate, Midface, locking Benefit
SK293
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Mid-Face Fixation Plates, Locking
8 Hole Y Plate, Midface, locking
SK294
Leibinger Titanium Implant System - Universal CMF Plate
locking; 5 Hole L Plate
Benefit Review, Detail Change
Mid-Face Fixation Plates, Locking
5 Hole L Plate 2mm Advancement, Midface,
5mm Advancement, Midface, locking
Mid-Face Fixation Plates, Locking
6 Hole L Plate 8mm Advancement, Midface,
12mm Advancement, Midface, locking
Mandible Plates
4 hole 2.3mm Compression Plate; 6 Hole 2.3mm
SK298
Leibinger Titanium Implant System - Universal CMF Plate
Benefit Review, Detail Change
Mandible Plates
4-6 Hole, Straight Plate, with/without bar, locking
SK299
Leibinger Screw (Various) - Universal CMF Screws
1.2mm Diameter, 3-12mm Length; 1.4mm Diameter 3-9mm Length
SK300
SK301
Leibinger Screw (Various) - Universal CMF Screws
Leibinger Screw (Various) - Universal CMF Screws
SK302
SK303
Leibinger Screw (Various) - Universal CMF Screws
Leibinger Screw (Various) - Universal CMF Screws
SK340
Leibinger Titanium Implant System - Universal CMF Plate
Self Drilling, 1.2mm Diameter, 3-4mm Length
Benefit Review, Detail Change
1.7mm Diameter, 3-12mm Length; 1.9mm Diameter, 3-9mm
Benefit Review, Detail Change
Length
Self Drilling, 1.7mm Diam; 3-6mm Length
Benefit Review, Detail Change
Locking, 1.7mm Diameter, 4-6mm Length; Locking 1.9mm
Benefit Review, Detail Change
Diameter, 5mm Length
Z Plate, Right/Left
4 holes Benefit Review, Detail Change
Leibinger Titanium Implant System - Universal CMF Plate
Benefit Review, Detail Change
SK292
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
SK295
Leibinger Titanium Implant System - Universal CMF Plate
locking; 6 Hole L-Plate
Benefit Review, Detail Change
SK296
Leibinger Titanium Implant System - Universal CMF Plate
Compression Plate
Benefit Review, Detail Change
Benefit
Benefit Review, Detail Change
SK345
Leibinger Titanium Implant System - Universal CMF Plate
Review, Detail Change
Changed Items for Prostheses List Report
Le Fort 1 Plate, Right/Left
11hole, Advancement 2 - 10mm
Benefit
Page 81 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
SK348
Leibinger Titanium Implant System - Universal CMF Plate
Titanium plates used for reconstruction and fixation of
Universal CMF 4 hole chin plate, 4mm. Universal
CMF 4 hole chin
Benefit Review, Detail Change
craniomaxillofacial fractures or osteotomy performed for correction plate, 6mm. Universal CMF 4 hole chin plate, 8mm. Universal CMF
of facial deformity
4 hole chin plate, 10mm. Universal CMF 4 hole chin plate, 12mm.
SK349
Leibinger Titanium Implant System - Universal CMF Plate
Titanium plates used for reconstruction and fixation of
Universal CMF 4 hole Z plate, Small,
Orthognathic, locking.
Benefit Review, Detail Change
craniomaxillofacial fractures or osteotomy performed for correction Universal CMF 4 hole Z plate, Large, Orthognathic, locking.
of facial deformity
SK355
Universal Neuro Titanium Low Profile Plate
Benefit Review, Detail Change
Titanium Low Profile plates used for the fixation of cranial bone flaps
Small, large, 20mm burr hole, 16 hole without bar
SK356
Universal Neuro Titanium Low Profile Plate
Review, Detail Change
Titanium Low Profile plates used for the fixation of cranial bone
2-hole plate, 12mm bar, 16mm bar
SK362
Universal Neuro Screws
Screws: Diameter
plates
Titanium screws used for the fixation of cranial bone flaps
Benefit Review, Detail Change
1.7mm, length 4mm.
Titanium Low Profile plates used for the fixation of cranial bone flaps
Benefit
Diameter 1.5mm, length 4-6mm. Emergency
SK363
6 hole 8mm
Universal Neuro Titanium Low Profile Plate
Benefit Review, Detail Change
SK370
SK385
SK389
SK420
SK421
SK422
Universal Neuro
Universal System
Universal System
Orthodontic Skeletal Anchor Plate
Orthodontic Skeletal Anchor Plate
Orthodontic Skeletal Anchor Screw
NeuroClip
1.5mm
Condyle Fastening Screws
One size only
Condylar Prosthesis
Left/Right
Orthodontic Skeletal Anchor Plate, Standard
1.7mm
Orthodontic Skeletal Anchor Plate Locking
1.7mm
Anchor Screw for Mandibular Maxillary Fixation Screw, Self-Drilling
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.7mm Benefit Review, Detail Change
SK423
Orthodontic Skeletal Anchor Screw
Anchor Screw for Mandibular Maxillary Fixation Screw, Self-Drilling
2.0mm Benefit Review, Detail Change
SK455
Leibinger Endosseous Alveolar Ridge Distraction System Dual plate with threaded transport rod, titianium
SK457
ST082
ST083
Maxillo-Mandibular Fixation Screw
Leibinger Screws
Leibinger Screws
MMF Screw, Self Drilling, Stainless Steel
Dia 1.7mm/2.0mm, Length 2mm to 20mm
Leibinger IMF: cross-slot screws Titanium
2.0x8mm, 2.0x14mm, 2.0x20mm
Leibinger Steinhauser Screw System: cross-slot screws Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
2.0x4-12mm
Benefit Review, Detail Change
ST084
Leibinger Screws
Leibinger Steinhauser Screw System: cross-slot screws Titanium
2.0x13-22mm
Benefit Review, Detail Change
ST092
Leibinger Titanium Implant System
Leibinger COM/MAND Fixation System: straight plate Titanium
2.3x8 holes
Benefit Review, Detail Change
ST098
Leibinger Titanium Implant System
Leibinger COM/MAND Fixation System: screws Titanium
2.3x6-22mm
Benefit Review, Detail Change
ST102
Leibinger Titanium Implant System
2.7mm, 17 holes
Benefit Review, Detail Change
ST110
ST111
Stryker Leibinger Plating System
Leibinger Screws
ST113
Leibinger Screws
Leibinger COM/MAND Fixation System: bridging, plate, straight
Titanium
Micro Self Tapping Screws
1.0 - 1.4mm Diameter, 2 - 12mm Lengths
Leibinger Mini Wurzburg Bone Screws: square fit, self-tapping
Titanium
Leibinger Mini Wurzburg Bone Screws: square fit, self-tapping
Titanium
Changed Items for Prostheses List Report
Single Tooth
8 hole plate without bar, 2 x 2 box plate, double Y
Benefit Review, Detail Change
Benefit Review, Detail Change
1.7x3-12mm
Benefit Review, Detail Change
1.9x5mm, 1.9x7mm Benefit Review, Detail Change
Page 82 of 99
Billing Code Product Name
Further Description
ST114
Leibinger Screws
2.0x4-19mm
Benefit Review, Detail Change
ST115
Leibinger Screws
2.3x6-9mm
Benefit Review, Detail Change
ST123
ST125
ST126
ST127
ST128
ST129
ST130
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Mini Wurzburg Bone Screws: square fit, self-tapping
Titanium
Leibinger Mini Wurzburg Bone Screws: square fit, self-tapping
Titanium
Leibinger Micro Plus Bone plate: Straight Titanium
4 holes
Leibinger Micro Plus Bone plate: Straight Titanium
6 holes
Leibinger Micro Plus Bone plate: Straight Titanium
8 holes
Leibinger Micro Plus Bone plate: Straight Titanium
12 holes
Leibinger Micro Plus Bone plate: Straight Titanium
16 holes
Leibinger Micro Plus Bone plate: Straight Titanium
24 holes
Leibinger Micro Plus Bone plate: straight, L-shape, right/left Titanium
ST131
Leibinger Titanium Implant System
Leibinger Micro Plus Bone plate: straight, L-shape, right/left Titanium
8 holes Benefit Review, Detail Change
ST132
Leibinger Titanium Implant System
Leibinger Micro Plus Bone plate: T-shape, 90 deg Titanium
5 holes Benefit Review, Detail Change
ST133
Leibinger Titanium Implant System
Leibinger Micro Plus Bone plate: T-shape, 90 deg Titanium
7 holes Benefit Review, Detail Change
ST135
Leibinger Titanium Implant System
Leibinger Micro Plus Bone plate: double-T-shape Titanium
9 holes Benefit Review, Detail Change
ST136
Leibinger Titanium Implant System
Leibinger Micro Plus Bone plate: double-T-shape Titanium
14 holes Benefit Review, Detail Change
ST137
ST138
ST139
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Micro Plus Bone plate: Y-shape Titanium
6 holes
Micro Plus Bone plate: double-Y-shape
6 - 7 Holes
Leibinger Micro Plus Bone plate: double-Y-shape Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
7holes Benefit Review, Detail Change
ST140
Leibinger Titanium Implant System
8 holes Benefit Review, Detail Change
ST141
ST142
ST143
ST144
ST148
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Screws
Leibinger Micro, Micro Plus and Low Profile Bone plate: orbital
plate, curved Titanium
Leibinger Burr Hole Cover: curved Titanium
7, 10, 14mm
Leibinger 3D plate Titanium
1.2x2-6mm, 0.55mm height
Leibinger 3D plate Titanium
1.2x7-10mm, 0.55mm height
Leibinger 3D plate Titanium
1.2x11-12mm, 0.55mm height
Leibinger Micro Plus Screws: cross-slot, self-tapping Titanium
ST149
Leibinger Screws
Leibinger Micro Plus Screws: cross-slot, self-tapping Titanium
1.4x7mm, 1.4x9mm Benefit Review, Detail Change
ST150
Leibinger Screws
Leibinger Micro Plus Screws: cross-slot, self-tapping Titanium
1.4x11mm
ST151
ST154
ST156
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Mini Wurzburg Bone plate: regular Titanium
Leibinger Mini Wurzburg Bone plate: regular Titanium
Leibinger Mini Wurzburg Bone plate: regular Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Size
4 holes, 0.55mm height
6 holes, 0.55mm height
8 holes, 0.55mm height
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
5 holes Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
1.4x3mm, 1.4x5mm Benefit Review, Detail Change
Benefit Review, Detail Change
Page 83 of 99
Billing Code Product Name
Further Description
ST157
Leibinger Titanium Implant System
ST158
Leibinger Titanium Implant System
ST159
Leibinger Titanium Implant System
ST160
Leibinger Titanium Implant System
ST162
Leibinger Titanium Implant System
Review, Detail Change
Leibinger Mini Wurzburg Bone plate: regular Titanium 16 holes, 0.55mm height
Leibinger Mini Wurzburg Bone plate: regular Titanium 30 holes, 6mm bar, 0.55mm height
LeibingerSteinhauser plate: regular Titanium
30 holes, 6mm bar, 0.55mm height
Bone plate L-shape, 90 deg, right/left
4 Holes
Leibinger Mini Wurzburg Bone plate: L-shape, 90 deg, with bar,
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
4 holes, 8mm bar, 0.55mm height
Benefit
right/left Titanium
Leibinger Mini Wurzburg Bone plate: L-shape, 90 deg, with bar,
4 holes, 10mm bar, 0.55mm height
Benefit
right/left Titanium
L-shape, right/left, with Bar
5 - 7 Hole
Leibinger Steinhauser plate: L-shape, right/left, with bar Titanium
Benefit Review, Detail Change
9 holes, 12mm bar, 0.55mm height
Benefit
ST164
Leibinger Titanium Implant System
Review, Detail Change
ST165
Leibinger Titanium Implant System
ST167
Leibinger Titanium Implant System
Review, Detail Change
ST170
ST171
ST172
ST180
ST181
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
ST183
Detail Change
Leibinger Titanium Implant System
Size
Bone plate T-shape with or without bar
4 HOLES
Leibinger Steinhauser plate: T-shape, with bar Titanium 8 holes, 12mm bar, 0.55mm height
Mini Wurzburg Bone plate, T-shape
5 - 6 holes
Bone plate Y-shape,
5 HOLES
Mini Wurzburg Bone plate: T- Shape, Y- Shape & Double -TShape
Leibinger Mini Wurzburg Bone plate: double-Y-shape, regular
Explanation of Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
5 - 6 holes
Benefit Review, Detail Change
6 holes, 0.55mm height
Benefit Review,
Titanium
Leibinger Mini Wurzburg Bone plate: double-Y-shape, with bar
6 holes, 8mm bar, 0.55mm height
Titanium
Leibinger Mini Wurzburg Bone plate: double-Y-shape, regular
7 holes, 0.55mm height
Titanium
Leibinger Mini Wurzburg Orbita Bone plate: curved, with bar Titanium
4 holes, 6mm bar, 0.55mm height
Benefit
ST189
Leibinger Titanium Implant System
Review, Detail Change
Leibinger Mini Wurzburg Orbita Bone plate: curved, with bar Titanium
6 holes, 8mm bar, 0.55mm height
Benefit
ST190
Leibinger Titanium Implant System
LeibingerSteinhauser Orbita Bone plate: curved Titanium 6 holes, 0.55mm height
Benefit Review, Detail Change
ST191
Detail Change
Leibinger Titanium Implant System
Leibinger Mini Wurzburg Orbita Bone plate: curved Titanium
8 holes, 0.55mm height
ST194
Leibinger Titanium Implant System
Leibinger Steinhauser Orbita Bone plate: curved Titanium 10 holes, 0.55mm height
Benefit Review, Detail Change
Bone plate, L-shape, 110 deg, right/left Titanium
4 holes
Leibinger Mini Wurzburg Bone plate: L-shape, 110 deg, regular,
Benefit Review, Detail Change
4 & 5 holes, with 12mm bar, 0.55mm height
ST184
Leibinger Titanium Implant System
Review, Detail Change
ST185
Detail Change
Leibinger Titanium Implant System
ST188
Leibinger Titanium Implant System
Review, Detail Change
ST195
Leibinger Titanium Implant System
ST197
Leibinger Titanium Implant System
Benefit Review, Detail Change
Benefit
Benefit Review,
Benefit Review,
ST198
Detail Change
Leibinger Titanium Implant System
with bar, right/left Titanium
Leibinger Mini Wurzburg 3D Bone plate: square, rectangular Titanium
2x2 holes, 0.55mm height
Benefit Review,
ST199
Detail Change
Leibinger Titanium Implant System
Leibinger Mini Wurzburg 3D Bone plate: square, rectangular Titanium
3x2 holes, 0.55mm height
Benefit Review,
ST200
Detail Change
Leibinger Titanium Implant System
Changed Items for Prostheses List Report
Leibinger Mini Wurzburg 3D Bone plate: square, rectangular Titanium
4x2 holes, 0.55mm height
Benefit Review,
Page 84 of 99
Billing Code Product Name
Further Description
ST201
Leibinger Titanium Implant System
Review, Detail Change
Leibinger Mini Wurzburg 3D Bone plate: square, rectangular Titanium
4x4 holes, 0.55mm, 0.55mm height
ST202
Detail Change
Leibinger Titanium Implant System
Leibinger Mini Wurzburg 3D Bone plate: square, rectangular Titanium
6x4 holes, 0.55mm height
Benefit Review,
ST203
Detail Change
Leibinger Titanium Implant System
Leibinger Mini Wurzburg 3D Zygoma Bone plate: rectangular Titanium
4x2 holes, 0.55mm height
Benefit Review,
ST204
ST231
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Mini Wurzburg Bone plate: straight Titanium 2 holes, 0.55mm height
Leibinger Mini Wurzburg Flexplate: L-shape, 110 deg, regular
Titanium
Leibinger Mini Wurzburg Flexplate: L-shape, 110 deg, right/left
Benefit Review, Detail Change
4 holes Benefit Review, Detail Change
ST232
Leibinger Titanium Implant System
Review, Detail Change
Size
Explanation of Change
4 holes, with 6mm, 8mm, 10mm bar
Benefit
Benefit
ST233
Detail Change
Leibinger Titanium Implant System
Titanium
Leibinger Mini Wurzburg Flexplate: L-shape, 110 deg, right/left
5 holes, with 12mm bar
Benefit Review,
ST234
Detail Change
Leibinger Titanium Implant System
Titanium
Leibinger Mini Wurzburg Compression Bone plate: L-shape, C-shape
4 holes, with 6 x 1mm bar
Benefit Review,
ST235
Detail Change
Leibinger Titanium Implant System
Titanium
Leibinger Mini Wurzburg Compression Bone plate: L-shape, C-shape
6 holes, with 8 x 1mm bar
Benefit Review,
ST236
ST240
ST245
ST246
ST247
ST250
ST311
Leibinger Titanium Screws
Leibinger Screws
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
ST312
Leibinger Titanium Implant System
ST314
Leibinger Titanium Implant System
ST315
Leibinger Titanium Implant System
ST326
Detail Change
Titanium
Bone Screw, cross-fit, self-tapping
Diameter 1.7mm, Length 3mm - 38mm
Leibinger Mini Wurzburg Emergency Screws Titanium 1.9 x 5mm
Leibinger Mesh Implants Titanium
75 x 12 x 0.5mm
Leibinger Mesh Implants Titanium
75 x 18 x 0.5mm
Leibinger Mesh Implants Titanium
.75 x 27 x 0.5mm
Mesh: Micro, Dumbach, Dynamic
Diameter 1.0mm - 2.3mm; Up to 90 x 90mm
Plate - Leibinger Low Profile Osteosynthesis System: mini, noncompression / compression, straight, regular / extended, medium /
long Titanium
Plate - Leibinger Low Profile Osteosynthesis System: mini, noncompression, compression, straight, regular / extended, medium /
long Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
4 holes Benefit Review, Detail Change
8 holes Benefit Review, Detail Change
4 holes Benefit Review, Detail Change
Leibinger Titanium Implant System
Leibinger Low Profile Osteosynthesis System: L-shape, right/left,
regular, medium, long Titanium
Leibinger Low Profile Osteosynthesis System: L-shape, right/left,
long, extended Titanium
Leibinger Micro 3D Plating System: square, rectangular Titanium
2x2 holes, 0.55mm profile
Benefit Review,
ST327
Detail Change
Leibinger Titanium Implant System
Leibinger Micro 3D Plating System: square, rectangular Titanium
2x3 holes, 0.55mm profile
Benefit Review,
ST328
Detail Change
Leibinger Titanium Implant System
Leibinger Micro 3D Plating System: square, rectangular Titanium
2x4 holes, 0.55mm profile
Benefit Review,
ST329
Detail Change
Leibinger Titanium Implant System
Leibinger Micro 3D Plating System: square, rectangular Titanium
4x4 holes, 0.55mm profile
Benefit Review,
5 holes Benefit Review, Detail Change
ST330
Detail Change
Leibinger Titanium Implant System
Changed Items for Prostheses List Report
Leibinger Micro 3D Plating System: square, rectangular Titanium
4x6 holes, 0.55mm profile
Benefit Review,
Page 85 of 99
Billing Code Product Name
Further Description
ST331
ST332
ST333
ST334
ST335
ST336
ST337
Detail Change
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Micro Bone plate Titanium
4 holes, 0.55mm profile
Leibinger Micro Bone plate Titanium
6 holes, 0.55mm profile
Leibinger Low Profile Bone Plate: straight titanium
6 holes, 0.55mm profile
Leibinger Low Profile Bone Plate: straight titanium
8 holes, 0.55mm profile
Leibinger Low Profile Bone Plate: straight titanium
16 holes, 0.55mm profile
Leibinger Low Profile Bone Plate: straight titanium
24 holes, 0.55mm profile
Leibinger Low Profile Bone Plate: L-shape, right/left Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
5 holes, 0.55mm profile
Benefit Review,
ST338
Detail Change
Leibinger Titanium Implant System
Leibinger Low Profile Bone Plate: L-shape, right/left Titanium
8 holes, 0.55mm profile
Benefit Review,
ST339
Detail Change
Leibinger Titanium Implant System
Leibinger Low Profile Bone Plate: T-shape, double-T-shape,
5, 7, 9 holes, 0.55mm profile
Benefit Review,
ST340
ST341
Detail Change
Leibinger Titanium Implant System
Leibinger Titanium Implant System
right/left, 90 deg Titanium
Leibinger Steinhauser Bone Plate: X-shape Titanium
4, 8, 9 holes, 0.55mm profile
Leibinger Micro Bone Plate: Y-shape, double-Y-shape Titanium
Benefit Review, Detail Change
6 holes, 0.55mm profile
Benefit Review,
ST342
ST343
Leibinger Titanium Implant System
Leibinger Titanium Implant System
Leibinger Steinhauser Bone Plate: Y-shape Titanium
8 holes, 0.55mm profile
Leibinger 3D Plating System: micro triangular plate Titanium
Benefit Review, Detail Change
3 holes Benefit Review, Detail Change
ST344
Leibinger Titanium Implant System
Leibinger 3D Plating System: micro circular plate Titanium
8 holes Benefit Review, Detail Change
ST356
ST358
Leibinger Titanium Implant System
Leibinger Screws
Benefit Review, Detail Change
2 holes Benefit Review, Detail Change
ST390
Luhr Fixation System
Paulus Chin plate Titanium
2, 4, 6, 8, 10, 12, 14mm bar, 0.6mm
Leibinger - Salzburg Lag Screw System: locking plate, Titanium,
with biconcave washers
Luhr Micro and Pan Fixation Systems: Micro mesh Vitallium
40x60mm
Benefit Review, Detail Change
ST391
Luhr Fixation System
Luhr Micro and Pan Fixation Systems: Micro mesh Vitallium
60x100mm
Benefit Review, Detail Change
ST392
Luhr Fixation System
Luhr Micro Fixation System: micro double-T-shape plate Vitallium
6 holes, 6x7mm
Benefit Review, Detail Change
ST393
Luhr Fixation System
Luhr Micro Fixation System: micro double-T-shape plate Vitallium
7 holes, 10x10mm Benefit Review, Detail Change
ST401
Luhr Fixation System
Luhr Micro Fixation System: micro straight plate Vitallium
22 holes, 90mm
ST402
Detail Change
Luhr Fixation System
Luhr Micro Fixation System: micro T-shape plate Vitallium
6 holes, 14mm, 8 holes, 22mm Benefit Review,
ST408
Luhr Fixation System
Luhr Micro Fixation System: emergency screws Vitallium1.0x2-6mm
Benefit Review, Detail Change
ST412
Luhr Fixation System
Benefit Review, Detail Change
Luhr Pan Fixation System: condensed, straight plate Vitallium
4 holes x 12mm, 6 holes x 18mm, 12 holes x 36mm
ST414
ST415
Detail Change
Luhr Pan Fixation System: ladder plate Vitallium
10 holes, 39 x 9mm
Luhr Pan Fixation System: L-shape plate, 90 deg Vitallium
Benefit Review, Detail Change
4 holes, 16 x 9mm, 22 x 9mm Benefit Review,
Luhr Fixation System
Luhr Fixation System
Changed Items for Prostheses List Report
Size
Explanation of Change
Benefit Review, Detail Change
Page 86 of 99
Billing Code Product Name
Further Description
ST416
Detail Change
Luhr Fixation System
Luhr Pan Fixation System: L-shape plate, 110 deg Vitallium
4 holes, 16 x 9mm, 22 x 9mm Benefit Review,
ST417
ST419
ST420
ST444
Luhr Fixation System
Luhr Fixation System
Luhr Fixation System
Luhr Fixation System
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
3-20mm. Pack of 6 Benefit Review, Detail Change
ST446
ST447
Wurzburg Bone Plates
Wurzburg Bone Plates
Luhr Pan Fixation System: straight plate Vitallium
4 holes, 21mm
Luhr Pan Fixation System: straight plate Vitallium
8 holes, 45mm
Luhr Pan Fixation System: straight plate Vitallium
16 holes, 93mm
Luhr Mini/ Pan Fixation System: emergency and standard screws
Vitallium
Wurzburg Mandibular Fracture plate: straight Titanium 4 hole x 35mm
Wurzburg Mandibular Fracture plate: 45 deg plate Titanium
ST448
ST449
ST450
ST451
ST452
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Mandibular Fracture plate: 45 deg Titanium
4 holes, 50mm
Wurzburg Mandibular Fracture plate: straight Titanium 8 holes, 60mm
Wurzburg Mandibular Fracture plate: straight Titanium 8 holes, 70mm
Wurzburg Mandibular Fracture plate: straight Titanium 16 holes, 120mm
Wurzburg Mandibular Fracture plate: angled, 60 deg Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
6 holes Benefit Review, Detail Change
ST477
Wurzburg Bone Plates
Mini Bone plate: straight, regular/long, with/without bar
6 holes Benefit Review, Detail Change
ST478
ST479
ST480
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg
Titanium
Wurzburg
Wurzburg
Wurzburg
Mini Bone plate: straight, long Titanium
8 holes
Mini Bone plate: straight, regular Titanium 16 holes
Mini Bone plate: H and Y-shape nasal plate Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
10, 12 holes
Benefit Review, Detail Change
ST481
Wurzburg Bone Plates
ST482
Wurzburg Bone Plates
ST483
Wurzburg Bone Plates
ST484
ST486
Wurzburg Bone Plates
Wurzburg Bone Plates
ST487
Wurzburg Bone Plates
ST488
Wurzburg Bone Plates
ST489
Wurzburg Bone Plates
ST490
ST491
ST492
ST493
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Bone Plates
Wurzburg Bone Plates
Changed Items for Prostheses List Report
Size
Explanation of Change
Benefit Review, Detail Change
4 holes, 40mm
Benefit Review, Detail Change
Wurzburg Bone plate: double-T-shape, with/without bar, 90 deg,
regular/short Titanium
Wurzburg Bone plate: double-Y-shape , with/without bar,
short/long/long extended Titanium
Wurzburg Bone plate: double-Y-shape, no bridge Titanium
4, 6 holes
Benefit Review, Detail Change
6, 8 holes
Benefit Review, Detail Change
L-shape, right/left, Titanium
4 - 5 holes
Wurzburg Bone plate: T-shape, with/without bar, 90 deg, 5, 6 holes
regular/long Titanium
Wurzburg Bone plate: T-shape, long, 80 deg, long, right/left
Titanium
Wurzburg Bone plate: Y-shape plate, regular/long Titanium
Benefit Review, Detail Change
Benefit Review, Detail Change
Wurzburg Bone plate: Z-shape plate, 100/110 deg, right/left
Titanium
Wurzburg Bone Screws: self-tapping Titanium
2x4-19mm, 2.3x7-9mm. Pack of 10
Leibinger 3D Plating System: square Titanium
2x2 holes
Leibinger 3D Plating System: rectangular Titanium
2x2 holes, 1mm thick
Leibinger 3D Plating System: square Titanium
3x2 holes, 1mm thick
4 holes Benefit Review, Detail Change
7 holes Benefit Review, Detail Change
5 holes Benefit Review, Detail Change
5 holes Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Page 87 of 99
Billing Code Product Name
Further Description
ST494
Detail Change
Wurzburg Bone Plates
Leibinger 3D Plating System: square, rectangular Titanium
4x2 holes, 1mm thick
ST495
ST496
Detail Change
Wurzburg Bone Plates
Wurzburg Bone Plates
Leibinger 3D Plating System: rectangular Titanium
4x4 holes, 1mm thick
Leibinger 3D Plating System: square, rectangular Titanium
Benefit Review, Detail Change
6x4 holes, 1mm thick
Benefit Review,
ST497
Wurzburg Bone Plates
2 holes Benefit Review, Detail Change
ST498
Wurzburg Bone Plates
ST500
Wurzburg Bone Plates
ST501
Wurzburg Bone Plates
ST502
Wurzburg Bone Plates
ST507
Wurzburg Bone Plates
ST516
ST517
ST518
ST519
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Wurzburg Mandibular Reconstruction Plating System: straight
bridging plate Titanium
Wurzburg Mandibular Reconstruction Plating System: straight
bridging plate Titanium
Wurburg Mandibular Reconstruction Plating System: straight
bridging plate Titanium
Wurzburg Mandibular Reconstruction Plating System: straight
bridging plate Titanium
Wurzburg Mandibular Reconstruction Plating System: straight
Titanium
Wurzburg Mandibular Reconstruction Plating System: total mandible
bridging plate Titanium
Resorbable plate: blank panel Tripolymer
55x55mm
Resorbable plate: box shape Tripolymer
2x2 holes
Resorbable plate: curved plate Trypolymer
8 holes
Resorbable plate: L-shape plate, 110 deg, right/left Tripoymer
ST520
ST521
ST524
ST525
ST526
ST527
ST528
ST529
ST855
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Stryker Leibinger Resorbable Fixation System
Leibinger Titanium Implant System
Resorbable plate: ladder shape plate Tripolymer
Resorbable plate: straight Tripolymer
Resorbable plate: Y-shape Tripolymer
Resorbable plate: Y-shape Tripolymer
Resorbable Mesh Tripolymer
Resorbable Screws Trypolymer
Resorbable Screws Trypolymer
Resorbable Screws Trypolymer
Mesh: Micro, Dumbach, Dynamic
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Size
2x5 holes
14 holes
6 holes
8 holes
55x55mm
1.7x4-5mm Pack of 10
1.7x3-6mm Pack of 2
1.7x3-6mm Pack of 4
Diameter 1.0mm - 2.3mm; 90 x 90mm to 200 x 200mm
Explanation of Change
Benefit Review,
3 holes Benefit Review, Detail Change
5 holes Benefit Review, Detail Change
6 holes Benefit Review, Detail Change
7 holes Benefit Review, Detail Change
9 holes Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
7 holes Benefit Review, Detail Change
Surgical House
Neurosurgical
SU077
SU082
SU092
SU198
Change
Cross bar clamp
Double loop
Occiput screw
Olerud ME-Connector
Hook/screw & rod spinal system component
For 7mm rod, for 6mm rod
Hook/screw & rod spinal system component
Left & right, 3.5 & 5.0mm
Hook/screw & rod spinal system component
4mm diam, length14-18 mm
Titanium. For polyaxial connection of Olerud cervical pedicle
Detail Change
Detail Change
Detail Change
for use with 3mm and 4mm Olerud screws Detail
screws to rod, claws etc for fixation of the cervical spine.
Changed Items for Prostheses List Report
Page 88 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
SU200
Titanium
Diameter 4, 5, 6, 7mm Length 45 - 90mm
Detail Change
Olerud Pedicle Screw
Orthopaedic
SU114
SU188
SU209
Diameter
Hintegra Total Ankle Prosthesis
Hintegra Total Ankle Prosthesis
Plus Spinal Fixation System - Pedicle Screws
Detail Change
Talar implant
Right and left, sizes 1 - 5
Talar Implant - Flat talar resection
Left - Size 1-5, Right - Size 1-5
Titanium, mono-axial pedicle screws for attachment to PLUS 6mm
Detail Change
Detail Change
Diameter 4.5mm, Length 20mm-45mm
diameter rods to form a multi-level spinal fixation construct
5.5mm, Length 20mm-50mm
Diameter 6.5mm, Length
25mm-60mm
Diameter 7.5mm, Length 25mm-90mm
Diameter 8.5mm, Length 30mm-90mm
SU211
PLUS Spinal Fixation System - Clip
Titanium clip that fits over the head of the PLUS system pedicle
screws to secure a 6mm rod to the screw. Clip incorporates a set
screw which tightens the clip firmly against the rod/pedicle screw.
one size Detail Change
SU215
20mm-65mm
PLUS Spinal Fixation System - MATC Bars
Titanium, 6mm diameter rods of various lengths for transverse
Detail Change
fixation between 2 PLUS system longitudinal rods as part of a multilevel spinal fixation construct. Available with one spherical end or
two for fixation to fixed angle MATC connectors or multi
Double Spherical Ends: Diameter 6mm, Length
Titanium clamp, fitted to a 6mm PLUS longitudinal rod that fixes a
One size each of fixed angle style and multi-axial
SU216
angle style
PLUS Spinal Fixation System - MATC
Detail Change
Single Spherical End: One size
short transverse support rod between two longitudinal rods as part
of pedicle screw/rod construct. Available in either fixed angle or
multi-axial angle. The use of a combination of a fixed
SU220
PLUS Spinal Fixation System - Set Screws
Titanium set screws used to secure PLUS system clips to PLUS
system pedicle screws and hooks and to tighten PLUS system
connectors against 6mm rods. All clips and connectors are supplied
with set screws pre-loaded. Separate set screws are only required
fo
Regular, Spherical Detail Change
SU223
SU226
Spacevision PLIF Cage
Uni-Thread Connector
PEEK Optima o to 8 degrees lordosis
Height 7-14mm, Length 21-25mm
Titanium pedicle screw/rod connector. Standard, offset or reduction
Detail Change
6.5mm-7.5mm
Reflexion metatarsal heads, 3 part 1st MPJ reconstruction system, 2
part composition - titanium/cobalt chrome, 1 part composition titanium/UHMWPE,
Standard, long, extra-long
Silicone elastomer
Micro, Midface, Mini & Maxi
Plates - Reconstruction
Plates - Fracture
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Detail Change
Surgiplas Medical
Orthopaedic
SP062
Reflexion 1st MPJ Implant System
Detail Change
Plastic and Reconstructive
SP004
SP018
SP024
SP026
Facial Prosthesis
Plates
OsteoMed Plating & Fixation System
OsteoMed Plating & Fixation System
Changed Items for Prostheses List Report
Small / Medium / Large / X-Large
Chin Plate 2, 3, 4, 6, 8, 10 & 12mm, Plates 4 to 7 holes.
5 x 16 Hole plate Right & Left
Rigid Comminuted Fracture Plate
Page 89 of 99
Billing Code Product Name
Further Description
Size
SP027
SP028
OsteoMed Plating & Fixation System
OsteoMed Plating & Fixation System
Plates - Fracture
Plates - Fracture
8 Hole Fracture Plate, 4 & 6 hole locking fracture plate. Benefit Review, Detail Change
4 hole Fracture Plate 32 -37mm; EDC Plate 32mm & 34mm
Benefit Review, Detail Change
Explanation of Change
SP031
OsteoMed Plating & Fixation System
Lag Screws - Micro, Mini
1.2mm x (6 - 16)mm; 1.6mm x (10-12)mm; 2.0mm x (8 - 22)mm; Benefit Review, Detail Change
SP033
OsteoMed Plating & Fixation System
Compression Plates - Micro, Mini & Maxi
Micro: 2 x 3 Hole Compression T Plate, Oblique Left & Right
Benefit Review, Detail Change
Compression T Plate, 4 Hole Straight Compression Plate; 5 Hole
Straight Plate, 13mm Left & Right L Plate, 19mm T Plate, 2 x 3
Hole Quad Plate; Mini: 4 Hole Left & Right L Plate, 4 Hole Left & Rig
SP034
OsteoMed Plating & Fixation System
Compression Plates - Maxi
Maxi: 4, 5 & 6 Hole Straight Plate
Benefit Review, Detail Change
Clamp
Set screw
Locking Screw
Anterior thoracolumbar screws - locking
Pedicle Hook Screw
Sleeve
Set Screw
Pedicle screw head
Expansion Head Screw
Plate
Screw
Locking Screw
Posterior Locking Screw
Locking Set screw
Internal fixator - cross link clamp
Artificial mechanical disc, inferior plate component
Pre contoured mini titanium plates
Cannulated Screws
Synex II, Titanium
Locking clip, PEEK/Titanium
Fracture Clamps
Sleeve
VA Plate
Occipital Clamp Titanium Alloy
Single, Double, Fracture, Left, Right
One size only
One size only
Locking screw 7.5mm, length 25 - 55mm
Length 20- 40mm
3.5 - 6mm
Standard
5 - 6mm
Dia 3.5 - 4.5mm, Length 12 - 25mm
22-33 holes
25-65mm
one size only
One size only
One size only
One size only
0 Degree, 3 Degree, 8 Degree,Medium, Large
4 to 16mm
4.0mm to 9.0mm
Height 14mm-123mm
Universal
Cranial, Standard, Low Profile
3.5 - 6mm
Length 23 - 109mm
1 or 2 holes
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review, Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review, Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review
Detail Change
Synthes Australia Pty Ltd
Neurosurgical
SY008
SY010
SY135
SY140
SY148
SY151
SY152
SY178
SY181
SY183
SY251
SY286
SY304
SY308
SY326
SY329
SY335
SY336
SY341
SY357
SY359
SY363
SY365
SY382
VentroFix
VentroFix
Cervical Spine Locking Plate (CSLP) System
Spinal Plate/Plate System AO/ASIF Spinal Implants
Universal Spine System (USS)
Universal Spine System (USS)
Universal Spine System (USS)
Spinal Fixation System
Cervical Spine Locking Plate (CSLP) System
Posterior Cervical Plate System
Ventrofix - MIS
USS llio-Sacral Fixation system
TeleFix Spinal System
Axon Spinal System
Spinal Plate/Plate System AO/ASIF Spinal Implants
Spine Solutions Prodisc
Arch Fixation System
Click'x Spinal System
Expandable Cage Titanium
ECD - Expandable Corpectomy Device
Universal Spine System (USS)
Universal Spine System (USS)
Cervical Spine Locking Plate (CSLP) System
Axon Occipital Fusion System
Changed Items for Prostheses List Report
Page 90 of 99
Billing Code Product Name
Further Description
SY383
SY385
length
Synmesh
Speciality Rods
Detail Change
Locking Screw, Low Profile, For Synmesh End Rings
Small, Large
Scoliosis / J/S Rod, Precontoured, Titanium / Stainless Steel
Detail Change
5mm, 6mm diameter. Left / Right50mm - 500mm
SY414
SY415
SY429
SY440
SY444
SY445
SY446
USS Micro-Crosslink
USS Micro-Crosslink
Vertecem Vertebral Augmentation
Synapse
CerviFix Posterior Cervical System
CerviFix Posterior Cervical System
CerviFix Posterior Cervical System
Crosslink Clamp
Crosslink Clamp Rod
Vertecem Cement, and Viscosafe Mixing System
Locking Screw
Rod: Straight or pre bent
Occipital Plate Rod
Rod: Tapered
Detail Change
Detail Change
Detail Change
Detail Change
Benefit Review
Benefit Review
Benefit Review
Size
One size only
One size only
21gm
One size
3.5mm diameter, 120-250mm length
one size
3.5/5.0 - 3.5/6.0 dual diameter, 300 -500mm
Explanation of Change
Orthopaedic
SY001
SY002
SY003
SY004
SY005
SY163
SY176
chronOS™ β-TCP
chronOS™ β-TCP
chronOS™ β-TCP
chronOS™ β-TCP
chronOS™ β-TCP
LCP Plate
chronOS™ β-TCP
Porous β-Tricalcium Phosphate Bone Graft Substitute
20g
Porous β-Tricalcium Phosphate Bone Graft Substitute
10g
Porous β-Tricalcium Phosphate Bone Graft Substitute
5g
Porous β-Tricalcium Phosphate Bone Graft Substitute
1g
Porous β-Tricalcium Phosphate Bone Graft Substitute
0.5g
Tibial Plate, Sterile/Non Sterile
1 - 24 hole
Porous β-Tricalcium Phosphate Bone Graft Substitute-Wedge
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Small, Medium, Large
Detail Change
SY177
chronOS™ β-TCP
Porous β-Tricalcium Phosphate Bone Graft Substitute-Block
Small, Medium, Large
Detail Change
SY189
chronOS™ β-TCP
Porous β-Tricalcium Phosphate Bone Graft Substitute-Cylinder
8.5, 9.5, 10.5, 12.5 & 14cm
Detail Change
SY263
SY333
SY358
AO/ASIF Intermedullary Nails
chronOS™ β-TCP
chronOS™ β-TCP
Hip Pin
30-200mm Length
Porous β-Tricalcium Phosphate Bone Graft Substitute
2.5cc
Porous β-Tricalcium Phosphate Bone Graft Substitute-Cervios
Cylinder
Detail Change
Detail Change
F1, 2, 3, 4, 5 & C1, 2, 3, 4, 5
Detail Change
Flapfix - Plates for fixation of cranial bone flaps
10 - 20mm
Titanium Mesh for reconstruction of cranial defects, Low Profile
Benefit Review, Detail Change
200 x 200mm square, 0.4mm - 0.6mm thick,
Benefit Review, Detail Change
0.5 to 0.99mm 4 -7 holes
Benefit Review,
Plastic and Reconstructive
SY252
SY314
Contourable
AO/ASIF Facio-Maxillary Plates
AO/ASIF Plate
Benefit Review, Detail Change
SY317
SY319
Detail Change
AO/ASIF Plate
CMF fracture or reconstruction plate
Neuro Mesh
Titanium Plate - straight
1.6mm Profile, 2-4 holes
Titanium adaption plates - Low profile neurosurgical plates
SY349
Multi Vector Distractor Set
Titanium Multi Vector Distractor
Changed Items for Prostheses List Report
MVD Arms:15mm-85mm. Pin holding clampsBenefit Review, Detail Change
ramus,body,universal,limited bone stock ramus and body. Assembly
left & right 35mm. K wires 2.0mm 150mm length. Connecting bar
4.0mm 100mm-200mm length
Page 91 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
SY391
SY397
SY399
SY400
SY401
SY402
SY403
SY404
SY405
SY406
SY408
SY409
SY410
SY411
1.5/2.0 Orbital Floor Plate
1.5 Burr Hole Cover
Vertical mandibular, maxilla alveolar ridge distractor
Fixation Screws
Head Frame Assembly, Carbon Fibre Rods
Horizontal Rod Assembly
Set Screw
Maxillary Footplate Assembly
Titanium Wire Fixation Screw
Titanium Zygomatic, Maxxilary Footplate
Three Quarter Mandible
Full Mandible
Full Mandible Ramus
Hemi Mandible
S, M, L
8 Hole
8-16mm
40-50mm
One size only
One size only
One size only
80mm-110mm
15-27mm
3 holes, 40mm
One size
One size only
One size
One size
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Tsunami Gold
Stainless Steel mounted on balloon catheter
Diameter 2.0mm - 4.0mm, Length 8mm - 30mm length
Detail Change
TU002
TU003
TU004
TU005
TU006
TU007
TU008
Anaconda Endovascular Graft System
Anaconda Endovascular Graft System
Anaconda Endovascular Graft System
Anaconda Endovascular Graft System
Twillweave Graft
Twillweave Graft
Fluoropassiv Graft
TU009
Fluoropassiv Graft
TU010
Fluoropassiv Graft
TU011
Fluoropassiv Graft
TU012
TU013
TU014
TU016
Fluoropassiv Patch
Gelweave Graft
Gelsoft Plus Graft
Gelsoft Plus Graft
Bifurcated Aortic System, Polyester/Nitinol
18 - 34mm
Aortic Extension Cuff, Polyester/Nitinol
18 - 34mm
Iliac Extension Cuff, Polyester/Nitinol
8 - 18mm
Iliac Leg, Polyester/Nitinol
8 - 18mm
Straight, Polyester, Woven, Unsealed
6-24mm x 50-60cm
Bifurcate, Polyester, Woven, Unsealed
12mm x 6mm x 45cm to 24mm x 12mm x 45cm
Straight Graft - Thin Wall, Crimped. Fluoropolymer/polyester,
Knitted
Straight Graft - Thin Wall, Crimped. Fluoropolymer/polyester,
Knitted
Straight Graft, Thin Wall, Externally Reinforced.
6 to10mm x 30cm
Fluoropolymer/polyester, Knitted
Straight Graft, Thin Wall, Externally Reinforced.
6 to10mm x 40 to 70cm
Fluoropolymer/polyester, Knitted
Thin wall, Fluoropolymer/polyester, Knitted
0.6 x 7.5cm to 1.5 x 7.5cm
Bifurcated, Polyester, Woven
12mmx 6mmx 45 cm to 24mmx12mm x 45cm
Bifurcated, Polyester, Knitted
12mmx6mmx45cm to 24mmx12mmx45cm
Polyester, Externally Reinforced, Knitted
6 to 10mm x 75m
PolyMax Resorbable Fixation System
PolyMax Resorbable Fixation System
Alveolar Distractor
External Midface Distractor System
External Midface Distractor System
External Midface Distractor System
External Midface Distractor System
External Midface Distractor System
External Midface Distractor System
External Midface Distractor System
Mandible External Fixator
Mandible External Fixator
Mandible External Fixator
Mandible External Fixator
Terumo Corporation Australia
Cardio-thoracic
TU001
Vascular
Changed Items for Prostheses List Report
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
6 to10mm x 30cm Detail Change
6 to10mm x 40 to 70cm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Page 92 of 99
Billing Code Product Name
Further Description
Size
TU017
TU018
Gelsoft Plus Graft
Gelsoft Plus Graft
Polyester, Externally Reinforced, Knitted
Axillofemoral, Polyester, Knitted
6 to 10mm x 100cm
Detail Change
8x8mm/100x60cm; 8x7mm/90x40cm; 10x8mm/90x40cm Detail Change
TU019
TU020
TU021
TU022
TU023
TU025
TU026
TU027
TU028
TU029
Gelsoft Plus Graft
Gelsoft Plus Graft
Gelsoft Plus Graft
Gelweave Graft
Gelweave Graft
SEALPTFE Graft
SEALPTFE Graft
SEALPTFE Graft
SEALPTFE Graft
SEALPTFE Graft
Femorofemoral, Polyester, Knitted
6mmx30cm to 8mmx40cm
Straight, Polyester, Knitted
6 - 24mm x 12.5 - 30cm
Straight, Polyester, Knitted
6-24mm x 50-60cm
Straight, Polyester, Woven
6-38mm x 10-30cm
Straight, Polyester, Woven
6-38mm x 40-60cm
Thin Wall, Straight, Sealed, PTFE
5 to 10mm x 10 to 40cm
Thin Wall, Straight, Sealed, PTFE
5 to 10mm x 50 to 80cm
Standard Wall, Straight, Sealed, PTFE
5 to 10mm x 10 to 40cm
Standard Wall, Straight, Sealed, PTFE
5 to 10mm x 50 to 80cm
Standard Wall, Straight, Sealed, Externally Reinforcement, PTFE
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
5 to 10mm x 10 to 40cm
Detail Change
TU030
SEALPTFE Graft
Standard Wall, Straight, Sealed, Externally Reinforcement, PTFE
5 to 10mm x 50 to 80cm
Detail Change
TU032
SEALPTFE Graft
Thin Wall, Straight, Sealed, Externally Reinforced, PTFE 5 to 10mm x 60 to 80cm
Detail Change
TU033
TU035
SEALPTFE Graft
SEALPTFE Graft
Standard Wall, Tapered, Sealed, PTFE
4 to 7mm Taper x 40 to 50cm
Thin Wall, Straight, Sealed externally Reinforced, Vascular Artificial
Arteries/Prostheses of PTFE, Sealed with Gelatin
Detail Change
5 to 10mm x 50cm Detail Change
TU039
Rapidax™ Rapid Access Haemodialysis
Triple layered self sealing haemodialysis Access Graft. ePTFE
internal and external layer with proprietary elastomer inner layer Straight
6mm x 20-50cm
Detail Change
TU040
Rapidax™ Rapid Access Haemodialysis
Triple layered self sealing haemodialysis Access Graft. ePTFE
internal and external layer with proprietary elastomer inner layer Per-curved
Flared iliac limb. Ultrathin woven polyester, nitinol ring stents,
Detail Change
tantalum markers
130mm
6mm x 30-50cm
Detail Change
TU041
Anaconda Endovascular Graft System
17-23mm; Length: 80-
Explanation of Change
Diameter: proximal end 12-17mm, distal end
Tornier Pty Ltd
Orthopaedic
TO041
TO042
TO043
Change
Aequalis Reversed Shoulder -Glenoid Base Plate
Ti HA Coated
Aequalis Reversed Shoulder -Glenoid Sphere
CoCr, Ti Alloy
Aequalis Reversed Shoulder -Metaphysis (Cemented or Cementless)
UMWHPE
TO044
Aequalis Reversed Shoulder - Stem (Cemented or Cementless)
Detail Change
TO045
Aequalis Reversed Shoulder - Lateralized Insertt
Changed Items for Prostheses List Report
UMWHPE
One Size
Detail Change
D.36mm & 42mm
Detail Change
Cemented: CoCr and UMWHPE, Cementless: CoCr, HA Coated and
Cemented: CoCr Cementless: Ti, HA coated
D.36mm & 42mm
Detail
D. 6.5, 9 , 12, 15mm L 100, 150, 180, 210mm
D. 36mm +6mm, D.36mm +9mm, D.36mm +12mm, D.42mm
+6mm, D. 42mm +9mm, D.42mm +12mm
Detail Change
Page 93 of 99
Billing Code Product Name
TO046
TO047
Further Description
Aequalis Reversed Shoulder - Self Locking Screw
Titanium
Aequalis Reversed Shoulder - Fixation Screw for Articular Implant
Size
Explanation of Change
D45mm, L20 to 50mm
Titanium
Detail Change
D. 4.5mm, L 18 to 45mm
Detail Change
W L Gore & Associates
General/Miscellaneous
GT001
GT065
GT066
GORE - Seamguard Staple Line Reinforcement Material 1pair of sleeves ePTFE
Gore-Tex ePTFE Mycro-Mesh Biomaterial
ePTFE
Gore-Tex Mycro-Mesh Biomaterial
ePTFE
One Size Only
Benefit Review, Detail Change
1mm Thickness 2.5 x 10cm
Benefit Review, Detail Change
1mm Thickness 5 x 10cm (Rectangle), 5 x 10cm (Key Hole)
Benefit Review, Detail Change
GT067
Gore-Tex Mycro-Mesh
ePTFE
GT068
GT069
GT070
GT071
GT072
GT074
GT084
GT087
GT092
GT093
GT094
GT095
GT096
GT097
GT098
GT099
GT100
GT101
GT102
GT103
GT104
GT107
GT116
GT201
GT202
Gore-Tex Mycro-Mesh Biomaterial
Gore-Tex Mycro-Mesh Biomaterial
Gore-Tex Mycro-Mesh Biomaterial
Gore-Tex Mycro-Mesh Biomaterial
Gore-Tex Mycro-Mesh Biomaterial
Gore-Tex Mycro-Mesh Biomaterial
Gore-Tex MycroMesh Plus
Gore-Tex MycroMesh Plus
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex Dual Mesh
Gore-Tex DualMesh PLUS
Gore-Tex DualMesh PLUS
Gore Biliary Endoprostheses
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
Configured for Inguinal Hernia repair ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE, oval
1mm Thickness 5 x 13cm (Configured for Vaginal Prolapse), 5 x Benefit Review, Detail Change
15cm
1mm Thickness 18 x 24cm
Benefit Review, Detail Change
1mm Thickness 20 x 30cm
Benefit Review, Detail Change
1mm Thickness Oval 26 x 34cm
Benefit Review, Detail Change
1mm Thickness Oval 10 x 15cm
Benefit Review, Detail Change
1mm Thickness Oval 15 x 19cm
Benefit Review, Detail Change
1mm Thickness 6cm x 12cm
Benefit Review, Detail Change
1mm Thickness 20cm x 30
Benefit Review, Detail Change
1mm thickness Oval 26 x 34cm
Benefit Review, Detail Change
1mm Thickness 7.5 x 10cm
Benefit Review, Detail Change
1mm Thickness 8 x 12cm
Benefit Review, Detail Change
1mm Thickness Oval 10 x 15cm
Benefit Review, Detail Change
1mm Thickness Oval 15.0 x 19.0cm
Benefit Review, Detail Change
1mm Thickness 18 x 24cm
Benefit Review, Detail Change
1mm Thickness 20 x 30cm
Benefit Review, Detail Change
1mm Thickness Oval 26 x 34cm
Benefit Review, Detail Change
2mm Thickness Oval 10 x 15cm
Benefit Review, Detail Change
2mm Thickness Oval 15 x 19cm
Benefit Review, Detail Change
2mm Thickness 18 x 24cm
Benefit Review, Detail Change
2mm Thickness 20 x 30cm
Benefit Review, Detail Change
2mm Thickness Oval 26 x 34cm
Benefit Review, Detail Change
1mm Thickness 7.5 x 10cm
Benefit Review, Detail Change
15.0 x 19.0cm x 1mm Oval
Benefit Review, Detail Change
Short or Long Catheter 8-10mmx4-8cm
Detail Change
8cm x 12cm x 1mm
Benefit Review, Detail Change
10cm x 15cm x 1mm
Benefit Review, Detail Change
Changed Items for Prostheses List Report
Page 94 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
GT203
GT204
GT205
GT206
GT207
GT208
GT209
GT210
ePTFE
ePTFE
ePTFE, oval
ePTFE, oval
ePTFE, oval
ePTFE,
ePTFE,
ePTFE, oval
18cm x 24cm x 1mm
20cm x 30cm x 1mm
26cm x 34cm x 1mm
10cm x 15cm x 2mm
15cm x 19cm x 2mm
18cm x 24cm x 2mm
20cm x 30cm x 2mm
26cm x 34cm x 2mm
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Benefit Review, Detail Change
Preclude Spinal Membrane
Preclude Spinal Membrane
Preclude Dura Substitute
Preclude Dura Substitute
Preclude Dura Substitute
Preclude Dura Substitute
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
ePTFE
0.7mm Thickness 6 x 6cm
0.7mm Thickness 6cm x 12cm
0.3mm Thickness 2 x 10cm
0.3mm Thickness 5 x 6 cm
0.3mm thickness 6 x 10cm
0.3mm thickness 10 x 12cm
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
GT020
Viabahn/Hemobahn Endoprosthesis
Endoluminal Graft System
GT021
Viabahn/Hemobahn Endoprosthesis
GT022
Viabahn/Hemobahn Endoprosthesis
GT023
GT024
Change
Excluder Endovascular Prostheses
Excluder Endovascular Prostheses
Viabahn 2.5mm - 8mm Diameter, 5cm Length; Hemobahn 6 Detail Change
13mm Diameter, 5cm Length
Endoluminal Graft System
Viabahn 2.5mm - 8mm Diameter, 10cm Length; Hemobahn 6 Detail Change
13mm Diameter, 10cm Length
Endoluminal Graft System
Viabahn 2.5mm - 8mm Diameter, 15cm Length; Hemobahn 6 Detail Change
11mm Diameter, 15cm Length
Thoracic Stent Graft Nitinol & ePTFE
26-40mm Diameter x 15-20cm Lengths
Detail Change
Abdominal Stent Graft Nitinol & ePTFE - Trunk - Ipsilateral Leg
23-28.5mm Diameter, 14-18cm Length
GT029
Gore Tips Endoprosthesis
ePTFE
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Dualmesh Plus Biomaterial
Neurosurgical
GT054
GT055
GT056
GT057
GT058
GT059
Vascular
Detail
8-12mm Diameter 4-8cm Graft-Lined Length 2cm Unlined Length Detail Change
GT188
Excluder Endovascular Prostheses
Detail Change
Abdominal Stent Graft Nitinol & ePTFE - Contralateral Leg
Diameter 12 - 14.5mm x 10 x 14cm Length
GT189
Change
Excluder Endovascular Prostheses
Abdominal Stent Graft Nitinol & ePTFE - Aortic Extender
Diameter 23 - 28.5mm, Length 3.3cm
GT190
GT191
Excluder Endovascular Prostheses
Excluder Endovascular Prostheses
Abdominal Stent Graft Nitinol & ePTFE - Iliac Extender Diameter 10 - 14.5mm, Length 7cm
Thoracic Stent Graft Nitinol & ePTFE
Diameter 26-40mm x 10cm Length
Detail Change
Detail Change
Nasobiliary drainage catheter Set includes: nasal transfer tube,
Diameter: 5 to 10 FRLength: 250cm
Detail
William A Cook Australia Pty Ltd
General/Miscellaneous
WC071
Change
Nasobiliary Drainage Set
Detail
drainage connecting tube, wire guide
Changed Items for Prostheses List Report
Page 95 of 99
Billing Code Product Name
Further Description
WC123
Change
Geenen Pancreatic Stent
Straight plastic pancreatic stent with or without ductal flaps
Diameter 3 - 11.5 FR, length 2 - 15cm
WC174
WC200
Gap removed
Zilver Biliary Stent System
Fusion Zilver Biliary Stent System
Self expanding Metal Biliary Stent System
Diameters: 6, 8, 10mm; Lengths: 4, 6,8cm
Self expanding Metal Biliary Stent with Fusion Introducer System
Gap removed
Diameters: 6, 8 & 10mm; length: 4, 6 & 8cm
Surgisis Biodesign Complex Hernia Graft is 8 perforated layers of
13cm x 15cm 8-Layer Perforated Tissue Graft
WC242
Surgisis Biodesign Complex Hernia Graft
Benefit Review, Detail Change
Explanation of Change
Size
Detail
processed small intestine submucosal porcine derived collagen
matrix, freeze dried, corrugated and non cross-linked material, that
signals surrounding tissues to restore and remodel, while
WC243
Surgisis Biodesign Anal Fistula Plug
Length. Conical Benefit Review, Detail Change
Surgisis Biodesign Anal Fistula Plug is a small intestine submucosal
porcine derived, rolled and shaped collagen matrix, non crosslinked, that signals the body and provides support for native tissue
remodeling, healing and closure of anal fistulas
WC244
Sugisis Biodesign 8-layer Tissue Graft
Benefit Review, Detail Change
8 layers of processed small intestine submucosal porcine derived
0.6cm Width Tapering to 0.2cm Width x 9.5cm
Shape
13cm x 15cm; 13cm z 22cm; 20cm x 20cm
collagen matrix, vacuum pressed and non crosslinked material that
sugnals surrounding tissues to restore and remodel while providing
extra strength and support to weakened areas.
WC247
Surgisis Biodesign 8-Layer Tissue Graft
Benefit Review, Detail Change
Surgisis Biodesign 8-Layer Tissue Graft is 8 Layers of processed
13cm x 22cm 8 Layer Perforated Tissue Graft
small intestine submucosal porcine derived collagen matrix, vacumm
pressed and non cross - linked material, that signals surrounding
tissues to restore and remodel while providing extra str
WC248
Surgisis Biodesign 8-Layer Tissue Graft
Benefit Review, Detail Change
Surgisis Biodesign 8-Layer Tissue Graft is 8 Layers of processed
20cm x 20cm 8 Layer Perforated Tissue Graft
small intestine submucosal porcine derived collagen matrix, vacumm
pressed and non cross - linked material, that signals surrounding
tissues to restore and remodel while providing extra str
WC249
Tissue Graft
Surgisis Biodesign Complex Hernia Graft
Benefit Review, Detail Change
Surgisis Biodesign Complex Hernia Graft is 8 perforated layers of
13cm x 22cm 8- Layer Perforated and Corrugated
processed small intestine submucosal porcine derived collagen
matrix, freeze dried, corrugated and non cross-linked material, that
signals surrounding tissues to restore and remodel, while
WC250
Tissue Graft
Surgisis Biodesign Complex Hernia Graft
Benefit Review, Detail Change
Surgisis Biodesign Complex Hernia Graft is 8 perforated layers of
20cm x 20cm 8-Layer Perforated and Corrugated
processed small intestine submucosal porcine derived collagen
matrix, freeze dried, corrugated and non cross-linked material, that
signals surrounding tissues to restore and remodel, while
WC251
Surgisis Biodesign Complex Hernia Graft
Surgisis Biodesign Complex Hernia Graft is 8 perforated layers of
20cm x 30cm 8 Layer Perforated and Corrugated
Tissue Graft
Benefit Review, Detail Change
processed small intestine submucosal porcine derived collagen
matrix, freeze dried, corrugated and non cross-linked material, that
signals surrounding tissues to restore and remodel, while
Changed Items for Prostheses List Report
Page 96 of 99
Billing Code Product Name
Further Description
Size
Explanation of Change
Orthopaedic
WC135
Change
Vertebroplasty Procedure Pack
Percutaneous Vertebroplasty set with Osteo-Site needle and bone
11/13 Gauge 10/15CM M1, M1M, M2
Detail
cement
Urogenital
WC035
Change
Ureteric Stent Set
Set includes Aqueous Coated (AQ) firm multilength ureteric stent,
Multiple French Sizes, Multi-Length
Detail
WC130
Change
Ureteric Stent Set
positioner, with or without wire guide
Set includes Aqueous Coated (AQ) firm fixed length ureteric stent,
Multiple French Sizes, and Lengths
Detail
positioner, with or without wire guide
Vascular
WC038
Coil - Embolisation Coils MWCE-TORNADO
Tornado Platinum
WC039
Cook Embolization Coil
Hilal Platinum
WC045
WC047
WC048
WC076
WC093
system
Zenith Endovascular Graft
Zenith Endovascular Graft
Zenith Endovascular Graft
Flipper-Patient Ducts Arteriosus-Occluding System
Cook Implantable Injection/Infusion Ports
Detail Change
Diameters: .018, .035 and .038, Coil Taper Diameters: 2mm to 10mm
Detail Change
Diameters: .018, Extended Lengths: .5cm to 6cm, Coil Diameters: Detail Change
Straight to 10mm
Converter
Diameter 20 thru 36 Length 80-85
Detail Change
Leg Extensions
Diameter 18 thru 24 Length 55
Detail Change
Body Extensions
Diameter 22 thru 36
Detail Change
Detachable Coil for PDA Closure
Coil Diameter 3,5,6.5 & 8 mm Number of Loops (3,4,5) Detail Change
Petite or Standard, single or multiple chamber Polysulfone Port
3 - 12 Fr pre-attached or detached catheter or valve
which may include micropuncture or standard introducer set
WC094
system
Cook Implantable Injection/Infusion Ports
Detail Change
Mini or Petite or Standard, single or multiple chamber titanium Port
3 - 12 Fr pre-attached or detached catheter or valve
which may include micropuncture or standard introducer set
WC096
WC115
valve system
Cook Vena Cava Filter
Cook Implantable Injection/Infusion Port
Detail Change
Universal Filter
Diameter up to 40mm, Length up to 60mm
Mini, single or multiple chamber titanium Port which may include
Detail Change
3 - 12 Fr pre-attached or detached catheter or
WC164
system
Cook Implantable Injection/Infusion Ports
Detail Change
micropuncture introducer set
Dual or Multiple Chamber Titanium Port which may include
3 - 12 Fr pre-attached or detached catheter or valve
WC168
Cook Vascular/Biliary Stent
micropuncture or standard introducer set
Vascular/Biliary stent
WC173
Cook Embolisation Coils
Nester Platinum
WC190
Detachable Mreye Embolization Coils
WC191
Cook Intravascular Embolization Prostheses
WC192
Detachable Mreye Embolization Coils
WC201
Cook Central Venous Catherisation Kits
5/6 Fr delivery system, 4 - 14mm diameter, 2 - 8cm length
Detail Change
Diameters: .018 and .035, Extended Lengths: 14cm, Coil Diameters:
Detail Change
3mm to 10mm
Standard Mreye
Diameters: .035 and .038, Extended Lengths: 1cm to 20cm, Coil Detail Change
Diameters: 3mm to 20mm
Hilal Platinum (Soft)
Diameters: .018; Extended Lengths: 5cm to 3cm, Coil Diameters: Detail Change
Straight to 10mm
Jackson Mreye
Diameters: .035 and .038 Extended Lengths: 4cm to 6cm Coil
Detail Change
Diameters: 3mm to 12mm
Turbo-Flo Peripherally Inserted Central Venous Catheter Set, Single
4Fr - 60cm and 5Fr - 60cm
Detail Change
Lumen Polyurethane with Micropuncture Peel-Away Sheath
Introducer and Wire Guide
Changed Items for Prostheses List Report
Page 97 of 99
Billing Code Product Name
Further Description
WC204
Cook Central Venous Catheterisation Kits
Turbo-Flo Over-The-Wire Peripherally Inserted Central Venous
Catheter Set, Single Lumen Polyurethane with Micropuncture PeelAway Sheath Introducer and Wire Guide
4Fr - 60cm and 5Fr -60cm
WC205
Cook Central Venous Catheterisation Kits
Turbo-Flo Over-The Wire Peripherally Inserted Central Venous
Catheter Set, Dual Lumen Polyurethane with Micropuncture PeelAway Sheath Introducer and Wire Guide
5Fr - 60cm
WC206
Change
Cook Central Venous Catheterisation Kits
PICC Peripherally Inserted Central Venous Catheter Set, Single
3Fr - 50cm and 4Fr and 5Fr - 60cm
Detail
Cook Central Venous Catheterisation Kits
Lumen Silicone with Micropuncture Peel-Away Sheath Introducer
and Nitinol Wire Guide
PICC Peripherally Inserted Central Venous Catheter Set, Catheter
3Fr - 50cm and 4Fr and 5Fr - 60cm
Detail
WC207
Change
Size
Explanation of Change
Detail Change
Detail Change
without Clamp, Single Lumen Silicone with Micropuncture PeelAway Sheath Introducer and Wire Guide
WC208
Cook Central Venous Catheterisation Kits
PICC Peripherally Inserted Central Venous Catheter Set, Catheter
without Clamp, Single Lumen Silicone with Micropuncture PeelAway Sheath Introducer and Nitinol Wire Guide
4Fr - 60cm and 5Fr - 60cm
Detail Change
Zimmer Pty Ltd
Neurosurgical
ZI479
ZI480
ZI488
ZI641
ZI659
ZI665
Silhouette Spinal System Implants
Silhouette Spinal System
Silhouette Transverse Connector Insert
BacFix (Thoracolumbar System)
Nex-Link
Incompass
Nut, Locking, Polyaxial
1 size
Adjustable Transverse Connector Sleeve with Set Screw 12 - 90mm lengths
Titanium
one size only
Non-threaded wedge with serrated teeth - Titanium alloy 5.5 - 6mm
Spinal Fixation System, Closed Screw Set Screw
4.0mm
Thoracolumbar Fixation System, Closed Implant Set Screw
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
5.5mm Detail Change
ZI698
ZI699
Java screw system
Universal Clamp
Java Blocker
Locking Screw
Set screw
.
Detail Change
Detail Change
Co Cr (Zimaloy), polished and tapered
PMMA/Plastic
Centring Plug, cement restrictor, hip - PE
Cobalt Chrome metal on metal
Titanium, grit blast, non HA, standard and high offset
Zweymuller, Ti alloy, Short Cone, Slender Neck
Forged CoCr femoral head
Screw set
Sizes 1 - 5
Extra Small, Small, Regular
1 to 7
28 to 40mm alloy
1 - 14
01, 0, 1, 10-13
A1 to L1
One size only
Benefit Review
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Detail Change
Orthopaedic
ZI009
ZI328
ZI356
ZI382
ZI462
ZI463
ZI472
ZI511
Zimmer CPT Hip Systems Femoral Stem
Coonrad/Morrey Elbow Cement Restrictor
Medullary Plug, MS 30
Metasul Femoral Head
Alloclassic Hip Stem
Alloclassic Hip Stem
Durom (Metasul) Resurfacing System - Ballhead
Optima Spinal System - Set Screw
Changed Items for Prostheses List Report
Page 98 of 99
Billing Code Product Name
Further Description
Size
ZI553
Neck component for M/L taper stem
size K, S, A, E, P, X, B, G, R, C, J, D, K1, S1, AA, E1, P1, X1,
K2, E2, BB, G1, R1 ,S2, P2, G2, CC, J1, X2, R2, J2, DD
M/L Taper Kinectiv Neck
Explanation of Change
Detail Change
Grand Total: 2190 Records
Changed Items for Prostheses List Report
Page 99 of 99