Schedule 5 - Appendix A - Surgically Implanted Prostheses

ORTHOPAEDIC
Billing Code Product Further Size Notations
AT017 PLUS Endoprothetik Hip Systems PLUS-Fit - Titanium 40-68 in increments of 2
AT018 PLUS Endoprothetik Hip Systems EPF-PLUS - Titanium 40-68 in increments of 2
AT019 PLUS Endoprothetik Hip Systems EPF-PLUS (HA) - Titanium 40-68 in increments of 2
AT020 PLUS Endoprothetik Hip Systems EPF-PLUS (Ceramic) - Titanium 50-68 in increments of 2
AT021 PLUS Endoprothetik Hip Systems EPF-PLUS (Metal) - Titanium 48-68 in increments of 2
AT022 PLUS Endoprothetik Hip Systems EPF-PLUS (Metal Antilux) - 46-68 in increments of 2
Prostheses, Joint, Knee
AT025 PLUS Endoprothetik Knee Systems TC-PLUS Solution (Cemented) 2-12 in increments of 2
CoCrMo
AT026 PLUS Endoprothetik Knee Systems TC-PLUS Solution (Cementless) - 2-12 in increments of 2
CoCrMo, Ti-Plasma Spray Coated
AT027 PLUS Endoprothetik Knee Systems TC-PLUS PS Solution - CoCrMo 2-12 in increments of 2
AT028 PLUS Endoprothetik Knee Systems RT-PLUS Solution - CoCrMo, 4, 6, 8 in Left & Right
FeCrNiMoNbN
AT029 PLUS Endoprothetik Knee Systems RT-PLUS Solution (Modular) - 4, 6, 8 in Left & Right
CoCrMo, FeCrNiMoNbN
AT030 PLUS Endoprothetik Knee Systems UC-PLUS Solution - CoCrMo F = 4, 6, 8 & 10 T = 40, 44, 48, 52
& 56
Prostheses, Joint, Toe
AT001 Toefit - Plus Total Prosthesis Titanium alloy Metatarsal Component S-L;
Proximal sizes: 6,7,8; Phalangeal
Component XS-L; Distal 11-15mm
AT002 Toefit - Plus Hemi Prosthesis Titanium alloy Phalangeal Component XS-L,
Distal Insert 13-17mm
Prostheses, Joint, Wrist
AT035 IPS Scaphoid Partial Implant Pyrocarbon Large (18 x 10mm), medium (17 x
9.1mm), small (16 x 8mm)
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