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Schedule 5 - Appendix A - Surgically Implanted Prostheses

Schedule 5 - Appendix A - Surgically Implanted Prostheses

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CARDIO-THORACIC<br />

Billing Code Product Further Size Notations<br />

GU091 Guidant Australia Fineline II Irox Silicone 52cm<br />

Model 4454<br />

GU092 Guidant Australia Fineline II EZ Irox Silicone 45cm<br />

Model 4466<br />

GU093 Fineline II Sterox Irox Model 55D Polyurethane 52cm<br />

4480-52cm lead<br />

GU094 Fineline II EZ Sterox Irox Model 4469 55D Polyurethane 45cm<br />

- 45cm lead<br />

GU112 Endotak Reliance S Lead Model 0127, defibrillation lead, 9fr 59cm<br />

introducer (silicone coated), steroid<br />

eluting, high impedence<br />

GU113 Endotak Reliance S Lead Model 0128, defibrillation lead, 9fr 64cm<br />

introducer (silicone coated), steroid<br />

eluting, high impedence<br />

GU115 Endotak Reliance Lead Model 0147, defibrillation lead, 9fr 59cm<br />

introducer (silicone coated), steroid<br />

eluting, high impedence<br />

GU116 Endotak Reliance Lead Model 0148, defibrillation lead, 9fr 64cm<br />

introducer (silicone coated), steroid<br />

eluting, high impedence<br />

GU117 Endotak Reliance Lead Model 0149, defibrillation lead, 9fr 90cm<br />

introducer (silicone coated), steroid<br />

eluting, high impedence<br />

Leads, Pacemaker, Implantable Myocardial<br />

GU037 Myocardial Pacing Lead Model 4312 and 4316 54cm and 35cm<br />

Pacemakers, Cardiac, Implantable<br />

GU045 Pulsar Max II Pacemaker DDDR Model 1280<br />

GU054 Discovery II Pacemaker SSIR Model 1187<br />

GU055 Ventak Prizm DR Model 1856<br />

GU061 Discovery II Pacemaker SSIR Model 1184<br />

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