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Schedule 5 - Appendix A - Surgically Implanted Prostheses

Schedule 5 - Appendix A - Surgically Implanted Prostheses

Schedule 5 - Appendix A - Surgically Implanted Prostheses

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ORTHOPAEDIC<br />

Billing Code Product Further Size Notations<br />

BX101 Cenator Total Hip System Femoral stem polished Co cr Stems ex-narrow, narrow,std &<br />

large Cups heads22,26,28mm<br />

BX109 Freeman -Morgan Total Hip System Cement spacer One size only<br />

BX110 Freeman -Morgan Total Hip System Canal occluder 12,14,16mm diameter<br />

BX112 C-Fit Total Hip System Head: alumina ceramic modular 22,26,28,32mm<br />

BX113 C-Fit Total Hip System Cocr and UHMWPE bipolar Short std and long neck 40-60mm<br />

modular head<br />

BX114 C-Fit Total Hip System Zirconia ceramic modular femoral 22,26,28,32mm<br />

BX115 C-Fit Total Hip System CoCr modular femoral head 22,26,28,32mm<br />

BX116 Freeman -Morgan Total Hip System Stem: modular cemented CoCr 14mm-22mm diameter<br />

BX117 Freeman -Morgan Total Hip System Long cemented CoCr 14mm-22mm diameter<br />

BX118 Freeman -Morgan Total Hip System Ridged Ti alloy stem 14mm-22mm diameter<br />

BX119 Freeman -Morgan Total Hip System Ridged titanium alloy HAP coated 14mm-22mm diameter<br />

<strong>Prostheses</strong>, Joint, Knee<br />

BX001 Rotaglide + Total Knee System, Tibial Latched, Porous Coat Ex Sml - Ex Lge<br />

Component<br />

BX005 Rotaglide + Total Knee System, Stem Cobalt chrome 30mm - 70mm<br />

Extensions<br />

BX006 Rotaglide + Total Knee System Tibial Augmentation Blocks Small 4mm - Large12mm<br />

BX007 Rotaglide + Total Knee System Tibial Boss Peg<br />

BX008 Rotaglide + Total Knee System, Asymmetric Sml (35/29mm)) - Lg (43/37mm)<br />

Patella UHMWPE<br />

BX009 Rotaglide + Total Knee System, Dome Sml (26mm OD) - Lg (34mm OD)<br />

Patella UHMWPE<br />

BX010 Rotaglide + Total Knee System, Tibial Mobile 7mm - 17mm<br />

Insert UHMWPE<br />

BX011 Rotaglide + Total Knee System, Tibial Fixed 9.5mm - 17mm<br />

Insert UHMWPE<br />

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