Schedule 5 - Appendix A - Surgically Implanted Prostheses

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ORTHOPAEDIC Billing Code Product Further Size Notations BI802 Ascent Total Knee System Tibial bearing, constrained, 59, 63/67, 71/75, 79/83, 87/91mm widths, 10-20mm thicknesses Orthopedic Internal Fixation Systems, Spinal BI001 Omega 21 Spine Fixation System Screw, Self Tapping, 4.75mm, 5.5mm, 25mm - 65mm 6.35mm, 7.5mm, 8.5mm diameter BI004 Omega 21 Spine Fixation System Connection Rod, Titanium 105-155mm BI006 Omega 21 Spine Fixation System Simple Coupling, Slotted; Titanium One size only BI007 Omega 21 Spine Fixation System Multidirectional Coupling, Slotted; One size only Titanium BI008 Omega 21 Spine Fixation System Screw, Spondylolisthesis, 4.75mm, 25mm - 65mm 5.5mm, 6.35mm, 7.5mm diameter BI010 Omega 21 Spine Fixation System Connection Rod, Titanium 165-255mm BI011 Omega 21 Spine Fixation System Connection Rod, Titanium 35-95mm BI322 Spinelink Spinal Fixation System Polydirectional Screws, Titanium (5.5,6.5,7.5mm) x (35-60mm) BI323 Spinelink Spinal Fixation System Standard Lock Nut, Titanium One size only BI324 Spinelink Spinal Fixation System Extended Lock Nut, Titanium One size only BI325 Spinelink Spinal Fixation System Standard Link, Titanium 21mm - 78mm BI326 Spinelink Spinal Fixation System Left Reverse Link, Titanium 21mm - 48mm BI327 Spinelink Spinal Fixation System Right Reverse Link, Titanium 21mm - 48mm BI328 Spinelink Spinal Fixation System Space Washer, Titanium One size only BI329 Spinelink Spinal Fixation System End Cap, Titanium One size only BI330 OMEGA 21 Spine Fixation System Multidirection Coupling, Titanium One size only BI331 OMEGA 21 Spine Fixation System Rods, Titanium 40mm, 60mm, 80mm BI332 OMEGA 21 Spine Fixation System Locking Nut, Titanium One size only BI333 OMEGA 21 Spine Fixation System Transverse Rod Connector , One size only Page 148 of 638
ORTHOPAEDIC Billing Code Product Further Size Notations BI336 Omega 21 Spine Fixation System Screw, Expandable, 5.5mm, 6.35mm, 25mm - 65mm 7mm, 8mm BI705 Spinelink Anterior Cervical Spinal Lock Nut, Titanium One size only System BI706 Spinelink Anterior Cervical Spinal Screw, Titanium Dia 4.5 - 6.5mm x 12mm System BI707 Spinelink Anterior Cervical Spinal Plate Cervical, Top or Bottom, Length 12 - 50mm System Titanium BI708 Spinelink Anterior Cervical Spinal End Cap, Titanium One size only System BI709 Vuelock Anterior Cervical Plate Plate, Cervical, Four Level, Titanium 60 - 92mm BI710 Vuelock Anterior Cervical Plate Plate, Cervical, Three Level, 44 - 66mm BI711 Vuelock Anterior Cervical Plate Plate, Cervical, Two Level, Titanium 26 - 42mm BI712 Vuelock Anterior Cervical Plate Plate, Cervical, One Level, Titanium 12 - 24mm BI713 Vuelock Anterior Cervical Plate Screw, Titanium Dia 4 - 5mm, length 12 - 16mm BI793 Omega 21 Spine Fixation System Hook titanium - Pedicle/Lt & Rt 6, 8, 10mm Angle/Wide/Narrow/Reduced Pins, Bone BI232 Moore Pins Scan Pin, Stainless Steel 16mm x 51-152mm BI298 Rush Intramedullary Pins Stainless Steel 2.4-6mm x (30-440mm) BI302 Knowles Hex Drive Pins Stainless Steel 4.0, 4.7mm x (57-152mm) BI303 Rush Intramedullary Pins Stainless Steel 2.4mm x (30-35mm) BI304 Rush Intramedullary Pins Stainless Steel 3.2mm x (100-250mm) BI305 Rush Intramedullary Pins Stainless Steel (2.4, 4.8)mm dia x (30-360)mm BI306 Rush Intramedullary Pins Stainless Steel 6.4mm x (280-440mm) Pins, Bone, Absorbable BI275 Lactosorb Suture Anchors Suture Anchor, Lactosorb, 2.0mm, 3.0mm Page 149 of 638
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Schedule 5 - Appendix A - Surgicall
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CARDIO-THORACIC Billing Code Produc
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EAR, NOSE & THROAT Billing Code Pro
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ENDOSCOPIC PRODUCTS Billing Code Pr
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GENERAL/MISCELLANEOUS Billing Code
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MECHANICAL INTERNAL WOUND CLOSURE B
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NEUROSURGICAL Billing Code Product
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Page 97 and 98: NEUROSURGICAL Billing Code Product
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ORTHOPAEDIC Billing Code Product Fu
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PLASTIC AND RECONSTRUCTIVE Billing
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UROGENITAL Billing Code Product Fur
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VASCULAR Billing Code Product Furth
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Schedule 5 - Appendix A - Surgically Implanted Prostheses

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