Schedule 5 - Appendix A - Surgically Implanted Prostheses

ORTHOPAEDIC
Billing Code Product Further Size Notations
BI227 Kirschner Integrated Shoulder System Neer II Humeral, Chrome Cobalt, Stem 6.3 to 12.7mm Head 15-22mm
UHMWPE
BI228 Kirschner Modular Shoulder Humeral Head, Modular, Chrome 38-51mm
Cobalt
BI229 Kirschner Modular Shoulder Humeral Stem, Chrome Cobalt 6.3 -15.9mm
BI230 Kirschner Modular Shoulder Glenoid Component, UHMWPE Small, Std
BI231 Humeral Replacement System Proximal Shoulder System: Chrome Body: std, +10mm Stem
Cobalt, Titanium, UHMWPE 6.5-12.5mm Sleeve 6.5-12.5mm
Humeral Head 40-52mm
BI342 Copeland Shoulder System Glenoid, UHMWPE One size only
BI343 Copeland Shoulder System Humeral, Chrome Cobalt Small, Std, Large (no specific size)
BI344 Copeland Shoulder System Glenoid Component, HA Coated, Small, Std, Extra Deep (no specific
Chrome Cobalt, UHMWPE size)
BI345 Copeland Shoulder System Humeral Component, Chrome Cobalt Small, Std, Large (no specific size)
Prostheses, Joint, Toe
BI021 Total Toe System Metatarsal Component UHMWPE, Small, Medium, Large Extra Large.
Titanium
BI022 Toe Joint Replacement Phalangeal Component, Titanium Small, Medium, Large Extra Large.
Prostheses, Leg
BI166 Compress Finn Limb Salvage System Distal Femoral Replacement: Anchor 15 plugs, 9 segments, 8 pins, 14
Plug, Femoral segment, transverse sleeves, 26 spindles
pins, centering sleeves, spindle.
Chrome Cobalt.
Screws
BI005 Re-Unite Orthopaedic System Rotator Cuff Butress, Lactosorb; One size only
PGA/PLA
BI012 Re-Unite Orthopaedic System Pop-Rivet - PGA/PLA One size only
BI241 Gentle Threads Ligament Fixation Screw, Graft Interference, PGA/PLA 7mm, 8mm, 9mm, 10mm
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