Schedule 5 - Appendix A - Surgically Implanted Prostheses

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ORTHOPAEDIC Billing Code Product Further Size Notations DP668 Small / Large Fragment Set S/S CHS Lag Screw Stainless Steel Length 50-145mm (sterile) DP669 Small / Large Fragment Set S/S Supracondylar Plate S/S 4-8 Hole 95 Deg DP670 Small / Large Fragment Set S/S Tronchanteric Support Plate Small-Large DP671 Small / Large Fragment Set S/S CHS Plate S/S Std & Short Bar 2-4 Hole 135-150 Deg DP672 Small / Large Fragment Set S/S CHS Plate S/S, Standard & Short 4-8 Hole 95 Deg Barrel (Sterile) DP673 Small / Large Fragment Set S/S SCS Plate Stainless Steel Sterile 3-9 Hole DP674 Small / Large Fragment Set S/S Narrow Bone Plate Stainless Steel 5-18 Hole DP675 Small / Large Fragment Set S/S Broad Bone Plate Stainless Steel 3-6 Hole for 1.5mm DP678 Small / Large Fragment Set S/S Small DCP Plate Stainless Steel LC 2-4 Hole 2.7mm DP679 Small / Large Fragment Set S/S Narrow DCP Plate Stainless Steel 6 Hole DP680 Small / Large Fragment Set S/S Broad DCP Plate Stainless Steel 6 Hole DP681 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 2.7mm 4-6 Hole DP682 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 3 Hole DP683 Small / Large Fragment Set S/S Cerclage Wire Loop Stainless Steel 0.8-1.2mm x 280-600 DP685 Small / Large Fragment Set S/S Angle Blade Plate DCP Stainless 95 Deg 5-7 Hole DP686 Small / Large Fragment Set S/S Stainless Steel Plate for Tib Forked Small-Large Blade DP687 Small / Large Fragment Set S/S Stainless Steel Plate for Tib Small-Large DP688 Small / Large Fragment Set S/S Stainless Steel Femoral Neck Pin Small-Large Support Plate DP689 Small / Large Fragment Set S/S Tibial Stainless Steel Condylar 1.5-2mm Plate & Mini Condylar Plate DP690 Small / Large Fragment Set S/S Mini Stainless Steel Condylar Plate D 1.5 mm DP691 Small / Large Fragment Set S/S Spoon Plate Stainless Steel 5-6 Hole Page 176 of 638
ORTHOPAEDIC Billing Code Product Further Size Notations DP692 Small / Large Fragment Set S/S Cloverleaf Plate Stainless Steel 3-4 Hole DP693 Small / Large Fragment Set S/S T-Plate Stainless Steel 3 Hole DP694 Small / Large Fragment Set S/S T-Plate Stainless Steel 3/3 - 5/3 - 4/4 - 6/4 Hole DP695 Small / Large Fragment Set S/S Y-Plate Stainless Steel 2 + 2 + 4 or 4 + 4 + 4 Slots DP696 Small / Large Fragment Set S/S T-Small Plate Stainless Steel D 2.7mm DP697 Small / Large Fragment Set S/S Stainless Steel L-Mini Plate / 2.0mm Oblique L-Mini DP698 Small / Large Fragment Set S/S H-Mini Stainless Steel Plate 2.0mm DP699 Small / Large Fragment Set S/S H-Mini Stainless Steel Plate 1.5mm DP700 Small / Large Fragment Set S/S K/Wire Stainless Steel each 0.8-3.0mm x 150-500mm DP701 Small / Large Fragment Set S/S Bored K/Wire Stainless Steel 2.0-3.0mm x 80/30-200-15 DP702 Small / Large Fragment Set S/S Threaded K/Wire Stainless Steel 1.5-2.5mm x 150/5-230-15 DP703 Small / Large Fragment Set S/S Steinmann Pin Stainless Steel 3.5-4 mm x 180mm DP704 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 10 Hole DP705 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 12 Hole DP706 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 14 Hole DP707 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 16 Hole DP708 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 18 Hole DP709 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 20-18 Hole DP710 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 4-6 Hole DP711 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 5 Hole DP712 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 6 Hole DP713 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 3.5mm 7-9 Hole DP714 Small / Large Fragment Set S/S Reconstruction Plate Stainless 2.7mm 18-26 Hole DP715 Small / Large Fragment Set S/S Reconstruction Plate Stainless Steel 2.7mm 12-16 Hole Page 177 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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OPHTHALMIC Billing Code Product Fur
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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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