Schedule 5 - Appendix A - Surgically Implanted Prostheses

ORTHOPAEDIC
Billing Code Product Further Size Notations
DY182 Monarch Spinal System Rods 1/4" x 450mm
DY183 Monarch Spinal System Dual Rod Connectors side by side 1/4" - 1/4", 1/4" - 3/16"
DY184 Monarch Spinal System Dual Rod Connectors End to End 1/4" - 1/4", 1/4" - 3/16"
DY185 Monarch Spinal System Plate J-Hooks One size only
DY186 Monarch Spinal System Band Clamp Connector One size only
DY198 Carbon Fibre Cages ALIF 1 C/F Cage 5 - 10 deg Sm to Lg 10 - 18 mm
DY289 Crossover System (Titanium) Crossconnector Small 18-30mm
DY290 Crossover System (Titanium) Crossconnector Medium 32-45mm
DY291 Crossover System (Titanium) CrossOver Nut One size only
DY292 Crossover System (Titanium) Crossconnector Large 45-107mm
DY293 Crossover System (Titanium) CrossOver Ball Screw One size only
DY297 Slim-loc Anterior Cervical Plate Plates - one level 22-37mm
DY298 Slim-loc Anterior Cervical Plate Plates - two level 39-53mm
DY299 Slim-loc Anterior Cervical Plate Plates - three level 54-78mm
DY300 Slim-loc Anterior Cervical Plate Screws - Self Tapping 4.5 x 12-26mm
DY301 Slim-loc Anterior Cervical Plate Screws - Large Diameter 4.8 x 12-16mm
DY302 Slim-loc Anterior Cervical Plate Screws - Self Drilling 4.5 x 12-18mm
DY303 Monarch Spinal System Typhoon Cap One size only
DY304 Monarch Spinal System Hooks - Open (Pedicle/Narrow 5-11mm
Tapered/Wide Blade)
DY306 Isola System (Titanium) Threadless TRC - Open body with 1/4" 1/4"
DY307 Isola System (Titanium) Dual Connector (end to end) 3
DY308 Isola System (Titanium) Threadless TRC - Open body no rod 1/4" 1/4 "
DY309 Frontier Anterior Scoliosis System Bone Screws 5.5 x 20-60mm
(Titanium)
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