Schedule 5 - Appendix A - Surgically Implanted Prostheses

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ORTHOPAEDIC Billing Code Product Further Size Notations LV025 Staplizer Bone Staple Cartridge 5 Titanium staples per cartridge 7 x 7mm, 7 x 10mm, 10 x 7mm, 10 x 10mm, 10 x 15mm, 13 x 7mm, 13 x 10mm, 13 x 15mm, 13 x 20mm, 16 x 10mm, 16 x 15mm, 16 x 20mm, 16 x 25mm LMT Surgical Pty Ltd Orthopedic Internal Fixation Systems, Fracture LM001 TriMed Wrist Fixation System Washer LM002 TriMed Wrist Fixation System Plates, Stainless Steel Radial and Ulna pin plate - 3 hole, 5 hole; L plate - left and right LM003 TriMed Wrist Fixation System Small Fragment Clamp/Buttress Pin 27mm length x 14mm bend, 24mm Combination length x 10 - 14mm bend, 20mm length x 10mm bend,16mm length x 8mm bend LM004 TriMed Wrist Fixation System Buttress Pin 16mm - 32mm length LM005 TriMed Wrist Fixation System Small Fragment Clamp Inner 24mm length x 10 -18mm bend, Component 20mm length x 10 -14mm bend, 16mm length x 8mm bend LM006 TriMed Wrist Fixation System Small Fragment Clamp Outer 20 x 32mm length Component LM007 TriMed Wrist Fixation System Cortical Bone Screw, Stainless Steel 2.3 x 10 - 32mm length Orthopedic Internal Fixation Systems, Other LM008 Spider and Mini-Spider Limited Wrist Stainless Steel 8 hole spider plate, 6 hole Fusion System mini-spider plate LM009 The Subtaler MBA Implant Titanium 6, 8, 9, 10, 12mm and guide pin LM013 Cobra Total Wrist Fusion System Titanium Plate and Screws Plate - one size only, Screws - diameter 2.8mm, length 10, 14, 18mm and diameter 3.5mm, length 14, 16, 18, 20, 22, 24, 28mm Page 274 of 638
ORTHOPAEDIC Billing Code Product Further Size Notations <strong>Prostheses</strong>, Finger/Thumb LM011 Ascension PIP Pyrocarbon Total Joint Pyrocarbon Proximal Interphalangeal size 10, 20, 30, 40 distal, Proximal interphalageal size 10, 20, 30, 40 LM012 Ascension MCP Pyrocarbon Total Pyrocarbon implant Metacarpophalageal joint sizes 10, 20, 30, 40, 50 <strong>Prostheses</strong>, Joint, Wrist LM010 Universal Total Wrist Implant System Consists of 3 parts, proximal radius Radial implant - small, medium, (UTW) component made of cobalt/chrome, large; Carpal implant - small, distal titanium plate, titanium medium, large; carpal poly implant - screws and polyethylene joint small, medium, large, +1, +2; carpal bone screws - 4.5mm x 20 - 35mm lengths Mathys Australia Bolts, Bone MA212 AO/ASIF Intermedullary Nails Locking bolts - steel 3.9 - 4.9mm , length 18 - 100mm MA213 AO/ASIF Intermedullary Nails Locking bolts - TAN 3.4 - 4.9mm, length 16 - 100mm, self cutting L 16 - 60mm Bone Matrix Implants, Artificial MA001 Chronos TCP Granules Porous Tricalcium Phosphate 20g MA002 Chronos TCP Granules Porous Tricalcium Phosphate 10g MA003 Chronos TCP Granules Porous Tricalcium Phosphate 5g MA004 Chronos TCP Granules Porous Tricalcium Phosphate 1g MA005 Chronos TCP Granules Porous Tricalcium Phosphate 0.5g MA295 ChronOS TCP Wedge Small, Medium, Large MA296 ChronOS TCP Blocks Small, Medium, Large MA313 ChronOS TCP Cylinder Dia 8.5 - 14mm Page 275 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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