Schedule 5 - Appendix A - Surgically Implanted Prostheses

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ORTHOPAEDIC Billing Code Product Further Size Notations SN463 Bone Staple Fixation - Osteotomy Fixation Staple 5mm- 14mm. McConnel HTO PF 15mm 0-S SN464 Bone Staple Fixation - Short Leg Xsmall - large SN465 Bone Staple Fixation - Table Small -Medium 13mm - 16mm. SN466 Bone Staple Krackow HTO 12,14,16mm SN630 Cannulated Hip Pins Knowles 1.8 x 2 - 5.32 x 5 1/2. SN631 Cannulated Hip Pins Rush Nails, Round Bevil Point 2.3mm Diameter 25.4mm- 101.6mm Hook Pins SN632 Cannulated Hip Pins Rush Nails, Round Bevil Point 3.1mm Diameter 101.6mm-254 Hook Pins SN633 Cannulated Hip Pins Rush Nails, Round Bevil Point 4.7mm Diameter 20.3mm-35.5mm Hook Pins SN634 Cannulated Hip Pins Rush Nails, Round Bevil Point 6.3mm Diameter 27.9mm-43.1mm Hook Pins Plates, Bone SN001 TC 100 Quarter Tubular plates (2.7mm Sterile 23 - 63mm cortex screws) SN006 TC 100 1.5mm Mini Plates Stainless steel, Sterile Straight 3-6 holes, T-Plates 3-4 SN011 TC 100 3.5mm Small Fragment Sterile, 14 - 26 hole 169 - 265mm (Compression) plates SN012 TC 100 3.5mm One Third Tubular Sterile, 2 - 8 holes 25 - 97mm SN013 TC 100 3.5mm Curved Reconstruction Sterile, 6 - 8 holes 70 - 94mm plates SN026 135 degree Angled Blade Plates - Shaft length 60 - 200mm SN044 TC 100 3.5mm Small Fragment Sterile, 2 - 7 holes 25mm - 85mm (Compression) Plates SN046 TC 100 2.0mm Condylar plates Sterile, Left and right 7 holes Page 318 of 638
ORTHOPAEDIC Billing Code Product Further Size Notations SN062 TC 100 4.5mm Narrow Compression Sterile, 5 - 7 holes 87 - 119mm plates SN063 TC 100 2.7mm Small Fragment 2 - 12 holes 20 - 100mm (Compression) plates SN065 TC 100 4.5mm T-Buttress plates Sterile, 4 - 6 holes 80 - 112mm SN068 TC 100 1.5mm Condylar plates Sterile, Left and right One size only SN069 TC 100 3.5mm Reconstruction plates Sterile, Straight 9 - 11 holes 106 - 130mm SN071 TC 100 4.5mm Narrow Compression Sterile, 2 - 4 holes 39 - 71mm plates SN073 TC 100 2.0mm T-plates Sterile, 2 hole shaft One size only SN074 TC 100 Bone Plates with provisional 3.5mm Small Compression Plate 7 - 8 hole fixation holes SN075 TC 100 4.5mm Reconstruction plates Sterile, 10 - 13 holes 157 - 205mm SN076 TC 100 3.5mm Curved Reconstruction Sterile, 14 - 18 holes 166 - 214mm plates SN077 TC 100 3.5mm Curved Reconstruction Sterile, 10 - 12 holes 118 - 142mm plates SN078 TC 100 4.5mm Broad Compression Sterile, 20 - 26 holes 326 - 423mm plates SN080 TC 100 4.5mm T-plate Sterile, 5 - 8 holes 100 - 148mm SN081 TC 100 2.0mm H-plates Sterile One size only SN083 TC 100 2.0mm T-plates Sterile, 9 hole shaft 3 - 4 holes SN087 TC 100 Semi Tubular plates 8 - 12 holes 135 - 199mm SN088 TC 100 Semi Tubular plates Sterile, 5 - 7 holes 87 - 119mm SN089 TC 100 2.7mm Condylar plates Sterile Right/left SN090 TC 100 2.0mm L-plates Sterile, Right/left, Oblique right/left One size each SN091 TC 100 Bone Plates with provisional Lateral Tibial Head Buttress 7 - 9 149 - 181mm fixation holes Page 319 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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