Schedule 5 - Appendix A - Surgically Implanted Prostheses

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ORTHOPAEDIC Billing Code Product Further Size Notations SN303 Synergy Femoral Stem HA Coated Porous 9 - 18 Titanium Alloy, Std and High offset SN697 Femoral Head Stainless steel 22-36mm,+0-+16mm <strong>Prostheses</strong>, Joint, Hip, Total SN256 Axis Ceramic Femoral Head AlO3 12./14Taper, 28 - 32mm, +0, +4-+8, SN257 Axis Ceramic Insert AlO3 28, 32mm ID; 44 - 60mm OD SN258 Axis Cup Uncoated Titanium Alloy 28, 32mm ID; 44 - 60mm OD SN259 Axis Femoral HA Stem Titanium Alloy 120 - 200mm SN260 Axis HA Cup Titanium Alloy Axis Shell 44 - 60mm Axis II Shell 44 - 64mm SN261 Bio-fit Femoral Stem Collarless Collarless Stem size 2-6. SN262 Bio-fit Femoral Stem Collared Collared size 1-6 SN265 Contour Acetabular Roof Reinforcement Shell 44 - 68mm OD SN266 Convene Bi-polar Liner 28 - 32mm SN267 Convene Bi-polar Metal Shell 43 - 64mm SN268 CPCS Femoral Stem Polished Non Porous, 1 - 5 Std and High Offset SN269 CPCS Polished Cemented Stem Distal 8 - 18 Centraliser SN270 Echelon Femoral Stem Porous Co Cr, Std and 9 - 19 High Offset SN271 Echelon Revision hip stem - Bowed, porous: Left/Right, 15 and 30mm, Sizes Calcar Replacement Collar 11-22 SN272 Echelon Revision hip stem - Bowed, porous: Left/Right Sizes 11 - 22 Standard Collar SN273 Echelon Revision hip stem - Non Porous: 15 and 30mm 175-235mm Sizes Calcar Replacement Collar 12-16. Page 326 of 638
ORTHOPAEDIC Billing Code Product Further Size Notations SN274 Echelon Revision hip stem - Non Porous: 12-16 175-225mm Standard Collar SN275 Echelon Revision hip stem - Straight, 15, 30mm, Sizes 11-22 porous: Calcar Replacement Collar SN276 Echelon Revision hip stem - Straight, 11-22 porous: Standard Collar SN277 Endoprosthesis CoCr 38 - 54mm SN279 Femoral Head Ceramic Zirconium Head- standard - Xlong. 12/14 Taper Head 28 mm, 32mm , +0, +4, SN280 Femoral Head Co Cr 14/16 taper, 22-32mm, Short -XXXLong Neck SN281 Femoral Head Co Cr 12/14Taper, 22 - 36mm, +0 - +16mm SN282 Opera Acetabular Cup Flanged UHMWPE 22 - 28mm; 40 - 53mm SN283 Optifix Acetabular: Liner, 20 degree 43 - 76mm SN284 Screws Cancellous 15mm - 50mm SN286 Reflection Acetabular Cup HA coated Titanium HA Reflection I 46mm- 70mm. HA Alloy Reflection FSO 5 46mm - 70mm SN287 Reflection Acetabular Cup Porous Titanium ReflectionFSO 3-5, 42 -70mm; ReflectionFSO 9, 50mm-76mm; ReflectionV, 42mm-70mm; Reflection1 42mm- 70mm SN288 Reflection Acetabular Cup 22 - 36mm, 42 - 76mm SN289 Reflection Acetabular Liner 22 - 36mm, 42 - 76mm SN291 Reflection Anteverted Acetabular Liner XLPE 22 - 36mm, 42 - 76mm SN292 Reflection Fixation peg Titanium Alloy One size only SN293 Reflection Lateralised Liner, UHMWPE 22 - 36mm, 42 - 76mm SN296 Reflection Acetabular Cup Revision Porous 42 - 76mm Titanium Alloy Page 327 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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