Schedule 5 - Appendix A - Surgically Implanted Prostheses

PLASTIC AND RECONSTRUCTIVE
Billing Code Product Further Size Notations
AR007 Genioplasty Wedge Porus Polyethylene. Genioplasty Small 60 x 25 x 5mm, medium 60 x Only to be funded where
wedges, models 8340 - 8343. 25 x 7.5mm, large 60 x 25 x 10mm used in a service for
which a Medicare Benefit
is payable
AR008 Prejowl Shape Porus Polyethylene. Model 8319. 45 x 41 x 4mm Only to be funded where
used in a service for
which a Medicare Benefit
is payable
AR009 Mandibular Angle Porus Polyethylene. RZ mandibular RZ mandibular angles: 65 x 35 x 3 x Only to be funded where
angles left and right (Models 9955 - 6.5 x 3 x 3mm, 65 x 35 x 7 x 6.5 x 3 x used in a service for
9960). Lateral augmentation onlay 3mm, 65 x 35 x 11 x 6.5 x 3 x 3mm. which a Medicare Benefit
shapes, mandibular angle left and Lateral augmentation onlay: 47 x is payable
right (Models 7535, 7536). 37 x 3 x 6.5 x 3 x 3mm.
Reconstructive onlay shapes, ramus Reconstructive onlay shapes: E-5
with inf ridge E-5 and E-10, left and 79 x 32 x 5 x 7 x 5 x 10mm, E-10 79
right (Models 7537 - 7540). x 32 x 10 x 7 x 10 x 10mm. Aesthetic
Aesthetic onlay shapes, ramus with onlay shapes: ES-5 79 x 32 x 5 x 5
inf ridge ES-5 and ES-10, left and x 5 x 4mm, ES-10 79 x 32 x 10 x 5 x
right (Models 7541 - 7544). 10 x 4mm.
AR010 Malar Shape Porus Polyethylene. Design RZ Design RZ malar shapes: super Only to be funded where
malar shapes, super petite and petite, petite 50 x 19 x 3mm, petite 50 x 19 used in a service for
left and right (Models 9501 - 9504). x 5mm. Design malar shapes: small which a Medicare Benefit
Design M malar shapes, left and 64 x 19 x 3mm, medium 64 x 19 x is payable
right (Models 9507 - 9512). 4.5mm, large 64 x 19 x 7mm.
Additional malar shapes, extended Additional malar shapes: small 45 x
contoured left and right (Models 24 x 3mm, medium 50 x 26 x 4mm,
large 55 x 27 x 5mm.
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