Schedule 5 - Appendix A - Surgically Implanted Prostheses

PLASTIC AND RECONSTRUCTIVE
Billing Code Product Further Size Notations
MO040 Martin Mandibular Fracture System Screw Titanium 2.3mm diameter, 16 to 19mm length Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO041 Martin Mandibular Fracture System Screw Titanium 2.3mm diameter, 20 to 32mm length Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO042 Martin Mandibular Fracture System Screw Titanium 2.5mm diameter, 9mm length Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO043 Martin Mandibular Fracture System Screw Titanium 2.5mm diameter, 13mm length Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO044 Martin Mandibular Fracture System Screw Titanium 2.5mm diameter, 17mm length Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO045 Martin Mandibular Fracture System Straight Plate Titanium 4 hole Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO046 Martin Mandibular Fracture System Straight Plate Titanium 6 hole Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO047 Martin Mandibular Fracture System Straight Plate Titanium 8 hole Only to be funded where
used in a service for
which a Medicare Benefit
is payable
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