Schedule 5 - Appendix A - Surgically Implanted Prostheses

PLASTIC AND RECONSTRUCTIVE
Billing Code Product Further Size Notations
MO087 Martin Miniplate Osteosynthesis Chin Plate Titanium 2 to 8mm, 0.6mm profile Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO088 Martin Miniplate Osteosynthesis Chin Plate Titanium 10 to14mm, 0.6mm profile Only to be funded where
used in a service for
which a Medicare Benefit
is payable
MO090 Martin Micro Plate Osteosynthesis 1mm Screw System Titanium 1mm diameter, 2-4mm length Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO092 Martin Micro Plate Osteosynthesis 1mm Screw System Titanium 1mm diameter, 5 - 6mm length Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO093 Martin Micro Plate Osteosynthesis 1mm system, Screw Titanium 1mm diameter, 7mm length Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO094 Martin Micro Plate Osteosynthesis 1mm system, Screw Emergency 1.2mm diameter,3 to 5mm length Only to be funded where
System Titanium used in a service for
which a Medicare Benefit
is payable
MO095 Martin Micro Plate Osteosynthesis 1mm system, Straight Plate Titanium 4 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO096 Martin Micro Plate Osteosynthesis 1mm system, Straight Plate Titanium 8 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
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