Schedule 5 - Appendix A - Surgically Implanted Prostheses

PLASTIC AND RECONSTRUCTIVE
Billing Code Product Further Size Notations
MO097 Martin Micro Plate Osteosynthesis 1mm system, Straight Plate Titanium 12 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO098 Martin Micro Plate Osteosynthesis 1mm system, Straight Plate Titanium 16 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO099 Martin Micro Plate Osteosynthesis 1mm system, Straight Plate Titanium 24 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO100 Martin Micro Plate Osteosynthesis 1mm system, Orbital Plate Titanium 8 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO101 Martin Micro Plate Osteosynthesis 1mm system, L Plate Titanium 5 to 8 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO102 Martin Micro Plate Osteosynthesis 1mm system, T Plate Titanium 5 to 7 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO103 Martin Micro Plate Osteosynthesis 1mm system, H Plate Titanium 11 hole 0.6mm profile Only to be funded where
System used in a service for
which a Medicare Benefit
is payable
MO104 Martin Micro Plate Osteosynthesis 1mm system, Y, Double Y Plate 6 to 7 hole 0.6mm profile Only to be funded where
System Titanium used in a service for
which a Medicare Benefit
is payable
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