Schedule 5 - Appendix A - Surgically Implanted Prostheses

PLASTIC AND RECONSTRUCTIVE
Billing Code Product Further Size Notations
ST372 Luhr Fixation System Luhr Mandibular Compression 8 holes, 84mm and 100mm Only to be funded where
System: 3D plate, condensed plate used in a service for
Vitallium which a Medicare Benefit
is payable
ST373 Luhr Fixation System Luhr Mandibular Compression 10 holes, 120mm Only to be funded where
System: 3D plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST374 Luhr Fixation System Luhr Mandibular Compression 12 holes, 150mm Only to be funded where
System: 3D plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST375 Luhr Fixation System Luhr Mandibular Compression 14 holes, 170mm Only to be funded where
System: 3D plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST376 Luhr Fixation System Luhr Mandibular Compression 16 holes, 200mm Only to be funded where
System 3D plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST378 Luhr Fixation System Luhr Mandibular Compression and 2.7x6-34mm, emergency: Only to be funded where
Reconstruction System Screws: 3.0x10-14mm used in a service for
self-tapping and MCS emergency which a Medicare Benefit
screws Vitallium is payable
ST379 Luhr Fixation System Luhr Mandibular Reconstruction 23 holes, 40x124mm Only to be funded where
System: 3D plate, angled, extra long, used in a service for
right/left Vitallium which a Medicare Benefit
is payable
ST380 Luhr Fixation System Luhr Mandibular Reconstruction 17 holes, 40x86mm Only to be funded where
System: 3D plate, angled, long, used in a service for
right/left Vitallium which a Medicare Benefit
is payable
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