Schedule 5 - Appendix A - Surgically Implanted Prostheses

PLASTIC AND RECONSTRUCTIVE
Billing Code Product Further Size Notations
ST381 Luhr Fixation System Luhr Mandibular Reconstruction 16 holes, 40x61mm Only to be funded where
System: 3D plate, angled, medium, used in a service for
right/left Vitallium which a Medicare Benefit
is payable
ST382 Luhr Fixation System Luhr Mandibular Reconstruction 12 holes, 40x36mm Only to be funded where
System: 3D plate, angled, short, used in a service for
right/left Vitallium which a Medicare Benefit
is payable
ST383 Luhr Fixation System Luhr Mandibular Reconstruction 40mm Only to be funded where
System: MRS connecting plate used in a service for
Vitallium which a Medicare Benefit
is payable
ST384 Luhr Fixation System Luhr Mandibular Reconstruction 11 holes, 2.7x80mm Only to be funded where
System: straight plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST385 Luhr Fixation System Luhr Mandibular Reconstruction 12 holes, 2.7x100mm Only to be funded where
System: straight plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST386 Luhr Fixation System Luhr Mandibular Reconstruction 15 holes, 2.7x130mm Only to be funded where
System: straight plate Vitallium used in a service for
which a Medicare Benefit
is payable
ST387 Luhr Fixation System Luhr Mandibular Reconstruction 19 holes, 2.7x160mm, 23 holes, Only to be funded where
System: straight plate Vitallium 2.7x190mm used in a service for
which a Medicare Benefit
is payable
ST388 Luhr Fixation System Luhr Mandibular Reconstruction Ramus 40mm Body 124mm Only to be funded where
System: ramus joint plate, used in a service for
extra-long, left Vitallium which a Medicare Benefit
is payable
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