Schedule 5 - Appendix A - Surgically Implanted Prostheses

VASCULAR
Billing Code Product Further Size Notations
WC089 Embolization Coils Additional MWCE Standard Coil Ext Length 1 - 20cm, Coil Length 2
- 45mm
WC090 Embolization Coils Additional MWCE Hilal Coil Ext Length 0.5 - 6.0cm, Coil
Length 0 - 10mm
WC091 Detach Embolisation Coil Additional MWCE Jackson Coil Ext Length 4 - 6cm, Coil Length 3 -
12mm
WC092 Embolization Coils Additional MWCE Tornado Coil Tapering Dia 3 - 10mm, 2 - 10mm
Filters, Vena Cava
WC043 Inferior Vena Cava Filter Birds Nest Vena Cava Filter Filter Catheter French Size 11.0
Length 40, 75 cm Introducer Sheath
Assembly French Size 12.0
Femoral/Jugular Approach
WC044 PVA Embolisation particles Embolization & Occlusion Particle Size Ranges (microns)
50-100, 100-200,
200-300,300-500, 500-700,
700-1000, 1000-1500, 1500-2000,
Grafts, Vascular, Synthetic
WC133 Zenith Flex AAA Endovascular Graft - Stainless steel Dia 22 - 32mm, length 82 - 140mm
body only
WC134 Zenith Flex AAA Endovascular Graft Three components consisting of a Body - Dia 22 - 32mm, length 82 -
body and 2 legs (ipsilateral iliac leg 140mm; Iliac leg extensions Dia 8 -
and contralateral leg) 24mm, length 37 - 139mm
Injection/Infusion Ports, Implantable
WC093 Cook Implantable Injection/Infusion Standard Polysulfone Single 5fr - 9.5fr
Ports Chamber Vital Port with Introducer
Set, Attached/Detached
WC094 Cook Implantable Injection/Infusion Standard Titanium Single Chamber 6.5fr - 9.5fr
Ports Vital Port with Introducer Set,
attached/detached
WC095 Cook Implantable Injection/Infusion Petite Titanium Single Chamber 6.5fr
Ports Vital port with Introducer Set,
Attached/Detached
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