Part 1 Preliminary
These Rules are the Private Health Insurance (Prostheses) Amendment Rules 2014
(No. 1).
2. Commencement
These Rules commence on 28 February 2014.
3. Authority
These Rules are made under the Private Health Insurance Act 2007.
4. Schedules
Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.
Schedule – Amendments
Private Health Insurance (Prostheses) Rules 2014 (No. 1)
1 Schedule, Part A, billing codes, BX296, BX297, BX298, BX299, BX300, BX301, BX302, BX303, BX304, BX305, BX306 and BX307
delete the contents of items 1 to 12 of the table from the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | BX296 | ACTIFUSE SHAPE 1.6mL–BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 1.6mL | $760.00 |
| 2 | BX297 | ACTIFUSE SHAPE 2.6mL–BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 2.6mL | $760.00 |
| 3 | BX305 | ACTIFUSE MICROGRANULES2.5mL–BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 2.5mL | $760.00 |
| 4 | BX306 | ACTIFUSE MICROGRANULES 5mL–BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 5mL | $760.00 |
| 5 | BX299 | ACTIFUSE SHAPE 8.0mL –BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 8.0mL | $1,200.00 |
| 6 | BX301 | ACTIFUSE GRANULES 10mL–BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 10mL | $1,200.00 |
| 7 | BX304 | ACTIFUSE EASY PREP –BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 10ml | $1,200.00 |
| 8 | BX307 | ACTIFUSE MICROGRANULES –BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 10mL | $1,200.00 |
| 9 | BX298 | ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 20mL | $1,500.00 |
| 10 | BX300 | ACTIFUSE SHAPE15.8mL –BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 15.8mL | $1,500.00 |
| 11 | BX302 | ACTIFUSE GRANULES –BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 5mL | $1,500.00 |
| 12 | BX303 | ACTIFUSE GRANULES 40mL–BONE MATRIX IMPLANT ARTIFICIAL | A silicate substituted synthetic bone graft | 40mL | $1,560.00 |
2 Schedule, Part A, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153 and MI141, after entry for billing code WC295
delete the subheadings:
8.14.01 – Implantable Cardiac Event Recorders
Biotronik Australia Pty Ltd
i
Medtronic Australasia Pty Ltd
delete the contents of item 1 of the table from the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | BT153 | BioMonitor | Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope | 53.3mm x 42.7mm x 7.1mm, 26 grams | $3,900.00 |
| 2 | MI141 | Reveal LINQ | Insertable Cardiac Monitor | 45 x 7 x 3.5mm, 1.18cc | $3,900.00 |
3 Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After subheading 8.14.01 – Implantable Cardiac Event Recorders,
insert the subheading “Biotronik Australia Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | BT153 | BioMonitor | Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope | 53.3mm x 42.7mm x 7.1mm, 26 grams | $3,900.00 |
| | | | | | |
4 Schedule, Part C, Group 8.14.01 – Implantable Cardiac Event Recorders, Billing Codes BT153, After entry for billing code BT153,
insert the subheading “i”
insert the subheading “Medtronic Australasia Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | MI141 | Reveal LINQ | Insertable Cardiac Monitor | 45 x 7 x 3.5mm, 1.18cc | $3,900.00 |
| | | | | | |
5 Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,
delete the subheading “Orthopaedic Solutions Pty Ltd”
delete the contents of item 1 of the table from the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | OE029 | BIOProfile Pyrocarbon Carpometacarpal Implants | Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty) | Small, Medium, Large & Extra Large | $884.00 |
5 Schedule, Part A, Subgroup 6.02.02.01 – Thumb, carpometacarpal, After entry for billing code LM028,
insert the subheading “Tornier Pty Ltd”
under that subheading insert the contents of item 1 of the table in the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | TO149 | BIOProfile Pyrocarbon Carpometacarpal Implants | Low Temperature Isotropic Pyrolytic Carbon Implants for carpometacarpal resurfacing (arthroplasty) | Small, Medium, Large & Extra Large | $884.00 |
| | | | | | |
6 Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO044,
insert the contents of item 1 of the table in the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | SO049 | FCI Masterka | Self-retaining monocanalicular nasal intubation WITHOUT nasal retrieval | 30mm to 40mm | $180.00 |
| | | | | | |
7 Schedule, Part A, Group 07.01.01 – Intracanalicular, After entry for billing code SO043,
insert the contents of item 1 of the table in the columns indicated:
| Item | Billing Code | Product | Description | Size | Minimum benefit |
| 1 | SO050 | FCI Nunchaku | Self-retaining bicanalicular nasal intubation WITHOUT nasal retrieval | 90mm to 105mm | $135.00 |
| | | | | | |