Private Health Insurance (Prostheses) Rules 2016 (No. 4)

made under item 4 of section 333-20 of the

Private Health Insurance Act 2007

Compilation No. 2

Compilation date:    20 February 2017

Includes amendments up to: F2017L00089

Registered:    20 February 2017

This compilation is in 6 volumes

Volume 1: Parts 1–3

Volume 2: Schedule, Part A (Categories 01–05)

Volume 3: Schedule, Part A (Category 06)

Volume 4: Schedule, Part A (Categories 07–08)

Volume 5: Schedule, Part A (Categories 09–10)

Volume 6: Schedule, Part A (Categories 11–13)

Volume 7: Schedule, Part B - Human Tissue List

Volume 8: Schedule, Part C - Other Prostheses

Volume 9: Endnotes

Each volume has its own contents

 

About this compilation

This compilation

This is a compilation of the Private Health Insurance (Prostheses) Rules 2016 (No. 4) that shows the text of the law as amended and in force on 20 February 2017 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self-repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes. 

 

 

 

Part C - Other Prostheses September 2016

 

03 - GENERAL MISCELLANEOUS

 

Billing Code   Product Name Description Size

3.2.3                 - Infusion Pumps, Battery Powered

3.2.3.2                  - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and ac


Minimum

Benefit


Maximum

Benefit


Condition

 

Managing Diabetes Pty Ltd

DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00

 

DE, SS

Australasian Medical & Scientific Ltd

AN011 Animas Vibe Insulin Pump Ambulatory insulin infusion pump with real-

time continuous glucose monitoring (CGM) capability


8.26 x 5.08 x 2.18cm $8,950.00

DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small device

about the size of a pager. It holds up to 300 units of insulin, which is delivered continuously through a small tube to the patient. The DANAR Insulin Pump also has an integrated blood glucose meter and remote control via bluetooth communication.


 

75 x 45 x 19mm, 60grams $8,950.00

RB001

Accu-Chek Combo System

Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided.

The Accu-Chek Combo System is only available in one size.

$8,950.00

RB002

ACCU-CHEK Insight System

Insulin delivery device capable of remotely receiving and acting on information about blood glucose levels, performing bolus calculation and bolus advice on additional parameters than what is normally provided.

No variable sizes offered. Only one system provided.

$8,950.00

03 - GENERAL MISCELLANEOUS

 

Minimum

Maximum

 

illing Code   Product Name

Description

Size

Benefit

Benefit

Condition

Medtronic Australasia Pty Ltd

MC839

Medtronic MiniMed Insulin Infusion Pump

Paradigm Veo Model MMT-554. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control.

5.1 x 7.6 x 2.0cm

$9,500.00

MC840

Medtronic MiniMed Insulin Infusion

Paradigm Veo Model MMT-754. 'Smart'

5.1 x 9.4 x 2.0cm

$9,500.00

 

Pump

Insulin Pump with REAL-Time continuous

 

 

 

 

glucose monitoring capability, incorporating a

 

 

 

 

low glucose suspend and with remote control.

 

 

MI150

MiniMed 640G Insulin Pump

MiniMed 640G Insulin Pump with SmartGuard

1.8ml and 3.0ml

$9,500.00

 

 

Technology and continuous glucose monitoring

 

 

 

 

capability, designed to automatically suspend

 

 

 

 

insulin delivery before dangerous lows occur,

 

 

 

 

and automatically resume after levels recover.

 

 

Billing Code   Product Name Description Size

08.14.01 - Implantable Cardiac Event Recorders

 

 

 

Medtronic Australasia Pty Ltd


Benefit


Benefit


Condition

MC763

Reveal XT

Reveal XT Insertable Cardiac Monitor

61 x 19 x 8 mm with a volume of 9cc

$3,900.00

MC768

Reveal DX

Insertable Cardiac Monitor

61 x 19 x 8 mm with a volume of 9cc

$3,900.00

St Jude Medical Australia Pty Ltd

SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with atrial

fibrillation monitoring.


 

6.5cc, 12g $3,900.00

 

 

Biotronik Australia Pty Ltd

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

BT186 BioMonitor 2-AF Implantable Cardiac Monitor

 

 


Implantable cardiac monitor for continuous remote monitoring of patients with Atrial Fibrillation (AF) or unexplained syncope


88.4 mm x 15.2 mm x 6.2 mm , 10.1g , 5cm3 $3,900.00

MI141 Reveal LINQ Insertable Cardiac Monitor 45 x 7 x 3.5mm, 1.18cc $3,900.00

08.16.01 - Remote Monitoring System

 

 

 

BT187 CardioMessenger Smart 3G Bedside/Remote transmitter w/ pacemaker/ICD

device life network access to Biotronik standard home monitoring data management service.


 

Length - 130mm, Width - 65mm, Height - 13mm Weight - 75g


 

$1,960.00

Billing Code   Product Name Description Size

Livanova Australia Pty Limited


Benefit


Benefit


Condition

SA173 Smartview Remote Monitoring

Solution

 

 

 

 

 

 

 


The Smartview PSTN monitor and Smartview Monitor GPRS - Pacemaker programmer is designed to allow physicians and nurses following patients with a Sorin PARADYMTM RF or INTENSIA family of ICD and CRT-D devices to access valuable cardiac data and alert messages from the device while the patient is at home.


Single Device Product $1,960.00

MI196 MyCareLink Smart Patient Reader Electronic cellular patient reader which gathers

and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.

SJ369 Merlin@Home wireless Home cardiac monitor (RF) with landline,

cellular and broadband connectivity

SJ370 Merlin@Home Inductive Home cardiac monitor (inductive) with

landline, cellular and broadband connectivity


One size only $1,960.00

 

 

 

 

 

one size $1,960.00

 

 

one size $1,960.00

Biotronik Australia Pty Ltd

BT179 Cardio Messenger II-S 3G Bedside/Remote transmitter w/ ICD device life

network access to Biotronik standard home monitoring data management service.


 

 

Bedside Device - 203 x 136mm x 80mm, 450 grams


 

 

$1,960.00

BS294 Latitude Communicator Remote patient management system for

implanted cardiac devices


One size only $1,960.00

MI180 MyCareLink Patient Monitor Electronic cellular patient monitor which

gathers and transmits cardiac information from an implanted cardiac device (CIED) to your health care professional for assessment.


 

One size $1,960.00

 

Grand Total: 22 Records