Document ID: chunk:federal_register_of_legislation:F2024L01386:schedule:1:p411
Version: federal_register_of_legislation:F2024L01386
Segment Type: schedule
Provision Reference: sch 1 (pt 411/696)
Character Range: 14427106–14455906

Vest                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Small, medium and large                                                                                                                                                                                                                                                                                                                       $328.00
SJ382                                                                     HeartMate II Left Ventricular Assist System - Modular Belt                                                                                                                                               Modular belt to hold System Controller and Batteries                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Small / Medium                                                                                                                                                                                                                                                                                                                                $328.00
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Large

  09.11.03.03 - Shower Bag
  No Suffix
     ABBOTT MEDICAL AUSTRALIA PTY LTD.
SJ397                                                                     Heart Mate 3 Shower Bag                                                                                                                                                                                  Shower Bag                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         One size only; set of 2                                                                                                                                                                                                                                                                                                                       $428.00
SJ380                                                                     HeartMate II Left Ventricular Assist System - Shower Bag                                                                                                                                                 Shower Bag                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         One size only; set of 2                                                                                                                                                                                                                                                                                                                       $428.00

09.12 - Pectus Bar
09.12.01 - Pectus Bar
     ZIMMER BIOMET PTY LTD
BI472                                                                     Adkins and Pectus Struts                                                                                                                                                                                 Pectus Bar, Stainless Steel or Titanium                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            80-432mm                                                                                                                                                                                                                                                                                                                                      $1,193.00

  09.12.01.99 - No SubGroup
     DEVICE TECHNOLOGIES AUSTRALIA PTY. LTD.
DE620                                                                     Park Modified Pectus Bar                                                                                                                                                                                 Park Modified Pectus bar available in titanium alloy and stainless steel                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           6" - 152mm, 7" - 178mm, 8" - 203mm, 9" - 228mm, 10" - 254mm, 11" - 279mm, 12" - 305mm, 13" - 330mm, 14" - 356mm, 15" = 381mm, 16" - 406mm, 17" - 432mm                                                                                                                                                                                        $1,193.00

09.12.02 - Stabilisers
     DEVICE TECHNOLOGIES AUSTRALIA PTY. LTD.
DE623                                                                     Park Claw Fixator, Clip and Nut Stabiliser                                                                                                                                                               Stabilisation of Pectus Bar                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        Park Claw Fixator - Small (20mm x 12mm), Medium (23mm x 15mm), Large (25mm x 18mm), Extra Large (30mm x 18mm).                                                                                                                                                                                                                                $480.00
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Fixator Clip - 15mm.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Nut - 7mm.
DE622                                                                     Park Bridge Stabiliser                                                                                                                                                                                   Stablisation of Pectus Bar - optional use for multiple bar placement                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               3 sizes: 6 hole - 60mm, 8 hole 80mm, 10 hole - 100mm                                                                                                                                                                                                                                                                                          $480.00

     ZIMMER BIOMET PTY LTD
BI483                                                                     Pectus Bar                                                                                                                                                                                               Stabilizer, Triangular or Elongated, Stainless Steel                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               One size only                                                                                                                                                                                                                                                                                                                                 $480.00

  09.12.02.99 - No SubGroup
     DEVICE TECHNOLOGIES AUSTRALIA PTY. LTD.
DE621                                                                     Park Pectus Hinge Plate Stabiliser                                                                                                                                                                       Stabilisation of Pectus Bar - optional use in asymmetric or adult pectus excavatum to prevent bar displacement stripping of intercostal muscles                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    65mm                                                                                                                                                                                                                                                                                                                                          $480.00

09.13 - Chordal Replacement Devices, fixed and adjustable
09.13.01 - Chordal Replacement Devices, fixed and adjustable
  No Suffix
     DEVICE TECHNOLOGIES AUSTRALIA PTY. LTD.
DE624                                                                     Chord-X                                                                                                                                                                                                  ePTFE chordal repair                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Five (5) loop lengths -(0mm/adjustable, 12mm, 16mm, 20mm and 24mm),                                                                                                                                                                                                                                                                           $256.00
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Two (2) sutures (2-0 ePTFE or 3-0 ePTFE),
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Two (2) needle shapes (1/2 circle and 3/8 circle),
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      Two (2) needle lengths (18mm and 22mm).

10 - Vascular
Billing Code                                                                               Product Name                                                                                                               Description                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                Size                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               Minimum Benefit  Condition
10.01 - Vascular Stents
10.01.01 - Bare Metal Stents
  10.01.01.01 - Balloon Expandable
     ABBOTT MEDICAL AUSTRALIA PTY LTD.
SJ442                                                                                      Omnilink Elite Vascular Balloon-Expandable Stent System                                                                    Omnilink Elite Vascular Balloon-Expandable Stent System is a balloon- expandable stent system  indicated for the treatment of atherosclerotic iliac artery lesions with reference vessel diameters of ≥ 5.0 mm and ≤ 11.0 mm, and lesion lengths up to 50 mm.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              6.0mm x (12,16,19,29,39,59)mm x 80cm                       7.0mm x (12,16,19,29,39,59)mm x 80cm                      8.0mm x (19,29,39,59)mm x 80cm                                 9.0mm