Document ID: chunk:federal_register_of_legislation:F2024L01386:schedule:1:p120
Version: federal_register_of_legislation:F2024L01386
Segment Type: schedule
Provision Reference: sch 1 (pt 120/696)
Character Range: 2791218–2809577

Occlusion Balloon Catheter consists of a single lumen catheter shaft with a balloon attached at the distal end. The balloon is available in a compliant version and a super compliant version. Radiopaque markers are located at the proximal and distal ends of the balloon to facilitate fluoroscopic visualization. The balloon catheter is recommended for use with a Stryker Neurovascular 0.014 in (0.36 mm) guidewire to seal the distal segment of the catheter lumen allowing inflation of the balloon. The guidewire can be moved distally or proximally once beyond the distal tip (seal portion) of the catheter and still maintain a positive seal for inflating the balloon. The distal outer segment of the catheter shaft is coated with a hydrophilic material that reduces friction during manipulation in the vessel. A luer fitting hub at the proximal end of the catheter is used for the attachment of accessories.                                                                                                          Effective Length: 150 cm  Balloon Outer Diameter: 3 mm - 7 mm  Balloon Nominal Length: 5 mm - 30 mm  Maximum Catheter Shaft Outer Diameter: 2.8 F                                                                                                                                                                                                                                 $1,500.00

04.09 - Intracranial Pressure (ICP) Monitoring
04.09.01 - Transducer
  Catheter
     INNOVATIVE MEDCARE TECHNOLOGY PTY LTD
IJ026                                                                                           NEUROVENT-P catheter                                                                                                                      RAUMEDIC NEUROVENT-P catheter for the continuous measurement of ICP (intracranial pressure) within the parenchyma.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                5F                                                                                                                                                                                                                                                                                                                                                                                $1,173.00

     INTEGRA NEUROSCIENCES PTY LTD
IG181                                                                                           MicroSensor Monitoring System                                                                                                             Ventricular catheter with transducer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              Catheter length 38cm                                                                                                                                                                                                                                                                                                                                                              $1,173.00

     LIFEHEALTHCARE PTY LIMITED
LH755                                                                                           Intracranial Pressure and Temperature Catheter                                                                                            Intracranial Pressure and Temperature Catheter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    Suitable for all patient anatomy                                                                                                                                                                                                                                                                                                                                                  $1,173.00

  Skull Bolt
     INTEGRA NEUROSCIENCES PTY LTD
IG189                                                                                           MicroSensor Monitoring System                                                                                                             Skull bolt with ICP transducer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    0.7mm sensor lead diameter                                                                                                                                                                                                                                                                                                                                                        $948.00

04.10 - Cerebrospinal Fluid (CSF) Diversion
04.10.01 - External Ventricular Drain
     INTEGRA NEUROSCIENCES PTY LTD
IG182                                                                                           Codman External Ventricular Drain (EVD) Catheter                                                                                          External Ventricular Drain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        1.5mm & 1.9mm diameter                                                                                                                                                                                                                                                                                                                                                            $167.00

     MEDTRONIC AUSTRALASIA PTY LTD
MI123                                                                                           EDM Ventricular Catheter                                                                                                                  External drainage ventricular catheter, non metallic latex free. Barium impregnated, includes stainless steel stylet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             35cm                                                                                                                                                                                                                                                                                                                                                                              $167.00

  Antibiotics
     INTEGRA NEUROSCIENCES PTY LTD
IG183                                                                                           Codman Bactiseal External Ventricular Drain (EVD) Catheter                                                                                Antibiotic impregated External Ventricular Drain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  1.5mm & 1.9mm lumen diameter                                                                                                                                                                                                                                                                                                                                                      $424.00

05 - Urogenital
Billing Code                                                Product Name                                                                                Description                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Size                                                                                                                                                                                                                                                        Minimum Benefit  Condition
05.01 - Incontinence Prostheses
05.01.01 - Inflatable
  05.01.01.01 - Pump
     BOSTON SCIENTIFIC PTY LTD
BS427                                                       AMS 800 Artificial Urinary Sphincter Pump                                                   Control Pump                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    One size                                                                                                                                                                                                                                                    $4,700.00
AM029                                                       AMS 800 Artificial Urinary Sphincter Pump                                                   Control Pump                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    One size                                                                                                                                                                                                                                                    $4,700.00

     ENDOTHERAPEUTICS PTY. LIMITED
ET085                                                       VICTO Adjustable Artificial Sphincter Pump Replacement Kit                                  A replacement control pump for the VICTO Adjustable Artificial Sphincter, artificial urinary sphincter.                                                                                                                                                                                                                                                                                                                                                                                                                                         1 size.                                                                                                                                                                                                                                                     $4,700.00

  A
     BOSTON SCIENTIFIC PTY LTD
BS409                                                       AMS 800 Urinary Control System Pump                                                         Pump with InhibiZone Antibiotic Surface Treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               One size only                                                                                                                                                                                                                                               $5,076.00

     RIGICON PTY LTD
VO008                                                       Conti Artificial Urinary Sphincter Control