Private Health Insurance (Prostheses) Rules 2018 (No. 2)
made under item 4 of the table in section 333‑20 of the
Private Health Insurance Act 2007
Compilation No. 1
Compilation date: 14 September 2018
Includes amendments up to: F2018L01283
Registered: 5 February 2019
This compilation is in 5 volumes
Volume 1: rules 1–13
Volume 2: Schedule, Part 1 – Prostheses List – Part A
Volume 3: Schedule, Part 2 – Prostheses List – Part B
Volume 4: Schedule, Part 3 – Prostheses List – Part C
Volume 5: Endnotes
Each volume has its own contents
About this compilation
This compilation
This is a compilation of the Private Health Insurance (Prostheses) Rules 2018 (No. 2) that shows the text of the law as amended and in force on 14 September 2018 (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If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.
Schedule
Part 3 –Prostheses List – Part C
3 Prostheses List – Part C
03 - General Miscellaneous
Billing Code | Product Name | Description | Size | Min Benefit | Max Benefit | Condition |
03.02.03 - Infusion Pumps, Battery Powered
03.02.03.02 - Insulin infusion pump (as 3.2.3.1) with integral calculator to determine boluses and active insulin
DE, SS
Australasian Medical & Scientific Ltd
AN011 | Animas Vibe/One Touch Vibe Plus Insulin Pump | Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability | 8.26 x 5.08 x 2.18cm | 8502 | | |
AN014 | t:slim X2 Insulin Pump | Ambulatory insulin infusion pump with real-time continuous glucose monitoring (CGM) capability | One size only. | 8502 | | |
Managing Diabetes Pty Ltd
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 | 8502 | | |
DF003 | DANA RS Diabecare insulin pump | DANA RS insulin pump is a BLE (bluetooth low energy) insulin pump which can be connected to and controlled from a BLE Smart Phone. Smart Phone connection is via a secure (alpha-numeric) pairing code, creating a large easy to read display for set-up and control of the DANA RS insulin pump. | 75mm x 45mm x 19mm (63grams) | 8502 | | |
Medical Specialties Australasia Pty Ltd
MS066 | Cellnovo Insulin Infusion System | Continuous Subcutaneous Insulin Infusion Pump | The Cellnovo Insulin Infusion System is only available in one size. | 8502 | | |
ROCHE DIABETES CARE AUSTRALIA PTY LIMITED
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. | 8502 | | |
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. | 8502 | | |
SS
YPSOMED AUSTRALIA PTY LIMITED
YA001 | mylife™ YpsoPump Insulin Pump System | Battery-operated, programmable ambulatory insulin infusion pump system | One size only | 7362 | | |
03.02.03.03 - Device has capability to automatically adjust the insulin delivery based on continuous glucose monitoring data
DE, SS
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 | 9025 | | |
MC840 | Medtronic MiniMed Insulin Infusion Pump | Paradigm Veo Model MMT-754. 'Smart' Insulin Pump with REAL-Time continuous glucose monitoring capability, incorporating a low glucose suspend and with remote control. | 5.1 x 9.4 x 2.0cm | 9025 | | |
MI150 | MiniMed 640G Insulin Pump | MiniMed 640G Insulin Pump with SmartGuard Technology and continuous glucose monitoring capability, designed to automatically suspend insulin delivery before dangerous lows occur, and automatically resume after levels recover. | 1.8ml and 3.0ml | 9025 | | |
DE, SS, ABD
MI290 | Medtronic MiniMed 670G Insulin Pump | MiniMed 670G Insulin Pump with SmartGuard Hybrid Closed Loop (HCL) technology and continuous glucose monitoring (CGM) capability which can be programmed to automatically adjust delivery of basal insulin based on CGM, and can suspend delivery of insulin when the sensor glucose value falls below or is predicted to fall below predefined threshold values. | One size only | 9025 | | |
03.02.05 - Infusion Pump Accessories
03.02.05.04 - Administration Set
Australasian Medical & Scientific Ltd
AN015 | Autosoft, Varisoft, TruSteel Infusion Set | For use with insulin infusion pump | 6 - 17mm | 7 | | |
08 - Cardiac
Billing Code | Product Name | Description | Size | Min Benefit | Max Benefit | Note |
08.14.01 - Implantable Cardiac Event Recorders
Medtronic Australasia Pty Ltd
MC763 | Reveal XT | Reveal XT Insertable Cardiac Monitor | 61 x 19 x 8 mm with a volume of 9cc | 3120 | | |
ABBOTT MEDICAL AUSTRALIA PTY LTD.
SJ152 | SJM Confirm Model DM2102 | Implantable cardiac monitor with atrial fibrillation monitoring. | 6.5cc, 12g | 3120 | | |
i
SJ390 | Confirm RX | Insertable Cardiac Monitor | 5cm X 0.95cm X 0.33cm | 3120 | | |
Biotronik Australia Pty Ltd
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 | 3120 | | |
Medtronic Australasia Pty Ltd
MI141 | Reveal LINQ | Insertable Cardiac Monitor | 45 x 7 x 3.5mm, 1.18cc | 3120 | | |
08.16.01 - Remote Monitoring System
Boston Scientific Australia Pty Ltd
BS294 | Latitude Communicator | Remote patient management system for implanted cardiac devices | One size only | 1568 | | |
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 | 1568 | | |
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 | 1568 | | |
Medtronic Australasia Pty Ltd
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 | 1568 | | |
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. | One size only | 1568 | | |
Livanova Australia Pty Limited
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 | 1568 | | |
ABBOTT MEDICAL AUSTRALIA PTY LTD.
SJ369 | Merlin@Home wireless | Home cardiac monitor (RF) with landline, cellular and broadband connectivity | one size | 1568 | | |
SJ370 | Merlin@Home Inductive | Home cardiac monitor (inductive) with landline, cellular and broadband connectivity | one size | 1568 | | |