Medicare Benefits Schedule - Item 45524

Search Results for Item 45524

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

45524

45524 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Nov-2012

Group
T8 - Surgical Operations
Subgroup
13 - Plastic And Reconstructive Surgery
Subheading
4 - Other Grafts And Miscellaneous Procedures

Mammaplasty, augmentation (unilateral) in the context of:

(a) breast cancer; or

(b) developmental abnormality of the breast, if there is a difference in breast volume, as demonstrated by an appropriate volumetric measurement technique, of at least:

(i) 20% in normally shaped breasts; or

(ii) 10% in tubular breasts or in breasts with abnormally high inframammary folds.

Applicable only once per occasion on which the service is provided

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $741.65 Benefit: 75% = $556.25

(See para TN.8.96 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.96

Augmentation Mammaplasty - (Items 45524, 45527 and 45528)

A Medicare benefit is generally not attracted under item 45524 unless the asymmetry in breast size is greater than 10%. Augmentation of a second breast sometime after an initial augmentation of one side would not attract benefits. Benefits are not payable for augmentation mammaplasty services performed using fat transfer to the breast. 

Item 45528 applies where bilateral mammaplasty is indicated because of malformation of breast tissue, disease or trauma of the breast, (but not as a result of previous cosmetic surgery) other than covered under item 45524 or 45527.

Volumetric measurement of the breasts should be performed using a technique which has been reported in a published study. 

Related Items: 45524 45527 45528


Legend

  • Assist - Addition/Deletion of (Assist.)
  • Amend - Amended Description
  • Anaes - Anaesthetic Values Amended
  • Emsn - EMSN Change
  • Fee - Fee Amended
  • Renum - Item Number Change (renumbered)
  • New - New Item
  • NewMin - New Item (previous Ministerial Determination)
  • Qfe - QFE Change