View Associated Notes
Category 3 - THERAPEUTIC PROCEDURES
45617 - Additional Information
Upper eyelid, reduction of, if:
(a) the reduction is for any of the following:
(i) history of a demonstrated visual impairment;
(ii) intertriginous inflammation of the eyelid;
(iii) herniation of orbital fat in exophthalmos;
(iv) facial nerve palsy;
(v) post‑traumatic scarring;
(vi) the restoration of symmetry of contralateral upper eyelid in respect of one of the conditions mentioned in subparagraphs (i) to (v); and
(b) photographic and/or diagnostic imaging evidence demonstrating the clinical need for this service is documented in the patient notes
(Anaes.)
Fee: $258.75 Benefit: 75% = $194.10 85% = $219.95
(See para TN.8.103 of explanatory notes to this Category)
Associated Notes
Category 3 - THERAPEUTIC PROCEDURES
TN.8.103
Reduction of Eyelids - (Items 45617 and 45620)
Where a reduction is performed for a medical condition of one eyelid, it may be necessary to undertake a similar compensating procedure on the other eyelid to restore symmetry. The latter operation would also attract benefits.
Medicare benefits are not payable for non-therapeutic cosmetic services. Full clinical details must be documented in patient notes, including clear photographic evidence of eyelid skin prolapsing over the lashes in a relaxed straight-ahead gaze, causing visual field obstruction. The clinical need for the service must be demonstrated as this may be subject to audit.
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