Medicare Benefits Schedule - Item 45635

Search Results for Item 45635

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

45635

45635 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Nov-2018
Schedule Fee Updated:
01-Nov-2023

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

Rhinoplasty, partial, involving correction of bony vault only, if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

(b) photographic and/or NOSE Scale evidence demonstrating the clinical need for this service is documented in the patient notes

Multiple Operation Rule

(Anaes.)

Fee: $646.75 Benefit: 75% = $485.10 85% = $549.75

(See para TN.8.104 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $517.40


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.104

Rhinoplasty - (Items 45632 to 45644, and 45650)

Benefits are payable for septoplasty (item 41671) where performed in conjunction with rhinoplasty. 

A Medicare benefit for items 45632 – 45644 and 45650 is payable where the indication for surgery is for:

(i) airway obstruction and the patient has a self-reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity.

The NOSE Scale refers to the Nasal Obstruction Symptom Evaluation Scale, as published in:

Stewart, M.G., Witsell, D.L., Smith, T.L., Weaver, E.M., Yueh, B. and Hannley, M.T. (2004), Development and Validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale. Otolaryngology–Head and Neck Surgery, 130: 157-163.

The NOSE Scale can be accessed here: https://www.entnet.org/wp-content/uploads/files/NOSE-Instrument.pdf

Full clinical details must be documented in patient notes, including pre-operative photographic and / or NOSE Scale evidence demonstrating the clinical need for the service as this may be subject to audit.

 

Related Items: 41671 45632 45635 45641 45644 45650


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