Medicare Benefits Schedule - Item 49542

Search Results for Item 49542

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

49542

49542 - Additional Information

Item Start Date:
01-Dec-1991
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Nov-2023

Group
T8 - Surgical Operations
Subgroup
15 - Orthopaedic
Subheading
12 - Knee

Reconstruction of anterior or posterior cruciate ligament of knee, by open or arthroscopic means, including any of the following (if performed):

(a) graft harvest;

(b) donor site repair;

(c) meniscal repair;

(d) collateral ligament repair;

(e) extra-articular tenodesis;

(f) any other associated intra-articular surgery;

other than a service associated with a service to which another item of this Schedule applies if the service described in the other item is for the purpose of performing a procedure on the knee by arthroscopic means (H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,450.55 Benefit: 75% = $1,087.95

(See para TN.8.117, TN.8.182 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.117

Autologous Chondrocyte Implantation in the Knee

The Medical Services Advisory Committee (MSAC) evaluated the available evidence and did not support public funding for matrix-induced autologous chondrocyte implantation (MACI) or autologous chondrocyte implantation (ACI) for the treatment of chondral defects in the knee and other joints, due to the increased cost compared to existing procedures and the lack of evidence showing short term or long-term improvements in clinical outcomes. Medicare benefits are not payable in association with this technology as per GN.13.33.

Related Items: 49500 49503 49506 49509 49512 49515 49516 49517 49518 49519 49521 49524 49525 49527 49530 49533 49534 49536 49542 49544 49548 49551 49554 49564 49565 49569 49570 49572 49574 49576 49578 49580 49582 49584 49586 49590

Category 3 - THERAPEUTIC PROCEDURES

TN.8.182

Procedure for ligament repair, reconstruction and associated intra-articular surgery (Items 49536 and 49542)

  • These items are intended to cover all knee ligament repair and reconstruction procedures and associated intra-articular surgery, including (but not limited to), meniscal surgery, notchplasty, chondroplasty and removal of loose bodies.
  • Repair is reattachment of a displaced structure and reconstruction is surgery that modifies or augments underlying anatomy. Each item is intended to cover all aspects of the surgery.
  • In rare circumstances, patients may require additional osteotomy or patella-femoral stabilisation and in these instances, the relevant item numbers can also be claimed.

Related Items: 49536 49542


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