Medicare Benefits Schedule - Item 45620

Search Results for Item 45620

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

45620

45620 - 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

Lower eyelid, reduction of, if:

(a) the reduction is for:

(i) herniation of orbital fat in exophthalmos, facial nerve palsy or post-traumatic scarring; or

(ii) the restoration of symmetry of the contralateral lower eyelid in respect of one of these conditions; and

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

Multiple Operation Rule

(Anaes.)

Fee: $358.90 Benefit: 75% = $269.20 85% = $305.10

(See para TN.8.103 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $287.15


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.

Related Items: 45617 45620


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