Medicare Benefits Schedule - Item 48430

Search Results for Item 48430

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

48430

48430 - Additional Information

Item Start Date:
01-Jul-2021
Description Updated:
01-Jul-2021
Schedule Fee Updated:
01-Jul-2021

Group
T8 - Surgical Operations
Subgroup
15 - Orthopaedic
Subheading
5 - Osteotomy And Osteectomy

Excision of one or more osteophytes of the foot or ankle, or simple removal of bunion, including any of the following (if performed):

(a) capsulotomy;

(b) excision of surrounding osteophytes;

(c) release of ligaments;

(d) removal of one or more associated bursae or ganglia;

(e) removal of bone;

(f) synovectomy;

—each incision (H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $279.20 Benefit: 75% = $209.40

(See para TN.8.196, TN.8.200, TN.8.201 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.196

Procedure for osteotomy (Items 48400 - 48421 and 48430)

  • Removal of prominent bone or osteophytes can be billed as an isolated procedure under 48430 or when through a separate incision to other procedures. 
  • When an osteotomy is performed through the bone to correct a deformity then the appropriate number is chosen from 48400, 48403, 48406, 48409, 48418 or 48421. 
  • Not to be used when performing joint arthroscopy (49703, 49730 or 49732), bunion correction (49827, 49830, 49833, 49836, 49837 or 49838), neurolysis (39330), wound debridement (30023) or an arthrodesis procedure unless performed at a site separate to the excluded items.

Related Items: 39330 48400 48403 48406 48409 48421 48430 49703 49827 49833 49836 49837 49838

Category 3 - THERAPEUTIC PROCEDURES

TN.8.200

Procedure for arthrodesis

  • An arthrodesis consists of joint preparation, removal of surrounding osteophytes, intraarticular joint correction and fixation by any means.
  • Bone procedures items (48430, 48400, 48403, 48406, 48409, 48418, or 48421) are not to be claimed unless performed at a separate site to the arthrodesis.
  • Neurolysis (39330), wound debridement (30023) and ganglion excision (30107) items are not to be claimed unless performed at a site separate to the arthrodesis site.

Related Items: 30023 39330 48400 48403 48406 48409 48421 48430 49712 49740 49742 49744 49760 49776 49777 49778 49779 49780 49781 49789 49790 49791 49792 49793 49794 49795 49796 49797 49798 49814 49815 49845 49851 50118

Category 3 - THERAPEUTIC PROCEDURES

TN.8.201

Procedures for excisional and interpositional arthroplasty

  • Items for excisional or interposition arthroplasty procedures are indicated for use when items 49734, 48430, 49860, or 49812 do not represent the complete procedure performed.
  • Not to be used on the same joint undergoing arthroscopy (49730 or 49732), bunion correction (49827, 49830, 49833, 49836, 49837 or 49838) or an arthrodesis procedure for stabilisation.

Related Items: 48430 49715 49716 49717 49730 49732 49734 49812 49821 49827 49830 49833 49836 49837 49838 49839 49857 49860


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