Medicare Benefits Schedule - Note TN.8.182

• 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

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Multiple Operation Rule

Either:

(a) repair of cruciate ligaments of knee; or

(b) repair or reconstruction of collateral ligaments of knee;

by open or arthroscopic means, including either or both of the following (if performed):

(c) graft harvest;

(d) intraarticular knee 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)

(Anaes.) (Assist.)

Fee: $1,036.25 Benefit: 75% = $777.20

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

Multiple Operation Rule

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)

(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)