Medicare Benefits Schedule - Note TN.8.95

For the purposes of items 45506 to 45518, revision of scar refers to modification of existing scars (traumatic, surgical or pathological) that is designed to decrease scar width, adapt scar position with regard to skin creases and landmarks, release scars from adhering to underlying structures, improve scar contour in keeping with undamaged skin or restore the shape of facial aperture. 

Items 45506 to 45518 are only claimable when performed by a specialist in the practice of his or her specialty or where undertaken in the operating theatre of a hospital. 

Only items 45506 and 45512, for the face and neck, can be claimed in association with items providing for graft or flap services. 

For excision of scar services which do not meet the requirements of the revision of scar items as defined, the appropriate item in the range 31206 to 31225 should be claimed.

Related Items: 45506 45512 45515 45518

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Multiple Operation Rule

SCAR, of face or neck, not more than 3 cm in length, revision of, where undertaken in the operating theatre of a hospital, or where performed by a specialist in the practice of his or her specialty

(Anaes.)

Fee: $232.50 Benefit: 75% = $174.40 85% = $197.65

(See para TN.8.95 of explanatory notes to this Category)

Multiple Operation Rule

SCAR, of face or neck, more than 3 cm in length, revision of, where undertaken in the operating theatre of a hospital, or where performed by a specialist in the practice of his or her specialty

(Anaes.)

Fee: $312.60 Benefit: 75% = $234.45 85% = $265.75

(See para TN.8.95 of explanatory notes to this Category)

Multiple Operation Rule

SCAR, other than on face or neck, not more than 7 cms in length, revision of, as an independent procedure, where undertaken in the operating theatre of a hospital or where performed by a specialist in the practice of his or her specialty

(Anaes.)

Fee: $197.20 Benefit: 75% = $147.90 85% = $167.65

(See para TN.8.95 of explanatory notes to this Category)

Multiple Operation Rule

SCAR, other than on face or neck, more than 7 cms in length, revision of, as an independent procedure, where undertaken in the operating theatre of a hospital, or where performed by a specialist in the practice of his or her speciality

(Anaes.)

Fee: $238.60 Benefit: 75% = $178.95 85% = $202.85

(See para TN.8.95 of explanatory notes to this Category)