Medicare Benefits Schedule - Note TN.8.104

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.104

Rhinoplasty - (Items 45638, 45639)

Benefits are payable for septoplasty (item 41671) where performed in conjunction with rhinoplasty.

Item 45638 applies where surgery is indicated for correction of nasal obstruction, post-traumatic deformity (but not as a result of previous elective cosmetic surgery), or both.

Item 45639 applies where surgery is indicated for the correction of significant developmental deformity. Developmental deformity includes cleft nose, bifid tip and twisted nose. Claims for benefits under this item should be accompanied by full clinical details and pre-operative photographs, including front, base (ie inferior view) and two laterals of the nose. Where digital photographs are supplied, the practitioner must sign each photograph to certify that the digital photograph has not been altered. The claim and the additional information should be lodged with the Department of Human Services for referral to the Medicare Claims Review Panel, in a sealed envelope marked 'Medical-in Confidence'.

Applications for approval should be addressed to:

The MCRP Officer

PO Box 9822

SYDNEY NSW 2001

Practitioners may also apply to the Department of Human Services for prospective approval for proposed surgery.

Related Items: 45638 45639


Related Items

Category 3 - THERAPEUTIC PROCEDURES

45638

45638 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Jan-2015
Schedule Fee Start Date:
01-Nov-2012

RHINOPLASTY, TOTAL, including correction of all bony and cartilaginous elements of the external nose, for correction of nasal obstruction or post-traumatic deformity (but not as a result of previous elective cosmetic surgery), or both (H)

(Anaes.)

Fee: $1,014.05 Benefit: 75% = $760.55

(See para TN.8.104 of explanatory notes to this Category)

Category 3 - THERAPEUTIC PROCEDURES

45639

45639 - Additional Information

Item Start Date:
01-Jul-1998
Description Start Date:
01-Jan-2015
Schedule Fee Start Date:
01-Nov-2012

RHINOPLASTY, TOTAL, including correction of all bony and cartilaginous elements of the external nose, where it can be demonstrated that there is a need for correction of significant developmental deformity (H)

(Anaes.)

Fee: $1,014.05 Benefit: 75% = $760.55

(See para TN.8.104 of explanatory notes to this Category)


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