Medicare Benefits Schedule - Note TN.8.104

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Category 3 - THERAPEUTIC PROCEDURES

TN.8.104

Rhinoplasty - (Items 45632 to 45644, and 45650)

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

 

A Medicare benefit for items 45632 – 45644 and 45650 is payable where the indication for surgery is for:

(i) airway obstruction and the patient has a self-reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity.

 

The NOSE Scale refers to the Nasal Obstruction Symptom Evaluation Scale, developed by Stewart et al, as published in the Otolaryngology-Head and Neck Surgery, 130: 2.

 

The NOSE Scale can be accessed here: https://www.entnet.org//content/facial-plasticsrhinology-outcome-tool-nose-scale

 

Full clinical details must be documented in patient notes, including pre-operative photographic and / or NOSE Scale evidence demonstrating the clinical need for the service as this may be subject to audit.

 

Related Items: 41671 45632 45635 45641 45644 45650


Related Items

Category 3 - THERAPEUTIC PROCEDURES

45632 Fee

45632 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Rhinoplasty, partial, involving correction of lateral or alar cartilages, if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

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

(Anaes.)

Fee: $520.15 Benefit: 75% = $390.15 85% = $442.15

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

Category 3 - THERAPEUTIC PROCEDURES

45635 Fee

45635 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Rhinoplasty, partial, involving correction of bony vault only, if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

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

(Anaes.)

Fee: $597.00 Benefit: 75% = $447.75 85% = $507.45

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

Category 3 - THERAPEUTIC PROCEDURES

45641 Fee

45641 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Rhinoplasty, total, including correction of all bony and cartilaginous elements of the external nose, with or without autogenous cartilage or bone graft from a local site (nasal), if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

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

(Anaes.)

Fee: $1,083.05 Benefit: 75% = $812.30

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

Category 3 - THERAPEUTIC PROCEDURES

45644 Fee

45644 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Rhinoplasty, total, including correction of all bony and cartilaginous elements of the external nose involving autogenous bone or cartilage graft obtained from distant donor site, including obtaining of graft, if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self‑reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

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

(Anaes.) (Assist.)

Fee: $1,299.90 Benefit: 75% = $974.95

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

Category 3 - THERAPEUTIC PROCEDURES

45650 Fee

45650 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Nov-2018
Schedule Fee Start Date:
01-Jul-2019

Rhinoplasty, revision of, if:

(a) the indication for surgery is:

(i) airway obstruction and the patient has a self-reported NOSE Scale score of greater than 45; or

(ii) significant acquired, congenital or developmental deformity; and

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

(Anaes.)

Fee: $150.15 Benefit: 75% = $112.65 85% = $127.65

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

Category 3 - THERAPEUTIC PROCEDURES

41671 Fee

41671 - Additional Information

Item Start Date:
01-Dec-1991
Description Start Date:
01-Dec-1991
Schedule Fee Start Date:
01-Jul-2019

NASAL SEPTUM, SEPTOPLASTY, SUBMUCOUS RESECTION or closure of septal perforation

(Anaes.)

Fee: $491.00 Benefit: 75% = $368.25

(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