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Insertion, removal or replacement of permanent cardiac synchronisation device, if the patient:

(a) has all of the following:

(i) chronic heart failure, classified as New York Heart Association class III or IV (despite optimised medical therapy);

(ii) left ventricular ejection fraction of less than 35%;

(iii) QRS duration of greater than or equal to 130 ms; or

(b) has all of the following:

(i) chronic heart failure, classified as New York Heart Association class II (despite optimised medical therapy);

(ii) left ventricular ejection fraction of less than 35%;

(iii) QRS duration of greater than or equal to 150 ms;

other than a service associated with a service to which item 38212 applies (H)

Multiple Operation Rule

Fee: $281.15 Benefit: 75% = $210.90

(See para TN.8.63 of explanatory notes to this Category)

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Insertion, removal or replacement of permanent transvenous left ventricular electrode, through the coronary sinus, for the purpose of cardiac resynchronisation therapy, including right heart catheterisation and any associated venograms, if the patient:

(a) has all of the following:

(i) chronic heart failure, classified as New York Heart Association class III or IV (despite optimised medical therapy);

(ii) left ventricular ejection fraction of less than 35%;

(iii) QRS duration of greater than or equal to 130 ms; or

(b) has all of the following:

(i) chronic heart failure, classified as New York Heart Association class II (despite optimised medical therapy);

(ii) left ventricular ejection fraction of less than 35%;

(iii) QRS duration of greater than or equal to 150 ms;

other than a service associated with a service to which item 35200, 38200 or 38212 applies (H)

Multiple Operation Rule

Fee: $1,347.90 Benefit: 75% = $1,010.95

(See para TN.8.63 of explanatory notes to this Category)

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