Medicare Benefits Schedule - Item 42504

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Category 3 - THERAPEUTIC PROCEDURES

42504

42504 - Additional Information

Item Start Date:
01-May-2020
Description Updated:
01-Jul-2025
Schedule Fee Updated:
01-Jul-2025

Group
T8 - Surgical Operations
Subgroup
9 - Ophthalmology

Implantation of a micro-bypass glaucoma surgery device or devices into the suprachoroidal space or the trabecular meshwork, if conservative therapies have failed, are likely to fail, or are contraindicated (H)

Multiple Operation Rule

(Anaes.)

Fee: $350.85 Benefit: 75% = $263.15

(See para TN.8.296 of explanatory notes to this Category)

Extended Medicare Safety Net Cap: $52.65


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.296

Implantation of a micro-bypass glaucoma surgery device or devices (Item 42504 and 42705)

Item 42504 provides for a standalone procedure for the implantation of micro-bypass glaucoma surgery device or devices into the suprachoroidal space or trabecular meshwork for the treatment of glaucoma patients if conservative therapies have failed, are likely to fail, or are contraindicated.

Item 42705 can provide for the implantation of a micro-bypass glaucoma surgery device or devices into the suprachoroidal space or trabecular meshwork, however 42504 is for a standalone procedure.

The suprachoroidal and supraciliary spaces are contiguous and are potential spaces opened by surgery to allow drainage of aqueous humour, and the terms are used interchangeably.

Related Items: 42504 42705


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