Medicare Benefits Schedule - Item 45558

Search Results for Item 45558

View Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

45558

45558 - Additional Information

Item Start Date:
01-Nov-2001
Description Updated:
01-Jul-2023
Schedule Fee Updated:
01-Nov-2023

Group
T8 - Surgical Operations
Subgroup
13 - Plastic And Reconstructive Surgery
Subheading
4 - Other Grafts And Miscellaneous Procedures

Correction of bilateral breast ptosis by mastopexy, if:

(a) at least two‑thirds of the breast tissue, including the nipple, lies inferior to the inframammary fold where the nipple is located at the most dependent, inferior part of the breast contour; and

(b) photographic evidence (including anterior, left lateral and right lateral views), with a marker at the level of the inframammary fold, demonstrating the clinical need for this service, is documented in the patient notes

Applicable only once per lifetime, other than a service associated with a service to which item 31512, 31513 or 31514 applies

(H)

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $1,264.70 Benefit: 75% = $948.55

(See para TN.8.99 of explanatory notes to this Category)


Associated Notes

Category 3 - THERAPEUTIC PROCEDURES

TN.8.99

Breast Ptosis - (Items 45556 and 45558)

For the purposes of item 45556, Medicare benefit is only payable for the correction of breast ptosis when performed unilaterally, in the context of breast cancer or developmental breast abnormality to match the position of the contralateral breast. This item is payable only once per patient. Additional benefit is not payable if this procedure is also performed on the contralateral breast.

Item 45558 applies where correction of breast ptosis is indicated because at least two-thirds of the breast tissue, including the nipple, lies inferior to the infra-mammary fold where the nipple is located at the most dependent, inferior part of the breast contour.

Item 45556 should not be used with the insertion of any prosthesis on the same side.

Item 45558 should not be used with the insertion of any prosthesis.

Full clinical details must be documented in patient notes, including pre-operative photographic evidence (including anterior, left lateral and right lateral views) as specified in the item descriptor which demonstrates the clinical need for the service, as this may be subject to audit.

 

 

 

Related Items: 45556 45558


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