Medicare Benefits Schedule - Item 38358

Extraction of one or more chronically implanted transvenous pacing or defibrillator leads, by percutaneous method, with locking stylets and snares, with extraction sheaths (if any), if:

(a) the leads have been in place for more than 6 months and require removal; and

(b) the service is performed:

(i) in association with a service to which item 61109 or 60509 applies; and

(ii) by a specialist or consultant physician who has undertaken the training to perform the service; and

(iii) in a facility where cardiothoracic surgery is available and a thoracotomy can be performed immediately and without transfer; and

(c) if the service is performed by an interventional cardiologist—a cardiothoracic surgeon is in attendance during the service

(H) 

Multiple Operation Rule

(Anaes.) (Assist.)

Fee: $3,345.75 Benefit: 75% = $2,509.35

(See para TN.8.64, TN.8.214 of explanatory notes to this Category)

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For the purposes of Item 38358 specialists or consultant physicians claiming this item must have training recognised by the Lead Extraction Certification Committee (LECC) under Cardiac Accreditation Services Limited (CASL), and Services Australia has been notified of that recognition. The procedure should only be undertaken in a hospital capable of providing cardiac surgery.

Related Items: 38358

International guidelines for chronic lead extraction state that delays from injury to open access to the heart of more than 5–10 minutes are often associated with a fatal outcome. Preparations for this procedure should provide for this rare but life threatening circumstance.

Claiming guide chronic lead extraction:

When the service to which item 38358 applies is provided to a patient by an accredited interventional cardiologist the following claiming will apply:

• Item 38358 is to be claimed by the accredited interventional cardiologist; and
• Item 90300 is to be claimed by the standby cardiothoracic surgeon.

When the service to which item 38358 applies is provided to a patient by an accredited cardiothoracic surgeon the following claiming will apply:

• Item 38358 is to be claimed by the accredited cardiothoracic surgeon only

Claiming guide leadless pacemaker extraction (for an interventional cardiologist):

When the service to which item 38374 or 38375 applies is provided to a patient by an accredited interventional cardiologist the following claiming will apply:

• Item 38374 is to be claimed by the accredited interventional cardiologist; and
• Item 90300 is to be claimed by the standby cardiothoracic surgeon.

When the service to which item 38375 applies is provided to a patient by an accredited cardiothoracic surgeon the following claiming will apply:

• Item 38375 is to be claimed by the accredited cardiothoracic surgeon only

Claiming guide TAVI intermediate risk (38514) or TAVI low risk (38522):

When the service to which item 38514 or 38522 applies is provided to a patient by an accredited interventional cardiologist the following claiming will apply:

• Item 38514 or 38522 is to be claimed by the accredited interventional cardiologist; and
• Item 90300 is to be claimed by the standby cardiothoracic surgeon.

When the service to which item 38514 or 38522 applies is provided to a patient by an accredited cardiothoracic surgeon the following claiming will apply:

• Item 38514 or 38522 is to be claimed by the accredited cardiothoracic surgeon only

Related Items: 38358 38373 38374 38514 38522 90300