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Total mastectomy (unilateral)

(H)

Multiple Operation Rule

Fee: $881.05 Benefit: 75% = $660.80

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• Next - Item 31520

Total mastectomy (bilateral)

(H)

Multiple Operation Rule

Fee: $1,541.65 Benefit: 75% = $1,156.25

• Previous - Item 31519
• Next - Item 31522

Autologous fat grafting, unilateral service (harvesting, preparation and injection of adipocytes) if:

(a) the autologous fat grafting is for one or more of the following purposes:

(i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage;

(ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction;

(iii) breast reconstruction in breast cancer patients;

(iv) the correction of developmental disorders of the breast; and

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

Up to a total of 4 services per side (for total treatment of a single breast), other than a service associated with a service to which item 45006 or 45012 applies

(H)

Multiple Operation Rule

Fee: $756.10 Benefit: 75% = $567.10

(See para TN.8.294 of explanatory notes to this Category)

• Previous - Item 45532
• Next - Item 45535

Autologous fat grafting, bilateral service (harvesting, preparation and injection of adipocytes) if:

(a) the autologous fat grafting is for one or more of the following purposes:

(i) the correction of defects arising from treatment and prevention of breast cancer in patients with contour defects, greater than or equal to 20% volume asymmetry, post‑treatment pain or poor prosthetic coverage;

(ii) the preparation of post mastectomy thin or irradiated skin flaps in patients intending to have breast reconstruction;

(iii) breast reconstruction in breast cancer patients;

(iv) the correction of developmental disorders of the breast; and

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

Up to a total of 4 services, other than a service associated with a service to which item 45006 or 45012 applies

 (H)

Multiple Operation Rule

Fee: $1,323.35 Benefit: 75% = $992.55

(See para TN.8.294 of explanatory notes to this Category)

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