S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.1 |
Craniotomy And Evacuation Of Hematoma Subdural |
MRI/ CT |
Post Procedure Clinical Photograph/Ct/Mri Post Op Suture Line Photo Mandatory For Claim |
- |
S18A01 |
I6203 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.2 |
Craniotomy And Evacuation Of Hematoma Extradural |
MRI/ CT |
Post Procedure Clinical Photograph/Ct/Mri Post Op Suture Line Photo Mandatory For Claim |
- |
S18A10 |
G9731 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.3 |
Evacuation Of Brain Abscess - Burr Hole |
MRI/ CT |
Post Procedure Clinical Photograph/Ct/Mri Post Op Suture Line Photo Mandatory For Claim |
- |
S18A16 |
G07 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.4 |
Excision Of Lobe (Frontal, Temporal, Cerebellum Etc.) |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A17 |
G379 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.5 |
Endoscopy Procedures Brain / Spine |
CT/MRI |
Endoscopy Picture/Ct/Mri |
- |
S18D01 |
G379 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.6 |
De-Compressive Craniotomy(Non Traumatic) |
CT/MRI |
Clinical Photo,Notes/CT/MRI/X-Ray Post Op Suture Line Photo Mandatory For Claim |
- |
S18D02 |
G07 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.7 |
Intra-Cerebral Hematoma Evacuation |
CT/MRI |
Clinical Photo,Notes/CT/MRI Post Op Suture Line Photo Mandatory For Claim |
- |
S18D03 |
G07 |
S10 |
Neurosurgery |
S10I1 |
Brain |
S10I1.8 |
Endoscopic Third Ventriculostomy |
CT/MRI |
Clinical Photo,Notes/Ct/Mri |
- |
S18D04 |
G07 |
S10 |
Neurosurgery |
S10I10 |
Epilepsy Surgery |
S10I10.1 |
Temporal Lobectomy |
MRI,VIDEO EEG,PSYCHOLOGIC ASSESSMENT |
CT/MRI,Hpe Post Op Suture Line Photo Mandatory For Claim |
- |
S18G01 |
M792 |
S10 |
Neurosurgery |
S10I10 |
Epilepsy Surgery |
S10I10.2 |
Lesionectomy Type 1 |
MRI,VIDEO EEG,PSYCHOLOGIC ASSESSMENT |
Clinical Photograph Ct/Mri,Hpe |
- |
S18G02 |
G40419 |
S10 |
Neurosurgery |
S10I10 |
Epilepsy Surgery |
S10I10.3 |
Lesionectomy Type 2 |
MRI,VIDEO EEG,PSYCHOLOGIC ASSESSMENT |
Clinical Photograph Ct/Mri,Hpe |
- |
S18G03 |
G40419 |
S10 |
Neurosurgery |
S10I10 |
Epilepsy Surgery |
S10I10.4 |
Temporal Lobectomy Plus Depth Electrodes |
MRI,VIDEO EEG,PSYCHOLOGIC ASSESSMENT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18G04 |
G40419 |
S10 |
Neurosurgery |
S10I11 |
Trigeminal Neuralgia |
S10I11.1 |
Radiofrequency Ablation |
CT/MRI |
CT/MRI |
- |
S18H01 |
M792 |
S10 |
Neurosurgery |
S10I11 |
Trigeminal Neuralgia |
S10I11.2 |
Micro Vascular Decompression |
CT/MRI |
Post Procedure Clinical Photograph/Ct/Xray |
- |
S18H02 |
M792 |
S10 |
Neurosurgery |
S10I12 |
Management Of Aneurysms |
S10I12.1 |
Embolization (Non coil) |
CT/MRI/ DSA |
Post Procedure Clinical Photograph/Ct/Mri/Angio |
- |
S18I01 |
I729 |
S10 |
Neurosurgery |
S10I12 |
Management Of Aneurysms |
S10I12.2 |
Cost Of Each Coil Coil Embolization |
CT/MRI/ DSA |
Post Procedure Clinical Photograph/Ct/Mri/Angio |
- |
S18I02 |
G9731 |
S10 |
Neurosurgery |
S10I13 |
Neurosurgical Trauma Consertative |
S10I13.1 |
Neurosurgical Trauma Consertative Management Stay General Ward @Rs.1500/ Day - 7 days |
X- RAY/ CT |
Clinical notes |
- |
S27N01 |
V899xxA |
S10 |
Neurosurgery |
S10I13 |
Neurosurgical Trauma Consertative |
S10I13.2 |
Neurosurgical Trauma Consertative Management Stay In Neuro ICU without ventilator@Rs.4000/Day - 7 da |
X- RAY/ CT/ MRI |
Clinical notes |
- |
S27N02 |
V899xxA |
S10 |
Neurosurgery |
S10I13 |
Neurosurgical Trauma Consertative |
S10I13.3 |
Neurosurgical Trauma Surgical Treatment (Up To) |
X- RAY/CT/MRI |
Lab Investigation,Post Procedure Clinical Photograph |
- |
S27N03 |
V899xxA |
S10 |
Neurosurgery |
S10I13 |
Neurosurgical Trauma Consertative |
S10I13.4 |
Depressed Fracture of Skull |
Clinical assessment |
Clinical assessment |
- |
|
|
S10 |
Neurosurgery |
S10I15 |
Tumores |
S10I15.13 |
Spine - Extradural Tumour with fixation |
CT/MRI/X-ray |
CT,X-ray,MRI |
- |
|
|
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.1 |
Parasagittal Tumour |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A18 |
C719 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.10 |
Ventriculoatrial Shunt |
CT/MRI |
CT/Xray |
- |
S02A40 |
Q052 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.11 |
Excision Of Brain Abscess |
CT/MRI |
Clinical Photograph/ Ct/Mri,HPE |
- |
S02A41 |
A066 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.12 |
Aneurysm Clipping |
ANGIOGRAM,MRI,CT |
CLINICAL PHOTOGRAPH,X- RAY |
- |
S18A14 |
I729 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.13 |
External Ventricular Drainage (EVD) |
CT/MRI |
Clinical Photograph / Xray/ Ct/ Mri |
- |
S18A15 |
G07 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.2 |
Basal Brain Tumour |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A19 |
C719 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.3 |
Brain Stem Tumour |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A20 |
C719 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.4 |
C P Angle Tumour |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A21 |
C719 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.5 |
Meningoencephalocele |
MRI/ CT |
Post Procedure Clinical Photograph/Ct/Xray |
- |
S18J01 |
G042 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.6 |
Meningomylocele |
CT/MRI |
Post Procedure Clinical Photograph/Ct/Xray |
- |
S18J02 |
G042 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.7 |
C.S.F. Rhinorrhoea |
CT/MRI |
Post Procedure Clinical Photograph |
- |
S18A11 |
G9731 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.8 |
Cranioplasty |
CT/MRI |
Post Procedure Clinical Photograph/Ct/Xray |
- |
S18A12 |
G07 |
S10 |
Neurosurgery |
S10I2 |
Brain Tumours |
S10I2.9 |
Meningocele / Meningomyelocele Excision |
CT/MRI |
Post Procedure Clinical Photograph/Ct/Xray |
- |
S18J03 |
G042 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.1 |
Other Procedures |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A02 |
I629 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.2 |
cerebellar tumours |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18A03 |
C719 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.3 |
Ventriculoperitoneal / Ventriculo pleural Shunt |
MRI/ CT |
Xray/ CT/MRI |
- |
S18A04 |
G07 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.4 |
Twist Drill Craniotomy |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri |
- |
S18A05 |
G07 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.5 |
Subdural Tapping |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri |
- |
S18A06 |
G07 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.6 |
Ventricular Tapping |
MRI/ CT |
Xray/ CT/MRI |
- |
S18A07 |
G07 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.7 |
Abscess Tapping (Twist drill) |
MRI/ CT |
Clinical Photograph / CT/ MRI/ Pus C/S |
- |
S18A08 |
G07 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.8 |
Vascular Malformations |
CT/MRI/Angio |
CT/MRI/Angio |
- |
S25A10 |
Q898 |
S10 |
Neurosurgery |
S10I3 |
Excision Of Brain Tumours |
S10I3.9 |
Thecoperitoneal Shunt |
MRI/ CT |
Xray/ CT/MRI |
- |
S33A08 |
K7469 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.1 |
Surgery On Cord Tumours |
CT/MRI |
Clinical Photograph/ Ct/Mri,HPE |
- |
S18B01 |
C719 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.10 |
Laminectomy |
MRI/ CT |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18B10 |
G320 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.11 |
Discectomy |
MRI/ CT |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18B11 |
G320 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.12 |
Spinal Fusion Procedure |
MRI/ CT |
Post Procedure Clinical Photograph /Xray/ Ct/Mri Bar Code Sticker If Allograft |
- |
S18B12 |
G320 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.14 |
Spine - Extradural Haematoma |
CT/MRI/X-ray |
CT/MRI/X-ray |
- |
|
|
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.15 |
Spine - Intradural Haematoma |
CT/MRI |
Scar Photo,X-Ray |
- |
|
|
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.16 |
Spine - Intradural Haematoma with fixation |
CT/MRI/X-ray |
CT/MRI/X-ray |
- |
|
|
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.17 |
Excision of Benign Orbital Tumour |
BIOPSY,Clinical and radiological investigations |
Post Procedure Clinical Photograph,HPE |
- |
|
|
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.2 |
Spinal Intramedullary Tumours |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18B02 |
C719 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.3 |
Spina Bifida Surgery Major |
MRI/ CT |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18B03 |
Q050 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.5 |
Excision Of Cervical Intervertebral Discs |
MRI/ CT |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18B05 |
G320 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.7 |
Anterior Cervical Discectomy |
MRI/ CT |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18B07 |
G320 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.8 |
Anterior Cervical Spine Surgery With Fusion - Cost per level per fusion |
X-RAY CERVICAL SPINE,MRI/ CT |
Post Procedure Clinical Photograph /Xray/ Ct/Mri Bar Code Sticker If Allograft |
- |
S18B08 |
G320 |
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.9 |
Anterolateral Decompression |
MRI/ CT |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18B09 |
G320 |
S10 |
Neurosurgery |
S10I6 |
Other Surgical Procedures |
S10I6.1 |
Stereotactic Procedures - Post Procedure Evidence Of Clinical Photograph |
CT/MRI |
CT/MRI/HPE |
- |
S18C01 |
G379 |
S10 |
Neurosurgery |
S10I6 |
Other Surgical Procedures |
S10I6.2 |
Trans Sphenoidal Surgery |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18C02 |
G379 |
S10 |
Neurosurgery |
S10I6 |
Other Surgical Procedures |
S10I6.3 |
Trans Oral Surgery |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
S18C03 |
G379 |
S10 |
Neurosurgery |
S10I6 |
Other Surgical Procedures |
S10I6.4 |
CV Junction Fusion |
CT/MRI,X-RAY CERVICAL SPINE |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18C04 |
G379 |
S10 |
Neurosurgery |
S10I6 |
Other Surgical Procedures |
S10I6.5 |
C.V. Junction Fusion |
CT/MRI,X-RAY CERVICAL SPINE |
Post Procedure Clinical Photograph /X-Ray/Ct/Mri |
- |
S18C05 |
G379 |
S10 |
Neurosurgery |
S10I8 |
Spine |
S10I8.1 |
Anterior Discectomy & Bone Grafting |
CT/MRI |
X Ray/Ct/Mri |
- |
S18E02 |
G320 |
S10 |
Neurosurgery |
S10I8 |
Spine |
S10I8.2 |
Discectomy With Implants Lumbar / Thoracic per level |
CT/MRI |
Bar Code Stickers,X Ray/Ct/Mri |
- |
S18E03 |
G320 |
S10 |
Neurosurgery |
S10I8 |
Spine |
S10I8.3 |
Corpectomy For Spinal Fixation per level |
CT/MRI |
X Ray/Ct/Mri |
- |
S18E05 |
G320 |
S10 |
Neurosurgery |
S10I8 |
Spine |
S10I8.4 |
Spinal Fixation Rods /Plates |
CT/MRI |
X Ray/Ct/Mri |
- |
S18E06 |
G320 |
S10 |
Neurosurgery |
S10I8 |
Spine |
S10I8.5 |
Syringomyelia |
CT/MRI |
Clinical Photograph/ Ct/Mri |
- |
S18E01 |
G07 |
S10 |
Neurosurgery |
S10I9 |
Soft Tissue And Vascular Injuries |
S10I9.1 |
Repair Of Brachial Plexus Injury |
NCV/EMG/CT/MRI |
Clinical Photograph/Emg/ Ncv |
- |
S02A42 |
S143 |
S10 |
Neurosurgery |
S10I9 |
Soft Tissue And Vascular Injuries |
S10I9.4 |
Decompression/Excision Of Optic Nerve Lesions |
CT/MRI |
Clinical Photograph/ Ct/Mri |
- |
S18F03 |
G07 |
S10 |
Neurosurgery |
S10I9 |
Soft Tissue And Vascular Injuries |
S10I9.5 |
Peripheral Nerve Injury Repair |
EMG,NERVE CONDUCTION |
Post Procedure Clinical Photograph |
- |
S18F05 |
M792 |
S10 |
Neurosurgery |
S10I9 |
Soft Tissue And Vascular Injuries |
S10I9.6 |
Proptosis |
CT/MRI |
CT/MRI |
- |
S18F04 |
G07 |
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.1 |
Duroplasty |
CT/MRI |
CT,MRI |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.12 |
Foramen Magnum Decompression |
MRI/CT-Angio |
CT-Head |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.13 |
Carpal Tunnel Release including pre and post Op. MRI |
CT/MRI |
CT,MRI |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.2 |
Intracerebral Hematoma |
CT/MRI |
CT,MRI |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.3 |
Local Neurectomy/R.F. or Surgery |
EMG,Nerve Conduction |
Clinical Photograph |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.4 |
Peripheral Neurectomy/R.F. or surgery |
EMG,Nerve Conduction |
Clinical Photograph |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.5 |
R.F. Lesion for Trigeminal Neuralgia |
EMG,Nerve Conduction |
Clinical Photograph |
- |
|
|
S10 |
Neurosurgery |
S10PM1 |
Neurosurgery PMJAY Sub Category |
S10PM1.6 |
Spine - Extradural Haematoma with Implant |
CT/MRI/X-ray |
CT,X-ray,MRI |
- |
|
|
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.1 |
Composite Resection & Reconstruction |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34A01 |
C490 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.10 |
Hemimandibulectomy |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S25G41 |
C800 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.3 |
Neck Dissection Any Type |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S25G40 |
C800 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.4 |
Hemiglossectomy |
BIOPSY,X-Ray Chest,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,HPE,CLINICAL PHOTOGRAPH |
- |
SO34A03 |
C029 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.5 |
Maxillectomy Any Type |
CLINICAL AND RADIOLOGICAL EVIDENCE,X- RAY,USG,CLINICAL PHOTOGRAPH,BIOPSY |
BIOPSY,Post Procedure Clinical Photograph,Operative Notes,HPE,CLINICAL PHOTOGRAPH |
- |
SO34A04 |
C048 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.6 |
Thyroidectomy Any Type |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34A05 |
C048 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.7 |
Parotidectomy Any Type |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34A06 |
C048 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.8 |
Laryngectomy Any Type |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34A07 |
C048 |
S11 |
Surgical Oncology |
S11J1 |
Head And Neck |
S11J1.9 |
Laryngo Pharyngo Oesophagectomy |
BIOPSY,X- RAY,USG,CLINICAL PHOTOGRAPH |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34A08 |
C048 |
S11 |
Surgical Oncology |
S11J10 |
Ca Git |
S11J10.1 |
Small Bowel Resection |
CLINICAL AND RADIOLOGICAL EVIDENCE |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34R01 |
C260 |
S11 |
Surgical Oncology |
S11J10 |
Ca Git |
S11J10.2 |
Closure Of Ileostomy |
CLINICAL PHOTOGRAPH |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34R02 |
C260 |
S11 |
Surgical Oncology |
S11J10 |
Ca Git |
S11J10.3 |
Closure Of Colostomy |
CLINICAL PHOTOGRAPH |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34R03 |
C260 |
S11 |
Surgical Oncology |
S11J10 |
Ca Git |
S11J10.4 |
Abdomino Perineal Resection (Apr) + Sacrectomy |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34S01 |
C260 |
S11 |
Surgical Oncology |
S11J11 |
Ca Rectum |
S11J11.2 |
Total Exenteration |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34S03 |
C260 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.1 |
Oesophagectomy Any Type |
BIOPSY,CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34B01 |
C260 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.2 |
Gastrectomy Any Type |
BIOPSY,CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S25G29 |
C800 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.3 |
Colectomy Any Type |
BIOPSY,CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34B02 |
C260 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.4 |
Anterior Resection |
BIOPSY,CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S25G35 |
C800 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.5 |
Abdominoperineal Resection |
BIOPSY,CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S02A43 |
C7A026 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.6 |
Whipples Any Type |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34B03 |
C260 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.7 |
Triple Bypass |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34B03 |
C260 |
S11 |
Surgical Oncology |
S11J12 |
Ca Git |
S11J12.8 |
Other Bypasses-Pancreas and others |
RADIOLOGICAL EVIDENCE,BIOPSY |
Operative Notes,Post Procedure Clinical Photograph |
- |
SO34B05 |
C260 |
S11 |
Surgical Oncology |
S11J13 |
Ca Gall Bladder |
S11J13.1 |
Radical / Revision Cholecystectomy |
RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34T01 |
C260 |
S11 |
Surgical Oncology |
S11J14 |
Ca Spleen |
S11J14.1 |
Splenectomy |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S25G39 |
C800 |
S11 |
Surgical Oncology |
S11J15 |
Ca Retroperitoneal Tumors |
S11J15.1 |
Resection Of Retroperitoneal Tumours |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34U01 |
C260 |
S11 |
Surgical Oncology |
S11J16 |
Ca Abdominal Wall Tumour |
S11J16.1 |
Abdominal Wall Tumour Resection |
BIOPSY/FNAC,CT/MRI/USG |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34V01 |
C260 |
S11 |
Surgical Oncology |
S11J16 |
Ca Abdominal Wall Tumour |
S11J16.2 |
Resection With Reconstruction of Abdominal Wall Tumour |
BIOPSY/FNAC,CT/MRI/USG |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34V02 |
C260 |
S11 |
Surgical Oncology |
S11J17 |
Gynec |
S11J17.1 |
Bilateral Pelvic Lymph Node Dissection(BPLND) |
BIOPSY,FNAC,CT |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34W01 |
C55 |
S11 |
Surgical Oncology |
S11J17 |
Gynec |
S11J17.4 |
Radical Vaginectomy and /or Reconstruction |
BIOPSY/ CT |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34W04 |
C55 |
S11 |
Surgical Oncology |
S11J18 |
Ca Cervix |
S11J18.4 |
Total Pelvic Exenteration |
Biopsy,CT |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34X04 |
C55 |
S11 |
Surgical Oncology |
S11J19 |
Ca Endometrium |
S11J19.1 |
Total Abdominal Hysterectomy(TAH) + Bilateral Salpingo Ophorectomy (BSO) + Bilateral Pelvic Lymph No |
CT,ENDOMETRIAL BIOPSY |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34Y01 |
C55 |
S11 |
Surgical Oncology |
S11J2 |
Ca.Eye/ Maxilla /Para Nasal Sinus |
S11J2.1 |
Orbital Exenteration |
RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34J01 |
C490 |
S11 |
Surgical Oncology |
S11J2 |
Ca.Eye/ Maxilla /Para Nasal Sinus |
S11J2.2 |
Maxillectomy + Orbital Exenteration |
CT |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34J02 |
C490 |
S11 |
Surgical Oncology |
S11J2 |
Ca.Eye/ Maxilla /Para Nasal Sinus |
S11J2.3 |
Maxillectomy + Infratemporal Fossa Clearance |
CT |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34J03 |
C490 |
S11 |
Surgical Oncology |
S11J2 |
Ca.Eye/ Maxilla /Para Nasal Sinus |
S11J2.4 |
Cranio Facial Resection |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34J04 |
C490 |
S11 |
Surgical Oncology |
S11J20 |
Soft Tissue /Bone Tumours. Chest Wall |
S11J20.1 |
Chest Wall Resection |
BIOPSY |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34Z01 |
C496 |
S11 |
Surgical Oncology |
S11J20 |
Soft Tissue /Bone Tumours. Chest Wall |
S11J20.2 |
Chest Wall Resection + Reconstruction |
BIOPSY |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34Z02 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.1 |
Limb Salvage Surgery Without Prosthesis |
BIOPSY,CT/MRI |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA01 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.10 |
Sacral Resection |
BIOPSY,MRI |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA10 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.2 |
Limb Salvage Surgery With Custom Made Prosthesis |
BIOPSY,CT/MRI |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA02 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.3 |
Limb Salvage Surgery With Modular Prosthesis |
BIOPSY,Ct/Mri |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA03 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.4 |
Forequarter Amputation |
BIOPSY |
Operative Notes,Post Procedure Clinical Photograph |
- |
SO34AA04 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.5 |
External Hemipelvectomy |
RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA05 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.6 |
Internal Hemipelvectomy |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA06 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.7 |
Curettage & Bone Cement |
BIOPSY / OR CLINICO RADIOLOGICAL C/O MALIGNANCY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA07 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.8 |
Bone Resection |
BIOPSY,X-Ray,MRI |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA08 |
C496 |
S11 |
Surgical Oncology |
S11J22 |
Limb Salvage Surgery |
S11J22.9 |
Shoulder Girdle Resection |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AA09 |
C496 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.1 |
Partial Nephrectomy |
RADIOLOGICAL ONDE OF MALIGNANCY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AB01 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.10 |
Radical Prostatectomy |
BIOPSY,IMAGING - MRI,FLUNDE PET CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C06 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.11 |
High Orchidectomy |
CT ABDOMEN PELVIS,TUMOUR MARKERS |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C07 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.12 |
Bilateral Orchidectomy |
BONE SCAN,TUMOUR MARKERS |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C08 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.2 |
Nephroureterectomy For Transitional Cell Carcinima Of Renal Pelvis Open / Lap |
RADIOLOGICAL EVIDENCE,PATHOLOGY / URINE CYTOLOGY/ BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AB02 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.3 |
Radical Nephrectomy |
RADIOLOGICAL ONDE OF MALIGNANCY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C01 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.4 |
Emasculation |
IMAGING -CT,MRI |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C02 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.5 |
Radical Cystectomy |
BIOPSY,USG,KUB,IVP,CT |
BIOPSY/USG,CLINICAL PHOTOGRAPH |
- |
SO34C03 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.6 |
Other Cystectomies |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C04 |
C670 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.7 |
Total Penectomy |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S25G33 |
C800 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.8 |
Partial Penectomy |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S25G34 |
C800 |
S11 |
Surgical Oncology |
S11J23 |
Genitourinary |
S11J23.9 |
Inguinal Block Dissection One Side |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34C05 |
C670 |
S11 |
Surgical Oncology |
S11J24 |
Testis Cancer |
S11J24.1 |
Retro Peritoneal Lymph Node Dissection(RPLND) (For Residual Disease) |
CT ABDOMEN THORAX PELVIS |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AC01 |
C670 |
S11 |
Surgical Oncology |
S11J24 |
Testis Cancer |
S11J24.2 |
Adrenalectomy |
IMAGING -CT,SERUM METARPHINES,SERUM HORMETAMERPHINES,SERUM CORTIZOL |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AC02 |
C670 |
S11 |
Surgical Oncology |
S11J24 |
Testis Cancer |
S11J24.3 |
Urinary Diversion |
INMAGING TO SHOW EVIDENCE OF URINARY OBSTRUCTION OR INVOLVEMENT OF LOWER URINARY TRACT IN MALIGNANCY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AC03 |
C670 |
S11 |
Surgical Oncology |
S11J24 |
Testis Cancer |
S11J24.4 |
Retro Peritoneal Lymph Node Dissection Rplnd As Part Of Staging |
PATHOLOGY IF PRIMARY OR NODES |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AC04 |
C670 |
S11 |
Surgical Oncology |
S11J25 |
Urinary Bladder |
S11J25.1 |
Anterior/Posterior Exenteration |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AD01 |
C670 |
S11 |
Surgical Oncology |
S11J25 |
Urinary Bladder |
S11J25.2 |
Total Exenteration |
BIOPSY,CYSTOSCOPY,CT |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34AD02 |
C670 |
S11 |
Surgical Oncology |
S11J25 |
Urinary Bladder |
S11J25.3 |
Bilateral Pelvic Lymph Node Dissection(BPLND) for CA Urinary Bladder |
CT |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34AD03 |
C670 |
S11 |
Surgical Oncology |
S11J26 |
Thorax, Mediastinum |
S11J26.1 |
Mediastinal Tumour Resection |
CT |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34AE01 |
C3490 |
S11 |
Surgical Oncology |
S11J27 |
Lung |
S11J27.1 |
Lung Metastatectomy. Solitary |
CT |
BIOPSY,X- RAY |
- |
SO34AF01 |
C3490 |
S11 |
Surgical Oncology |
S11J27 |
Lung |
S11J27.2 |
Lung Metastatectomy. Multiple |
CT THORAX |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AF02 |
C3490 |
S11 |
Surgical Oncology |
S11J27 |
Lung |
S11J27.3 |
Sleeve Resection Of Lung Cancer |
BIOPSY,CYTOLOGY,CT THORAX |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AF03 |
C3490 |
S11 |
Surgical Oncology |
S11J27 |
Lung |
S11J27.4 |
Lung Cancer Pnumenectomy |
BIOPSY/ CYTOLOGY,CT THORAX |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34H01 |
C3490 |
S11 |
Surgical Oncology |
S11J27 |
Lung |
S11J27.5 |
Lung Cancer Lobectomy |
BIOPSY/ CYTOLOGY,CT THORAX |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34H02 |
C3490 |
S11 |
Surgical Oncology |
S11J28 |
Esophagus |
S11J28.1 |
Oesophagectomy With Two Field Lymphadenectomy |
CT THORAX |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AG01 |
C260 |
S11 |
Surgical Oncology |
S11J28 |
Esophagus |
S11J28.2 |
Oesophagectomy With Three Field Lymphadenectomy |
CT THORAX,CT THORAX |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AG02 |
C260 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.1 |
Tracheostomy for all malignancies |
CLINICAL PHOTOGRAPH |
CLINICAL PHOTOGRAPH |
- |
SO34AH01 |
C3490 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.10 |
Ileotransverse Colostomy |
BIOPSY,Post Procedure Clinical Photograph,Operative Notes |
BIOPSY,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AH10 |
C260 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.3 |
Gastrostomy |
BIOPSY |
Operative Notes,Post Procedure Clinical Photograph |
- |
SO34AH03 |
C260 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.4 |
Jejunostomy |
CLINICAL PHOTOGRAPH,Operation Notes |
CLINICAL PHOTOGRAPH |
- |
SO34AH04 |
C260 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.5 |
Ileostomy |
BioSpy,CLINICAL PHOTOGRAPH |
CLINICAL PHOTOGRAPH,Operation Notes |
- |
SO34AH05 |
C260 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.6 |
Colostomy |
- |
BIOPSY,Post Procedure Clinical Photograph,Operative Notes,HPE |
- |
S09J02G |
K639 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.8 |
Intercostal Drainage(ICD) |
BIOPSY |
Operative Notes,Post Procedure Clinical Photograph |
- |
SO34AH08 |
C3490 |
S11 |
Surgical Oncology |
S11J29 |
Palliative Surgeries |
S11J29.9 |
Gastro Jejunostomy |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AH09 |
C260 |
S11 |
Surgical Oncology |
S11J3 |
Nasopharynx |
S11J3.1 |
Resection Of Nasopharyngeal Tumour |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34K01 |
C490 |
S11 |
Surgical Oncology |
S11J30 |
Reconstruction |
S11J30.1 |
Myocutaneous / Cutaneous Flap |
Clinical indications |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AI01 |
C800 |
S11 |
Surgical Oncology |
S11J30 |
Reconstruction |
S11J30.2 |
Micro Vascular Reconstruction (Free flap) |
Clinical indications |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AI02 |
C800 |
S11 |
Surgical Oncology |
S11J31 |
Gynecology |
S11J31.4 |
Surgery For Ca Ovary - Omentectomy, Bilateral Salping oophorectomy |
USG/CT |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34D04 |
C55 |
S11 |
Surgical Oncology |
S11J31 |
Gynecology |
S11J31.5 |
Vulvectomy with reconstruction |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34D05 |
C55 |
S11 |
Surgical Oncology |
S11J31 |
Gynecology |
S11J31.6 |
Salpino Oophorectomy |
BIOPSY/USG |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34D06 |
C55 |
S11 |
Surgical Oncology |
S11J32 |
Breast |
S11J32.1 |
Mastectomy Any Type |
FNAC |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34E01 |
C50910 |
S11 |
Surgical Oncology |
S11J32 |
Breast |
S11J32.2 |
Axillary Dissection |
FNAC |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34E02 |
C50910 |
S11 |
Surgical Oncology |
S11J32 |
Breast |
S11J32.3 |
Wide Excision of Breast for Tumour |
Mamography,FNAC |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34E03 |
C50910 |
S11 |
Surgical Oncology |
S11J32 |
Breast |
S11J32.4 |
Lumpectomy Breast |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34E04 |
C50910 |
S11 |
Surgical Oncology |
S11J32 |
Breast |
S11J32.5 |
Breast Reconstruction |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
S25G08 |
T8541 |
S11 |
Surgical Oncology |
S11J32 |
Breast |
S11J32.6 |
Chest Wall Resection |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34Z01 |
C496 |
S11 |
Surgical Oncology |
S11J33 |
Skin Tumours |
S11J33.1 |
Skin Tumours Wide Excision |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34F01 |
C439 |
S11 |
Surgical Oncology |
S11J33 |
Skin Tumours |
S11J33.2 |
Skin Tumours Wide Excision + Reconstruction |
BioSpy,CLINICAL PHOTOGRAPH |
CLINICAL PHOTOGRAPH,Operation Notes,HPE |
- |
SO34F02 |
C439 |
S11 |
Surgical Oncology |
S11J33 |
Skin Tumours |
S11J33.3 |
Skin Tumours Amputation |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34F03 |
C439 |
S11 |
Surgical Oncology |
S11J34 |
Soft Tissue /Bone Tumours |
S11J34 |
Wide Excision for tumour |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34A02 |
C490 |
S11 |
Surgical Oncology |
S11J34 |
Soft Tissue /Bone Tumours |
S11J34.1 |
Wide Excision soft tissue/Bone Tumours |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34G01 |
C496 |
S11 |
Surgical Oncology |
S11J34 |
Soft Tissue /Bone Tumours |
S11J34.2 |
Wide Excision + Reconstruction soft tissue/Bone Tumours |
- |
HPE,Operative Notes |
- |
SO34G02 |
C496 |
S11 |
Surgical Oncology |
S11J34 |
Soft Tissue /Bone Tumours |
S11J34.3 |
Amputation for soft tissue/Bone Tumours |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34G03 |
C496 |
S11 |
Surgical Oncology |
S11J37 |
Oral Cavity |
S11J37.1 |
Marginal Mandibulectomy |
BIOPSY,CT/MRI |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AJ01 |
C005 |
S11 |
Surgical Oncology |
S11J37 |
Oral Cavity |
S11J37.2 |
Segmental Mandibulectomy |
BIOPSY |
Ct/Mri,Post Procedure Clinical Photograph,Operative Notes,HPE |
- |
SO34AJ02 |
C005 |
S11 |
Surgical Oncology |
S11J37 |
Oral Cavity |
S11J37.3 |
Total Glossectomy + Reconstruction |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AJ03 |
C005 |
S11 |
Surgical Oncology |
S11J37 |
Oral Cavity |
S11J37.4 |
Full Thickness Buccal Mucosal Resection & Reconstruction |
CT/MRI |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34AJ04 |
C005 |
S11 |
Surgical Oncology |
S11J38 |
Ca Liver |
S11J38.1 |
Haemangioma SOL Liver Hepatectomy + Wedge Resection |
CT-Scan,USG,FNAC & Tumour marker |
Biopsy,Clinical Photograph |
- |
S33A07 |
K769 |
S11 |
Surgical Oncology |
S11J38 |
Ca Liver |
S6E2.3 |
Segmentectomy |
CT,USG,FNAC |
- |
- |
S33A04 |
K759 |
S11 |
Surgical Oncology |
S11J4 |
Ca - Soft Palate |
S11J4.1 |
Palatectomy Any Type |
BIOPSY,CT Scan |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34L01 |
C490 |
S11 |
Surgical Oncology |
S11J5 |
Ca.Ear |
S11J5.1 |
Sleeve Resection |
BIOPSY,CT- SCAN |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34M01 |
C490 |
S11 |
Surgical Oncology |
S11J5 |
Ca.Ear |
S11J5.2 |
Lateral Temporal Bone Resection |
CLINICAL AND RADIOLOGICAL EVIDENCE,FNAC,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34M02 |
C490 |
S11 |
Surgical Oncology |
S11J5 |
Ca.Ear |
S11J5.3 |
Subtotal Temporal Bone Resection |
CLINICAL AND RADIOLOGICAL EVIDENCE,FNAC,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34M03 |
C490 |
S11 |
Surgical Oncology |
S11J5 |
Ca.Ear |
S11J5.4 |
Total Temporal Bone Resection |
CLINICAL AND RADIOLOGICAL EVIDENCE,FNAC,BIOPSY |
HPE |
- |
SO34M04 |
C490 |
S11 |
Surgical Oncology |
S11J6 |
Surgical Oncology |
S11J6.1 |
Submandibular Gland Excision |
CLINICAL AND RADIOLOGICAL EVIDENCE,BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34N01 |
C490 |
S11 |
Surgical Oncology |
S11J6 |
Surgical Oncology |
S11J6.2 |
Oesophageal stenting including stent cost |
Biopsy Report,Clinical & Radiological Evidence of Oesophageal Malignancy |
Sticker along with evidence of stent placement |
- |
|
|
S11 |
Surgical Oncology |
S11J6 |
Surgical Oncology |
S11J6.3 |
Enucleation of pancreatic neoplasm(Other than Neck of Pancreas) |
CT,TUMOUR MARKERS,FNAC |
BIOPSY,USG,Post Procedure Clinical Photograph |
- |
|
|
S11 |
Surgical Oncology |
S11J7 |
Ca.Thyroid |
S11J7.1 |
Tracheal Resection |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34O01 |
C490 |
S11 |
Surgical Oncology |
S11J8 |
Ca Trachea |
S11J8.2 |
Tracheal Resection with or without carinal resection |
BIOPSY |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34O01 |
C490 |
S11 |
Surgical Oncology |
S11J9 |
Ca Parathyroid |
S11J9.2 |
Parathyroidectomy |
- |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
SO34Q01 |
C490 |
S11 |
Surgical Oncology |
S11PM1 |
Surgical Oncology |
S11PM1.1 |
Voice prosthesis (US FDA /CE approved) |
Evidence of Laryngectomy |
Evidence of Use of Prosthesis |
- |
|
|
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.1 |
Cleft Lip |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25G01 |
Q899 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.11 |
Benign tumour of Mandible And Maxilla - Excision |
CT/MRI/Xray/HPE clinical photograph |
Biopsy Report,Clinical Phoptograph/ Xray |
- |
S25A08 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.12 |
Vaginal Atresia |
Clinical notes with sketch |
Sketch/ Clinical Photograph |
- |
S25A09 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.13 |
Vascular Malformations - Minor up to 5 Cms |
MR angio/Doppler study |
Clinical Photo Of Affected Part |
- |
S25A10 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.14 |
Corrective Surgery For Congenital Deformity of Hand and foot (Per Hand) |
CLINICAL PHOTOGRAPH,X-Ray |
Clinical Phoptograph/ Xray |
- |
S25A11 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.15 |
Corrective surgery for craniosynostosis |
CLINICAL PHOTOGRAPH,CT |
Clinical Photo Of Affected Part |
- |
S25A12 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.16 |
Cup And Bat Ears |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25A02 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.17 |
Flap Cover For Electrical Burns With Vitals Exposed for each flap |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25A13 |
T2631xD |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.18 |
Reduction Surgery For Filarial Lymphedema |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25A03 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.2 |
Cleft Palate |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25G02 |
Q899 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.20 |
Diabetic Foot ? Surgery |
Clinical Photo,X-Ray Chest,Lab Investigations |
Clinical Photo |
- |
|
|
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.4 |
Syndactyly Of Hand For Each finger |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25G03 |
Q899 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.5 |
Microtia/Anotia for each stage |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S25G04 |
Q899 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.6 |
TM Joint Ankylosis |
Clinical Phoptograph,X-Ray / OPG |
Clinical Phoptograph / Opg/ Xray |
- |
S25G05 |
Q899 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.7 |
Hemifacial Microsmia |
CT/ Xray / OPG |
Clinical Photo Of Affected Part |
- |
S25A05 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.8 |
Leprosy Reconstructive Surgery for each procedure |
Clinical Phoptograph |
Clinical Photo Of Affected Part |
- |
S25A06 |
Q898 |
S12 |
Plastic Surgery |
S12M1 |
Plastic Surgery |
S12M1.9 |
Nerve And Tendon Repair + Vascular Repair for each limb |
Clinical Phoptograph |
Clinical Photo Of Affected Part |
- |
S25A07 |
Q898 |
S12 |
Plastic Surgery |
S12M2 |
Vascular Injuries |
S12M2.1 |
Tendon/Vascular/ nerve Injury Repair - In forearm/leg/foot or hand - Payable maximum upto for each p |
Doppler |
Doppler / Scar Photo |
- |
S35B05 |
S098xxA |
S12 |
Plastic Surgery |
S12M2 |
Vascular Injuries |
S12M2.2 |
Minor Vascular Injury Repair- Tibial Vessels In Leg - Payable maximum upto |
Doppler |
Doppler / Scar Photo |
- |
S35B04 |
S098xxA |
S12 |
Plastic Surgery |
S12PM1 |
Plastic Surgery PMJAY Sub Category |
S12PM1.1 |
Ear Pinna Reconstruction with costal cartilage/ Prosthesis(including the cost of prosthesis /implant |
Clinical Photo |
Clinical Photo |
- |
|
|
S12 |
Plastic Surgery |
S12PM1 |
Plastic Surgery PMJAY Sub Category |
S12PM1.2 |
Tissue Expander for disfigurement following burns/ trauma/congenital deformity (including cost of ex |
Clinical Photo,Lab Investigations |
Clinical Photo |
- |
|
|
S12 |
Plastic Surgery |
S12PM1 |
Plastic Surgery PMJAY Sub Category |
S12PM1.3 |
Hemangioma ? Sclerotherapy (under GA) |
USG |
Clinical Photograph |
- |
|
|
S12 |
Plastic Surgery |
S12PM1 |
Plastic Surgery PMJAY Sub Category |
S12PM1.4 |
Pressure Sore ? Surgery for Malignant and Non malignant conditions |
Clinical Photo |
Clinical Photo |
- |
|
|
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.1 |
Up To - 30% ( Conservative) -5 days15 to 30% in Adults5 to 30% in below 12 years patients |
Clinical photo of affected part,diagramatic distribution of burns mandatory(Rule of 9) Note that lessthan 30 % burns are covered by the scheme |
Clinical Photo Of Affected Part |
- |
S26A01 |
T3122 |
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.2 |
30 - 40% Mixed Burns( With Surgeries) |
Clinical photo of affected part,diagramatic distribution of burns mandatory(Rule of 9) Note that lessthan 30 % burns are covered by the scheme |
Clinical Photo Of Affected Part |
- |
S26A02 |
T3122 |
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.3 |
30 to 45% (Conservative) 7 days |
Clinical photo of affected part,diagramatic distribution of burns mandatory(Rule of 9) |
Clinical Photo Of Affected Part |
- |
S26A03 |
T3123 |
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.4 |
10-30% Mixed Burns( With Surgeries) |
Clinical photo of affected part,diagramatic distribution of burns mandatory(Rule of 9) |
Clinical Photo Of Affected Part |
- |
S26A04 |
T3123 |
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.5 |
45 to 60% ( Conservative) 7 days |
Clinical photo of affected part,diagramatic distribution of burns mandatory(Rule of 9) |
Clinical Photo Of Affected Part |
- |
S26A05 |
T3124 |
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.6 |
40- 60% Mixed Burns( With Surgeries) |
Clinical photo of affected part,diagramatic distribution of burns mandatory(Rule of 9) |
Clinical Photo Of Affected Part,Diagramatic distribution of burns mandatory(Rule of 9) |
- |
S26A06 |
T3124 |
S13 |
Burns |
S13N1 |
Burns Above 50% |
S13N1.7 |
Above 60% MixedBurns( With Surgeries)10 days |
Clinical Photo Of Affected Part,Diagramatic distribution of burns mandatory(Rule of 9) |
Clinical Photo Of Affected Part |
- |
S26A07 |
T3125 |
S13 |
Burns |
S13N2 |
Burns Post Burn Contracture Surgeries For Functional Improvement (Package And Physiotherapy) |
S13N2.1 |
Mild Contracture Surgeries For Functional Improvement (including splints, pressure garments And Phys |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S26B01 |
T2899xS |
S13 |
Burns |
S13N2 |
Burns Post Burn Contracture Surgeries For Functional Improvement (Package And Physiotherapy) |
S13N2.2 |
Moderate Contracture Surgeries For FunctionalImprovement (including splints, pressure garments And P |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S26B02 |
T2899xS |
S13 |
Burns |
S13N2 |
Burns Post Burn Contracture Surgeries For Functional Improvement (Package And Physiotherapy) |
S13N2.3 |
Severe Contracture Surgeries For FunctionalImprovement (including splints, pressure garments And Phy |
Clinical photo of affected part |
Clinical Photo Of Affected Part |
- |
S26B03 |
T2899xS |
S5 |
Orthopedic Surgery And Procedures |
S5D8 |
Orthpedic Trauma |
S5D8.1 |
Open Reduction And Internal Fixation Of Long Bone Fractures |
X ray |
OT Notes,X ray |
- |
S21AG |
M8000xA |
S14 |
Poly Trauma |
S14O1 |
Orthpedic Trauma |
S14O1.2 |
Amputation Surgery finger and toes(Per finger per toe) |
X- RAY |
Post Procedure Clinical Photograph |
- |
S02A44 |
A480 |
S14 |
Poly Trauma |
S14O1 |
Orthpedic Trauma |
S14O1.3 |
Multiple CLWs or incised wounds or crush injuries or Soft Tissue Injury for Debridement & Closure - |
CLINICAL PHOTOGRAPH |
CLINICAL PHOTOGRAPH |
- |
S21D01G |
M798 |
S14 |
Poly Trauma |
S14O10 |
Poly Trauma |
S14O10.1 |
Corneal Foreign Body |
CLINICAL PHOTOGRAPH,X- RAY |
Post Procedure Clinical Photograph Ot Notes |
- |
S27A01G |
V899xxA |
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.1 |
Corneal tear operative management |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S27A02G |
|
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.2 |
Flap Cover Surgery For Wound In Compound Fracture |
CLINICAL PHOTOGRAPH,X- RAY,CT face 3D reconstruction |
Post Procedure Clinical Photograph,X- Ray Ot Notes |
- |
S27A03G |
V899xxA |
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.3 |
Surgery For Patella Fracture (Fixation / Excision) |
X- RAY |
X- Ray Ot Notes |
- |
S27B01G |
V899xxA |
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.4 |
Corneoscleral tear with Intraoccular foreign body |
X- RAY |
X- Ray Ot Notes |
- |
S27B02G |
|
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.5 |
Facial Bone Fractures (Closed or Compound) - Single (Faciomaxillary Injuries) |
CLINICAL PHOTOGRAPH,X- RAY |
Post Procedure Clinical Photograph,X- Ray Ot Notes |
- |
S02A29 |
S0292 |
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.6 |
Surgical Correction Of Pelvic Bone Fractures. |
X- RAY |
X- Ray Ot Notes |
- |
S27C01G |
V899xxA |
S14 |
Poly Trauma |
S14O4 |
Chest Consertative Treatment |
S14O4.1 |
Chest Injuries Conservative Stay In General Ward @Rs.1500/Day - 5 days stay |
X- RAY/CT |
Post Procedure Clinical Photograph |
- |
S27M01 |
V899xxA |
S14 |
Poly Trauma |
S14O4 |
Chest Consertative Treatment |
S14O4.2 |
Chest Injuries Stay In Respiratory ICU/ICCU@Rs.4000/Day - 5 days stay |
Clinical photograph,X- RAY/CT |
Post Procedure Clinical Photograph |
- |
S27M02 |
V899xxA |
S14 |
Poly Trauma |
S14O5 |
Polytrauma Chest |
S14O5.1 |
Polytrauma Chest Surgical Treatment |
X-RAY/USG/CT |
X-RAY/USG/CT |
- |
S27M03 |
V899xxA |
S14 |
Poly Trauma |
S14O6 |
Abdomen Consertative Treatment |
S14O6.1 |
Abdominal Injuries Conservative Stay In General Ward @Rs.1500 - 2 Day stay |
X-RAY/USG/CT |
USG |
- |
S27O01 |
V899xxA |
S14 |
Poly Trauma |
S14O6 |
Abdomen Consertative Treatment |
S14O6.2 |
Abdominal Injuries Stay In Surgical ICU@Rs.4000/Day- 5 days stay |
X-RAY/USG/CT |
USG |
- |
S27O02 |
V899xxA |
S14 |
Poly Trauma |
S14O7 |
Polytrauma Abdomen |
S14O7.1 |
Abdominal Injuries Surgical Treatment |
X-RAY/USG/CT |
Post Procedure Clinical Photograph,USG |
- |
S27O03 |
V899xxA |
S14 |
Poly Trauma |
S14O8 |
Emergency Room Procedures |
S14O8.1 |
Tracheostomy for polytrauma and non polytrauma other causes. |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S09M01G |
J960 |
S14 |
Poly Trauma |
S14O8 |
Emergency Room Procedures |
S14O8.2 |
Thoracostomy |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S09M02 |
J960 |
S14 |
Poly Trauma |
S14PM1 |
Poly Trauma |
S14PM1.1 |
Plexus injury along with Vascular injury repair with Graft |
CT,Pre-op. Doppler study,Nerve Conduction study |
Clinical photo showing scar,Post-op. Doppler study |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.2 |
Rehabilitative management of spine deformity -Milwaukee Brace Plastic Model |
CLINICAL PHOTOGRAPH,Clinical photograph |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.3 |
Below Elbow Prosthesis |
CLINICAL PHOTOGRAPH |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.4 |
Finger Prosthesis |
CLINICAL PHOTOGRAPH,Clinical photograph,CLINICAL PHOTOGRAPH |
Clinical Photograph With Prosthesis,Clinical Photograph With Prosthesis Mandatory For Claim |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.5 |
Wrist Disarticulation Prosthesis |
CLINICAL PHOTOGRAPH,Clinical photograph |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.6 |
Rehabilitative management of non healing ulcers of foot - Modified footwear with Silicon |
CLINICAL PHOTOGRAPH,Clinical photograph |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.7 |
Rehabilitative management of lower limb deformity & weakness - Calipers HKFO/ KFO/ FO |
CLINICAL PHOTOGRAPH,Clinical photograph |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.8 |
Rehabilitative management of weakness in foot-Fibre Foot Drop Splint |
CLINICAL PHOTOGRAPH,Clinical photograph |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P11 |
Prosthesis and Orthosis |
S15P11.9 |
Hemipelvectomy Prosthesis |
CLINICAL PHOTOGRAPH,X-Ray,Clinical photograph |
CLINICAL PHOTOGRAPH,Clinical Photograph With Prosthesis Mandatory For Claim,Clinical Photograph With Prosthesis |
- |
|
|
S15 |
Prostheses |
S15P3 |
Prosthesis Below Knee(Bk/Ptb) |
S15P3.3 |
Below Knee(BK/PTB) Prostheses Modular |
Clinical photograph |
Clinical Photograph Clinical Photograph With Prosthesis Mandatory For Claim |
- |
S27E03 |
V899xxA |
S15 |
Prostheses |
S15P4 |
Prosthesis Through Knee Prostheses |
S15P4.3 |
Through Knee Prostheses Modular |
Clinical photograph |
Clinical Photograph Clinical Photograph With Prosthesis Mandatory For Claim |
- |
S27F03 |
V899xxA |
S15 |
Prostheses |
S15P5 |
"Prosthesis Above Knee(Ak)Prostheses" |
S15P5.3 |
Above Knee(AK) Prostheses Modular |
Clinical photograph |
Clinical Photograph Clinical Photograph With Prosthesis Mandatory For Claim |
- |
S27G03 |
V899xxA |
S15 |
Prostheses |
S15P6 |
Prosthesis Hip Disarticulation Prosthesis |
S15P6.3 |
Hip Disarticulation Prosthesis Modular |
Clinical photograph |
Clinical Photograph Clinical Photograph With Prosthesis Mandatory For Claim |
- |
S27H03 |
V899xxA |
S15 |
Prostheses |
S15P7 |
Prosthesis Upper Limb Above Elbow |
S15P7.6 |
Above Elbow Prosthesis Modular |
Clinical photograph |
Clinical Photograph Clinical Photograph With Prosthesis Mandatory For Claim |
- |
S27K03 |
V899xxA |
S15 |
Prostheses |
S15P8 |
Prosthesis Upper Limb Whole Upper Limb |
S15P8.3 |
Whole Upper Limb Prosthesis Modular |
Clinical photograph |
Clinical Photograph Clinical Photograph With Prosthesis Mandatory For Claim |
- |
S27L03 |
V899xxA |
S1 |
General Surgery |
S1A1 |
Head And Neck |
S1A1.2 |
Cervical Rib Excision |
CT chest,X- Ray,Color Doppler |
Post Procedure Evidence Of X-Ray |
- |
S09A05 |
Q765 |
S1 |
General Surgery |
S1A1 |
Head And Neck |
S1A1.8 |
Carotid Body-Tumours Excision |
Clinical Photograph,USG Neck/ Color doppler,MRI |
Biopsy,Post Procedure Evidence Of Clinical Photograph |
- |
S35A18 |
D446 |
S1 |
General Surgery |
S1A10 |
Liver |
S1A10.1 |
Operation For Hydatid Cyst Liver |
CT,USG |
USG |
- |
S33A04 |
K759 |
S1 |
General Surgery |
S1A10 |
Liver |
S1A10.2 |
Portocaval Anastomosis |
MRI/ USG/ UGI ENDOSCOPY |
Endoscopy/ Usg |
- |
S33A05 |
K7469 |
S1 |
General Surgery |
S1A11 |
Gall Bladder |
S1A11.1 |
Open Cholecystectomy |
CT/USG,LFT |
Post Procedure Clinical Photograph,Usg Post Op Hp For Claim |
- |
S25G26 |
K77 |
S1 |
General Surgery |
S1A11 |
Gall Bladder |
S1A11.2 |
Lap.Cholecystectomy |
CT/USG,LFT |
Post Procedure Clinical Photograph,Video,Usg Post Op Hp For Claim |
- |
S25G27 |
K77 |
S1 |
General Surgery |
S1A11 |
Gall Bladder |
S1A11.5 |
Cystojejunostomy |
CT/USG,LFT |
Post Procedure Clinical Photograph,Usg Intra Op Photographic E/O Surgery Mandatory For Claim |
- |
S33I11 |
K868 |
S1 |
General Surgery |
S1A11 |
Gall Bladder |
S1A11.6 |
Cystogastrostomy / Cystojejunostomy |
CT/USG,LFT |
Post Procedure Clinical Photograph,Usg Intra Op Photographic E/O Surgery Mandatory For Claim |
- |
S33I12 |
K868 |
S1 |
General Surgery |
S1A11 |
Gall Bladder |
S1A11.7 |
Repair Of CBD |
CT/USG,LFT |
T-Tube Cholangiogram,Usg Post Procedure Clinical Photograph |
- |
S33H07 |
K8081 |
S1 |
General Surgery |
S1A12 |
Abdomen |
S1A12.2 |
Operation On Adrenal Glands Unilateral For Tumour |
Biochemical Investigations,USG,CT |
Biopsy,Post Procedure Evidence Of Usg |
- |
SO34I02 |
C495 |
S1 |
General Surgery |
S1A13 |
Spleen |
S1A13.1 |
Splenectomy For Hypersplenism |
CT,USG,PERIPHERAL SMEAR |
Biopsy,USG,Post Procedure Clinical Photograph |
- |
S25G39 |
C800 |
S1 |
General Surgery |
S1A13 |
Spleen |
S1A13.2 |
Splenorenal Anastomosis |
MRI,USG,UGI Endoscopy |
Endoscopy,Post Procedure Evidence Of Usg |
- |
S33B01 |
K766 |
S1 |
General Surgery |
S1A13 |
Spleen |
S1A13.3 |
Warren Shunt |
MRI,USG,UGI Endoscopy |
Endoscopy,Post Procedure Evidence Of Usg |
- |
S33B02 |
K766 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.1 |
Mal-Rotation & Volvulus Of The Midgut |
CT,X-RAY ABD |
X- Ray/Post Procedure Clinical Photograph |
- |
S25G21 |
Q899 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.2 |
Operation For Volvulus Of Large Bowel |
CT-CONTRAST,X-RAY ABDOMEN |
X- Ray/Post Procedure Clinical Photograph |
- |
S25G21 |
Q899 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.3 |
Operation Of The Duplication Of The Intestines |
CT-Contrast/ USG |
Post Procedure Evidence Of Clinical Photograph |
- |
S09J06 |
K639 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.4 |
Left Hemi Colectomy |
Barium / CT,USG,Endoscopy,Biopsy |
Post Procedure Evidence Of Clinical Photograph/Biopsy |
- |
S25G37 |
C800 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.5 |
Right Hemi Colectomy |
Barium / CT,USG,Endoscopy,Biopsy |
Post Procedure Evidence Of Clinical Photograph/Biopsy |
- |
S25G38 |
C800 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.6 |
Total Colectomy |
BARIUM,USG/ CT,ENDOSCOPY/ Sketch |
Biopsy,Post Procedure Clinical Photograph |
- |
S09J01G |
K639 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.7 |
Colostomy for Malignant and Non Malignant conditions |
ENDOSCOPY/ Sketch,USG/ CT |
Post Procedure Clinical Photograph |
- |
S09J02G |
K639 |
S1 |
General Surgery |
S1A14 |
Abdomen Large Intestine |
S1A14.8 |
Colostomy Closure for Malignant and Non malignant conditions |
Barium Study,CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S09J03G |
K639 |
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.1 |
Drainage of liver Abscess |
USG Abdomen |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.10 |
Scrotal Swelling (Multiple) ? Excision |
CLINICAL PHOTOGRAPH |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.11 |
Drainage of perivertebral abscess |
CLINICAL PHOTOGRAPH,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.12 |
Ligation of Ankle Perforators |
CLINICAL PHOTOGRAPH,Doppler venous |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.13 |
Benign Retroperitoneal Tumor ? Excision |
CT,FNAC |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.14 |
Malignant Soft Tissue Tumor ? Excision |
CT,FNAC |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.15 |
Benign Submandibular Lymph node ? Excision |
BIOPSY,Clinical & Radiological Evidence |
Hpe,Post Procedure Clinical Photograph,Operation Notes |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.16 |
Benign Submandibular Mass Excision + Reconstruction |
BIOPSY,X-Ray Chest |
Hpe,Post Procedure Clinical Photograph,Operation Notes |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.17 |
Pharyngectomy & Reconstruction for Benign Tumours |
CT- SCAN,FNAC |
BIOPSY,Post Procedure Clinical Photograph |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.18 |
Rib Resection & Drainage for empyema in adults |
CBC,X- RAY,Fluid Analysis |
X-Ray Chest |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.19 |
Drainage of Ischio Rectal Abscess with minimum 2 followup dressings |
CLINICAL PHOTOGRAPH,Clinical Notes |
CLINICAL PHOTOGRAPH,Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.2 |
Excision Pilonidal Sinus |
Clinical Notes |
Post operative evidence of surgery |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.20 |
Drainage of Intra abdominal abscess Fr ex - Psoas Abscess, Pelvic abscess, Appendicular abscess etc |
Scar Photo,USG Abdomen |
Scar Photo,USG Abdomen |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.21 |
Varicose Veins - Radiofrequency Ablation / Excision and Ligation |
CLINICAL PHOTOGRAPH,Doppler venous |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.22 |
Excision of salivary glands |
CLINICAL PHOTOGRAPH,FNAC |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.3 |
Eversion of Hydrocele Sac- unilateral |
CLINICAL PHOTOGRAPH,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.4 |
Haemorroidectomy+ Fistulectomy with or without sphinctor repair |
CLINICAL PHOTOGRAPH,Clinical Notes/sckech |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.5 |
Fissurectomy |
Clinical Notes/sckech |
Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.6 |
Anal fissures with or without Sphincterotomy with anal dilatation |
Clinical Notes/sckech |
Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.7 |
Inguinal Hernia Repair |
CLINICAL PHOTOGRAPH,Clinical Notes |
Laproscopic Video,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.8 |
Surgery on Rectal prolapse |
CLINICAL PHOTOGRAPH |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1A15 |
General Surgery |
S1A15.9 |
Haemorroidectomy |
Clinical Notes/sckech |
Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1A16 |
Genitourinary |
S1A16.1 |
Suprapubic Cystostomy |
Clinical indications |
Operation Notes,Post Procedure Clinical Photograph |
- |
SO34AH07 |
C3490 |
S1 |
General Surgery |
S1A2 |
Head And Neck Thyroid Non Malignant |
S1A2.4 |
Resection Enucleation |
Biopsy,USG/ Thyroid Scan(optional),T F T,FNAC |
Biopsy,Post Procedure Clinical Photograph |
- |
S09D04G |
D34 |
S1 |
General Surgery |
S1A3 |
Breast |
S1A3.1 |
Simple Mastectomy(NM) |
FNAC,MAMMOGRAPHY |
Biopsy,Post Procedure Clinical Photograph |
- |
S09E01G |
D2400 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.1 |
Epigastric Hernia Without Mesh |
CLINICAL PHOTOGRAPH,USG Abdomen |
Post Procedure Clinical Photograph |
- |
S09F01G |
K469 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.2 |
Epigastric Hernia With Mesh |
CLINICAL PHOTOGRAPH,USG Abdomen |
Post Procedure Clinical Photograph |
- |
S09F02G |
K469 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.4 |
Hiatus Hernia Repair Abdominal |
UGI ENDOSCOPY/ Sketch,USG ABDOMEN |
Post Procedure Clinical Photograph |
- |
S09F04G |
K469 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.5 |
Rare Hernias (Spigalion,Obuturator,Sciatic) |
CLINICAL PHOTOGRAPH,USG |
Post Procedure Clinical Photograph |
- |
S09F05G |
K469 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.6 |
Umbilical Hernia Without Mesh |
CLINICAL PHOTOGRAPH,USG |
Post Procedure Clinical Photograph |
- |
S09F06G |
K420 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.7 |
Umbilical Hernia With Mesh |
CLINICAL PHOTOGRAPH,USG |
Post Procedure Clinical Photograph |
- |
S09F07G |
K420 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.8 |
Ventral and Scar Hernia Without Mesh |
CLINICAL PHOTOGRAPH,USG |
Post Procedure Clinical Photograph |
- |
S09F08G |
K4300 |
S1 |
General Surgery |
S1A4 |
Abdomen Hernia |
S1A4.9 |
Ventral And Scar Hernia With Mesh |
CLINICAL PHOTOGRAPH,USG |
Post Procedure Clinical Photograph |
- |
S09F09G |
K4300 |
S1 |
General Surgery |
S1A5 |
Abdomen |
S1A5.1 |
Lap. Appendectomy |
USG/ X-ray Abdomen |
Biopsy,Video,CLINICAL PHOTOGRAPH |
- |
S09G01G |
K389 |
S1 |
General Surgery |
S1A5 |
Abdomen |
S1A5.2 |
AppendIcular Perforation |
CBC,X-ray Abdomen,USG |
Biopsy,Pus C/S,Post Procedure Clinical Photograph |
- |
S09G02G |
K389 |
S1 |
General Surgery |
S1A7 |
Abdomen Stomach, Duodenum, Jejunum |
S1A7.10 |
Gastrostomy Closure |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S09H09G |
K3189 |
S1 |
General Surgery |
S1A7 |
Abdomen Stomach, Duodenum, Jejunum |
S1A7.2 |
Duodenal Perforation |
USG/ CT- ABDOMEN,X-RAY |
Post Procedure Clinical Photograph |
- |
S09H02 |
K3189 |
S1 |
General Surgery |
S1A7 |
Abdomen Stomach, Duodenum, Jejunum |
S1A7.6 |
Operation For Bleeding Peptic Ulcer |
ENDOSCOPY/ Sketch |
Post Procedure Clinical Photograph |
- |
S09H04G |
K3189 |
S1 |
General Surgery |
S1A7 |
Abdomen Stomach, Duodenum, Jejunum |
S1A7.7 |
Partial/Subtotal Gastrectomy For Ulcer |
ENDOSCOPY/ Biopsy / Barium meal |
Post Procedure Clinical Photograph |
- |
S09H05G |
K3189 |
S1 |
General Surgery |
S1A7 |
Abdomen Stomach, Duodenum, Jejunum |
S1A7.8 |
Pyloromyotomy |
ENDOSCOPY / Sketch |
Post Procedure Clinical Photograph |
- |
S09H06G |
K5669 |
S1 |
General Surgery |
S1A7 |
Abdomen Stomach, Duodenum, Jejunum |
S1A7.9 |
Gastrostomy |
BIOPSY,USG,ENDOSCOPY/ Sketch |
Post Procedure Clinical Photograph |
- |
S09H08G |
K3189 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.1 |
Intussusception |
USG / CT abd,X-RAY ABD |
Biopsy,Post Procedure Clinical Photograph |
- |
S25G20 |
Q899 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.2 |
Operation For Acute Intestinal Obstruction |
USG / CT abd,X-RAY ABD |
Biopsy,Post Procedure Clinical Photograph |
- |
S09J04G |
K5669 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.3 |
Operation For Duodinal / Jejunal / Ileal Perforation |
USG / CT abd,X-RAY ABD |
Biopsy,Post Procedure Clinical Photograph |
- |
S09J05G |
K5669 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.4 |
Operation For Haemorrhage Of The Small Intestine |
CT WITH CONTRAST |
Biopsy,Post Procedure Clinical Photograph |
- |
S09I01 |
K639 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.5 |
Operations For Recurrent Intestinal Obstruction (Noble Plication Other) |
CT-CONTRAST / USG,Xray |
Biopsy,Post Procedure Clinical Photograph |
- |
S09I02 |
K5669 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.6 |
Resection & Anastomosis Of Small Intestine |
CT/ USG,X-RAY ABD |
Biopsy,Post Procedure Clinical Photograph |
- |
S09I03G |
K5669 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.7 |
Ileostomy |
CT abd / USG |
Hp Report,Post Procedure Clinical Photograph |
- |
S09I04G |
K639 |
S1 |
General Surgery |
S1A8 |
Abdomen Small Intestine |
S1A8.8 |
Ileostomy Closure |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S09I05G |
K639 |
S1 |
General Surgery |
S1A9 |
Abdomen Rectum And Anus |
S1A9.1 |
Pull Through Abdominal Resection |
CLINICAL PHOTOGRAPH,CT Abdomen + Pelvis |
Post Procedure Clinical Photograph,Rectal Biopsy |
- |
S09K01G |
K639 |
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.1 |
Dermoid Cyst ? Excision |
Clinical Notes,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.10 |
Fibroadenoma - Bilateral |
BIOPSY,Clinical Notes |
Operation Notes,Post Procedure Clinical Photograph |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.11 |
Drainage of Subdiaphramatic Abscess |
USG Abdomen |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.12 |
Fibroadenoma - unilateral |
BIOPSY,Clinical Notes |
HPE,Post Procedure Clinical Photograph,Operative Notes |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.14 |
Evacuation of Scrotal Hematoma |
Clinical Notes,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.15 |
Excision Benign Tumor -Small intestine |
USG |
HPE,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.17 |
Excision Filarial Scrotum |
Clinical Notes,Clinical Photo |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.18 |
Excision Mammary Fistula |
Clinical Notes,Clinical Photograph |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.20 |
Excision Small Intestinal Fistula |
X-ray Abdomen |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.22 |
Excision of Growth from Tongue with neck node dissection |
Clinical Photo |
HPE |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.23 |
Excision of Neurofibroma |
CLINICAL PHOTOGRAPH,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.24 |
Exicision of Sinus and Curettage |
CLINICAL PHOTOGRAPH,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.28 |
Excision and Skin Graft of Venous or non healing Ulcer Unilateral,single |
CLINICAL PHOTOGRAPH,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.29 |
Excision and Skin Graft of Venous or non healing Ulcer Unilateral, multiple |
CLINICAL PHOTOGRAPH,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.3 |
Incision and Drainage of large Abscess with minimum 2 followup dressings |
Clinical Photograph and clinical notes |
Clinical Notes,Post Procedure Evidence of Surgery |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.31 |
Mesenteric Cyst Excision |
Scar Photo,USG - Abdomen/CT Scan |
Scar Photo,USG - Abdomen/CT Scan |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.32 |
Mesenteric Caval Anastomosis |
USG - Abdomen/CT Scan |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.35 |
Scalp tumour Excision with skull bone excision |
Clinical Photo |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.37 |
Rectopexy |
Clinical Photo |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.38 |
Resection Anastomosis (Large Intestine) |
CT/ USG,X-RAY ABD |
Biopsy, Post Procedure Clinical Photograph |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.41 |
Sigmoid Diverticulum |
Lab Investigations,USG |
Post procedure evidence of Surgery |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.42 |
Tracheoplasty (Throat) |
CT Contrast |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.43 |
Umbilical Sinus ? Excision |
Clinical Notes,Clinical Photograph |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.45 |
Debridement of Ulcer-Leprosy And 3 follow up dressing |
Clinical Photograph |
Clinical Photograph |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.46 |
Estlander Operation (lip) |
Clinical Notes,Clinical Photograph |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.47 |
I and D cold Abscess minimum 2 follow up dressing |
Clinical Notes,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.48 |
Free Grafts - Wolfe Grafts |
Clinical Photograph |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.49 |
Caecostomy |
Clinical Photograph,USG,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.5 |
Bakers Cyst ? Excision |
Clinical Notes |
Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.51 |
Cervial Lymphnodes / Cervical swelling |
Clinical Notes ,Clinical Photograph |
HPR,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.52 |
Cystic mass ? Excision |
Clinical Notes ,Clinical Photograph |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.53 |
Ganglion - Excision |
Clinical Notes ,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.54 |
Granuloma - Excision |
Clinical Notes ,Clinical Photograph |
Clinical Notes,Scar Photo,Clinical Photograph |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.55 |
Lipoma in lower limb |
Clinical Notes ,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.56 |
Excision of Swelling in Right Cervical Region |
Clinical Notes |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.57 |
Excision Meckels Diverticulum Isolated |
USG Abdomen |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.58 |
Ganglion - Sclerotherapy |
Clinical Notes ,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.59 |
Papilloma Rectum ? Excision |
Clinical Notes ,Clinical Photograph,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.6 |
Branchial Fistula |
Clinical Photograph |
Clinical Photograph |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.60 |
Gastric Perforation Isolated |
X-ray Abdomen |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.61 |
Cyst over Scrotum ? Excision |
Clinical Photograph, Clinical Notes |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.62 |
Epidymal Cyst |
Clinical Photograph, Clinical Notes |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.63 |
Epidedectomy |
Clinical Photograph, Clinical Notes |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.65 |
Infected Bunion Foot ? Excision |
clinical photo,Clinical Notes |
Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.66 |
Rectal Dilation |
Clinical Notes |
Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.7 |
Hydrocele + Orchidectomy / Epidydectomy |
Clinical Photograph |
Scar Photo,Clinical Notes |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.73 |
Benign Soft Tissue Tumor ? Excision |
CT,FNAC |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.8 |
Epididymal Swelling / Cyst ? Excision |
Clinical Notes,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.9 |
Excision of Growth from Tongue |
Clinical photo |
HPE |
- |
|
|
S20 |
Oral and Maxillofacial Surgery |
S20A1 |
Oral & Maxillofacial Surgery |
S20A1.4 |
Benign Mandible Tumour Resection and reconstruction |
BIOPSY,X- RAY CHEST |
Post Procedure Clinical Photograph,Operative Notes,HPE |
- |
|
|
S20 |
Oral and Maxillofacial Surgery |
S20PM1 |
Oral & Maxillofacial Surgery PMJAY Sub Category |
S20PM1.3 |
Release of fibrous bands & grafting -in (OSMF) treatment under GARelease of fibrous bands & grafting |
Clinical Notes, Clinical Photograph,X-Ray |
Clinical Photograph,X-ray |
- |
|
|
S21 |
Pediatric Cancer |
S21A1 |
Pediatric Cancer/Adult |
S21A1.1 |
Chronic Myeloid Leukemia Imatinib(Per month) |
BIOPSY,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Histopathplogy report,Clinical Notes,Chemo Sheets |
BIOPSY,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Histopathplogy report,Clinical Notes,Chemo Sheets |
- |
|
|
S21 |
Pediatric Cancer |
S21A1 |
Pediatric Cancer/Adult |
S21A1.2 |
Chronic Myeloid Leukemia Nilotinib(Per month) |
BIOPSY,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Histopathplogy report,Clinical Notes,Chemo Sheets |
BIOPSY,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Histopathplogy report,Clinical Notes,Chemo Sheets |
- |
|
|
S21 |
Pediatric Cancer |
S21A1 |
Pediatric Cancer/Adult |
S21A1.3 |
Chronic Myeloid Leukemia Dasatinib(Per month) |
BIOPSY,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Histopathplogy report,Clinical Notes,Chemo Sheets |
BIOPSY,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Histopathplogy report,Clinical Notes,Chemo Sheets |
- |
|
|
S2 |
ENT Surgery |
S2B1 |
Ear |
S2B1.1 |
Labyrinthectomy |
CT Scan Ear microscopic finding and clinical findings |
Clinical Photo |
- |
S05D04 |
H748x9 |
S2 |
ENT Surgery |
S2B1 |
Ear |
S2B1.4 |
Tympanoplasty |
Audiometry |
Intra Op Photo PTA after 2 months,ear findings |
- |
S05D03G |
H748x9 |
S2 |
ENT Surgery |
S2B1 |
Ear |
S2B1.5 |
Stapedectomy + Veingraft |
CT Temporal Bone,PTA,Impedance audiometry |
Clinical Photo With Piston |
- |
S05D02G |
H748x9 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.1 |
Microlaryngeal Surgery |
IDL Findings |
Clinical Photo,IDL Findings |
- |
S05E01 |
H9589 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.2 |
Phono Surgery For Vocal Cord Paralysis |
IDL examination finding |
Clinical Photo,IDL examination finding |
- |
S05E02 |
H9589 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.3 |
Laryngo Fissure |
CT scan |
Clinical Photo,Clinical findings |
- |
S05E03G |
H9589 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.4 |
Excision Of Tumours In Pharynx |
CT Scan |
Post Procedure Clinical Photograph,histopath |
- |
S05E06G |
H9589 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.5 |
Parapharyngeal Tumour Excision |
CT- SCAN /MRI SCAN,FNAC |
Post Procedure Clinical Photograph,histopath |
- |
S05E07G |
H9589 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.6 |
Adenoidectomy |
X-RAY NASOPHARYNX |
Nasal endoscopy,Post Procedure Clinical Photograph |
- |
S05E04G |
H9589 |
S2 |
ENT Surgery |
S2B2 |
Throat |
S2B2.7 |
Uvulo-Palato Pharyngoplasty |
Polysomnography |
CT/MRI,Clinical Photo |
- |
S05E05G |
H9589 |
S2 |
ENT Surgery |
S2B3 |
Nose |
S2B3.1 |
Endoscopic Sinus Surgery |
CT PNS |
DNE PHOTO GRAPH,Endoscopic Photograph/ Sketch |
- |
S05F04G |
H9589 |
S2 |
ENT Surgery |
S2B3 |
Nose |
S2B3.2 |
Modified radical Mastoidectomy / Radical mastoidectomy |
PTA findings & X-ray Mastoid |
Post Procedure Clinical Photograph |
- |
S05D01G |
H748x9 |
S2 |
ENT Surgery |
S2B3 |
Nose |
S2B3.5 |
Excision Of Benign Tumour Nose |
CT PNS,DNE |
Post Procedure Clinical (endoscopic) Photograph |
- |
S05F01G |
J349 |
S2 |
ENT Surgery |
S2B3 |
Nose |
S2B3.6 |
Angiofibroma Nose |
CT PNS,DNE |
Clinical Photo (Nasal endoscopy) |
- |
S05F02G |
J349 |
S2 |
ENT Surgery |
S2B3 |
Nose |
S2B3.7 |
Endoscopic DCR |
Clinical photo |
Clinical photo |
- |
S05F03G |
J349 |
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.1 |
Bronchoscopic Foreign Body Removal |
RELEVANT X-RAY |
Post Op Xray,Post Procedure Clinical (Bronchoscopic) Photograph |
- |
S09L01G |
T81529 |
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.2 |
Myringotomy without grommet insertion |
Ear findings by ENT surgeon |
Post Procedure Ear Microscopy and Pure Tone Audiogram |
- |
|
|
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.3 |
Fracture setting nasal bone with surgical intervention |
X-Ray Skull Lateral view |
Post Operative Patient Photograph after 6 weeks |
- |
|
|
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.4 |
Myringoplasty |
Ear Microscopy and Pure Tone Audiogram,Ear findings by ENT surgeon |
Post Procedure Ear Microscopy and Pure Tone Audiogram |
- |
|
|
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.5 |
Septo-rhinoplasty |
X-ray- skull AP & lateral clinical findings by surgeon |
CLINICAL PHOTOGRAPH,X-ray- skull AP & lateral ,Post Procedure,Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.6 |
Drainage of Peritonsillor abscess |
Clinical findings by surgeon |
Clinical Notes of 5 days after surgery |
- |
|
|
S2 |
ENT Surgery |
S2B4 |
Ent |
S2B4.7 |
Facial Nerve Decompression |
Clinical photo of facial palsy |
Clinical Photo after 2 months |
- |
S05D05G |
H9589 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5 |
Brachial Cyst / Sinus Excision |
Clinical Photograph |
Post Procedure Clinical Photo,histopath |
- |
S09A01G |
Q180 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5 |
Total Thyroidectomy |
FNAC,USG Neck,Thyroid Function Test |
Histopathology Report |
- |
S09D06G |
D34 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.1 |
Abbe Operation |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
SO34AK01 |
C005 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.10 |
Isthmectomy |
FNAC,USG,Thyroid Scan(optional),T F T |
Post Procedure Clinical Photograph,histopath |
- |
S09D02G |
D34 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.11 |
Parathyroidectomy |
USG |
Post Procedure Clinical Photograph,histopath |
- |
S09A09G |
D351 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.12 |
Parotid Duct Repair |
Silography |
Post Procedure Evidence Of Silography |
- |
S09A08G |
D110 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.13 |
Partial Glossectomy |
Biopsy,CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph,histopath |
- |
S09C01G |
D101 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.14 |
Removal Of Submandibular Salivary Gland |
CLINICAL PHOTOGRAPH,USG,FNAC |
Post Procedure Clinical Photograph,histopath |
- |
S09A07G |
D105 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.15 |
Segmental Mandible Excision |
X- RAY Mandible |
CLINICAL PHOTOGRAPH,X- RAY Mandible |
- |
S09B01 |
D1039 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.17 |
Wedge Excision |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph,histopath |
- |
SO34AK04 |
C005 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.18 |
Branchial Sinus Excision |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph,histopath |
- |
S09A02G |
Q180 |
S2 |
ENT Surgery |
S2B6 |
Bronchial Injuries |
S2B5.3 |
Bronchial Injuries Due To Foreign Body Repair Surgery |
Broncoscopy / CT scan |
Post Procedure Endoscopic Picture |
- |
S03A04 |
J986 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.4 |
Cystic Hygroma Excision |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph,histopath |
- |
S09A03G |
D1801 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.6 |
Cystic Hygroma Excision-Minor |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph,histopath |
- |
S09A04G |
D1801 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.7 |
Excision Of Thyroglossal Cyst Fistula |
CLINICAL PHOTOGRAPH,USG Neck |
Post Procedure Clinical Photograph,histopath |
- |
S09D01G |
D34 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.8 |
Hemimandibulectomy |
CLINICAL PHOTOGRAPH,CT Scan |
CLINICAL PHOTOGRAPH,histopath,X- Ray |
- |
S25G41 |
C800 |
S2 |
ENT Surgery |
S2B5 |
Head And Neck |
S2B5.9 |
Hemi/Subtotal/ Total thyroidectomy for Benign Thyroid lesion |
FNAC,USG Neck,Thyroid Scan(optional),T F T |
Post Procedure Clinical Photograph,histopath |
- |
S09E01G |
D34 |
S2 |
ENT Surgery |
S2B7 |
Hearing Aid |
S2B7.1 |
Behind The Ear Analogue Hearing Aid |
machine generated Audiometry |
Clinical Photo(10% Of The Cases Will Be Reinvestigated In Government Hospitals For Audiometry After Discharge) PTA with hearing aid |
- |
S02A45 |
H6549 |
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.1 |
Excision of Pinna for Growths (Squamous/Basal) Injuries - Skin and cartilage |
Clinical Photograph |
Post procedure evidance of Surgery |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.10 |
Excision of Pinna for Growths (Squamous/Basal) Injuries - Total Amputation |
Clinical Photograph |
Post procedure evidance of Surgery |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.11 |
Excision of Pinna for Growths (Squamous/Basal) Injuries - Total Amputation & Excision of External Au |
Clinical Photograph |
Post procedure evidance of Surgery |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.12 |
Skull base surgery |
CT Scan of Skull base,Clinical notes |
Post procedure evidance of Surgery,Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.13 |
Tympanotomy |
Ear Microscopy and Pure Tone Audiogram |
Ear Microscopy and Pure Tone Audiogram |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.14 |
Antrostomy - Bilateral |
X-Ray Paranasal Sinus |
Clinical notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.15 |
Antrostomy - Unilateral |
X-Ray Paranasal Sinus |
Clinical notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.16 |
Septoplasty |
Xray /CT |
Post Procedure Clinical Photograph |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.18 |
Fracture - setting nasal bone |
X-Ray |
Post procedure X-Ray |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.19 |
Rhinotomy ? Lateral |
CT Scan PNS |
CLINICAL PHOTOGRAPH,Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.2 |
Excision of Pinna for Growths (Squamous/Basal) / Injuries - Total amputation |
Clinical Photograph |
Post procedure evidance of Surgery |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.20 |
Turbinectomy Partial - Bilateral |
X-Ray PNS |
Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.21 |
Turbinectomy Partial - unilateral |
X-Ray PNS |
Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.22 |
Radical fronto ethmo sphenodectomy |
CT Scan PNS |
CLINICAL PHOTOGRAPH,Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.23 |
Youngs operation |
X-Ray PNS Clinical Notes |
Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.24 |
Endoscopic Hypophysectomy |
CT Scan Skull |
CT Scan Skull ,Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.25 |
Intranasal Diathermy |
Clinical Notes |
Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.26 |
Rhinosporidiosis |
Biopsy and endoscopic report |
CT Scan/X-Ray PNS,Endoscopy |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.28 |
Arytenoidectomy |
Clinical Notes,IDL Photograph,Clinical Notes |
Clinical Notes,IDL Photograph,Clinical Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.29 |
Choanal atresia |
CTScan/ X-Ray PNS,Nasal Endoscopy |
CTScan/ X-Ray PNS,Post Procedure Nasal Endoscopy |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.30 |
Pharyngeal diverticulums Excision |
Clinical Notes,Clinical Photograph |
Clinical Notes,Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.31 |
Laryngophayryngectomy |
CT Scan of Neck |
Clinical Notes,Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.32 |
Oro Antral fistula |
CT Scan/X-Ray PNS,Nasal Endoscopy |
Nasal Endoscopy,Post Procedure CT Scan/X-Ray PNS |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.33 |
Parapharyngeal ? Exploration |
CT/MRI scan,Nasal Endoscopy |
Nasal Endoscopy,Post Procedure CT Scan/X-Ray PNS |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.34 |
Parapharyngeal / Retropharyngeal Abscess ? Drainage |
Xray,CLINICAL PHOTOGRAPH |
Xray,CLINICAL PHOTOGRAPH |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.36 |
Retro pharyngeal abscess ? Drainage |
clinical Photograph |
Post procedure Evidence of Surgery |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.37 |
Ranula excision |
Clinical Photograph |
Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.38 |
Laryngopharyngectomy with Gastric pull-up/ jejunal graft |
CT Scan of Neck, Thorax and abdomen |
Clinical Notes,Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.39 |
Excision of CA cheek/ oral cavity + radial forearm flap |
CT Scan Maxilla and Mandible.,Clinical Photograph,Clinical Notes |
Clinical Notes,Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.40 |
Excision of growth Jaw + free fibular flap reconstruction |
CT Scan Maxilla and Mandible.,Clinical Photograph,Clinical Notes |
Clinical Notes,Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.41 |
Intra Nasal Ethmoidectomy |
CT ethmoidal sinus |
Clinical Photograph |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.42 |
Vidian neurectomy ? Micro |
EMG,Nerve Conduction |
Clinical Photograph |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.43 |
Nasal polypectomy ? Unilateral single or multiple |
X-Ray PNS |
Clinical Notes,HPR |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.44 |
Ant. Ethmoidal artery ligation - open/ endoscopic |
Evidence of anterior Nasal Packing and Post Nasal Packing |
Evidence of Stopage of Epistaxis |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.45 |
Ethmoidectomy ? External |
CT ethmoidal sinus |
Clinical Photograph with Notes |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.7 |
Myringotomy with Grommet - One ear |
Ear Microscopy and Pure Tone Audiogram |
Post Procedure Ear Microscopy and Pure Tone Audiogram |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.8 |
Myrinogotomy with Grommet - Both ear |
Ear Microscopy and Pure Tone Audiogram |
Post Procedure Ear Microscopy and Pure Tone Audiogram |
- |
|
|
S2 |
ENT Surgery |
S2PM1 |
ENT PMJAY Sub Category |
S2PM1.9 |
Ossiculoplasty |
Ear Microscopy and Pure Tone Audiogram |
Post Procedure Ear Microscopy and Pure Tone Audiogram |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B10 |
Pediatric Ophthalmic Surgery |
S3B10.2 |
Pediatric Cataract Surgery - Phacoemulsification ? IOL |
B.SCAN |
Post Procedure Clinical Photograph |
- |
S20F01 |
H28 |
S3 |
Ophthalmology Surgery |
S3B10 |
Pediatric Ophthalmic Surgery |
S3B10.3 |
Glaucoma Filtering Surgery For Paediatric Glaucoma |
Clinical notes |
Post Procedure Evidence Of Clinical Photograph |
- |
S20F03 |
H4010 |
S3 |
Ophthalmology Surgery |
S3B11 |
Retina |
S3B11.1 |
Scleral Buckle For Retinal Detachment |
B.SCAN,FUNDUS PHOTOGRAPH & Sketch |
Fundus Photograph & Sketch |
- |
S20B06 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B11 |
Retina |
S3B11.2 |
Photocoagulation For Diabetic Retinopathy Per Sitting |
Fundus Photograph & Sketch |
Post Procedure Evidence Of Fundus Photograph & Sketch |
- |
S20B07 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B4 |
Opthalmology Surgery |
S3B4.1 |
Pterygium + Conjunctival Autograft |
Clinical Photograph and clinical notes |
Clinical Notes,Post procedure evidance of Surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B4 |
Opthalmology Surgery |
S3B4.2 |
Dacryocystectomy |
Clinical Photograph and clinical notes |
Clinical Notes,Post procedure evidance of Surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B4 |
Opthalmology Surgery |
S3B4.3 |
Perforating Corneo - Scleral Injury |
Clinical Photograph and clinical notes |
Clinical Notes,Post procedure evidance of Surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B4 |
Opthalmology Surgery |
S3B4.4 |
Anterior Chamber Reconstruction +Perforating corneo - Scleral Injury + IOL |
Clinical Photograph and clinical notes |
Post op photograph |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B4 |
Opthalmology Surgery |
S3B4.5 |
Photocoagulation for Retinopathy ofPrematurity |
Grading of Retinopathy by opthalmologist |
Proof of Treatment |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B5 |
Cornea Sclera |
S3B5.1 |
Therapeutic / Optical Penetrating Keratoplasty |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S20A01 |
H16109 |
S3 |
Ophthalmology Surgery |
S3B5 |
Cornea Sclera |
S3B5.2 |
Lamellar Keratoplasty |
Clinical photograph showing corneal opacity |
Post Procedure Clinical Photograph |
- |
S20A02 |
H16109 |
S3 |
Ophthalmology Surgery |
S3B5 |
Cornea Sclera |
S3B5.3 |
Corneal Patch Graft |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (Graft in photograph) |
- |
S20A03 |
H16109 |
S3 |
Ophthalmology Surgery |
S3B5 |
Cornea Sclera |
S3B5.4 |
Scleral Patch Graft |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (graft photo) |
- |
S20A04 |
H16109 |
S3 |
Ophthalmology Surgery |
S3B5 |
Cornea Sclera |
S3B5.5 |
Penetrating Keratoplasty |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S20A05 |
H16109 |
S3 |
Ophthalmology Surgery |
S3B5 |
Cornea Sclera |
S3B5.7 |
Amniotic Membrane Graft - Grade 3 Pterigium |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (Graft in photograph) |
- |
S20A07 |
H16109 |
S3 |
Ophthalmology Surgery |
S3B6 |
Vitreo |
S3B6.1 |
Vitrectomy |
B.SCAN,Fundus photograph is mandatory at time of preauth |
Fundus Photograph(Submitted At The Time Of Preauth) |
- |
S20B02 |
H35449 |
S3 |
Ophthalmology Surgery |
S3B6 |
Vitreo |
S3B6.2 |
Vitrectomy + Membrane Peeling+ Endolaser |
B.SCAN,FUNDUS PHOTOGRAPH & Sketch |
Fundus Photograph & Sketch |
- |
S20B03 |
H35449 |
S3 |
Ophthalmology Surgery |
S3B6 |
Vitreo |
S3B6.3 |
Monthly Intravitreal Anti-VEGF For Macular Degeneration - Per Injection (Maximum ? 6) |
FUNDUS PHOTOGRAPH & Sketch,OCT |
Post Procedure Evidence Of Fundus Photo/ Sketch / Optical Coherence Tomography |
- |
S20B04 |
H35449 |
S3 |
Ophthalmology Surgery |
S3B6 |
Vitreo |
S3B6.4 |
Vitrectomy - Membrane Peeling Endolaser , Silicon Oil Or Gas |
B.SCAN,FUNDUS PHOTOGRAPH & Sketch |
Fundus Photograph & Sketch |
- |
S20B05 |
H35449 |
S3 |
Ophthalmology Surgery |
S3B6 |
Vitreo |
S3B6.5 |
Removal Of Silicon Oil Or Gas |
B.SCAN,FUNDUS PHOTOGRAPH & Sketch |
Fundus Photograph & Sketch |
- |
S20B01 |
H35449 |
S3 |
Ophthalmology Surgery |
S3B6 |
Vitreo |
S3B6.6 |
Vitrectomy Plus Silicon Oil Or Gas. |
B.SCAN,FUNDUS PHOTOGRAPH & Sketch |
Fundus Photograph & Sketch |
- |
S20B08 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B7 |
Orbit |
S3B7.1 |
Socket Reconstruction |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (reconstructed orbit photo) |
- |
S20C01 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B7 |
Orbit |
S3B7.2 |
Dermis Fat Graft |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (Graft in photograph) |
- |
S20C02 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B7 |
Orbit |
S3B7.3 |
Orbitotomy |
CT Scan |
Post Procedure Clinical Photograph |
- |
S20C03 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B7 |
Orbit |
S3B7.4 |
Enucleation With Orbital Implant |
CLINICAL PHOTOGRAPH ORBIT |
Post Procedure Clinical Photograph (photograph of implant) |
- |
S20C04 |
H3570 |
S3 |
Ophthalmology Surgery |
S3B8 |
Squint Correction Surgery |
S3B8.1 |
Rectus Muscle Surgery Single. |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (corrected squint) |
- |
S20D01 |
H526 |
S3 |
Ophthalmology Surgery |
S3B8 |
Squint Correction Surgery |
S3B8.2 |
Rectus Muscle Surgery Two/Three |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (corrected squint) |
- |
S20D02 |
H526 |
S3 |
Ophthalmology Surgery |
S3B8 |
Squint Correction Surgery |
S3B8.3 |
Oblique Muscle |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph (corrected squint) |
- |
S20D03 |
H526 |
S3 |
Ophthalmology Surgery |
S3B9 |
Lid Surgery |
S3B9.1 |
Lid Reconstruction Surgery |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph of reconstructed lid |
- |
S20E01 |
H4430 |
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.1 |
Buckle Removal |
B.SCAN,Sketch ,FUNDUS PHOTOGRAPH |
FUNDUS PHOTOGRAPH,Sketch |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.11 |
IRIS Prolapse ? Repair |
Preop photograph |
Post op photograph |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.12 |
Iridectomy- laser |
Clinical Photograph and clinical notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.13 |
Iridectomy- surgical |
Clinical Photograph and clinical notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.14 |
Iris cyst removal |
Clinical Photograph and clinical notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.15 |
Conjunctival tumour excision + AMG |
Biopsy and endoscopic report |
CT Scan,X-Ray PNS,Endoscopy |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.16 |
Entropion correction |
Clinical Photograph and clinical notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.17 |
Ectropion correction |
Clinical Photograph and clinical notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.18 |
Evisceration |
B Scan Preop photograph |
Post op photograph |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.2 |
Canaliculo Dacryocysto Rhinostomy |
Clinical Photograph,DCG-Dacryocystogram |
DCG,Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.3 |
Prophylactic Cryoretinopexy- Closed |
Retinal Sketch,FUNDUS PHOTOGRAPH |
Fundus Photograph,Retinal Sketch |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.4 |
Cyclocryotherapy |
Evidence of Raised IOP & Clinical Notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.5 |
Cyclophotocoagulation |
Evidence of Raised IOP & Clinical Notes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.8 |
Glaucoma Surgery (Trabeculectomy only) with or without Mitomycin C, including postoperative medicati |
Evidence of Raised IOP & Clinical Notes along with field of vision,Optic disc changes |
Post procedure evidence of surgery |
- |
|
|
S3 |
Ophthalmology Surgery |
S3PM1 |
Opthalmology Surgery PMJAY Sub Category |
S3PM1.9 |
Limbal Dermoid Removal |
Clinical Photograph and clinical notes |
Post procedure evidence of surgery |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4C1 |
Obstetrics |
S4C1.1 |
Obstetric Hysterectomy /Internal iliac ligation With or without Bladder Repair |
USG |
Photograph,USG |
- |
OG11A01G |
O711 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C1 |
Obstetrics |
S4C1.2 |
Rupture Uterus |
USG |
Clinical Photograph/ Hpe,USG |
- |
OG11A02G |
O711 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C1 |
Obstetrics |
S4C1.3 |
Eclampsia With Complication Requiring Ventilatory Support |
(S.FIBRINOGEN LEVEL, PT, PLATELET COUNT, HAEMATOCRIT, APTT) / Sr. Uric acid,Urine albumin,Sr. Creat,LFT/RFT,ABG |
Biochemical Investigations,Post Procedure Evidence Of Clinical Photograph |
- |
OG11A03G |
O159 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C1 |
Obstetrics |
S4C1.4 |
Abruptio Placenta With Coagulation Defect - DIC |
LFT,USG / (APTT, S.FIBRINOGEN LEVEL, PT, PLATELET COUNT, HAEMATOCRIT) Coagulation profile,RFT |
Clinical Photograph Of Retroplacental Clots,USG |
- |
OG11A04 |
O365110 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.1 |
LAVH |
USG |
HPE |
- |
OG11B01 |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.10 |
Laparoscopic Cystectomy |
USG |
HPE,Video Is Mandatory |
- |
OG11B10G |
N979 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.11 |
Surgical management of ruptured ectopic pregnancy |
USG |
HPE,Video Is Mandatory,USG |
- |
OG11B11 |
O365110 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.12 |
Laparoscopic Ovarian Drilling |
USG |
USG,Video Is Mandatory |
- |
OG11B12 |
N979 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.13 |
Laparoscopic Myomectomy |
USG |
HPE,Video Is Mandatory,USG |
- |
OG11B13 |
D259 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.14 |
Laparoscopic Recanalisation |
HSG,evidence of blockage |
USG,Video Is Mandatory |
- |
OG11B14 |
N979 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.15 |
Laparoscopic Sling Operations |
USG |
USG,Video Is Mandatory |
- |
OG11B15 |
N895 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.16 |
Laparoscopic Adhesolysis (G) |
USG |
HPE,Video Is Mandatory |
- |
OG11B16 |
N895 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.17 |
Vaginal Hysterectomy |
USG |
HPE |
- |
OG11B17G |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.2 |
Vaginal Hysterectomy With Pelvic Floor Repair |
USG |
HPE |
- |
OG11B02G |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.22 |
Perineal/ Vesico-vaginal/ Recto-vaginal tear repair |
Clinical Notes |
CLINICAL IMPROVEMENT |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.3 |
Vaginal Hysterectomy With Mesh Repair |
USG |
HPE |
- |
OG11B03 |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.4 |
Cystocele,Rectocele & Perineorraphy |
USG |
Sketch,USG |
- |
OG11B04G |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.5 |
Pelvic Floor Reconstruction With Mesh |
USG |
Sketch,USG |
- |
OG11B05 |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.6 |
Mc Indo-S Repair For Vaginal Atresia |
USG |
Sketch,USG |
- |
OG11B06 |
N895 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.7 |
Slings With Mesh Repair For Prolapse |
USG |
Sketch,USG |
- |
OG11B07 |
N993 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.8 |
Vault Prolapse Abdominal Repair |
USG |
Sketch,USG |
- |
OG11B08 |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C2 |
Gynaecology |
S4C2.9 |
Vault Prolapse Abdominal / Vaginal Repair With or without Mesh |
USG |
Intra Op Photo Showing Mesh,USG |
- |
OG11B09 |
N819 |
S4 |
Gynaecology And Obstetrics Surgery |
S4C3 |
Gynaecology And Obstetrics Surgery |
S4C3.2 |
LLETZ (Large Loop Excision of the transformation zone ) |
Clinical/ Histopathological report |
Post.op ultrasound (pelvis) |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4C3 |
Gynaecology And Obstetrics Surgery |
S4C3.3 |
Tuboplasty (G) |
USG and HSG |
USG |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4C3 |
Gynaecology And Obstetrics Surgery |
S4C3.4 |
Hysteroscopic adhesiolysis |
USG |
USG |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.1 |
Repair for rectovaginal fistulas / Vsicovaginal fistula |
Clinical Notes |
Intra Operative Photoghraph |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.10 |
HaematoColpo/Excision - Vaginal Septum |
Clinical Notes |
Clinical Notes |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.11 |
Cervical Polypectomy |
Clinical Notes |
Post op Evidence of Surgery |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.12 |
Bartholins Cyst Enucleation |
Clinical Notes |
Post op Evidence of Surgery |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.13 |
Bartholins Cyst Incision drainage / Enucleation |
Clinical Notes |
Post op Evidence of Surgery |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.14 |
McDonalds stitch |
USG |
USG,sketch |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.15 |
Shirodkars stitch |
USG |
USG,sketch |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.17 |
Colpotomy |
Clinical Notes |
Clinical Notes |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.18 |
Intrauterine transfusions |
Clinical Notes |
Clinical photograph ,Record of Blood Transfusion |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.3 |
Broad Ligment Haemotoma/ Abdominal Haematoma drainage |
USG |
USG |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.4 |
Cyst -Vaginal Enucleation / Removal of Labial cyst |
Clinical Notes, Clinical Photograph |
Post op evidence of Surgery |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.5 |
Hysteroscopic myomectomies |
USG |
USG |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.6 |
Hysteroscopic polypectomy |
Clinical/ Histopathological report |
Post.op ultrasound (pelvis) |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.8 |
Laparotomy for broad ligament haematoma |
USG |
USG |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4PM1 |
Obstetrics & Gynaecology PMJAY Surgery Sub Category |
S4PM1.9 |
Cyst-Labial / Bartholin cyst enucleation |
Clinical Notes, Clinical Photograph |
Post op evidence of Surgery |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D1 |
Orthopedics Fracture Correction Surgeries |
S5D1.1 |
Bone Grafting As Exclusive Procedure |
x ray |
Post Procedure X Ray |
- |
S21F01G |
M8000xD |
S5 |
Orthopedic Surgery And Procedures |
S5D1 |
Orthopedics Fracture Correction Surgeries |
S5D1.2 |
Excision Or Other Operations For Scaphoid Fractures |
x ray |
Post Procedure X Ray |
- |
S21F02G |
S929 |
S5 |
Orthopedic Surgery And Procedures |
S5D1 |
Orthopedics Fracture Correction Surgeries |
S5D1.3 |
Open Reduction & Internal Fixation of Fingers & Toes @Rs 6000 Each Up To Maximum Of Rs 15000 |
x ray |
Post Procedure X Ray |
- |
S21F03G |
S929 |
S5 |
Orthopedic Surgery And Procedures |
S5D1 |
Orthopedics Fracture Correction Surgeries |
S5D1.4 |
Reduction Of Compound Fractures & External Fixation |
X ray |
Post Procedure X Ray Mandatory Requireed Clinical Photo Of Part For Claim,mandatory required clinical photo of part for pre auth |
- |
S21F04G |
S929 |
S5 |
Orthopedic Surgery And Procedures |
S5D1 |
Orthopedics Fracture Correction Surgeries |
S5D1.5 |
Ilizarov Ring Fixator Application. |
X ray |
Post Procedure X Ray Mandatory Requireed Clinical Photo Of Part For Claim,mandatory required clinical photo of part for pre auth |
- |
S21F05 |
M8000xA |
S5 |
Orthopedic Surgery And Procedures |
S5D1 |
Orthopedics Fracture Correction Surgeries |
S5D1.6 |
CTEV Neglected. JESS Fixator |
Clinical Photograph |
Post Procedure Evidence Of Clinical Photograph,x ray |
- |
S21F06 |
M8000xA |
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.11 |
Hand/Foot Amputation (whole) |
?X-Ray , Clinical Photograph |
?X-Ray , Clinical Photograph |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.1 |
Open Reduction of Dislocations - Shoulder/Elbow/Hip/Knee/Ankle |
x ray |
Post Procedure X Ray |
- |
S21G01G |
M435x9 |
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.16 |
Closed reduction of dislocation (hip/elbow/knee/Shoulder) |
CLINICAL PHOTOGRAPH,X-Ray |
CLINICAL PHOTOGRAPH,X-Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.17 |
Scoliosis (Rs. 90000) + special spinal brace (Rs. 10000) |
CLINICAL PHOTOGRAPH,X-Ray |
CLINICAL PHOTOGRAPH,bill of spinal brace,X-Ray,Implant sticker (barcode) |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.18 |
Amputation - Above/Below Elbow |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.19 |
Closed Interlocking Intramedullary (Matches with Close reduction and percuteneous nailing) |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.2 |
Amputations - Forequarter |
X Ray |
Post Procedure X Ray / Clinical Photgraph |
- |
S21H01 |
S98 |
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.20 |
Hand/Foot Amputation ( partial) |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.21 |
Closed Reduction and Internal Fixation with Kwire |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.22 |
Closed Reduction and Percutaneous Screw Fixation (neck Femur) |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.23 |
Closed Reduction and Percutaneous Pinning / Screw fixation |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.24 |
Closed Reduction and Percutaneous Nailing |
X Ray |
X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.25 |
Amputation - Wrist |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.26 |
Amputation ? Below Knee |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.27 |
Closed reduction of dislocation (Knee) |
Clinical photograph |
Post Procedure Evidence of Surgery |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.28 |
Correction of club foot per cast |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.29 |
Closed reduction of dislocation (Shoulder) |
Clinical photograph,X Ray |
X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.3 |
Amputations - Hind Quarter And Hemipelvectomy |
X Ray |
Post Procedure X Ray / Clinical Photgraph |
- |
S21H02 |
S98 |
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.30 |
Primary Hip Replacement (with implant) cemented THR (Imported implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.31 |
External fixation - Long bone/pelvis |
Clinical photograph,X Ray |
Clinical photograph,X Ray,Clinical photograph |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.32 |
External fixation - Small bone |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.33 |
Limb Lengthening |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.34 |
Tendon Repair (Multiple) |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.35 |
Open Reduction Internal Fixation (Small Bones) - Calcaneum / Talus and others |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.36 |
Open Reduction of CDH |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.37 |
Open Reduction of Small Joint |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.38 |
Primary Hip Replacement (with implant) uncemented THR (Imported implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.39 |
Amputation - Above/Below Elbow |
CLINICAL PHOTOGRAPH,X-Ray |
CLINICAL PHOTOGRAPH,X-Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.40 |
Total Hip Replacement hybrid (procedure cost + Imported implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.41 |
Primary knee replacement (with implant) metal back (imported implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.42 |
Primary Hip Replacement (with implant) cemented THR (Indian implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.43 |
Primary knee replacement (with implant) All poly (indian implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.44 |
Primary Hip Replacement (with implant) uncemented THR (Indian implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.45 |
Primary knee replacement (with implant) All poly (imported implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.46 |
Total Hip Replacement hybrid (procedure cost + Indian implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.47 |
Primary knee replacement (with implant) metal back (indian implant) |
Clinical and radiological investigations |
Clinical and radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.48 |
Excision Arthoplasty of Femur head |
X-Ray , Clinical Photograph |
Clinical Photograph, X-Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.49 |
Amputation ? Above Knee |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.50 |
Amputation ? Below Knee |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.51 |
Close Fixation - Hand Bones |
Clinical Photograph,X-Ray |
Clinical Photograph,X-Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.52 |
Amputation - Wrist |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.53 |
Close Reduction- small joints |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.54 |
Accessory bone ? Excision (limbs) ? congenital Accessory digits sometime can be removed (pre-auth) |
Clinical photgraph ,X rays of affected limb |
Clinical photgraph ,X rays of affected limb |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.55 |
Disarticulation (hind & for quarter) |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.56 |
Hand Amputation ( partial) |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.57 |
Close Fixation -Foot bones |
- |
- |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.58 |
Closed reduction of dislocation (elbow) |
- |
- |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D3 |
Orthopedics Bone And Joint Surgery Procedures |
S5D2.4 |
Arthrodesis Of - Major Joints |
X Ray |
X Ray |
- |
S21E01G |
M6618 |
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.5 |
Accessory bone ? Excision (limbs) ? congenitalAccessory digits sometime can be removed (pre-auth) |
Clinical Photo,X rays of affected limb |
Clinical Photo,X rays of affected limb |
- |
S21E02 |
M6618 |
S5 |
Orthopedic Surgery And Procedures |
S5D3 |
Orthopedics Bone And Joint Surgery Procedures |
S5D2.6 |
Arthroscopy. Operative Meniscectomy |
Clinical Photograph,X ray |
Clinical Photograph,X ray |
- |
S21E03 |
M6618 |
S5 |
Orthopedic Surgery And Procedures |
S5D3 |
Orthopedics Bone And Joint Surgery Procedures |
S5D2.7 |
Arthroscopy - ACL / PCL Repair |
Clinical Photograph,X ray |
Clinical Photograph,Post Procedure X Ray |
- |
S21I01 |
M6618 |
S5 |
Orthopedic Surgery And Procedures |
S5D3 |
Orthopedics Bone And Joint Surgery Procedures |
S5D2.8 |
Avascular Necrosis Of Femoral Head (Core Decompression) |
Clinical Photograph,X ray |
Clinical Photograph,X ray |
- |
S21I02G |
M87059 |
S5 |
Orthopedic Surgery And Procedures |
S5D3 |
Orthopedics Bone And Joint Surgery Procedures |
S5D2.9 |
Soft Tissue Reconstruction Procedures For Joints or osteotomy |
Clinical Photograph,X ray |
Clinical Photograph,X ray |
- |
S21I03G |
M940 |
S5 |
Orthopedic Surgery And Procedures |
S5D4 |
Orthopedics Spine Surgery |
S5D2.10 |
Anterolateral Clearance For Tuberculosis |
Clinical Photograph,X ray |
Clinical Photograph,X ray |
- |
S21J01 |
B909 |
S5 |
Orthopedic Surgery And Procedures |
S5D4 |
Orthopedics Spine Surgery |
S5D4.1 |
Spinal Ostectomy And Internal Fixations |
MRI/ Xray |
Post Procedure X Ray |
- |
S21J03 |
S140xxA |
S5 |
Orthopedic Surgery And Procedures |
S5D5 |
Orthopedics Soft Tissue Surgery |
S5D2.14 |
Neurolysis/Nerve Suture |
Clinical Photograph,X ray |
Clinical Photograph,X ray |
- |
S21K02 |
R94130 |
S5 |
Orthopedic Surgery And Procedures |
S5D6 |
Orthopedics Bone Tumours |
S5D6.1 |
Excision Of Bone Tumours. Deep With Re-Construction With Conventional Prosthesis |
MRI/ Xray |
Biopsy,Post Procedure X Ray,Post Procedure Clinical Photograph |
- |
S21L01 |
C419 |
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.15 |
Osteochondroma excision/ Excision of Exostosis |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.16 |
Excision Arthoplasty |
CLINICAL PHOTOGRAPH,X-Ray |
Post Procedure Clinical Photograph,Post Procedure X-ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.17 |
Arthorotomy of any joint |
X-Ray , Clinical Photograph |
Clinical Photograph, X-Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.20 |
Bone Tumour Excision (malignant/ benign) + Joint replacement(depending upon type of joint and implan |
Clinical and radiological investigations |
radiological investigations,Clinical investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.3 |
Foot Amputation (partial) |
X-Ray,Clinical Photograph |
X-Ray,Clinical Photograph |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.39 |
Duputryen?s Contracture release + rehabilitation |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.4 |
Hand Amputation (whole) |
Clinical photgraph ,x ray |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.42 |
Fasciotomy |
Clinical Photograph |
Post Procedure evidence of Surgery |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.45 |
Tendon Grafting (isolated grafting) |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.46 |
Nerve Repair Surgery |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.5 |
AC joint reconstruction/ Stabilization/ Acromionplasty Nonoperative management is recommended for Ro |
MRI of shoulder,X rays of affected limb |
X rays of affected limb |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.50 |
Open Reduction with bone grafting of nonunion |
Clinical photograph,X Ray |
Clinical photograph,X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.53 |
Pelvic Osteotomy with fixation with plaster. |
Clinical and radiological investigations |
radiological investigations,Clinical investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.54 |
Percutaneous - Fixation of Fracture |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.55 |
Excision of Bursa |
Clinical and radiological investigations |
Clinical investigations,radiological investigations |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.56 |
Sequestrectomy of Long Bones + anti-biotics + dressing |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.61 |
Application of P.O.P. casts for Upper & Lower Limbs |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.62 |
Skeletal tractions with pins Isolated |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.63 |
skin traction isolated |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.64 |
Application of P.O.P. Spikas & Jackets |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.66 |
External fixation - both bones of forearms |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.67 |
Fracture intercondylarHumerus + olecranon osteotomy |
x ray & Clinical photgraph |
Clinical Photgraph Req,Post Procedure X Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.75 |
Clavicle fracture management - conservative (daycare) |
X-Ray, Clinical Notes, Clinical Photograph |
Clinical Notes,X-Ray, Clinical Photograph |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5PM1 |
Orthopaedics PMJAY Sub Category |
S5PM1.76 |
Surgical management of simple or comminuted fracture of patella (isolated) |
CLINICAL PHOTOGRAPH,X-Ray,Clinical Notes |
Clinical Notes,X-Ray |
- |
|
|
S6 |
Surgical Gastro Enterology |
S6E11 |
Gall Bladder |
S6E11.1 |
GB+ Calculi CBD Stones Or Dilated CBD |
USG |
Post Treatment Evidence Of Clinical Improvement And Usg |
- |
S33H03 |
K8081 |
S6 |
Surgical Gastro Enterology |
S6E11 |
Gall Bladder |
S6E11.3 |
Choledochoduodenostomy Or Choledocho Jejunostomy Or Hepaticojejunostomy |
MRCP LFT required for pre auth,USG |
Biopsy,Clinical Photograph |
- |
S33H04 |
K8081 |
S6 |
Surgical Gastro Enterology |
S6E11 |
Gall Bladder |
S6E11.4 |
Cholecystectomy & Exploration CBD |
CT/USG,LFT |
Post Procedure Clinical Photograph,USG,T-Tube Cholangiogram Post Op Hp For Claim |
- |
S25G28 |
K77 |
S6 |
Surgical Gastro Enterology |
S6E12 |
Spleen |
S6E12.1 |
Splenectomy |
CT/USG abdomen,lab investigations |
Histopath,Usg,Post Procedure Clinical Photograph |
- |
S25G39 |
C800 |
S6 |
Surgical Gastro Enterology |
S6E12 |
Spleen |
S6E12.3 |
Spleenectomy For Space Occupying Lesion/Portal Hypertension/ Hypersplenism etc |
Hp Req At The Time Of Claim.,USG/CT |
Clinical Photograph,Usg |
- |
S33B04 |
C800 |
S6 |
Surgical Gastro Enterology |
S6E13 |
Surgical Gastro Enterology |
S6E13.1 |
Oesophageal Diverticula /Achlasia Cardia |
Barium studies / CT scan |
Usg /Scar Photo |
- |
S03A02 |
J986 |
S6 |
Surgical Gastro Enterology |
S6E2 |
Liver |
S6E2.1 |
Rt/Lt Hepatectomy |
CT,USG |
Biopsy,Usg,Usg,Clinical Photograph,Biopsy |
- |
S33A01 |
C227 |
S6 |
Surgical Gastro Enterology |
S6E2 |
Liver |
S6E2.6 |
Hydatid Cyst- Excision or Pericystectomy Open / Laparoscopic |
USG / CT- SCAN |
Biopsy,Clinical Photograph |
- |
S02A31 |
Q505 |
S6 |
Surgical Gastro Enterology |
S6E2 |
Liver |
S6E2.7 |
Cyst Excision + Hepatic Jejunostomy |
CT/USG |
Clinical Photograph,Histopath |
- |
S33H01 |
K769 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.1 |
Distal Pancreatectomy |
CT required for pre auth |
Post Procedure Clinical Photograph |
- |
S33I01 |
K862 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.3 |
Whipples Any Type |
CT/ USG |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
SO34B03 |
C260 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.4 |
Triple Bypass |
CT |
Clinical Photograph,Usg |
- |
SO34B04 |
C260 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.5 |
Other Bypasses |
CT |
Clinical Photograph,Usg |
- |
SO34B05 |
C260 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.6 |
Lap- Pancreatic Necrosectomy |
CT- SCAN |
Biopsy,Clinical Photograph |
- |
S33I06 |
C250 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.7 |
Lateral Pancreaticojejunostomy(Non- Malignant)/FREYS PROCEDURE |
CT- SCAN |
Biopsy,Clinical Photograph |
- |
S33I07 |
K868 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.8 |
Pancreatic Necrosectomy (Open) |
CT- SCAN serum amylase required for pre auth |
Biopsy,Post Procedure Clinical Photograph |
- |
S33I08 |
K868 |
S6 |
Surgical Gastro Enterology |
S6E3 |
Pancreas |
S6E3.9 |
Distal Pancreatectomy + Splenectomy |
CT- SCAN |
Biopsy,Clinical Photograph |
- |
S33I09 |
K868 |
S6 |
Surgical Gastro Enterology |
S6E4 |
Oesophagus |
S6E4.1 |
Colonic Pull Up / Gastric Pull Up |
Biopsy,ENDOSCOPY,CT- SCAN |
Clinical Photograph,Usg |
- |
S33D01 |
K229 |
S6 |
Surgical Gastro Enterology |
S6E4 |
Oesophagus |
S6E4.2 |
Oesophagectomy |
Biopsy,ENDOSCOPY,CT- SCAN |
Clinical Photograph,Usg |
- |
S33D02 |
K229 |
S6 |
Surgical Gastro Enterology |
S6E4 |
Oesophagus |
S6E4.3 |
Oesophago-Gastrectomy |
Biopsy,ENDOSCOPY,CT- SCAN |
Biopsy,Endoscopic Photograph Mandatory |
- |
S33D03 |
K229 |
S6 |
Surgical Gastro Enterology |
S6E4 |
Oesophagus |
S6E4.4 |
Lap Heller?s Myotomy |
ENDOSCOPY |
Biopsy,Endoscopic Photograph Mandatory |
- |
S33D04 |
K229 |
S6 |
Surgical Gastro Enterology |
S6E4 |
Oesophagus |
S6E4.5 |
Lap Fundoplications |
ENDOSCOPY |
Biopsy,Endoscopic Photograph Mandatory |
- |
S33D05 |
K229 |
S6 |
Surgical Gastro Enterology |
S6E5 |
Stomach |
S6E5.1 |
Partial Gastrectomy |
Endoscopic photograph,USG,EUS,BIOPSY |
BIOPSY,Histopath,CLINICAL PHOTOGRAPH |
- |
S25G31 |
I864 |
S6 |
Surgical Gastro Enterology |
S6E5 |
Stomach |
S6E5.2 |
Total Gastrectomy |
BIOPSY,USG,ENDOSCOPY,CT- SCAN,CLINICAL PHOTOGRAPH |
BIOPSY,USG,Post Procedure Clinical Photograph,Histopath,ENDOSCOPY,CT- SCAN |
- |
S25G32 |
C800 |
S6 |
Surgical Gastro Enterology |
S6E5 |
Stomach |
S6E5.4 |
Distal Gastrectomy or Gastrojejunostomy For Gastric Outlet Obstruction |
BIOPSY,USG,ENDOSCOPY,CT- SCAN |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33E01 |
K259 |
S6 |
Surgical Gastro Enterology |
S6E5 |
Stomach |
S6E5.5 |
Surgery For Corrosive Injury Stomach/Esophagus |
BIOPSY,USG,ENDOSCOPY,CT- SCAN |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33E02 |
K259 |
S6 |
Surgical Gastro Enterology |
S6E6 |
Small Intestine |
S6E6.1 |
Volvulus |
CT- SCAN,X-RAY ABD |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S25G21 |
Q899 |
S6 |
Surgical Gastro Enterology |
S6E6 |
Small Intestine |
S6E6.3 |
Lap Adhesiolysis |
CT- SCAN,X-RAY ABD |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33F01 |
Q433 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.1 |
Right Hemicolectomy |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S25G37 |
C800 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.2 |
Left Hemicolectomy Open |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S25G38 |
C800 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.3 |
Extended Right Hemicolectomy |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33G06 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.4 |
Anterior Resection - Rectum and Anus/Large Intestine Open / Laparoscopic |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S25G35 |
C800 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.5 |
Anterior Resection With Ileostomy Open / Laparoscopic |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33G07 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.6 |
Abdomino Perineal Resection(Non- Malignant) |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
SO34S01 |
C260 |
S6 |
Surgical Gastro Enterology |
S6E7 |
Large Intestine |
S6E7.7 |
Hartman.S Procedure With Colostomy (for Obstruction) |
BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33G08 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E8 |
Ulcerative Colitis Iii Stage Procedure |
S6E8.1 |
I Stage-Sub Total Colectomy + Ileostomy |
COLONOSCOPY,ENDOSCOPY,CT-SCAN WITH CONTRAST |
BIOPSY,CLINICAL PHOTOGRAPH |
- |
S33G01 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E8 |
Ulcerative Colitis Iii Stage Procedure |
S6E8.2 |
II Stage-J - IPAA with Ileostomy |
COLONOSCOPY (submitted during stage I),Clinical Photograph |
Clinical Photograph |
- |
S33G02 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E8 |
Ulcerative Colitis Iii Stage Procedure |
S6E8.3 |
Ileostomy Closure |
CT Scan contrast/ USG |
Biopsy,USG,Clinical Photograph |
- |
S33G03 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E9 |
Ulcerative Colitis Ii Stage Procedure |
S6E9.1 |
I Stage- Sub Total Colectomy + Ileostomy + J - Pouch |
COLONOSCOPY |
Biopsy,Clinical Photograph |
- |
S33G04 |
K319 |
S6 |
Surgical Gastro Enterology |
S6E9 |
Ulcerative Colitis Ii Stage Procedure |
S6E9.2 |
II Stage- Ileostomy |
COLONOSCOPY |
Clinical Photograph |
- |
S33G05 |
K319 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F1 |
Cardiology |
S7F1.4 |
VSD Device Closure |
2D ECHO |
Fluroscopy Video/Images,Stickers As And Where Applicable,OT Notes |
- |
S02A05 |
Q212 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F10 |
Pericardium |
S7F10.1 |
Pericardiectomy without CPB |
2D Echo / CT |
2D Echo/Scar Photo |
- |
S02B46 |
I319 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F10 |
Pericardium |
S7F10.2 |
Pericardiocentesis |
2D Echo / CT |
2D Echo/Scar Photo |
- |
S02B47 |
I319 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F11 |
Coarctation Of Aorta Repair |
S7F11.1 |
Coarctation Of Aorta Repair With Graft |
2D Echo & CT Angio (AORTOGRAM) |
Operation Notes,Post Procedure Doppler |
- |
S02A14 |
Q251 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F11 |
Coarctation Of Aorta Repair |
S7F11.2 |
Coarctation Of Aorta Repair Without Graft |
2D Echo & CT Angio (AORTOGRAM) |
Operation Notes,Post Procedure Doppler |
- |
S02A15 |
Q251 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F11 |
Coarctation Of Aorta Repair |
S7F11.4 |
Intrathoracic Aneurysm-Aneurysm Not Requiring Bypass (With Graft) |
CT-ANGIO |
Operation Notes,Post Procedure Doppler |
- |
S02B14 |
I718 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F12 |
Cardiac Injuries |
S7F12.1 |
Surgery Without CPB |
2D Echo / Xray chest/ CT |
2D Echo / Xray chest/ CT |
- |
S02D01 |
I519 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F12 |
Cardiac Injuries |
S7F12.2 |
Surgery With CPB |
2D Echo / Xray chest/ CT |
2D Echo / Xray chest/ CT |
- |
S02D02 |
I519 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.1 |
Aorto-Aorto Bypass With Graft |
Angio /CT angio/ MR angio |
Doppler,Operation Notes/ Scar Photo |
- |
S02B17 |
I700 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.11 |
Carotid Embolectomy |
CT- Angio |
Doppler,Operation Notes |
- |
S02B28 |
I6501 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.12 |
Surgery For Intracardiac Tumours |
2D ECHO |
2D Echo/ Histopath,Post Surgery Photograph,Operation Notes Scar Photo Is Mandatory(Female Patients May Be Made An Exception) |
- |
S02B29 |
C388 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.13 |
Ruptured Sinus Of Valsalva Correction |
CAG / 2D Echo |
2D Echo/Scar Photo |
- |
S02B30 |
Q259 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.14 |
TAPVC Correction |
2D Echo/ CT |
2D Echo/Scar Photo |
- |
S02B31 |
Q213 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.15 |
Intracardiac Repair Of VSD |
2D Echo |
2D Echo,Operation Notes |
- |
S02B37 |
Q210 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.16 |
Surgery-PDA |
2D Echo |
2D Echo,Operation Notes |
- |
S02B38 |
Q250 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.18 |
Failed device closure for ASD and/or VSD. Emergency retrieval of device with defect closure under ca |
2D ECHO |
Scar photo/Post-op 2 D Echo/Post-op X ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.19 |
Truncus Arteriosus surgery |
2D ECHO |
Scar photo/Post-op 2 D Echo/Post-op X ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.20 |
Surgery for HOCM (Hypertrophic obstructive cardiomyopathy) |
2D ECHO |
Scar photo/Post-op 2 D Echo/Post-op X ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.21 |
Pulmonary arterio venous malformation |
HRCT Thorax or CT Pulmonary Angiogram |
HRCT Thorax or CT Pulmonary Angiogram |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.22 |
Pulmonary Valve Replacement - with mechanical valve |
2D ECHO |
ECHO,scar photo,Post op X Ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.23 |
Surgery for Arterial Aneurysm Renal Artery with graft / patch |
ANGIOGRAM,Spiral CT Angiogram |
Color Doppler |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.24 |
Thyomectomy |
X- RAY |
CT-Chest,X- RAY,Clinical Photgraph Req |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.25 |
Thoracotomy, Thoraco Abdominal Approach |
CT Scan |
Clinical Photo With Scar |
- |
S03A03 |
J986 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F13 |
Cvts |
S7F13.26 |
Carotid Body Tumour Excision |
Angiogram / Spiral CT |
Color Doppler / Scar Photo,Operation Notes |
- |
S35A18 |
D446 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F13.28 |
Peripheral Embolectomy Without Graft |
ANGIOGRAM/ COLOR DOPPLER |
Color Doppler,Operation Notes |
- |
S35A04 |
I872 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.19 |
Arterial Embolectomy |
?ANGIOGRAM/COLOR DOPPLER |
Colour Doppler & Proceedure Notes |
- |
S35A07 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F14 |
Systemic Pulmonary Shunts |
S7F14.1 |
Systemic Pulmonary Shunts With Graft without CPB |
2D Echo |
2D Echo,Operation Notes |
- |
S02B32 |
Q259 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F16 |
Ross Procedure Intracardiac Repair Of Complex Congenital Heart Diseases |
S7F16.1 |
Ross procedure - Intracardiac repair of complex congenital heart diseases Without Special Conduits |
2D Echo |
2D Echo/Scar Photo |
- |
S02B40 |
Q223 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F16 |
Ross Procedure Intracardiac Repair Of Complex Congenital Heart Diseases |
S7F16.2 |
Ross procedure - Intracardiac repair of complex congenital heart diseases With Special Conduits |
2D Echo |
2D Echo/Scar Photo |
- |
S02B41 |
Q223 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F17 |
Cvts Valve Repairs |
S7F17.1 |
Valve Repair Without Prosthetic Ring / Supramitral membrane |
2D Echo |
2D Echo/Scar Photo |
- |
S02B42 |
Q223 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F17 |
Cvts Valve Repairs |
S7F17.2 |
Open Pulmonary Valvotomy |
2D Echo |
2D Echo,Operation Notes,Clinical Photo Showing Suture/Incision/Scar((Female Patients May Be Made An Exception) |
- |
S02B43 |
Q223 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F17 |
Cvts Valve Repairs |
S7F17.4 |
Open Mitral Valvotomy |
2D Echo |
2D Echo,Operation Notes,Clinical Photo Showing Suture/Incision/Scar((Female Patients May Be Made An Exception) |
- |
S02B48 |
Q238 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F17 |
Cvts Valve Repairs |
S7F17.5 |
Annulus Aortic Ectasia With Valved Conduits |
Angio / 2D Echo/ CT |
2D Echo/Scar Photo |
- |
S02B18 |
I700 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F17 |
Cvts Valve Repairs |
S7F17.6 |
Valve Repair With Prosthetic Ring |
2D Echo |
2D Echo/Scar Photo |
- |
S02B39 |
Q223 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F18 |
Cvts Lungs |
S7F18.1 |
Pneumonectomy |
CT-CHEST /X- RAY |
Clinical Photo,Xray,Operation Notes,Histopathology Report,Ct/Mri (Submitted At Time Of Preauth) |
- |
S02C01 |
J851 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F18 |
Cvts Lungs |
S7F18.2 |
Lobectomy |
CT-CHEST /X- RAY |
Clinical Photo,Xray,Operation Notes,Histopathology Report,Ct/Mri (Submitted At Time Of Preauth) |
- |
S02C02 |
J851 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F18 |
Cvts Lungs |
S7F18.3 |
Pleurectomy Decortication |
CT Chest |
Clinical Photo / Xray |
- |
S02C03 |
J848 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F18 |
Cvts Lungs |
S7F18.4 |
Lung Cyst |
CT-CHEST /X- RAY |
Clinical Photo Showing Suture/Incision/Scar((Female Patients May Be Made An Exception),Xray,Operation Notes,Histopathology Report |
- |
S02C04 |
J984 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F18 |
Cvts Lungs |
S7F18.5 |
SOL Mediastinum |
CT-CHEST /X- RAY |
Clinical Photo Showing Suture/Incision/Scar((Female Patients May Be Made An Exception),Xray,Operation Notes,Histopathology Report |
- |
S02C05 |
J985 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F19 |
Surgical Correction Of Bronchopleural Fistula |
S7F19.5 |
Transpleural BPF Closure/Myoplasty/Thoracoplasty |
CT Chest |
Clinical Photo / Xray |
- |
S02C08 |
J984 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F2 |
Cardiology Balloon Procedures |
S7F2.1 |
Balloon Valvotomy |
2D ECHO |
Fluroscopy Video/Images,Stickers As And Where Applicable,Ot Notes |
- |
S02A10 |
Q232 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F2 |
Cardiology Balloon Procedures |
S7F2.2 |
Balloon Atrial Septostomy |
2D ECHO |
Fluroscopy Video/Images,Stickers As And Where Applicable,Ot Notes |
- |
S02A11 |
Q211 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F20 |
Cvts Chest |
S7F20.1 |
Diaphragmatic Eventeration |
Barium studies / CT scan |
Clinical Photo / Xray |
- |
S03A01 |
J986 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F20 |
Cvts Chest |
S7F20.2 |
Diaphragmatic Hernia |
USG,X-ray |
Clinical Photo Showing Suture/Incision/Scar((Female Patients May Be Made An Exception),Xray,Post Procedure Clinical Photo,Operation Notes |
- |
S25G13 |
Q899 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.1 |
Surgery Without Graft For Arterial Injuries, Venous Injuries |
Angiogram /Doppler/ CT angio |
Clinical Photo With Scar |
- |
S35B01 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.10 |
Thoracic Vascular Injuries - Payable maximum upto |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B10 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.2 |
Vascular Injury In Upper Limbs ? Axillary,Branchial,Radial And Ulnar - Repair With Vein Graft - Paya |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B02 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.3 |
Major Vascular Injury -In Lower Limbs-Repair without graft- Payable maximum upto |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B03 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.6 |
Surgery With Vein Graft |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B06 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.7 |
Vascular Injuries Repair With Prosthetic Graft |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B07 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.8 |
Neck Vascular Injury - Carotid Vessels without graft - Payable maximum upto |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B08 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F24 |
Vascular Injuries |
S7F24.9 |
Abdominal Vascular Injuries - Aorta, Iliac Arteries, IVC, Iliac Veins without graft- Payable maximum |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
S35B09 |
S098xxA |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F25 |
Vasular |
S7F13.3 |
Femoro Popliteal Bypass With Graft |
- |
- |
- |
S02B20 |
I70209 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F25 |
Vasular |
S7F13.5 |
Femoroileal Bypass With Graft |
- |
- |
- |
S02B22 |
I70209 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F25 |
Vasular |
S7F13.7 |
Femoro-Femoral Bypass With Graft |
CT- Angio/ MRI Angio |
Doppler,Operation Notes |
- |
S02B24 |
I70209 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F25 |
Vasular |
S7F14.2 |
Systemic Pulmonary Shunts Without Graft |
- |
- |
- |
S02B33 |
Q259 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.12 |
Femorodistal Bypass With Vein Graft |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Color Doppler,Operation Notes |
- |
S35A14 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.13 |
Femorodistal Bypass With Synthetic Graft |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Barcode Sticker,Operation Notes,Color Doppler |
- |
S35A15 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.14 |
Axillo Brachial Bypass Using With Synthetic Graft |
Angiogram / Spiral CT |
Color Doppler / Scar Photo,Operation Notes |
- |
S35A16 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.15 |
Brachioradial Bypass With Synthetic Graft |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Barcode Sticker,Operation Notes,Color Doppler |
- |
S35A17 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.17 |
Carotid Artery Bypass With Synthetic Graft |
CT angio |
Barcode Sticker,Operation Notes,Color Doppler |
- |
S35A19 |
I720 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.18 |
Excision Of AV Malformation without graft |
MRI ANGIOGRAM/SPIRAL CT /ANGIOGRAM |
Color Doppler,Operation Notes |
- |
S35A06 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.22 |
Excision Of AV Malformation Large - with graft |
MRI ANGIOGRAM/SPIRAL CT /ANGIOGRAM |
Color Doppler,Operation Notes |
- |
S35A05 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.8 |
Medium Size Arterial Aneurysms - Repair |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Color Doppler,Operation Notes |
- |
S35A10 |
I729 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.9 |
Medium Size Arterial Aneurysms With Synthetic Graft |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Barcode Sticker,Operation Notes,Color Doppler |
- |
S35A11 |
I729 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F26 |
Congenital heart disease |
S7F19.1 |
Intracardiac Repair Of ASD |
- |
- |
- |
S02B36 |
Q211 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F26 |
Congenital heart disease |
S7F19.6 |
Total Correction Of Tetralogy Of Fallots |
- |
- |
- |
S02B34 |
Q213 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F6 |
Cad |
S7F6.1 |
CABG On Pump Without IABP |
2D Echo,Coronary Angiography report & Video |
Clinical Photo Showing Suture/Incision/Scar (Female Patients May Be Made An Exception),X-Ray Chest,Operation Notes Post Surgery Photo |
- |
S02A32 |
I251 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F6 |
Cad |
S7F6.2 |
CABG Off Pump Without IABP |
2D Echo,Coronary Angiography report & Video |
Operation Notes Post Surgery Photo (Female Patients May Be Made An Exception For Scar Photo),X-Ray Chest |
- |
S02B05 |
I2101 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F6 |
Cad |
S7F6.3 |
CABG With Aneurysmal Repair |
Angiography |
Operation Notes (Female Patients May Be Made An Exception For Scar Photo),Post Surgery Photograph / Doppler |
- |
S02B06 |
I2101 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F6.4 |
Mitral Valve Replacement (With mechanical Valve) |
2D Echo |
2D Echo/ Xray Chest,Post Procedure Clinical Photo,Operation Notes Sticker Mandatory For Claim (Female Patients May Be Made An Exception For Scar Photo) |
- |
S02B07 |
I058 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F6 |
Cad |
S7F6.5 |
CABG On Pump With IABP |
2D Echo,Coronary Angiography report & Video |
2D Echo Required,X-Ray Chest,Post Surgery Photo,Operation Notes,Iabp Sticker For Claims Required |
- |
S02B03 |
I2101 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F6 |
Cad |
S7F6.6 |
CABG Off Pump With IABP |
2D Echo,Coronary Angiography report & Video |
2D Echo Required,X-Ray Chest,Post Surgery Photo,Operation Notes,Iabp Sticker For Claims Required |
- |
S02B04 |
I2101 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.1 |
Aortic Valve Replacement (With Mechanical valve) |
2D ECHO |
2D Echo/ Xray,Post Surgery Photo,Operation Notes (Female Patients May Be Made An Exception For Scar Photo),Bar Code Sticker |
- |
S02B08 |
I060 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.10 |
Aorto Billac - Bifemoral Bypass With Synthetic Graft |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Barcode Sticker,Operation Notes,Color Doppler |
- |
S35A12 |
I729 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.11 |
Axillo Bifemoral Bypass With Synthetic Graft |
CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM |
Barcode Sticker,Operation Notes,Color Doppler |
- |
S35A13 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.2 |
Tricuspid Valve Replacement with mechanical valve |
2D ECHO |
2D Echo/ Xray,Post Surgery Photo,Operation Notes (Female Patients May Be Made An Exception For Scar Photo),Bar Code Sticker |
- |
S02B09 |
Q224 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.26 |
Mitral Valve Replacement (With biprosthatic Valve) |
2D ECHO,X-Ray Chest,Procedure Clinical Photo,Operation Notes |
2D ECHO,X-Ray Chest,Post Procedure Clinical Photo,Operation Notes |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.3 |
Double Valve Replacement (With mechnical Valve) |
2D ECHO |
2D Echo/ Xray,Post Surgery Photo,Operation Notes (Female Patients May Be Made An Exception For Scar Photo),Bar Code Sticker |
- |
S02B10 |
I060 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.5 |
D V T - IVC Filter |
COLOR DOPPLER |
Post Procedure Angio |
- |
S35A03 |
N186 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.6 |
Vascular Tumours |
Angiogram / Spiral CT |
Color Doppler / Scar Photo,Operation Notes |
- |
S35A08 |
I778 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.1 |
Intracardiac repair - TOF with RVPA Conduit |
2D ECHO |
ECHO,scar photo,Post op X Ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.10 |
Encysted Empyema/Pleural Effusion - Tubercular |
Aspirate For Culture,Pulmonary Function Test(Major),PUS Culture & Sensitivity,Chest X-Ray PA View(1 Film),CT Scan Chest With Contrast |
Chest X-Ray PA View(1 Film) |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.2 |
Glenn Shunt (without cardiopulmonary bypass) |
2D ECHO |
ECHO,scar photo,Post op X Ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.5 |
Thromboembolectomy usually done as emergency by ETI) |
Angio report,Duplex ultrasound |
Post op CT angio,Scar Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.6 |
Thoracocentesis |
Clinical Notes,X-Ray |
Clinical Notes,Clinical Photograph |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.7 |
Thrombendarterectomy |
CT-Angio,Colour Doppler |
Color Doppler |
- |
|
|
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.1 |
Oesophageal Atresia |
Imaging,X-Ray,TOF test req at time of preauth |
Post Procedure Clinical Photograph |
- |
S22A01 |
Q390 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.2 |
Diaphragmatic Hernia |
Chest X-ray AP/Lat,USG/CT scan |
Chest Xray Ap/Lat,Post Procedure Clinical Photograph |
- |
S25G13 |
Q899 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.3 |
Intestinal Atresias & Obstructions |
Imaging,X-Ray |
Post Procedure Clinical Photograph,Usg/Imaging Is Mandatory At Time Of Claims |
- |
S22A02 |
Q403 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.4 |
Biliary Atresia & Choledocal Cyst |
CLINICAL PHOTOGRAPH,USG/ Imaging,LFT |
Lft Is Mandatory At Time Of Claims,Post Procedure Clinical Photograph Usg |
- |
S22A03 |
Q443 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.5 |
Anorectal Malformations Stage 1 |
CLINICAL PHOTOGRAPH,Xray Abdomen(Inverted position),Clinical Notes |
Post Procedure Scar Photograph |
- |
S22A04 |
Q436 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.6 |
Anorectal Malformations Stage 2 Open or Laparosopic |
Clinical Photograph,Xray Lumbosacral spine (inverted position),USG Abdomen,Distal Cologram |
Post Procedure Scar Photograph Operative/ Procedure Notes |
- |
S22A05 |
Q436 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.7 |
Hirschsprung Disease Stage 1 |
CLINICAL PHOTOGRAPH/Imaging/ Biopsy |
Biopsy,Post Procedure Scar Photograph |
- |
S22A07 |
Q431 |
S8 |
Pediatric Surgery |
S8G1 |
Congenital Malformations - Gi Tract |
S8G1.8 |
Hirschsprung Disease Stage 2 Open or Lap |
CLINICAL PHOTOGRAPH/ Imaging/ Biopsy |
Biopsy,Post Procedure Scar Photograph |
- |
S22A08 |
Q431 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.1 |
Congenital Hydronephrosis |
USG / Renogram |
Post Procedure Evidence Of Clinical Photograph |
- |
S22A09 |
Q620 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.11 |
Velo-Pharyngial Incompetence |
Endoscopy, Contrast Study |
Post Procedure Photo |
- |
S25G06 |
Q899 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.15 |
Hypospadius Stage 1 |
Clinical Photograph |
Post Procedure Clinical Photograph |
- |
S25G18 |
Q899 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.16 |
Hamartoma Excision |
CT / Clinical Photograph |
Biopsy Is Mandatory At Time Of Claims,Post Procedure Photo |
- |
S22B01 |
Q808 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.17 |
Hemangioma Excision |
Colour Doppler,Neuro USG + CT |
Post Procedure Photo |
- |
S22B02 |
Q808 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.18 |
Lymphangioma Excision |
Clinical photo,USG + CT |
Post Procedure Photo |
- |
S22B03 |
Q820 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.2 |
Ureteric Reimplantations |
Clinical Photograph/USG,IVP/MCU |
Post Procedure Clinical Photograph/Scar/Suture Req At The Time Of Claim |
- |
S25G14 |
Q899 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.3 |
Extrophy Bladder Stage 1 |
Clinical Photograph/USG,Xray Pelvis |
Post Procedure Clinical Photograph |
- |
S22A10 |
Q6410 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.4 |
Extrophy Bladder Stage 2 |
Clinical Photograph/USG,Xray Pelvis |
Post Procedure Clinical Photograph |
- |
S22A10 |
Q6410 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.5 |
Posterior Urethral Valves |
MCU / USG |
Clinical Notes,Clinical Photo With Catheter |
- |
S22A11 |
Q6410 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.6 |
Hypospadias Single Stage |
Clinical Photograph |
Post Procedure Clinical Photograph |
- |
S22A12 |
Q6432 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.7 |
Hypospadius Stage 2 |
Clinical Photograph |
Post Procedure Clinical Photograph |
- |
S22A12 |
Q6432 |
S8 |
Pediatric Surgery |
S8G2 |
Congenital Malformations |
S8G2.8 |
Pediatric Tumours |
Imaging / BIOPSY/ tumour markers |
Hp Report At The Time Of Claims,Post Procedure Clinical Photograph |
- |
S02A33 |
C7A010 |
S8 |
Pediatric Surgery |
S8G3 |
Head And Neck |
S8G3.1 |
Neuroblastoma |
Imaging / biopsy |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
S22C01 |
Q078 |
S8 |
Pediatric Surgery |
S8G3 |
Head And Neck |
S8G3.2 |
Congenital Dermal Sinus |
CT Contrast study /MRI |
Biopsy,Post Procedure Clinical Photograph |
- |
S22C02 |
Q078 |
S8 |
Pediatric Surgery |
S8G3 |
Head And Neck |
S8G3.3 |
Cystic Lesions Of The Neck |
Clinical Photograph,USG/MRI /CT |
Histopath,Post Procedure Clinical Photograph |
- |
S22C03 |
Q079 |
S8 |
Pediatric Surgery |
S8G3 |
Head And Neck |
S8G3.4 |
Encephalocele |
MRI/ CT/ NEURO USG |
Post Procedure Clinical Photograph |
- |
S22C04 |
Q018 |
S8 |
Pediatric Surgery |
S8G3 |
Head And Neck |
S8G3.5 |
Sinuses & Fistula Of The Neck |
Clinical Photograph,USG/CT contrast study |
Biopsy,Post Procedure Clinical Photograph |
- |
S22C05 |
Q079 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.1 |
Bronchoscopy Foreign Body Removal |
Imaging/ ENDOSCOPIC VIDEO |
Xray /Scopy Photo/Video Ensure Bronchoscopy Is Done Only Once |
- |
S09L01G |
T81529 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.2 |
Paediatric Esophageal Obstructions- Surgical Correction |
contrast UGI |
Clinical Photograph |
- |
S22D01 |
P7889 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.3 |
Paediatric Esophageal Substitutions |
contrast study |
Clinical Photograph |
- |
S22D02 |
P7889 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.4 |
Thoracoscopic Cysts Excision |
USG / CT |
Biopsy/Video,Post Procedure Clinical Photograph |
- |
S22D03 |
Q330 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.5 |
Decortication Open or Thoracoscopic |
USG / CT |
Biopsy/Video,Post Procedure Clinical Photograph |
- |
S22D04 |
Q330 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.6 |
Thoracic Duplications |
CT,Xray |
Biopsy,Post Procedure Clinical Photograph |
- |
S22D05 |
Q339 |
S8 |
Pediatric Surgery |
S8G4 |
Chest |
S8G4.7 |
Thoracic Wall Defects- Correction |
CT,Xray |
Post Procedure Clinical Photograph |
- |
S22D06 |
Q339 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.1 |
Gastric Outlet Obstructions |
Contrast USG,Xray |
Post Procedure Clinical Photograph |
- |
S22E05 |
P7889 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.11 |
Laparoscopic Choleycystectomy |
Clinical Photo,Usg |
Histopath,Video,Post Procedure Clinical Photograph |
- |
S25G27 |
K77 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.12 |
Laparoscopic Pull Through For Ano Rectal Anomalies |
Clinical Photograph,Usg |
Clinical Photograph,Video,Usg |
- |
S22E04 |
P7889 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.2 |
Laparoscopic Pull Through Surgeries For HD |
Clinical Photograph,USG/Biopsy |
Biopsy,Video,Post Procedure Clinical Photograph |
- |
S22E01 |
P7889 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.3 |
Paediatric Splenectomy (Non Traumatic) |
Heamogram,Usg |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
S22E07 |
P7889 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.4 |
Surgeries On Adrenal Gland In Children |
CT,Hormone Assays |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
S22E06 |
Q891 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.5 |
Gastro Esophageal Reflux Correction |
Endoscopy/ CT Scan Contrast |
Post Procedure Evidence Of Clinical Photograph |
- |
S22E02 |
P7889 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.6 |
Hydatid Cysts In Paediatric Patient |
CT,Usg |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
S22E08 |
P7889 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.8 |
Intussusception |
CT/ USG,Usg |
Post Procedure Clinical Photograph |
- |
S02A34 |
K561 |
S8 |
Pediatric Surgery |
S8G5 |
Abdomen |
S8G5.9 |
Paediatric Acute Intestinal Obstruction |
CT/ USG,X-ray |
Post Procedure Clinical Photograph/Scar/Suture Req At The Time Of Claim |
- |
S22E09 |
P7889 |
S8 |
Pediatric Surgery |
S8G6 |
Urogenital |
S8G6.1 |
Nephrectomy |
DMSA scan,USG / CT Clnical Photograph |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
S25G24 |
Q899 |
S8 |
Pediatric Surgery |
S8G6 |
Urogenital |
S8G6.3 |
Scrotal Transposition Repair |
Clinical Photograph |
Post Procedure Photo |
- |
S22F03 |
Q5300 |
S8 |
Pediatric Surgery |
S8G6 |
Urogenital |
S8G6.4 |
Undescended Testis |
Clinical Photograph,Usg |
Post Procedure Clinical Photograph |
- |
S22F04 |
Q5300 |
S8 |
Pediatric Surgery |
S8G6 |
Urogenital |
S8G6.5 |
Torsion Testis |
clinical photo and colour doppler |
Clinical Photo,Notes |
- |
S10F01 |
N4400 |
S8 |
Pediatric Surgery |
S8G6 |
Urogenital |
S8G6.6 |
Laparoscopic Orchidopexy Bilateral |
Clinical Photograph,Usg |
Clinical Photograph,Video,Usg |
- |
S22F01 |
Q5300 |
S8 |
Pediatric Surgery |
S8G7 |
Pediatric Surgery |
S8G7.1 |
Hirschsprung?s Disease -Biopsy |
BIOPSY,imaging,CLINICAL PHOTOGRAPH |
BIOPSY,Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8G7 |
Pediatric Surgery |
S8G7.2 |
Inguinal Hernia & Hydrocele |
CLINICAL PHOTOGRAPH,Clinical Notes |
Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8G7 |
Pediatric Surgery |
S8G7.3 |
Sacrococcygeal Teratoma |
CLINICAL PHOTOGRAPH,X-RAY/USG,Clinical Notes |
Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8G7 |
Pediatric Surgery |
S8G7.4 |
Hirschsprung?s Disease - Sphinecterotomy |
BIOPSY,imaging,CLINICAL PHOTOGRAPH |
BIOPSY,Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8G7 |
Pediatric Surgery |
S8G7.5 |
Caecocystoplasty |
IVP/ MCU ,USG |
CLINICAL PHOTOGRAPH,Post Procedure Evidence Of Usg |
- |
S10J01 |
N29 |
S8 |
Pediatric Surgery |
S8PM1 |
Pediatric Surgery |
S8PM1.10 |
Exomphalos/gastroschisis |
Clinical Photo |
Clinical Notes |
- |
|
|
S8 |
Pediatric Surgery |
S8PM1 |
Pediatric Surgery |
S8PM1.2 |
Ankyloglossia Major |
Clinical Notes,Clinical Photograph |
Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8PM1 |
Pediatric Surgery |
S8PM1.3 |
Ankyloglossia Minor |
Clinical Notes,Clinical Photograph |
Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8PM1 |
Pediatric Surgery |
S8PM1.5 |
Fecal Fistula Closure |
Clinical Notes,Clinical Photograph |
Post Procedure Evidence of Surgery |
- |
|
|
S8 |
Pediatric Surgery |
S8PM1 |
Pediatric Surgery |
S8PM1.6 |
GI Tumor Excision |
USG |
Biopsy ,Post Procedure Evidence of Surgery , Post Procedure USG |
- |
|
|
S8 |
Pediatric Surgery |
S8PM1 |
Pediatric Surgery |
S8PM1.9 |
Congenital Lobar Emphysema |
X-Ray Chest/ HRCT |
Intra Operative Photograph |
- |
|
|
S9 |
Genitourinary System |
S9H1 |
Transplantation |
S9H1.2 |
Renal Transplantation Surgery Including cost of renal transpalntation, AV fistula & Doners Nephrecto |
All legal formalities of transplantation of Human Organs Act shall be completed.,USG,RFT |
Ot Notes,Post Procedure Clinical Photograph/ Usg |
- |
T31A02 |
N2889 |
S9 |
Genitourinary System |
S9H1 |
Transplantation |
S9H1.3 |
Post-Transplant Immunosuppression Treatment From 1st To 6th Month After Transplantation |
RFT,USG |
BILLS COPY |
- |
T31A03 |
N2889 |
S9 |
Genitourinary System |
S9H2 |
Urology Testis, Testis And Penis |
S9H2.1 |
Orchidopexy Bilateral |
USG/ Clinical photograph |
Post Procedure Clinical Photograph |
- |
S10F02 |
N4400 |
S9 |
Genitourinary System |
S9H2 |
Urology Testis, Testis And Penis |
S9H2.2 |
Torsion Testis |
USG |
Post Procedure Clinical Photograph |
- |
S25G23 |
Q899 |
S9 |
Genitourinary System |
S9H2 |
Urology Testis, Testis And Penis |
S9H2.3 |
Chordee Correction (Plication) |
Clinical Photo |
Post Procedure Evidence Of Clinical Photograph |
- |
S10F03 |
N448 |
S9 |
Genitourinary System |
S9H3 |
Renal Calculi |
S9H3.1 |
Open Pyelolithotomy |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
S10B01 |
N22 |
S9 |
Genitourinary System |
S9H3 |
Renal Calculi |
S9H3.2 |
Open Nephrolithotomy |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
S10B02 |
N22 |
S9 |
Genitourinary System |
S9H3 |
Renal Calculi |
S9H3.3 |
Open Cystolithotomy |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
S10B03 |
N22 |
S9 |
Genitourinary System |
S9H3 |
Renal Calculi |
S9H3.4 |
Laparoscopic Pyelolithotomy |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
S10B04 |
N22 |
S9 |
Genitourinary System |
S9H4 |
Lithotripsy |
S9H4.1 |
Cystolithotripsy |
USG/KUB/IVP/ CT Abd |
Usg / X Ray |
- |
S10C01 |
N22 |
S9 |
Genitourinary System |
S9H4 |
Lithotripsy |
S9H4.2 |
PCNL or RIRS or Push back PCNL for upper ureretic calculus less than 1 cm |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
S10C02 |
N22 |
S9 |
Genitourinary System |
S9H4 |
Lithotripsy |
S9H4.3 |
ESWL |
USG/KUB/IVP/ CT Abd |
During Procedure Photo,X Ray/Usg |
- |
S10C03 |
N22 |
S9 |
Genitourinary System |
S9H4 |
Lithotripsy |
S9H4.4 |
URSL |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
S10C04 |
N22 |
S9 |
Genitourinary System |
S9H4 |
Lithotripsy |
S9H4.6 |
DJ Stent (One Side) |
USG/KUB/IVP/ CT Abd |
X-Ray |
- |
S10C06 |
N22 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.1 |
Urethroplasty For Stricture Urethra Single Stage |
RGU |
Post Procedure Evidence Of Clinical Photograph |
- |
S10D02 |
N29 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.2 |
Urethroplasty For Stricture Urethra Double Stage Stage-1 |
RGU |
Post Procedure Evidence Of Clinical Photograph |
- |
S10D03 |
N29 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.3 |
Urethroplasty For Stricture Urethra Double Stage Stage-2 |
Clinical photo & RGU(submitted during stage I) is mandatory for preauth |
Post Procedure Evidence Of Clinical Photograph |
- |
S10D04 |
N29 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.5 |
Hypospadius Single Stage |
Clinical Photograph |
Post Procedure Evidence Of Clinical Photograph |
- |
S25G15 |
Q899 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.6 |
Hypospadius Double Stage - Stage-1 |
Clinical Photograph |
Post Procedure Evidence Of Clinical Photograph |
- |
S25G16 |
Q899 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.7 |
Hypospadius Double Stage - Stage-2 |
Clinical Photograph |
Post Procedure Evidence Of Clinical Photograph |
- |
S25G18 |
Q899 |
S9 |
Genitourinary System |
S9H5 |
Corrective Procedures |
S9H5.8 |
Hypospadius Adult Double Stage - TURBT |
Clinical photgraph |
Clinical photgraph |
- |
S02A37 |
Q540 |
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.1 |
Laparaoscopic Anderson Hynes Pyeloplasty |
RFT,USG |
Bills Copy |
- |
T31A04 |
N2889 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H10.1 |
Anatrophic Pyelolithotomy For Staghorn Calculus |
IVP/ CT abd,X ray,USG |
Post Procedure Clinical Photograph,X- Ray/Usg |
- |
S10E01 |
N29 |
S9 |
Genitourinary System |
S9H10 |
Urology Kidney Stone |
S9H10.2 |
Open Anderson Hynes Pyeloplasty |
IVP/ CT abd,X ray,USG |
Clinical Photo |
- |
S10I06 |
N3642 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.1 |
Nephrostomy |
IVP/USG/CT Abd |
Usg/Xray Post Op Photo Of Nephrostomy Required For Claim |
- |
S10C05 |
N22 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.10 |
Surgery for correction of ureteric stricture (Ureteric Reimplantation) Unilateral |
IVP/CT,USG |
CLINICAL PHOTOGRAPH,USG |
- |
|
|
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.11 |
Ultrasound guided Perinephric Abscess drainage |
USG |
USG |
- |
|
|
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.12 |
Varicocele-bilateral |
Clinical photograph ,USG |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.13 |
Varicocele-unilateral |
Clinical photograph ,USG |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.2 |
Nephrectomy Pyonephrosis/XGP |
IVP,USG/CT Abd urine routine microscopy mandatory for pre auth |
Usg/ Biopsy |
- |
S10G02 |
N29 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.3 |
Open simple Nephrectomy |
USG / CT scan |
Biopsy,Post Procedure Evidence Of Usg |
- |
S10G03 |
N29 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.5 |
Lap. Nephrectomy Radical |
CT scan,USG |
Biopsy,Post Procedure Evidence Of Usg |
- |
S10G05 |
N29 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.6 |
Lap. Partial Nephrectomy |
CT scan,USG |
Biopsy,Post Procedure Evidence Of Usg |
- |
S10G06 |
N29 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.7 |
Bilateral Nephroureterectomy |
IVP,USG |
Post Procedure Evidence Of Usg |
- |
S02A38 |
C676 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.8 |
Laparoscopic Renal Cyst Excision |
USG/CT Abd |
Biopsy,USG,Intra Op Photo |
- |
S10G01 |
N29 |
S9 |
Genitourinary System |
S9H7 |
Urology Kidney Stone |
S9H7.9 |
Endoscope Removal Of Stone In Bladder |
USG/KUB/IVP/ CT Abd |
Endoscopic Photograph,Usg/Xray Kub |
- |
S10H01 |
N22 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.1 |
Vasico Vaginal Fistula |
IVP/MCU,Scopy |
Clinical Notes |
- |
S10I01 |
N898 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.2 |
Epispadiasis - Correction - Stage 1 |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
S25G19 |
Q899 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.3 |
Closure Of Urethral Fistula |
Clinical photograph,Retrograde Urethrogram |
Post Procedure Clinical Photograph |
- |
S10I02 |
N369 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.4 |
Optical Urethrotomy |
RGU |
Post Procedure Evidence Of Intra Operative Endoscopic Picture |
- |
S10I03 |
N3642 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.5 |
Perineal Urethrostomy |
RGU,X-Ray |
Post Procedure Evidence Of Clinical Picture |
- |
S10I04 |
N3642 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.6 |
Distal ureterectomy with Reimplantation |
IVP/ MCU ,USG |
Intra Op Photo,Post Op Xray |
- |
S25G14 |
Q899 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.7 |
Ileal Conduit formation |
CT abd |
Post Procedure Evidence Of Clinical Photograph |
- |
S10I05 |
N3642 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.8 |
Endoscopic Ureterocele incision |
X Ray/ IVP/MCU |
Post Procedure Evidence Of Intra Operative Clinical Photograph |
- |
S25G25 |
Q899 |
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.9 |
Transurethral Resection Of Prostate (TURP) / Bladder neck incision |
USG WITH POST VOID VOLUME AT TIME OF PREAUTH,USG with prostate size |
BIOPSY,Post Op Specimen Photo |
- |
S10J05 |
N423 |
S9 |
Genitourinary System |
S9H9 |
Bladder Prostate |
S9H9.2 |
Open Prostatectomy (Freyers ) |
PSA,USG with prostate size |
BIOPSY,Post Op Specimen Photo |
- |
S10J07 |
N423 |
S9 |
Genitourinary System |
S9H9 |
Bladder Prostate |
S9H9.4 |
Total Cystectomy / Radical cystectomy |
CT abd,USG |
Post Procedure Evidence Of Usg Biopsy Clinical Photo |
- |
S10J08 |
N423 |
S9 |
Genitourinary System |
S9H9 |
Bladder Prostate |
S9H9.6 |
Incontinence Urine (Female) |
U.SCOPY,USG,UDS (optional) |
USG |
- |
S10J03 |
N29 |
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.10 |
Endoureterotomy (laser/bugbee) |
CT,USG,IVP |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.11 |
Uretero-vaginal/uterine fistula repair Open |
CT,USG,IVP |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.12 |
Urethral Dilatation- as an independent procedure |
RGU |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.13 |
Intravesical BCG/Mitomycin 6 induction cycles (weekly for 6 weeks-total cost of 6 cycles) |
Histopathplogy report |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.14 |
Intravesical BCG/Mitomycin maintenance for 12 doses (total cost of 12 Doses) |
Histopathplogy report |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.15 |
Bladder Neck incision-endoscopic |
USG |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.16 |
Surgery for Bladder injury repair with or without urethral injury (as an independent procedure) |
CT,USG,RGU ,MCU |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.17 |
Suprapubic Drainage - Closed/Trocar |
RGU ,USG |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.18 |
Urethrovaginal fistula repair (independent procedure) |
MCU ,URETEROSCOPY,RGU |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.19 |
Bladder Neck Reconstruction |
CYSTOSCOPY ,USG,MCU |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.2 |
Augmentation cystoplasty |
CT,USG |
USG /clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.22 |
Urinary tract trauma Repair Open/Laparoscopy |
CT ABDOMEN |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.23 |
Post Urethral Valve fulguration |
MCU ,RGU |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.24 |
Internal Ureterotomy including cystoscopy as an independent procedure |
RGU |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.25 |
Reduction of Paraphimosis |
Clinical Notes,Clinical Photograph |
Clinical Notes,Clinical Photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.26 |
Excision of Urethral Caruncle |
Clinical photograph |
Clinical photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.27 |
Emergency management of Acute retention of Urine |
USG |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.28 |
Partial Cysteectomy / Urachal Cyst excision -open |
USG |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.3 |
Meatoplasty |
Clinical Notes,Clinical Photograph |
Clinical Notes,Clinical Photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.4 |
Meatotomy |
Clinical Notes,Clinical Photograph |
Clinical Notes,Clinical Photograph |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.5 |
Endopyelotomy (anterograde with laser/bugbee) |
IVP |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.6 |
Ureterocalycostomy Open |
IVP |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.7 |
Uretero-ureterostomy Open |
CT IVP |
USG, CLINICAL PHOTOGRAPH |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.9 |
Ureterotomy (Cutaneous) |
Usg |
CLINICAL PHOTOGRAPH |
- |
|
|
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.1 |
Lung Abscess, Non Resolving - Ct Scan Chest, per day - Rs 2500 - 10 Days stay |
CT Scan Chest |
Post Treatment Evidence Of Clinical And Lab Investigations,Pus C/S |
- |
M28A06 |
J9819 |
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.2 |
Pneumothorax (Large/Recurrent) HRCT-10 Days Stay |
Chest HRCT |
Post Treatment Evidence Of Clinical And Lab Investigations Xray |
- |
M28A07 |
J9819 |
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.3 |
Interstitial Lung Diseases - 7 Days Stay |
HR CT - Chest |
Post Treatment Evidence Of Clinical And Lab Investigations,Spirometry |
- |
M28A02 |
J9819 |
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.4 |
Pneumoconiosis - per day Stay - Rs 2500 - 10 Days stay |
HR CT - Chest |
Post Treatment Evidence Of Clinical And Lab Investigations |
- |
M28A03 |
J9819 |
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.5 |
Acute Respiratory Failure (Without Ventilator) 4000 per day ICU stay - 5 Days |
ABG,Sputum / Bronchial Washing / ET Suctions for Analysis x ray mandatory for pre auth,Serum Electrolytes,ECG |
Post Treatment Evidence Of Clinical And Lab Investigations |
- |
M28A04 |
J9819 |
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.6 |
Acute Respiratory Failure (With NIV Ventilator) per day - Rs 5000 - 7 Days |
ABG,Sputum / Bronchial Washing / ET Suctions for Analysis x ray mandatory for pre auth,Serum Electrolytes,ECG |
Post Treatment Evidence Of Clinical And Lab Investigations |
- |
M28A05 |
J9819 |
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.8 |
Bronchiectasis Requiring Hospitalisation - 7 Days Stay |
HR CT - Chest |
Post Treatment Evidence Of Clinical And Lab Investigations,Sputum Culture /Drug Susceptibility |
- |
M28A01 |
J9819 |
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.1 |
Toxic Epidermal Necrolysis 7 Days ICU Stay. Rs 30000 if LOS 7 days complete |
CBC,Urine R/M,Skin Swab,RFT,LFT |
CBC,Skin Biopsy,RFT,LFT,Clinical Notes |
- |
M04A02 |
L512 |
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.2 |
Stevens- Johnson Syndrome 5 Days ICU Stay |
CBC,Urine R/M,Skin Swab,RFT,LFT |
CBC,Skin Biopsy,RFT,LFT,Clinical Notes |
- |
M04A03 |
L508 |
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.3 |
Pemphigus / Pemphigoid Tzanck Clinical Protocol 15 Days Stay |
Serum DSG 1& 3,Tzanck Smear |
Clinical Notes,Skin Biopsy |
- |
M04A01 |
L109 |
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.1 |
SLE With Sepsis 4 Weeks Stay |
ANA/Anti DSDNA (new or old report),Blood Culture or source of infection |
Lab Investigation,Post Treatment Evidence Of Clinical Improvement |
- |
M32A02 |
L931 |
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.2 |
Scleroderma 7 Days Stay |
ANA (old or new) / skin biopsy/ PFT,Anti SCL 70 |
Lab Investigation,Post Treatment Evidence Of Clinical Improvement |
- |
M32A03 |
L940 |
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.3 |
MCTD Mixed Connective Tissue Disorder 7 Days Stay |
(old or new) /Renal biopsy/ CPK,RA,Anti U1 RNP ab,ANA |
Lab Investigation,Post Treatment Evidence Of Clinical Improvement |
- |
M32A04 |
L948 |
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.5 |
Vasculitis 6 Days Stay. Rs 10000 if LOS 6 Days. |
ANA / Renal biopsy/ Skin biopsy/ NCS,Thromboplastin time,Routine Urine at the time of preauth,PTA,PT,APTT,ANCA
Lab Investigation,Post Treatment Evidence Of Clinical Improvement |
- |
M32A05 |
L959 |
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.6 |
SLE (Systemic Lupus Erythematosis) 10 Days Stay |
24 Hour urine protein,ACL Antibodies / ANA/ Anti DSDNA/ C3 C4 |
Lab Investigation,Post Treatment Evidence Of Clinical Improvement |
- |
M32A01 |
L931 |
M13 |
Endocrinology |
M13U1 |
Endocrinology Uncontrolled Diabetes Mellitus With Infectious Emergencies |
M13U1.1 |
Lower Respiratory Tract Infection 13 Days General ward Stay. Rs 20000 if complete 13 days stay. |
CXR,Sputum gram stain |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A68 |
J22 |
M13 |
Endocrinology |
M13U1 |
Endocrinology Uncontrolled Diabetes Mellitus With Infectious Emergencies |
M13U1.2 |
Fungal Sinusitis Pns 10 Days Stay |
CT PNS,Direct microscopy report to confirm Fungal hyphae is mandatory during preauth |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A69 |
J329 |
M13 |
Endocrinology |
M13U1 |
Endocrinology Uncontrolled Diabetes Mellitus With Infectious Emergencies |
M13U1.3 |
Cholecystitis - Abd 10 Days Stay |
LFT,USG /CT Abd |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A70 |
K81 |
M13 |
Endocrinology |
M13U1 |
Endocrinology Uncontrolled Diabetes Mellitus With Infectious Emergencies |
M13U1.4 |
Cavernous / Saggital Sinus Thrombosis 10 Days Stay |
MRI,Venogram |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
S06A01 |
E1365 |
M13 |
Endocrinology |
M13U1 |
Endocrinology Uncontrolled Diabetes Mellitus With Infectious Emergencies |
M13U1.5 |
Rhinocerebral Mucormycosis 10 Days Stay |
(Brain PNS Chest) when necessary,Direct microscopy report for Fungal hyphae is mandatory during preauth,CT-Scan |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
S06A02 |
E1365 |
M13 |
Endocrinology |
M13U1 |
Endocrinology Uncontrolled Diabetes Mellitus With Infectious Emergencies |
M13U2.4 |
Pyelonephritis 10 Days Stay |
USG,Urine R/M |
Lab Investigations,Urine C/S,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A67 |
N119 |
M13 |
Endocrinology |
M13U2 |
Other Endocrinal Disorders |
M13U1.6 |
Hypopitutarism (Injections/tablets to be given of 6 months duration) (three day indoor stay) |
FSH/LH,basal cortisol post-ACTH cortisol,Testosterone or Estradiol GH stimulation test 1 yr. needed MRI pic visual field water deprivation test 1 yr. needed,T3 T4 TSH,GH stimulation test |
Injection Vial With Patient Name On It And Bills Of The Injection Are Mandatory For Claims,Post Procedure Evidance Of Clinical Imrovement,Lab Investigations |
- |
M06B01 |
E228 |
M13 |
Endocrinology |
M13U2 |
Other Endocrinal Disorders |
M13U2.1 |
Pituitary - Acromegaly (Injections/tablets to be given of 6 months) (three day indoor stay) - Cost o |
Basal cortisol cost FSH / LH,water deprivation test (if needed),testosterone / estriol,t3 t4 TSH,prolactin,Post glucose GH assay |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M06B02 |
E228 |
M13 |
Endocrinology |
M13U2 |
Other Endocrinal Disorders |
M13U2.2 |
Endogenous Cushings Syndrome (minimum three day stay)(Injections/tablets to be given of 6 months dur |
ACTH assay,MRI pituitary CT Abd,Dexa of Hip spine,DHEAS,Cortisol assay after dexamethasone |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M06B03 |
E278 |
M13 |
Endocrinology |
M13U2 |
Other Endocrinal Disorders |
M13U2.3 |
Turner syndrome/ Prader willi syndrome , three Days indoor Stay (Injections/tablets to be given of 6 |
2D echo,testosterone,karyotyping,Xray bone age,USG pelvis,T4 TSH,MRI brain DEXA,FSH/LH |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M06B04 |
E278 |
M13 |
Endocrinology |
M13U3 |
Endocrinology |
M13U3.1 |
Adrenal Insufficiency - (medicines should be given for 6 months duration)(3 day indoor stay) |
Basal ACTH,Serum Sodium,Serum Potassium,Basal Cortisol |
Clinical Improvement |
- |
|
|
M13 |
Endocrinology |
M13U3 |
Endocrinology |
M13U3.2 |
Endogenous Hyperthyroidism with or without Graves opthalmopathy (3 day indoor stay)medicines to give |
T3 T4 TSH,TC-99 thyroid scan |
Clinical Improvement |
- |
|
|
M13 |
Endocrinology |
M13U3 |
Endocrinology |
M13U3.3 |
Gonadotropin releasing hormone excess state, 3 day indoor stay(medicines to be given for 6 months du |
FSH / LH,X rays of affected limb |
Clinical Improvement |
- |
|
|
M13 |
Endocrinology |
M13U3 |
Endocrinology |
M13U3.4 |
Prolactin Excess (Prolactinoma) medicines to be given for 6 months duration) (3 day indoor stay) |
Basal Cortisol,T3 T4 TSH,MRI pituitary CT Abd,IGF1,FSH / LH |
Clinical Improvement |
- |
|
|
M13 |
Endocrinology |
M13U3 |
Endocrinology |
M13U3.5 |
PTH deficiency/ PTH resistance/ Vit D resistance states/Renal rickets (medicines to be given for 6 m |
ALBUMIN,Phosphorus,PTH,Calcium,CREATININE,ALKALINE PHOSPHATASE |
Clinical Improvement |
- |
|
|
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.10 |
Acute Pancreatitis (Severe) -2 Weeks Stay - Payable maximum upto |
CT Abdomen/ EUS,electolytes,Sr. Amylase,Sr Lipase,RFT,RBS,RANSON Scoring/ BISAP Scoring,LFT,Etiology of pancreatitis |
Ct Scan Abdomen,USG Abdomen,Sr. Amylase,Sr Calcium Level,Ranson/Bisap Score At Time Of Admission,RFT: Urea & Creatinine Level,Post Treatment Evidence Of Usg. Lab Investigation ( Sr. Amylase/Sr. Lipase ) Wbc Count,Lipase Which Are Repeated At An Interval Of 48 Hours Of Admission,LFT : Esp. Ast,Blood Sugar Level,Diet Chart |
- |
M07A02 |
K850 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.11 |
Management of acute pancreatitis with Acute Pancreatitis With Pseudocyst / Walled off Necrosis 3 Wee |
CBC,USG,Sr Lipase,S. AMYLASE,EUS/ CT- ABDOMEN |
Lab Investigations(S. Amylase/ Sr Lipase),USG |
- |
M07A08 |
K850 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.12 |
Chronic Pancreatitis With Severe Pain - 7 Days Stay - Payable maximum upto |
CT Scan abdomen/ USG/ EUS / ERCP/ MRCP, Etiology of pancreatitis,LFT,RFT,RFT,RBS,LFT,Etiology of pancreatitis |
Apache Score At Time Of Admission & 48 Hrs Post Admission,Usg Abdomen/Ct Scan Abdomen,Sr. Amylase,Sr Calcium Level,RFT: Urea & Creatinine Level,Post Treatment Lab Investigation Wbc Count,Lipase Which Are Repeated At An Interval Of 48 Hours Of Admission,LFT : Esp. Ast,Blood Sugar Level,Diet Chart |
- |
M07A09 |
K850 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.13 |
Obscure GI Bleed - 1 Week Stay |
CAPSULE ENDOSCOPY/ CT enterography/ Barium Meal Follow Through,ENTEROSCOPY BIOPSY (optional) |
Endoscopic Photograph/ Lab Investigations |
- |
S33C07 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.14 |
Cirrhosis With Hepatic Encephalopathy -11 Days Stay |
LFT,USG / ascitic fluid analysis,UGI Endoscopy(optional) Clinician notes of diagnosis & clinical finiding,Sr Ammonia(optional),PT- INR |
LFT,Post Procedure Clinical Photograph And Lab Invistigations |
- |
M07A04 |
K769 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.15 |
Cirrhosis With Hepato Renal Syndrome - 14 days Stay |
Reports of Serum Chemistry,USG/CT ABDOMEN IS MANDATORY AT TIME OF PREAUTH |
Post Treatment Evidence Of Lab Investigation |
- |
M07A05 |
K769 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.16 |
Endoscopic stenting for Benign Biliary Stricture - 3 Days |
EUS & LFT,USG,Per cutaneous Transhepatic Billiary/ Endoscopic Drainage,MRCP/ ERCP |
Endoscopic Image/ Video Radiological |
- |
M07A10 |
K838 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.17 |
Biliary Stricture 2) Post Op Leaks 7 Days Stay |
MRCP/ ERCP,USG,Per cutaneous Transhepatic Billiary/ Endoscopic Drainage |
Endoscopic Image/ Video Radiological |
- |
M07A11 |
K838 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.18 |
Biliary Stricture 3) Sclerosing Cholangitis 7 Days Stay |
MRCP/ ERCP,USG & LFT,Per cutaneous Transhepatic/ Endoscopic Billiary Drainage |
Post Treatment Evidence Of Radiological And Endoscopic Image/ Video |
- |
M07A12 |
K838 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.2 |
Oesophageal Perforation- 7 Days Stay |
CT SCAN THORAX and Abdomen |
Ct- Abdomen Optional |
- |
M07A13 |
K220 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.20 |
Corrosive Oesophageal Injury 7 Days Stay |
Alkali/corrosive,clinical history of acid ingestion |
Mlc,Post Treatment Evidence Of Barium Swallow / Ugi Scopy Optional |
- |
M07A07 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.21 |
Gastro Study Followed By Thoracotomy And Repairs For Oesophageal Injury For Corrosive Injuries/FB |
Gastroscopy |
Post Procedure Endoscopic Picture |
- |
S03A05 |
J986 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.3 |
Achalasia Cardia - 7 Days Stay for POEM ( Peroral Endoscopic Myotomy) |
Barium swallow,manometry,UGI endoscopy |
Post Treatment Evidence Of Endoscopic Photograph/ Barium Swallow |
- |
M07A14 |
K220 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.4 |
Oesophageal Varices, Variceal Banding One Day Stay |
UGI endoscopy |
Post Treatment Evidence Of Endoscopic Photograph |
- |
M07A15 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.5 |
Oesophageal Varices, Sclerotherapy- One Day Stay |
UGI ENDOSCOPY |
Endoscopic Photograph |
- |
M07A16 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.6 |
Oesophageal Fistula -3 Days Stay |
CT Thorax |
Post Treatment Evidence Of Photograph Of Stent In Position |
- |
M07A06 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.7 |
GAVE (Gastric Antral Vascular Ectasia) - 2 Days Stay |
UGI Endoscopy |
Post Treatment Evidence Of Endoscopic Photograph |
- |
M07A17 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.8 |
Gastric Varices / Ectopic varices 3 Days Stay |
UGI ENDOSCOPY |
Endoscopic Photograph |
- |
M07A18 |
I864 |
M14 |
Gastroenterology |
M14V1 |
Gastroenterology |
M14V1.9 |
Acute Pancreatitis (Mild) - 1 Week Stay With Post Treatment Evidence Of - Payable maximum upto |
CT Abdomen/ EUS,electolytes,Sr Lipase,Sr AMYLASE,RFT,RBS,RANSON Scoring/ BISAP Scoring,LFT,Etiology of pancreatitis |
Ct Scan Abdomen,USG Abdomen,Sr. Amylase,Sr Calcium Level,Ranson/Bisap Score At Time Of Admission,RFT: Urea & Creatinine Level,Post Treatment Evidence Of Usg. Lab Investigation ( Sr. Amylase/Sr. Lipase ) Wbc Count,Lipase Which Are Repeated At An Interval Of 48 Hours Of Admission,LFT : Esp. Ast,Blood Sugar Level,Diet Chart |
- |
M07A01 |
K850 |
M15 |
Interventional Radiology |
M15PM1 |
Interventional Radiology PMJAY Sub Category |
M15PM1.1 |
Balloon test occlusion |
MRI/CT-Angio,MRI/CT-Angio |
CT-Head,CT-Head |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.1 |
Inferior Vena Cava Stenting Single Stent |
USG/ CT scan/ DSA IVC Gram |
Post Procedure Angiographic Image |
- |
R14A02 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.10 |
Gastrointestinal Visceral Arterial Embolization In Upper or Lower Gastrointestinal Bleeding With Mic |
CT,USG,Endoscopy |
Intra Op Video (Mandatory),Post Procedure Clinical Photograph |
- |
R14A10 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.11 |
Bronchial Artery Embolization In Hemoptysis Using PVA And Micro Catheter |
Xray/CT chest |
Intra Op Video (Mandatory),Post Procedure Clinical Photograph |
- |
R14A11 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.12 |
Radiofrequency Tumor Ablation Therapy |
USG/CT/ MRI |
Post Procedure CT/MRI Scan,intra operative images showing RF probe |
- |
S33A06 |
K769 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.13 |
Embolization Of Postoperative or Post Traumatic Bleeding |
clinical photo |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A12 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.14 |
Inferior Vena Cava Filter Placement |
COLOR DOPPLER/ Venogram IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A06 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.15 |
Biliary Drainage Procedures - External Drainage And Stent Placement - Single Metallic Stent |
CT/MRI/ USG/ERCP req at the time of preauth |
Post Procedure Clinical Photograph,Stent Sticker At Time Of Claims Mandatory,Radiographic Image/Cd |
- |
R14A13 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.16 |
Nephrostomy Tube And Nephroureteral Stent Placement |
USG/CT IS MANDATORY AT TIME OF PREAUTH. |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A14 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.17 |
Uterine Artery Embolization In Severe Menorrhagia Secondary To PPH or Uterine Fibroids or AVM |
USG/CT IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A15 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.18 |
Intra-Arterial Thrombolysis For Acute Ischemic Limbs |
COLOR DOPPLER/PERIPHERAL ANGIOGRAM IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A16 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.19 |
Permanent Tunnelled Catheter Placement As Substitute For AV Fistula In Long Term Dialysis / CAPD |
COLOR DOPPLER MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A17 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.2 |
Hepatic Vein Stenting In Budd - Chiari Syndrome Single Stent |
CT/MRI Liver |
Angiography,Stent Sticker Req At The Time Of Claims |
- |
M13A02 |
K7469 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.20 |
Central Venous Stenting For Central Venous Occlusion ( Brachiocephalic or Subclavian Vein or Sup Ven |
COLOR DOPPLER IS MANDATORY AT TIME OF PREAUTH,DSA/CT venography/MRI |
Post Procedure Clinical Photograph,Radiographic Image/Cd Stent Sticker At Time Of Claims Mandatory |
- |
R14A18 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.21 |
Endovascular Intervention For Salvaging Hemodialysis AV Fistula |
COLOR DOPPLER IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A19 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.22 |
Balloon Retrograde Transvenous Obliteration Of Bleeding Gastric Varices ( BRTO) |
endoscopic images of gastric varices,clinical history,CT |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A20 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.23 |
Preoperative Portal Vein Embolization For Liver Tumors |
USG/CT IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A21 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.24 |
Chemo Embolization For Liver Tumors or metastases Using Drug And PVA Or DC Beads |
USG/CT IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A22 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.25 |
Percutaneous Vertebro Plasty/Cementoplasty (For Each Level) Post Procedure Evidence Of Clinical Phot |
CT/MRI MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A23 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.26 |
Trans Jugular Intrahepatic Portosystemic Shunt (TIPSS) |
MRI/COLOR DOPPLER MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A24 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.27 |
Embolization Of Pulmonary AV Malformation Post Procedure Evidence Of Clinical Photograph And Radiogr |
CT MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A25 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.28 |
Preoperative Prophylactic Tumor Embolization |
CT/MRI/ USG req at the time of preauth |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A26 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.29 |
Embolization Of AV Malformation Of Brain Per Sitting With Onyx |
CT/MRI MANDATORY AT TIME OF PREAUTH,DSA |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A27 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.3 |
Acute Stroke Thrombolysis With rTPA |
CT/ CT-perfusion/ MRI |
CT,Post Procedure Dsa |
- |
R14A03 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.30 |
Carotid Stenting Single Stent With Protection Device |
MRI/CT- Angiogram,Pre- Doppler (carotid) |
Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video,Post Porocedure Dsa Stent Sticker |
- |
R14A28 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.31 |
Intracranial Arterial And Venous Stenting |
DSA,MRI/CT- Angiogram |
Post Procedure Dsa |
- |
R14A29 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.32 |
Peripheral Stent Graft For aorta or Peripheral Aneurysms And AV Fistulae |
CT or Doppler |
Post Procedure Angiography Picture |
- |
R14A30 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.33 |
Embolization Of Caratico-Cavernous Fistula |
CT/MRI MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A31 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.34 |
Embolization of AV Malformation Of Peripheral Extremity or Craniofascial or Visceral Per Sitting |
CT scan/ MRI,DSA |
Post Procedure Angiographic Image |
- |
R14A01 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.35 |
Intracranial clot retrieval |
CT,MRI,CT-perfusion |
CT,Post Procedure Dsa |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.4 |
Renal Artery Embolization With Multiple Coils And Microcatheter |
CT-Angiogram/ DSA Angiogram |
Post Procedure Angiographic Image |
- |
R14A04 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.5 |
Cortical Venous Sinus Thrombolysis |
CT/MRI |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A05 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.6 |
Deep Venous Thrombolysis For DVT With IVC Filter |
Color Doppler/ Clinical Photograph |
Doppler/ Venographic Dsa Image,Post Procedure Clinical Photograph |
- |
M02A72 |
I825 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.7 |
Subclavian Artery Stenting with stent |
Angiogram / Doppler |
Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video.,Radiographic Image/Cd Stent Sticker,Post Procedure Clinical Photograph |
- |
R14A07 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.8 |
Tibial Angioplasty In Critical Limb Ischemia |
Angiogram / Doppler |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
R14A08 |
R9089 |
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.9 |
Mesenteric Artery Angioplasty & Stenting In Chronic Mesenteric Ischemia - Single Stent |
Angiogram / CT angio |
Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video.,Radiographic Image/Cd Stent Sticker,Post Procedure Clinical Photograph |
- |
R14A09 |
R9089 |
M16 |
GENERAL MEDICINE |
M16PM1 |
General Medicine PMJAY Sub Category |
M16PM1.1 |
Acute inflammatory demyelinatingpolyneuropathy |
Nerve Conduction Study(NCS) |
Clinical Notes |
- |
|
|
M16 |
GENERAL MEDICINE |
M16PM1 |
General Medicine PMJAY Sub Category |
M16PM1.2 |
Metabolic encephalopathy/encephalitis due to any cause |
EEG,Lab Investigations |
Clinical Notes |
- |
|
|
M16 |
GENERAL MEDICINE |
M16PM1 |
General Medicine PMJAY Sub Category |
M16PM1.4 |
Hyperosmolar Non-Ketotic coma |
ABG,Electrolyte Studies,Blood Sugar |
Clinical Notes |
- |
|
|
M16 |
GENERAL MEDICINE |
M16PM1 |
General Medicine PMJAY Sub Category |
M16PM1.5 |
Acute transverse myelitis |
CBC,MRI Spine,CSF analysis,CBC |
Clinical Notes |
- |
|
|
M16 |
GENERAL MEDICINE |
M16PM1 |
General Medicine PMJAY Sub Category |
M16PM1.6 |
Cerebral sino-venous thrombosis(any Isolated/Multiple sinovenus thrombosis without involvment of cav |
MRI,Venogram |
Post Procedure Evidance Of Clinical Improvement ,Lab Investigations |
- |
|
|
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.1 |
Thrombocytopenia With Bleeding Diathesis 7 days |
BT,PT INR,CT,CBC (platelet count),Bone marrow aspiration |
Post Procedure Evidance Of Clinical Imrovement |
- |
M12A01 |
D759 |
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.10 |
Sickle cell Crisis presenting with Fever, Joint pains, Tachycardia) per day including PCV administra |
Electrophorosis and other confirmatory test |
Clinical Improvement,Lab Investigations |
- |
|
|
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.11 |
Diabetic Ketoacidosis - per day ICU Stay - 10 Days |
Sr. Fe + B12,CBC,BONE MARROW EXAMINATION |
BONE MARROW EXAMINATION,PBS report,EVIDENCE OF PLATELET TRANSFUSION |
- |
|
|
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.5 |
Cerebral Malaria management with or without Ventilatory support and treatment - 10 Days |
CBC,Test for detection of Malarial Parasite/ Rapid test,CT brain |
E/O ARDS,Post Treatment Evidence Of Clinical Improvement & Lab Investigations |
- |
M08B04 |
B500 |
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.6 |
TB Meningitis or Tuberculoma 10 days - ICU Stay |
CSF Analysis,Chest X-Ray,CT Scan-Brain |
Csf,Post Treatment Evidence Of Clinical Improvement & Lab Investigations |
- |
M17A11 |
G031 |
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.7 |
Snake Bite Requiring Ventilator Support - 10 Days stay |
ECG,Serial ABG,PT/PTTK/ DIC profile RFT |
BT CT,Serum Cholinesterase,RFT,Post Treatment Evidence Of Clinical Improvement & Cpk,Lab Investigations |
- |
M12A05 |
D759 |
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.8 |
Scorpion Sting Requiring Ventilator Support per day - 6000 per day - 5 Days |
ECG,Serial ABG |
Post Treatment Evidence Of Clinical Improvement & Rft Investigations |
- |
M12A06 |
D759 |
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.9 |
Metabolic Coma with or without Ventilatory Support per day - 7 days stay - 6000 per day |
Blood Urea,clinical photo with ventilatory support,Sr. Electrolites,Sr. Creat,Machine generated ABG,LFT,ECG,CT brain/ MRI brain,Blood sugar |
Post Treatment Evidence Of Clinical Improvement,Vit B12 Level / Lab Investigations |
- |
M08A09 |
E889 |
M17 |
Mental Disorders Packages |
M17A1 |
Mental Disorders Packages |
M17A1.1 |
F20-F29Schizophrenia, schizotypal and delusional disorders - Rs. 2000 per day - Length of stay 10 da |
Clinical assessment/Risk assessment and investigations |
Clinical assessment & Report |
- |
|
|
M17 |
Mental Disorders Packages |
M17A1 |
Mental Disorders Packages |
M17A1.2 |
F30-F39Mood (affective) disorders - Rs. 2000 per day - Length of stay 10 days |
Clinical assessment/Risk assessment and investigations |
Clinical assessment & Report |
- |
|
|
M17 |
Mental Disorders Packages |
M17A1 |
Mental Disorders Packages |
M17A1.3 |
Pre- Electro Convulsive Therapy - Rs 3000 per sitting(ECT)Transcranial MagneticStimulation (TMS)Pack |
Clinical assessment |
Clinical assessment |
- |
|
|
M17 |
Mental Disorders Packages |
M17A1 |
Mental Disorders Packages |
M17A1.4 |
Electro Convulsive Therapy (ECT) per setting |
Basic investigations for anaesthesia - CBC, RBS, ECG,urine culture & microscopy,X- RAY CHEST |
Clinical assessment |
- |
|
|
M17 |
Mental Disorders Packages |
M17PM1 |
Mental Disorders Packages PMJAY Sub Category |
M17PM1.5 |
Transcranial Magnetic Stimulation (TMS) |
Clinical assessment |
Clinical assessment |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.1 |
Anaemia treated with Haematinics, Blood Transfusion etc for per day - Rs 2000 per day - Length of st |
BONE MARROW EAMINATION SOS,HAEMOGRAM / HB ELECTROPHORESIS |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations (Cbc) |
- |
M02A62 |
D649 |
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.2 |
Haemophilia A treatment with , Recombinant or Plasma derived Factor VIII Day Care procedure |
VON WILL BRANDS / FACTOR VIII/ IX ASSAY Coagulation Parameters |
Case Sheet With Records Of Factor Given,Post Procedure Evidance Of Clinical Imrovement |
- |
M12A02 |
D759 |
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.3 |
Thalassemia trasfusion dependant or Thalassemia and Sickle cell combination requiring parental Chela |
HB ELECTROPHORESIS/ HPLC,SERUM FERRITIN(6 monthly)req |
Case Sheet With Records Of Chelation Therapy |
- |
M23A12 |
P619 |
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.4 |
Oral Chelation Therapy for Thalassemia or Thalassemia and Sickle cell combination - Day care blood t |
Haemogram,Serum Ferritin,Hb Electrophoresis |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement & Lft |
- |
M12A04 |
D759 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.1 |
Adriamycin/Cyclophosphamide (Ac) protocol 2 weekly or 3 weekly |
Biopsy/Histopathology report,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A01 |
C50910 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.2 |
5- Flurouracil A-C (FAC) |
Biopsy/Histopatholigy report,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A02 |
C50910 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.3 |
AC (AC Then T) |
Biopsy/Histopathology report,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A03 |
C50910 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.4 |
Paclitaxel/Docitaxel two or Three weekly |
Biopsy/Histopathology report,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A04 |
C50910 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.5 |
Cyclophosphamide / Methotraxate / 5flurouracil (CMF) |
Biopsy/Histopathology report |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A05 |
C50910 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.6 |
Tamoxifen Tabs - Per month |
Biopsy/Histopathology report,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A06 |
C50910 |
M1 |
Medical Oncology |
M1K1 |
Breast |
M1K1.7 |
Hormonal Treatment - Per month (Letrozole/Tamoxifen) |
Biopsy/Histopathology report,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15A07 |
C50910 |
M1 |
Medical Oncology |
M1K10 |
Multiple Myeloma |
M1K10.1 |
Vincristin, Adriamycin,Dexamethasone (VAD) |
Bence Jones Protiens (urine),S. Immune electrophoresis,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Bone marrow |
Chemo Charts,Clinical Photograph |
- |
MO15J01 |
C9000 |
M1 |
Medical Oncology |
M1K10 |
Multiple Myeloma |
M1K10.2 |
Thalidomide+Dexamethasone(Oral) /Lenalidomide |
Bence Jones Protiens (urine),S. Immune electrophoresis,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Bone marrow |
Chemo Charts,Clinical Photograph |
- |
MO15J02 |
C9000 |
M1 |
Medical Oncology |
M1K10 |
Multiple Myeloma |
M1K10.3 |
Melphalan+Thalidomide+Prednisone Oral |
Bence Jones Protiens (urine),S. Immune electrophoresis,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Bone marrow |
Chemo Charts,Clinical Photograph |
- |
MO15J03 |
C9000 |
M1 |
Medical Oncology |
M1K10 |
Multiple Myeloma |
M1K10.4 |
Zoledronic Acid/Pamindronic acid Along With any chemotherapy regime |
Bence Jones Protiens (urine),S. Immune electrophoresis,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Bone marrow |
Chemo Charts,Clinical Photograph,Chemo Charts |
- |
MO15AH01 |
C9590 |
M1 |
Medical Oncology |
M1K10 |
Multiple Myeloma |
M1K10.5 |
Bortezomib+Lenoladomide+Dexamethasone/Cyclophosphamide+Bortezomib+Dexamethasone |
- |
- |
- |
MO15J03 |
C9000 |
M1 |
Medical Oncology |
M1K11 |
Wilm's Tumour |
M1K11.1 |
SIOP/NWTS Regimen (Stages I III) - Per month |
Biopsy / USG/CT,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Charts,Clinical Photograph |
- |
MO15K01 |
C801 |
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.1 |
5FU + Leucovorin + Irinotecan 5 FU 1200mg/m2 D1 D2 Leucovorin 400mg/m2 D1 Irinotecan 180mg/m2 85 mg/ |
Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,SG/CT Scan / Biopsy |
Chemo Charts,Clinical Photograph |
- |
MO15L01 |
|
M1 |
Medical Oncology |
M1K13 |
Cervix |
M1K13.1 |
Vinblastin Vinblastine 6 mg/m2 every week |
Biopsy,USG/CT,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Charts,Clinical Photograph |
- |
MO15M01 |
|
M1 |
Medical Oncology |
M1K14 |
Childhood B-Cell Lymphomas |
M1K14.1 |
Variable Regimen |
Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Tumour Biospy/Bone marrow aspi / USG/CT/PET-CT |
Chemo Charts,Clinical Photograph |
- |
MO15N01 |
C8100 |
M1 |
Medical Oncology |
M1K15 |
Neuroblastoma Stage I ? III |
M1K15.1 |
Variable Regimen Inv - X-Ray/CT Scan - Payable maximum upto/Per month |
Biopsy,Plan of CHEMOTHERAPY REGIMEN(any change in regimen should be informed promptly),CT scan/PET |
Chemo Charts,Clinical Photograph |
- |
MO15N01 |
C8100 |
M1 |
Medical Oncology |
M1K16 |
Retinoblastoma |
M1K16.1 |
Topotecan Topotecan 1.5 mg/m2 D1-D5 every 21 days |
MRI/CT Orbit/USG orbit,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Clinical Photograph |
- |
MO15P01 |
|
M1 |
Medical Oncology |
M1K17 |
Histocytosis |
M1K17.1 |
Variable Regimen |
Planned CHEMOTHERAPY REGIMEN (any change in regimen should be informed promptly),CT/Skeletal study,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15Q01 |
C961 |
M1 |
Medical Oncology |
M1K18 |
Rhabdomyosarcoma |
M1K18.1 |
Vincristin-Actinomycin- Cyclophosphamide (VAC) Based Chemo - Per Cycle |
Biopsy,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,CT/USG/PET-CT |
Chemo Sheets,Clinical Photograph |
- |
MO15R01 |
C800 |
M1 |
Medical Oncology |
M1K19 |
Ewing'S Sarcoma |
M1K19.1 |
Variable Regimen Inv - Hematology, Biopsy - Payable maximum upto |
Planned CHEMOTHERAPY REGIMEN (any change in regimen should be informed promptly),CT/USG/PET-CT,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15S01 |
C800 |
M1 |
Medical Oncology |
M1K2 |
Urinary Bladder |
M1K2.1 |
Weekly Cisplastin |
Biopsy/Histopathology report,USG |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15B01 |
C670 |
M1 |
Medical Oncology |
M1K2 |
Urinary Bladder |
M1K2.2 |
Methotraxate Vinblastin Adriamycin Cyclophosphamide (MVAC) |
Biopsy/Histopathology report,USG,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Post Treatment Evidence Of Clinical Improvements,lab investigations |
- |
MO15B02 |
C670 |
M1 |
Medical Oncology |
M1K20 |
Acute Myeloid Leukemia |
M1K20.1 |
Induction Phase - Payable maximum upto |
BM Asp Biopsy,cytochemistry/ Surface markers,CBC |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15T01 |
C9200 |
M1 |
Medical Oncology |
M1K20 |
Acute Myeloid Leukemia |
M1K20.2 |
Consolidation Phase up to 4 Cycles - Payable maximum upto for each cycle |
BM Asp Biopsy |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15T02 |
C9200 |
M1 |
Medical Oncology |
M1K20 |
Acute Myeloid Leukemia |
M1K20.3 |
Maintenance Phase - Per month |
CBC |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15T03 |
C9200 |
M1 |
Medical Oncology |
M1K21 |
Acute Lymphatic Leukemia |
M1K21.1 |
Induction 1st And 2 nd Months - Payable maximum upto |
BM Asp Biopsy,cytochemistry/ Surface markers,CBC |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15U01 |
C9100 |
M1 |
Medical Oncology |
M1K21 |
Acute Lymphatic Leukemia |
M1K21.2 |
Induction 3rd, 4th, 5th months - Payable maximum upto |
BM Asp Biopsy |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15U02 |
C9100 |
M1 |
Medical Oncology |
M1K21 |
Acute Lymphatic Leukemia |
M1K21.3 |
Maintenance Phase - Per month |
CBC |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15U03 |
C9100 |
M1 |
Medical Oncology |
M1K22 |
Unlisted Regimen |
M1K22.1 |
Chemotherapy -Unlisted Regimen - Payable maximum upto per cycle |
Biopsy/Histopatholigy report,USG/CT Scan |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15V01 |
C9000 |
M1 |
Medical Oncology |
M1K23 |
Supportive Care |
M1K23.1 |
Palliative And Supportive Therapy - Per month (Analgesics, Antibiotices, Nutrional supplements, vita |
Biopsy,USG/CT/ Blood test |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15W01 |
C9100 |
M1 |
Medical Oncology |
M1K24 |
Medical Oncology |
M1K24.1 |
Cisplastin- 5FU |
Biopsy/Histopatholigy report |
Chemo Sheets,Post Treatment Clinical Notes |
- |
MO15X01 |
C55 |
M1 |
Medical Oncology |
M1K25 |
Rectal Cancer Stage 2 And 3 |
M1K25.1 |
Xelox Along With Adjuvant Chemotherapy Of AS-I |
Biopsy/Histopathology report,CT Abdomen |
Usg/Ct/Biopsy/Biochemical Investigations |
- |
MO15AF01 |
C762 |
M1 |
Medical Oncology |
M1K27 |
Febrile Neutropenia Fn High Risk 2 |
M1K27.1 |
1st Line Iv Antibiotics And Other Supportive Therapy ( Third Generation Cephalosporin, Aminoglycosid |
Blood C/s / Urine C/S,Clinical notes,CXR/ CT scan,CBC |
Usg/Ct/Biopsy/Biochemical Investigations |
- |
MO15AG01 |
D703 |
M1 |
Medical Oncology |
M1K27 |
Febrile Neutropenia Fn High Risk 2 |
M1K27.2 |
2nd Line Iv Antibiotics And Other Supportive Therapy(Carbapenems, Fourth Generation Cephalosporins, |
Biopsy,Clinical notes,CXR,CBC,Blood C/s / Urine C/S |
Usg/Ct/Biopsy/Biochemical Investigations |
- |
MO15AG02 |
D703 |
M1 |
Medical Oncology |
M1K28 |
Vaginal Cancer |
M1K28.1 |
Cisplastin/5-FU |
Biopsy,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,CT Scan/ USG |
Chemo Sheets,Clinical Photograph |
- |
MO15Y01 |
C55 |
M1 |
Medical Oncology |
M1K29 |
Ovary |
M1K29.1 |
Carboplastin/ Paclitaxel 3weekly |
Biopsy,USG/CT,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Ca 125 |
Chemo Sheets,Clinical Photograph |
- |
MO15Z01 |
C55 |
M1 |
Medical Oncology |
M1K3 |
Small Cell Lung Cancer |
M1K3.1 |
Cisplastin and Etoposide or Carboplatin and etoposide |
Biopsy/FNAC,X-Ray/CT Scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Clinical Photograph |
- |
MO15C01 |
C3491 |
M1 |
Medical Oncology |
M1K30 |
Ovary Germ Cell Tumour |
M1K30.1 |
Bleomycin-Etoposide-Cisplastin (BEP) / VIP Protocol - 3 weekly |
Biopsy,S.A FP/ B HC,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Clinical Photograph |
- |
MO15AA01 |
C55 |
M1 |
Medical Oncology |
M1K31 |
Gestational Trophoblast Ds. Low Risk |
M1K31.1 |
Weekly Methotrexate |
B HCG,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15AB01 |
C55 |
M1 |
Medical Oncology |
M1K31 |
Gestational Trophoblast Ds. Low Risk |
M1K31.2 |
Actinomycin (Unlisted) |
B HCG,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15AB02 |
C55 |
M1 |
Medical Oncology |
M1K32 |
Gestational Trophoblast Ds. High Risk |
M1K32.1 |
Etoposide - Methotrexate - Actinomycin / Cyclophosphamide vincristine (EMA-CO) |
B HCG,USG/CT,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15AC01 |
C800 |
M1 |
Medical Oncology |
M1K33 |
Testis |
M1K33.1 |
Trastuzumab 3 weekly protocol |
Biopsy,USG/CT,S.A FP/ B HC,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Sheets,Clinical Photograph |
- |
MO15AD01 |
|
M1 |
Medical Oncology |
M1K34 |
Prostate |
M1K34.1 |
Gemcitabine + Docetaxel (3 weekly protocol) |
Biopsy,USG,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,PSA |
Chemo Sheets,Clinical Photograph |
- |
MO15AE01 |
|
M1 |
Medical Oncology |
M1K4 |
Oncologyoesophagus |
M1K4.1 |
Palbociclib 21 days out of 28 day cycle |
Endoscopy/CT scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15D01 |
|
M1 |
Medical Oncology |
M1K49 |
Medical Oncology |
M1K49.1 |
Radioiodine ablation therapy for cancer thyroid |
BIOPSY,USG,THYROID PROFILE,Iodine scan,CT Scan of Neck |
Chemo Charts |
- |
|
|
M1 |
Medical Oncology |
M1K49 |
Medical Oncology |
M1K49.2 |
Gemcitabine + cisplatin 21 days or Gemcitabin + Carboplatin 21 days |
BIOPSY,CT |
Chemotherapy drug batch number with bar code |
- |
|
|
M1 |
Medical Oncology |
M1K49 |
Medical Oncology |
M1K49.3 |
Brain GBM(Temozolomide) (per month) |
BIOPSY,MRI,CT BRAIN |
Chemotherapy drug batch number with bar code |
- |
|
|
M1 |
Medical Oncology |
M1K5 |
Stomach |
M1K5.1 |
Fulvestrant Fulvestrant 500 mg D1 D15 D28 then every 28 days |
Endoscopy/CT scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy |
Chemo Sheets,Clinical Photograph |
- |
MO15E01 |
|
M1 |
Medical Oncology |
M1K6 |
Colon Rectum |
M1K6.1 |
Monthly 5-FU/Capacitabine |
Biopsy,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Endoscopy/CT Scan,CEA Optional |
Chemo Charts,Clinical Photograph |
- |
MO15F01 |
C189 |
M1 |
Medical Oncology |
M1K6 |
Colon Rectum |
M1K6.2 |
5- Flurouracil-Oxaliplastin Leucovorin (Folfox) - 2 weeks cycle |
Biopsy,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Endoscopy/CT Scan |
Chemo Charts,Clinical Photograph |
- |
MO15F02 |
C189 |
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.1 |
Gemcitabine + Paclitaxel Gemcitabine 1000mg/m2 D1 D8 D15 Paclitaxel 100 mg/m2 D1 D8 D15 every 28 day |
Biopsy,Xray/CT scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Charts,Clinical Photograph |
- |
MO15G01 |
|
M1 |
Medical Oncology |
M1K8 |
Lymphoma, Hodgkin'S |
M1K8.1 |
Adriamycin Bleomycin Vinblastin Dacarbazine (ABVD) 2 weekly |
Biopsy,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,CT scan/PET |
Chemo Charts,Clinical Photograph |
- |
MO15H01 |
C8100 |
M1 |
Medical Oncology |
M1K9 |
NHL |
M1K9.1 |
Cyclophosphamide Adriamycin Vincristin Prednisolone (CHOP)+Rituximab/Bendamustine+Rituximab/R-CVP/Ch |
Biopsy,CT scan/PET Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH |
Chemo Charts,Clinical Photograph |
- |
MO15I01 |
C8101 |
M2 |
Radiation Oncology |
M2L1 |
Cobalt 60 External Beam Radiotherapy |
M2L1.1 |
Radical Treatment with Cobalt 60 |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29A01 |
C800 |
M2 |
Radiation Oncology |
M2L1 |
Cobalt 60 External Beam Radiotherapy |
M2L1.2 |
Palliative Treatment with Cobalt 60 |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29A02 |
C800 |
M2 |
Radiation Oncology |
M2L1 |
Cobalt 60 External Beam Radiotherapy |
M2L1.3 |
Adjuvant Treatment with Cobalt 60 |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29A03 |
C800 |
M2 |
Radiation Oncology |
M2L2 |
External Beam Radiotherapy (On Linear Acclerator) |
M2L2.1 |
Radical Treatment With Photons |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29B01 |
C800 |
M2 |
Radiation Oncology |
M2L2 |
External Beam Radiotherapy (On Linear Acclerator) |
M2L2.2 |
Palliative Treatment With Photons |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29B02 |
C800 |
M2 |
Radiation Oncology |
M2L2 |
External Beam Radiotherapy (On Linear Acclerator) |
M2L2.3 |
Radical Treatment With Photons and Electrons |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29B03 |
C800 |
M2 |
Radiation Oncology |
M2L3 |
Brachytherapy Intracavitary |
M2L3.1 |
A) Intracavitary I. LDR Per Application |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29C01 |
C800 |
M2 |
Radiation Oncology |
M2L3 |
Brachytherapy Intracavitary |
M2L3.2 |
A) Intracavitary II. HDR Per Application |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29C02 |
C800 |
M2 |
Radiation Oncology |
M2L4 |
Brachytherapy Interstitial |
M2L4.1 |
B) Interstitial I. LDR Per Application |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29D01 |
C800 |
M2 |
Radiation Oncology |
M2L4 |
Brachytherapy Interstitial |
M2L4.2 |
B) Interstitial II. HDR One Application And Multiple Dose Fractions. Non OBGY Malignancie |
Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29D02 |
C800 |
M2 |
Radiation Oncology |
M2L5 |
Specialized Radiation Therapy - Imrt (Intensity Modulated Radiotherapy) |
M2L5.1 |
IMRT-Up To 35 Fractions In 8 Weeks - Preferably Pre/Post op head and neck cancer, Cancer Esophagus, |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29E01 |
C800 |
M2 |
Radiation Oncology |
M2L6 |
Specialized Radiation Therapy - 3DCRT (3-D Conformal Radiotherapy) |
M2L6.1 |
3DCRT-Up upto 30 Fractions In 6 Weeks (Preferably Right breast Cancer Cervix, Endometrium, Rectum, W |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29F01 |
C800 |
M2 |
Radiation Oncology |
M2L7 |
Specialized Radiation Therapy - Srs/Srt |
M2L7.1 |
SRS / SRT upto 5fractions |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29G01 |
C800 |
M2 |
Radiation Oncology |
M2L8 |
Specialized Radiation Therapy Rapid Arc Therapy |
M2L8.1 |
RapidArc/ VMAT/ ART/ Tomotherapy with IGRT Up To 30 Fractions in 6 Weeks - Preferably Radical head a |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29H01 |
C800 |
M2 |
Radiation Oncology |
M2L9 |
Specialized Radiation Therapy - Imrt With Igrt |
M2L9.1 |
Intraluminal Brachytherapy per fraction |
Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings |
Rt Treatment Charts |
- |
R29I01 |
|
M2 |
Radiation Oncology |
M2PM1 |
Radiation Oncology PMJAY Sub category |
M2PM1.1 |
Tomotherapy(Radical/Adjuvant/Neoadjuvant) |
Biopsy,CT,Blood test |
Data of RT treatment plan & dose |
- |
|
|
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.1 |
Acute Severe Asthma With Acute Respiratory Failure 10 Days ICU Stay. Rs 45000 if complete stay of 10 |
Chest X-Ray,Machine generated ABG,Clinical photo with ventilatory support |
Abg,X-Ray,Post Treatment Evidence Of Clinical Improvement,Lab Investigations |
- |
M24A03 |
J191 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.2 |
COPD Respiratory Failure (Infective Exacerbation) 11 Days Stay with ventilator support. Rs 70000 wil |
2D ECHO,SPIROMETRY,Machine generated ABG,HR CT ? CHEST,CLINICAL PHOTOGRAPH |
ABG,Post Treatment Evidence Of Clinical Improvement,LAB INVESTIGATIONS |
VENTILATORY CARE |
M08A02 |
J45998 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.3 |
Acute Bronchitis And Pneumonia With Respiratory Failure, Ventilator 8 Days Stay - Rs 6000 per day. R |
Chest X-Ray/ HRCT Chest,Machine generated ABG,Clinical photo with ventilatory support |
Abg,Post Treatment Evidence Of Clinical Improvement,Lab Investigations |
- |
M08A03 |
J45998 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.4 |
ARDS With Ventilatory Care 10 Days Stay. Rs 65000 if LOS complete. |
BiPAP is not accepted,Machine generated ABG,For ARDS packages Ventilator with NIV Mask / invasive ventilator should be discretion of treating physician,Clinical photo with ventilatory support,Chest X-Ray/ HRCT Chest,CPAP |
Abg,Post Treatment Evidence Of Clinical Improvement,Lab Investigations |
- |
M08A04 |
J960 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.5 |
ARDS With Multi Organ Failure With Ventilatory Care 14 Days Stay |
CBC,Sr ElectrolitesFor ARDS packages Ventilator with NIV Mask / invasive ventilator should be discretion of treating physician,RFT,Machine generated ABG,LFT,Clinical photo,Chest X-Ray/ HRCT Chest |
Abg,Post Treatment Evidence Of Clinical Improvement,Lab Investigations(Cbc, Lft, Rft),Justification From Treating Dr For Standalone Niv Treatment(If Given) In Ards |
- |
M08A05 |
J960 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.6 |
ARDS Plus DIC (Blood & Blood Products) With Ventilatory Care - 14 Days |
CBC,Machine generated ABG,DIC profile,Clinical photo with ventilatory support,Chest X-Ray |
Abg,Post Treatment Evidence Of Clinical Improvement,Lab Investigations |
- |
M08A06 |
J960 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.7 |
OP Poisoning / Other Poisoning Requiring Ventilatory Assistance Clinical Photo - 5 days Stay |
Clinical photo on ventilator,Sr cholinesterase,RFT,Machine generated ABG |
Abg,Post Treatment Evidence Of Clinical Improvement,Lab Investigations |
- |
M02A46 |
T400X1 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.8 |
Septic Shock(ICU Management) With Ventilatory Assistance - 7 Days |
CBC,Xray chest,Urine R/M,USG,RFT,Machine generated ABG,Justification from treating Physician for necessity of ventilatory support if SpO2 is >80%, esp. of no evidence of alkalosis/acidosis,Clinical photograph |
Abg,Report Of Blood Culture/ Urine Culture,Post Treatment Evidence Of Clinical Improvement,Lab Investigations,If Blood Culture Report Is Negative Then Other Markers Of Sepsis Like Urine Culture/ Sputum Culture/Csf Analysis/ C3 Marker To Be Given To Confirm The Dignosis Of Septic Shock |
- |
M08A08 |
R6520 |
M3 |
Critical Care |
M3Q1 |
Critical Care |
M3Q1.9 |
OP or other Poisoning without Ventilatory Assistance Clinical Photo 7 days ICU Stay |
Machine generated ABG,X-Ray Chest,Sr cholinesterase,RFT |
LAB INVESTIGATIONS,Post Treatment Evidence Of Clinical Improvement |
- |
|
|
M5 |
Infectious Diseases |
M5R1 |
Infectious Diseases |
M5R1.1 |
Tetanus Severe 21 days |
ABG,Clinical Photo of posture |
Clinical Photograph Post Treatment E/O Clinical Improvement,Swab For C/S Mandatory For Claims Settlement |
- |
M08B01 |
A35 |
M5 |
Infectious Diseases |
M5R1 |
Infectious Diseases |
M5R1.2 |
Diphtheria Complicated 10 days |
Clinical photograph,Throat swab for C/S,ECG |
Lab Investigations |
- |
M08B02 |
A360 |
M5 |
Infectious Diseases |
M5R1 |
Infectious Diseases |
M5R1.3 |
Cryptococcal Meningitis 21 days |
Investigation foe cryptococcal antigen/ CSF India ink preparation |
Lab Investigations |
- |
M08B03 |
B458 |
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.1 |
Idiopathic Thrombocytopenic Purpura per day - Rs 4000 per day ICU stay - 7 Days. (IVIG and other Inj |
Bone Marrow,HBSAG,CBC |
Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.10 |
Refractory seizures - Rs 2000 per day |
CSF ANALYSIS,SERIAL ABG |
CT Scan,Post Procedure Evidance Of Clinical Imrovement With Lab Investigations,Eeg |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.11 |
Acute neuroregression |
CT ? Scan,MRI,Investigations justyfying the diagnosis |
Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.2 |
Juvenile myasthenia gravis - per day |
CT-Abdomen,Thyroid profile,RNS,Neostgmine test,CT-Chest |
Clinical and lab investigation |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.3 |
Intracranial ring enhancing lesion with complication (neurocysticercosis, tuberculoma) |
CT ? Scan,X-Ray Chest,ESR |
Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.4 |
Acute glomerulonephritis - 2000 per day - 5 days |
Urine Analysis,USG,CT and KFT |
Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.5 |
Infantile cholestasis - per day |
LFT,Urine BS - BP,USG Abdomen |
LFT |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.6 |
Haemolytic uremic syndrome |
CBC,USG Abdomen,RFT |
RFT |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.7 |
Immune haemolytic anemia per day |
Reticulocytes Count,PS,Coomb's Test,CBC |
CBC,PS,Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.8 |
Cyanotic spells |
2DEcho,CBC |
Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6PM1 |
Pediatrics Medical Management PMJAY Sub Category |
M6PM1.9 |
Rheumatoid arthritis - Rs 2000 per day - 5 days |
RA Factor |
Clinical Notes |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.1 |
Term Baby With Culture Positive Sepsis- Non Ventilated Hyperbilirubinemia |
BLOOD CULTURE/ CBC,SERUM BILIRUBIN,CRP |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations (Blood Culture/Crp/Cbc) |
- |
M19A01 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.10 |
Term Baby, Fulminant Culture Positive Sepsis, Septic Shock, Ventilated, Rs 6000 per day - 14 Days |
ABG APGAR Score to be mandate at time of admission,SERUM BILIRUBIN,RFT,CRP,BLOOD CULTURE / CBC |
Lab Investigations (Blood Culture/Crp/Cbc/Rft) Usg Abdomen Is Required In Claims Which Was There Previously,Post Procedure Evidance Of Clinical Imrovement |
- |
M19A02 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.11 |
32 To 36 Weeks Preterm Baby Hyaline Membrane Disease Clinical / Culture Positive Sepsis Bubble CPAP |
ABG,X- RAY CHEST,SERUM BILIRUBIN,CRP,CBC,APGAR Score (mandatory) |
ABG,X- RAY CHEST,Post Procedure Evidance Of Clinical Imrovement |
- |
M19A03 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.13 |
35 To 36 Weeks Preterm Hyaline Membrane Disease Culture Positive Sepsis Nonventilated Hyperbilirubin |
BLOOD CULTURE/ CRP/ CBC,X- RAY CHEST,SERUM BILIRUBIN APGAR Score to be mandate at time of admission |
Lab Investigations (Cbc, Sr Bilirubin),Post Procedure Evidance Of Clinical Imrovement |
- |
M02A48 |
P0737 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.14 |
33 To 34 Weeks Preterm Mild Hyaline Membrane Disease Culture Positive Sepsis ? Nonventilated Hyperbi |
CBC,X- RAY CHEST,SERUM BILIRUBIN APGAR Score to be mandate at time of admission,CRP/BLOOD CULTURE |
CRP,Post Procedure Evidance Of Clinical Imrovement,Lab Investigations (Cbc, Sr Bilirubin) |
- |
M02A49 |
P599 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.15 |
33 To 34 Weeks Preterm Severe Hyaline Membrane Disease Culture Positive Sepsis Mechanical Ventilatio |
ABG,X- RAY CHEST,SERUM BILIRUBIN,CRP,CBC,BLOOD CULTURE / CBC APGAR Score to be mandate at time of admission |
Lab Investigations (Cbc, Xray Chest /Abg),SERUM BILIRUBIN,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A50 |
P0736 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.16 |
32 To 36 Weeks Preterm Hyaline Membrane Disease Clinical/ Culture Positive Sepsis Mechanical Ventila |
ABG,X- RAY CHEST,SERUM BILIRUBIN,Clinical photo with ventilatory care,CRP/BLOOD CULTURE,CBC |
Lab Investigations (Cbc, Xray Chest /Abg),Post Procedure Evidance Of Clinical Imrovement |
- |
M02A51 |
P0733 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.17 |
<32 Weeks Preterm Severe Hyaline Membrane Disease Clinical/ Culture Positive Sepsis Mechanical Venti |
ABG,X- RAY CHEST,SERUM BILIRUBIN,CRP/ BLOOD CULTURE APGAR Score to be mandate at time of admission,CBC |
Lab Investigations (Cbc, Xray Chest /Abg),SERUM BILIRUBIN,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A52 |
P0732 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.18 |
33 To 34 Weeks Preterm Severe Hyaline Membrane Disease Clinical/Culture Positive Sepsis Patent Ductu |
2D ECHO,blood culture/ CRP,X- RAY CHEST,Serum bilirubin APGAR Score to be mandate at time of admission,CBC,ABG |
2D ECHO,Post Procedure Evidance Of Clinical Imrovement,Lab Investigations (Cbc, Xray Chest /Abg) |
- |
M02A53 |
Z3A34 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.19 |
Pre term - Necrotising Enterocolitis, Clinical Sepsis Ventilated - Rs 6000 - 14 Days |
CBC, Sr Bilirubin/ Reticulocyte Count/USG abdomen/ Blood Culture & Sensitivity |
CBC, Sr Bilirubin/ Reticulocyte Count/USG abdomen/ Blood Culture & Sensitivity |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.2 |
32-36 Weeks Preterm Hyaline Membrane Disease Clinical Sepsis Patent Ductus Arteriosus - Medical Mana |
2D ECHO,Xray chest APGAR Score to be mandate at time of admission,Sr Bilirubin,CBC ABG,Blood culture / CRP |
2D Echo,Post Procedure Evidance Of Clinical Imrovement,Lab Investigations (Cbc, Xray Chest /Abg) |
- |
M19A02 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.20 |
"Idiopathic Thrombocytopenic Purpura (Stay in general ward @Rs.1000/day/Stay in NICU @Rs.2000/day) + |
CBC with P.S/ Bone Marrow |
CBC with P.S |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.3 |
<32 Weeks Preterm Hyaline Membrane Disease Clinical/Culture Positive Sepsis Patent Ductus Arteriosus |
2D ECHO,X- RAY CHEST,Sr Bilirubin APGAR Score to be mandate at time of admission,CBC,Blood culture /CRP,ABG |
CRP,Post Procedure Evidance Of Clinical Imrovement,Lab Investigations (Cbc, Xray Chest /Abg) |
- |
M19A03 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.4 |
Term Baby With Persistent Pulmonary Hypertension Ventilation- HFO Clinical Sepsis - Rs 6000 per day |
2D ECHO APGAR Score to be mandate at time of admission,Xray chest,Sr. Bilirubin,ABG |
ABG,Xray chest,Sr. Bilirubin,Post Treatment Evidence Of Clinical Improvement And Lab Investigations |
- |
M19A04 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.5 |
Term Baby With Severe Perinatal Asphyxia - Non Ventilated Clinical Sepsis Hyperbilirubinemia 7 days |
CBC ,Sr Bilirubin APGAR Score to be mandate at time of admission,CRP/ BLOOD CULTURE |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement,Neurosonogram/Ct- Scan/ Mri |
- |
M19A05 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.6 |
Term Baby With Severe Perinatal Asphyxia - Ventilated Clinical Sepsis per day - Rs 6000 - 10 Days |
ABG,X- RAY CHEST,Sr Bilirubin APGAR Score to be mandate at time of admission,CRP/ BLOOD CULTURE,CBC |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement,Neurosonogram/Ct- Scan/ Mri |
- |
M19A06 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.7 |
Term Baby Severe Hyperbilirubinemia Clinical or Culture positive Sepsis per day - Rs 4000 - 7 Days |
CBC / CRP,SERUM BILIRUBIN APGAR Score to be mandate at time of admission |
( Cbc Sr Bilirubin) Blood Culture Report Is Mandatory At Time Of Claims,Post Procedure Evidance Of Clinical Imrovement,Lab Investigations |
- |
M19A07 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.8 |
Term Baby With Seizures Ventilated Inv - Neurosonogram, CT-Scan Brain, Ultrasound Abdomen, CSF Analy |
ABG APGAR Score to be mandate at time of admission,Electrolytes,Calcium,CSF ANALYSIS,Blood sugar |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations Neurosonogram/Ct- Scan/Mri) |
- |
M19A06 |
P578 |
M6 |
Pediatrics Medical Management |
M6S1 |
Paediatrics Neonatal |
M6S1.9 |
Necrotising Enterocolitis, Clinical Sepsis Non Ventilated per day - Rs 4000 - 14 Days |
CBC,Xray Abdomen ultrasound optional stool exam and usg mandatory for pre auth,CRP/Blood culture |
CBC,Xray Abdomen,Post Treatment Evidence Of Clinical Improvement,CRP |
- |
M24B04 |
P84 |
M6 |
Pediatrics Medical Management |
M6S10 |
Gen Pediatrics Respiratory |
M6S10.1 |
Acute Broncho/ Lobarpneumonia With Empyema/ Pleural Effusion per day - Rs 4000 per day - 10 Days |
CBC,X- RAY,Fluid Analysis |
CBC,X- Ray Chest,CRP |
- |
M24A21 |
J181 |
M6 |
Pediatrics Medical Management |
M6S11 |
Gen Paediatrics Cvs |
M6S11.1 |
Acute Broncho/ Lobarpneumonia With Pyo Pneumothorax 14 Days |
BLOOD CULTURE/ CBC/CRP,X- Ray,PUS CULTURE/ Gram stain |
CBC,X- Ray Chest,CRP |
- |
M02A59 |
J181 |
M6 |
Pediatrics Medical Management |
M6S11 |
Gen Paediatrics Cvs |
M6S11.2 |
Congenital Heart Disease With Congestive Cardiac Failure - 7 Days |
2D ECHO,X- RAY chest,ECG,CBC req at time of preauth |
Post Procedure Evidence Of Post Procedure Evidance Of Clinical Imrovement 2D Echo,X- Ray Chest |
- |
M02A60 |
Q209 |
M6 |
Pediatrics Medical Management |
M6S11 |
Gen Paediatrics Cvs |
M6S11.3 |
Acquired Heart Disease With Congestive Cardiac Failure- 7 Days Stay |
2D ECHO,X- Ray,ECG |
2D ECHO,Post Treatment Evidence Of X-Ray Chest,ECG |
- |
M23A01 |
P2989 |
M6 |
Pediatrics Medical Management |
M6S11 |
Gen Paediatrics Cvs |
M6S11.4 |
Viral Myocarditis 7 Days Stay |
2D ECHO,X- Ray,ECG |
2D ECHO,X- Ray Chest,ECG |
- |
M02A61 |
B3322 |
M6 |
Pediatrics Medical Management |
M6S12 |
General Paediatrics Renal |
M6S12.1 |
Steroid Resistant Nephrotic Syndrome Complicated - per day - Rs 2500 - 14 Days |
RFT'S MANDATORY AT THE TIME OF PREAUTH.,URINE EXAM,RENAL BIOPSY SOS |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations( Urine Albumin, Hpe If Biopsy Done) |
- |
M16A02F |
N04 |
M6 |
Pediatrics Medical Management |
M6S12 |
General Paediatrics Renal |
M6S12.2 |
Urinary Tract Infection With Complications Like Pyelonephritis And Renal Failure - 10 Days Stay |
BUN,Urine R/M / URINE FOR CULTURE AND SENSITIVITY/ USG,Sr. Creat |
Post Procedure Evidance Of Clinical Imrovement And Urine Culture/ Uriner/M / Usg |
- |
M24A24 |
P9689 |
M6 |
Pediatrics Medical Management |
M6S12 |
General Paediatrics Renal |
M6S12.3 |
Acute Renal Failure without dialysis Rs 1500 per day - Length of stay 10 days |
ELECTROLYTES req at time of preauth,RFT |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations (Rft) |
- |
M24A15 |
P960 |
M6 |
Pediatrics Medical Management |
M6S12 |
General Paediatrics Renal |
M6S12.4 |
Acute Renal Failure With Dialysis - 10 Days Stay. |
RFT,Uric acid / SERUM ELECTROLYTES(optional) |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations (Rft) |
- |
M24A25 |
P9689 |
M6 |
Pediatrics Medical Management |
M6S14 |
General Paediatrics Infections |
M6S14.1 |
Pyogenic Meningitis per Day ICU Stay - 10 Days Rs 4000 per day |
CSF ANALYSIS ,X- RAY CHEST |
Post Procedure Evidance Of Clinical Imrovement And Csf Analysis |
- |
M24A27 |
P84 |
M6 |
Pediatrics Medical Management |
M6S14 |
General Paediatrics Infections |
M6S14.2 |
Neuro Tuberculosis- 10 Days Stay - DOTS Rx Free without ventilator - Rs 1500 per day |
CSF ANALYSIS,X- RAY CHEST,CT- SCAN BRAIN |
Lab Investigations,Post Procedure Evidance Of Clinical Improvement |
- |
M24A28 |
P84 |
M6 |
Pediatrics Medical Management |
M6S14 |
General Paediatrics Infections |
M6S14.3 |
Neuro Tuberculosis With Ventilation- per day Stay - DOTS Rx Free - Rs 6000 - 10 Days |
ABG,X- RAY CHEST,CT- SCAN BRAIN,CSF ANALYSIS |
Lab Investigations,Post Procedure Evidance Of Clinical Improvement |
- |
M02A63 |
A1781 |
M6 |
Pediatrics Medical Management |
M6S14 |
General Paediatrics Infections |
M6S14.4 |
Suspected Dengue Shock Syndrome With Thrombocytopenia - 7 Days |
CBC (PLATELET COUNT) / Dengue SEROLOGY |
CBC,Evidence Of Platelet Transfusion If Given |
- |
M24A17 |
A91 |
M6 |
Pediatrics Medical Management |
M6S14 |
General Paediatrics Infections |
M6S14.5 |
Cerebral Malaria (Falciparum) 7 Days Stay |
Blood sugar,Test for P. Falciparum PARASITE,CSF ANALYSIS |
Lab Investigations,Post Procedure Evidance Of Clinical Improvement |
- |
M08B04 |
B500 |
M6 |
Pediatrics Medical Management |
M6S15 |
General Paediatrics Neurology |
M6S15.2 |
Stroke Syndrome-per day - Rs 2000 - 10 Days |
CT |
Post Treatment Evidence Of Clinical And Lab Investigation |
- |
M02A65 |
G463 |
M6 |
Pediatrics Medical Management |
M6S15 |
General Paediatrics Neurology |
M6S15.3 |
Encephalitis / Encephalopathy - per Day Stay - Rs 1500 - 14 Days |
CSF Analysis,CT-brain/ MRI |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A66 |
G05 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.1 |
Severe Bronchiolitis (Ventilated) per day - Rs 6000 - 10 Days |
CLINICAL PHOTOGRAPH,X- RAY CHEST |
X-Ray |
- |
M02A54 |
Z382 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.2 |
Severe Bronchiolitis (Non Ventilated) per day High Flow Nasal Canula - Rs 4000 - 7 Days |
ABG,X- RAY CHEST,CLINICAL PHOTOGRAPH |
ABG,X-Ray |
- |
M24A01 |
P369 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.3 |
Severe Bronchopneumonia (Non Ventilated) per day - Rs 4000 - 7 Days |
X-Ray Chest re at the time of preauth |
X-Ray |
- |
M24A02 |
P369 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.4 |
Severe Bronchopneumonia (Ventilated) per day - Rs 6000 - Length of stay 10 days |
Clinical photo with ventilatory support SERIAL ABG,X-RAY CHEST |
ABG,X-Ray |
- |
M24A03 |
J191 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.5 |
Acute Severe Asthma with CPAP or high flow canula per day - Rs 4000 - 10 Days |
Clinical photo with ventilatory support SERIAL ABG,X-RAY CHEST |
ABG,X-Ray |
- |
M24A04 |
P369 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.6 |
Severe Aspiration Pneumonia (Non Ventilated) ICU Stay per day - Rs 4000 - 7 Days |
X-RAY CHEST |
Lab Investigations,Post Procedure Evidance Of Clinical Imrovement And Xray |
- |
M02A55 |
J690 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.7 |
Severe Aspiration Pneumonia (Ventilated) per day - Rs 6000 - 10 Days |
Clinical photo with ventilatory support SERIAL ABG,X-RAY CHEST |
ABG,Post Procedure Evidance Of Clinical Imrovement And Xray Chest |
- |
M02A56 |
J954 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.8 |
ARDS With Multi- Organ Failure per day with invasive ventilator or BIPAP - Rs 6000 per day -15 Days |
ABG,X- RAY CHEST,RFT,LFT,CLINICAL PHOTOGRAPH |
ABG,Xray Chest Blood Culture At Claim,Lab Investigations (Lft, Rft) |
- |
M08A05 |
J960 |
M6 |
Pediatrics Medical Management |
M6S2 |
Pediatric Ic Care Respiratory |
M6S2.9 |
ARDS Plus DIC (Blood & Blood Products) per day with invasive ventilator or BIPAP - Rs 6000 - 14 days |
ABG optional,X- RAY CHEST,COAGULATION PROFILE |
Lab Investigations( Coagulation Profile Optional) Blood Culture At Claim,X- RAY CHEST |
- |
M08A06 |
J960 |
M6 |
Pediatrics Medical Management |
M6S3 |
Pediatric Ic Care Cardiovascular |
M6S3.1 |
Severe Myocarditis - 10 Days |
2 D Echo,X- RAY CHEST,ECG |
Post Procedure Evidance Of Clinical Imrovement And X-Ray |
- |
M24A05 |
P369 |
M6 |
Pediatrics Medical Management |
M6S3 |
Pediatric Ic Care Cardiovascular |
M6S3.2 |
Congenital Heart Disease With Infection (Non Ventilated) ICU Stay 7 days |
2 D Echo,X- RAY CHEST,CBC / CRP |
Post Procedure Evidance Of Clinical Imrovement And X-Ray |
- |
M24A04 |
P369 |
M6 |
Pediatrics Medical Management |
M6S3 |
Pediatric Ic Care Cardiovascular |
M6S3.3 |
Congenital Heart Disease With Infection And Cardiogenic Shock (Ventilated) per day - Rs 6000 - 10 Da |
2D ECHO,clinical photo with ventilatory support,X- RAY CHEST,SERIAL ABG |
Post Procedure Evidance Of Clinical Imrovement Photo And Abg,X-Ray |
- |
M24A04F |
Q249 |
M6 |
Pediatrics Medical Management |
M6S3 |
Pediatric Ic Care Cardiovascular |
M6S3.4 |
Cardiogenic Shock or severe myocarditis per day PICU stay - Rs 5000 - 10 Days |
ECHO /CVP Monitoring,X-RAY CHEST |
Post Procedure Evidance Of Clinical Imrovement Photo And X-Ray |
- |
M02A57 |
R570 |
M6 |
Pediatrics Medical Management |
M6S3 |
Pediatric Ic Care Cardiovascular |
M6S3.5 |
Infective Endocarditis per day - Rs 4000 - 15 Days |
CBC,ECHO,CRP/BLOOD CULTURES X- RAY CHEST |
Post Procedure Evidance Of Clinical Imrovement Photo And Blood Culture |
- |
M02A58 |
I330 |
M6 |
Pediatrics Medical Management |
M6S4 |
Pediatric Ic Care Cns |
M6S4.1 |
Meningo-Encephalitis (Non Ventilated) - Rs 4000 - 14 Days |
CSF ANALYSIS,CT- SCAN |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations ( Csf Analysis) |
- |
M24A08 |
P84 |
M6 |
Pediatrics Medical Management |
M6S4 |
Pediatric Ic Care Cns |
M6S4.2 |
Meningo- Encephalitis (Ventilated) per day - Rs 6000 - 15 Days |
CSF ANALYSIS,SERIAL ABG,Clinical photo with ventilatory support,CT- SCAN |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations ( Csf Analysis) |
- |
M24A09 |
P84 |
M6 |
Pediatrics Medical Management |
M6S4 |
Pediatric Ic Care Cns |
M6S4.3 |
Status Epilepticus per day PICU stay - Rs 4000 - 7 Days. Rs 30000 if complete 7 days stay |
Clinical Notes,EEG optional |
Eeg/ Ct Scan,Post Procedure Evidance Of Clinical Imrovement With Lab Investigations |
- |
M24A09 |
P84 |
M6 |
Pediatrics Medical Management |
M6S4 |
Pediatric Ic Care Cns |
M6S4.4 |
Febrile Seizures (Atypical- Mechanical Ventilated) per day - Rs 6000 - 7 Days |
CSF ANALYSIS,SERIAL ABG |
Eeg/ Ct Scan,Post Procedure Evidance Of Clinical Imrovement With Lab Investigations |
- |
M24A07 |
P90 |
M6 |
Pediatrics Medical Management |
M6S4 |
Pediatric Ic Care Cns |
M6S4.5 |
Intra Cranial Bleed without ventilator per day - Rs 4000 - 10 Days |
CT- SCAN/ MRI |
Post Procedure Evidance Of Clinical Imrovement With Lab Investigations |
- |
M24A10 |
P84 |
M6 |
Pediatrics Medical Management |
M6S5 |
Pediatric Ic Care Git |
M6S5.1 |
Acute Gastro Intestinal Bleed Inv - ABG/Upper GI Endoscopy, USG Abdomen PICU Stay With Post Treatmen |
Upper GI Endoscopy |
Post Treatment Evidence For Clinical Improvement With Lab Investigations |
- |
M24A11 |
P781 |
M6 |
Pediatrics Medical Management |
M6S5 |
Pediatric Ic Care Git |
M6S5.2 |
Acute Pancreatitis - Rs 4000 per day PICU Stay - 12 Days. Rs 50000 for complete LOS of 12 days |
LIPASE,USG/CT SCAN ABDOMEN,SERUM AMYLASE |
Post Procedure Evidance Of Clinical Imrovement With Lab Investigations( Sr. Amylase, Sr Lipase) |
- |
M24A12 |
P781 |
M6 |
Pediatrics Medical Management |
M6S5 |
Pediatric Ic Care Git |
M6S5.3 |
Acute Hepatitis With Hepatic Encephalopathy ? Rs 4000 per day - 14 Days |
ABG,USG req,S. AMMONIA,LFT,HEPATIC VIRAL STUDIES (HEPATITIS B, HEPATITIS C),(HEPATITIS A optional),BLOOD SUGAR LEVELS |
Post Procedure Evidance Of Clinical Imrovement With Lab Investigations ( Lft, Sr. Ammonia) |
- |
M24A13 |
P781 |
M6 |
Pediatrics Medical Management |
M6S6 |
Pediatric ICU Care Renal |
M6S6.1 |
Acute Renal Failure With Dialysis Haemodialysis or Peritoneal Dialysis - Rs 4000 per Day PICU Stay - |
RFT,XRAY CHEST,USG MANDATORY ,SERUM ELECTROLYTES |
Post Procedure Evidance Of Clinical Imrovement And Lab Investigations (Rft) |
- |
M24A14 |
P781 |
M6 |
Pediatrics Medical Management |
M6S7 |
Pediatric ICU Care Endocrine |
M6S7.1 |
Diabetic Ketoacidosis - per day PICU Stay - 7 Days |
ABG optional,Urine Ketone,Blood sugar |
Blood Sugar,Post Treatment Evidence For Clinical Improvement With Biochemical Parameters |
- |
M24A15 |
P960 |
M6 |
Pediatrics Medical Management |
M6S8 |
Pediatric ICU Care Infection |
M6S8.1 |
Septic Shock- per Day PICU ventilated - Rs 6000 - 10 Days |
ABG,X- RAY CHEST,CRP,CBC,BLOOD SUGAR LEVELS MANDATORY |
Blood Culture,Post Procedure Evidance Of Clinical Imrovement With Lab Investigations(Cbc, Crp) |
- |
M24A06 |
P84 |
M6 |
Pediatrics Medical Management |
M6S9 |
Pediatric Ic Care Toxicology |
M6S9.1 |
Snake Bite Requiring Ventilatory Assistance With 10 Days PICU Stay |
Serial ABG,coagulation profile(optional) |
ABG,Picu Stay With Post Treatment Evidence For Clinical Improvement With Biochemical Parameters |
- |
M12A05 |
D759 |
M6 |
Pediatrics Medical Management |
M6S9 |
Pediatric Ic Care Toxicology |
M6S9.2 |
Scorpion Sting With Myocarditis And Cardiogenic Shock Requiring Ventilatory Assistance 10 Days ICU S |
CVP monitoring,Serial ABG,Echo,ECG |
Post Treatment Evidence For Clinical Improvement With Lab Investigations |
- |
M24A19 |
T63001A |
M6 |
Pediatrics Medical Management |
M6S9 |
Pediatric Ic Care Toxicology |
M6S9.3 |
Poison Ingestion/ Aspiration Requiring Ventilatory Assistance per day PICU Stay - Rs 6000 - 10 Days |
CVP monitoring(optional),Serial ABG |
Mlc,Post Treatment Evidence For Clinical Improvement With Biochemical Parameters |
- |
M24A20 |
T63001A |
M7 |
Cardiology |
M7F1 |
Angioplasty |
M7F1.1 |
Coronary Balloon Angioplasty |
Coronary Angiography report & Video |
Angioplasty Video,Stent Stickers Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video |
- |
S02A01 |
I2101 |
M7 |
Cardiology |
M7F1 |
Angioplasty |
M7F1.2 |
PTCA Additional Stent |
Coronary Angiography report & Video |
Angioplasty Video,Stent Stickers Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video |
- |
S02A03 |
I2101 |
M7 |
Cardiology |
M7F1 |
Angioplasty |
M7F1.4 |
Renal Angioplasty |
Angiography |
Angioplasty Video,Stent Stickers Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video |
- |
S02A17 |
I701 |
M7 |
Cardiology |
M7F1 |
Angioplasty |
M7F1.5 |
Vertebral Angioplasty |
Angiography |
Angioplasty Video,Stent Stickers Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video |
- |
S02A19 |
M47029 |
M7 |
Cardiology |
M7F1 |
Angioplasty |
M7F1.6 |
Peripheral Angioplasty |
Angiography |
Angioplasty Video,Stent Stickers Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video |
- |
S02A18 |
I70209 |
M7 |
Cardiology |
M7F3 |
Cardiology Pacemaker Implantation |
M7F3.1 |
Single chamber Permanent Pacemaker Implantation - 5 Days |
ECG with date & name of patient (preferably printed) |
Ecg,X-Ray Chest/ Fluoroscopic Image,Post Procedure Clinical Photo |
- |
S02A12 |
I479 |
M7 |
Cardiology |
M7F3 |
Cardiology Pacemaker Implantation |
M7F3.2 |
Temporary Pacemaker Implantation - 2 Days |
ECG with date & name of patient (preferably printed) |
Ecg,Post Procedure Clinical Photo |
- |
S02A13 |
I479 |
M7 |
Cardiology |
M7F4 |
Coarctation Of Aorta Repair / Aortoplasty |
M7F4.1 |
Coarctation Of Aorta Repair With Stent |
2D ECHO,CT Aortogram |
Claims Approval,Sticker,Fluroscopy |
- |
S02A14 |
Q251 |
M7 |
Cardiology |
M7F4 |
Coarctation Of Aorta Repair / Aortoplasty |
M7F4.2 |
Coarctation Of Aorta Repair Without Stent |
- |
- |
- |
S02A15 |
Q251 |
M7 |
Cardiology |
M7PM1 |
Cardiology PMJAY Sub Category |
M7PM1.1 |
Alcohol septal ablation for hypertrophic Obstructive Cardiomyopathy |
2D ECHO report |
stills of ECHO,2D ECHO report |
- |
|
|
M7 |
Cardiology |
M7PM1 |
Cardiology PMJAY Sub Category |
M7PM1.2 |
PTSMA (Percutaneous Transluminal Septal Myocardial Ablation) |
2D ECHO,ECG,CAG stills showing blocks & reports |
Post op. Angiogram report,showing stent & post Stent flow,carton of the stents used approved by FDA/DCGI only |
- |
|
|
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.1 |
Pulmonary artery stenting |
Angiogram report & stills/ Video |
Post procedure Angio stills |
- |
|
|
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.10 |
Pericardial Effusion / Tamponade - 4 days |
2D ECHO |
2D Echo,Lab Investigations Of Pericardial Fluid |
- |
M01A10 |
I4430 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.11 |
Thrombolytic Therapy for Acute MI - 5 Days |
Cardiac Enzymes,Serial ECG with date & name |
Clinical notes,Lab Investigations |
- |
M01A01 |
I2101 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.12 |
Right ventricular outflow tract (RVOT) stenting |
Angiogram report & stills/ Video |
2D ECHO,Post procedure Angio stills |
- |
|
|
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.13 |
Percutaneous Transluminal Tricuspid Commissurotomy (PTTC) |
2D ECHO |
2D ECHO,Fluroscopy Images |
- |
|
|
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.14 |
ASD Device Closure |
2D ECHO |
Fluroscopy Video/Images,Stickers As And Where Applicable,Ot Notes |
- |
S02A04 |
Q211 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.15 |
Coil Closure Multiple Coils (MAPCA - Major Aortopulmonary Collaterals) |
2D ECHO |
Fluroscopy Video/Images,Stickers As And Where Applicable,Ot Notes |
- |
S02A09 |
Q250 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.16 |
Coil Closure Single Coil (PDA etc) |
2D Echo |
Fluroscopy Video/Images,Stickers As And Where Applicable,OT Notes |
- |
S02A08 |
Q250 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.17 |
Coronary - Cameral Fistula closure / Pulmonary AV fistula Closure /PDA Device Closure |
2D Echo |
Fluroscopy Video/Images,Stickers As And Where Applicable,OT Notes |
- |
S02A07 |
Q250 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.18 |
PDA Stenting |
2D Echo |
Fluroscopy Video/Images,Stickers As And Where Applicable,OT Notes |
- |
S02A06 |
Q250 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.2 |
Pulmonary artery stenting (double) |
Anigo,CT Pul angio/ angio |
Clinical Notes,ECG,Ct Pulm (Submitted During Preauth) |
- |
|
|
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.3 |
Acute MI With Cardiogenic Shock - 7 Days |
2D Echo,ECG with date & name,Clinical notes,Cardiac Enzymes |
Clinical notes,Lab Investigations |
- |
M01A03 |
I2101 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.4 |
Acute MI Requiring IABP Pump - 7 Days |
2D Echo,TROPONIN/CPKMB,ECG,Clinical notes |
Clinical Notes Iabp Sticker Mandatory At The Time Of Claim,Lab Investigations |
- |
M01A02 |
I2101 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.5 |
Refractory Cardiac Failure - 5 Days |
2D Echo,Patient has to be certified by cardiologist/Physician for the same,Evidence of treatment resulting in refractory cardiac failure,ECG |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement & 2D Echo |
- |
M01A05 |
I428 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.6 |
Infective Endocarditis |
2D Echo,ESR,ECG,CBC,Blood culture |
Blood Culture (Can Be Negative),Post Procedure Evidence Of Clinical Improvement & Ecg,Lab Investigations |
- |
M01A06 |
I400 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.7 |
Pulmonary Embolism - 5 Days |
CT Pul angio/ angio,Doppler |
Clinical notes,ECG,Ct Pulm (Submitted During Preauth) |
- |
M01A07 |
I400 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.8 |
Complex Arrhythmias - 2 Days |
ECG with date & name of patient (preferably printed) |
Clinical Notes,Then Procedure Notes Are Mandatory For Claims,Ecg Cartoguided Ablation If Done |
- |
M01A08 |
I4430 |
M7 |
Cardiology |
M7T1 |
Cardiology |
M7T1.9 |
Simple Arrhythmias - 2 Days |
ECG with date & name of patient (preferably printed) |
Clinical Notes,Then Procedure Notes Are Mandatory For Claims,Ecg Focus Ablation If Done |
- |
M01A09 |
I4430 |
M8 |
Nephrology |
M8S1 |
Nephrology |
M8S1.1 |
A V Fistula At Elbow or Wrist - Day Care |
COLOR DOPPLER |
Clinical Photo/Color Doppler |
- |
S35A02 |
N186 |
M8 |
Nephrology |
M8S1 |
Nephrology |
M8S1.2 |
Resistant Nephritic Syndrome - 5 days stay |
COLOR DOPPLER |
Clinical Photo/Color Doppler |
- |
S35A01 |
|
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.1 |
Post-Transplant Immunosuppression Treatment After Transplantation for first 6 months of a year.To be |
USG/RFT |
BILLS COPY |
- |
|
|
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.2 |
Acute Renal Failure-(ARF) -10 Days Stay in ICU or General ward |
RFT,USG Abdomen,Sr. Electrolites,S. Protein |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M24A15 |
P960 |
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.3 |
Nephrotic Syndrome - 4 Days Stay (Except Diabetic Nephropathy) |
RFT,USG Abdomen,S. Protein |
Lab Investigations,Renal Biopsy,Post Treatment Evidence Of Clinical Improvement |
- |
M16A02 |
N19 |
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.4 |
Rapidly Progressive Renal Failure (RPRF)10 Days |
ANA/DsDNA/ANCA/C3 /C4 optional,USG Abdomen,Sr. Electrolites,S. Protein,RFT |
Lab Investigations,Renal Biopsy,Post Treatment Evidence Of Clinical Improvement |
- |
M16A03 |
N19 |
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.5 |
Chronic Renal Failure (CRF) - 10 Days Stay for Initial treatment and Dialysis and supportive therapy |
RFT,USG Abdomen( At the time of first preauthorisation),USG Abdomen,Sr. Electrolites,S. Protein,RFT |
Lab Investigations,Sr. Creatinine Photo Of Each Dialysis Sessions Mandatory For Claim,Post Treatment Evidence Of Clinical Improvement |
- |
M16A04 |
N19 |
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.6 |
Maintenance Haemodialysis For CRF- Dialysis and supportive therapy (12 dialysis per 28 days or as pe |
S. Protein,USG Abdomen,RFT |
Post Treatment Evidence Of Clinical Improvements ,Sr. Creatinine Photo Of Each Dialysis Sessions Mandatory For Claim |
- |
M16A05 |
N19 |
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.7 |
Post-Transplant Immunosuppression Treatment After Transplantation for second 6 months of a year.To b |
USG/RFT |
BILLS COPY |
- |
|
|
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.8 |
Post-Transplant Immunosuppression Treatment From 25th To 30th Month After Transplantation |
USG/RFT |
BILLS COPY |
- |
|
|
M8 |
Nephrology |
M8T2 |
Nephrology |
M8T2.9 |
Post-Transplant Immunosuppression Treatment From 31st To 36th Month After Transplantation |
USG/RFT |
BILLS COPY |
- |
|
|
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.1 |
CIDP -10 Days Stay |
CSF ANALYSIS,SERUM PROTEIN ELECTROPHORESIS,NERVE BIOPSY(optional),NCS,EMG |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A05 |
G35 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.10 |
Management of optic Neuritis - 5 Days Stay |
CSF Analysis,VEPs,MRI Brain and optic nerves |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A03 |
G35 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.11 |
Immunoglobulin Therapy -5 Days Stay as per indications of Concerned specialist |
CSF Analysis,sr.pottassium,Investigation Indicative of Disease |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A04 |
G35 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.12 |
ADEM or NMO Spectrum disorders or Transverse Myelitis or relapse in Multiple Sclerosis 10 Days Stay |
CSF ANALYSIS,MRI BRAIN/ SPINAL CORD (3 SITES) PLAIN/ CONTRAST |
Clinical Improvement,Lab Investigations |
- |
M17A01 |
G35 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.13 |
Management of Guillian-Barre Syndrome 15 Days Stay |
CSF Analysis,sr.pottassium |
EMG,Post Treatment Evidence Of Clinical Improvements & Lab Investigations,Nerve Conduction Study |
- |
M23A11 |
Q079 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.2 |
Haemorrhagic Stroke/Strokes Management with all necessary investigations 15 days stay without surger |
CT-Brain/ MRI/MRV/MRA,ECG - not mandatory |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A06 |
G463 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.3 |
Ischemic Strokes-Management with all necessary investigations without Thrombolysis 7 days stay |
CT-Brain/ Carotid vertebral doppler |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A07 |
G463 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.4 |
Myopathies - Acquired NCS, 15 Days Stay |
EMG,Serum alkaline phosphatase,Muscle biopsy,Endocrine evaluation |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A08 |
G35 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.5 |
Neuroinfections - Fungal Meningitis- 10 Days - ICU stay |
CSF analysis,cell count,CT Brain/MRI Brain,ADA |
Lab Investigations/ Blood Culture,Post Treatment Evidence Of Clinical Improvement |
- |
M17A12 |
G031 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.6 |
Neuroinfections - Pyogenic Meningitis - 7 Days - ICU |
CSF analysis,cell count,CT Brain/MRI Brain,ADA |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A10 |
G031 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.7 |
Neuroinfections - Viral Meningoencephalitis (Including Herpes Encephalitis) - 7 Days - ICU |
CSF Antibodies for HSV,CT/MRI Brain,CSF analysis |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A12 |
G031 |
M9 |
Neurology |
M9T3 |
Neurology |
M9T3.8 |
Neuromuscular (Myasthenia Gravis or LEMS) -10 Days Stay |
RNS/ CT chest/ Neostigmine test/ thyroid profile |
Lab Investigations,Post Treatment Evidence Of Clinical Improvement |
- |
M17A09 |
G35 |
M9 |
Neurology |
M9T4 |
Epilepsy |
M9T4.1 |
Convulsive Disorders/Status EpileptICUs (Fits) - 7 Days Stay |
Blood Sugar,ELECTROLYTES |
Lab Investigations Eeg / Ct-Brain,Post Procedure Evidance Of Clinical Imrovement |
- |
M02A64 |
G40821 |
M7 |
Cardiology |
M7T1 |
Cardiology |
CAG12.1 |
CAG |
2D ECHO/ECG |
CAG report,CAG CD |
- |
|
|
S9 |
Genitourinary System |
S9H4 |
Lithotripsy |
DJR1.1 |
DJ Stent Removal |
|
|
- |
|
|
CGHS |
Orthopedic Surgery And Procedures |
CGHS |
Orthopedics |
TPA-IPD822 |
Removal of Wires & Screw |
|
|
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.8 |
Hemiarthroplasty (Bipolar) |
Clinical Photograph,X-Ray |
Clinical Photograph,X-Ray,Scar photo |
- |
|
|
S1 |
General Surgery |
S1A6 |
General Surgery |
S1A6.1 |
Surgery of low fistula in ano |
CLINICAL PHOTOGRAPH,FNAC |
CLINICAL PHOTOGRAPH with face of patient |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F9 |
Valve Replacement |
S7F9.1 |
Aortic Valve Replacement (With Mechanical
valve) |
2D ECHO |
2D Echo/ Xray,Post Surgery Photo,Operation Notes (Female Patients May Be Made An Exception For Scar Photo),Bar Code Sticker |
- |
S02B08 |
I060 |
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.10 |
Removal of implants with screws |
Preprocedure X Ray |
Post Procedure X Ray |
- |
|
|
S10 |
Neurosurgery |
S10I14 |
Neurovascular Bypass Surgeries |
S10I14.1 |
EATV (Extra Axial Third Ventriculostomy) |
CT Scan / MRI |
Clinical Photograph. Post op CT |
- |
|
|
S10 |
Neurosurgery |
S10I14 |
Neurovascular Bypass Surgeries |
S10I14.2 |
Encephaloduroangiomyo synangiosis (EDAMS) |
CT Angio / MRI Angio / DSA |
Clinical Photograph,Post op CT |
- |
|
|
S10 |
Neurosurgery |
S10I14 |
Neurovascular Bypass Surgeries |
S10I14.3 |
Neurovascular Bypass Surgeries |
CT Angio / MRI Angio / DSA |
Clinical Photograph,Post op CT |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.1 |
Neurosurgical Trauma Consertative Management Stay ICU with ventilator -6000 per day - 7 days stay |
X- RAY/ CT/ MRI |
Clinical notes |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.2 |
Stereotactic assisted brain tumor surgeries - |
?CT/MRI |
CT/MRI/HPE |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.3 |
Tethered cord syndrome with anomalies of bone, dura and spinal cord |
X Rsy/ CT/MRI |
CT/MRI/X-ray |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.4 |
Decompression or fixation for CV Junction anomalies |
?X Rsy/ CT/MRI |
CT/MRI/X-ray |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.5 |
Endoscopic Discectomy |
MRI/ CT |
Clinical Photograph/X-Ray/Ct/Mri |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.6 |
Laminectomy (Cervical / Thoracic / Lumbar) |
MRI/ CT |
Clinical Photograph /X-Ray/Ct/Mri |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.7 |
Surgery for Spinal Tumours Intramedullary / Extramedullary / Bone |
MRI/ CT |
Clinical Photograph/Xray/ Ct/Mri,Hpe |
- |
|
|
S10 |
Neurosurgery |
S10I4 |
Spinal Surgeries |
S10I4.8 |
Transtoracic Anterolateral decompression with fusion |
CT/MRI |
CT/MRI/ X Ray and Scar photo |
- |
|
|
S10 |
Neurosurgery |
S10I5 |
Spinal Surgeries |
S10I5.13 |
Spine - Extradural Tumour with fixation |
CT/MRI/X-ray |
CT/MRI/X-ray |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.1 |
Brain abscess aspiration under GA |
CT/MRI |
Post op scar CT/MRI |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.2 |
Intracranial pressure probe insertion for moderate to severe brain injuries or Haemorrhage |
CT/MRI |
CT/MRI Monitoring photograph |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.3 |
Surgical procedure of Aneurysm clipping |
CT/MRI/DSA |
CT/MRI/DSA with sticker of clip |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.4 |
Cranioplasty using artificial implant |
X Ray |
CT |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.5 |
Surgical repair of Meningoencephalocele |
CT/MRI |
Photograph/Ct/Xray |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.6 |
Skull base tumors excision |
CT/MRI |
CT/MRI/ X Ray and Scar photo |
- |
|
|
S10 |
Neurosurgery |
S10I7 |
Brain Tumours |
S10I7.7 |
Surgery for CSF Rhinorroea / Otorrhoea - Open / Endoscopic |
CT/MRI |
CT/MRI/ X Ray |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.1 |
Haemostatic surgery in advanced cancer patient or Haemostatic Radiotherapy |
Clinical photo,Evidence of advanced Malignancy |
Clinical documents,Intraoperative photo |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.10 |
Sacral tumor Excision |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.11 |
Fasciocutaneous flap |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.12 |
Vertebral tumor excision and reconstruction |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.13 |
Orbital decompression |
CT/MRI,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.14 |
Clival tumor excision |
CT/MRI,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.15 |
Subtotal petrosectomy |
CT/MRI,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.16 |
Skull base surgery Fisch / Translabyrynthine / Transcochlear approach |
CT/MRI,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.17 |
Total Pharyngectomy |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.18 |
Tracheal stenosis (End to end anastamosis) |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.19 |
Central airway tumor debulking |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.2 |
Wide Excision of Tumor |
Biopsy and CT Neck |
Post op HPR,Scar photo |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.20 |
Mediastinal tumour or Lymphadenectomy |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.21 |
Wedge excision and Vermilionectomy |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.22 |
Cheek advancement |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.23 |
Excision of tumor of oral cavity or paranasal sinus or Laryngopharynx without reconstruction |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.24 |
Excision of tumor of oral cavity or paranasal sinus or Laryngopharynx with reconstruction |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.25 |
Open laryngeal framework surgery or Thyroplasty |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.26 |
Selective pharyngeal diverticulum excision |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.27 |
Maxillary swing |
CT/MRI,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.28 |
Excision of rectal polyp |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.29 |
Ureteric End to end anastamosis |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.3 |
Wertheims Hysterectomy |
HPR and CT |
Post op HPR,Scar photo |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.30 |
Radical Urethrectomy |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.31 |
Germ cell tumor excision |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.32 |
Partial Cystectomy |
HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.4 |
Tracheal stenting |
Clinical photo,HPR |
Procedure video,Surgery notes,Stent sticker |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.5 |
Intersphinctoric Resection Open/ Laparoscopic |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.6 |
Hepatoblastoma - Excision |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.7 |
Wilms tumour surgery |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.8 |
Leiomyoma Excision |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11J39 |
Skull base surgery |
S11J39.9 |
Radical Trachelectomy |
Clinical photo,HPR |
Post op HPR,Surgery notes |
- |
|
|
S11 |
Surgical Oncology |
S11K13 |
Genitourinary |
S11K13.13 |
Penile preserving Surgery (WLE, Glansectomy, Laser) |
BIOPSY / CLINICAL PHOTOGRAPH |
Hpe,Post Procedure Clinical Photograph,Operative Notes |
- |
|
|
S12 |
Plastic Surgery |
S12M3 |
Plastic Surgery |
S12M3.1 |
Vascular Malformations - Major more than 5 Cms |
MR angio/Doppler study |
Clinical Photo Of Affected Part |
- |
|
|
S12 |
Plastic Surgery |
S12M3 |
Plastic Surgery |
S12M3.2 |
Non healing wound - Diabetic foot dail dressing with skin grafting including antidiabetics |
Clinical Photo,X-ray,Lab Investigation |
Clinical Photo |
- |
|
|
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.13 |
Corneoscleral tear |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.15 |
Lid tear |
Geotagged Photograph of patient and wounds,Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done,Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O11 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S14O11.22 |
Scleral tear |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O12 |
Poly Trauma |
S14O12.1 |
Stabilization of patient with Long Bone Fractures before internal fixation |
Geotagged Photograph of patient/wounds & X ray |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O2 |
Poly Trauma |
S14O2.1 |
Trauma associated with less than 10-15 % BURNS (CONSERVATIVE MANAGEMENT) |
Geotagged |
Police Information |
- |
S27N01 |
|
S14 |
Poly Trauma |
S14O3 |
Neurosurgical Trauma |
S14O3.1 |
Black eye with haemorrhage (day care basis) |
Geotagged |
Police Information |
- |
S27N03 |
|
S14 |
Poly Trauma |
S14O3 |
Neurosurgical Trauma |
S14O3.2 |
Hyphaema (Blood in eye) Non-surgical Management |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O3 |
Neurosurgical Trauma |
S14O3.3 |
Hyphaema (Blood in eye) Surgical Management |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O3 |
Neurosurgical Trauma |
S14O3.4 |
Vitreous haemorrhage Conservative |
Geotagged Photograph of patient and wounds,Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done,Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O3 |
Neurosurgical Trauma |
S14O3.5 |
Vitreous haemorrhage Surgical Management |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O9 |
Poly Trauma |
S14O9.1 |
Trauma associated with less than 10 % BURNS (CONSERVATIVE MANAGEMENT) |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O9 |
Poly Trauma |
S14O9.2 |
Traumatic glaucoma with angle recession |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S14 |
Poly Trauma |
S14O9 |
Poly Trauma |
S14O9.3 |
Traumatic glaucoma without angle recession |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S16 |
Maxillofacial Surgery & plastic Surgery |
S161 |
Plastic Surgery |
S161.1 |
Benign tumour of Mandible And Maxilla - Excision with reconstruction |
Clinical Photograph |
Biopsy report,Clinical Photograph |
- |
|
|
S16 |
Maxillofacial Surgery & plastic Surgery |
S162 |
Orthopedic And Facial Trauma Wound Management For Compound Fractures |
S162.1 |
Facial Bone Fractures (Closed or Compound) - Multiple (Faciomaxillary Injuries) |
Clinical Photograph,xray |
Clinical Photograph,xray |
- |
|
|
S1 |
General Surgery |
S1A12 |
Abdomen |
S1A12.1 |
Mesentric cyst excision |
USG |
HPE,Scar photo,Operation notes |
- |
SO34I01 |
|
S1 |
General Surgery |
S1A13 |
Spleen |
S1A13.4 |
Burst abdomen (Complete Dehiscence) closure |
Clinical Photo |
Clinical Photo |
- |
|
|
S1 |
General Surgery |
S1A6 |
General Surgery |
S1A6.2 |
Surgery of high fistula in ano |
CLINICAL PHOTOGRAPH,FNAC |
CLINICAL PHOTOGRAPH with face of patient |
- |
|
|
S1 |
General Surgery |
S1PM1 |
General Surgery PMJAY Sub Category |
S1PM1.39 |
Drainage of intraperitoneal Abscess |
USG Abdomen |
Scar Photo |
- |
|
|
S2 |
ENT Surgery |
S2B8 |
ENT Surgery |
S2B8.1 |
Tonsillectomy |
Evidence of chronic Tonsillitis |
Clinical Photo |
- |
|
|
S2 |
ENT Surgery |
S2B8 |
ENT Surgery |
S2B8.2 |
Myringoplasty with Ossiculoplasty |
OTO Endoscopic photos,X Ray both mastoids,PTA |
PTA |
- |
|
|
S2 |
ENT Surgery |
S2B8 |
ENT Surgery |
S2B8.3 |
Cochlear Implant surgery for Children below 2 Years |
Brain stem Auditory Evoked respose (BERA),MRI brain with contrast/ CT Scan brain Plain and Cntrast - Preauth will be approved by Committee approved by CEO,IA with Stapedial reflex,Hearing aid Trial |
IA with Stapedial reflex,Warranty,Telemetry reports,Scar Photo,PTA,Invoice,Implant registration form |
- |
|
|
S2 |
ENT Surgery |
S2B8 |
ENT Surgery |
S2B8.4 |
Sailo endoscopy for removal of Salivary gland stone |
Sialogram,USG / X Ray Mandible |
Post op Sialogram |
- |
|
|
S2 |
ENT Surgery |
S2B8 |
ENT Surgery |
S2B8.5 |
FESS |
Xray /CT |
Post Procedure Clinical Photograph |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B1 |
Squint Correction Surgery |
S3B1.1 |
Rectus Muscle Surgery Two/Three Plus Oblique |
Clinical Photograph |
Post Procedure Clinical Photograph (corrected squint) |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B2 |
Vitreo |
S3B2.1 |
Vitrectomy - Endolaser , Silicon Oil Or Gas |
B.SCAN,FUNDUS PHOTOGRAPH & Sketch |
Fundus Photograph & Sketch |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B3 |
Opthalmology Surgery |
S3B3.1 |
DCR (Dacryocysto Rhinostomy) with implant |
Clinical Photograph,Clinical notes |
Implant Photo,Scar Photo with face visible & Clinical Notes |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B3 |
Opthalmology Surgery |
S3B3.2 |
Surgical Excision of Chalazion - Per Chalazion |
Clinical Notes,Clinical Photograph |
Clinical Notes,Clinical Photo |
- |
|
|
S3 |
Ophthalmology Surgery |
S3B3 |
Opthalmology Surgery |
S3B3.3 |
Intravitreal Anti-VEGF For ROP |
Fundus Photograph & Sketch |
Intraoperative Video during injection with face visible |
- |
|
|
S4 |
Gynaecology And Obstetrics Surgery |
S4C4 |
Gynaecology And Obstetrics Surgery |
S4C4.1 |
Abdominal Hysterectomy |
HPR of D and C if indicated,USG |
SCAR PHOTO,USG |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.12 |
Close Reduction of fractures under Anaesthesia - Short bones |
x ray |
Procedure X Ray |
- |
S21J03 |
S140xxA |
S5 |
Orthopedic Surgery And Procedures |
S5D2 |
Orthopedics |
S5D2.15 |
Excision Arthoplasty of Femur head |
Clinical Photograph,X-Ray |
Clinical Photograph,X-Ray |
- |
S21K03 |
Q765 |
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.1 |
Post Management of traumatically amputed limb |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.11 |
Arthoscopy - 2 ligaments repair or reconstruction of knee joint |
MRI |
Post Op X Ray,scar photo,Stickers |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.12 |
High Tibial Osteotomy with miniscus and root repair |
MRI,X Ray,Scannogram |
X Ray and sticker |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.13 |
Latarjet procedure for recurrent dislocation of shoulder |
CT Scan,X Ray,MRI |
Post Op X Ray,scar photo,Stickers |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.2 |
Degloving injuries of extremities |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.3 |
Whole blood or PCV in trauma |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.4 |
Traumatic internal de-arrangement of knee |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.5 |
POP cast immobilization of undisplaced fracture without Anaesthesia |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.6 |
Stabilization before amputation above knee or above elbow |
Geotagged Photograph of patient and wounds |
Police Information report and Discharge card in prescribed proforma with evidence of investigations and treatment done |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.7 |
Close Reduction of fractures under Anaesthesia - long bones |
x ray & Clinical photgraph |
Post Procedure X Ray & Clinical Photgraph Req |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5D7 |
Ortopaedics |
S5D7.9 |
Tendon Repair (Single) |
Clinical Photograph,X-Ray |
Clinical Photograph,X-Ray |
- |
|
|
S5 |
Orthopedic Surgery And Procedures |
S5E11 |
Orthopedic Surgery And Procedures |
S5E11.1 |
AC joint reconstruction/ Stabilization/ AcromionplastyNonoperative management is recommended for Roc |
MRI of shoulder,X rays of affected limb |
X rays of affected limb |
- |
|
|
S6 |
Surgical Gastro Enterology |
S6E1 |
Emergency |
S6E1.1 |
Left Hemicolectomy Laparoscopic |
CT,Colonoscopic Biopsy report |
HPR,Scar Photo |
- |
S33C06 |
I864 |
S6 |
Surgical Gastro Enterology |
S6E1 |
Emergency |
S6E1.2 |
Shunt/Devascularization Surgery for PHT |
CT Angio |
Barcode of stapler,Scar Photo,Operation notes |
- |
S33C07 |
I864 |
S6 |
Surgical Gastro Enterology |
S6E1 |
Emergency |
S6E1.3 |
Bariatric Procedures |
Blood Investigations,Preop Photo |
Barcode of stapler,Scar Photo,Operation notes |
- |
S25G13 |
Q899 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F3 |
S7F3 |
S7F3.1 |
Abdominal Vascular Injuries - Aorta, Iliac Arteries, IVC, Iliac Veins with graft - Payable maximum u |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F3 |
S7F3 |
S7F3.2 |
Major Vascular Injury -In Lower Limbs-Repair with graft - Payable maximum upto |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F3 |
S7F3 |
S7F3.3 |
Neck Vascular Injury - Carotid Vessels with graft - Payable maximum upto |
Angiogram /Doppler/ CT angio |
Doppler / Scar Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F4 |
CVTS Chest |
S7F4.1 |
Thoracoplasty |
2D ECHO & CT Aortogram or aortogram |
Claims Approval Subject To Stent/ Balloon Visiblity And Restoration Of Arterial Lumen In Angioplasty Video,Sticker Mandatory For Claim,Fluroscopy Video/Images Req |
- |
S02A14 |
Q251 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F5 |
Angioplasty |
S7F5.1 |
Systemic Pulmonary Shunts With Graft with CPB |
2D ECHO |
2D ECHO,Operation Notes |
- |
S02A17 |
I701 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F5 |
Angioplasty |
S7F5.2 |
Systemic Pulmonary Shunts Without Graft with CPB |
2D Echo |
2D Echo,Operaation notes |
- |
S02A18 |
I70209 |
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.1 |
Pulmonary Valve Replacement - with biprosthatic valve |
2D ECHO |
ECHO,scar photo,Post op X Ray |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.2 |
On pump multivessel minimal?invasive coronary artery bypass grafting |
2 D echo,coronary angiography |
operative notes,x-ray chest,scar photo,operative photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.3 |
Minimal invasive atrial/ventricular septal defect closure |
2 D Echo |
operative notes,x-ray chest,scar photo,operative photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.4 |
Minimal Invasive Aortic/Mitral valve replacement with mechanical valve |
2 D Echo |
operative notes,x-ray chest,scar photo,operative photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.5 |
Minimal Invasive Aortic/Mitral valve replacement with bioprosthetic ?valve |
2 D Echo |
operative notes,x-ray chest,scar photo,operative photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.6 |
Partial Anomalous?pulmonary venous connection/return |
2 D echo |
operative notes,x-ray chest,scar photo,operative photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F7 |
CVTS |
S7F7.7 |
Minimal invasive valve repair with ring |
2 D Echo |
operative notes,x-ray chest,scar photo,operative photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7F8 |
Limb Ischaemia |
S7F8.1 |
ICU Management of Acute Limb Ischaemia 4 days |
Clinical Photo,Color Doppler |
Clinical Photo,Color Doppler |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.11 |
Double valve replacement with tricuspid valve repair - with ring |
2D Echo,Clinical Photo |
2D Echo,Operation notes,Clinical Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.12 |
Double valve replacement with tricuspid valve repair - without ring |
2D Echo,Clinical Photo |
2D Echo,Operation notes,Clinical Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.13 |
Mitral valve replacement with tricuspid valve repair with ring |
2D Echo,Clinical Photo |
2D Echo,Operation notes,Clinical Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.14 |
Mitral valve replacement with tricuspid valve repair without ring |
2D Echo,Clinical Photo |
2D Echo,Operation notes,Clinical Photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.15 |
Emergency IABP insertion |
Clinical notes |
IABP sticker |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.16 |
Carotid to brachial bypass with prosthetic graft |
Color doppler |
Graft sticker,Scar photo |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.17 |
Aortic debranching surgery with prosthetic graft |
CT Angio |
Scar photo and doppler |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.18 |
Fontan Procedure |
CT Angio,RFT,Partial thromboplastin time(PTT) Hyperornithilemia,LFT,Hyperammoniemia,Homocitrullinuria (HHH),ECHO,ECG,Chest X Ray |
Cardiac Cath,X Ray chest PA View,Scar photo,Procedure video,Echo showing graft in situ |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.19 |
Open aortic Valvotomy/ Supra / Subvalvular Aortic stenosis |
CT Angio/ Cardiac Cath,RFT,PTT,LFT,HHH,ECHO,ECG,Chest X Ray |
Echo showing stent in situ,X Ray chest PA View,Scar photo,Procedure video |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.20 |
TGA (Transposition of greater arteries) Arterial switch / Senning procedure / Mustard Procedure |
ABG,USG Abdomen,Serum calcium,RFT,PTTK,PT,LFT,HHH,ECHO/CT Angio/CT Scan chest without contrast,Chest X Ray,CRP,CBC |
2D ECHO,RFT,LFT,Chest X RAY,ABG |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.21 |
Carotid End arterectomy |
MR angio/CT Angiography / DSA |
Clinical Photo,MR angio/CT Angiography / DSA |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.3 |
Aortic Valve Replacement (With Biprosthetic Valve) |
2D Echo |
2D Echo,Post Surgery Photo,Operation Notes ,Bar Code Sticker |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.4 |
Double Valve Replacement (With Biprosthatic Valve) |
2D ECHO |
Bar Code Sticker,Xray,Surgery Photo,Operation Notes |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.8 |
Pericardiectomy with CPB |
2D ECHO |
2D ECHO |
- |
|
|
S7 |
Cardiac And Cardiothoracic Surgery |
S7PM1 |
Cardiology PMJAY Sub Category |
S7PM1.9 |
Tricuspid Valve Replacement with biprosthatic valve |
?2D ECHO |
2D Echo/ Xray,Post Surgery Photo,Operation Notes,Bar Code Sticker |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.1 |
Surgery for Peritonitis in Children |
X Ray abdomen and USG Abdomen |
Clinical notes,Scar Photo |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.2 |
Colostomy closure for ARM or Hirsphsprungs disease Stage 3 |
Clinical Photograph,USG Abdomen,Distal Cologram |
Post Procedure Scar Photograph Operative/ Procedure Notes |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.3 |
Hypospadius Fistula |
DRU (Distal Retrograde Urethrogram) |
Clinical photograph showing patient micturating without leakage |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.4 |
Orchidopexy - Stage 1 - Open / Lap |
Clinical Photograph,USG |
Clinical Photograph,Video,Usg |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.5 |
Orchidopexy - Stage 2 - Open / Lap |
Clinical Photograph,USG |
Clinical Photograph,Video,Usg |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.6 |
Urinary Diversion (Vasicostomy / Ureterostomy) |
Micturating Cystourethrogram,USG,RFT |
Clinical notes,Scar Photo |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.7 |
Urinary Undiversion |
Clinical Photo,USG abdomen |
Clinical notes,Scar Photo |
- |
|
|
S8 |
Pediatric Surgery |
S8G8 |
Congenital Malformations - GI Tract |
S8G8.8 |
Surgery on Thoracic cyst - Open or Thoracoscopic |
CT,Xray |
Biopsy,Post Procedure Clinical Photograph |
- |
|
|
S8 |
Pediatric Surgery |
S8H1 |
Abdomen |
S8H1.4 |
Benign Abdominal Cysts In Paediatric Patient |
CT,USG |
Biopsy,Usg,Post Procedure Clinical Photograph |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.10 |
Laparoscopic simple Nephrectomy |
USG / CT scan |
Biopsy,Post Procedure Evidence Of Usg |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.11 |
Open Ureterolithotomy |
USG / CT scan |
Scar photo |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.2 |
Open Prostatectomy (Millins ) |
IVP/ CT abd,X ray,USG,Renal scan |
Clinical Photo |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.3 |
Laparoscopic Ureterolithotomy |
USG / CT scan |
Post op USG |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.4 |
Chordae Correction (Patch) |
Precorrection photo |
Intraoperative photo and post discharge correction photo |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.5 |
DJ Stent removal Unilateral / Bilateral |
Preaoperative X Ray |
Post operative X ray |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.6 |
Epispadiasis - Correction - Stage 2 |
CLINICAL PHOTOGRAPH |
Post Procedure Clinical Photograph |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.7 |
Open Nephrectomy Radical |
CT scan,USG |
Biopsy,Post Procedure Evidence Of Usg |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.8 |
Open Partial Nephrectomy |
CT scan,USG |
Biopsy,Post Procedure Evidence Of Usg |
- |
|
|
S9 |
Genitourinary System |
S9H6 |
Urology |
S9H6.9 |
PCNL or RIRS or Push back PCNL for upper ureretic calculus more than 1 cm |
USG/KUB/IVP/ CT Abd |
Clinical Photo,X Ray/Usg |
- |
|
|
S9 |
Genitourinary System |
S9H8 |
Urology Corrective Procedures |
S9H8.10 |
Open Adrenalectomy |
CT Scan,Tumour markers |
Scar photo,Surgery notes |
- |
|
|
S9 |
Genitourinary System |
S9PM1 |
Urology PMJAY Sub Category |
S9PM1.8 |
Bladder Augmentation |
IVP/ MCU,USG |
Clinical Photograph,Procedure Evidence |
- |
|
|
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.10 |
Treatment of mediastinal/lymphadenopathy requiring EBUS(Endobronchial ultrasound)with 3 days stay |
CT,X Ray chest,Evidence of lab investigations |
Post Treatment Evidence Of Clinical And Lab Investigations Xray |
- |
|
|
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.7 |
Acute Respiratory Failure (ICU stay With Invasive Ventilator) per day - Rs 6000 - 7 Days stay |
ABG,Sputum / Bronchial Washing / ET Suctions for Analysis x ray mandatory for pre auth,Serum Electrolytes,ECG |
Post Treatment Evidence Of Clinical And Lab Investigations |
- |
|
|
M10 |
Pulmonology |
M10T4 |
Pulmonology |
M10T4.9 |
Treatment of Pleural diseases requiring Thoracoscopy 3 days stay |
CT,X Ray chest,Evidence of lab investigations |
Post Treatment Evidence Of Clinical And Lab Investigations Xray |
- |
|
|
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.4 |
CBC, X-ray of joints, clinical notes |
CBC,clinical notes,X-ray of joints |
Clinical Notes,Skin Biopsy |
- |
|
|
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.5 |
CBC, sr. IgE, clinical notes |
CBC,sr. IgE,clinical notes |
Cbc,Skin Biopsy,Rft,Lft,Clinical Notes |
- |
|
|
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.6 |
CBC, Skin swab, clinical notes |
CBC,clinical notes,Skin swab |
Cbc,Skin Biopsy,Rft,Lft,Clinical Notes |
- |
|
|
M11 |
Dermatology |
M11T5 |
Dermatology |
M11T5.7 |
Leprosy and recurrent lepra reactions 10 days stay |
CBC,clinical notes,RFT,LFT |
Cbc,Skin Biopsy,Rft,Lft,Clinical Notes |
- |
|
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.10 |
Spondyloarthropathy with Biologic therapy - One day |
CRP,ESR,CT/MRI |
Clinical notes,Empty vials of injections |
- |
|
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.11 |
SLE AIHA / SLE Thrombocytopenia - 10 days stay |
CBC,DCT/ICT |
Clinical notes,Empty vials of injections and blister packs,Empty bottles of platelets or PCV |
- |
|
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.12 |
Osteoporosis - Zoledronic acid injection - One day stay |
DEXA Scan |
Clinical notes |
- |
|
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.4 |
Rheumatoid Arthritis with ILD/ Vasculitis 7 days stay |
Anti CCP,biopsy/NCD,RF,HRCT |
Evidence Of Clinical,Lab Investigation |
- |
M32A06 |
L959 |
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.7 |
Polymyocitis / Dermatomyocitis 7 days stay |
CPK Total |
EMG,Treatment chart,Muscle biosy |
- |
|
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.8 |
Antiphospholipid Antibody syndrome 7 days |
Antiphospholipid Antibody,CT/MRI/Color dopplerindicating e/o thrombosis |
Clinical notes |
- |
|
|
M12 |
Rheumatology |
M12T6 |
Rheumatology |
M12T6.9 |
Spondyloarthropathy 5 days stay |
MRI Spine / SI Joint |
Clinical notes |
- |
|
|
M13 |
Endocrinology |
M13U4 |
Endocrinology |
M13U4.1 |
Thyrotoxic crisis - Routine Ward - 1500 ICU (without Ventilator) - 4000 ICU (with Ventilator) - 6000 |
CBC,T3T4TSH |
Post Procedure Evidence Of Clinical Improvement |
- |
|
|
M13 |
Endocrinology |
M13U4 |
Endocrinology |
M13U4.2 |
Somatostatin receptor based nuclear scan (at time of initial diagnosis), CT scan chest or adbdomen ( |
CT scan chest or adbdomen (baseline) and hormonal test ( optional),Somatostatin receptor based nuclear scan (at time of initial diagnosis) |
Photograph of patient given stock of six months injection/tablets |
- |
|
|
M13 |
Endocrinology |
M13U4 |
Endocrinology |
M13U4.3 |
DEXA Scan, calcium biochemistry |
DEXA Scan,calcium biochemistry |
Photograph of patient given stock of six months injection/tablets |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.1 |
Albumin Therapy for Liver Cirrhosis, Nephrotic or Nephritic Syndrome, Sepsis etc per day - 6000 per |
Abdomen,serum albumin |
Evidence of Albumin |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.10 |
ERCP For CBD /PD Stones - Day Care |
LFT REPORT,RFT,MRCP Report for CBD and USG |
REPORT,procedure video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.11 |
ESWL For CBD /PD Stones - Day Care |
LFT REPORT,RFT,MRCP Report |
REPORT,procedure video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.12 |
Gastric / Colonic Polypectomy- Day Care |
gasroscopy report |
HP report,procedure video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.13 |
Glue Insertion For Fundal Varices- Day Care |
gasroscopy report |
REPORT,procedure video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.14 |
Rectal Banding- Day Care |
colonoscopy report |
REPORT,procedure video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.15 |
Immunomodulatory refractory IBD (Inflammatory Bowel Disease) requiring Biologic Drug Therapy (14 day |
Diagnosis of IBD |
packets of Drugs |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.16 |
Endoscopic Management of Refractory Variceal bleed - 5 days |
endoscopic image |
stent sticker,video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.17 |
Endoscopic resection of Early GI Luminal Malignant/ Premalignant lesions - 5 days |
endoscopic image |
HPR,video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.18 |
Endoscopic Ultrasound guided coiling of Gastric Varices - 3 days |
endoscopic image |
coil sticker,video |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.19 |
Endoscopic management of refractoty Non variceal GI bleeding with OTSC Placement- 5 Days |
Endoscopic evidence |
Endoscopic photo |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.2 |
Endoscopic management of Benign Oesphagial Strictures 3 days |
CT scan,endoscopic with biopsy |
X-RAY,endoscopic image |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.20 |
Endoscopic bilary drainage in recurrent / refractory benign biliary obstruction - 3 days |
radiological image |
endoscopic image,stent sticker |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.21 |
Stricturising Crohns Disease - 7 days |
Clinical and Radiological findings |
Empty Vials with batch no |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.22 |
Fistulising Crohns disease - 5 Days |
Endoscopic CT or MRI |
Empty vials of Injections |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.3 |
Endoscopic management of GI Fistule / Perforation / Leak 10 stays stay |
Endoscopic and Radiological evidence |
Endoscopic picture |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.4 |
Percutaneous endoscopic Gastrostomy - Day Care |
Physician's notes |
Endoscopic photo |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.5 |
Endoscopic management of Non variceal GI bleeding - 5 Days |
Endoscopic evidence |
Endoscopic photo |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.6 |
Endoscopic management of Malignant biliary obstruction |
CT with biopsy |
endoscopic photo of stent |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.7 |
Endoscopic management of Malignant enteral or luminal obstruction |
CT with biopsy |
endoscopic photo of stent |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.8 |
Steroid refarctory acute severe ulcerative colitis 3 weeks stay |
Endoscopic and biopsy proven ulcerative colitis with physician's note suggestive of steroid refractory disease |
Clinical resolution of symptoms or progression to surgery |
- |
|
|
M14 |
Gastroenterology |
M14V2 |
Gastroenterology |
M14V2.9 |
Achalasia Cardia Balloon Dilatation - Day Care |
Swallow report |
gasroscopy report,procedure video |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.36 |
Central Venous Balloon plasty For Central Venous Occlusion ( Brachiocephalic or Subclavian Vein or S |
COLOR DOPPLER,DSA/CT venography/MRI |
Clinical Photograph,Radiographic |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.37 |
Catheter directed thrombolysis in acute Mesenteric arterial or venous Ischemia |
Angiogram |
Claims Approval And Restoration ,Radiographic Image/Cd rTPA Sticker,Procedure Clinical Photograph |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.38 |
Iliac Artery Stenting with stent |
Angiogram |
Claims Approval And Restoration,Radiographic,Clinical Photograph |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.39 |
Superficial Femoral Artery Stenting With Stent. |
Angiogram / Doppler |
Claims Approval Subject To Stent Visiblity And Restoration Of Arterial Lumen In Angioplasty Video,Radiographic Image/Cd Stent Sticker,Post Procedure Clinical Photograph |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.40 |
Prostate artery embolisation in BPH or Haematuria |
USG/CT IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.41 |
Arterial Chemoinfusion in malignant tumours |
USG/CT |
Clinical Photograph,Radiographic Image/Cd |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.42 |
Microwave ablation for tumor |
USG/CT IS MANDATORY AT TIME OF PREAUTH |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.43 |
HIFU (High intensity focus ultrasound) or Cryoablation or IRE (Irreversible Eletroporration) for tum |
USG/CT |
Clinical Photograph,Radiographic |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.44 |
Chemoport or Implantable lines |
CT or USG |
Clinical Photograph,Radiographic |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.45 |
PICC line insertion for Chemotherapy or longterm antibiotic infusion |
CT or USG images |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.46 |
USG or Fluoroscopy or CT guided percutaneous Neoronolysis for reducing pain in Cancer or Non maligna |
Radiographic or HPE diagnosis |
CT or USG images |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.47 |
Endovenous thermal ablation for one limb in Vericose veins |
Doppler or Venogram |
Fluoroscopic DSA |
- |
|
|
M15 |
Interventional Radiology |
M15W1 |
Interventional Radiology |
M15W1.48 |
Retrieval of foreign body for example IVC Filter or device or IV line |
Radiographic images |
Post Procedure Clinical Photograph,Radiographic Image/Cd |
- |
|
|
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.2 |
Rituximab Treatment for Neurological, Rheumatological, Nephrological Haematological and dermatologic |
CSF,Renal Biopsy,RFT |
Lab Investigations,Procedure Evidance |
- |
M12A02 |
|
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.3 |
NSTEMI / Evolved MI - 5 Days stay |
CPKMB,ECG |
2D Echo |
- |
M12A03 |
|
M16 |
GENERAL MEDICINE |
M16Q1 |
Critical Care Gen Medicine |
M16Q1.4 |
Acute LVF (Known IHD / Valvular Heart Disease. - 5 Days |
BNP,X-RAY,ECG |
2D Echo |
- |
M12A04 |
|
M17 |
Mental Disorders Packages |
M17A2 |
Mental Disorders Packages |
M17A2.1 |
Substance use disorder - 30 days stay - Rs 1000 per day |
Clinical |
Report |
- |
|
|
M17 |
Mental Disorders Packages |
M17A2 |
Mental Disorders Packages |
M17A2.2 |
Psychological testing reports |
Psychological testing reports |
Clinical assessment and reports |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.10 |
Immune Thrombocytopenia per month with immunosupressants |
CBC,Treatment protocol sheet and Clinical notes,Peripheral smear |
Post Treatment Clinical Notes & Geotagged photo |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.11 |
Immune Thrombocytopenia per month with Oral TPO agonist |
CBC,Treatment protocol sheet and Clinical notes,Peripheral smear |
Post Treatment Clinical Notes & Geotagged photo |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.12 |
Immune Thrombocytopenia per month with Injectable TPO agonist |
CBC,Treatment protocol sheet and Clinical notes,Peripheral smear |
Post Treatment Clinical Notes & Geotagged photo |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.13 |
Autoimmune hemolytic Anaemia with Rituximab Rs 20000 per week- 4 weeks |
CBC,Serum LDH,LFT,ICT,DCT |
CBC |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.5 |
Haemophilia with Inhibitors treatment by Factor VII or FEIBA or Emicizumab (Hemlibra) for Haemophili |
FACTOR VIII/ IX ASSAY Coagulation Parameters and Inhibitor report |
Case Sheet With Records of Factors,injections Given,Post Procedure Evidence of Clinical Imrovement |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.6 |
Aplastic Anaemia with ATG+Cyclosporin+Eltrombopeg / Danazol+Cyclosporin+Eltrombopeg - 7 Days |
CBC+Bone marrow biopsy |
Treatment protocol sheet and Clinical notes |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.7 |
Immune Thrombocytopenia per month |
CBC,Peripheral smear |
Treatment protocol sheet and Clinical notes |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.8 |
Haemophilia A with VWF deficiency - Treatment with factor VIII with VWF - Day care procedure |
Coagulation Parameters,VON WILL BRANDS / FACTOR VIII ASSAY |
Case Sheet With Records Of Factor Given,Post Procedure Evidence Of Clinical Improvement |
- |
|
|
M18 |
Hematology |
M18Q1 |
Hematology |
M18Q1.9 |
Hemophilia B with Plasma derived / Recombinant Factor IXDay care |
Coagulation Parameters,Factor IX ASSAY and Inhibitor Assay |
Case Sheet With Records Of Factor Given,Post Procedure Evidence Of Clinical Improvement |
- |
|
|
M18 |
Hematology |
M18R1 |
Acute Lymphatic Leukemia |
M18R1.2 |
Consolidation Chemotherapy / Intensive Chemotherapy upto 4 Cycles - Payable maximum upto for each cy |
CBC,cytochemistry/ Surface markers/bone marrow report |
Post Treatment Chemo Sheets |
- |
|
|
M18 |
Hematology |
M18R3 |
Multiple Myeloma |
M18R3.34 |
Imatinib(Per month) |
Planned Chemotherapy regimen and /Biopsy/Histopatholigy report/ / FISH/Cytogenetics/Mlecular for BCR/ABL |
Post Treatment Clinical Notes & Chemo Sheets |
- |
|
|
M18 |
Hematology |
M18R3 |
Multiple Myeloma |
M18R3.44 |
Bortezomib+Lenoladomide+Dexamethasone/Cyclophosphamide+Bortezomib+Dexamethasone |
Bence Jones Protiens (urine) Planned CHEMOTHERAPY REGIMEN,S. Immune electrophoresis,Bone marrow |
Chemo charts,Clinical Photograph |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.1 |
AEVD Lymphoma and others Adriamycin 25mg/m2 Vinblastine 6mg/m2 Dacarbazine 375 mg/m2 Day 1,15 Etopo |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.10 |
NK/T Cell Lymphoma/NHL and others - SMILE Methotrexate 2gm/m2 D1 Ifosfamide 1500mg/m2 D2-4 Etoposide |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.11 |
GELOX NHL and others Gemcitabine 1000mg/m2 D1 and D8 Oxaliplatin 130mg/m2 D1 L- asparginase 6000 U/ |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.12 |
ICE - NHL and others Ifosfamide 1.5 mg/m2 D1-3 Carboplatin AUC5 D2 Etoposide 100mg/m2 D1-3 Every 3 |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.13 |
MINE - NHL and others Ifosfamide 4 gm/m2 over 3days (D1-3) Mitoxantrone 8mg/m2 Etoposide 65mg/m2 D1- |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.14 |
PTCL - GDP, NHL and others Gemcitabine 1000mg/m2 D1 and D8 Dexamethasone 40mg D1-4 Cisplatin 75mg/m |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.15 |
DHAP - NHL and others Dexamethasone 40mg D1-4 Cisplatin 100mg/m2 or Carboplatin AUC-5D1 Cytarabine |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.16 |
Arsenic trioxide ATRA - Daunomycin or Idarubcin Cytarabine - multiagent - vary in each protocol - A |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.17 |
Arsenic trioxide ATRA Daunomycin or Idarubcin Cytarabine - multiagent - vary on protocol - AML M3/A |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.18 |
ATO 0.15 mg / kg day 1- Day 5, day 8-12, day 15- 19, day 22-26 every 56 days for 4 cycles ATRA 45 mg |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.19 |
ATO 0.15 mg / kg day 1- 45 or 60 ATRA 45 mg / M2 - day 1-45 or 60 - AML M3/APML/Promyelocytic |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.2 |
Multiple Myeloma / Plasma Cytoma Pomalidomide + Dexamethasone Pomalidomide 4 mg daily Day 1-21 Dexam |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.20 |
ICICLE BFM KLALL MCP:841 - ALL |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.21 |
Dasatinib + chemo (to be used only with ALL therapy)To be used with Philadelphia Chromosome/PH Posit |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics Fish t (9:22) /PCR BCR:ABL Copies |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.22 |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / CytogeneticsCytogenetics Fi |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / CytogeneticsCytogenetics Fish t (9:22) /PCR BCR:ABL Copies |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.23 |
Cytrabine 3 gram/m2 twice a day Days 1, 3 and 5 - AML Consolidation phase |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.24 |
Cytrabine 200mg/m2/day days 1- 10 and Daunorubicin 50 mg/m2 days 1, 3 and 5 Etposide 100mg/m2 days 1 |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.25 |
Cytrabine 100- 200mg/m2/day days 1-7 and Daunorubicin 50mg/m2 days 1, 3 and 5 - AML Induction |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.26 |
LMB 89 - 96 - Consolidation (second month) - ALL/NHL and others |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.27 |
LMB 89 - 96 - Induction - COPADAM ( first month) - ALL/NHL and others |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.28 |
LMB 89 - 96 - Maintenance - ALL/NHL and others |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.29 |
MCP - 842 - ALL and others |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.3 |
Langerhans Cell Histiocytosis (Histiocytosis Protocol - Induction) |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.30 |
De-Angelis/MTR (methotrexate, dexamethasone, procarbazine, vincristine, intrathecal MTX, CYTARABINE) |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.31 |
Carfinzomib +Pomalidomide+Dexamethasone / Carfinzomib +Thalidomide+Dexamethasone/Carfinzomib +Lenali |
Bence Jones Protiens (urine) Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,S. Immune electrophoresis,Bone marrow |
Chemo Charts,Clinical Photograph |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.32 |
Dasatinib per month |
Planned Chemotherapy regimen and /Biopsy/Histopatholigy report/ / FISH/Cytogenetics/Mlecular for BCR/ABL |
Post Treatment Clinical Notes & Chemo Sheets |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.33 |
Nilotinib(Per month) |
Planned Chemotherapy regimen and /Biopsy/Histopatholigy report/ / FISH/Cytogenetics/Mlecular for BCR/ABL |
Post Treatment Clinical Notes & Chemo Sheets |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.34 |
Bosutinib (Per Month) |
Planned Chemotherapy regimen and /Biopsy/Histopatholigy report/ / FISH/Cytogenetics/Mlecular for BCR/ABL |
Post Treatment Clinical Notes & Chemo Sheets |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.35 |
CLL and other lymphomas- Acalbrutinib - per month |
CBC,Peripheral smear,Flow cytometry |
Geotagged photo,Post Treatment Clinical Notes & Chemo Sheets |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.36 |
Inj Crinzalizumab for Sickle cell anemia - per month |
CBC,HPLC,Clinical notes mentioning refractory to Cap Hydroxyurea |
Geotagged photo,Post Treatment Clinical Notes |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.37 |
Primary Myelofibrosis and Other MPN - Ruxolitinib - per month |
Bone marrow aspiration and biopsy,PS,Molecular studies,CBC |
Clinical notes,Geotagged photo |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.38 |
Non Hodgkins Lymphoma and others -CHOEP Cyclophosphamide 750mg/m2 D1 Vincristine 1.4mg/m2 D1 Adriamy |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.4 |
Langerhans Cell Histiocytosis (Histiocytosis Protocol - Maintenance) |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.5 |
Burkitt Lumphoma and others - Codox - M - IVAC / Acute Lymphoblastic Leukemia - GMALL or BFM or Hype |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.6 |
Follicular Lymphoma/Non Hodgkins Lumphoma/CLL/SLL and others Lenalidomide Rituximab Rituximab 375m |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.7 |
Low grade lymphomas /NHL (Low grades) and others - RituximabRituximab 375mg/m2 per week for 6 week |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.8 |
Follicular Lymphoma - Fludarabine + Cyclophosphamide Fludarabine 25mg/m2 D1-3 Cyclophosphamide 250 m |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M19 |
Haematooncology / Medical Oncology |
M19U |
Haematooncology |
M19U.9 |
Follicular Lymphoma/CLL/NHL and others - Rituximab + Fludarabine + Cyclophosphamide Rituximab 375mg/ |
HPE/Bone marrow aspiration / Biopsy/ Immunophenotyping/ flow Cytometry / Cytogenetics |
Chemo charts,Clinical photographs |
- |
|
|
M1 |
Medical Oncology |
M1A4 |
Medical Oncology |
M1A4.27 |
VIE (Vincristin, Ifosphamide,Etoposide) Inv - Hematology, Biopsy - Payable maximum upto |
Biopsy,Xray/CT/PET-CT |
Chemo Charts,Clinical Photograp |
- |
|
|
M1 |
Medical Oncology |
M1A4 |
Medical Oncology |
M1A4.30 |
CAPOX |
Biopsy/Histopathology,CT Abdomen |
Usg/Ct/Biopsy/Biochemical |
- |
|
|
M1 |
Medical Oncology |
M1A4 |
Medical Oncology |
M1A4.37 |
Temozolamide 28 days cycle |
MRI |
Chemotherapy |
- |
|
|
M1 |
Medical Oncology |
M1A4 |
Medical Oncology |
M1A4.38 |
5-FU 2 weekly/Capacitabine 3 weekly |
Biopsy,CT Scan,CHEMOTHERAPY |
Chemo Charts,Clinical Photograph |
- |
|
|
M1 |
Medical Oncology |
M1A4 |
Medical Oncology |
M1A4.40 |
Cisplatin plus Adriamycin/Cisplatin plus Ifosfamide/Ifosmide plus Adriamycin |
Biospy,Xray/CT |
Chemo Charts,Clinical Photograph |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.10 |
Vincristine + Carboplatin Vincristine 1.5mg/m2 (day 1, 8 and 15 for first 4 cycles and then only day |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.2 |
Gemcitabine + Nanopaclitaxel Gemcitabine 1000mg/m2 D1 D8 Albumin bound Paclitaxel 125mg/m2 D1 D8 ev |
HPE |
Clinical Photograph,chemochart |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.3 |
Capecitabine + Gemcitabine Gemcitabine 1000mg/m2 D1 D8 D15 Capecitabine 830mg/m2 twice daily D1-D21 |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.4 |
Oxaliplatin + Gemcitabine Gemcitabine 1000 mg/m2 D1 Oxaliplatin 100 mg/m2 D1 every 14 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.5 |
Cisplatin + Adriamycin + Cyclophosphamide Cisplatin 50 mg/m2 D1 Doxorubicin 50 mg/m2 D1 Cyclophospha |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.6 |
Cisplatin Cisplatin 100mg/m2 every 21 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.7 |
Cabozantinib 60 mg od x 1 month every 4 weeks |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.8 |
LHRH Agonist Leuprolide 22.5 ug every 3 months |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K12 |
Hepatoblastoma -Operable |
M1K12.9 |
Mitoxantrone + Prednisolone Mitoxantrone 12mg/m2 every 3 weeks Prednsiolone 10 mg daily |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K13 |
Cervix |
M1K13.2 |
PACKER |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K13 |
Cervix |
M1K13.3 |
Cisplatin + Cyclophosphamide + Vincristine Cyclophosphamide 1000mg/m2 (2 days every cycles) Vincrist |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K13 |
Cervix |
M1K13.4 |
Pediatric - Germ Cell Tumor / JEB |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K16 |
Retinoblastoma |
M1K16.2 |
Vinorelbine + Carboplatin Vinorelbine 25mg/m2 D1 D8 CarboplatinAUC 5-6 D1 every 21 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K16 |
Retinoblastoma |
M1K16.3 |
Vinorelbine + Cisplatin Vinorelbine 25mg/m2 D1 D8 Cisplatin 75mg/m2 D1 every 21 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K16 |
Retinoblastoma |
M1K16.4 |
HPE and Chemoprotocol |
HPE and Chemoprotocol |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K16 |
Retinoblastoma |
M1K16.5 |
Cyclophosphamide + Doxorubicin + Etoposide + Vincristine + Dactinomycin Vincristine 1.5 mg/m2Dactino |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K26 |
Medical Oncology |
M1K26.1 |
DCF protocol (Docetaxel + Cisplatin/Carboplatin + 5 Flurouracil) 2 or 3 weekly cycle |
Biopsy/Histopatholigy report,CHEMOTHERAPY |
Clinical Notes & Chemo Sheets,Geotagged photo |
- |
|
|
M1 |
Medical Oncology |
M1K26 |
Medical Oncology |
M1K26.2 |
FOLFIRINOX protocol (5 Flurouracil + Leucovorin + Irinotecan + Oxaliplatin) 2weekly cycle |
Biopsy report,Chemotherapy |
Geotagged photo,clinical notes |
- |
|
|
M1 |
Medical Oncology |
M1K26 |
Medical Oncology |
M1K26.3 |
Lenvatinib 30 days |
Biopsy/Histopatholigy,CHEMOTHERAPY |
Chemo Sheets,Geotagged,Clinical Notes |
- |
|
|
M1 |
Medical Oncology |
M1K26 |
Medical Oncology |
M1K26.4 |
Paclitaxel + Trastuzumab weekly protocol |
Biopsy/Histopatholigy,Chemotherapy |
Clinical Notes & Chemo Sheets,Geotagged photo |
- |
|
|
M1 |
Medical Oncology |
M1K33 |
Testis |
M1K33.2 |
Sorafenib 30 days |
Biopsy/Histopatholigy report,Chemotherapy |
Clinical Notes & Chemo Sheets,Geotagged photo |
- |
|
|
M1 |
Medical Oncology |
M1K33 |
Testis |
M1K33.3 |
Abiraterone 30 days |
Biopsy/Histopatholigy,CHEMOTHERAPY |
Chemo Sheets,Geotagged,Clinical Notes |
- |
|
|
M1 |
Medical Oncology |
M1K33 |
Testis |
M1K33.4 |
Ibrutinib 30 days |
Biopsy report,Chemotherapy |
Geotagged photo,clinical notes |
- |
|
|
M1 |
Medical Oncology |
M1K33 |
Testis |
M1K33.5 |
Temozolomide Plus Capcitabine 28 Cycles or Temozolomide plus Cisplatin 21 cycle) |
Biopsy/Histopatholigy report,CHEMOTHERAPY |
Geotagged photo,Treatment Clinical Notes & Chemo Sheets |
- |
|
|
M1 |
Medical Oncology |
M1K33 |
Testis |
M1K33.6 |
FLOT protocol (Docetaxel + Oxaliplatin + 5 Flurouracil) 2 weekly cycle |
Biopsy report,Chemotherapy |
Geotagged photo,clinical notes |
- |
|
|
M1 |
Medical Oncology |
M1K34 |
Prostate |
M1K34.2 |
Bevacizumab 2weekly or 3weekly protocol |
Biopsy/Histopatholigy,CHEMOTHERAPY |
Chemo Sheets,Geotagged,Clinical Notes |
- |
|
|
M1 |
Medical Oncology |
M1K4 |
Oncologyoesophagus |
M1K4.2 |
Pazopanib 30 days cycle |
Biopsy,Clinical Photograph |
Discharge Photograph |
- |
|
|
M1 |
Medical Oncology |
M1K4 |
Oncologyoesophagus |
M1K4.3 |
Regorafenib 21 days out of 28 day cycle |
Biopsy,Clinical Photograph |
Discharge |
- |
|
|
M1 |
Medical Oncology |
M1K4 |
Oncologyoesophagus |
M1K4.4 |
Docetaxel + Cyclophosphamide Docetaxel 75mg/m2 D1 Cyclophosphamide 600 mg/m2 D1 every 21 days |
HPE and Chemoprotocol |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K5 |
Stomach |
M1K5.2 |
Lapatinib plus Capecitabine |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K5 |
Stomach |
M1K5.3 |
Cisplatin + Irinotecan Cisplatin 60mg/m2 D1 Irinotecan 60 mg/m2 D1 D8 D15 every 28 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K5 |
Stomach |
M1K5.4 |
Lipodox + Carboplatin Lipopdox 30 mg/m2 D1 Carboplatin AUC 5-6 D1 every 28 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K5 |
Stomach |
M1K5.5 |
Lipodox Lipodox 40 mg/m2 IV every 28 days |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.2 |
Paclitaxel + Ifosfamide + Cisplatin Paclitaxel 240 mg/m2 D1 Ifosfamide 1500mg/m2 D2-D5 Mesna 300 mg/ |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.3 |
Etoposide + Methotrexate + Dactinomycin + Cisplatin Etoposide 100mg/m2 IV D1 D2 D8 Dactinomycin 0.5 |
HPE and Chemoprotocol |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.4 |
Vincristine + Topotecan + Cyclophosphamide + Irinotecan + Temozolamide Vincristine 1.5mg/m2( day 1) |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.5 |
Methotrexate + Doxorubicin + Cisplatin for Relapsed Osteogenic Sarcoma Cisplatin 120mg/sq.m Doxorubi |
HPE |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.6 |
Dacarbazine + Cisplatin Dacarbazine 250mg/m2 D1-D5 Cisplatin 75 mg/m2 Every 21 days |
HPE and Chemoprotocol |
Chemochart,Clinical photo |
- |
|
|
M1 |
Medical Oncology |
M1K7 |
Bone Tumors/Osteosarcoma |
M1K7.7 |
Capecitabine + Mitomycin C Capecitabine 825mg/m2 PO twice daily till completion of RT Mitomycin 10mg |
HPE |
Chemochart,Clinical photo |
- |
|
|
M2 |
Radiation Oncology |
M2L9 |
Specialized Radiation Therapy - Imrt With Igrt |
M2L9.2 |
Surface mould Brachytherapy for skin tumors and vaginal tumors |
Biopsy/Histopatholigy report,USG/CT/PET/MRI |
Rt Treatment Charts |
- |
|
|
M2 |
Radiation Oncology |
M2L9 |
Specialized Radiation Therapy - Imrt With Igrt |
M2L9.3 |
Interstitial plus Intracavitory per fraction - For OBGY Malignancies |
Biopsy/Histopatholigy report,USG/CT/PET/MRI |
Rt Treatment Charts |
- |
|
|
M3 |
Critical Care |
M3Q2 |
Critical Care Gen Medicine |
M3Q2.1 |
Snake bite with Coagulopathy without Dialysis 7 days |
INR, Platelet count, BTCT |
Evidence Of Clinical And Lab Investigations |
- |
M12A01 |
D759 |
M3 |
Critical Care |
M3Q2 |
Critical Care Gen Medicine |
M3Q2.2 |
Snake bite with Coagulopathy with Dialysis 7 days |
RFT, INR, BTCT |
Evidence Of Clinical And Lab Investigations |
- |
M12A02 |
D759 |
M3 |
Critical Care |
M3Q2 |
Critical Care Gen Medicine |
M3Q2.3 |
Acute liver failure with Coagulopathy - 5 days |
LFT,PTINR |
Evidence of FFP,PTINR |
- |
M12A03 |
D759 |
M5 |
Infectious Diseases |
M5E7 |
Neonatal |
M5E7.1 |
Term Baby With clinical/ Culture Positive Sepsis- Non Ventilated per day - Rs 4000 - 7 Days |
?BLOOD CULTURE/ CBC,SERUM BILIRUBIN,CRP |
(Blood Culture/Crp/Cbc),Clinical Imrovement And Lab |
- |
|
|
M5 |
Infectious Diseases |
M5E7 |
Neonatal |
M5E7.19 |
Term Baby With Seizures per day - Rs 2500 - 21 Days |
ABG APGAR,Electrolytes,CSF ANALYSIS,CRP,CBC |
Neurosonogram/Ct- Scan/Mri) |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S13 |
General Paediatrics Severe Anemia |
M6S13.1 |
<32 Weeks Preterm Hyaline Membrane Disease Clinical/Culture Positive Sepsis Patent Ductus Arteriosus |
Xray chest,CBC,Blood culture /CRP,APGAR,2D ECHO |
CRPE/o Surfactan,Procedure Evidance,Cbc |
- |
M23A12 |
|
M6 |
Pediatrics Medical Management |
M6S13 |
General Paediatrics Severe Anemia |
M6S13.2 |
32 To 36 Weeks Preterm Hyaline Membrane Disease Clinical/ Culture Positive Sepsis without Mechanical |
ABG,X- RAY ,SERUM BILIRUBIN,Clinical photo,CRP,CBC |
Lab Investigations,Procedure Evidance |
- |
M12A02 |
D759 |
M6 |
Pediatrics Medical Management |
M6S13 |
General Paediatrics Severe Anemia |
M6S13.3 |
Term baby hyperbilirubinemia non septic more than 15 mg% per day - Rs 1500 - 5 Days |
CBC,Serum Bilirubin |
Serum bilirubin |
- |
M02A62 |
D649 |
M6 |
Pediatrics Medical Management |
M6S13 |
General Paediatrics Severe Anemia |
M6S13.4 |
Term baby Meconium Aspiration Syndrome bubble CPAP/ Mechanical Ventilation - Rs 6000 - 10 Days |
APGAR,CXR Photo with CPAP /ventilator,CBC |
CBC,blood culture,Clinical improvement |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S16 |
Pediatric ICU Care CNS |
M6S16.1 |
Intra Cranial Bleed with ventilator per day - Rs 4000 - 14 Days |
CT- SCAN/ MRI |
Evidance |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S16 |
Pediatric ICU Care CNS |
M6S16.2 |
Rickettsial fever 7 days stay |
Weil felix test positive |
Clinical improvement,regression |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S17 |
pediatrics endocrine |
M6S17.1 |
congenital hypothyroidism for new born - 10 Days |
MRI Brain,usg neck,freeT4,free T3,THS |
clinical levothyroxin |
- |
|
|
M6 |
Pediatrics Medical Management |
M6S17 |
pediatrics endocrine |
M6S17.2 |
short stature with growth hormone deficiency - 14 Days |
IGF-1,karyotyping,growth hormone levels,X-ray Skull,MRI/CT brain,IGF1 binding protine level-3.clinical photo |
HBA1C,thyroid level,procedure evidance,bone age x-ray |
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M6 |
Pediatrics Medical Management |
M6S17 |
pediatrics endocrine |
M6S17.3 |
Congenital adrenal hyperplasia with failure to thrive - 10 Days |
17 hydroxy progestrone,usg abdomen,sr.testostrone,sr.cortisole level,serum eletrolytes,karyotyping,cbc,ABG |
post procedure evidance of hydrocortisone tretment and fludrocortisone |
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M7 |
Cardiology |
M7F2 |
Coarctation Of Aorta Repair / Aortoplasty |
M7F2.1 |
Baloon dilatation of Coarctation of Aorta Without Stent |
2D ECHO & CT Aortogram or aortogram |
Claims Approval Subject To Stent/ Balloon Visiblity And Restoration Of Arterial Lumen In Angioplasty Video,Sticker Mandatory For Claim,Fluroscopy Video/Images Req |
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M7 |
Cardiology |
M7F5 |
Cardiology Balloon Procedures |
M7F5.1 |
Percutaneous Balloon Dilatation procedures in Cardiology |
2D Echo,X Ray Chest,Procedure with Haemodynamics,ECG |
Post procedures 2 D ECHO and Video |
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M7 |
Cardiology |
M7T2 |
Cardiology |
M7T2.1 |
Device closure of RSOV (Rupture of Sinus of Valsalva Aneurysm) |
ECG,TEE,ECHO |
Fluoroscopy,Vedio and Post procedure ECHO |
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M7 |
Cardiology |
M7T2 |
Cardiology |
M7T2.2 |
Post MI Ventricular septal Rupture - Device closure |
Cardiac Enzymes,TEE,ECHO,ECG |
Fluoroscopy,Vedio and Post procedure ECHO |
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M8 |
Nephrology |
M8S1 |
Nephrology |
M8S1.3 |
Plasmapheresis - 7 Days |
CBC,proteins and Clinical notes,Urine Routine exam,RFT |
RFT,Clinical improvement,CBC |
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M8 |
Nephrology |
M8S1 |
Nephrology |
M8S1.4 |
CAPD (Contineous Ambulatory Peritoneal Dialysis) One preauth of 30 days |
CBC,RFT,Nephrologist |
CBC,RFT,Clinical Photograph |
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M8 |
Nephrology |
M8S1 |
Nephrology |
M8S1.5 |
CRRT (Contineous Renal Replacement Therapy) 3days stay for ALF and others |
CBC,USG,RFT,Nephrologist |
CBC,RFT,Clinical Photograph |
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M9 |
Neurology |
M9T1 |
Neurology |
M9T1.1 |
Plasma Exchange for GBS/Myesthenic Crisis/NMOSD/MS Relapse/Refractory Optic Neuritis/HUSTTP/RPRF/ Tr |
NCS / CSF/ Imaging ,Serum Creatinine,PS,Nephrological indications ? CBC |
Clinical Improvements & Lab,Nerve Conduction Study,Emg |
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M9 |
Neurology |
M9T2 |
Neurology |
M9T2.1 |
Ischemic Strokes presenting in Window period - Management with all necessary investigations and Thro |
CT / MRI |
CT Bain Plain |
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M9 |
Neurology |
M9T5 |
Neurology |
M9T5.1 |
ACTH Therapy for Epileptic Encephalopathy |
EEG,MRI,Expert Opinion |
Proof of administration of ACTH |
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