Category Code Category Name Sub Category Code Sub Category Name Surgery Code Surgery Name Pre Investigation Post Investigation Mid Investigation PCS Code ICD Code
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 -
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 -
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 -
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 -
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 -
M7 Cardiology M7T2 Cardiology M7T2.2 Post MI Ventricular septal Rupture - Device closure Cardiac Enzymes,TEE,ECHO,ECG Fluoroscopy,Vedio and Post procedure ECHO -
M8 Nephrology M8S1 Nephrology M8S1.3 Plasmapheresis - 7 Days CBC,proteins and Clinical notes,Urine Routine exam,RFT RFT,Clinical improvement,CBC -
M8 Nephrology M8S1 Nephrology M8S1.4 CAPD (Contineous Ambulatory Peritoneal Dialysis) One preauth of 30 days CBC,RFT,Nephrologist CBC,RFT,Clinical Photograph -
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 -
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 -
M9 Neurology M9T2 Neurology M9T2.1 Ischemic Strokes presenting in Window period - Management with all necessary investigations and Thro CT / MRI CT Bain Plain -
M9 Neurology M9T5 Neurology M9T5.1 ACTH Therapy for Epileptic Encephalopathy EEG,MRI,Expert Opinion Proof of administration of ACTH -
Category Code Category Name Sub Category Code Sub Category Name Surgery Code Surgery Name Pre Investigation Post Investigation Mid Investigation PCS Code ICD Code