| 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 Et | MRI/ CT | Clinical Photograph/Xray/ Ct/Mri,Hpe | - | S18A17 | G379 |
| S10 | Neurosurgery | S10I1 | Brain | S10I1.5 | Endoscopy Procedures | 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 | 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 | X- RAY/ CT | Clinical notes | - | S27N01 | V899xxA |
| S10 | Neurosurgery | S10I13 | Neurosurgical Trauma Consertative | S10I13.2 | Neurosurgical Trauma Consertative Management Stay | 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 | S10I2.8 | Cranioplasty | CT/MRI | Post Procedure Clinical Photograph/Ct/Xray | - | S18A12 | G07 |
| S10 | Neurosurgery | S10I2 | Brain Tumours | S10I2.9 | Meningocele 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 | Ventriculolateral / Ventriculoperitoneal 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 | S10I3.8 | 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 | S10I5.12 | 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 | 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 | 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 | Combined Trans Oral Surgery And 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 | S10I8.3 | Corpectomy For Spinal Fixation | CT/MRI | X Ray/Ct/Mri | - | S18E05 | 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. M | 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 | Tripple 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 | RADIOLOGICAL EVIDENCE,BIOPSY | Operative Notes,Post Procedure Clinical Photograph | - | SO34B05 | C260 |
| S11 | Surgical Oncology | S11J13 | Ca Gall Bladder | S11J13.1 | Radical 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 Tu | 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 + 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 Salp | 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 | 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 | 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 | 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 Pa | 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 | 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 | 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 | Clinical indications | HPE,Post Procedure Clinical Photograph,Operative Notes | - | SO34AI02 | C800 |
| S11 | Surgical Oncology | S11J31 | Gynecology | S11J31.4 | Surgery For Ca Ovary Advance Stage | USG/CT | HPE,Post Procedure Clinical Photograph,Operative Notes | - | SO34D04 | C55 |
| S11 | Surgical Oncology | S11J31 | Gynecology | S11J31.5 | Vulvectomy | - | 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 Tu | - | 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 & Reconstr | CT/MRI | HPE,Post Procedure Clinical Photograph,Operative Notes | - | SO34AJ04 | C005 |
| S11 | Surgical Oncology | S11J38 | Ca Liver | S11J38.1 | Haemangioma SOL Liver Hepatectomy + Wedge Resectio | 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 | 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 | 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 PMJAY Sub Category | S11PM1.1 | Voice prosthesis (US FDA /CE approved) | Evidence of Laryngectomy | Evidence of Use of Prosthesis | - | ||
| S12 | Plastic Surgery | S12M1 | Plastic Surgery | S12M1.11 | Tumour Of Mandible And Maxilla | CT/MRI/Xray/HPE clinical photograph | Biopsy Report,Clinical Phoptograph/ Xray | - | S25A08 | Q898 |
| S12 | Plastic Surgery | S12M1 | Plastic Surgery | S12M1.13 | Vascular Malformations | 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 Han | 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 | S12M1.17 | Flap Cover For Electrical Burns With Vitals Expose | 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 | S12M1.20 | 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 Hand | 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 | S12M1.7 | Hemifacial Microsmia | CT/ Xray / OPG | Clinical Photo Of Affected Part | - | S25A05 | Q898 |
| S12 | Plastic Surgery | S12M1 | Plastic Surgery | S12M1.9 | Nerve And Tendon Repair + Vascular Repair | Clinical Phoptograph | Clinical Photo Of Affected Part | - | S25A07 | Q898 |
| S12 | Plastic Surgery | S12M2 | Plastic Sugrey | S12M2.1 | Minor Vascular Injury Repair - Vessels In Foot - P | Doppler | Doppler / Scar Photo | - | S35B05 | S098xxA |
| S12 | Plastic Surgery | S12M2 | Plastic Sugrey | S12M2.2 | Minor Vascular Injury Repair- Tibial Vessels In Le | Doppler | Doppler / Scar Photo | - | S35B04 | S098xxA |
| S12 | Plastic Surgery | S12PM1 | Plastic Surgery PMJAY Sub Category | S12PM1.1 | Ear Pinna Reconstruction with costal cartilage/ Pr | Clinical Photo | Clinical Photo | - | ||
| S12 | Plastic Surgery | S12PM1 | Plastic Surgery PMJAY Sub Category | S12PM1.2 | Tissue Expander for disfigurement following burns/ | 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 | Clinical Photo | Clinical Photo | - | ||
| S13 | Burns | S13N1 | Burns Above 50% | S13N1.1 | Up To -40% With Scalds ( Conservative) | 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 | Upto-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 | Upto-50% With Scalds(Conservative) | 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 | Up To -50% 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 | Up To -60% With Scalds ( Conservative) | 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 | Up To -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% Mixed Burns( With Surgeries) | 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 Function | S13N2.1 | Mild Contracture Surgeries For Functional Improvem | Clinical photo of affected part | Clinical Photo Of Affected Part | - | S26B01 | T2899xS |
| S13 | Burns | S13N2 | Burns Post Burn Contracture Surgeries For Function | S13N2.2 | Moderate Contracture Surgeries For Functional Impr | Clinical photo of affected part | Clinical Photo Of Affected Part | - | S26B02 | T2899xS |
| S13 | Burns | S13N2 | Burns Post Burn Contracture Surgeries For Function | S13N2.3 | Severe Contracture Surgeries For Functional Improv | Clinical photo of affected part | Clinical Photo Of Affected Part | - | S26B03 | T2899xS |
| S14 | Poly Trauma | S14O1 | Orthpedic Trauma | S14O1.1 | Open Reduction And Internal Fixation Of Long Bone | X ray | OT Notes,X ray | - | S21AG | M8000xA |
| S14 | Poly Trauma | S14O1 | Orthpedic Trauma | S14O1.2 | Amputation Surgery | X- RAY | Post Procedure Clinical Photograph | - | S02A44 | A480 |
| S14 | Poly Trauma | S14O1 | Orthpedic Trauma | S14O1.3 | Soft Tissue Injury | CLINICAL PHOTOGRAPH | CLINICAL PHOTOGRAPH | - | S21D01G | M798 |
| S14 | Poly Trauma | S14O10 | Orthopedic And Facial Trauma Wound Management For | S14O10.1 | Grade I& II | CLINICAL PHOTOGRAPH,X- RAY | Post Procedure Clinical Photograph Ot Notes | - | S27A01G | V899xxA |
| S14 | Poly Trauma | S14O11 | Orthopedic And Facial Trauma Wound Management For | S14O11.1 | Grade -III | CLINICAL PHOTOGRAPH | Post Procedure Clinical Photograph | - | S27A02G | V899xxA |
| S14 | Poly Trauma | S14O11 | Orthopedic And Facial Trauma Wound Management For | 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 | S14O11.3 | Surgery For Patella Fracture (To Be Covered With O | X- RAY | X- Ray Ot Notes | - | S27B01G | V899xxA |
| S14 | Poly Trauma | S14O11 | Orthopedic And Facial Trauma Wound Management For | S14O11.4 | Small Bone Fractures K-Wiring (To Be Covered With | X- RAY | X- Ray Ot Notes | - | S27B02G | V899xxA |
| S14 | Poly Trauma | S14O11 | Orthopedic And Facial Trauma Wound Management For | S14O11.5 | Facial Bone Fractures (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 | 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 @ | 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.400 | 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 Wa | X-RAY/USG/CT | USG | - | S27O01 | V899xxA |
| S14 | Poly Trauma | S14O6 | Abdomen Consertative Treatment | S14O6.2 | Abdominal Injuries Stay In Surgical ICU@Rs.1000/D | 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 | 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 | Polytrauma PMJAY Sub Category | S14PM1.1 | Plexus injury along with Vascular injury repair wi | 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 -Milw | 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 | 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 | 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-Fibr | 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 | S1A10.2 | Portocaval Anastomosis | MRI/ USG/ UGI ENDOSCOPY | Endoscopy/ Usg | - | S33A05 | K7469 |
| 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 | CT/USG,LFT | Post Procedure Clinical Photograph,Usg Intra Op Photographic E/O Surgery Mandatory For Claim | - | S33I12 | K868 |
| S1 | General Surgery | S1A12 | Adrenals | 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 | S1A13.2 | 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 | ENDOSCOPY/ Sketch,USG/ CT | Post Procedure Clinical Photograph | - | S09J02G | K639 |
| S1 | General Surgery | S1A14 | Abdomen Large Intestine | S1A14.8 | Colostomy Closure | 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 | S1A15.11 | Drainage of perivertebral abscess | CLINICAL PHOTOGRAPH,Clinical Notes | 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 | S1A15.15 | 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 + Reconstructio | 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 | CLINICAL PHOTOGRAPH,Clinical Notes | CLINICAL PHOTOGRAPH,Clinical Notes | - | ||
| S1 | General Surgery | S1A15 | General Surgery | S1A15.20 | Drainage of Psoas Abscess with minimum 2 followup | Scar Photo,USG Abdomen | Scar Photo,USG Abdomen | - | ||
| S1 | General Surgery | S1A15 | General Surgery | S1A15.21 | Varicose Veins - Radiofrequency Ablation / Excisio | 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 | 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 | 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 | S1A7.9 | 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 Acute Intestinal 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 (N | 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 | S1PM1.11 | Drainage of Subdiaphramatic Abscess | USG Abdomen | Scar Photo | - | ||
| 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 diss | 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 Ulcer Unilateral | CLINICAL PHOTOGRAPH,Clinical Notes | Scar Photo | - | ||
| S1 | General Surgery | S1PM1 | General Surgery PMJAY Sub Category | S1PM1.29 | Excision and Skin Graft of Venous Ulcer Unilateral | CLINICAL PHOTOGRAPH,Clinical Notes | Scar Photo | - | ||
| S1 | General Surgery | S1PM1 | General Surgery PMJAY Sub Category | S1PM1.3 | Incision and Drainage of large Abscess with minimu | 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 | Growth in the Scalp ? 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 dress | 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 | Aspiration of cold Abscess of Lymphnode minimum 2 | 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 | S1PM1.56 | Excision of Swelling in Right Cervical Region | Clinical Notes ,Clinical Photograph | Clinical Notes,Scar Photo | - | ||
| S1 | General Surgery | S1PM1 | General Surgery PMJAY Sub Category | S1PM1.57 | Excision Meckel's 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 | S1PM1.60 | Gastric Perforation Isolated | X-ray Abdomen | 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 | S1PM1.9 | Excision of Benign Growth from Tongue only | Clinical photo | HPE | - | ||
| S20 | Oral and Maxillofacial Surgery | S20A1 | Oral & Maxillofacial Surgery | S20A1.4 | Benign Mandible Tumour Resection and reconstructio | 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) tre | 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 | S2B2 | Throat | S2B2.1 | Microlaryngeal Surgery | IDL Findings | Clinical Photo,IDL Findings | - | S05E01 | H9589 |
| S2 | ENT Surgery | S2B2 | Throat | S2B2.3 | Laryngo Fissurectomy | CT scan | Clinical Photo,Clinical findings | - | S05E03G | 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 | S2B2.7 | Uvulo-Palato Pharyngoplasty | Polysomnography | CT/MRI,Clinical Photo | - | S05E05G | H9589 |
| 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 | S2B4.3 | Fracture reduction nose with septal correction | 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 | Peritonsillor abscess under LA | Clinical findings by surgeon | Clinical Notes of 5 days after surgery | - | ||
| 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 | S2B5.3 | Bronchial Injuries Due To Foreign Body Repair Surg | Broncoscopy / CT scan | Post Procedure Endoscopic Picture | - | S03A04 | J986 |
| S2 | ENT Surgery | S2B5 | Head And Neck | S2B5.8 | Hemimandibulectomy | CLINICAL PHOTOGRAPH,CT Scan | CLINICAL PHOTOGRAPH,histopath,X- Ray | - | S25G41 | C800 |
| 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 | S2PM1.18 | 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 | S2PM1.20 | 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 diverticulum's ? 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 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 | S2PM1.38 | Laryngopharyngectomy with Gastric pull-up/ jejunal | 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 | 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 reconst | 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 | S2PM1.9 | 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 ? | 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 Sitt | Fundus Photograph & Sketch | Post Procedure Evidence Of Fundus Photograph & Sketch | - | S20B07 | H3570 |
| S3 | Ophthalmology Surgery | S3B4 | Opthalmology Surgery | S3B4.2 | Dacryocystectomy with implants | 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 corne | Clinical Photograph and clinical notes | Post op photograph | - | ||
| S3 | Ophthalmology Surgery | S3B4 | Opthalmology Surgery | S3B4.5 | Advanced Surgery for Retinopathy of Prematurity | Grading of Retinopathy by opthalmologist | Proof of Treatment | - | ||
| S3 | Ophthalmology Surgery | S3B5 | Cornea Sclera | S3B5.1 | Therapeutic 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 | 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 Degener | 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 | 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 | 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 | S3PM1.15 | Conjunctival tumour excision + AMG | Biopsy and endoscopic report | CT Scan,X-Ray PNS,Endoscopy | - | ||
| S3 | Ophthalmology Surgery | S3PM1 | Opthalmology Surgery PMJAY Sub Category | S3PM1.18 | 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 wit | Evidence of Raised IOP & Clinical Notes along with field of vision,Optic disc changes | Post procedure evidence of surgery | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4C1 | Obstetrics | S4C1.1 | Caesarean Hysterectomy With 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 | (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 | Abruptioo 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 | S4C2.11 | Laparoscopic Ectopic Resection | 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 | USG | HPE,Video Is Mandatory | - | OG11B16 | N895 |
| S4 | Gynaecology And Obstetrics Surgery | S4C2 | Gynaecology | S4C2.22 | Perineal/ Vesico-vaginal/ Recto-vaginal tear repai | Clinical Notes | CLINICAL IMPROVEMENT | - | ||
| 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 Repair With 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 z | Clinical/ Histopathological report | Post.op ultrasound (pelvis) | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.1 | Repair for rectovaginal fistulas | Clinical Notes | Intra Operative Photoghraph | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.10 | HaematoColpo/Excision - Vaginal Septum | Clinical Notes | Clinical Notes | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.17 | Colpotomy | Clinical Notes | Clinical Notes | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.18 | Intrauterine transfusions | Clinical Notes | Clinical photograph ,Record of Blood Transfusion | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.3 | Broad Ligment Haemotoma/ Abdominal Haematoma drain | USG | USG | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.5 | Hysteroscopic myomectomies | USG | USG | - | ||
| S4 | Gynaecology And Obstetrics Surgery | S4PM1 | Obstetrics & Gynaecology PMJAY Surgery Sub Categor | S4PM1.8 | Laparotomy for broad ligament haematoma | USG | USG | - | ||
| 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 Fracture | 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 & To | 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 Fixatio | 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 | Foot Amputation (whole) | - | - | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.1 | Open Reduction Of Dislocations - Deep | x ray | Post Procedure X Ray | - | S21G01G | M435x9 |
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.16 | Closed reduction of dislocation (hip) | CLINICAL PHOTOGRAPH,X-Ray | CLINICAL PHOTOGRAPH,X-Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.17 | Scoliosis (Rs. 90000) + special spinal brace (Rs. | CLINICAL PHOTOGRAPH,X-Ray | CLINICAL PHOTOGRAPH,bill of spinal brace,X-Ray,Implant sticker (barcode) | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.18 | Closed Interlock Nailing + Bone Grafting ? femur | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.19 | Closed Interlocking Intermedullary | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.20 | Closed Interlocking Tibia + Orif of Fracture Fixat | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.21 | Closed Reduction and Internal Fixation with K wire | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.22 | Closed Reduction and Percutaneous Screw Fixation ( | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.23 | Closed Reduction and Percutaneous Pinning | 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 | Closed Reduction of the Hip (including hip Spika) | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.26 | Debridement & Closure of Major injuries - contused | 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 | S5D2.31 | 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 | S5D2.34 | Multiple Tendon Repair | Clinical photograph,X Ray | Clinical photograph,X Ray | - | ||
| S5 | Orthopedic Surgery And Procedures | S5D2 | Orthopedics | S5D2.35 | Open Reduction Internal Fixation (2 Small Bones) | 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 | S5D2.39 | Amputation - Above/Below Elbow | CLINICAL PHOTOGRAPH,X-Ray | CLINICAL PHOTOGRAPH,X-Ray | - | ||
| 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 Acc | Clinical photgraph ,X rays of affected limb | Clinical photgraph ,X rays of affected limb | - | ||
| 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 | S5D3 | Orthopedics Bone And Joint Surgery Procedures | S5D2.5 | Arthroscopy - Diagnostic | 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 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 Decompres | 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/ | 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-Constructio | 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 r | 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/ Acromionpl | 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 | S5PM1.56 | Sequestrectomy of Long Bones + anti-biotics + dres | 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 Limb | 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 osteotom | 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 (dayca | 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 fractu | 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 | 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 | USG / CT- SCAN | Biopsy,Clinical Photograph | - | S02A31 | Q505 |
| 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) | 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 | S6E5.5 | Surgery For Corrosive Injury Stomach | 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 | 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 Intesti | BIOPSY,ENDOSCOPY,CT- SCAN,COLONOSCOPY | BIOPSY,CLINICAL PHOTOGRAPH | - | S25G35 | C800 |
| S6 | Surgical Gastro Enterology | S6E7 | Large Intestine | S6E7.5 | Anterior Resection With Ileostomy | 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 | 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 - Pouch | 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 - Pou | 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 | Percardectomy | 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 Bypa | 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. Emergenc | 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 cardiom | 2D ECHO | Scar photo/Post-op 2 D Echo/Post-op X ray | - | ||
| S7 | Cardiac And Cardiothoracic Surgery | S7F13 | Cvts | S7F13.21 | Pulmonary artero 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 | 2D ECHO | ECHO,scar photo,Post op X Ray | - | ||
| S7 | Cardiac And Cardiothoracic Surgery | S7F13 | Cvts | S7F13.23 | Surgery for Arterial Aneurysm Renal Artery | 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 | S7F13 | Cvts | S7F13.28 | Peripheral Embolectomy Without Graft | ANGIOGRAM/ COLOR DOPPLER | Color Doppler,Operation Notes | - | S35A04 | I872 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F13 | Cvts | S7F9.19 | Arterial Embolectomy | ANGIOGRAM/ COLOR DOPPLER | Colour Doppler & Proceedure Notes Sufficient (For Peripheral Arterial Embolectomy) & Ct Angio For Other Arteries | - | S35A07 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F14 | Systemic Pulmonary Shunts | S7F14.1 | Systemic Pulmonary Shunts With Graft | 2D Echo | 2D Echo,Operation Notes | - | S02B32 | Q259 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F16 | Ross Procedure Intracardiac Repair Of Complex Cong | S7F16.1 | Ross procedure - Intracardiac repair of complex co | 2D Echo | 2D Echo/Scar Photo | - | S02B40 | Q223 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F16 | Ross Procedure Intracardiac Repair Of Complex Cong | S7F16.2 | Ross procedure - Intracardiac repair of complex co | 2D Echo | 2D Echo/Scar Photo | - | S02B41 | Q223 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F17 | Cvts Valve Repairs | S7F17.1 | Valve Repair Without Prosthetic Ring | 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 | 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, Venou | 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,Branchia | 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 - Pay | 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 - Payable m | Angiogram /Doppler/ CT angio | Doppler / Scar Photo | - | S35B08 | S098xxA |
| S7 | Cardiac And Cardiothoracic Surgery | S7F24 | Vascular Injuries | S7F24.9 | Abdominal Vascular Injuries - Aorta, Iliac Arterie | 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 | S7F25 | Vasular | S7F9.12 | Femorodistal Bypass With Vein Graft | - | - | - | S35A14 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.13 | Femorodistal Bypass With Synthetic Graft | - | - | - | S35A15 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.14 | Axillo Brachial Bypass Using With Synthetic Graft | - | - | - | S35A16 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.15 | Brachioradial Bypass With Synthetic Graft | - | - | - | S35A17 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.17 | Carotid Artery Bypass With Synthetic Graft | CT angio/ MRI-angio/ Color Doppler/ ANGIOGRAM | Barcode Sticker,Operation Notes,Color Doppler | - | S35A19 | I720 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.18 | Excision Of AV Malformation Small | - | - | - | S35A06 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.22 | Excision Of AV Malformation Large | - | - | - | S35A05 | I778 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.8 | Medium Size Arterial Aneurysms - Repair | - | - | - | S35A10 | I729 |
| S7 | Cardiac And Cardiothoracic Surgery | S7F25 | Vasular | S7F9.9 | Medium Size Arterial Aneurysms With Synthetic Graf | - | - | - | 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 | S7F6 | Cad | S7F6.4 | Mitral Valve Replacement (With 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 | Coronary Bypass Surgery 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 | Coronary Bypass Surgery 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 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 Gra | 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 | 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 bioprosthetic 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 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 | Blalock?Thomas?Taussig (BT) Shunt (inclusives of g | 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 (pre-auth not required, usually | 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 | 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 | CLINICAL PHOTOGRAPH/ Imaging/ Biopsy | Biopsy,Post Procedure Scar Photograph | - | S22A08 | Q431 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.1 | Congenital Hydronephrosis | USG / Renogram | Post Procedure Evidence Of Clinical Photograph | - | S22A09 | Q620 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.11 | Velo-Pharyngial Incompetence | Contrast Study,Endoscopy | Post Procedure Photo | - | S25G06 | Q899 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.15 | Hypospadius Stage 1 | Clinical Photograph | Post Procedure Clinical Photograph | - | S25G18 | Q899 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | 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 ?Urogenital | S8G2.17 | Hemangioma Excision | Colour Doppler,Neuro USG + CT | Post Procedure Photo | - | S22B02 | Q808 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.18 | Lymphangioma Excision | Clinical photo,USG + CT | Post Procedure Photo | - | S22B03 | Q820 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | 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 ?Urogenital | S8G2.3 | Extrophy Bladder Stage 1 | Clinical Photograph/USG,Xray Pelvis | Post Procedure Clinical Photograph | - | S22A10 | Q6410 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.4 | Extrophy Bladder Stage 2 | Clinical Photograph/USG,Xray Pelvis | Post Procedure Clinical Photograph | - | S22A10 | Q6410 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.5 | Posterior Urethral Valves | MCU / USG | Clinical Notes,Clinical Photo With Catheter | - | S22A11 | Q6410 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.6 | Hypospadias Single Stage | Clinical Photograph | Post Procedure Clinical Photograph | - | S22A12 | Q6432 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | S8G2.7 | Hypospadius Stage 2 | Clinical Photograph | Post Procedure Clinical Photograph | - | S22A12 | Q6432 |
| S8 | Pediatric Surgery | S8G2 | Congenital Malformations ?Urogenital | 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 | S8G3.4 | Encephalocele | MRI/ CT/ NEURO USG | Post Procedure Clinical Photograph | - | S22C04 | Q018 |
| 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 Corre | 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 | Thoracoscopic Decortication | 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 | S8G5 | Abdomen | S8G5.1 | Gastric Outlet Obstructions | Contrast USG,Xray | Post Procedure Clinical Photograph | - | S22E05 | P7889 |
| 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 | S8G5.6 | 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 | S8G6.5 | Torsion Testis | clinical photo and colour doppler | Clinical Photo,Notes | - | S10F01 | N4400 |
| S8 | Pediatric Surgery | S8G6 | Urogenital | S8G6.6 | Laparoscopic Orchidopexy | Clinical Photograph,Usg | Clinical Photograph,Video,Usg | - | S22F01 | Q5300 |
| S8 | Pediatric Surgery | S8G7 | Pediatric Surgery | S8G7.1 | Hirschsprung?s Disease - Pull Through | BIOPSY,imaging,CLINICAL PHOTOGRAPH | BIOPSY,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 PMJAY Sub Category | S8PM1.10 | Exomphalos/gastroschisis | Clinical Photo | Clinical Notes | - | ||
| S8 | Pediatric Surgery | S8PM1 | Pediatric Surgery PMJAY Sub Category | S8PM1.2 | Ankyloglossia Major | Clinical Notes,Clinical Photograph | Post Procedure Evidence of Surgery | - | ||
| S8 | Pediatric Surgery | S8PM1 | Pediatric Surgery PMJAY Sub Category | S8PM1.3 | Ankyloglossia Minor | Clinical Notes,Clinical Photograph | Post Procedure Evidence of Surgery | - | ||
| S8 | Pediatric Surgery | S8PM1 | Pediatric Surgery PMJAY Sub Category | S8PM1.5 | Fecal Fistula Closure | Clinical Notes,Clinical Photograph | Post Procedure Evidence of Surgery | - | ||
| S8 | Pediatric Surgery | S8PM1 | Pediatric Surgery PMJAY Sub Category | S8PM1.6 | GI Tumor Excision | USG | Biopsy ,Post Procedure Evidence of Surgery , Post Procedure USG | - | ||
| S8 | Pediatric Surgery | S8PM1 | Pediatric Surgery PMJAY Sub Category | 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 re | 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 | RFT,USG | BILLS COPY | - | T31A03 | N2889 |
| 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 | Chordae Correction | Clinical Photo | Post Procedure Evidence Of Clinical Photograph | - | S10F03 | N448 |
| 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 | S9H3.4 | 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 | 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 S | RGU | Post Procedure Evidence Of Clinical Photograph | - | S10D03 | N29 |
| S9 | Genitourinary System | S9H5 | Corrective Procedures | S9H5.3 | Urethroplasty For Stricture Urethra Double Stage S | 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 Adult Single Stage | Clinical Photograph | Post Procedure Evidence Of Clinical Photograph | - | S25G15 | Q899 |
| S9 | Genitourinary System | S9H5 | Corrective Procedures | S9H5.6 | Hypospadius Adult Double Stage - Stage-1 | Clinical Photograph | Post Procedure Evidence Of Clinical Photograph | - | S25G16 | Q899 |
| S9 | Genitourinary System | S9H5 | Corrective Procedures | S9H5.7 | Hypospadius Adult 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 | Post-Transplant Immunosuppressive Treatment From 7 | 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 | S9H7 | Urology Kidney Stone | S9H10.2 | 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 | IVP/CT,USG | CLINICAL PHOTOGRAPH,USG | - | ||
| S9 | Genitourinary System | S9H7 | Urology Kidney Stone | S9H7.11 | Perinephric Abscess drainage | USG | USG | - | ||
| 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 | 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 | S9H7.9 | 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 | S9H8.3 | 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 | Ureteric 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 | S9H8.9 | Transurethral Resection Of Prostate (TURP) | 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 | S9H9.6 | 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 (wee | Histopathplogy report | Clinical photograph | - | ||
| S9 | Genitourinary System | S9PM1 | Urology PMJAY Sub Category | S9PM1.14 | Intravesical BCG/Mitomycin maintenance for 12 dose | 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 | 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 procedu | MCU ,URETEROSCOPY,RGU | Clinical photograph | - | ||
| S9 | Genitourinary System | S9PM1 | Urology PMJAY Sub Category | S9PM1.19 | Y V Plasty of Bladder Neck/Bladder Neck Reconstruc | 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 in | 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 | 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,10 Da | 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- 10 Days Stay | HR CT - Chest | Post Treatment Evidence Of Clinical And Lab Investigations,Spirometry | - | M28A02 | J9819 |
| M10 | Pulmonology | M10T4 | Pulmonology | M10T4.4 | Pneumoconiosis - 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) 10 | 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 Ventilator) 10 Day | 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 - 10 Days | HR CT - Chest | Post Treatment Evidence Of Clinical And Lab Investigations,Sputum Culture /Drug Susceptibility | - | M28A01 | J9819 |
| M11 | Dermatology | M11T5 | Dermatology | M11T5.2 | Stevens- Johnson Syndrome 15 Days Stay | CBC,Urine R/M,Skin Swab,RFT,LFT | CBC,Skin Biopsy,RFT,LFT,Clinical Notes | - | M04A03 | L508 |
| M13 | Endocrinology | M13U1 | Endocrinology Uncontrolled Diabetes Mellitus With | M13U1.1 | Lower Respiratory Tract Infection 10 Days Stay | CXR,Sputum gram stain | Lab Investigations,Post Procedure Evidance Of Clinical Imrovement | - | M02A68 | J22 |
| M13 | Endocrinology | M13U1 | Endocrinology Uncontrolled Diabetes Mellitus With | 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 | 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 | M13U1.4 | Cavernous 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 | 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 | 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 - 1 Week 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 1 Week Stay | 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 | Cushings Syndrome Inv - Cortisol Assay After Dexam | 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 | Delayed Puberty Hypogonadism (Ex.Turners Synd, Kle | 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 | Basal ACTH,Serum Sodium,Serum Potassium,Basal Cortisol | Clinical Improvement | - | ||
| M13 | Endocrinology | M13U3 | Endocrinology | M13U3.2 | Endogenous Hyperthyroidism | T3 T4 TSH,TC-99 thyroid scan | Clinical Improvement | - | ||
| M13 | Endocrinology | M13U3 | Endocrinology | M13U3.3 | Gonadotropin releasing hormone excess state (For 1 | FSH / LH,X rays of affected limb | Clinical Improvement | - | ||
| M13 | Endocrinology | M13U3 | Endocrinology | M13U3.4 | Prolactin Excess (Prolactinoma) | 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 s | ALBUMIN,Phosphorus,PTH,Calcium,CREATININE,ALKALINE PHOSPHATASE | Clinical Improvement | - | ||
| M14 | Gastroenterology | M14V1 | Gastroenterology | M14V1.10 | Acute Pancreatitis (Severe) -3 Weeks Stay - Payabl | 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 | Acute Pancreatitis With Pseudocyst (Infected) 3 We | 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 Sta | 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 - 10 Days Sta | 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 | Biliary Stricture 1) Post Op Stent 7 Days Stay | 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 | 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 F | Gastroscopy | Post Procedure Endoscopic Picture | - | S03A05 | J986 |
| 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 S | UGI Endoscopy | Post Treatment Evidence Of Endoscopic Photograph | - | M07A17 | I864 |
| M14 | Gastroenterology | M14V1 | Gastroenterology | M14V1.9 | Acute Pancreatitis (Mild) - 1 Week Stay With Post | 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 | 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 | 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 And Post Traumatic B | 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 An | 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 Placemen | 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 | 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 Lim | 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 Substitu | 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 Si | 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 Occlusi | 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 Hemodialys | 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 Ble | 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 Tu | 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 Using Drug And | 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 E | 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 (TI | 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 Pro | 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 Sitti | 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 Devi | 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 Peripheral Aneurysms An | 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 Extr | 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 | 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/ Iliac Arte | 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 Acute | 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 demyelinating Polyneuropathy | Nerve Conduction Study(NCS) | Clinical Notes | - | ||
| M16 | GENERAL MEDICINE | M16PM1 | General Medicine PMJAY Sub Category | M16PM1.2 | Metabolic encephalopathy/encephalitis due to any c | 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/Mult | MRI,Venogram | Post Procedure Evidance Of Clinical Improvement ,Lab Investigations | - | ||
| M16 | GENERAL MEDICINE | M16Q1 | Critical Care Gen Medicine | M16Q1.1 | Thrombocytopenia With Bleeding Diathesis | 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 pa | Electrophorosis and other confirmatory test | Clinical Improvement,Lab Investigations | - | ||
| M16 | GENERAL MEDICINE | M16Q1 | Critical Care Gen Medicine | M16Q1.11 | Severe anemia | 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 (Falciparum) requiring Ventilator | 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 | 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 | 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 | 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 Requiring Ventilatory Support | 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 | M17PM1 | Mental Disorders Packages PMJAY Sub Category | M17PM1.5 | Transcranial Magnetic Stimulation (TMS) | Clinical assessment | Clinical assessment | - | ||
| M18 | Hematology | M18Q1 | Hematology | M18Q1.1 | Anaemia Of Unknown Cause treated with Haematinics, | 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 treatment with IV FPP, Factor VIII /Cr | 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 Major Requiring Chelation Therapy - 7 | HB ELECTROPHORESIS/ HPLC,SERUM FERRITIN(6 monthly)req | Case Sheet With Records Of Chelation Therapy | - | M23A12 | P619 |
| M18 | Hematology | M18Q1 | Hematology | M18Q1.4 | Chelation Therapy For Thalassemia | 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) | 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 | 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 (CM | 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/Tamoxif | 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) | 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 ch | 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/Cyclophospha | - | - | - | MO15J03 | C9000 |
| M1 | Medical Oncology | M1K11 | Wilm'S Tumor | 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 | Cisplastin Adriamycin | Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,SG/CT Scan / Biopsy | Chemo Charts,Clinical Photograph | - | MO15L01 | C260 |
| M1 | Medical Oncology | M1K13 | Cervix | M1K13.1 | Cervical Cancer Weekly Cisplastin | Biopsy,USG/CT,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH | Chemo Charts,Clinical Photograph | - | MO15M01 | C55 |
| M1 | Medical Oncology | M1K14 | Childhood B-Cell Lymphomas | M1K14.1 | Variable Regimen Inv - Hematology - Payable maximu | 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 max | 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 | Carbo/Etoposide/Vincristin | MRI/CT Orbit/USG orbit,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH | Chemo Sheets,Clinical Photograph | - | MO15P01 | C6960 |
| M1 | Medical Oncology | M1K17 | Histocytosis | M1K17.1 | Variable Regimen Inv - CT, Biopsy - Payable maximu | 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 (VACTC) B | 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 - Payabl | 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 | Bladder Cancer 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 Cyclophosphamid | 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 - Payable maximum upto | 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 up | 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 u | 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 | Palliative Chemotherapy -Unlisted Regimen - Payabl | Biopsy/Histopatholigy report,USG/CT Scan | Chemo Sheets,Post Treatment Clinical Notes | - | MO15V01 | C9000 |
| M1 | Medical Oncology | M1K23 | Terminally Ill | M1K23.1 | Palliative And Supportive Therapy - Per month | Biopsy,USG/CT/ Blood test | Chemo Sheets,Post Treatment Clinical Notes | - | MO15W01 | C9100 |
| M1 | Medical Oncology | M1K24 | Vulval Cancer | M1K24.1 | Cisplastin/5-FU | 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 Thera | 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 Thera | 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 | 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/Etoposide (IIIB) | 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) | 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 | 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 / Cyclophos | 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 | Bleomycin-Etoposide-Cisplastin (BEP) | Biopsy,USG/CT,S.A FP/ B HC,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH | Chemo Sheets,Clinical Photograph | - | MO15AD01 | C62 |
| M1 | Medical Oncology | M1K34 | Prostate | M1K34.1 | Hormonal Therapy - Per month | Biopsy,USG,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,PSA | Chemo Sheets,Clinical Photograph | - | MO15AE01 | C61 |
| M1 | Medical Oncology | M1K4 | Oncologyoesophagus | M1K4.1 | Cisplastin- 5FU | Endoscopy/CT scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy | Chemo Sheets,Clinical Photograph | - | MO15D01 | C159 |
| 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 | 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 | 5-Fu Leucovorin (MCDONALD Regimen) | Endoscopy/CT scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,Biopsy | Chemo Sheets,Clinical Photograph | - | MO15E01 | C169 |
| 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) (S | 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 | Cisplatin/Adriamycin/Ifosfamide | Biopsy,Xray/CT scan,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH | Chemo Charts,Clinical Photograph | - | MO15G01 | C4092 |
| M1 | Medical Oncology | M1K8 | Lymphoma, Hodgkin'S | M1K8.1 | Adriamycin Bleomycin Vinblastin Dacarbazine (ABVD) | Biopsy,Planned CHEMOTHERAPY REGIMEN AT TIME OF PREAUTH,CT scan/PET | Chemo Charts,Clinical Photograph | - | MO15H01 | C8100 |
| M1 | Medical Oncology | M1K9 | Lymphoma Nhl | M1K9.1 | Cyclophosphamide Adriamycin Vincristin Prdnisone ( | 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 | 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 | 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 | 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 | Adjuvant Treatment With Photons/Electrons | Histopatholigy report,USG/CT/X-RAY/Imagings | Rt Treatment Charts | - | R29B03 | C800 |
| M2 | Radiation Oncology | M2L3 | Brachytherapy Intracavity | 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 Intracavity | 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 Multip | Histopatholigy report,USG/CT/X-RAY/Imagings | Rt Treatment Charts | - | R29D02 | C800 |
| M2 | Radiation Oncology | M2L5 | Specialized Radiation Therapy - Imrt (Intensity Mo | M2L5.1 | IMRT-Up To 40 Fractions In 8 Weeks | Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings | Rt Treatment Charts | - | R29E01 | C800 |
| M2 | Radiation Oncology | M2L6 | Specialized Radiation Therapy - 3dcrt(3-D Conforma | M2L6.1 | 3DCRT-Up To 30 Fractions In 6 Weeks | 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 5 fractions | Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings | Rt Treatment Charts | - | R29G01 | C800 |
| M2 | Radiation Oncology | M2L8 | Specialized Radiation Therapy Rapid Ax Therapy | M2L8.1 | VMAT Therapy-Up To 40 Fractions In 8 Weeks | 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 | IMRT+IGRT-Up To 40 Fractions In 8 Weeks | Biopsy/Histopatholigy report,USG/CT/X-RAY/Imagings | Rt Treatment Charts | - | R29I01 | C800 |
| 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 | 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)1 | 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 Fa | 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 14 Days Stay | 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 Car | 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 Ventil | 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 Ventilato | 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 Assi | 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 Poisoning without Ventilatory Assistance Clinic | 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 | 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 | Clinical photograph,Throat swab for C/S,ECG | Lab Investigations | - | M08B02 | A360 |
| M5 | Infectious Diseases | M5R1 | Infectious Diseases | M5R1.3 | Cryptococcal Meningitis | 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 | Bone Marrow,HBSAG,CBC | Clinical Notes | - | ||
| M6 | Pediatrics Medical Management | M6PM1 | Pediatrics Medical Management PMJAY Sub Category | M6PM1.10 | Refractory seizures | 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 | 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 complicati | CT ? Scan,X-Ray Chest,ESR | Clinical Notes | - | ||
| M6 | Pediatrics Medical Management | M6PM1 | Pediatrics Medical Management PMJAY Sub Category | M6PM1.4 | Acute glomerulonephritis | Urine Analysis,USG,CT and KFT | Clinical Notes | - | ||
| M6 | Pediatrics Medical Management | M6PM1 | Pediatrics Medical Management PMJAY Sub Category | M6PM1.5 | Infantile cholestasis | 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 | 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 | RA Factor | Clinical Notes | - | ||
| M6 | Pediatrics Medical Management | M6S1 | Paediatrics Neonatal | M6S1.1 | Term Baby With Culture Positive Sepsis- Non Ventil | 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, Sept | 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 | 33 To 34 Weeks Preterm Baby Severe Hyaline Membran | 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 Mild Hyaline Membrane Disea | 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 Disea | 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 Dis | 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 | 30 To 32 Weeks Preterm Severe Hyaline Membrane Dis | 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 | <30 Weeks Preterm Severe Hyaline Membrane Disease | 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 Dis | 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 | "Necrotising Enterocolitis, Clinical Sepsis Non Ve | 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 | 30 To 32 Weeks Preterm Severe Hyaline Membrane Dis | 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 gene | CBC with P.S/ Bone Marrow | CBC with P.S | - | ||
| M6 | Pediatrics Medical Management | M6S1 | Paediatrics Neonatal | M6S1.3 | <30 Weeks Preterm Severe Hyaline Membrane Disease | 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 V | 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 Ven | 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 - Ventila | 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 Sepsi | 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 - Neurosono | 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 Ven | 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 Paediatrics Respiratory | M6S10.1 | Acute Broncho/ Lobarpneumonia With Empyema/ Pleura | 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 Pneumothora | 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 F | 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 Fai | 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 O | 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 Py | 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 10 Days Stay | 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 With 10 Days Stay | 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- 12 Days Stay - DOTS Rx Free | 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- 12 Days Stay | 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 Thrombocytope | 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-14 Days Stay | CT | Post Treatment Evidence Of Clinical And Lab Investigation | - | M02A65 | G463 |
| M6 | Pediatrics Medical Management | M6S15 | General Paediatrics Neurology | M6S15.3 | Encephalitis / Encephalopathy - 10 Days Stay | 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) | CLINICAL PHOTOGRAPH,X- RAY CHEST | X-Ray | - | M02A54 | Z382 |
| M6 | Pediatrics Medical Management | M6S2 | Pediatric Ic Care Respiratory | M6S2.2 | Severe Bronchiolitis (Non Ventilated) | 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) | 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) | 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 (Ventilated) | 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) | 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) | 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 | 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) | 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 | 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 Venti | 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 Cardio | 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 | 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 | 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) | 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) | 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 | 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) | 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 | 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 E | 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 - 10 Days PICU Stay | 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 ? 10 D | 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 Ic Care Renal | M6S6.1 | Acute Renal Failure With Dialysis - 10 Days PICU S | 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 Ic Care Endocrine | M6S7.1 | Diabetic Ketoacidosis - 8 Days PICU Stay | 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 Ic Care Infection | M6S8.1 | Septic Shock- 10 Days PICU Stay | 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 1 | 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 Sh | 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 | CVP monitoring(optional),Serial ABG | Mlc,Post Treatment Evidence For Clinical Improvement With Biochemical Parameters | - | M24A20 | T63001A |
| M7 | Cardiology | M7F1 | Angioplasty | M7F1.1 | Coronary Ballon 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 | Permanent Pacemaker Implantation | 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 | 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 | - | - | - | 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 | Coarctation dilatation | 2D ECHO report | stills of ECHO,2D ECHO report | - | ||
| M7 | Cardiology | M7PM1 | Cardiology PMJAY Sub Category | M7PM1.2 | PTSMA (Percutaneous Transluminal Septal Myocardial | 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 | 2D ECHO | 2D Echo,Lab Investigations Of Pericardial Fluid | - | M01A10 | I4430 |
| M7 | Cardiology | M7T1 | Cardiology | M7T1.11 | Thrombolytic Therapy for Acute MI | 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 Commissurotorm | 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 | 2D ECHO | Fluroscopy Video/Images,Stickers As And Where Applicable,Ot Notes | - | S02A09 | Q250 |
| M7 | Cardiology | M7T1 | Cardiology | M7T1.16 | Coil Closure Single Coil | 2D Echo | Fluroscopy Video/Images,Stickers As And Where Applicable,OT Notes | - | S02A08 | Q250 |
| M7 | Cardiology | M7T1 | Cardiology | M7T1.17 | 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 | 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 | 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 | 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 | CT Pul angio/ angio,Doppler | Clinical notes,ECG,Ct Pulm (Submitted During Preauth) | - | M01A07 | I400 |
| M7 | Cardiology | M7T1 | Cardiology | M7T1.8 | Complex Arrhythmias | 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 | 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 | COLOR DOPPLER | Clinical Photo/Color Doppler | - | S35A02 | N186 |
| M8 | Nephrology | M8S1 | Nephrology | M8S1.2 | A V Fistula At Wrist | COLOR DOPPLER | Clinical Photo/Color Doppler | - | S35A01 | N186 |
| M8 | Nephrology | M8T2 | Nephrology | M8T2.1 | Post-Transplant Immunosuppression Treatment From 1 | USG/RFT | BILLS COPY | - | ||
| M8 | Nephrology | M8T2 | Nephrology | M8T2.2 | Acute Renal Failure-(ARF) -10 Days Stay In MICU | 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 | 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) - 5 Days Stay for Ini | 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 su | 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 From 1 | USG/RFT | BILLS COPY | - | ||
| M8 | Nephrology | M8T2 | Nephrology | M8T2.8 | Post-Transplant Immunosuppression Treatment From 2 | USG/RFT | BILLS COPY | - | ||
| M8 | Nephrology | M8T2 | Nephrology | M8T2.9 | Post-Transplant Immunosuppression Treatment From 3 | 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 | Optic Neuritis - Analysis 3 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 | 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 Relapse In Multiple Sclerosis 15 Days Stay | CSF ANALYSIS,MRI BRAIN/ SPINAL CORD (3 SITES) PLAIN/ CONTRAST | Clinical Improvement,Lab Investigations | - | M17A01 | G35 |
| M9 | Neurology | M9T3 | Neurology | M9T3.13 | 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 ne | 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 inv | 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- Min 20 Days - | 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 -Min 10 Days | 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 (Inclu | 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)-15 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 | Blood Sugar,ELECTROLYTES | Lab Investigations Eeg / Ct-Brain,Post Procedure Evidance Of Clinical Imrovement | - | M02A64 | G40821 |
| Category Code | Category Name | Sub Category Code | Sub Category Name | Surgery Code | Surgery Name | Pre Investigation | Post Investigation | Mid Investigation | PCS Code | ICD Code |
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