SEHAT SAHULAT PROGRAM

“BENEFIT PACKAGE (2019 – 2021)”

Benefit First Level and Tertiary Level Health Care Services Package included
Package: in Essential Packages of Healthcare Services (EPHS) & beyond
Services
Only Hospitalization Services (Required indoor / day care)
Offered:
FINANCIAL LIMITS PROVIDED

Package Priority Disease Treatment Secondary Disease Treatment

Classification: Package Package

Initial Coverage: Rs: 300,000 / family / year Rs: 60,000 / family / year
Additional
Rs: 300,000 / family / year Rs: 60,000 / family / year
Coverage*:
Total
Rs: 720,000 / family / year
Coverage:
TREATMENT PACKAGES PROVIDED

Package Priority Disease Treatment Secondary Disease Treatment

Classification: Package Package

Diseases • Heart Diseases: • Medical Procedures /

Package 1:
- Requires Indoor / Day Care
treatment
- Medical and Surgical: Covered
- Acute & Chronic: Covered
- Angiography, Stent Insertion,
CABG, Myocardial Infarction
management etc: Covered
- Evolving list of covered
treatments / procedures
present in Annex-A
Treatment, not covered under
priority disease treatments, are
covered under this package.
- Acute & Chronic: Covered
- Typhoid management, Pyrexia of
Unknown origin, Eclampsia,
Hepatitis, Pancreatitis, Abscess,
Seizure, Animal bite etc:
Covered
- Evolving list of covered
treatments / procedures present
in Annex-A

Diseases • Diabetes mellitus • Surgical Procedures /

Package 2: complications:
- Requires Indoor / Day Care
treatment
- Medical and Surgical: Covered
- Acute & Chronic: Covered
- Amputation, Gangrene
management, Diabetic
ketoacidosis management,
Diabetic Foot Management etc:
Covered
- Evolving list of covered
treatments / procedures
present in Annex-A
Treatment, not covered under
priority disease treatment, are
covered under this package.
- Acute & Chronic: Covered
- Appendectomy, renal stone, gal-
stones, laparoscopic procedures,
Hernia management, neck
surgeries, etc: Covered
- Evolving list of covered
treatments / procedures present
in Annex-A

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Diseases • Burns, Accident, Trauma • Maternity services:
Package 3: Treatment:
- Including normal delivery & C-
- Requires Indoor / Day Care section.
treatment
- Including 3 antenatal visits
- Medical and Surgical: Covered
- Acute and Chronic: Covered - Including 1 post-delivery follow-
up visit of mother
- Emergency management, skin
grafting, ventilatory support, - Including 1 post-delivery follow-
Intensive Care, fractures, joint up visit of newborn.
etc: Covered
- Evolving list of covered
treatments / procedures
present in Annex-A
Diseases • Dialysis:
Package 4: - Covered
Diseases • Chronic Disease necessitating
Package 5: admission:
- Requires Indoor / Day Care
treatment
- Medical and Surgical: Covered
- Acute and Chronic: Covered
- Complication of Tuberculosis,
Complication of COVID-19,
Complication of HIV,
Rheumatology conditions etc:
Covered
• Evolving list of covered
treatments / procedures
present in Annex-A
Diseases • Organ Failure Management:
Package 6: - Requires Indoor / Day Care
treatment
- Medical and Surgical: Covered
- Acute and Chronic: Covered
- Chronic Kidney Disease
Management, Ventilatory
Support etc: Covered
- Evolving list of covered
treatments / procedures
present in Annex-A
Diseases • Cancer Management:
Package 7: - Requires Indoor / Day Care
treatment
- Medical and Surgical: Covered
- Acute and Chronic: Covered
- Including but not limited to
Chemotherapy, Radiotherapy,

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 Surgical Removal, Indoor scans,
Histopathology etc: Covered
- Evolving list of covered
treatments / procedures
present in Annex-A
Diseases • Neuro-Surgical Procedures:
Package 8:
- Requires Indoor / Day Care
treatment
- Medical and Surgical: Covered
- Acute and Chronic: Covered
- Laminectomy, Intra-cranial
hemorrhage management, spine
surgery etc: Covered
- Evolving list of covered
treatments / procedures
present in Annex-A

Benefit Riders: 1. All emergencies covered

2. Up to 4 Antenatal and 1 Post Natal check-up.
3. Complementary counselling on family planning on available
contractive methods, nutrition, immunization and maternal-new born
health.
4. Provision of one long-term contraception, if agreed by family.
5. One free follow-up post admission
6. Transportation Cost of Rs: 1,000 per discharge from hospital, 3 times
in a given year.
7. Burial Support to family of Rs: 10,000 per death of beneficiary in an
empaneled hospital.
8. Inter-provincial / inter-district / nation-wide portability of benefit
package through which an enrolled family member can access services
in any empaneled hospital, include private sector hospitals, across
Pakistan.
Conditions for Execution of Additional (Excess of Loss) Coverage will only be done in below
the Execution of cases:
Additional
(Excess of Loss) a) During the course of an admission for treatment, if a beneficiary has
Coverage: exceeded their coverage limit, all treatments that specific admission,
including complications and or additional treatments will be covered
(continuity of care).
b) In the event of a life-threatening case where the coverage limit will be
exhausted by the admission (or has already been exhausted) the
beneficiary will be eligible for life saving / stabilizing treatment. The
treatment and the transportation charges excess of the program
coverage will be covered.
c) All maternity and maternity related services exceeding the program
limits will be covered.

Conditions for Treatments beyond initial financial limits for which reserve funds are to be
the execution of used:
Reserve Funds:
1) Continuation of dialysis and related procedures.

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 2) Continuation of cancer management (Chemotherapy, Radiotherapy,
Surgery).
3) Continuation of neuro surgical treatments
4) Continuation of cardiology (pediatric and valvular only) treatment.
5) Continuation of Rheumatology treatment.
6) Renal transplant
7) Anything treatment identified and approved by National Steering
Committee of Sehat Sahulat Program
8) Provinces can add separate funds in reserve funds to finance their
preferences.

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 ANNEX – A
“EVOLVING / DYNAMIC LIST OF COVERED TREATMENT / PROCEDURES”
CATEGORY: PROCEDURE: PROCEDURE: PROCEDURE:
Advanced Procedures Chemo medicines cost CT - Contrast PCR HCV Qualitative
Advanced Procedures CT – KUB Albumin - 100ml Inj Meronem 500mg
Advanced Procedures Inj. Anti-D Laboratory Charges Fine Needle Aspiration Cytology (FNAC)
Advanced Procedures Brain Angio Epidular Package Inj. Diclair ST 1500000 IU
Advanced Procedures Brochoscopy CT Chest plain Albumin - 50ml
Advanced Procedures Echocardiography CT Chest Contrast Inj Vancomycin
Advanced Procedures Doppler studies CT Abdomen Pelvis Plain Bone Marrow Biopsy
Advanced Procedures Carotid Doppler CT Abdomen Pelvis Contrast Histopathology (Post-Op) – Small
Advanced Procedures MRI Brain True Cut Biopsy Histopathology (Post-Op) – Large
Advanced Procedures MRI Neck USG Guided Ascitictap Inj Tanzo
Advanced Procedures Laproscopic Biopsy V V Fistula repair CVP Line
Advanced Procedures Excision Biopsy under local anaesthesia
Advanced Procedures CT - 3D Inj Meronem 1000mg
Advanced Procedures Excision Biopsy under GA Inj. Espogen 4000ml Inj. Terlipressin
Advanced Procedures Medicines cost CT - Brain CT – Triphasic
Advanced Procedures MRI (Plain) Inj. Koate (Factor VIII) Inj. Penro 1gm
Advanced Procedures MRI (Contrast) Inj. Espogen 2000ml Inj. Rhogam
Advanced Procedures CT – Plain Immune Globulin
Burns Correction of spastic hand free flap Cleft lip Repair unilateral
Burns 1st stage ear reconstruction of microtia per ear
Burns Finger reconstruction with flap complex
Burns Harvest Full Thickness Skin Graft Foreskin
Burns Block Dissection - Axilla/groin per side
Burns Exploration of hand/forearm/arm Finger reconstruction with flap Epispadias
Burn Correction of Chordee Burn Dressing <25% Hypospadias: 1st stage repair

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Burns Hand contracture release – simple Skin Graft - Medium Canthoplasty Bilateral
Burns Hand contracture release – complex Skin Graft - Major Repair of Urethral Fistula
Burns Nerve exploration microsurgical Burns - 1st Degree Canthoplasty Unilateral
Burns Burns - 3rd Degree Z – Plasty Syndactyly Release per finger
Burns Burns - 2nd Degree Zadeks Procedure per toe Ulnar Nerve Decompression Simple
Burns repair complex hand injuury Release of Construction by Local Flap
Burns Repair of Laceration Medium Excision & Biopsy Excision Haemangioma Complex
Burns Scar Revision Medium Cleft lip Repair Secondary Conservative Management (Per day Package)
Cardiology PCI Double Valve Repair with Ring Streptokinase (SK)
Cardiology PTMC - New Balloon Double Valve Replacement (DVR) ONE (1) BMS + ONE (1) DES
Cardiology PTMC - Used Balloon Epicardial Permanent Pacemaker Implant Double Lumen Catheter
Cardiology Pulmonary Valve Ballooning VSD - Device Closure
Cardiology Exploration of Wound & Repositioning of PPM Battery
Cardiology Coronary Artery By-Pass Grafting (CABG) + Aortic valve replacement (AVR)
Cardiology Partial Anamulous Venous Drainage Repair(PAPVD)
Cardiology Percutaneous transluminal coronary angioplasty (PTCA)
Cardiology Ventricular Septal Defects (VSD) - Repair TAPVD
Cardiology Total anomalous pulmonary venous return (TAPVC)
Cardiology Arterial Embolectomy - Radial Aretry Fem. Pop
Cardiology AtrioVentricular Septal Defect (AVSD) – Repair
Cardiology Open Heart Bypass Surgery with all inclusive
Cardiology Acute M.I with 3 Days Charges in CCU Stay
Cardiology PDA Ligation Surgery with all inclusive
Cardiology Permanent Pace Maker - PPM VVIR (Single Chamber)
Cardiology Aortic Root Replacement Pericardial Intubation TWO (2) BMS + ONE (1) DES
Cardiology Aortic Valvatomy / Repair Pulmonary Valvotomy (Open) DDDR PACEMAKER (PPM)
Cardiology Aorto-Femoral Grafting Emergency Thoractomy For Trauma Electro Physiology (EP studies) - Right
Cardiology AP Window Closure VSD + Aortic Valve Repair Acute M.I with 3 days C.C.U Charges
Cardiology ASD+ Valve Repair Single BMS Stent with all inclusive Cor. Angio Plasty with 1 stent (BMS)

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Cardiology Total Correction Cor. Angio Plasty with 2 stent (BMS)
Cardiology AVR + Mitral Valve Repair VSD Surgery with all inclusive CABG
Cardiology Axilary Artery Repair / Grafting ASD - Device Occluder ASD Repair
Cardiology C.C.F Coro Angiography with all inclusive AVR one Valve
Cardiology T.P.M Single BMS2 Stent with all inclusive Tricuspid Valve Repair - TVR one Valve
Cardiology P.P.M Diagnostic Angiography - D/C M.com (close)
Cardiology VSD Repair Dual Chamber Replacement PDA
Cardiology Cardiac Myxome Pace Maker Coarctation Of Aorta
Cardiology MVR one Valve Aortic Valve Replacement (AVR) Peripheral Vascular Surgery
Cardiology DVR Two Valves Mitral Valve Replacement (MVR) Hematoma Removal
Cardiology B.T Shunt Total Correction – Cardiology MVR+ Aortic Valve Repair
Cardiology P.A Bunching PDA Ligation RCA- RA Fistula
Cardiology Aortic Valve Ballooning Angioplasty - 1 Bare Metal Stent Rigid Esophagoscopy/Bronchoscopy
Cardiology Failure to Proceed to Angioplasty Angioplasty - 2 Bare Metal Stent DEB (Drug Eluted Balloon) - Single
Cardiology Brachiao Radial Vein Graft Angioplasty with three stent (bare metal) VSD with PS
Cardiology CABG + DVR Angioplasty with single stent (Drug eluted) Triple Valve Replacement (TVR)
Cardiology CABG + IABP Angioplasty with two stent (Drug eluted) DVR + TV Repair
Cardiology CABG + MVR Angioplasty with three stent (Drug eluted) Myxoma + Valve
Cardiology CABG + VSD Closure Glenn (OFF pump)
Cardiology CABG+Valve Replacement TOF / Paeds Surgery Glenn (ON pump)
Cardiology Chest Intubation Pericardecetomy Angioplasty - four Stents (Drug Eluted)
Cardiology COAO Repair + PA Banding Ambolectomy ElectroPhysiology (EP studies) - Left
Cardiology Cortriatriatum Repair Cardiac Cath Fontan with Gore-Tex graft
Dental ORIF Mandible Bilateral Tumour excision ORIF Fracture Mandible
Dental Fixation of fracture of jaw ORIF Maxilla ORIF Zygomatic fracture (complex)
Dental Sequestrectomy ORIF Mandible and Maxilla Osteotomy - Unimax
Ear Ear lobe repair - single Decompression sac Partial amputation - Pinna
Ear Myringoplasty Preauricular sinus
Ear Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin and Cartilage

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Ear Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin Only
Ear Excision of Pinna for growth Small - Squamous/Basal/injuries (Including Biopsy)
Ear Excision of Pinna for growth Large – Squamous / Basal / injuries
Ear Total Amputation & Excision of External Auditory Meatus
Ear Skull base surgery Myringoplasty with Ossiculoplasty Stapedectomy
Ear Total amputation of Pinna Myringotomy - Bilateral Tympanoplasty
Ear Aural polypectomy Myringotomy – Unilateral Vidian neurectomy - Micro
Ear Ossiculoplasty Myringotomy with Grommet - One ear Facial nerve decompression
Ear Mastoidectomy - Closed Canal Myrinogotomy with Grommet - Both ear
Endocrine Parotid Tumour - Excision Thyroidectomy - Hemi Thyroidectomy - Total
Endocrine Axillary lymphnode - Excision (With Biopsy)
Endoscopic Proc. Lap. Hemicolectomy MRCP Lap. Salpingo Ophrectomy
Endoscopic Proc. Upper GI endoscopy Adhenolysis Lap. Varicocele – Unilateral
Endoscopic Proc. Upper GI endoscopy with biopsy Lap. Ovarian Cystectomy Incisional Hernia - Repair (With Mesh)
Endoscopic Proc. ERCP Lap. Inguinal Hernia – Bilateral Myomectomy
Endoscopic Proc. Colonoscopy Lap. Inguinal hernia – Unilateral Lap. Oophrectomy
Endoscopic Proc. Lap. Varicocele – Bilateral
Endoscopic Proc. Lap. Hysterectomy with bilateral Salpingo Operectomy
Endoscopic Proc. Esophageal Sclerotheraphy for varies (GI endoscopy with Banding)
G Surgery Herniorraphy and Hydrocelectomy Sac Excision
G Surgery Intestinal Perforation (Resection Anastomosis)
G Surgery Excision of Parathyroid Adenoma/Carcinoma
G Surgery Oesophagectomy for Carcinoma Easophagus
G Surgery Partial/Subtotal Gastrectomy for Carcinoma
G Surgery Skin Flaps - Rotation Flaps Less Than 10cm
G Surgery Rectal Benign Tumour (Incl. Histopath)
G Surgery Excision Benign Tumor - Gastrointestinal tract (with Biopsy)
G Surgery Appendicectomy + Appendicular Perforation
G Surgery Mastectomy / (Complete Breast Excision)

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G Surgery Microlaryngoscopic Surgery [microlaryngoscopy]
G Surgery Abscess drainage under Local Anesthesia (LA)
G Surgery Abscess drainage under General Anesthesia (GA)
G Surgery Removal of Foreign Body from Trachea
G Surgery Total Thyroidectomy and Block Dissection
G Surgery Drainage Pericardial Effusion (Pericardiocentesis)
G Surgery Arteriovenous (AV) Malformation of Soft Tissue Tumour – Excision
G Surgery Cholecystectomy (Open) & Exploration of CBD
G Surgery Video-Assisted Thoracoscopic Surgery (VATS)
G Surgery Fissurectomy with Eversion of Sac – Bilateral
G Surgery Foreign Body Removal in Deep Region - Deep pelvious / perineum (under GA)
G Surgery Haemato Colpo/Excision - Vaginal Septum
G Surgery Phytomatous Growth in the Scalp - Excision
G Surgery Radical Mastectomy Hernia – Epigastric Laparoscopic umbilical hernia repair
G Surgery Retroperitoneal Tumor - Excision Hernia – Umbilical Laparoscopic Ureterolithotomy
G Surgery Segmental Resection of Breast Hernia - Femoral Operation of Choledochal Cyst
G Surgery Spindle Cell Tumor - Excision Granuloma – Excision Suturing of wounds with local anesthesia
G Surgery Carotid artery aneurism Hydrocele – Excision Total Thyroidectomy (Cancer)
G Surgery Decortication (Pleurectomy) Intussusception Urtheral Dilatation
G Surgery Abdominal aortic aneurysm Laproscopic Hiatus Hernia Repair Vasectomy
G Surgery Hydatid Cyst of Liver Posterior Siggtal Anorectoplasty Laparoscopic Adhesiolysis
G Surgery Femoropopliteal by pass procedure Graham's Operation Laparoscopic Cholecystectomy
G Surgery Duodenectomy Drainage of Psoas Abscess
G Surgery Renal Artery aneurysm and disection Haemangioma - Excision Laparoscopic Thyroidectomy
G Surgery Thoracoscopic Lebectomy Hepatic Resection (lobectomy) Bursa - Excision
G Surgery Hernia - Hiatus (Stomach Prolapse) Hernia - Incisional Corn - Large - Excision
G Surgery Thoracoscopic Decortication Hernia - Repair & release of obstruction Dermoid Cyst - Large - Excision
G Surgery Anterior Resection for CA Hernioplasty (mesh repair) Dorsal Slit and Reduction of Paraphimosis
G Surgery Endoscopic band ligation Hydrocelectomy+ Hernioplasty (With Mesh) Epididymal Swelling -Excision

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 G Surgery Gastrojejunostomy CA Ilieo Sigmoidostomy
G Surgery Gastrotomy Instestinal perforation Excision Pilonidal Sinus (Karydikays procedure)
G Surgery Hemicolectomy Intestinal Obstruction Fibroadenoma - Bilateral (With Biopsy)
G Surgery Jejunostomy Cysto Reductive Surgery Fissurectomy
G Surgery Ileostomy Gastric Perforation Bronchial Cyst With Thoracoscopy
G Surgery Pancreatrico Deodeneotomy Burst Abdomen Obstruction Cholecystectomy (Open)
G Surgery Coloectomy - Total Caecopexy Cyst over Scrotum - Excision
G Surgery Tracheoplasty (Throat) Oeshophagoscopy for foreign body removal Dermoid Cyst - Small - Excision
G Surgery Aspiration of Empymema Oesophagectomy Diverticulectomy
G Surgery Exploratory Thorocotomy Pelvic Abscess - Open Drainage Drainage of Ischio Rectal Abscess
G Surgery Hemithyroidectomy Orchidectomy + Herniorraphy Drainage of Subdiaphragmatic Abscess
G Surgery Laparoscopic Adrenalectomy Orchidopexy Duodenal Jejunostomy
G Surgery Thoracoplasty Orchidopexy with Circumsion Hydrocelectomy + Orchidectomy
G Surgery Thoracoscopic Segmental Resection Orchidopexy With Eversion of Sac Epididymectomy
G Surgery Laparotomy Orchidopexy with Herniotomy Epididymal Cyst
G Surgery Colostomy Reversal Papilloma Rectum - Excision Evacuation of Scrotal Hematoma
G Surgery Radical Neck Dissection – Excision Haemorrhoidectomy + Fistulectomy Excision Mammary Fistula
G Surgery Excision Meckel's Diverticulum Fibroadenoma - Unilateral (With Biopsy) Orchidectomy – Unilateral
G Surgery Laparoscopic Nephrectomy Pyeloroplasty Excision of Neurofibroma
G Surgery Thorachostomy (Under Water Seal) Rectal Dilation Fissurectomy and Haemorrhoidectomy
G Surgery Fibroma – Excision Rectal polyp Fissurectomy with Sphincterotomy
G Surgery Breast Lump - Excision - Bilateral Rectopexy Ganglion - Small - Excision
G Surgery Carbuncle back Haemorrhoidectomy Appendicectomy
G Surgery Abdominoperineal Resection Sigmoid Diverticulum Appendicectomy + Appendicular Abscess
G Surgery Breast Lump - Excision - Unilateral Soft Tissue Tumor - Excision (WIth Biopsy) Lymphnode - Excision with Biopsy
G Surgery Colostomy Splenectomy Bakers Cyst - Excision
G Surgery Liver Abscess Drainage – Open Thyroplasty Branchial Fistula
G Surgery Lipoma Cystectomy – Total Sling Surgery
G Surgery Laproscopic Spleenectomy Umbilical Sinus - Excision Liver Abscess Drainage - Needle Aspiration

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 G Surgery Fistulectomy (Peri Anal) Varicose Veins - Excision and Ligation Mesenteric Cyst - Excision
G Surgery Ganglion - large – Excision Volvlous of Large Bowel Debulking of Tumor under GA
G Surgery Laparoscopic cystogastrostomy Block dissection Cervical Nodes Reversal of Ileostomy
G Surgery Foreign body removal under GA Excision and Skin Graft of Venous Ulcer Rubber band ligation - Hemorrhoid
G Surgery Cystogastrostomy Excision of Lingual Thyroid Glomus Tumor Excision
G Surgery Tube Thoracostomy Excision of Sebaceous Cysts Bullectomy
G Surgery Arterial Embolectomy - Mesenteric Laparoscopic Hernia Repair Foreign Body in Fascia
G Surgery Incision & Drainage - Major (GA) Lap. Cholecystectomy & CBD exploration Foreign Body Removal in Abdomen / Perinuem
G Surgery Incision & Drainage - Minor (LA) Lap. For intestinal obstruction Cystic Mass - Excision Abdominal
G Surgery Chest Intubation under Waterseal Laparoscopic Appendicectomy Laparoscopic Cystectomy
Gynecology Vulvectomy – Radical Cesarean delivery Abdomonal open for stress incision
Gynecology Hysterotomy -Tumors removal Cesarean Hysterectomy Myomectomy - Abdominal (including Biopsy)
Gynecology Hymenectomy Conventional Tubectomy Cervical Polypectomy
Gynecology Hysterectomy – abdominal D&C (Dilatation & curetage) Cyst -Vaginal Enucleation
Gynecology Hysterectomy – Vaginal Laproscopy Hysterectomy Cystocele - Anterior repair
Gynecology Bartholin cyst removal Fractional Curretage Electro Cauterisation Cryo Surgery
Gynecology Ovarectomy/Oophrectomy Laparotomy -failed laproscopy to explore Bartholin abscess I & D
Gynecology Perineal Tear Repair (Trauma) Laparotomy for ectopic repture Cyst – Labial
Gynecology Prolapse Uterus -L forts Low Forceps Ovarian Cystectomy
Gynecology Prolapse Uterus - Manchester Manual removel of Plecenta E&C
Gynecology Retro Vaginal Fistula -Repair Normal delivery with episiosty and P repair Vaginal Vault Prolapse
Gynecology Tuboplasty Cervical Cerclage Perforation of Uterus after D/E lapmy and closure
Gynecology Vaginal Tear Repair (Trauma) Repair of post coital tear, perineal injury Termination of Pregnancy More than 24 weeks
Gynecology Vulvectomy Rupture Uterus, closer/repair/t.ligation Abdomen Open for Removal of IUD
Gynecology Normal Delivery Salphingo-oophorectomy Diagnostic D&C with Biopsy
Gynecology Post Natal Visit Shirodhkar Mc. Donalds stich Ante-Natal Visit
Interventional Radio Angioplasty peripheral + stenting Mammography US guided biopsy-Complex
Interventional Radio Angioplasty Peripheral - Complex Angioplasty Peripheral – Simple Oesophageal Dilatation
Interventional Radio Filter Placement IVC Transplant Percutaneous Biliary drainage Catheter Recheck

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 Interventional Radio Percutaneous Nephrostomy Unilateral Radio Frequency Ablation (RFA) 2 needle
Interventional Radio Venoplasty CT guided drainage-Complex Sclerotherapy
Interventional Radio Perma Cath Insertion Embolization Uterine Artery Central Venous Catheter
Interventional Radio Central Venous Cath Tunneled Trans Jugular Porto Systemic Shunt Gastrostomy Placement
Interventional Radio US guided drainage-Complex Angiography Peripheral Nerve Block
Interventional Radio Angiography Single Vessel Angioplasty Av Fistula/Graft Us Guided Biopsy Complex DC
Interventional Radio Embolization Avm Cerebral Percutaneous Biliary Drainge US guided biopsy-Simple
Interventional Radio Embolization-Peripheral/Visceral Percutaneous Nephrostomy(Bi lateral) CT guided biopsy -Complex
Interventional Radio Catheter Exchange-Complex CT guided biopsy-Simple
Interventional Radio Angioplasty AV Fistula/Graft Catheter Exchange-Simple Trans arterial embolization of Liver (TAE)
Interventional Radio Venography Upper Extremities Radio Frequency Ablation (RFA) Staging CT for oncology patients with contrast
Interventional Radio Post transplant Cholangiogram and Cholangioplasty
Medical Cases Ischemic Heart Disease Diabetic Complication Viral encephalitis
Medical Cases Chronic Liver Disease (CLD) Drug Reaction Visceral leishmaniasis
Medical Cases Chronic viral hepatitis DVT (Deep Vein Thrombosis) UTI (Urinary Tract Infection)
Medical Cases Diabetic ketoacidosis Eclampsia Uncontrolled Diabetes Mellitus (Greater 300)
Medical Cases Enteric Fever (Typhiod) Epididymitis / Epididymo-orchitis Subarachnoid haemorrhage
Medical Cases Hepatic Encephalopathy Hypothyroidism Severe / Myxedema Head Injury
Medical Cases Urosepsis Metabolic Encephalopathy Complications of Cerebral Palsy
Medical Cases Workup For Malignancy Obstructive Jaundice Gestational Diabetes
Medical Cases Acute Gastritis Pancytopenia Workup Arthritis
Medical Cases Esophagitis Peripheral Vascular Disease Cervical Spondylosis
Medical Cases Peptic Ulcer Disease Pleural Effusion Workup Cardiac Care Unit (CCU)
Medical Cases Hypertension Emergencies Pulmonary Embolism Hypokalemic Periodic Paralysis
Medical Cases Malabsorption syndrome Acute Viral Hepatitis Appendicitis
Medical Cases Mesenteric Lymphadenitis Acute Asthmatic Attack Anhydramnios Pregnancy
Medical Cases Crohn's Disease Acute bronchitis Pelvic inflammatory disease (PID)
Medical Cases Bronchiatasis Acute and chronic meningitis Intestinal Obstruction
Medical Cases Renal encephalopathy Acute and chronic pancreatitis High Dependency Units (HDU)

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 Medical Cases Cholangitis Acute Suppurative Otitis Media
Medical Cases Cerebral infarction (Ischaemic/hemorrhagic stroke)
Medical Cases Acute inflammatory demyelinating polyneuropathy
Medical Cases Neo Natal Care (Birth Complications exchange NEC)
Medical Cases Gestational [pregnancy-induced] hypertension without significant proteinuria
Medical Cases Neonatal jaundice due to other excessive haemolysis
Medical Cases Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, poisoning, head injury etc.) SPO2 < 70
Medical Cases Other bacterial foodborne intoxications, not elsewhere classified
Medical Cases Gestational [pregnancy-induced] hypertension with significant proteinuria
Medical Cases Neonatal jaundice from other and unspecified causes
Medical Cases Respiratory tuberculosis, bacteriologically and histologically confirmed
Medical Cases Intracerebral haemorrhage Acute organophosphorus poisoning Plasmodium Vivax malaria
Medical Cases Heart Failure Acutre excaberation of COPD
Medical Cases Acute and subacute endocarditis Malaria (severe/cerebral) Other bacterial intestinal infections
Medical Cases Gullian bar syndrome Heat stroke Dengue fever [classical dengue]
Medical Cases Nephrotic syndrome HIV with complications Dengue haemorrhagic fever
Medical Cases Emphysema Hydrocephalus Plasmodium falciparum malaria
Medical Cases Glomerulonephritis Hyperosmolar Non-Ketotic coma Pneumonia due to Streptococcus pneumoniae
Medical Cases Tetanus Liver abscess Pneumonia due to Haemophilus influenzae
Medical Cases Acute renal failure Lung abscess/ Empyema Celiac Disease
Medical Cases Birth Asphysia Pericardial/ Pleural tuberculosis Simple and mucopurulent chronic bronchitis
Medical Cases Intensive Care Unit – ICU Acute/ Chronic diarrohea Upper GI bleeding (conservative)
Medical Cases Ventilator Plasmapheresis (pre-auth) Amoebiasis
Medical Cases CKD Conservative Rx Pyrexia of unknown origin GBS (Guillian Barre Syndrome)
Medical Cases Rheumatic Heart Disease Renal colic AFI (Acute febrile illness)
Medical Cases Acute Gastroentritis Severe sepsis/Septic shock Sheehan Syndrome Conservative Rx
Medical Cases Septic Wound Infection Seizures Pneumonia / LRTI
Medical Cases Traumatic Optic Neuropathy Severe anemia HB < 6.0 Pneumothorax
Medical Cases Workup for Splenomegaly Sickle cell Anemia Acute Cholecystitis

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 Medical Cases Ascites Workup Snake bite Dysfunctional Uterine Bleeding (DUB)
Medical Cases Amyloidosis Systematic lupus erythematosus Cellulitis
Medical Cases Biliary Colic / Choledocholithiasis Type 1/2 respiratory failure SPO2<70 Vasculitis
Neuro-surgery Encephalocele Craniotomy for Tumors Trans Sphenoidal
Neuro-surgery Carotid Endartrectomy Lumbosacral Spine Surgery (RTA) Cervical Ribs - Bilateral
Neuro-surgery Cranioplasty Pedicle Screw Fixation Haematoma - Brain (hypertensive)
Neuro-surgery Duroplasty Endoscopic Third Ventriculostomy (ETV) Haematoma (Child irritable subdural)
Neuro-surgery Posterior Fossa - Decompression Anneurysm Surgery Neurolysis
Neuro-surgery Repair & Transposition Nerve Cerebrospinal Fluid (CSF) Rhinorrohea Spina Bifida - Large - Repair
Neuro-surgery Spine - Extradural Tumour Laminectomy with Fusion Spina Bifida - Small - Repair
Neuro-surgery Spine - Intramedullar Tumour Lumbar Disc Temporal Rhizotomy
Neuro-surgery Tumours – Supratentorial Meningocele – Anterior Peripheral Neurectomy (Tirgeminal)
Neuro-surgery Tumours Meninges - Posterior Meningocele – Lumbar Carpal Tunnel Release
Neuro-surgery Brain Biopsy Microdiscectomy - Cervical Cervical Ribs - Unilateral
Neuro-surgery Subdural Tapping Microdiscectomy - Lumber Local Neurectomy
Neuro-surgery Twist Drill Craniostomy Spine - Decompression and Fusion Peripheral Nerve Surgery
Neuro-surgery Spine - Disc Cervical/Lumber Spine - Canal Stenosis
Neuro-surgery Burr hole Subdural aspiration Ventricular Puncture
Neuro-surgery Craniostenosis Nerve Biopsy excluding Hensens R.F. Lesion for Trigeminal Neuralgia
Neuro-surgery Haematoma - Brain (head injuries) Peritoneal Shunt Artierovenous Malformation Excision
Neuro-surgery Spine - Intradural Tumour Meningococle Ocipital EVD ( External Venticular Drian )
Neuro-surgery Tumours Meninges - Gocussa VP Shunt Depressed Fracture
Neuro-surgery Corpectomy with bone grafting and plating
Nose Fracture reduction nose with septal correction
Nose Dacryocystorhinostomy (DCR) Rhinoplasty
Nose Fracture - setting maxilla Ethmoidectomy - External Septoplasty
Nose Fracture - setting nasal bone Functional Endoscopic Sinus (FESS) Sinus Antroscopy
Nose Nasal Cautery Intra Nasal Ethmoidectomy Submucos resection
Nose Antrostomy Bilateral Nasal polypectomy Trans Antral Ethmoidectomy

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 Nose Antrostomy Unilateral Turbinectomy Partial – Bilateral Angiofibrom Exision
Nose Cryosurgery Turbinectomy Partial – Unilateral Intranasal Diathermy
Nose Rhinorrhoea - Repair Radical fronto ethmo sphenodectomy Lateral Rhinotomy
Oncology Thyroid CA Follow up: DTC (NMMI) 3 or 6 monthly
Oncology Urinary System - Renal Scan with DMSA (Cortical Imaging)
Oncology Thyroid CA Follow up: DTC (NMMI) Baseline / Recurrence
Oncology I-131 Therapy Thyroid Carcinoma:DTC(NMMI) (up to 120mCi)
Oncology I-131 Therapy Thyroid Carcinoma:DTC(NMMI) (greater than 120mCi)
Oncology Radionuclide Therapies - I-131 Therapy for Thyrotoxicosis
Oncology Cardiovascular System - MIBI Rest Scan:Viability & Perfusion
Oncology Cardiovascular System - Myocardial Perfusion with Sestamibi
Oncology Diagnostic Gamma Imaging - Skeletal System - Bone Scan
Oncology Carcinoma lip - Wedge excision Fungal Granuloma Radical Cystectomy with Ileal Conduit
Oncology Chemotherapy - Per sitting Thyroid CA Follow up: DTC (NMMI) Yearly Endocrine System - Thyroid Scan and Uptake
Oncology Malignant ovarian Oncology - Radio Therapy Thyroid CA Follow up: MTC (NMMI) Baseline
Oncology Operation for Neoblastoma Oncology – Medical Urinary System - Renal Scan with DTPA (GFR)
Oncology Radiotherapy - Per sitting Radiotherapy - Per Fraction - 3D Partial Subtotal Gastrectomy & Ulcer
Oncology Chemotherapy Excision Cartoid Body tumour Oncology – Surgery
Oncology Adenoma Excision Oncology - Package rate per episod Oncology - Chemo Therapy
Oncology Squamous Cell Carcinoma
Ophthalmology Tumours of IRIS Pterygium + Conjunctival Autograft Retinal Detachment Surgery (Partial)
Ophthalmology Perforating corneo - Scleral Injury Ectropion Correction Trabeculectomy - Right
Ophthalmology Cauterisation of ulcer/subconjuctival injection - both eye
Ophthalmology Cauterisation of ulcer/subconjuctival injection - One eye
Ophthalmology Intraocular Foreign Body Removal (Penetrated to Anterior Chamber)
Ophthalmology Cataract with IOL Phacoemulsification – Unilateral
Ophthalmology Open Angle Glaucoma Surgery (trabeculectomy)
Ophthalmology Intraocular Foreign Body Removal (Penetrated to Posterior Chamber)
Ophthalmology Socket Reconstruction Enucleation without implant Dacryocystorhinostomy (DCR) with Intubation

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 Ophthalmology Vitrectomy Limbal Dermoid Removal Corneal Perforation (Minor)
Ophthalmology Vitrectomy + Retinal Detachment Pterygium (Day care) Chalazion - one eye
Ophthalmology Eviseration (With Impant) Small Tumour of Lid - Excision Conjuntival Melanoma
Ophthalmology Buckle Removal Laser for retinopathy Dacryocystectomy (DCY)
Ophthalmology Capsulotomy Lid tear DCR (Dacryocystorhinostomy)
Ophthalmology Cyclocryotherapy Squint correction Decompression of Optic nerve
Ophthalmology Dacryocystectomy Abscess Drainage of Lid Entropion correction
Ophthalmology Enuleation with Implant Canaliculo Dacryocysto Rhinostomy (CDR) Epicantuhus correction (Trauma Only)
Ophthalmology Exentration (With Implant) Cataract (Unilateral) Orbitotomy
Ophthalmology Ptosis (Sling Procedure) Lensectomy Trabeculectomy
Ophthalmology Corneal Grafting Membranectomy Corneal Cross Linking
Ophthalmology Cyst Anterior Chamber Reconstruction Glaucoma surgeries Open Angle
Ophthalmology Glaucoma surgeries Closed Angle IRIS Prolapse - Repair Corneal Perforation (Major)
Ophthalmology Retinal Detachment Surgery Total Enucleation (with implant) Ptosis Internal Procedure
Orthopedic / Rheum. Acromion reconstruction Removal of Hip Implant Hemi-Arthroplasty (Cemented) – Bipolar
Orthopedic / Rheum. Bone Tumour and Reconstruction - Minor – Excision
Orthopedic / Rheum. Amputation - Part of Toe and Fixation of K Wire
Orthopedic / Rheum. Amputation - Wrist Axillary Node Dissection
Orthopedic / Rheum. Closed Reduction and Internal Fixation with K wire
Orthopedic / Rheum. Decompression and Stabilization with Steffiplate
Orthopedic / Rheum. Application of P.O.P. casts for Upper & Lower Limbs
Orthopedic / Rheum. Anterior & Posterior Spine Fixation & Decompression
Orthopedic / Rheum. Bone Tumour and Reconstruction -Major – Excision
Orthopedic / Rheum. Open Reduction Internal Fixation (1 small bone or more)
Orthopedic / Rheum. Reduction of Fractures of Mandible & Maxilla - Eye Let Splinting
Orthopedic / Rheum. Closed Reduction and Percutaneous Screw Fixation
Orthopedic / Rheum. Congenital Talipes Equinovarus (CTEV) – Unilateral
Orthopedic / Rheum. Closed Reduction and Percuteneous Pinning
Orthopedic / Rheum. Congenital Talipes Equinovarus (CTEV) – Bilateral

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 Orthopedic / Rheum. Closed Reduction and Percutaneous Nailing
Orthopedic / Rheum. Reduction of Fractures of Mandible & Maxilla - Cast Netal Splints
Orthopedic / Rheum. Reduction of Fractures of Mandible & Maxilla - Gumming Splints
Orthopedic / Rheum. Dymanic Hip Screw / Damage Control Surgery (DHS / DCS)
Orthopedic / Rheum. Open Reduction Internal Fixation (Large Bone)
Orthopedic / Rheum. Knee Arthroscopy & Partial Meniscectomy
Orthopedic / Rheum. Arthroscopy (Arthroscopic Meniscus Repair/ Meniscectomy)
Orthopedic / Rheum. Total Hip / Knee Replacement (Cemented) - Trauma Only
Orthopedic / Rheum. Total Hip Replacement (Un-Cemented) - Trauma Only
Orthopedic / Rheum. ORIF + Bone Grafting (Complex) + (incl. removal of implant)
Orthopedic / Rheum. Closed Reduction of Dislocation Elbow & Shoulder
Orthopedic / Rheum. Removal of Tension Band Wires Patella, Olecrenon
Orthopedic / Rheum. Amputation - Foot Removal of One or More Screws Total Elbow Replacement (Trauma Only)
Orthopedic / Rheum. Amputation – Wrist Removal of DHS Close Reduction of Fractures of Limb & P.O.P.
Orthopedic / Rheum. Osteotomy -Long Bone Removal of IM Nail Debridement & Closure – Major
Orthopedic / Rheum. Close Fixation - Foot Bones Amputation - Fore Arm Exostosis Small bones Excision
Orthopedic / Rheum. Closed Interlocking Intermedullary ORIF Ulna Fixater with Joint Arthrolysis
Orthopedic / Rheum. Below Knee Amputation Amputation - Ankle Above Knee Amputation
Orthopedic / Rheum. Tendon Grafting Amputation – Arm Patellectomy
Orthopedic / Rheum. Dupuytren Contracture Amputation – Forefoot Reduction of Facial Fractures of Maxilla
Orthopedic / Rheum. ORIF Femoral Neck External fixation - Long bone Leg Lengthening
Orthopedic / Rheum. Hip Region Surgery External fixation - Small bone Sequestrectomy of Long Bones
Orthopedic / Rheum. Tension Band Wiring Patella Clavicle Surgery (With Impant) Tendo Achilles Tenotomy
Orthopedic / Rheum. Pelvic Fracture - Fixation Closed Fixation - Hand Bones Tenotomy - Tendon Release / Repair
Orthopedic / Rheum. Reconstruction of ACL/PCL Closed Interlock Nailing + Bone Grafting Application of P.O.P. Spicas & Jackets
Orthopedic / Rheum. K Wire Fixation – Complex External fixation - Pelvis Prepatellar Bursa and Repair of MCL of Knee
Orthopedic / Rheum. K Wire Fixation – Simple Fracture - Acetabulam Internal Wire Fixation of Mandible & Maxilla
Orthopedic / Rheum. Dynamic Hip Screw (DHS) ORIF Fibula Wound debridement under local anesthesia
Orthopedic / Rheum. ORIF Radius and Ulna (Combined) ORIF Humerus Wound debridement under general anesthesia

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 Orthopedic / Rheum. ORIF Femur bone ORIF Radius MUA Manipulation Under (General) Anesthesia
Orthopedic / Rheum. ORIF Tibia and Fibula (Combined) ORIF TIBIA Total Knee Replacement (Trauma Only)
Orthopedic / Rheum. Illizarove Exostosis of Long Bone Neurolysis
Orthopedic / Rheum. Removal of Illizarove Contractures Release Osteotomy -Small Bone
Orthopedic / Rheum. Fasciotomy Hemi-Arthroplasty Cemented Arthrodesis Ankle Triple
Orthopedic / Rheum. Head Radius – Excision Hemi-Arthroplasty Uncemented Arthroplasty of Femur head – Excision
Orthopedic / Rheum. Joint Reconstruction Multiple Tendon Repair Debridement & Closure – Minor
Orthopedic / Rheum. Laminectomy Open Reduction of Small Joint Decompression and Spinal Fixation
Orthopedic / Rheum. Arthoplasty Excision Hip Spica (Close Reduction of Hip) Decompression of Carpal Tunnel Syndrome
Orthopedic / Rheum. Arthorotomy Internal Fixation Lateral Epicondyle Decompression Stabilization and Laminectomy
Orthopedic / Rheum. ORIF+Bone Grafting (Simple) Elbow Reconstruction Exploration Of Ulna Nerve (Decompression)
Orthopedic / Rheum. Removal of Rush Nail Amputation Three or More Toe Closed Reduction of Dislocation Hip and Knee
Orthopedic / Rheum. Removal of External Fixator Spinal Fusion More than 4 Levels ORIF-Pelvic Fracture/ Sacro Iliac Joint
Orthopedic / Rheum. Removal of Pin Fixator Sequestrectomy of Small Bone Developmental Dislocation of Hip (DDH) Surgery
Orthopedic / Rheum. Removal of One or more Plate ORIF with K wires Amputation Three or More Digits
Orthopedic / Rheum. Nerve Repair Surgery Lymphs ORIF Humerus - Philos Locking Plate Amputation (One or Two) Toe
Orthopedic / Rheum. Removal of K Wire Amputation (One or Two) Digit Nerve Repair Surgery Digits
Orthopedic / Rheum. Synovectomy Arthrodesis - Shoulder Hip & Knee Tendon Nerve Surgery of Foot
Orthopedic / Rheum. Arthrodesis of Ankle (With Implant) Skin Grafting - Minor (Post Traumatic) Hemi-Arthroplasty (Uncemented) – Bipolar
Orthopedic / Rheum. Skin Grafting - Major (Post Traumatic)
Paediatric Paeds. Closure Colostomy Anal Transposition for Ectopic Anus Chordee Correction
Paediatric Colectomy Hernia-Inguinal -Unilateral Hernia - Diaphragmatic
Paediatric Gastrostomy Meniscectomy Hernia-Inguinal - Bilateral
Paediatric Resection & Anastamosis of Intestine Nephrolithotomy Meckel's Diverticulectomy
Paediatric Hirschsprung Disease (Duhamel Pull Orchidopexy - Unilateral Orchidopexy - Bilateral
Through)
Paediatric Imperferate Anus Pyelolithotomy Pyeloplasty
Paediatric Tracheo Esophageal Fistula Pyloric Stenosis (Ramsted OP) Rectal Polyp
Paediatric Abdomino Perioneal (Exomphalos) Torsion Testis Ureterotomy

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 Paediatric Anal Dilatation Urethroplasty Vesicostomy
Paeds Cardiology Atrial Septal Defect (ASD) Partial AV (Atrioventricular) Canal RVOT + PDA Stening
Paeds Cardiology Tetralogy of Fallot (TOF) Coarctation of Aorta Stenting PDA Device Closure
Paeds Cardiology Complete AV (Atrioventricular) Canal Ventricular Septal Defect (VSD)
Prosth / Orthotics Knee Disarticulation Prosthesis Trans Tibia Prosthesis Partial Foot Prosthesis
Prosth / Orthotics Trans Radial Prosthesis Trans Femoral Prosthesis
Tertiary/Priority Arteriovenous (AV) Fistula Double Lumen Catheter Trans Arterial Chemo Embolization (TACE)
Tertiary/Priority Dialysis Organ Failure - Cardio pulmonary Rx Organe Failure - Renal treatment /day charges
Throat Parapharyngeal -Tumour excision Excision of Branchial Cyst Tonsillectomy - Bilateral
Throat Total Glossectomy Excision of Cystic Hygroma Major Total Parotidectomy
Throat Partial Glossectomy Excision of the Maxilla Uvulophanyngo Plasty
Throat Sialectomy Palatopharyngoplasty Cleft palate repair
Throat Excision of Keloid Neck Parotidectomy - Radical Total Excision of Branchial Sinus
Throat Quinsy Drainage under GA Removal of Submandibular Salivary gland Excision of Cystic Hygroma Extensive
Throat Adeno Tonsillectomy Adenoidectomy Excision of Cystic Hygroma Minor
Throat Pharyngeal diverticulum's Excision Tonsillectomy + Myrinogotomy Excision of the Mandible Segmental
Throat Parapharyngeal Abscess - Drainage Laryngectomy Hemiglossectomy
Throat Release of Tongue tie Parapharyngeal – Exploration Parotidectomy - Superficial
Throat Thyroglossal Cyst - Excision Retro pharyngeal abscess - Drainage Ranula excision
Throat Tonsillectomy – Unilateral Tonsillectomy + Styloidectomy Torticollis
Urology Bladder Tumour (Fulgration) Ureteroscopy Urethroplasty Suprapubic Drainage – Closed
Urology Torsion Testis Urethral Dilatation Retrograde IntraRenal Surgery (RIRS) - Tumour
Urology Kidney Transplant Ureteric Catheterization – Cystoscopy Pyeloplasty
Urology V V F Repair Uretrostomy (Cutanie) Cysto-Urethroscopy and proceed
Urology Vesico uretero Reflux - Bilateral URS (Ureteroscopic stone Removal) TURP (Trans-Urethral Resection of Prostate)
Urology Vesico Uretero Reflux - Unilateral URS Extraction of Stone Ureter - Bilateral Correction of Extrophy of Bladder
Urology Vesicolithotomy URS with DJ Stenting With ESWL Cystolithotomy
Urology TURP VIU (Visual Internal Urethrotomy ) Drainage of Perinepheric Abscess
Urology Ureteral Stents Removal VIU for Stricture Urethra Cystolitholapaxy

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 Urology Nephrectomy Varicocele PCNL (Percutaneous nephro lithotomy)
Urology Operation for Injury of Bladder Bilateral Laproscopic Pyelolithotomy Urachal Cyst
Urology Partial Cystectomy Excision of Renal Cyst Hypospadias Repair
Urology Partial Nephrectomy Litholapexy Lithotripsy
Urology Pyelolithotomy Meatoplasty Nephrostomy (Percutaneous)
Urology Radical Nephrectomy Nephro Uretrectomy Repair of Ureterocele
Urology Suprapubic Cystostomy - Open Post Urethral Valve Retropubic Prostatectomy
Urology Repair of Tunica Albuginea Reimplanation of Urethra Open Nephrostomy with Tube
Urology Trans Vesical Prostatectomy Reimplantation of Ureter Lithotripsy with DJ Stenting
Urology Uretero Colic Anastomosis Repair of Uretero Vaginal Fistula Cystoscopy with Bilateral DJ Stent
Urology Ureterolithotomy Spleno Renal Anastomosis Cystoscopy with Unilateral DJ Stent
Urology Bladder Diverticulectomy (Transurethral Fulguration)
Urology Exploration of Epididymus (Unsuccesful Vasco vasectomy)
Urology TURBT (Transurethral Resection of the Bladder Tumor) with Histopathology

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