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Speciality Speciality Package Package Name Procedure Procedure Name Procedure STRAT NO OF IMPLANT IMPLANT VAL SPL CONDITION
Procedure STRAT NO OF IMPLANT IMPLANT VAL SPL CONDITION RESRV PBL HOSP LVL OF LOS AUTO MNDTRY MNDTRY PROC LEVEL SPL SPL ENHANCE MEDICINE DAY CARE RSRV PROC IS APRVD IS ACTUAL IS PKG TREAT IS ELOS IMPLANT DETAILS STARTIFICATION DETAIL PROC NAME DOCUMENT DETAILS
Name Code Code Code Rate CRITERIA STRAT FLAG FLAG FLAG CARE APPROVED DOC PRE DOC CONDITIO CONDITIO MENT OR PROC TWO HRS BASIS TRANSPLAN CATEGORY
FLAG CRITERIA AUTH CLAIM N N RULE FLAG SURGICAL T
BURNS BM BM000011 Post Burn BM000011900 Post Burn Contracture surgeries for Functional 40000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Post Burn Contracture surgeries for Functional Clinical history detailing the burns - etiology-P | Functional disability to be detailed and
MANAGE 90 Contracture 0009 Improvement (Package including splints, pressure garments, Improvement (Package including splints, pressure garments, expected functional improvement to be shared-P | Post Treatment clinical photograph;
MENT surgeries for silicone - gel sheet and physiotherapy): Excluding Neck silicone - gel sheet and physiotherapy): Excluding Neck Detailed discharge summary; Detailed Procedure / Operative Notes-C | Pre-op clinical
Functional contracture; Contracture release with - Split thickness Skin contracture; Contracture release with - Split thickness Skin photograph-P | Treatment given and resultant contractures left-P | X-ray-P
Improvement Graft (STSG) / Full Thickness Skin Graft (FTSG) / Flap cover is Graft (STSG) / Full Thickness Skin Graft (FTSG) / Flap cover is
done for each joint with post - operative regular dressings done for each joint with post - operative regular dressings
for STSG / FTSG / Flap cover. for STSG / FTSG / Flap cover.
BURNS BM BM000026 Conservative BM000026900 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Medical No Insurance N N N Regular Ward-1800 Conservative Management - stand alone All investigations reports-C | Any investigations done; planned line of management-P |
MANAGE 9 Management 001 Clinical notes detailing history and Admission notes showing vitals and examination
MENT findings-P | Daily Patient Photo-C | Detailed ICPs-C | Detailed discharge summary-C |
Planned line of management-P | Treatment details-C
BURNS BM BM000028 Conservative BM000028000 Conservative Management - (Chest/Head/Face/Abdomen) 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Medical No Insurance N N R N Regular Ward-1800 Conservative Management - (Chest/Head/Face/Abdomen) All investigations reports.-C | Any investigations done -P | Clinical notes detailing history
MANAGE 0 Management of 002 stand alone stand alone and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
MENT injury Detailed discharge summary-C | Planned line of management-P | Treatment details-C
BURNS BM BM000063 Extended LOS BM000063700 Extended LOS care pkg for advance surgeries after 6 days 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N Y ICU (with Ventilator) -6000 | Extended LOS care pkg for advance surgeries after 6 days All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MANAGE 7 care pkg for 003 (allowed after pre auth, if justifies max 3 days in single go) ICU (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go)
and Admission notes showing vitals and examination findings-P | Daily Patient Photo-C |
MENT advance surgeries Routine Ward-1800 Detailed ICPs-C | Detailed discharge summary-C | Planned line of management-P |
Treatment details-C
BURNS BM BM000066 Flame / scald / BM000066700 % Total Body Surface Area Burns (TBSA) - any % (not 7000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA) - any % (not Clinical Notes-P | Detailed discharge summary.-C | Extent of burns visible on
MANAGE 7 thermal / 004 requiring admission). Needs at least 5-6 dressing requiring admission). Needs at least 5-6 dressing photograph (with rule of 9 chart)-P | Lab tests-C | MLC copy with number / FIR copy-P
MENT Chemical Burn/ | Post Treatment clinical photograph-C | X-rays or other diagnostic procedures done as
Electrical burns a part of treatment-C
BURNS BM BM000066 Flame / scald / BM000066700 % Total Body Surface Area Burns (TBSA): Upto 40 %; 35000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA): Upto 40 %; Clinical Notes-P | Detailed discharge summary.-C | Extent of upto 40% burns visible on
MANAGE 7 thermal / 006 Includes % TBSA skin grafted, flap cover, follow-up Includes % TBSA skin grafted, flap cover, follow-up dressings photograph (with rule of 9 chart)-P | Lab tests-C | MLC copy with number / FIR copy-P
MENT Chemical Burn/ dressings etc. as deemed necessary; Surgical procedures etc. as deemed necessary; Surgical procedures are required | Post Treatment clinical photograph-C | X-rays or other diagnostic procedures done as
Electrical burns are required for deep burns that are not amenable to heal for deep burns that are not amenable to heal with dressings a part of treatment-C
with dressings alone. alone.
BURNS BM BM000066 Flame / scald / BM000066700 % Total Body Surface Area Burns (TBSA): 40 % - 60 %; 45000 No 0 No 0 Yes No Tertiary 20 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA): 40 % - 60 %; Clinical Notes-P | Detailed discharge summary-C | Extent of upto 40% - 60% burns
MANAGE 7 thermal / 005 Includes % TBSA skin grafted, flap cover, follow-up Includes % TBSA skin grafted, flap cover, follow-up dressings visible on photograph (with rule of 9 chart)-P | Lab tests-C | MLC copy with number /
MENT Chemical Burn/ dressings etc. as deemed necessary; Surgical procedures etc. as deemed necessary; Surgical procedures are required FIR copy-P | Post Treatment clinical photograph-C | Scar Photo-C | X-rays or other
Electrical burns are required for deep burns that are not amenable to heal for deep burns that are not amenable to heal with dressings diagnostic procedures done as a part of treatment-C
BURNS BM BM000066 Flame / scald / BM000066800 Criteria 3: % Total Body Surface Area Burns (TBSA): 25-40 %; 50000 No 0 No 0 Yes No Tertiary 15 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Criteria 3: % Total Body Surface Area Burns (TBSA): 25-40 %; Clinical Notes-P | Detailed discharge summary-C | Extent of upto 40% - 60% burns
MANAGE 8 thermal / 007 Includes % TBSA skin grafted, flap cover, follow-up Includes % TBSA skin grafted, flap cover, follow-up dressings visible on photograph (with rule of 9 chart)-P | Lab tests-C | MLC copy with number-P |
MENT electrical burns dressings etc. as deemed necessary; Surgical procedures etc. as deemed necessary; Surgical procedures are required Post Treatment clinical photograph-C | Scar Photo-C | X-rays or other diagnostic
are required for deep burns that are not amenable to heal for deep burns that are not amenable to heal with dressings procedures done as a part of treatment-C
BURNS BM BM000066 Flame / scald / BM000066800 % Total Body Surface Area Burns (TBSA): > 60 %; Includes % 80000 No 0 No 0 Yes No Tertiary 20 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA): > 60 %; Includes % Clinical Notes-P | Detailed discharge summary-C | Extent > 60% burns visible on
MANAGE 8 thermal / 008 TBSA skin grafted, flap cover, follow-up dressings etc. as TBSA skin grafted, flap cover, follow-up dressings etc. as photograph (with rule of 9 chart)-P | Lab tests-C | MLC copy with number-P | Post
MENT electrical burns deemed necessary; Surgical procedures are required for deemed necessary; Surgical procedures are required for Treatment clinical photograph-C | Scar Photo-C | Wound Photo-P | X-rays or other
deep burns that are not amenable to heal with dressings deep burns that are not amenable to heal with dressings diagnostic procedures done as a part of treatment-C
alone. alone.
CARDIOLO CA CA000010 Atrial Fibrillation CA0000103000 Atrial Fibrillation 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator-6000 | ICU Atrial Fibrillation All investigations reports-C | Clinical notes with planned line of treatment-P | Detailed
GY 3 011 (without Ventilator)-4700 | Discharge Summary-C | Detailed ICPs-C | ECG-P | Post treatment ECG-C | Post
Routine Ward-1800 treatment ECG; Detailed Discharge Summary; Detailed ICPs; Treatment details; All
investigations reports.-C | Thyroid function test-P | Treatment details-C
CARDIOLO CA CA000010 Optical coherence CA0000105600 Optical coherence tomography (OCT) - GOVT Reserve add 32000 No 0 No 0 No Yes Tertiary 2 Yes Yes Yes Govt No No No Medical No Insurance N N N Optical coherence tomography (OCT) - GOVT Reserve add Angiogram report-C | Detailed Discharge Summary-C | ECG, ECHO, CAG stills showing
GY 56 tomography (OCT) 0039 on Reserve and on blocks & Reports-P | OCT Catheter Image and report-C | Procedure / Operative notes
Add On with still images-C
CARDIOLO CA CA000011 PDA Device CA0000111300 PDA Device Closure with PDA device 62600 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N PDA Device Closure with PDA device Clinical notes detailing history and Admission notes showing vitals and examination
GY 13 Closure 0040 findings-P | Detailed Discharge Summary-C | Invoice of device used-C | Post
procedure stills of ECHO with report-C | Procedure / Operative notes with still images-C
| Relevant investigations, ECHO report showing PDA-P
CARDIOLO CA CA000011 PDA stenting CA0000111400 PDA stenting 40000 Yes 0 Yes 3 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Drug Eluting stent (FDA)-23625 PDA stenting Clinical notes detailing history and Admission notes showing vitals and examination
GY 14 0041 Max :3 | Drug Eluting stent findings-P | Detailed Discharge Summary .-C | Invoice of barcode of stent used-C |
(NON FDA) -12500 Max :3 Post procedure stills of ECHO with report-C | Procedure / Operative notes with still
images-C | Relevant investigations and ECHO report / Angio showing PDA-P | barcode
of the stent used-C
CARDIOLO CA CA000011 Percutaneous CA0000113100 Percutaneous Transluminal Septal Myocardial Ablation 25000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Percutaneous Transluminal Septal Myocardial Ablation All investigations reports-C | Angiogram report with stills-C | Barcode / Invoice of the
GY 31 Transluminal 0042 balloon if used-C | Clinical notes detailing history and Admission notes showing vitals and
Septal Myocardial examination findings-P | Detailed ICPs-C | Detailed discharge summary-C | Relevant
Ablation investigations and ECG, ECHO, CAG report justifying the procedure-P | Treatment details-
C
CARDIOLO CA CA000011 Pericardiocentesis CA0000113400 Pericardiocentesis 5000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N Pericardiocentesis All investigations reports-C | Analysis of fluid removed-C | Clinical notes detailing
GY 34 0043 history and Admission notes showing vitals and examination findings-P | Detailed ICPs-C
| Detailed discharge summary-C | Intra procedure clinical photograph-C | Post
procedure ECHO report-C | Relevant investigations and ECHO report justifying need of
procedure-P | Treatment details-C
CARDIOLO CA CA000011 Peripheral CA0000113900 Peripheral Angioplasty - Subclavian , Mesenteric , Femoral, 25000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Peripheral Stent-37000 Max :1 Peripheral Angioplasty - Subclavian , Mesenteric , Femoral, All investigations reports-C | Angiogram report/ stills-C | Clinical notes detailing history
GY 39 Angioplasty 0044 iliac - Popliteal ETC iliac - Popliteal ETC and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Detailed discharge summary-C | Implant / barcode of stent used-C | Post op-C |
Relevant investigations and ECHO, Doppler / Angio stills showing blocks & Reports-P |
Showing stent-C | Treatment details-C
CARDIOLO CA CA000011 Balloon Dilatation CA0000114000 Coarctation of Aorta/Pulmonary Artery Stenosis /aortic 60800 No 0 No 0 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Medical No Insurance N N N Coarctation of Aorta/Pulmonary Artery Stenosis /aortic Barcode of balloon used-C | CT angiogram report & stills(Only for aneurysm)-P | Clinical
GY 4 012 aneurysm repair - GOVT Reserved Reserve aneurysm repair - GOVT Reserved Notes-P | Detailed Discharge Summary-C | ECHO-P | Post Procedure images /
Angiogram-C | Procedure / Operative Notes with images-C
CARDIOLO CA CA000011 Peripheral CA0000114100 Peripheral Angioplasty - carotid with filter 60000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Bare Metal-37000 Max :1 | Peripheral Angioplasty - carotid with filter All investigations reports-C | Angiogram report/ stills-C | Clinical notes detailing history
GY 41 Angioplasty - 0045 Embolic protection device-40000 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
carotid with filter Max :1 Detailed discharge summary-C | Implant / barcode of stent used-C | Post op-C |
CARDIOLO CA CA000011 Peripheral CA0000114200 Peripheral Angioplasty - POBA 30000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Medical No Insurance N N N Bare Metal-37000 Max :1 Peripheral Angioplasty - POBA All investigations reports-C | Angiogram report/ stills-C | Clinical notes detailing history
GY 42 Angioplasty - 0046 Reserve and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
POBA Detailed discharge summary-C | Implant / barcode of stent used-C | Post op-C |
CARDIOLO CA CA000011 Peripheral CA0000114400 Peripheral Angioplasty - Renal 18000 Yes 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Bare Metal-37000 Max :1 Peripheral Angioplasty - Renal All investigations reports-C | Angiogram report/ stills-C | Clinical notes detailing history
GY 44 Angioplasty - 0047 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Renal Detailed discharge summary-C | Implant / barcode of stent used-C | Post op-C |
CARDIOLO CA CA000011 Peripheral Arterial CA0000114900 Peripheral Arterial Thrombosis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Peripheral Arterial Thrombosis All investigations reports-C | Clinical notes detailing history and Admission notes showing
GY 49 Thrombosis 0048 (without Ventilator)-4700 | vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Relevant investigations ( Doppler,PT INR,BT CT,etc ) done.-P | Treatment details-C
CARDIOLO CA CA000011 Balloon Mitral CA0000116000 Balloon Mitral Valvotomy 65000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Medical No Insurance N N N Balloon Mitral Valvotomy Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | ECHO
GY 6 Valvotomy 013 report with stills-P | Invoice of device used-C | Post procedure stills of ECHO with
report-C | Procedure / Operative notes with still images-C
CARDIOLO CA CA000011 Balloon CA0000117000 Balloon Pulmonary Valvotomy/Balloon Aortic Valvotomy 47800 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Balloon Pulmonary Valvotomy/Balloon Aortic Valvotomy Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | ECHO
GY 7 Pulmonary / 014 report with stills-P | Invoice of device used-C | Post procedure stills of ECHO with
Aortic Valvotomy report-C | Procedure / Operative notes with still images-C
CARDIOLO CA CA000012 PTCA, inclusive of CA0000120700 PTCA, inclusive of diagnostic angiogram ( if coronary 40000 Yes 0 Yes 3 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Drug Eluting stent (FDA)-23625 PTCA, inclusive of diagnostic angiogram ( if coronary Admission notes showing vitals-P | All investigations reports-C | Angiogram report-C |
GY 07 diagnostic 0049 angiography pkg booked separately then 6000 rs will be Max :3 | Drug Eluting stent angiography pkg booked separately then 6000 rs will be Barcode of the stents used-C | CAG-P | Clinical notes detailing history-P | Detailed
angiogram deducted from 40000 (NON FDA)-12500 Max :3 deducted from 40000 Discharge Summary-C | Detailed ICPs-C | Detailed discharge summary-C | ECG-P |
ECHO-P | Examination findings-P | Procedure / Operative notes with still images-C |
Reports-P | Showing stent & post Stent flow-C | Stills showing blocks-P | Treatment
details-C
CARDIOLO CA CA000012 Rheumatic fever CA0000128600 Acute rheumatic fever/ Rheumatic valvular heart disease 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute rheumatic fever/ Rheumatic valvular heart disease All investigations reports-C | Clinical notes detailing history and Admission notes showing
GY 86 0050 (without Ventilator)-4700 | vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Planned line of management-P | Relevant investigations ( 2D Echo ,PT INR, etc ) done-P |
Treatment details-C
CARDIOLO CA CA000012 Right / Left Heart CA0000129300 Right Heart Catheterization/Left Heart Catheterization 5000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Right Heart Catheterization/Left Heart Catheterization All investigations reports-C | Clinical notes detailing history and Admission notes showing
GY 93 Catheterization 0051 vitals and examination findings-P | Clinical notes with planned line of treatment, ECG,
ECHO-P | Detailed discharge summary-C | Invoices of catherter and other accessories
used.-C | Procedure / Operative Notes-C | Treatment details-C
CARDIOLO CA CA000013 Rotational CA0000130200 Rotational Atherectomy (ROTA) Ablation - GOVT Reserve 52000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Medical No Insurance N N N Rotational Atherectomy (ROTA) Ablation - GOVT Reserve CAG still showing block-P | Detailed Clinical record with line of management-P |
GY 02 Atherectomy 0052 Reserve Detailed ICPs-C | Detailed clinical reports-C | Discharge summery-C | Invoices of
(ROTA) Ablation consumables and other accessories used-C | Notes to justify procedure-P | Post
thrombolysis Doppler report-C | Procedure / Operative Notes-C | Treatment details-C
CARDIOLO CA CA000013 Ruptured sinus of CA0000130400 Ruptured sinus of Valsalva aneurysm (RSOV) - GOVT 98000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Medical No Insurance N N N Ruptured sinus of Valsalva aneurysm (RSOV) - GOVT Reserve Clinical notes -P | Clinical notes detailing history and Admission notes showing vitals and
GY 04 Valsalva aneurysm 0053 Reserve Reserve examination findings-P | Discharge summary and relevant investigation reports-C |
(RSOV) ECG, 2D Echo and other supportive investigation-P | Invoice / barcode-C | OT/
Procedure notes-C | Still image of device-C
CARDIOLO CA CA000013 Single chamber CA0000133800 Single chamber AICD - GOVT Reserve 28000 Yes 0 Yes 1 Yes Yes Tertiary 20 No Yes Yes Govt Yes No No Medical No Insurance N N N 3 Testla MRI Compatible - AICD- Single chamber AICD - GOVT Reserve Clinical notes -P | Clinical notes detailing history and Admission notes showing vitals and
GY 38 AICD 0054 Reserve 200000 Max :1 examination findings-P | Discharge summary and relevant investigation reports-C |
ECG, 2D Echo and other supportive investigation-P | Invoice / barcode-C | OT/
Procedure notes-C | Still image of device-C
CARDIOLO CA CA000013 Single Chamber CA0000133900 Permanent Pacemaker Implantation - 24500 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Single chamber VVIR ( 3 tesla MRI Permanent Pacemaker Implantation - Angiogram if done-P | Clinical notes detailing history and Admission notes showing vitals
GY 39 Permanent 0055 Single Chamber - Single chamber VVIR Compatible) Life Long Battery Single Chamber - Single chamber VVIR and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
Pacemaker warranty-45000 Max :1 discharge summary-C | ECG + Report by cardiologist necessitating procedure-P |
Implantation Invoice / Barcode of designated pacemaker-C | X Ray showing the pacemaker in situ-C
CARDIOLO CA CA000014 Systemic CA0000142200 Systemic Thrombolysis (for MI) 0 Yes 3 No 0 Add on with No Tertiary 2 No Yes Yes Regular PKG Add on Yes No Medical No Insurance N N N Fibrin Specific Agent -17900 Max ICU (with Ventilator)-6000 | ICU Systemic Thrombolysis (for MI) All investigations reports-C | Clinical notes detailing history and Admission notes showing
GY 22 Thrombolysis (for 0057 CAG (Only for with CAG :1 | Streptokinase -3000 Max :1 (without Ventilator)-4700 | vitals and examination finding-P | Detailed ICPs-C | Detailed discharge summary-C |
MI) Govt. Hospital) (Only for | Urokinase -5000 Max :1 Routine Ward-1800 ECG + Report by cardiologist necessitating procedure-P | ECHO report-C | Invoice/
Govt. Barcode of Thrombolytic Agent-C | Treatment details-C
Hospital)
CARDIOLO CA CA000014 Temporary CA0000142400 Temporary Pacemaker implantation 7000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular No No No Medical No Insurance N N N Temporary Pacemaker implantation Clinical notes detailing history and Admission notes showing vitals and examination
GY 24 Pacemaker 0058 PKG/add on findings-P | Detailed ICPs-C | Detailed Procedure / Operative Notes-C | Detailed
implantation discharge summary-C | ECG + Report by cardiologist necessitating procedure-P |
Invoice / barcode of pacemaker-C | X Ray showing the pacemaker in situ-C
CARDIOLO CA CA000015 VSD Device CA0000154900 VSD Device Closure with VSD device 75000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N VSD Device Closure with VSD device Clinical notes detailing history and Admission notes showing vitals and examination
GY 49 Closure 0059 findings-P | Detailed Discharge Summary-C | Detailed ICPs-C | ECHO report showing
VSD-P | Invoice of device used-C | Post procedure stills of ECHO with report-C |
Procedure / Operative notes with still image-C
CARDIOLO CA CA000016 Bronchial artery CA0000169000 Bronchial artery Embolisation 30000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N Bronchial artery Embolisation Check Angiography of same bronchial artery after the procedure-C | Chest X-Ray / HRCT
GY 9 Embolisation 015 (for Hemoptysis) (for Hemoptysis) chest with CT Angiogram / Invasive Angiogram-P | Clinical notes-P | Detailed Procedure
(for Hemoptysis) / Operative Notes-C | Detailed discharge summary-C | Hb-C | Other investigations-P |
Serum Creatinine-C
CARDIOLO CA CA000018 Cardiac CA0000183000 Cardiac Tamponade 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cardiac Tamponade 2D echo-P | All investigations reports-C | Clinical notes-P | Detailed ICPs-C | Detailed
GY 3 Tamponade 016 (without Ventilator)-4700 | discharge summary-C | ECG-P | Fluid Aspirated report-C | Post treatment 2D echo-C |
Routine Ward-1800 Procedure notes-C | Serum Electrolytes-P | Treatment details-C
CARDIOLO CA CA000019 Central Line ( CA0000195000 Central Line ( Double Lumen / Triple Lumen ) with 0 Yes 2 No 0 Yes No Secondary 0 No Yes Yes Add On Yes No No Medical No Insurance N N N Double Lumen-2000 | Triple Central Line ( Double Lumen / Triple Lumen ) with All investigations reports-C | Detail notes & X ray after procedure-C | Detailed ICPs-C |
GY 5 Double Lumen / 017 procedure - add on Lumen-2500 procedure - add on Detailed discharge summary-C | Invoice / bar code-C | Review notes of primary
Triple Lumen ) physician for requirent of procedure-P | Treatment details-C
CARDIOLO CA CA000021 CHD /RHD CA0000211000 CHD / RHD 0 Yes 3 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU CHD / RHD All investigations reports-C | Any investigations done-P | Clinical notes detailing history
GY 1 018 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Planned line of management, ECG & ECHO-P |
Treatment details-C
CARDIOLO CA CA000026 Congestive heart CA0000264000 Congestive heart failure 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Congestive heart failure All investigations reports-C | Any investigations done-P | Clinical notes detailing history
GY 4 failure 019 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Planned line of management, ECG & ECHO-P |
Treatment details-C
CARDIOLO CA CA000030 Coronary CA0000303000 Coronary Angiography 5300 No 0 No 0 Yes Yes Tertiary 2 No Yes Yes Govt Yes Yes No Medical No Insurance N N N Coronary Angiography Clinical notes with planned line of treatment, ECG, ECHO, Cardiac Markers / CTMT-P |
GY 3 Angiography 020 Reserve Discharge summary-C | Invoices of catherter and other accessories used.-C | Procedure
/ Operative Notes-C
CARDIOLO CA CA000031 CRT - D ( CA0000317000 CRT - D ( Quadripolar lead) MRI Compatible - GOVT Reserve 18000 Yes 0 Yes 1 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Medical No Insurance N N N 3 Testla MRI Compatible CRT - D- CRT - D ( Quadripolar lead) MRI Compatible - GOVT Reserve Clinical notes and ECHO and ECG report justifying need of procedure-P | Discharge
GY 7 Quadripolar lead) 021 Reserve 325000 Max :1 summary with detail treatment & interventions-C | Final bill with payment receipt.-C
MRI Compatible
CARDIOLO CA CA000031 CRT - P ( CA0000318000 CRT - P ( Quadripolar lead) MRI Compatible - GOVT Reserve 18000 Yes 0 Yes 1 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Medical No Insurance N N N 3 Testla MRI Compatible CRT - P- CRT - P ( Quadripolar lead) MRI Compatible - GOVT Reserve Cine images & interventions-C | Clinical notes and ECHO report justifying need of
GY 8 Quadripolar lead) 022 Reserve 175000 Max :1 procedure-P | Discharge summary with detail treatment-C | Final bill with payment
MRI Compatible receipt-C
CARDIOLO CA CA000031 CRT With CA0000319000 CRT With Physiological pacemaker - add on with CRT / DDD 0 Yes 0 Yes 1 Yes Yes Tertiary 5 No Yes Yes Govt Yes Yes No Medical No Insurance N N N Physiological pacemaker-60000 CRT With Physiological pacemaker - add on with CRT / DDD Cine images & interventions-C | Clinical notes and ECG/ECHO + Report by cardiologist
GY 9 Physiological 023 Pacemaker PKG - GOVT Reserve - add on Reserve and Max :1 Pacemaker PKG - GOVT Reserve - add on necessitating procedure-P | Discharge summary with detail treatment-C | Final bill with
pacemaker a Add On payment receipt-C
CARDIOLO CA CA000036 Acute thrombosis CA0000360000 Acute thrombosis Systemic Thrombolysis and 30400 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Medical No Insurance N N N Acute thrombosis Systemic Thrombolysis and Clinical notes detailing history and Admission notes showing vitals and examination
GY Systemic 56 anticoagulation ( Including thrombolytic agent r - TPA ) anticoagulation ( Including thrombolytic agent r - TPA ) findings-P | Clinical notes-C | Clinical notes-P | Discharge summary and relevant
Thrombolysis and investigation reports-C | Invoice/ Barcode of Thrombolytic Agent-C | Post thrombolysis
anticoagulation ECHO report-C | Supportive investigation (ECHO & Other)-P
CARDIOLO CA CA000051 Double Chamber CA0000514000 Permanent Pacemaker Implantation - Double Chamber 33000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Double chamber DDDR ( 3 tesla Permanent Pacemaker Implantation - Double Chamber Angiogram if done-P | Clinical notes and ECG + Report by cardiologist necessitating
GY 4 Permanent 024 MRI Compatible) Life Long procedure-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C
Pacemaker Battery warranty-75000 Max :1 | Invoice / Barcode of designated pacemaker-C | X Ray showing the pacemaker in situ-C
Implantation
CARDIOLO CA CA000052 DVT/Acute CA0000521000 DVT/Acute thrombosis Catheter guided Thrombolysis and 35000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Catheter guided Thrombolysis and Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
GY 1 Thrombosis 025 anticoagulation ( Including r-TPA ) anticoagulation ( Including r-TPA ) Doppler/Angio Report, Clinical notes detailing history and Admission notes showing vitals
and examination findings-P | Invoice / bar code of used coil-C | Procedural image with
catheter in place-C
CARDIOLO CA CA000052 DVT/Acute CA0000521000 DVT/Acute thrombosis Systemic Thrombolysis and 21700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Systemic Thrombolysis and All investigations reports-C | Detailed ICPs-C | Detailed discharge summary-C |
GY 1 Thrombosis 026 anticoagulation ( Including thrombolytic agent expect r - anticoagulation ( Including thrombolytic agent expect r - TPA Doppler/Angio Report, Clinical notes detailing history and Admission notes showing vitals
TPA ) ) and examination findings-P | Invoice / barcode of thrombolytic agent used-C | Post
thrombolysis Doppler report-C | Treatment details-C
CARDIOLO CA CA000053 Electrophysiologic CA0000532000 Electrophysiological Study with/ without Radio Frequency 27000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Radio Frequency Catheter-76000 Electrophysiological Study with/ without Radio Frequency Clinical notes with planned line of treatment, ECG, ECHO, Serum Electrolytes-P |
GY 2 al Study 027 Ablation Max :1 | Steerable decapolar Ablation Discharge summary-C | EP study report-C | Still images of procedure-C
catheter, Quadripolar Catheter-
46000 Max :1
CARDIOLO CA CA000053 Embolization CA0000533000 Arteriovenous Malformation (AVM) in the Limbs 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Arteriovenous Malformation (AVM) in the Limbs Angio Report, Clinical notes detailing history and Admission notes showing vitals and
GY 3 028 examination findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Invoice / bar code of used coil-C | Procedural image with coils in place-C
CARDIOLO CA CA000054 Endocarditis CA0000549000 Bacterial Endocarditis / Fungal Endocarditis 0 Yes 3 No 0 Yes No Secondary 6 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Bacterial Endocarditis / Fungal Endocarditis All investigations reports-C | Blood culture reports-C | Clinical notes with planned line
GY 9 029 (without Ventilator)-4700 | of treatment, ECHO, CBC, ECG-P | Detailed Discharge Summary-C | Detailed ICPs-C |
Routine Ward-1800 Post treatment ECHO-C | Treatment details-C
CARDIOLO CA CA000063 Extended LOS CA0000638000 Extended LOS care pkg for advance surgeries after 6 days 0 Yes 3 No 0 Yes No Secondary 19 No Yes Yes Regular PKG Yes No No Medical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance surgeries after 6 days Clinical notes detailing history and Admission notes showing vitals and examination
GY 8 care pkg for 030 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) findings, indication for Extended LOS-P | Detailed discharge summary-C | Lab tests-C |
advance surgeries Routine Ward-1800 Post Treatment clinical photograph-C | X-rays or other diagnostic procedures done as a
part of treatment-C
CARDIOLO CA CA000067 follow up - CA0000672000 First Follow-up 15-90 days after discharge 4000 No 0 No 0 No No Tertiary 5 No Yes Yes follow up No No No Medical No Insurance N N N First Follow-up 15-90 days after discharge All investigations reports-C | Clinical notes with planned line of treatment, ECG, Sr
GY 2 Cardiology / CTVS 031 Electrolytes-P | Detailed Discharge Summary-C | Detailed ICPs-C | Post treatment ECG-
C | Treatment details-C
CARDIOLO CA CA000067 follow up - CA0000672000 quarterly Follow-up - After 6 month of discharge date 2000 No 0 No 0 No No Tertiary 5 No Yes Yes follow up No No No Medical No Insurance N N N quarterly Follow-up - After 6 month of discharge date All investigations reports-C | Any investigations done-P | Clinical notes detailing history
GY 2 Cardiology / CTVS 032 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Detailed discharge summary-C | Planned line of management-P | Treatment details-C
CARDIOLO CA CA000067 follow up - CA0000672000 Second Follow-up- 3 - 6 months after discharge date 4000 No 0 No 0 Yes No Tertiary 5 No Yes Yes follow up Yes No No Medical No Insurance N N N Second Follow-up- 3 - 6 months after discharge date All investigations reports.-C | Clinical notes detailing history and Admission notes
GY 2 Cardiology / CTVS 033 showing vitals and examination findings; ECG, Tropinin,2D Echo investigations done.-P |
Detailed ICPs-C | Detailed discharge summary-C | Treatment details-C
CARDIOLO CA CA000068 Fractional flow CA0000682000 Fractional flow reserve (FFR) - GOVT Reserve - add on 38000 No 0 No 0 No Yes Tertiary 2 No Yes Yes Govt No Yes No Medical No Insurance N N N Fractional flow reserve (FFR) - GOVT Reserve - add on Angiogram report-C | Detailed Discharge Summary-C | ECG, ECHO, CAG stills showing
GY 2 reserve (FFR) - 034 Reserve and blocks & Reports-P | FFR Catheter Image and report-C | Procedure / Operative notes
Govt Reserve Add On with still images-C
CARDIOLO CA CA000075 High end CA0000754000 High end histopathology (Biopsies) and advanced serology 5000 Yes 1 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology All investigations reports-C | Any investigations done-P | Clinical notes detailing history
GY 4 histopathology 035 investigations - Add on investigations - Add on and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
(Biopsies) and Detailed discharge summary-C | Planned line of management-P | Treatment details-C
advanced
serology
investigations
CARDIOLO CA CA000076 High end CA0000761000 High end radiological diagnostic 5000 Yes 1 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic All investigations reports-C | Any investigations done-P | Clinical notes detailing history
GY 1 radiological 036 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
diagnostic Detailed discharge summary-C | Planned line of management-P | Treatment details-C
(CT, MRI, Imaging
including nuclear
imaging)
CARDIOLO CA CA000079 IHD / CAD / CA0000796000 IHD / Arrhythmia / CAD 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU IHD / Arrhythmia / CAD All investigations reports-C | Clinical notes detailing history and Admission notes showing
GY 6 Arrhythmia 037 (without Ventilator)-4700 | vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Relevant investigations (such as ECG,CBC,Serum electrolyte ETC.) -P | Treatment details-
C
CARDIOLO CA CA000083 Intravascular CA0000836000 Intravascular ultrasound (IVUS) - GOVT Reserve add on 30000 No 0 No 0 Yes Yes Tertiary 3 Yes Yes Yes Govt Yes No No Medical No Insurance N N N Intravascular ultrasound (IVUS) - GOVT Reserve add on Angiogram report-C | Detailed Discharge Summary-C | ECG, ECHO, CAG stills showing
GY 6 ultrasound (IVUS) 038 Reserve and blocks & Reports-P | IVUS Catheter Image and report-C | Procedure / Operative notes
Add On with still images-C
CARDIOLO CA CA000097 ASD Device CA0000970000 ASD Device Closure with ASD device 83800 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Medical No Insurance N N N ASD Device Closure with ASD device Clinical notes and ECHO report showing ASD-P | Detailed Discharge Summary-C |
GY Closure 10 Invoice of device used-C | Post procedure stills of ECHO with report-C | Procedure /
Operative notes with still images-C
CTVS CT CT0000111 Patent Ductus CT0000111100 Patent Ductus Arteriosus (PDA) Closure via thoracotomy 57000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Patent Ductus Arteriosus (PDA) Closure via thoracotomy All investigations reports-C | Clinical notes detailing history and Admission notes showing
1 Arteriosus (PDA) 0095 vitals and examination findings-P | Detailed ICPs-C | Detailed Operation notes-C |
Closure via Detailed discharge summary-C | ECHO report-P | Treatment details-C
thoracotomy
CTVS CT CT0000111 Pectus excavation CT0000111500 Pectus excavation 50000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N To be updated by analyser-0 Max Pectus excavation All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical
5 0096 :1 examination notes, X- ray, CT scan, Electrocardiogram(ECGor EKG), Echocardiogram , lung
function test-P | Detailed ICPs-C | Detailed Operation notes-C | Detailed discharge
summary-C | OT notes-C | Post Op clinical photo-C | Treatment details-C
CTVS CT CT0000113 Pericardial CT0000113200 Pericardial window (via thoracotomy) 30000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Pericardial window (via thoracotomy) All investigations reports-C | Clinical notes and CT Chest establishing the aetiology for
2 window (via 0097 which surgery is done-P | Detailed ICPs-C | Detailed Operation notes-C | Detailed
thoracotomy) discharge summary-C | Treatment details-C
CTVS CT CT0000113 Pericardiectomy CT0000113300 Pericardiectomy 67000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pericardiectomy All investigations reports-C | Clinical notes detailing history and Admission notes showing
3 0098 vitals and examination findings -P | Detailed ICPs-C | Detailed Operation notes-C |
Detailed discharge summary-C | ECHO report-P | Treatment details-C
CTVS CT CT0000114 Peripheral arterial CT0000114600 Peripheral arterial injury repair (with Interpostion vain graft) 47800 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Peripheral arterial injury repair (with Interpostion vain graft) Clinical Photograph shwoing primary suture line and vain harvesting site-C | Clinical
6 injury repair (with 00100 notes with planned line of treatment, Admission notes showing vitals and examination
Interpostion vain findings-P | Detailed discharge summary and operative notes-C | Doppler-P
graft)
CTVS CT CT0000114 Peripheral arterial CT0000114700 Peripheral arterial injury repair (without 30000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Peripheral arterial injury repair (without All investigations reports-C | Clinical notes with planned line of treatment, Admission
7 injury repair 0099 bypass/interposition graft) bypass/interposition graft) notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
(without bypass) notes-C | Detailed discharge summary-C | Doppler-P | Treatment details-C
CTVS CT CT0000114 Peripheral Arterial CT0000114800 Femoro - Femoral Bypass /Carotid - 55000 Yes 0 Yes 2 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N PTFE Graft Large (<8mm)-50000 Femoro - Femoral Bypass /Carotid - All investigations reports-C | Angiogram / CT Angiogram / MRI reports-P | Barcode of
8 Surgeries 00101 endearterectomy/Carotid Body Tumor Excision/Thoracic Max :2 | PTFE graft small (upto 8 endearterectomy/Carotid Body Tumor Excision/Thoracic graft used-C | Clinical notes with planned line of treatment, Admission notes showing
Outlet syndrome Repair/Carotid aneurysm mm)-30000 Max :2 Outlet syndrome Repair/Carotid aneurysm vitals and examination findings-P | Detailed ICPs-C | Detailed Operation notes-C |
repair/Subclavian aneurysm repair/Axillary aneurysm repair/Subclavian aneurysm repair/Axillary aneurysm Detailed discharge summary-C | Treatment details-C
repair/Brachial artery aneurysm repair/Femoral artery repair/Brachial artery aneurysm repair/Femoral artery
aneurysm repair/Popliteal artery aneurysm repair/Femoral - aneurysm repair/Popliteal artery aneurysm repair/Femoral -
popliteal Bypass/Axillo - Brachial Bypass/Carotio - carotid popliteal Bypass/Axillo - Brachial Bypass/Carotio - carotid
Bypass/Carotido - subclavian artery bypass/Carotido - Bypass/Carotido - subclavian artery bypass/Carotido -
axillary bypass/Axillo - femoral bypass - U/L/Axillo - femoral axillary bypass/Axillo - femoral bypass - U/L/Axillo - femoral
bypass - B/L/Aorto - carotid bypass/Aorto - subclavian bypass - B/L/Aorto - carotid bypass/Aorto - subclavian
bypass/Patch Graft Angioplasty/Small Arterial Aneurysms – bypass/Patch Graft Angioplasty/Small Arterial Aneurysms –
Repair/Medium size arterial aneurysms with synthetic Repair/Medium size arterial aneurysms with synthetic
graft/Surgery for Arterial Aneursysm –Vertebral/Surgery for graft/Surgery for Arterial Aneursysm –Vertebral/Surgery for
Arterial Aneurysm Renal Artery/Operations for Acquired Arterial Aneurysm Renal Artery/Operations for Acquired
Arteriovenous Fistual/Congenital Arterio Venous Fistula Arteriovenous Fistual/Congenital Arterio Venous Fistula
CTVS CT CT0000121 Pulmonary CT0000121000 Pulmonary Embolectomy/Pulmanary 141000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pulmonary Embolectomy/Pulmanary All investigations reports-C | Clinical notes with planned line of treatment, Admission
0 Embolectomy / 00102 Thromboendarterectomy Thromboendarterectomy notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
Thromboendarter notes-C | Detailed discharge summary-C | ECHO report + CT Chest report -P |
ectomy Treatment details-C
CTVS CT CT0000121 Pulmonary CT0000121100 Pulmonary Resection 77000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pulmonary Resection All investigations reports-C | Clinical notes with planned line of treatment, Admission
1 Resection 00103 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
notes-C | Detailed discharge summary-C | HPE of resected tissue detailed operation
notes-C | Pre-Op X-ray / CT Scan-P | Treatment details-C
CTVS CT CT0000125 Re-do sternotomy CT0000125200 Re-do sternotomy - ADD On PKG 20000 No 0 No 0 No No Tertiary 5 No Yes Yes Add On No No No Surgical No Insurance N N N Re-do sternotomy - ADD On PKG All investigations reports-C | Clinical notes with planned line of treatment (including
2 00104 indication for need of required Procedure ) Admission notes showing vitals and
examination findings;-P | Detailed ICPs-C | Detailed Operation notes-C | Detailed
discharge summary-C | Procedure / Operative Notes-C | Treatment details-C
CTVS CT CT0000128 Rib Resection & CT0000128900 Rib Resection & Drainage 17300 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Rib Resection & Drainage All investigations reports-C | Clinical notes with planned line of treatment, Admission
9 Drainage 00105 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
notes-C | Detailed discharge summary-C | Post procedure Detailed Operative notes-C |
Post procedure X Ray-C | Pus C/S-C | Treatment details-C | X Ray, CT/ MRI confirming
the diagnosis for which the surgery is done, Clinical photograph-P
CTVS CT CT0000130 Ross Procedure CT0000130100 Ross Procedure 165000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N RV - PA Conduit-120000 Max :1 Ross Procedure All investigations reports-C | Barcode of RV-PA conduit-C | Clinical notes with planned
1 00106 line of treatment, Admission notes showing vitals and examination findings-P | Detailed
ICPs-C | Detailed Operation notes-C | Detailed discharge summary-C | ECHO report-P
| Treatment details-C
CTVS CT CT0000134 Single Chamber CT0000134000 Permanent Pacemaker Implantation - 24500 Yes 0 Yes 1 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Single chamber VVIR ( 3 tesla MRI Permanent Pacemaker Implantation - All investigations reports-C | Angiogram if done-P | Clinical notes with planned line of
0 Permanent 00107 Single Chamber - Single chamber VVIR Compatiable) Life Long Battery Single Chamber - Single chamber VVIR treatment, Admission notes showing vitals and examination findings-P | Detailed ICPs-C
Pacemaker warrentry-45000 Max :1 | Detailed Operation notes-C | Detailed Procedure / Operative Notes-C | Detailed
Implantation discharge summary-C | ECG + Report by cardiologist necessitating procedure-P |
Invoice / Barcode of designated pacemaker-C | Treatment details-C | X Ray showing the
pacemaker in situ-C
CTVS CT CT0000134 Single Valve CT0000134300 Aortic valve / Mitral valve / Tricuspid valve - replacement 120000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mechanical Valve - Bileaflet- Aortic valve / Mitral valve / Tricuspid valve - replacement All investigations reports-C | Barcode of implant-C | Clinical notes with planned line of
3 Procedure 00108 /repair 45000 Max :1 | Mechanical /repair treatment, Admission notes showing vitals and examination findings-P | Detailed ICPs-C
Valve - Tilting Disc-28000 Max :1 | Detailed Operation notes-C | Detailed discharge summary-C | ECHO / Doppler report-
| Tissue Valve-90000 Max :1 P | Post op ECHO-C | Treatment details-C
CTVS CT CT0000135 Space - Occupying CT0000135300 Space - Occupying Lesion (SOL) mediastinum 65500 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Space - Occupying Lesion (SOL) mediastinum All investigations reports-C | CT Chest-P | Clinical notes with planned line of treatment,
3 Lesion (SOL) 00109 Admission notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed
mediastinum Operation notes-C | Detailed Operation notes-C | Detailed discharge summary-C | HPE
of SOL-C | Treatment details-C
CTVS CT CT0000139 Surgery for CT0000139300 Surgery for Cardiac Tumour 113000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Surgery for Cardiac Tumour All investigations reports-C | Clinical notes with planned line of treatment, Admission
3 Cardiac Tumour 00111 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
notes-C | Detailed discharge summary-C | ECHO report-P | HPE report of tumor-C |
Treatment details-C
CTVS CT CT0000140 Surgery for CT0000140000 Surgery for Hypertrophic Obstructive Cardiomyopathy 111000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mechanical Valve - Bileaflet - Surgery for Hypertrophic Obstructive Cardiomyopathy All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical notes
0 Hypertrophic 00112 (HOCM) 45000 Max :1 | Mechanical (HOCM) with planned line of treatment, Admission notes showing vitals and examination findings-
Obstructive Valve - Tilting Disc-28000 Max :1 P | Detailed ICPs-C | Detailed Operation notes-C | Detailed discharge summary-C |
Cardiomyopathy | Tissue Valve-90000 Max :1 | ECHO report-P | Treatment details-C
(HOCM) Valve Ring - Mitral-35000 Max :1
| Valve Ring - Tricuspid-35000
Max :1
CTVS CT CT0000140 Surgical CT0000140500 Surgical Correction of Bronchopleural Fistula 65000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Surgical Correction of Bronchopleural Fistula All investigations reports-C | CT Chest-P | Clinical notes with planned line of treatment,
5 Correction of 00113 Admission notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed
Bronchopleural Operation notes-C | Detailed discharge summary-C | Treatment details-C
Fistula
CTVS CT CT0000140 Surgical CT0000140600 Isolated Secundum Atrial Septal Defect (ASD) Repair/Glenn 100000 Yes 0 Yes 2 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N PTFE Graft - Thin-30000 Max :2 Isolated Secundum Atrial Septal Defect (ASD) Repair/Glenn All investigations reports-C | Barcode of Implant-C | Clinical notes with planned line of
6 Correction of 00114 procedure/Pulmonary Artery Banding/Systemic - procedure/Pulmonary Artery Banding/Systemic - Pulmonary treatment, Admission notes showing vitals and examination findings-P | Detailed ICPs-C
Category - I Pulmonary Artery shunt/Vascular Ring division. Artery shunt/Vascular Ring division. | Detailed Operation notes-C | Detailed discharge summary-C | ECHO and / or doppler
Congenital Heart reports-P | Treatment details-C
Disease
CTVS CT CT0000140 Surgical CT0000140700 ASD closure + Partial Anomalous Venous Drainage 120000 Yes 0 Yes 3 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Dacron Graft Straight-30000 Max ASD closure + Partial Anomalous Venous Drainage All investigations reports-C | Barcode of Implant-C | Clinical notes with planned line of
7 Correction of 00115 Repair/ASD Closure + Mitral procedure/ASD Closure + :3 | Mechanical Valve - Bileaflet- Repair/ASD Closure + Mitral procedure/ASD Closure + treatment, Admission notes showing vitals and examination findings-P | Detailed ICPs-C
Category - II Tricuspid procedure/ASD Closure + Pulmonary 40000 Max :3 | Mechanical Tricuspid procedure/ASD Closure + Pulmonary | Detailed Operation notes-C | Detailed discharge summary-C | ECHO report-P |
Congenital Heart procedure/ASD Closure + Infundibular procedure/VSD Valve - Tilting Disc-28000 Max :3 procedure/ASD Closure + Infundibular procedure/VSD Treatment details-C
Disease closure/Infundibular PS repair/Valvular PS / PR | PTFE Graft Large (<8mm)- closure/Infundibular PS repair/Valvular PS / PR repair/Partial
repair/Partial AV canal repair/Intermediate AV canal 50000 Max :3 | PTFE Patch - Thin- AV canal repair/Intermediate AV canal repair/Atrial
repair/Atrial septectomy + Glenn/Atrial septectomy + PA 30000 Max :3 | PTFE graft small septectomy + Glenn/Atrial septectomy + PA Band /Sinus of
Band /Sinus of Valsalva aneurysm repair with aortic valve (upto 8 mm)-30000 Max :3 | Valsalva aneurysm repair with aortic valve procedure/Sinus
procedure/Sinus of Valsalva aneurysm repair without aortic Valve Ring - Mitral-350000 Max :3 of Valsalva aneurysm repair without aortic valve
valve procedure/Sub-aortic membrane resection | Valve Ring - Tricuspid-35000 procedure/Sub-aortic membrane resection
Max :3
CTVS CT CT0000140 Surgical CT0000140800 ALCAPA repair / Unifocalization of MAPCA with intercardiac 191300 No 0 No 0 Yes No Tertiary 12 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N ALCAPA repair / Unifocalization of MAPCA with intercardiac All investigations reports-C | Barcode of Implant-C | Clinical notes with planned line of
8 Correction of 00116 repair / Arterial switch operation/Senning repair / Arterial switch operation/Senning treatment, Admission notes showing vitals and examination findings-P | Detailed ICPs-C
Category - III Operation/Mustard Operation Operation/Mustard Operation | Detailed Operation notes-C | Detailed discharge summary-C | ECHO / Doppler Report-
Congenital Heart P | Treatment details-C
Disease
CTVS CT CT0000140 Surgical CT0000140800 TOF Repair/Ebstien anomoly repair/Double switch 150000 Yes 0 Yes 3 Yes No Tertiary 12 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mechanical Valve - Bileaflet- TOF Repair/Ebstien anomoly repair/Double switch All investigations reports-C | Barcode of Implant-C | Clinical notes with planned line of
8 Correction of 00117 operation/Rastelli Procedure/Fontan procedure/AP window 40000 Max :3 | Mechanical operation/Rastelli Procedure/Fontan procedure/AP window treatment, Admission notes showing vitals and examination findings-P | Detailed ICPs-C
Category - III repair/Arch interruption Repair without VSD closure/Arch Valve - Tilting Disc-28000 Max :3 repair/Arch interruption Repair without VSD closure/Arch | Detailed Operation notes-C | Detailed discharge summary-C | ECHO / Doppler Report-
Congenital Heart interruption Repair with VSD closure/DORV | PTFE Patch - Thin-30000 Max :3 interruption Repair with VSD closure/DORV P | Treatment details-C
Disease Repair/Supravalvular AS repair/Konno procedure/Norwood | Pericardial Patch-18000 Max :3 Repair/Supravalvular AS repair/Konno procedure/Norwood
procedure/VSD closure + RV - PA conduit/VSD + Aortic | RV - PA Conduit-120000 Max :3 procedure/VSD closure + RV - PA conduit/VSD + Aortic
procedure/VSD + Mitral procedure/VSD + Tricuspid | Tissue Valve -90000 Max :3 | procedure/VSD + Mitral procedure/VSD + Tricuspid
procedure/VSD + Pulmonary artery procedure/VSD + Valve Ring - Mitral-35000 Max :3 procedure/VSD + Pulmonary artery procedure/VSD +
Infundibular procedure/VSD + Coarctation repair/TAPVC | Valve Ring - Tricuspid-35000 Infundibular procedure/VSD + Coarctation repair/TAPVC
Repair/Truncus arteriosus repair/Tetralogy of Fallot Max :3 Repair/Truncus arteriosus repair/Tetralogy of Fallot
Repair/Complete AV canal repair Repair/Complete AV canal repair
CTVS CT CT0000142 Temporary CT0000142500 Temporary Pacemaker implantation 7000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Temporary Pacemaker implantation All investigations reports-C | Clinical notes with planned line of treatment, Admission
5 Pacemaker 00118 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Procedure
implantation / Operative Notes-C | Detailed discharge summary-C | ECG + Report by cardiologist
necessitating procedure-P | Invoice / barcode of pacemaker-C | Treatment details-C |
X Ray showing the pacemaker in situ-C
CTVS CT CT0000143 Thoracotomy / CT0000143800 Thoracotomy / Thoraco Abdominal Approach 30000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Thoracotomy / Thoraco Abdominal Approach All investigations reports-C | CT Chest establishing the aetiology for which surgery is
8 Thoraco 00119 done-P | Clinical notes with planned line of treatment, Admission notes showing vitals
Abdominal and examination findings-P | Detailed ICPs-C | Detailed Operation notes-C | Detailed
Approach discharge summary-C | Treatment details-C
CTVS CT CT0000143 Thromboembolec CT0000143900 Peripheral Thromboembolectomy 28000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Peripheral Thromboembolectomy All investigations reports-C | Clinical notes with planned line of treatment, Admission
9 tomy 00120 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
notes-C | Detailed discharge summary-C | Soon as documents are uploaded, confirm
evidence of embolus/ Thrombus in duples USG/ Angio-P | Treatment details-C
CTVS CT CT0000145 Tracheal / CT0000145800 Tracheal / Bronchial repair 50000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tracheal / Bronchial repair All investigations reports-C | Clinical notes with planned line of treatment, Admission
8 Bronchial repair 00121 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed discharge
summary-C | ECG, 2D Echo, MRI clinical notes preoprative photo-P | Stent/ implant
invoice-C | Treatment details-C
CTVS CT CT0000147 Triple valve CT0000147600 Triple valve replacement / repair 170000 Yes 0 Yes 3 Yes No Tertiary 12 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mechanical Valve - Bileaflet- Triple valve replacement / repair All investigations reports-C | Barcode of valves/rings used-C | Clinical notes with
6 procedure 00122 45000 Max :3 | Mechanical planned line of treatment, Admission notes showing vitals and examination findings-P |
Valve - Tilting Disc-28000 Max :3 Detailed ICPs-C | Detailed Operative notes-C | Detailed discharge summary-C | ECHO
| Tissue Valve-90000 Max :3 | and doppler reports showing three cardiac valves diseased -P | Treatment details-C
Valve Ring - Mitral-35000 Max :3
Max :3
CTVS CT CT0000152 Varicose vein: CT0000152500 Varicose vein: endovenous treatment (for one limb) - Govt 43400 No 0 No 0 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Surgical No Insurance N N N Varicose vein: endovenous treatment (for one limb) - Govt All investigations reports-C | CT/MRI/ DSA confirming the diagnosis-P | Clinical notes
5 endovenous 00123 Reserve Reserve Reserve with planned line of treatment, Admission notes showing vitals and examination findings-
treatment (for P | Detailed ICPs-C | Detailed Procedure / Operative Notes-C | Detailed discharge
one limb) summary-C | Treatment details-C
CTVS CT CT0000152 Vascular CT0000152600 Vascular reconstruction with or without vein graft 55000 No 0 No 0 No No Tertiary 9 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Vascular reconstruction with or without vein graft All investigations reports-C | Clinical notes with planned line of treatment, Admission
6 reconstruction 00124 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed discharge
summary-C | Treatment details-C
CTVS CT CT0000152 Vascular CT0000152900 Vascular reconstruction with Graft/Patch 35000 Yes 0 Yes 2 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N 0 PTFE Graft Large (>8mm)-50000 Vascular reconstruction with Graft/Patch Barcode of Implant-C | Clinical notes with planned line of treatment, Admission notes
9 reconstruction 00125 Max :2 | PTFE Patch-30000 Max showing vitals and examination findings-P | Detailed Operative notes-C | Detailed
with graft/patch :2 | PTFE graft small (upto 8 mm discharge summary-C | Doppler reports-P
)-30000 Max :2
CTVS CT CT0000175 CABG + Ischemic CT0000175000 CABG + Ischemic Mitral Valve Repair/Replacement 156500 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mechanical Valve - Bileaflet CABG + Ischemic Mitral Valve Repair/Replacement All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical notes ,
Mitral Valve 067 -45000 Max :1 | Mechanical detailing history and Admission notes showing vitals and examination findings-P |
Repair/Replaceme Valve - Tilting Disc-28000 Max :1 Detailed ICPs-C | Detailed discharge summary-C | Detailed procedure notes-C | ECHO /
nt | Tissue Valve-90000 Max :1 | Angio / CT angio / MRI reports showing aneurysm-P | Treatment details-C
CTVS CT CT0000176 CABG + Ischemic CT0000176000 CABG + Ischemic VSR / wall Rupture repair / ventricular 170000 Yes 0 Yes 2 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N PTFE / Dacron Patch-30000 Max CABG + Ischemic VSR / wall Rupture repair / ventricular All investigations reports-C | Angiogram if done-P | Bar code of Implant / Invoice(If
VSR/ Rupture 068 Rupture repair / Aneurysm Rupture repair / Mitral Valve :2 Rupture repair / Aneurysm Rupture repair / Mitral Valve used)-C | Clinical notes , detailing history and Admission notes showing vitals and
repair Rupture repair Rupture repair examination findings-P | Detailed ICPs-C | Detailed discharge summary-C | Detailed
procedure notes-C | ECG + Report by cardiologist necessitating procedure-P |
Treatment details-C
CTVS CT CT0000189 Carotid Body CT0000189000 Carotid Body tumour - Excision / Carotid Endarteractomy 26000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Carotid Body tumour - Excision / Carotid Endarteractomy All investigations reports-C | Clinical notes , detailing history and Admission notes
tumour - Excision 069 showing vitals and examination findings-P | Detailed ICPs-C | Detailed discharge
/ Carotid summary-C | Detailed procedure notes-C | Histopathology-C | Treatment details-C |
Endarteractomy USG Neck/ Colour doppler confirming the diagnosis / CT Angio-P
CTVS CT CT0000200 Central Line ( CT0000200000 Central Line ( Double Lumen / Triple Lumen ) with 0 Yes 0 Yes 1 Yes No Secondary 0 No Yes Yes Add On Yes No No Medical No Insurance N N R N Double Lumen-2000 Max :1 | Central Line ( Double Lumen / Triple Lumen ) with Detail notes & X ray after procedure-C | Invoice / bar code-C | Review notes of primary
Double Lumen / 070 procedure - add on Triple Lumen-2500 Max :1 procedure - add on physician for requirent of procedure-P
Triple Lumen /
Single Lumen )
with procedure -
add on
CTVS CT CT0000231 Closed Mitral CT0000231000 Closed mitral valvotomy 57000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Closed mitral valvotomy All investigations reports-C | Clinical notes , detailing history and Admission notes
Valvotomy 071 showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operative notes-
including C | Detailed discharge summary-C | Detailed procedure notes-C | ECHO and / or
thoracotomy doppler reports-P | Treatment details-C
CTVS CT CT0000270 Conservative CT0000270000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Stand alone Yes No No Medical No Insurance N N N Conservative Management - stand alone All investigations reports-C | Any investigations done-P | Clinical notes detailing history
Management 072 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
CTVS CT CT0000304 Coronary CT0000304000 Coronary Angiography 5300 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Coronary Angiography Any investigations done-P | Clinical notes detailing history and Admission notes showing
Angiography 073 Reserve vitals and examination findings-P | Detailed ICPs-C | Discharge summary and relavent
invetigation reports-C | Fluoroscopy picture with report-C | OT notes-C | Planned line
of management:ECG, 2D Echo.and other supportive investigation clinical notes -P |
Treatment details-C
CTVS CT CT0000305 Coronary artery CT0000305000 Coronary artery bypass grafting (CABG), Off Pump 100000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Coronary artery bypass grafting (CABG), Off Pump 2D Echo-P | Admission notes showing vitals-P | All investigations reports-C | Any
bypass grafting 074 investigations done-P | CAG report-P | Clinical notes detailing history-P | Clinical notes-
(CABG) P | Detailed ICPs-C | Detailed discharge summary-C | ECG-P | Examination findings-P
| Planned line of management-P | Treatment details-C | other supportive investigation-
P
CTVS CT CT0000306 Coronary artery CT0000306000 Coronary artery bypass grafting (CABG), On Pump 118100 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Coronary artery bypass grafting (CABG), On Pump Admission notes showing vitals and examination findings-P | All investigations reports-C
bypass grafting 075 | Any investigations done-P | Barcode of oxygenetor used-C | Clinical notes detailing
(CABG), history and Admission notes showing vitals and Examination findings; any investigations
done; planned line of management:Clinical notes and ECHO report-P | Clinical notes-P |
Detailed ICPs-C | Detailed Operation notes-C | Detailed discharge summary-C | ECHO
report-P | Examination findings-P | Planned line of management-P | Treatment details-
C
CTVS CT CT000037 Acute thrombosis CT0000370000 Acute thrombosis Systemic Thrombolysis and 30800 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Acute thrombosis Systemic Thrombolysis and Clinical notes-C | Discharge summary and relavent invetigation reports-C | Post
Systemic 110 anticoagulation ( Including thrombolytic agent r - TPA ) anticoagulation ( Including thrombolytic agent r - TPA ) thrombolysis Doppler report-C | Ultrasonography for suspected deep vein thrombosis,/
Thrombolysis and CT scan venography .and other supportive investigation Clinical notes with planned line of
anticoagulation treatment, Admission notes showing vitals and examination findings-P
CTVS CT CT0000500 Diaphragmatic CT0000500000 Diaphragmatic Repair 32000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Mesh - 6 X 3 - Polypropylene- Diaphragmatic Repair All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Detailed ICPs-C |
Repair 076 2000 Max :1 Detailed discharge summary-C | Planned line of management:Chest XRAY, CT Chest-P |
Treatment details-C
CTVS CT CT0000515 Double Chamber CT0000515000 Permanent Pacemaker Implantation - 33000 Yes 0 Yes 1 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Double chamber DDDR ( 3 tesla Permanent Pacemaker Implantation - All investigations reports-C | Angiogram if done-P | Angiogram if done-P | Any
Permanent 077 Double Chamber MRI Compatiable) Life Long Double Chamber investigations done-P | Any investigations done; planned line of management: ECG +
Pacemaker Battery warrantry-75000 Max :1 Report by cardiologist necessitating procedure-P | Clinical notes detailing history and
Implantation Admission notes showing vitals and examination findings-P | Clinical notes detailing
history and Admission notes showing vitals and examination findings-P | Detailed ICPs-C
| Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Invoice /
Barcode of designated pacemaker-C | Planned line of management: ECG + Report by
cardiologist necessitating procedure-P | Treatment details-C | X Ray showing the
pacemaker in situ-C
CTVS CT CT0000516 Double Valve CT0000516000 Double valve replacement / repair 142000 Yes 0 Yes 3 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mechanical Valve - Bileaflet- Double valve replacement / repair All investigations reports-C | Any investigations done-P | Barcode of valves/rings used-C
Procedure 078 45000 Max :3 | Tilting Disc- | Clinical notes detailing history and Admission notes showing vitals and examination
28000 Max :3 | Tissue Valve- findings-P | Detailed ICPs-C | Detailed Operative notes-C | Detailed discharge summary-
90000 Max :3 | Valve Ring - C | Planned line of management: ECHO and doppler reports showing two cardiac valves
Mitral-35000 Max :3 | Valve Ring diseased -P | Treatment details-C
- Tricuspid-35000 Max :3
CTVS CT CT0000522 DVT/Acute CT0000522000 DVT/Acute thrombosis Catheter guided Thrombolysis and 30800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Catheter guided Thrombolysis and Angio Report / or Color doppler showing evidence of venous thrombosis, Clinical notes
Thrombosis 079 anticoagulation ( Including r-TPA ) anticoagulation ( Including r-TPA ) detailing history and Admission notes showing vitals and examination findings-P | For
Acute thrombosis Systemic : All investigations reports-C | For Acute thrombosis Systemic
: Detailed ICPs-C | For Acute thrombosis Systemic : Detailed discharge summary-C | For
Acute thrombosis Systemic : ECHO if Available-C | For Acute thrombosis Systemic : Post
thrombolysis Doppler report-C | For Acute thrombosis Systemic : Thrombolysis and
anticoagulation-C | For Acute thrombosis Systemic : Treatment details-C | For Acute
thrombosis Systemic : invoice / barcode of thrombolytic agent used-C | For DVT : All
investigations reports-C | For DVT : Detailed ICPs-C | For DVT : Detailed discharge
summary-C | For DVT : Invoice / barcode of thrombolytic agent used-C | For DVT : Lab
Investigation-C | For DVT : Post thrombolysis Doppler report-C | For DVT : Treatment
details-C
CTVS CT CT0000522 DVT/Acute CT0000522000 DVT/Acute thrombosis Systemic Thrombolysis and 25000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Systemic Thrombolysis and Any investigations done-P | Clinical notes detailing history and Admission notes showing
Thrombosis 080 anticoagulation ( Including thrombolytic agent expect r - anticoagulation ( Including thrombolytic agent expect r - TPA vitals and examination findings-P | FOR Acute MI: All investigations reports-C | FOR
TPA ) ) Acute MI: Detailed ICPs-C | FOR Acute MI: Detailed discharge summary-C | FOR Acute
MI: ECG-C | FOR Acute MI: Lab Investigation (TROP - T report)-C | FOR Acute MI: Post
thrombolysis Doppler report-C | FOR Acute MI: Systemic thrombolysis and
anticoagulation ECHO-C | FOR Acute MI: Treatment details-C | FOR Acute MI: invoice /
barcode of thrombolytic agent used-C | For DVT : All investigations reports-C | For DVT
: Detailed ICPs-C | For DVT : Detailed discharge summary-C | For DVT : Lab Investigation-
C | For DVT : Post thrombolysis Doppler report-C | For DVT : Treatment details-C | For
DVT : invoice / barcode of thrombolytic agent used-C | Planned line of management: ,
1. For Acute MI: Serial ECGs showing MI, Cardiac markers - CPK-MB, TROP I or TROP T
2. For DVT : Color doppler showing evidence of venous.-P
CTVS CT CT0000593 Excessive bleeding CT0000593000 Excessive bleeding requiring re-exploration - ADD On PKG 10000 No 0 No 0 No No Tertiary 5 No Yes Yes Add On No Yes No Surgical No Insurance N N N Excessive bleeding requiring re-exploration - ADD On PKG All investigations reports-C | Any investigations done-P | Clinical notes detailing history
requiring re- 081 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
exploration Detailed Operative notes-C | Detailed discharge summary-C | Planned line of
management:
(including indication for need of required Procedure )-P | Treatment details-C
CTVS CT CT0000627 Extended LOS CT0000627000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Medical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days All investigations reports-C | Any investigations done-P | Clinical notes detailing history
care pkg for 082 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
advance sugeries Routine Ward-1800 Detailed discharge summary-C | Planned line of management-P | Treatment details-C
CTVS CT CT0000673 follow up - CT0000673000 First Follow-up 15-90 days after discharge 4000 No 0 No 0 No No Tertiary 5 No Yes Yes follow up No No No Medical No Insurance N N N First Follow-up 15-90 days after discharge All investigations reports-C | Any investigations done-P | Clinical notes detailing history
Cardiology / CTVS 083 and Admission notes showing vitals and examination findings-P | Detailed Discharge
Summary-C | Detailed ICPs-C | Planned line of management, ECG, Sr Electrolytes-P |
Post treatment ECG-C | Treatment details-C
CTVS CT CT0000673 follow up - CT0000673000 quarterly Follow-up - After 6 month of discharge date 2000 No 0 No 0 No No Tertiary 5 Yes Yes Yes follow up No No No Medical No Insurance N N N quarterly Follow-up - After 6 month of discharge date All investigations reports-C | Any investigations done-P | Clinical notes detailing history
Cardiology / CTVS 084 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
CTVS CT CT0000673 follow up - CT0000673000 Second Follow-up- 3 - 6 months after discharge date 4000 No 0 No 0 Yes No Tertiary 5 No Yes Yes follow up Yes No No Medical No Insurance N N N Second Follow-up- 3 - 6 months after discharge date All investigations reports-C | Clinical notes detailing history and Admission notes showing
Cardiology / CTVS 085 vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
ECG, Tropinin,2D Echo investigations done.-P | Treatment details-C
CTVS CT CT000077 Aortic Aneurysm CT0000770000 Aortic Aneurysm Repair using Cardiopulmonary bypass 132000 Yes 0 Yes 2 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Dacron Graft - Straight-30000 Aortic Aneurysm Repair using Cardiopulmonary bypass All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical notes
Repair 60 (CPB)/Aortic Aneurysm Repair using Left Heart Bypass Max :2 (CPB)/Aortic Aneurysm Repair using Left Heart Bypass detailing history and Admission notes showing vitals and examination finding-P | Detailed
ICPs-C | Detailed Operation notes-C | Detailed discharge summary-C | ECHO / Angio /
CT Angio / MRI reports showing aneurysm-P | Treatment details-C
CTVS CT CT000077 Aortic Aneurysm CT0000770000 Aortic Aneurysm Repair without using Cardiopulmonary 72000 Yes 0 Yes 2 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Dacron Graft - Straight-30000 Aortic Aneurysm Repair without using Cardiopulmonary All investigations reports-C | Angio / CT Angio / MRI reports -P | Bar code of Implant /
Repair 61 bypass (CPB)/Aortic Aneurysm Repair without using Left Max :2 bypass (CPB)/Aortic Aneurysm Repair without using Left Invoice(If used)-C | Clinical notes , detailing history and Admission notes showing vitals
Heart Bypass Heart Bypass and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
Treatment details-C
CTVS CT CT000078 Aortic Arch CT0000780000 Aortic Arch Replacement using cardiopulmonary 200000 Yes 0 Yes 4 Yes No Tertiary 12 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Arch Graft-85000 Max :4 | Aortic Arch Replacement using cardiopulmonary All investigations reports-C | Angio / CT Angio / MRI reports -P | Bar code of Implant /
Replacement / 62 bypass/Thoracoabdominal aneurysm Repair using partial Complex grafts other than Arch bypass/Thoracoabdominal aneurysm Repair using partial Invoice(If used)-C | Clinical notes , detailing history and Admission notes showing vitals
Thoracoabdomina cardiopulmonary bypass Graft & Coseli Graft-85000 Max :4 cardiopulmonary bypass and examination findings-P | Detailed ICPs-C | Detailed Operation notes-C | Detailed
l aneurysm Repair | Coselli Graft -85000 Max :4 | discharge summary-C | Treatment details-C
using bypass Tissue Glue (3 ml)-12000 Max :4
CTVS CT CT000079 Aortic Root CT0000790000 Bental Procedure/Aortic Dissection/Aortic Aneurysm ( Root 150000 Yes 0 Yes 3 Yes No Tertiary 12 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Dacron Graft - Straight Bental Procedure/Aortic Dissection/Aortic Aneurysm ( Root All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical notes,
Replacement 63 Ascending )/Valve sparing root replacement/AVR + Root -30000 Max :3 | Mechanical Ascending )/Valve sparing root replacement/AVR + Root detailing history and Admission notes showing vitals and examination findings-P |
Surgery enlargement Valve - Bileaflet enlargement Detailed ICPs-C | Detailed Operation notes-C | Detailed discharge summary-C | ECHO
-45000 Max :3 | Mechanical report, CT Angio / Angio / MRI report-P | Treatment details-C
Valve - Tilting Disc
-28000 Max :3 | Mechanical-
100000 Max :3 | Tissue Glue (3
ml)-12000 Max :3 | Tissue Valve -
90000 Max :3
CTVS CT CT000080 Aortic stenting CT0000800000 Aortic stenting 50000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Stent-350000 Max :1 Aortic stenting Clinical notes , detailing history and Admission notes showing vitals and examination
64 findings-P | Clinical photo-C | Discharge summary-C | ECG, 2D Echo, MRI clinical notes
preoperative photo-P | Relevant investigation reports-C | Stent/ implant invoice-C
CTVS CT CT0000806 Immediate CT0000806000 Aortic valve / Mitral valve / Tricuspid valve - replacement 142000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Add On Yes Yes No Surgical No Insurance N N N Mechanical Valve - Bileaflet valve- Aortic valve / Mitral valve / Tricuspid valve - replacement All investigations reports-C | Any investigations done-P | Ascertain the need for
reoperation 086 /repair- Add On 45000 Max :1 | Mechanical /repair- Add On reoperation-C | Barcode of implant-C | Clinical notes detailing history and Admission
(within 5 days) Valve - Tilting Disc-28000 Max :1 notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed discharge
| Tissue Valve-90000 Max :1 summary-C | Detailed procedure notes-C | Planned line of management: ECHO /
Doppler report, Detailed Operative notes indicating need for Reoperation-P | Post op
ECHO-C | Treatment details-C
CTVS CT CT0000806 Immediate CT0000806000 Double valve replacement / repair -Add On 142000 Yes 0 Yes 2 Yes No Tertiary 10 No Yes Yes Add On Yes Yes No Surgical No Insurance N N N Mechanical Valve - Bileaflet- Double valve replacement / repair -Add On All investigations reports-C | Any investigations done-P | Ascertain the need for
reoperation 087 45000 Max :2 | Mechanical reoperation-C | Barcode of valves/rings used-C | Clinical notes detailing history and
(within 5 days) Valve - Tilting Disc-28000 Max :2 Admission notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed
| Tissue Valve-90000 Max :2 | Operative notes-C | Detailed discharge summary-C | Planned line of management:
Valve Ring - Mitral-35000 Max :2 ECHO and doppler reports, Detailed Operative notes indicating need for Reoperation-P |
| Valve Ring - Tricuspid-35000 Treatment details-C
Max :2
CTVS CT CT0000806 Immediate CT0000806000 Tetralogy of Fallot Repair (immediate re operation) - Add 150000 Yes 0 Yes 1 Yes No Tertiary 12 No Yes Yes Add On Yes Yes No Surgical No Insurance N N N Mechanical Valve - Bileaflet- Tetralogy of Fallot Repair (immediate re operation) - Add ON All investigations reports-C | Ascertain the need for reoperation-C | Barcode of Implant-
reoperation 088 ON 45000 Max :1 | Mechanical C | Clinical notes detailing history and Admission notes showing vitals and examination
(within 5 days) Valve - Tilting Disc-280000 Max :1 findings-P | Detailed ICPs-C | Detailed discharge summary-C | ECHO / Doppler Report,
| PTFE Patch - Thin-30000 Max :1 Detailed Operative notes indicating need for Reoperation-P | Treatment details-C
| Pericardial Patch-18000 Max :1
| RV - PA Conduit-120000 Max :1
| Tissue Valve-90000 Max :1 |
Max :1
CTVS CT CT0000806 Immediate CT0000806000 Triple valve replacement / repair - Add On 93500 Yes 0 Yes 3 Yes No Tertiary 12 No Yes Yes Add On Yes Yes No Surgical No Insurance N N N Mechanical Valve - Bileaflet- Triple valve replacement / repair - Add On All investigations reports-C | Ascertain the need for reoperation-C | Barcode of Implant-
reoperation 089 450000 Max :3 | Mechanical C | Clinical notes detailing history and Admission notes showing vitals and examination
(within 5 days) Valve - Tilting Disc-280000 Max :3 findings-P | Detailed ICPs-C | Detailed discharge summary-C | ECHO / Doppler Report,
| Tissue Valve-90000 Max :3 | Detailed Operative notes indicating need for Reoperation-P | Treatment details-C
Max :3
CTVS CT CT000081 Aorto Iliac / Aorto CT0000810000 Aorto Iliac bypass - U/L/Aorto femoral bypass - U/L/Aorto 71000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Dacron Graft - Bifurcated-35000 Aorto Iliac bypass - U/L/Aorto femoral bypass - U/L/Aorto All investigations reports-C | Barcode of synthetic graft-C | Clinical notes , detailing
femoral bypass 65 Iliac bypass - B/L/Aorto femoral bypass - B/L Max :1 | Dacron Graft - Straight- Iliac bypass - B/L/Aorto femoral bypass - B/L history and Admission notes showing vitals and examination findings-P | Clinical notes ,
(Uni and Bi) 30000 Max :1 | PTFE Graft - detailing history and Admission notes showing vitals and examination findings-P |
Bifurcated-50000 Max :1 Detailed ICPs-C | Detailed Operation notes-C | Detailed discharge summary-C | MRA /
CT angio / Angio reports-P | MRA / CT angio / Angio reports-P | Treatment details-C
CTVS CT CT0000851 Isolated CT0000851000 Isolated Intercostal Drainage and Management of ICD, 10000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Isolated Intercostal Drainage and Management of ICD, All investigations reports-C | Clinical notes detailing history and detailing need of ICD ,
Intercostal 090 Intercostal Block, Antibiotics & Physiotherapy Intercostal Block, Antibiotics & Physiotherapy Admission notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed
Drainage and discharge summary-C | Detailing need of ICD; X-ray chest-P | Treatment details-C
Management of
ICD, Intercostal
Block, Antibiotics
& Physiotherapy
CTVS CT CT0000873 Left ventricular CT0000873000 Left ventricular aneurysm repair 130000 Yes 0 Yes 2 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N PTFE / Dacron Patch-30000 Max Left ventricular aneurysm repair All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical notes
aneurysm repair 091 :2 detailing history and detailing need of ICD , Admission notes showing vitals and
examination findings-P | Detailed ICPs-C | Detailed discharge summary-C | MRI/EPHS
study, ECG, clinical notes , pre operative photo-P | OT notes-C | Treatment details-C
CTVS CT CT0000892 Low Cardiac CT0000892000 Low Cardiac Output syndrome requiring IABP insertion 5000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Add On Yes No No Surgical No Insurance N N N IABP Catheter-50000 Max :1 Low Cardiac Output syndrome requiring IABP insertion All investigations reports-C | Bar code of Implant / Invoice(If used)-C | Clinical notes
Output syndrome 092 Pre/Intra/post - operatively - ADD On PKG Pre/Intra/post - operatively - ADD On PKG with planned line of treatment (including indication for need of required Procedure )-P |
requiring IABP Detailed ICPs-C | Detailed discharge summary-C | Procedure / Operative Notes-C |
insertion Treatment details-C
Pre/Intra/post -
operatively
CTVS CT CT0000898 Lung surgery CT0000898000 Lung cyst exision/Decortication/ Thorcoplasty/Hydatid 45000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Lung cyst exision/Decortication/ Thorcoplasty/Hydatid All investigations reports-C | CT Chest-P | Clinical notes detailing history and Admission
including 093 cyst/Other simple lung procedure excluding lung resection cyst/Other simple lung procedure excluding lung resection notes showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation
Thoracotomy /Bronchial Repair Surgery for Injuries/ FB Removal /Bronchial Repair Surgery for Injuries/ FB Removal notes-C | Detailed discharge summary-C | Treatment details-C
CTVS CT CT0000937 Mediastinotomy CT0000937000 Mediastinotomy 26900 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Mediastinotomy All investigations reports-C | CT Chest establishing the aetiology for which surgery is
094 done-P | Clinical notes detailing history and Admission notes showing vitals and
examination findings-P | Detailed ICPs-C | Detailed Operation notes-C | Detailed
discharge summary-C | Treatment details-C
CTVS CT CT000098 aspiration/ CT0000980000 aspiration/ Intercostal drainage Only 4800 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular No No No Surgical No Insurance N N R N aspiration/ Intercostal drainage Only All investigations reports-C | Clinical notes , detailing history and Admission notes
Intercostal 66 PKG/add on showing vitals and examination findings-P | Detailed ICPs-C | Detailed Operation notes-
drainage Only C | Detailed discharge summary-C | Detailing need of ICD; Chest X-Ray PA-P | Post
procedure chest X ray-C | Treatment details-C
DENTAL & DO DO000010 Nerve root block DO000010020 Nerve root block 3000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical Yes Insurance Y N R N Nerve root block Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C |
ORAL 02 000151 / day care History with supporting documents-P | Intra op photo; Procedure / Operation notes-C
MAXILLOF
ACIAL
SURGERY
DENTAL & DO DO000010 Osteoradionecrosi DO000010660 Osteoradionecrosis of Jaws management by excision and 12000 Yes 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Osteoradionecrosis of Jaws management by excision and Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op photo-C | Planned
ORAL 66 s management by 000152 reconstruction under GA inlcuidng Implant reconstruction under GA inlcuidng Implant line of treatment-P | Post procedure X-Ray / OPG/ CBCT / CT-C | Procedure / Operation
MAXILLOF excision notes-C | Radiotherapy history notes-P | X-Ray / OPG/ CBCT / CT-P
ACIAL
SURGERY
DENTAL & DO DO000010 Osteoradionecrosi DO000010660 Osteoradionecrosis of jaws management by excision under 5000 Yes 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Osteoradionecrosis of jaws management by excision under Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op photo-C | Photo-P |
ORAL 66 s management by 000153 LA / day care LA Post procedure X-Ray / OPG/ CBCT / CT-C | Procedure / Operation notes-C |
MAXILLOF excision Radiotherapy history notes-P | X-Ray / OPG/ CBCT / CT-P
ACIAL
SURGERY
DENTAL & DO DO000010 Palatectomy DO000010730 Soft palate / Hard palate Under GA 0 Yes 1 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hard + Soft Palate-20000 | Soft palate / Hard palate Under GA )+/- CT/ MRI-P | Clinical notes-P | Detailed discharge summary-C | General Anesthesia
ORAL 73 000154 Soft Palate / Hard Palate-15000 Notes-C | Histopathology / Specimen photo-C | Intra & Post op photo-C | Photograph-
MAXILLOF P | detailed Procedure / Operative Notes-C
ACIAL
SURGERY
DENTAL & DO DO000011 Parotid DO000011040 Extraoral parotid sialolithotomy under GA 12000 Yes 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Extraoral parotid sialolithotomy under GA Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 04 sialolithotomy 000155 / day care C | Intra & Post op photo-C | Photograph-P | Post X-Ray / OPG/ CBCT / CT / USG / MRI-
MAXILLOF C | X-Ray / OPG/ CBCT / CT / USG / MRI-P
ACIAL
SURGERY
DENTAL & DO DO000011 Parotid DO000011040 Intraoral parotid sialolithotomy 7000 Yes 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Intraoral parotid sialolithotomy Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 04 sialolithotomy 000156 / day care C | Intra & Post op photo-C | Photograph-P | Post X-Ray / OPG/ CBCT / CT / USG / MRI-
MAXILLOF C | X-Ray / OPG/ CBCT / CT / USG / MRI-P
ACIAL
SURGERY
DENTAL & DO DO000011 Peripheral DO000011520 Peripheral Neurectomy - Govt Reserve 20000 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Peripheral Neurectomy - Govt Reserve Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 52 Neurectomy 000157 Reserve C | General Anesthesia Notes-C | History & supporting documents-P | Intra & Post op
MAXILLOF photo-C | MRI if done-P | Photograph-P
ACIAL
SURGERY
DENTAL & DO DO000012 Radical Neck DO000012290 Radical / comprehensive Neck Dissection 22600 No 0 No 0 No No Tertiary 7 no Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical / comprehensive Neck Dissection Biopsy-P | CT / CECT / PET Scan / MRI Neck confirming the diagnosis-P | Clinical notes-P
ORAL 29 Dissection 000158 | Detailed Operative notes-C | Detailed discharge summary-C | Histopathology /
MAXILLOF Specimen photo-C | Intra & Post op photo-C | Photograph-P | Tumor board report-P
ACIAL
SURGERY
DENTAL & DO DO000012 Re-implantation of DO000012560 Re-implantation of Avulsed tooth with wiring (1-3 teeth) 2000 Yes 1 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical Yes Insurance Y N R N Re-implantation of Avulsed Re-implantation of Avulsed tooth with wiring (1-3 teeth) Clinical Photograph-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
ORAL 56 Avulsed tooth 000159 3-6 :6000 / day care tooth with wiring (4-6 teeth)- 3-6 :6000 Detailed discharge summary-C | Intra & Post op photo-C | Photo of avulsed tooth/teeth-
MAXILLOF with wiring 12000 | Re-implantation of P | Post procedure X-ray-C
ACIAL Avulsed tooth with wiring (7-9
SURGERY teeth):18000-18000
DENTAL & DO DO000012 Release of fibrous DO000012570 15000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 57 bands & grafting - 000160 Release of fibrous release bands & coronoidectomy with Release of fibrous release bands & coronoidectomy with C | Intra & Post op photo-C | Photo-P | Post procedure X-Ray / OPG/ CBCT / CT-C | X-
MAXILLOF in (OSMF) grafting - under GA grafting - under GA Ray / OPG/ CBCT / CT / USG / MRI-P
ACIAL treatment under
SURGERY GA
DENTAL & DO DO000012 Release of fibrous DO000012580 Release of fibrous bands & grafting under GA/LA 4300 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Release of fibrous bands & grafting under GA/LA Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 58 bands & grafting - 000161 C | Intra & Post op photo-C | Photo-P | Post procedure X-Ray / OPG/ CBCT / CT-C | X-
MAXILLOF in (OSMF) Ray / OPG/ CBCT / CT / USG / MRI-P
ACIAL treatment under
SURGERY GA/LA
DENTAL & DO DO000012 Removal of DO000012600 Removal of Submandibular SalivaryGland / Salivary Ranula- 15000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance N N N Removal of Submandibular SalivaryGland / Salivary Ranula- Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 60 Submandibular 000162 with or without Lymph Node with or without Lymph Node C | General Anesthesia Notes-C | HPE / Specimen photo-C | Intra & Post op photo-C |
MAXILLOF SalivaryGland / Photo-P | X-Ray / OPG/ CBCT / CT / USG / MRI-P
ACIAL Salivary Ranula-
SURGERY with or without
Lymph Node
DENTAL & DO DO000012 Repair of tongue DO000012670 Repair of tongue laceration 14000 No 0 No 0 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N R N Repair of tongue laceration Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 67 laceration 000163 / day care C | History-P | Intra & Post op photo-C | Photo-P
MAXILLOF
ACIAL
SURGERY
DENTAL & DO DO000012 Root canal DO000012970 Root canal treatment per tooth - govt reserve 0 Yes 5 No 0 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical Yes Insurance Y N N per - tooth-800 Root canal treatment per tooth - govt reserve Clinical notes with Photo showing evidence of per procedure / Visit-C | Clinical notes-P |
ORAL 97 treatment per - 000164 Reserve / Detailed discharge summary-C | Intra & Post op photo-C | Photo-P | Post procedure X-
MAXILLOF tooth Day care Ray / OPG / CBCT-C | X-Ray / OPG / CBCT-P
ACIAL
SURGERY
DENTAL & DO DO000013 Biopsy under LA DO000013200 Biopsy under LA 5000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Biopsy under LA )+/- FNAC report-P | Admission notes showing vitals and examination findings-P |
ORAL 2 00129 / day care Clinical Photo of involved area-P | Clinical notes-P | Detailed ICPs-C | Detailed
MAXILLOF Operative notes-C | Detailed discharge summary-C | Doctor's Prescription-P |
ACIAL Histopathology report / Specimen Photo-C | Planned line of treatment-P | Post
SURGERY procedure clinical photograph-C
DENTAL & DO DO000013 Sequestrectomy / DO000013230 Sequestrectomy / Curettage 10000 Yes 0 Yes 1 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Antibiotic cement beads-5000 Sequestrectomy / Curettage Clinical notes with planned line of treatment including planned line of treatment-P |
ORAL 23 Curettage 000165 / day care Max :1 Detailed Discharge Summary-C | Intra & Post op photo-C | Post procedure X-Ray / OPG
MAXILLOF / CBCT / CT-C | Procedure / Operation notes-C | X-Ray / OPG / CBCT / CT-P
ACIAL
SURGERY
DENTAL & DO DO000013 Submandibular DO000013820 Submandibular duct stone removal LA/GA 0 Yes 1 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N GA - Submandibular duct stone Submandibular duct stone removal LA/GA Clinical notes & photograph-P | Detailed Procedure / Operative Notes-C | Detailed
ORAL 82 duct stone 000166 / day care removal-5000 | LA-2000 discharge summary-C | Intra & Post op photo-C | Post X-Ray / OPG/ CBCT / CT / USG /
MAXILLOF removal MRI-C | X-Ray / OPG/ CBCT / CT / USG / MRI-P
ACIAL
SURGERY
DENTAL & DO DO000013 Surgery for Cyst & DO000013950 Enucleation / excision of cyst / tumour of jaws under GA 5000 No 0 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Enucleation / excision of cyst / tumour of jaws under GA Clinical Notes & Photo-P | Detailed Procedure / Operative Notes-C | Detailed discharge
ORAL 95 tumour of Maxilla 000167 / day care summary-C | Histopathology / Specimen Photo-C | Intra & Post op photo-C | X-Ray/
MAXILLOF / Mandible OPG/ CBCT / CT Scan confirming the diagnosis-P | X-Ray/ OPG/ CBCT / CT-C
ACIAL
SURGERY
DENTAL & DO DO000013 Surgery for Cyst & DO000013950 Enucleation / excision of cyst / tumour of jaws under LA 2500 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Enucleation / excision of cyst / tumour of jaws under LA Clinical Notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 95 tumour of Maxilla 000168 / day care C | Histopathology / Specimen Photo-C | Intra & Post op photo-C | Photo-P | X-Ray/
MAXILLOF / Mandible OPG/ CBCT / CT Scan confirming the diagnosis-P | X-Ray/ OPG/ CBCT / CT-C
ACIAL
SURGERY
DENTAL & DO DO000014 Surgical DO000014140 Cyst / biopsy / FNAC/ I&D/ In growing toe nail - Day care 700 No 0 No 0 Yes No Secondary 1 No Yes Yes Day care Yes No No Surgical Yes Insurance Y N N Cyst / biopsy / FNAC/ I&D/ In growing toe nail - Day care Biopsy Report if applicable-C | Deailed Clinical notes-P | Detailed Operative notes-C |
ORAL 14 procedure under 000169 Detailed discharge summary-C | Intra & Post op photo-C | Photo-P
MAXILLOF LA
ACIAL
SURGERY
DENTAL & DO DO000014 Bone grafting for DO000014400 Bone grafting for Fracture Non union Under GA 10000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone grafting for Fracture Non union Under GA Clinical notes detailing earlier surgery that resulted in non-union and radiological
ORAL 4 Non union 00130 investigations confirming the diagnosis (X-ray / OPG / CBCT / CT)-P | Clinical photograph-
MAXILLOF P | Detailed ICPs-C | Detailed Procedure / Operative Notes-C | Detailed discharge
ACIAL summary-C | Post Procedure clinical photgraph of donor and recipient sites-C | Post
SURGERY procedure imaging study (X-ray / OPG / CBCT / CT)-C
DENTAL & DO DO000014 TM joint ankylosis DO000014490 TM joint ankylosis of both jaws - under GA (Unilateral) / 0 Yes 1 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral-21700 | Unilateral- TM joint ankylosis of both jaws - under GA (Unilateral) / Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 49 of both jaws - 000170 (Bilateral) 15000 (Bilateral) C | Intra & Post op photo-C | Photo-P | Post procedure X-Ray / OPG/ CBCT / CT-C | X-
MAXILLOF under GA Ray / OPG/ CBCT / CT-P
ACIAL
SURGERY
DENTAL & DO DO000014 Tracheostomy / DO000014610 Tracheostomy/Tracheotomy 9500 No 0 No 0 Yes No Secondary 2 Yes Yes Yes Regular Yes No No Surgical No Insurance N N R N Tracheostomy/Tracheotomy Clinical notes with planned line of treatment justifying indication-P | Detailed Operative
ORAL 61 Tracheotomy 000171 PKG/add on notes-C | Detailed discharge summary-C | Intra & Post op photo-C
MAXILLOF
ACIAL
SURGERY
DENTAL & DO DO000014 Treatment of early DO000014730 Treatment of early childhood caries under GA 10000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N Treatment of early childhood caries under GA Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ORAL 73 childhood caries 000172 / day care C | IOPA X-Ray / OPG-P | Intra & Post op photo-C | Photo-P | Post procedure IOPA / X-
MAXILLOF under GA Ray / OPG-C
ACIAL
SURGERY
DENTAL & DO DO000022 Cleft Lip and DO000022800 Cleft Lip and Palate Surgery (per stage) Under GA 15000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Cleft Lip and Palate Surgery (per stage) Under GA Photograph-P | Admission notes showing vitals and examination findings-P | Clinical
ORAL 8 Palate Surgery 00131 notes with planned line of treatment-P | Detailed ICPs-C | Detailed Procedure /
MAXILLOF (per stage) Operative Notes-C | Detailed discharge summary-C | Intra & Post procedure clinical
ACIAL photograph-C | X-ray / OPG / CBCT / CT-P
SURGERY
DENTAL & DO DO000023 Closed reduction / DO000023400 Closed reduction / intermaxillary fixation for fracture of 5000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N R N Closed reduction / intermaxillary fixation for fracture of Admission notes showing vitals and examination findings-P | Clinical Photograph-P |
ORAL 4 intermaxillary 00132 maxilla / mandible / zygoma/ Nasal / day care maxilla / mandible / zygoma/ Nasal Clinical notes with planned line of treatment-P | Detailed ICPs-C | Detailed discharge
MAXILLOF fixation for summary-C | Post Procedure Photograph of affected part-C | Procedure / Operative
ACIAL fracture of maxilla Notes-C | X-ray / OPG / CBCT / CT-C | X-ray / OPG / CBCT / CT-P
SURGERY / mandible /
zygoma/ Nasal
DENTAL & DO DO000024 Complete denture DO000024900 Complete denture - govt reserve 2500 No 0 No 0 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical Yes Insurance Y N N Complete denture - govt reserve Admission notes showing vitals and examination findings-P | Clinical Photograph-P |
ORAL 9 00133 Reserve / Clinical notes with Photo showing evidence of per procedure / Visit-C | Clinical notes
MAXILLOF Day care with planned line of treatment-P | Detailed ICPs;Detailed discharge summary-C |
ACIAL Detailed Operative notes-C | Post procedure clinical photograph-C
SURGERY
DENTAL & DO DO000025 Complete Excision DO000025400 Complete Excision of Growth from Tongue only (inclusive of 16500 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Complete Excision of Growth from Tongue only (inclusive of Admission notes showing vitals and examination findings-P | Clinical Photograph-P |
ORAL 4 of Growth from 00134 Histopathology) - Govt Reserve Reserve Histopathology) - Govt Reserve Clinical notes confirming the diagnosis and with planned line of treatment-P | Detailed
MAXILLOF Tongue only Operative notes-C | Detailed discharge summary-C | FNAC if done-P | General
ACIAL (inclusive of Anesthesia Notes-C | Histopath / Specimen Photo-C | Post procedure clinical
SURGERY Histopathology) - photograph-C
Govt Reserve
DENTAL & DO DO000027 Conservative DO000027100 Conservative Management - stand alone 0 Yes 3 No 0 Yes Yes Secondary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Routine Ward-1800 Conservative Management - stand alone Admission notes showing vitals and examination findings-P | All investigations reports-C
ORAL 1 Management 00135 reserve / | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
MAXILLOF Stand alone Detailed clinical notes-C | Detailed discharge summary-C | Planned line of management-
ACIAL P | Treatment details-C
SURGERY
DENTAL & DO DO000030 Correction of oro- DO000030800 Correction of oro-antral Fistula- Govt Reserve 7000 No 0 No 0 No Yes Secondary 3 No Yes Yes Govt No No No Surgical Yes Insurance Y N N Correction of oro-antral Fistula- Govt Reserve Admission notes showing vitals and examination findings-P | Any investigations done-P |
ORAL 8 antral Fistula- 00136 Reserve / Clinical Photograph-P | Clinical notes detailing history-P | Dental IOPA-Xray / OPG /
MAXILLOF Govt Reserve Day care Xray/CBCT/CT-P | Detailed ICPs-C | Detailed Procedure / Operative Notes-C | Detailed
ACIAL discharge summary-C | Intra & Post procedure clinical photograph-C | Planned line of
SURGERY management-P
DENTAL & DO DO000048 Dentoalveolar DO000048500 Dentoalveolar trauma - wiring (dental /trauma wiring- one 3000 Yes 0 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N R N Dentoalveolar trauma - wiring (dental /trauma wiring- one Admission notes showing vitals and examination findings-P | Any investigations done-P |
ORAL 5 trauma - wiring 00137 jaw) / day care jaw) Clinical Photograph-P | Clinical notes detailing history-P | Dental IOPA / Xray / OPG /
MAXILLOF CBCT / CT-P | Detailed ICPs-C | Detailed Procedure / Operative Notes-C | Detailed
ACIAL discharge summary-C | Planned line of management-P | Post procedure clinical
SURGERY photograph-C
DENTAL & DO DO000058 Estlander DO000058000 Estlander Operation (lip) Under GA only 14000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Estlander Operation (lip) Under GA only Admission notes showing vitals and examination findings-P | Any investigations done-P
ORAL 0 Operation (lip) 00138 | Clinical Photograph-P | Clinical notes detailing the original pathology thet has led to
MAXILLOF this surgery with suporting investigation reports-P | Detailed ICPs-C | Detailed
ACIAL Operative notes-C | Detailed discharge summary-C | General Anesthesia notes-C |
SURGERY Intra & Post procedure clinical photograph-C | Planned line of management-P
DENTAL & DO DO000060 Excision of DO000060200 Excision of Growth from Tongue with neck node dissection 31000 No 0 No 0 No No Tertiary 7 No Yes Yes Stand alone No No No Surgical No Insurance N N N Excision of Growth from Tongue with neck node dissection Admission notes showing vitals and examination findings-P | Any investigations done-P |
ORAL 2 Growth from 00139 Stand alone Stand alone Clinical Photograph-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed
MAXILLOF Tongue with neck Operative notes-C | Detailed discharge summary-C | General Anesthesia notes-C |
ACIAL node dissection Histopath / Specimen Photo-C | Intra & Post procedure clinical photograph-C | Planned
SURGERY line of management-P | Tumour Board report-P | USG/CT/MRI report confirming the
diagnosis-P
DENTAL & DO DO000060 Excision of Partial DO000060900 Excision of Partial mandible Under GA only 12000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Partial mandible Under GA only Admission notes showing vitals and examination findings-P | Any investigations done-P |
ORAL 9 mandible 00140 Clinical Photograph-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed
MAXILLOF Procedure / Operative Notes-C | Detailed discharge summary-C | General Anesthesia
ACIAL notes-C | HPE/ specimen photo-C | Intra & Post procedure clinical photograph-C |
SURGERY Planned line of management-P | X-ray / OPG / CBCT/CT-C | X-ray / OPG / CBCT/CT-P
DENTAL & DO DO000061 Excision of DO000061200 Excision of tumour of oral cavity / paranasal sinus/ 20000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of tumour of oral cavity / paranasal sinus/ Admission notes showing vitals and examination findings-P | Any investigations done-P
ORAL 2 tumour of oral 00141 Laryngopharynx with reconstruction Under GA only Laryngopharynx with reconstruction Under GA only | Biopsy / FNAC-P | Clinical Photograph X-ray / OPG / CBCT/CT showing extension of
MAXILLOF cavity / paranasal lesion to paranasal sinus / Laryngopharynx-P | Clinical notes detailing history-P |
ACIAL sinus / Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | General
SURGERY laryngopharynx Anesthesia notes-C | HPE/ specimen photo-C | Intra & Post procedure clinical
photograph-C | Planned line of management-P | Tumour Board report-P
DENTAL & DO DO000061 Excision of DO000061200 Excision of tumour of oral cavity / 36500 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of tumour of oral cavity / Photograph-P | Biopsy / FNAC-P | Clinical notes-P | Detailed Procedure / Operative
ORAL 2 tumour of oral 00142 paranasal sinus / laryngopharynx with free flap paranasal sinus / laryngopharynx with free flap Notes-C | Detailed discharge summary-C | Donor and reciepient site photo-C |
MAXILLOF cavity / paranasal reconstruction reconstruction General Anesthesia notes-C | HPE/ specimen photo-C | Intra & Post procedure clinical
ACIAL sinus / photograph-C | Tumour Board report; -P | X-ray / OPG / CBCT/CT showing extension of
SURGERY laryngopharynx lesion to paranasal sinus / Laryngopharynx-P
DENTAL & DO DO000061 Excision of DO000061400 Excision of tumour of oral cavity / paranasal sinus / 10000 No 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for Excision of tumour of Excision of tumour of oral cavity / paranasal sinus / Biopsy / FNAC-P | Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed
ORAL 4 tumour of oral 00143 laryngopharynx laryngopharynx-20000 Max :1 | laryngopharynx discharge summary-C | General Anesthesia notes-C | HPE/ specimen photo-C | Intra &
MAXILLOF cavity / paranasal without reconstruction Implant for Excision of tumour of without reconstruction Post procedure clinical photograph-C | Photograph-P | X-ray / OPG / CBCT/CT showing
ACIAL sinus / oral cavity-20000 Max :1 | extension of lesion to paranasal sinus / Laryngopharynx-P
SURGERY laryngopharynx Implant for Excision of tumour of
paranasal sinus-20000 Max :1
DENTAL & DO DO000062 Extended LOS DO000062800 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals and examination findings-P | All investigations reports-C
ORAL 8 care pkg for 00144 (allowed after pre auth, if justifies max 3 days in single go) Reserve / (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) | Any investigations done-P | Clinical notes detailing history-P | Detailed clinical notes-C
MAXILLOF advance sugeries Regular PKG Routine Ward-1800 | Detailed discharge summary-C | Documentation of all Consents by patient / attendent-
ACIAL P | Patient's Daily photo with attacehed instruments & supportive machine-P | Planned
SURGERY line of management-P | Treatment details-C
DENTAL & DO DO000064 Extraction in DO000064400 Extraction in mentally retarded / Patient with systemic 6000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Extraction in mentally retarded / Patient with systemic Clinical Notes-P | Detailed discharge summary-C | Intra & Post op Photo-C |
ORAL 4 mentally retarded 00145 diseases / patient with special need - under GA diseases / patient with special need - under GA Photograph of affected part-P | Procedure / Operative Notes-C | Supporting
MAXILLOF / Patient with investigations( X-ray / OPG / CBCT/CT)-P
ACIAL systemic diseases
SURGERY / patient with
special need -
under GA
DENTAL & DO DO000064 Extraction of DO000064500 Extraction of impacted tooth under LA 600 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N Extraction of impacted tooth under LA Clinical Photograph-P | Dental X-ray / OPG / CBCT / CT showing impacted tooth-P |
ORAL 5 impacted tooth 00146 / day care Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Extracted
MAXILLOF under LA tooth-C | Intra op Photo/Post procedure X-ray / clinical photo-C
ACIAL
SURGERY
DENTAL & DO DO000066 Fixation of DO000066400 Open reduction and fixing of plates / wire - under LA / GA. 12000 Yes 0 Yes 3 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N R N Plate -5000 Max :3 Open reduction and fixing of plates / wire - under LA / GA. Circumstances that led to fracture-P | Clinical Notes-P | Detailed Discharge Summary-C
ORAL 4 fracture of jaw 00147 Cost of implant Titanium:- TBF at pre-auth / day care Cost of implant Titanium:- TBF at pre-auth | Detailed Procedure / Operative Notes-C | Intra & Post op photo-C | Photo-P | Post X-
MAXILLOF ray / OPG / CBCT / CT-C | X-ray / OPG / CBCT / CT-P
ACIAL
SURGERY
DENTAL & DO DO000067 Ankyloglossia DO000067000 Ankyloglossia Major Under GA 15000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ankyloglossia Major Under GA Clinical notes with planned line of treatment; Admission notes showing vitals and
ORAL 0126 examination findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge
MAXILLOF summary-C | Doctor's Prescription-P | General Anaesthesia Notes-C | Intra & Post OP
ACIAL Photo-C | Pre-op photo-P
SURGERY
DENTAL & DO DO000067 Ankyloglossia DO000067000 Ankyloglossia Minor 3000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Ankyloglossia Minor Clinical notes with planned line of treatment; Admission notes showing vitals and
ORAL 0127 / day care examination findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge
MAXILLOF summary-C | Doctor's Prescription-P | Intra & Post OP Photo-C | Pre-op photo-P
ACIAL
SURGERY
DENTAL & DO DO000081 Implant Removal DO000081100 Nail/ Plate / TBW / cc-screw from NOF 15000 No 0 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Nail/ Plate / TBW / cc-screw from NOF Clinical Notes-P | Detailed Discharge Summary-C | Detailed Procedure / Operative
ORAL 1 under RA / GA 00148 / day care Notes-C | Intra & Post op photo-C | Photo-P | Post X-ray / OPG / CBCT / CT-C | X-ray /
MAXILLOF OPG / CBCT / CT-P
ACIAL
SURGERY
DENTAL & DO DO000082 Apicoectomy DO000082000 Apicoectomy 1 to 6 teeth 0 Yes 1 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N 1 to 3 teeth-3000 | 4 to 6 teeth- Apicoectomy 1 to 6 teeth Clinical notes & Doctor's Prescription; Clinical Photo of involved area-P | Dental IOPA-
ORAL Tooth 0128 / day care 5000 Xray / OPG / X-Ray / CBCT / CT-P | Detailed ICPs-C | Detailed Procedure / Operative
MAXILLOF Notes-C | Detailed discharge summary-C | Intra & Post OP clinical photograph-C | Post
ACIAL op X-ray / OPG / CBCT / CT-C
SURGERY
DENTAL & DO DO000092 Mandible Tumour DO000092500 Maxilla / Mandible neoplastic Tumour Resection and 13500 No 0 No 0 No No Secondary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Maxilla / Mandible neoplastic Tumour Resection and Biopsy / FNAC if tumour-P | Clinical Notes-P | Clinical Photograph-P | Detailed
ORAL 5 Resection and 00149 reconstruction (Cancer surgery) reconstruction (Cancer surgery) Procedure / Operative Notes-C | Detailed discharge summary-C | Histopathology /
MAXILLOF reconstruction / Specimen Photo-C | Intra & Post op photo-C | Photo-P | X-Ray/ OPG/ CBCT / CT Scan
ACIAL Cancer surgery confirming the diagnosis-P | X-Ray/ OPG/ CBCT / CT-C
SURGERY
DENTAL & DO DO000093 Maxillectomy DO000093000 Partial / Total Maxillectomy 0 Yes 1 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Maxillectomy -50000 | Partial / Total Maxillectomy Biopsy / FNAC if tumour-P | Clinical Notes-P | Clinical Photograph-P | Detailed
ORAL 0 00150 Partial Maxillectomy-25000 Procedure / Operative Notes-C | Detailed discharge summary-C | Histopathology /
MAXILLOF Specimen Photo-C | Intra & Post op photo-C | Photo-P | X-Ray/ OPG/ CBCT / CT Scan
ACIAL confirming the diagnosis-P | X-Ray/ OPG/ CBCT / CT-C
SURGERY
ENDOCRIN EN EN000014 Thyrotoxic crisis EN0000144500 Thyrotoxic crisis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Thyrotoxic crisis Throid profile-P | Admission notes showing vitals and examination findings-P | Any
OLOGY 45 00187 (without Ventilator)-4700 | investigations done-P | Clinical notes detailing history-P | Detailed Discharge Summary-
Routine Ward-1800 C | Detailed ICPs-C | Planned line of management-P | Post treatment Thyroid Profile-C
| Radionuclide Iodine uptake study-C | USG- Thyroid Gland-P
ENDOCRIN EN EN000043 Addison’s disease EN0000430000 Addison’s disease 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Addison’s disease Admission notes showing vitals and examination findings-P | All investigations reports-C
OLOGY 185 (without Ventilator)-4700 | | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Planned line of management-P | Post treatment
cortisol levels-C | Sr. Cortisol levels-P | Treatment details-C | USG- abdomen-P
ENDOCRIN EN EN000097 Myxedema coma EN0000972000 Myxedema coma 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myxedema coma Throid profile-P | Admission notes showing vitals and examination findings-P | All
OLOGY 2 0186 (without Ventilator)-4700 | investigations reports-C | Any investigations done-P | Clinical notes detailing history-P |
Routine Ward-1800 Detailed ICPs-C | Detailed discharge summary-C | Planned line of management-P |
Post treatment Thyroid Profile-C | Treatment details-C | USG- Thyroid Gland-P
EMERGEN ER ER0000126 Renal colic ER0000126300 Renal colic 2600 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Renal colic Admission notes showing vitals and examination findings-P | All investigations reports-C
CY ROOM 3 00184 | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
PACKAGES Detailed discharge summary-C | Planned line of management-P | Treatment details-C |
USG report /KUB-C
EMERGEN ER ER000015 Accelerated ER0000150000 Accelerated hypertension/Hypertensive emergencies 2600 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Accelerated hypertension/Hypertensive emergencies Admission notes showing vitals and examination findings-P | All investigations reports-C
CY ROOM hypertension 173 | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
PACKAGES Detailed discharge summary-C | Planned line of management-P | Treatment details-C
EMERGEN ER ER000017 Acute abdomen ER0000170000 Acute abdomen pain 2600 No 0 No 0 No No Secondary 3 Yes Yes Yes Regular PKG No No No Medical No Insurance N N R N Acute abdomen pain Admission notes showing vitals and examination findings-P | All investigations reports-C
CY ROOM Pain 174 | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
PACKAGES Detailed discharge summary-C | Planned line of management-P | Treatment details-C |
USG report-C
EMERGEN ER ER000018 Acute asthma ER0000180000 Acute asthma/Status asthmaticus 2600 No 0 No 0 No No Secondary 3 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Acute asthma/Status asthmaticus Admission notes showing vitals-P | All investigations reports-C | Chest X ray-P | Clinical
CY ROOM 175 notes detailing history-P | Detailed ICPs-C | Detailed discharge summary-C | Treatment
PACKAGES details-C | planned line management-P
EMERGEN ER ER0000185 Cardiopulmonary ER0000185000 Emergency with stable/ unstable cardiopulmonary status 2600 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N R N Emergency with stable/ unstable cardiopulmonary status Admission notes showing vitals-P | All investigations reports-C | Clinical notes with
CY ROOM emergency 0177 with resuscitation with resuscitation planned line of treatment-P | Detailed ICPs-C | Detailed discharge summary-C | ECG-P
PACKAGES | Treatment details-C
EMERGEN ER ER0000490 Diabetic ER0000490000 Diabetic ketoacidosis 2600 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Diabetic ketoacidosis ABG-C | Admission notes showing vitals and examination findings-P | All investigations
CY ROOM ketoacidosis 0178 reports-C | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-
PACKAGES C | Detailed discharge summary-C | Planned line of management -P | Treatment
details-C | Urine ketones test-C
EMERGEN ER ER0000531 Electrolyte ER0000531000 Hypercalcemia/ /Hypocalcaemia/ Hyponatremia/ 2600 No 0 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Hypercalcemia/ /Hypocalcaemia/ Hyponatremia/ All investigations reports-C | Clinical notes with planned line of treatment-P | Detailed
CY ROOM Imbalance 0179 Hypernatremia/ Hyperkalaemia/ Hypokalaemia Hypernatremia/ Hyperkalaemia/ Hypokalaemia Discharge Summary-C | Detailed ICPs-C | Post treatment Serum Calcium-C | Serum
PACKAGES electrolyte-P | Serum Calcium-P | Treatment details-C
EMERGEN ER ER0000538 Emergency ER0000538000 Emergency management of Hematuria 0 Yes 1 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N R N Routine Ward-1800 Emergency management of Hematuria Admission notes showing vitals and examination findings-P | Any investigations done-P |
CY ROOM management of 0180 Clinical notes detailing the hematuria with urine report showing frank or microscopic-P |
PACKAGES Hematuria Detailed ICPs-C | Detailed discharge summary-C | Evidence of investigations done
treatment given-C | Planned line of management -P | Treatment details-C
EMERGEN ER ER000064 Anaphylaxis ER0000640000 Anaphylaxis 2600 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Anaphylaxis Admission notes showing vitals-P | All investigations reports-C | CBC-P | Clinical notes
CY ROOM 176 with planned line of treatment-P | Detailed ICPs-C | Detailed discharge summary-C |
PACKAGES Treatment details-C | Tryptase if done-C
EMERGEN ER ER0000779 Hyperosmolar ER0000779000 Hyperosmolar Non-Ketotic coma 2600 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Hyperosmolar Non-Ketotic coma Admission notes showing vitals and examination findings-P | All investigations reports-C
CY ROOM Non-Ketotic coma 0181 | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
PACKAGES Detailed discharge summary-C | Planned line of management-P | Treatment details-C
EMERGEN ER ER0000780 Hypoglycemia ER0000780000 Hypoglycemia 2600 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Hypoglycemia Admission notes showing vitals and examination findings-P | Any investigations done-P |
CY ROOM 0182 Clinical notes detailing history-P | Detailed Discharge Summary-C | Hba1C-C | Planned
PACKAGES line of management Blood sugar level-P | Post treatment Blood sugar levels-C
EMERGEN ER ER0000858 Laceration - ER0000858000 Laceration - Suturing / Dressing 0 Yes 1 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N R N Routine Ward-1800 Laceration - Suturing / Dressing Clinical notes / discharge summary with planned line of treatment-C | Clinical notes with
CY ROOM Suturing / 0183 planned line of treatment-P | Post clinical photograph-C | Pre-clinical photograph-P
PACKAGES Dressing
ENT ET ET0000103 Open laryngeal ET0000103000 Open laryngeal framework surgery / Thyroplasty 18000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Open laryngeal framework surgery / Thyroplasty Clinical Photograph-P | Clinical notes detailing history and Admission notes showing vitals
0 framework 00221 and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
surgery / discharge summary-C | Evidence through CT/ MRI/ Biopsy-P | Laryngoscopic photo to
Thyroplasty establish indication and justification of surgery-P | Post procedure clinical photograph of
affected part-C
ENT ET ET0000103 Open reduction ET0000103200 Open reduction and internal fixation of maxilla/Open 14000 Yes 0 Yes 3 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for Open reduction and Open reduction and internal fixation of maxilla/Open Any investigations done-P | Clinical notes detailing history and Admission notes showing
2 and internal 00222 reduction and internal fixation of mandible/Open reduction internal fixation of mandible - reduction and internal fixation of mandible/Open reduction vitals and examination findings-P | MLC/FIR / Non MLC consent along with treating
fixation of maxilla and internal fixation of zygoma 4000 Max :3 | Implant for Open and internal fixation of zygoma doctor & patient signature for traumatic injuries and circumstances of the incident which
/ mandible / reduction and internal fixation of led to fracture-P | Post Procedure Photograph of affected part-C | Procedure /
zygoma maxilla -4000 Max :3 | Implant Operative Notes-C | X Ray/CT-P
for Open reduction and internal
fixation of zygoma (Plates /
Screws)-4000 Max :3
ENT ET ET0000103 Open sinus ET0000103700 Open Sinus Surgery (Single/Multiple Sinuses) 15000 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Open Sinus Surgery (Single/Multiple Sinuses) Any investigations done-P | Clinical notes detailing history and Admission notes showing
7 surgery 00223 vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailing
chronicity of sinusitis-P | Histopathology-C | Indications for surgery with supporting
CTpre-procedure photograph-P | Intra procedure clinical photograph-C | Post
procedure Imaging-C | Post procedure clinical photograph of affected part-C
ENT ET ET0000106 Oroantral fistula ET0000106500 Oroantral fistula Repair - Govt. reserve 8000 No 0 No 0 No Yes Secondary 1 Yes Yes Yes Govt No No No Surgical No Insurance N N N Oroantral fistula Repair - Govt. reserve Any investigations done-P | Clinical Photograph-P | Clinical notes detailing history and
5 Repair 00224 Reserve Admission notes showing vitals and examination findings-P | Detailed Procedure /
Operative Notes-C | Detailed discharge summary-C | Evidence through CT/ MRI/ Biopsy-
P | Histopathology report in case of tumours-C | Post procedure clinical photograph of
affected part-C | To establish indication and justification of surgery-P
ENT ET ET0000107 Palatectomy ET0000107400 Soft palate / Hard palate 20000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Soft palate / Hard palate Biopsy and clinical photograph +/- CT/ MRI-P | Clinical notes detailing history and
4 00225 Admission notes showing vitals and examination findings-P | Clinical photgraph showing
scar-C | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | HPE-
C | any investigations done-P
ENT ET ET0000110 Parotidectomy ET0000110500 Superficial Parotidectomy 23000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Superficial Parotidectomy Any investigations done-P | CT Scan / MRI / USG parotid area-P | Clinical Photograph of
5 00226 affected part-P | Clinical notes detailing history and Admission notes showing vitals and
examination findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | FNAC-P | Histopathology report / Specimen photo-C | Post procedure
clinical photograph of affected part-C
ENT ET ET0000110 Parotidectomy ET0000110500 Total Parotidectomy 28000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Parotidectomy Any investigations done-P | CT Scan / MRI / USG parotid area-P | Clinical Photograph of
5 00227 affected part-P | Clinical notes detailing history and Admission notes showing vitals and
examination findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | FNAC-P | Histopathology report / Specimen photo-C | Post procedure
ENT ET ET0000115 Peritonsillar ET0000115600 Peritonsillar abscess drainage/Intraoral calculus removal 5800 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Peritonsillar abscess drainage/Intraoral calculus removal Any investigations done-P | C/S of pus-C | Clinical notes detailing history and Admission
6 abscess drainage / 00228 notes showing vitals and examination findings-P | Clinical photograph if possible-P |
intraoral calculus Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Doctor's
removal notes with presenting complaints-P | Duration and physicial examination findings of oral
cavity and tonsils-P | Post procedure clinical photograph of affected part-C
ENT ET ET0000116 Pinna surgery ET0000116300 Pinna surgery for benign tumor/ trauma 8600 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pinna surgery for benign tumor/ trauma Any investigations done-P | Clinical notes detailing history and Admission notes showing
3 00229 vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Histopathology report / Specimen photo (Only for tumour)-C |
History-P | Post procedure clinical photograph of affected part-C | Pre-op Clinical
photograph and Biopsy report only for tumour-P
ENT ET ET0000120 Pre auricular sinus ET0000120100 Pre auricular sinus 7000 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pre auricular sinus Any investigations done-P | Clinical photo & notes detailing history and Admission notes
1 00230 showing vitals and examination findings-P | Detailed Procedure / Operative Notes-C |
Detailed discharge summary-C | Histopathology report / Specimen photo-C | Intra &
Post procedure clinical photograph of affected part-C
ENT ET ET0000121 Benign Head and ET0000121000 Benign Head and Neck Lesion Excision/ Sclerotheraphy- LA 0 Yes 1 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N GA - Benign Head and Neck Benign Head and Neck Lesion Excision/ Sclerotheraphy- LA Admission notes showing vitals and examination findings-P | Any investigations done-P |
Neck Lesion 0194 or GA Lesion Excision/ Sclerotheraphy- or GA CT / USG to confirm need of surgery-P | Clinical notes & Photo detailing history-P |
Excision LA/GA 8000 | LA - Benign Head and Detailed Discharge Summery-C | Detailing aetiology-P | Histopathology report /
Neck Lesion Excision/ Specimen Photo-C | Intra & Post Procedure Photograph of affected part-C | Procedure
Sclerotheraphy-5000 / Operative Notes-C
ENT ET ET0000123 Radical Neck ET0000123000 Radical / comprehensive Neck Dissection 22600 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical / comprehensive Neck Dissection Any investigations done-P | Clinical Photograph-P | Clinical notes detailing history and
0 Dissection 00231 Admission notes showing vitals and examination findings-P | Detailed Procedure /
Operative Notes-C | Detailed discharge summary-C | FNAC / Biospy in case of tumours-
P | Histopathology report / Specimen photo-C | Indication for surgery with supporting
investigation reports (X-ray/ CT/MRI)-P | Post procedure Imaging-C | Post procedure
ENT ET ET0000126 Removal of ET0000126100 Removal of Submandibular SalivaryGland / Salivary Ranula- 15000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Removal of Submandibular SalivaryGland / Salivary Ranula- Any investigations done-P | Clinical notes detailing history and Admission notes showing
1 Submandibular 00232 with or without Lymph Node with or without Lymph Node vitals and examination findings-P | Detailed discharge summary-C | Discharge summary-
SalivaryGland / C | FNAC-P | Histopathology report / Specimen photo-C | OT notes-C | Relavant
Salivary Ranula- invetsigation reports-C | USG/color doppler if done -P
with or without
Lymph Node
ENT ET ET0000127 Resection of ET0000127200 Resection of nasopharyngeal tumour 56000 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Resection of nasopharyngeal tumour Any investigations done-P | Biopsy of primary-P | CECT/MRI-P | Clinical Photograph
2 nasopharyngeal 00233 showing scar-C | Clinical notes detailing history and Admission notes showing vitals and
tumour examination findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | HPE report / Specimen photo-C
ENT ET ET0000129 Rigid laryngoscopy ET0000129400 Rigid laryngoscopy / bronchoscopy / 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N with biopsy-7000 | without Rigid laryngoscopy / bronchoscopy / Any investigations done-P | Clinical notes detailing history and Admission notes showing
4 / bronchoscopy / 00234 oesophagoscopy - Diagnostic + / - biopsy / day care biopsy -2000 oesophagoscopy - Diagnostic + / - biopsy vitals and examination findings-P | Detailed discharge summary-C | HPE report /
oesophagoscopy - Specimen photo(if biopsy done)-C | Laryngoscopic photo-P | Planned line of treatment-
Diagnostic + / - P | Post Procedure Photograph of affected part-C | Procedure / Operative Notes-C
biopsy
ENT ET ET0000132 Septoplasty ET0000132100 Septoplasty - Govt. reserve 12000 No 0 No 0 No Yes Secondary 3 Yes Yes Yes Govt No No No Surgical No Insurance N N N Septoplasty - Govt. reserve Clinical notes detailing history and Admission notes showing vitals and examination
1 00235 Reserve findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Endoscopic picture/ Clinical picture-P | Post procedure clinical photograph of affected
part-C | X-ray / CT Scan Indication for this surgery with supporting medical records-P
ENT ET ET0000137 Stapedectomy / ET0000137500 Stapedectomy / tympanotomy/stapedotomy - Govt. 17000 No 0 No 0 Yes Yes Secondary 2 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Stapedectomy / tympanotomy/stapedotomy - Govt. reserve Any investigations done-P | Audiometry confirming conductive deafness-P | Clinical
5 tympanotomy 00236 reserve Reserve notes detailing history and Admission notes showing vitals and examination findings-P |
Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Intra
procedure microscope clinical photograph-C
ENT ET ET0000138 Submandibular ET0000138300 Submandibular duct stone removal LA/GA 0 Yes 1 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N GA - Submandibular duct stone Submandibular duct stone removal LA/GA Any investigations done-P | Clinical notes detailing history and Admission notes showing
3 duct stone 00237 removal-5000 | LA-2000 vitals and examination findings-P | Detailed discharge summary-C | Post Procedure
removal Photograph of affected part-C | Procedure / Operative Notes-C | Specimen photo-C |
USG / X-ray-P
ENT ET ET0000144 Thyroglossal / ET0000144100 Thyroglossal cyst excision/Thyroglossal sinus 15300 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Thyroglossal cyst excision/Thyroglossal sinus Any investigations done-P | CT Scan / USG-P | Clinical notes detailing history and
1 Branchial cyst / 00238 excision/Thyroglossal fistula excision/Branchial sinus excision/Thyroglossal fistula excision/Branchial sinus Admission notes showing vitals and examination findings-P | Detailed Procedure /
sinus / fistula excision/ Branchial cyst excision/Branchial fistula excision excision/ Branchial cyst excision/Branchial fistula excision Operative Notes-C | Detailed discharge summary-C | FNAC-P | Histopathology report-
excision C | Post procedure clinical photograph of affected part-C | Pre-operative clincial
photograph-P
ENT ET ET0000144 Thyroidectomy ET0000144200 Hemi thyroidectomy 20000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hemi thyroidectomy Any investigations done-P | Clinical notes detailing history and Admission notes showing
2 00239 vitals and examination findings-P | Detailed Operative notes-C | Detailed discharge
summary-C | FNAC-P | Histopath report / Specimen Photo-C | Post procedure clinical
photograph-C | Thyroid Function Test-P | USG / CT Scan confirming the diagnosis and
justifying the surgery-P
ENT ET ET0000144 Thyroidectomy ET0000144200 Total thyroidectomy 20000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total thyroidectomy Any investigations done-P | Clinical notes detailing history and Admission notes showing
2 00240 vitals and examination findings-P | Detailed Operative notes-C | Detailed discharge
summary-C | FNAC-P | Histopath report / Specimen Photo-C | Post procedure clinical
photograph-C | Thyroid Function Test-P | USG / CT Scan confirming the diagnosis and
justifying the surgery-P
ENT ET ET0000144 Thyroidectomy ET0000144200 Total Thyroidectomy with central neck Dissection 26000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Thyroidectomy with central neck Dissection Any investigations done-P | Clinical notes detailing history and Admission notes showing
2 00241 vitals and examination findings-P | Confirming the diagnosis and need for surgery-P |
Detailed Operative notes-C | Detailed discharge summary-C | FNAC/ Biopsy-P |
Histopath report / Specimen Photo-C | Post procedure clinical photograph-C | Thyroid
Function Test-P | USG / CT Scan / MRI-P
ENT ET ET0000145 Tongue Tie ET0000145100 Tongue Tie 2000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tongue Tie Any investigations done-P | Clinical notes detailing history and Admission notes showing
1 00242 vitals and examination findings-P | Clinical photograph and planned line of treatment-P |
Clinical photograph-C | Detailed Discharge Summary-C
ENT ET ET0000145 Tonsillectomy ET0000145200 Tonsillectomy - U/L tonsillectomy 10400 No 0 No 0 Yes Yes Secondary 2 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Tonsillectomy - U/L tonsillectomy Any investigations done-P | Clinical notes detailing history and Admission notes showing
2 00243 (unilateral/bilateral)/Tonsillectomy - B/L Reserve (unilateral/bilateral)/Tonsillectomy - B/L adenotonsillectomy vitals and examination findings-P | Detailed Discharge Summary-C | Detailed Procedure
adenotonsillectomy - Govt. reserve - Govt. reserve / Operative Notes-C | Histopathology report / Specimen Photo-C | Indication for
surgery from treating doctor with supporting case history-P | Physical examination
findings-P | Post procedure clinical photograph of affected part-C | Supporting
investigation reports-P
ENT ET ET0000146 Tracheostomy / ET0000146200 Tracheostomy/Tracheotomy 9500 No 0 No 0 Yes No Secondary 2 Yes Yes Yes Regular Yes No No Surgical No Insurance N N R N Tracheostomy/Tracheotomy Any investigations done-P | Clinical notes detailing history and Admission notes showing
2 Tracheotomy 00244 PKG/add on vitals and examination findings-P | Detailed Discharge Summary-C | Planned line of
treatment justifying indication-P | Post Procedure Photograph of affected part-C |
Procedure / Operative Notes-C
ENT ET ET0000146 Tracheostomy ET0000146500 Tracheostomy Closer 2000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular Yes No No Surgical No Insurance N N N Tracheostomy Closer Any investigations done-P | Clinical notes detailing history and Admission notes showing
5 Closer 00245 PKG/add on vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Post procedure clinical photograph of affected part-C | Pre-
operative clincial photograph-P
ENT ET ET0000149 Tympanoplasty ET0000149000 Tympanoplasty (can be stratified (GA/LA) and price adjusted 12000 No 0 No 0 No Yes Secondary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Tympanoplasty (can be stratified (GA/LA) and price adjusted Any investigations done-P | Audiogram / Tympanometry (or impedence audiometry) as
0 00246 accordingly ) - Govt. reserve Reserve accordingly ) - Govt. reserve justification of surgery-P | Clinical notes detailing history and Admission notes showing
vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Intra procedure clinical photograph-C | Post procedure clinical
photograph of affected part-C
ENT ET ET0000151 Uvulopalatophary ET0000151800 Uvulopalatopharyngoplasty (UPPP) 15000 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Uvulopalatopharyngoplasty (UPPP) Any investigations done-P | Clinical notes detailing history and Admission notes showing
8 ngoplasty (UPPP) 00247 vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Polysomnography (Sleep Study) + CT/MRI-P | Post procedure
ENT ET ET0000180 Canalopasty For ET0000180000 Canalopasty For EAC Atresia - Govt. reserve 8000 No 0 No 0 Yes Yes Tertiary 2 No Yes Yes Govt Yes No No Surgical No Insurance N N N Canalopasty For EAC Atresia - Govt. reserve Admission notes showing vitals and examination findings-P | Biopsy-P | CT Scan-P |
EAC Atresia 0195 Reserve Clinical notes detailing history-P | Clinical notes with planned line of treatment-P |
Detailed Discharge Summery-C | Histopathology report-C | Intra & Post Procedure
Photograph of affected part-C | Pre operative Clinical Photograph of affected part-P |
Procedure / Operative Notes-C | any investigations done-P
ENT ET ET0000230 Clinic based ET0000230000 Biopsy/Intratympanic injections/Wide bore aspiration/ 1200 No 0 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Biopsy/Intratympanic injections/Wide bore aspiration/ Clinical notes detailing history-P | Admission notes showing vitals and examination
therapeutic 0196 Turbinate reduction Turbinate reduction findings-P | Any investigations done-P | Detailed Discharge Summery-C |
interventions of EXAMINATION FINDINGS-P | Histopathology report-C | Intra & Post Procedure
ENT Photograph of affected part-C | Nasoendoscopy findings-P | Procedure / Operative
Notes-C
ENT ET ET0000232 Closed reduction / ET0000232000 Closed reduction for fracture of 5000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Closed reduction for fracture of Admission notes showing vitals and examination findings-P | Any investigations done-P |
intermaxillary 0197 maxilla/mandible/zygoma/Closed reduction and maxilla/mandible/zygoma/Closed reduction and Circumstances of the incident which led to fracture-P | Clinical notes detailing history-P
fixation for Intermaxillary fixation Intermaxillary fixation | Histopathology report-C | Intra & Post Procedure Photograph of affected part-C |
fracture of maxilla MLC/FIR for traumatic injuries-P | Procedure / Operative Notes-C | X Ray/CT-P
/ mandible /
zygoma
ENT ET ET0000272 Conservative ET0000272000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Stand alone Yes No No Surgical No Insurance N N N Routine Ward-1800 Conservative Management - stand alone Admission notes showing vitals and examination findings-P | All investigations reports-C
Management 0198 | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
ENT ET ET0000281 Conservative ET0000281000 Conservative Management - 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Routine Ward-1800 Conservative Management - Admission notes showing vitals and examination findings-P | Any investigations done-P |
Management of 0199 (Chest/Head/Face/Abdomen)stand alone (Chest/Head/Face/Abdomen)stand alone Clinical notes detailing history-P | Detailed discharge summary-C | In case of burn-
injury Extent of upto 40% burns visible on photograph (with rule of 9 chart)-P | Lab tests-C |
MLC copy with number if done-P | Post Treatment clinical photograph-C | X-rays or
other diagnostic procedures done as a part of treatment-C
ENT ET ET000046 Adenoidectomy ET0000460000 Adenoidectomy - Govt. reserve 7800 No 0 No 0 No Yes Secondary 2 Yes Yes Yes Govt No No No Surgical No Insurance N N N Adenoidectomy - Govt. reserve Admission notes showing vitals and examination findings-P | Any investigations done-P |
188 Reserve Clinical Photograph-P | Clinical notes detailing history-P | Detailed Procedure /
Operative Notes-C | Detailed discharge summary-C | Histopathology report / Specimen
Photo-C | Planned line of management-P | Post procedure clinical photograph of
affected part-C | Supporting investigation reports-P | X Ray Adenoids-P
ENT ET ET0000479 Deep neck ET0000479000 Deep neck abscess drainage/Post trauma neck exploration 16000 No 0 No 0 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Deep neck abscess drainage/Post trauma neck exploration Admission notes showing vitals and examination findings-P | Any investigations done-P
abscess drainage/ 0200 | C/S of pus-C | CT / MRI-P | Clinical notes detailing history-P | Detailed Procedure /
Post trauma neck Operative Notes-C | Detailed discharge summary-C | Post procedure clinical
exploration photograph of affected part-C | Supporting diagnosis-P
ENT ET ET000053 Advanced anterior ET0000530000 Endoscopic Hypophysectomy/ Clival tumour excision 39000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fibrin Glue -9000 Max :1 Endoscopic Hypophysectomy/ Clival tumour excision Clinical notes detailing history and Admission notes showing vitals and examination
skull base surgery 189 findings-P | Any investigations done and Coronal CT/MRI establishing diagnosis and
establishing need of surgery-P | Histopathology report / Specimen Photo-C | Intra &
Post Procedure Photograph of affected part-C | Procedure / Operative Notes-C
ENT ET ET000055 Advanced lateral ET0000550000 Fisch approach/ Translabyrinthine approach/ Transcochlear 40000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fibrin Glue-9000 Max :1 Fisch approach/ Translabyrinthine approach/ Transcochlear Admission notes showing vitals and examination findings-P | Any investigations done and
skull base surgery 190 approach/ Temporal Bone resection approach/ Temporal Bone resection Audiogram report justfying surgery-P | Clinical notes detailing history-P |
Histopathology report / Specimen Photo-C | Intra & Post Procedure Photograph of
affected part-C | MRI / CT- TEMPORAL BONE of affected side-P | Procedure / Operative
Notes-C
ENT ET ET0000555 Endoscopic DCR ET0000555000 Endoscopic DCR 15000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Endoscopic DCR Admission notes showing vitals and examination findings-P | Any investigations done and
0201 endoscopy findings-P | Clinical notes detailing history-P | Clinical photograph of
Lacrimal sac syringing-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Endoscopic still images / Report-C | Intra & Post Procedure Photograph of
affected part-C
ENT ET ET0000575 Epistaxis ET0000575000 Epistaxis treatment - packing 2100 Yes 0 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Epistaxis treatment - packing Admission notes showing vitals and examination findings-P | Any investigations done
treatment - 0202 with planned line of treatment-P | Clinical notes detailing history-P | Clinical
packing photograph-C | Detailed Discharge Summary-C
ENT ET ET0000586 EUA separate add ET0000586000 EUA only in GA separate - add on package 3000 No 0 No 0 No No Secondary 1 No Yes Yes Add On No No No Surgical No Insurance N N R N EUA only in GA separate - add on package Admission notes showing vitals and examination findings-P | Any investigations done-P |
on package 0203 Clinical Notes for the associated surgery / disease along with Pre OP-C | Clinical notes
detailing history-P | Justifying the need for GA in the associated surgery-P | Operative
and Anesthesia-C | Post OP notes-C
ENT ET ET0000610 Excision of Pinna ET0000610000 Growth - Squamous/ Basal/ Injury 20000 No 0 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Growth - Squamous/ Basal/ Injury Admission notes showing vitals and examination findings-P | Any investigations done;
for Growths / 0204 HPE report (if tumour); CT Scan Report; cinical notes with planned line of treatment; -P |
Injuries - Total CT Scan Report-P | Cinical notes with planned line of treatment -P | Clinical notes
Amputation & detailing history-P | Detailed Discharge Summary-C | HPE report (if tumour)-P | HPE
Excision of report after surgery / specimen photo-C | Post Procedure Photographs of surgical site-C
External Auditory | Procedure / Operative Notes-C
Meatus
ENT ET ET0000613 Excision of ET0000613000 Excision of tumour of oral cavity / 36500 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of tumour of oral cavity / Any investigations done-P | CT Scan-P | Clinical Photograph of affected part-P | Clinical
tumour of oral 0205 paranasal sinus / laryngopharynx with free flap paranasal sinus / laryngopharynx with free flap notes detailing history and Admission notes showing vitals and examination findings-P |
cavity / paranasal reconstruction reconstruction HPE report / FNAB report-P | Histopathology report / Specimen Photo-C | Intra & Post
sinus / Procedure Photograph of affected part-C | Procedure / Operative Notes-C
laryngopharynx
ENT ET ET0000615 Excision of ET0000615000 Excision of tumour of oral cavity / paranasal sinus / 10000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for Excision of tumour of Excision of tumour of oral cavity / paranasal sinus / Any investigations done-P | CT Scan-P | Clinical notes detailing history and Admission
tumour of oral 0206 laryngopharynx oral cavity -20000 Max :1 | laryngopharynx notes showing vitals and examination findings-P | Clinical notes with planned line of
cavity / paranasal without reconstruction Implant for Excision of tumour of without reconstruction treatment-P | HPE report / FNAB report-P | Histopathology report / Specimen Photo-C
sinus / oral laryngopharynx -20000 Max | Intra & Post Procedure Photograph of affected part-C | Pre operative Clinical
laryngopharynx :1 | Implant for Excision of Photograph of affected part-P | Procedure / Operative Notes-C
tumour of oral paranasal sinus -
20000 Max :1
ENT ET ET0000615 Excision of ET0000615000 Excision of tumour of oral cavity / paranasal sinus/ 20000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of tumour of oral cavity / paranasal sinus/ CT Scan-P | Clinical Photograph of affected part-P | Clinical notes detailing history and
tumour of oral 0207 laryngopharynx with reconstruction laryngopharynx with reconstruction Admission notes showing vitals and examination findings-P | HPE report / FNAB report-P
cavity / paranasal | Histopathology report / Specimen Photo-C | Intra & Post Procedure Photograph of
sinus / affected part-C | Procedure / Operative Notes-C | any investigations done-P
laryngopharynx
ENT ET ET0000629 Extended LOS ET0000629000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days All investigations reports-C | Clinical notes detailing history and Admission notes showing
care pkg for 0208 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
advance sugeries Routine Ward-1800 Planned line of management-P | Treatment details-C | any investigations done-P
ENT ET ET0000660 Fibreoptic ET0000660000 Fibreoptic bronchoscopy (FOB) 2500 No 0 No 0 No No Secondary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Fibreoptic bronchoscopy (FOB) Any investigations done-P | Clinical notes detailing history and Admission notes showing
bronchoscopy 0209 vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailing
(FOB) chronicity of sinusitis-P | HPE report / FNAB report-P | Histopathology-C | Indications
for surgery with supporting CT-P | Intra & Post procedure clinical photograph of affected
part-C | Intra procedure clinical photograph-C | Post procedure Imaging-C | Pre-
procedure photograph-P
ENT ET ET0000678 Foreign Body ET0000678000 Foreign Body Removal ( Esophageal) 5200 No 0 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Foreign Body Removal ( Esophageal) Any investigations done-P | CT Scan / X-ray Clinical Photograph of affected part-P |
Removal ( 0211 Clinical notes detailing history and Admission notes showing vitals and examination
Esophageal) findings-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Post procedure clinical photograph of Foreign Body-C
ENT ET ET0000681 Foreign Body ET0000681000 Foreign Body Removal (Airway) 8600 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Foreign Body Removal (Airway) Any investigations done-P | Clinical notes detailing history and Admission notes showing
Removal (Airway) 0210 vitals and examination findings-P | Detailed Operative notes-C | Detailed discharge
summary-C | Post procedure clinical photograph of Foreign Body-C | Relevant imaging
study for comparison-C | Still Photograph of the imaging-P | X-ray/ CT report of the
affected part confirming the diagnosis-P
ENT ET ET0000687 Fracture - setting ET0000687000 Fracture - setting nasal bone - Regular PKG / Day care 8000 No 0 No 0 No No Secondary 2 Yes Yes Yes Regular PKG No No No Surgical Yes Insurance Y N R N Fracture - setting nasal bone - Regular PKG / Day care Any investigations done-P | Clinical notes detailing history and Admission notes showing
nasal bone 0212 / day care vitals and examination findings-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | MLC/FIR / Non MLC consent along with treating doctor & patient
signature for traumatic injuries and circumstances of the incident which led to fracture-P
| Post procedure X-ray-C | Post procedure clinical photograph of affected part-C | X
Ray/CT-P
ENT ET ET0000694 Functional ET0000694000 Functional Endoscopic Sinus (FESS)stratified as U/L or B/L 13900 No 0 No 0 No Yes Secondary 2 Yes Yes Yes Govt No No No Surgical No Insurance N N N Functional Endoscopic Sinus (FESS)stratified as U/L or B/L Any investigations done-P | CT confirming the diagnosis-P | Clinical notes detailing
Endoscopic Sinus 0213 and cost adjusted - Govt. reserve Reserve and cost adjusted - Govt. reserve history and Admission notes showing vitals and examination findings-P | Detailed
(FESS) Procedure / Operative Notes-C | Detailed discharge summary-C | Post procedure
clinical photograph-C | Stills of procedure being done-C
ENT ET ET0000695 Functional septo ET0000695000 Septo rhinoplasty - Govt. reserve 21800 No 0 No 0 No Yes Tertiary 2 Yes Yes Yes Govt No No No Surgical No Insurance N N N Septo rhinoplasty - Govt. reserve Any investigations done-P | Clinical notes detailing history and Admission notes showing
rhinoplasty 0214 Reserve vitals and examination findings-P | Clinical picture-P | Detailed Procedure / Operative
Notes-C | Detailed discharge summary-C | MLC/FIR / Non MLC consent along with
treating doctor & patient signature for traumatic injuries and circumstances of the
incident which led to disfigurement-P | Post procedure clinical photograph of affected
part-C | Supporting medical records-P | X-ray-P
ENT ET ET000070 Ant. Ethmoidal / ET0000700000 Ant. Ethmoidal artery ligation - Open/Ant. Ethmoidal artery 12000 No 0 No 0 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ant. Ethmoidal artery ligation - Open/Ant. Ethmoidal artery
sphenopalatine 191 ligation - Endoscopic/ Sphenopalatine artery ligation - ligation - Endoscopic/ Sphenopalatine artery ligation - Indications of this surgery with clinical evidence (CT Angiography)-P | Admission notes
artery ligation Open/Sphenopalatine artery ligation - Endoscopic Open/Sphenopalatine artery ligation - Endoscopic showing vitals and examination findings-P | Any investigations done-P | Clinical notes
detailing history-P | Detailed Procedure / Operative Notes-C | Discharge summary-C |
Intraoperative photograph-C | Post procedure clinical photograph of affected part-C | X-
ray of clips used-C
ENT ET ET000074 Anterior skull base ET0000740000 CSF Rhinorrhea Repair - open / Endoscopic 26000 Yes 0 Yes 2 Yes No Tertiary 6 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Fibrin Glue-9000 Max :2 CSF Rhinorrhea Repair - open / Endoscopic Admission notes showing vitals and examination findings-P | Any investigations done
surgery 192 detailing aetiology-P | CT to confirm need of surgery-P | Clinical notes detailing history-
P | Detailed Discharge Summery-C | Intra & Post Procedure Photograph of affected part-
C | Procedure / Operative Notes-C
ENT ET ET000074 Anterior skull base ET0000740000 Optic nerve decompression/Orbital 25500 Yes 0 Yes 2 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mini plate-3000 Max :2 Optic nerve decompression/Orbital Admission notes showing vitals and examination findings-P | Any investigations done-P |
surgery 193 decompression/Craniofacial resection/Maxillary swing decompression/Craniofacial resection/Maxillary swing CT to confirm need of surgery-P | Clinical notes detailing history-P | Detailed Discharge
Summery-C | Detailing aetiology-P | Intra & Post Procedure Photograph of affected part-
ENT ET ET0000868 Laryngocele ET0000868000 Laryngocele 15000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Laryngocele Any investigations done with planned line of treatment-P | Clinical notes detailing history
0215 and Admission notes showing vitals and examination findings-P | Histopathology report /
Specimen photo-C | Post Procedure Photograph of affected part-C | Procedure /
Operative Notes-C
ENT ET ET0000871 Lateral skull base ET0000871000 Subtotal petrosectomy/Post-traumatic facial nerve 24000 Yes 0 Yes 1 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fibrin Glue-9000 Max :1 Subtotal petrosectomy/Post-traumatic facial nerve Any investigations done-P | CT/MRI/ biopsy to establish the indication and justify the
procedures 0216 decompression/CSF Otorrhoea repair decompression/CSF Otorrhoea repair surgery-P | Clinical notes detailing history and Admission notes showing vitals and
examination findings-P | Histopathology report / Specimen photo-C | Post Procedure
Photograph of affected part-C | Procedure / Operative Notes-C
ENT ET ET0000929 Mastoidectomy ET0000929000 Simple/modified Radical Mastoidectomy - Govt. reserve 24000 No 0 No 0 Yes Yes Tertiary 2 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Simple/modified Radical Mastoidectomy - Govt. reserve Any investigations done-P | Audiometry-P | Clinical notes detailing history and
0217 Reserve Admission notes showing vitals and examination findings-P | Confirming the indication
for the procedure with imaging (X-ray/ CT) Evidence-P | Detailed Procedure / Operative
Notes-C | Detailed discharge summary-C | Histopath-C | Post procedure clinical
photograph-C | Scar photo-C
ENT ET ET0000958 Microlaryngoscopi ET0000958000 Microlaryngoscopic Surgery 15000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Microlaryngoscopic Surgery Any investigations done-P | Clinical notes detailing history and Admission notes showing
c Surgery 0218 vitals and examination findings-P | Detailed Operative notes-C | Detailed discharge
summary-C | Intra and Post procedure clinical photograph-C | Pre operative photo of
lesion confirming the diagnosis for which this surgery is done-P
ENT ET ET0000971 Myringotomy with ET0000971000 Unilateral/Bilateral 6000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Unilateral/Bilateral Any investigations done-P | Audiogram justifying surgery-P | Clinical notes detailing
or without 0219 history and Admission notes showing vitals and examination findings-P | Detailed
Grommet Procedure / Operative Notes-C | Detailed discharge summary-C | Photograph of patient
while undergoing the procedure-C
ENT ET ET0000975 Neck dissection ET0000975000 Selective Benign neck tumour 18000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Selective Benign neck tumour Any investigations done-P | Clinical Photograph-P | Clinical notes detailing history and
0220 excision/Comprehensive Benign neck tumour excision/Comprehensive Benign neck tumour Admission notes showing vitals and examination findings-P | Detailed Procedure /
excision/Selective Pharyngeal diverticulum excision/Selective Pharyngeal diverticulum Operative Notes-C | Detailed discharge summary-C | FNAC / Biospy in case of tumours-
excision/Comprehensive Pharyngeal excision/Comprehensive Pharyngeal P | Histopathology report / Specimen photo-C | Indication for surgery with supporting
diverticulum excision diverticulum excision investigation reports (X-ray/ CT/MRI)-P | Post procedure Clinical photograph of affected
part-C | Post procedure Imaging-C
GASTROEN GL GL0000102 Oesophageal GL0000102200 Oesophageal Varices Banding 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Oesophageal Varices Banding All investigations reports;Endoscopic Variceal band ligation still photo and Report-C |
TEROLOGY 2 Varices Banding 00265 (without Ventilator)-4700 | Any investigations done-P | Clinical notes detailing history and Admission notes showing
Routine Ward-1800 vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
GASTROEN GL GL0000110 Pancreatitis GL0000110000 Acute necrotizing severe pancreatitis / Pancreatitis 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute necrotizing severe pancreatitis / Pancreatitis All investigations reports-C | Clinical notes with planned line of treatment (incl birth &
TEROLOGY 0 00266 (without Ventilator)-4700 | past history)-P | Detailed Discharge Summary-C | Detailed ICPs (daily Treatment details)-
Routine Ward-1800 C | Investigation Reports supporting diagnosis (including ABG)-P | Planned line of
treatment-P | Serum amylase / lipase-P | USG / CT abdomen-C
GASTROEN GL GL0000118 PORTAL GL0000118700 NON-SHUNTS 45000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N NON-SHUNTS Any investigations done-P | Clinical Photograph showing scar-C | Clinical notes detailing
TEROLOGY 7 HYPERTENSION 00267 history and Admission notes showing vitals and examination findings-P | Endoscopy/
USG/ CT/ MRI -P | Planned line of management -P
GASTROEN GL GL0000133 Sigmoidoscopy GL0000133700 Sigmoidoscopy - ADD ON 1500 No 0 No 0 No No Tertiary 0 Yes Yes Yes Add On No No No Medical No Insurance N N N Sigmoidoscopy - ADD ON All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY 7 00268 and Admission notes showing vitals and examination findings-P | Detailed Discharge
Summary-C | Detailed ICPs (daily Treatment details)-C | Planned line of management-P
GASTROEN GL GL0000141 Surgical GL0000141000 Surgical management of Lower GI bleed (inclusive of 18000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Medical No Insurance N N N Surgical management of Lower GI bleed (inclusive of All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY 0 management of 00269 sigmoidoscopy / colonoscopy) - Colonoscopic management sigmoidoscopy / colonoscopy) - Colonoscopic management and Admission notes showing vitals and examination findings-P | Colonoscopy report-C
Lower GI bleed only excluding local perineal conditions only excluding local perineal conditions | Detailed ICPs-C | Detailed discharge summary-C | Planned line of management-P |
(inclusive of Treatment details-C
sigmoidoscopy /
colonoscopy) -
Colonoscopic
management only
excluding local
perineal
GASTROEN GL GL0000149 conditions
Upper GI GL0000149400 Upper GI Endoscopy - ADD ON 900 No 0 No 0 No No Tertiary 0 Yes Yes Yes Add On No No No Medical No Insurance N N N Upper GI Endoscopy - ADD ON All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY 4 Endoscopy 00270 and Admission notes showing vitals and examination findings-P | Detailed Discharge
Summary-C | Detailed ICPs (daily Treatment details)-C | Planned line of management-P
| UGI Stills and report-C
GASTROEN GL GL0000181 Capsule GL0000181000 Capsule Endoscopy - ADD ON 5500 No 0 No 0 No No Tertiary 1 Yes Yes Yes Add On No No No Medical No Insurance N N N Capsule Endoscopy - ADD ON All Investigations reports-C | Any investigations done-P | Capsule Endoscopy Report-C
TEROLOGY Endoscopy 0250 | Clinical notes detailing history and Admission notes showing vitals and examination
findings-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
management-P | Treatment details-C
GASTROEN GL GL0000221 Cholangitis GL0000221000 Cholangitis 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cholangitis All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY 0251 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Planned line of management-P | Treatment details-C |
USG Report-P
GASTROEN GL GL000023 Acute GL0000230000 Acute gastroenteritis with moderate dehydration/Acute 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute gastroenteritis with moderate dehydration/Acute All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY gastroenteritis 248 gastroenteritis with severe dehydration/ Recurrent gastroenteritis with severe dehydration/ Recurrent vomiting and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
with dehydration vomiting with dehydration/Chronic diarrohea/Persistent with dehydration/Chronic diarrohea/Persistent Detailed discharge summary-C | Planned line of management-P | Treatment details-C
diarrohea/Dysentery diarrohea/Dysentery
GASTROEN GL GL0000244 Colonoscopy GL0000244000 Colonoscopy- ADD ON 3000 No 0 No 0 No No Tertiary 0 Yes Yes Yes Add On No No No Medical No Insurance N N N Colonoscopy- ADD ON All investigations reports-C | Any other investigations reports in support of diagnosis-P |
TEROLOGY 0252 Clinical notes detailing history and Admission notes showing vitals and examination
findings-P | Colonoscopy report-C | Detailed ICPs-C | Detailed discharge summary-C |
GASTROEN GL GL000034 Acute severe GL0000340000 Acute severe ulcerative colitis 0 Yes 3 No 0 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute severe ulcerative colitis Clinical notes Confirming diagnosis-P | Detailed Operative notes-C | Detailed discharge
TEROLOGY ulcerative colitis 249 summary-C | Histopathology report-C | Post procedure clinical photograph-C |
Sigmoidoscopy / Colonoscopy-C
GASTROEN GL GL0000556 Endoscopic Glue GL0000556000 Endoscopic Glue injection - ADD ON 2800 No 0 No 0 No No Tertiary 0 Yes Yes Yes Add On No No No Medical No Insurance N N N Endoscopic Glue injection - ADD ON All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY injection 0253 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Detailed discharge summary-C | Endoscopic report showing varices and Usg Abdomen-P
| Glue injection Bar code / invoice-C | Planned line of management-P | Treatment
details-C
GASTROEN GL GL0000557 Endoscopic GL0000557000 Endoscopic hemoclip application - ADD ON 2500 No 0 No 0 No No Tertiary 0 Yes Yes Yes Add On No No No Medical No Insurance N N N Endoscopic hemoclip application - ADD ON All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY hemoclip 0254 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
application Detailed discharge summary-C | Endoscopic report showing varices-P | Hemoclip Bar
code / invoice-C | Planned line of management-P | Treatment details-C
GASTROEN GL GL0000558 Endoscopic GL0000558000 Endoscopic Sclerotherapy - ADD ON 2800 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Endoscopic Sclerotherapy - ADD ON All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY Sclerotherapy 0255 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Detailed discharge summary-C | Endoscopic report showing varices and Usg Abdomen-P
| Planned line of management-P | Treatment details-C | Used bar code / invoice-C
GASTROEN GL GL0000560 Endoscopic GL0000560000 Endoscopic Variceal band ligation (EVL) including band - 2800 No 0 No 0 No No Tertiary 5 Yes Yes Yes Add On No No No Medical No Insurance N N N Endoscopic Variceal band ligation (EVL) including band - ADD All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY Variceal band 0256 ADD ON ON and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
ligation (EVL) Detailed discharge summary-C | Endoscopic report showing varices and Usg Abdomen-P
including band | Planned line of management-P | Treatment details-C | Variceal Band bar code /
invoice-C
GASTROEN GL GL0000576 ERCP GL0000576000 ERCP 15000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N ERCP Any others investigations reports in support of diagnosis-P | Clinical notes detailing
TEROLOGY 0257 history and Admission notes showing vitals and examination findings-P | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | ERCP report-C | Intra
op-C | Planned line of management-P | Progress notes-C | Stills with date & patient ID-
C | USG report / MRCP report-P
GASTROEN GL GL0000576 ERCP GL0000576000 ERCP + Stenting/Stone removal 20000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Medical No Insurance N N N ERCP + Stenting/Stone removal Admission Notes comprising of history and examination with indications for the
TEROLOGY 0258 procedure-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C
| ERCP photograph and report-C | Intraop-C | Progress notes-C | Relavant
Investigations (establishing diagnosis)-P | Stills with date & patient ID-C | USG report /
MRCP report-P
GASTROEN GL GL0000706 GI bleeding GL0000706000 Lower GI bleeding / Upper GI bleeding 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Lower GI bleeding / Upper GI bleeding All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY 0259 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | ENDOSCOPY / Colonoscopy if done-C | Planned line of
GASTROEN GL GL0000743 Hepatitis GL0000743000 Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis All investigations reports-C | Any investigations reports in support of diagnosis-P |
TEROLOGY 0260 /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver (without Ventilator)-4700 | /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver Clinical notes detailing history and Admission notes showing vitals and examination
abscess Routine Ward-1800 abscess findings-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
GASTROEN GL GL0000755 High end GL0000755000 High end histopathology (Biopsies) and advanced serology 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology All investigations reports-C | Clinical notes detailing history and Admission notes showing
TEROLOGY histopathology 0261 investigations - Add on investigations - Add on vitals and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
(Biopsies) and Planned line of management-P | Pny investigations done-P | Treatment details-C
advanced
serology
investigations
GASTROEN GL GL0000762 High end GL0000762000 High end radiological diagnostic 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic All investigations reports-C | Any investigations done-P | Clinical notes detailing history
TEROLOGY radiological 0262 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
diagnostic Detailed discharge summary-C | Planned line of management-P | Treatment details-C
(CT, MRI, Imaging
including nuclear
imaging)
GASTROEN GL GL0000824 Intestinal GL0000824000 Intestinal obstruction- medical managment 6000 No 0 No 0 No No Secondary 7 No Yes Yes Regular PKG No No No Medical No Insurance N N N Intestinal obstruction- medical managment All investigations reports-C | Any investigations reports in support of diagnosis-P |
TEROLOGY obstruction 0263 Clinical notes detailing history and Admission notes showing vitals and examination
findings-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
management-P | Treatment details-C | X ray abdomen / CT abdomen -P | X ray
abdomen-C
GASTROEN GL GL0000955 Mesenteric GL0000955000 Mesenteric Ischemia 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Mesenteric Ischemia All investigations reports-C | Any investigations reports in support of diagnosis-P | CT
TEROLOGY Ischemia 0264 (without Ventilator)-4700 | abdomen-C | Clinical notes detailing history and Admission notes showing vitals and
Routine Ward-1800 examination findings-P | Detailed ICPs-C | Detailed discharge summary-C | Planned
line of management;-P | Treatment details-C
INTERVEN IR IR0000100 aspiration/ IR0000100000 aspiration/ Intercostal drainage Only 4800 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Medical No Insurance N N R N aspiration/ Intercostal drainage Only Admission notes showing vitals and examination findings-P | Analysis report of drained
TIONAL Intercostal 0507 fluid-C | Chest X-Ray PA-P | Clinical notes detailing history-P | Clinical photograph-P |
RADIOLOG drainage Only Detailed Operative notes-C | Detailed discharge summary-C | Detailing need of ICD-P |
Y Intra & Post Procedure images-C | Post procedure clinical photograph-C
INTERVEN IR IR0000102 Oesophageal IR0000102100 Oesophageal /gastric / duodenal / colonic stenting/balloon 10000 Yes 0 Yes 2 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Balloon-9800 Max :2 | Metallic Oesophageal /gastric / duodenal / colonic stenting/balloon Admission notes showing vitals and examination findings-P | CT/MRI/ DSA confirming
TIONAL 1 /gastric / 00528 dilatation stent-37000 Max :2 dilatation the diagnosis-P | Clinical notes detailing history-P | Detailed Discharge summary-C |
RADIOLOG duodenal / colonic Detailed Procedure / Operative Notes with procedure deployed-C | Detailed discharge
Y stenting/balloon summary-C | Intra procedure still photograph showing Stent-C | Invoice / bar code of
dilatation implants used-C
INTERVEN IR IR0000113 Percutaneous IR0000113000 Percutaneous cholangioplasty/Gastrostomy/ vacuum 25000 No 0 No 0 No Yes Tertiary 3 No Yes Yes Govt No No No Medical No Insurance N N N Percutaneous cholangioplasty/Gastrostomy/ vacuum Admission notes showing vitals and examination findings-P | CT/MRI/ DSA confirming
TIONAL 0 cholangioplasty/G 00529 assisted biopsy/thrombin injection- Govt Reserve Reserve assisted biopsy/thrombin injection- Govt Reserve the diagnosis-P | Clinical notes detailing history-P | Detailed Discharge summary-C |
RADIOLOG astrostomy/ Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | HPE/
Y vacuum assisted Specimen Photo in vaccume Assisted Biopsy-C | Intra & Post procedure clinical
biopsy/thrombin photograph-C | Invoices / bar code of thrombolytic agentused-C
injection
INTERVEN IR IR0000114 Peripheral IR0000114000 Peripheral Angioplasty - Subclavian , Mesenteric , Femoral, 25000 Yes 0 Yes 1 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Peripheral Stent -37000 Max :1 Peripheral Angioplasty - Subclavian , Mesenteric , Femoral, Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 0 Angioplasty 00530 iliac - Popliteal ETC iliac - Popliteal ETC history-P | Detailed Discharge summary-C | Doppler / CT / MR Angio Reports-P |
RADIOLOG Implant / barcode of stent used-C | Intra & Post procedure clinical photograph-C | Post
Y op. Angiogram report/ stills-C | Showing stent-C
INTERVEN IR IR0000114 Peripheral IR0000114300 Peripheral Angioplasty - POBA 30000 No 0 Yes 2 No Yes Tertiary 5 No Yes Yes govt No No No Medical No Insurance N N N Bare Metal -37000 Max :2 Peripheral Angioplasty - POBA Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 3 Angioplasty - 00531 Reserve history-P | Detailed Discharge summary-C | Doppler / CT / MR Angio Reports-P |
RADIOLOG POBA Implant / barcode of stent used-C | Intra & Post procedure clinical photograph-C | Post
INTERVEN IR IR0000114 Peripheral IR0000114500 Peripheral Angioplasty - Renal 18000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Bare Metal -37000 Max :1 Peripheral Angioplasty - Renal Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 5 Angioplasty - 00532 history-P | Detailed Discharge summary-C | Doppler / CT / MR Angio Reports-P |
RADIOLOG Renal Implant / barcode of stent used-C | Intra & Post procedure clinical photograph-C | Post
INTERVEN IR IR0000115 Balloon Dilatation IR0000115000 Coarctation of Aorta/Pulmonary Artery Stenosis /aortic 70000 No 0 No 0 Yes Yes Tertiary 2 No Yes Yes Govt Yes No No Medical No Insurance N N N Coarctation of Aorta/Pulmonary Artery Stenosis /aortic Admission notes showing vitals and examination findings-P | Barcode of balloon used-C
TIONAL 0508 aneurysm repair - GOVT Reserved Reserve aneurysm repair - GOVT Reserved | CT angiogram report & stills-P | Clinical notes detailing history-P | Detailed Discharge
RADIOLOG Summary-C | ECHO-P | Intra & Post Procedure images / Angiogram-C | Procedure /
Y Operative Notes with images-C
INTERVEN IR IR0000115 PET scan IR0000115800 PET scan 14000 Yes 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N PET scan Admission notes showing vitals and examination findings-P | All investigations reports
TIONAL 8 00533 including PETs scan report-C | Any investigations done-P | Clinical notes detailing
RADIOLOG history-P | Detailed discharge summary-C | Intra & Post procedure clinical photograph-
Y C | Planned line of management-P | Treatment details-C
INTERVEN IR IR0000124 Radiofrequency/L IR0000124200 Radiofrequency/Laser ablation -Trigeminal nerve/Genicular 55000 No 0 No 0 No Yes Tertiary 3 No Yes Yes Govt No No No Medical No Insurance N N N Radiofrequency/Laser ablation -Trigeminal nerve/Genicular Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 2 aser ablation - 00534 nerve/Celiac plexus/stellate ganglion/Symphathetic nerve Reserve nerve/Celiac plexus/stellate ganglion/Symphathetic nerve history of varicose vein / visceral / bony tumour-P | Detailed Discharge summary-C |
RADIOLOG Trigeminal /Varicose vein- Govt Reserve /Varicose vein- Govt Reserve Doppler / CT / MR Reports-P | Intra & Post procedure clinical photograph-C | Invoice
Y nerve/Genicular and barcode of fiber / RFA probe-C | Procedure Notes-C
nerve/Celiac
plexus/stellate
ganglion/Symphat
hetic nerve
/Varicose vein
INTERVEN IR IR0000130 Rotational IR0000130300 Rotational Atherectomy (ROTA) Ablation - GOVT Reserve 52000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Medical No Insurance N N N Rotational Atherectomy (ROTA) Ablation - GOVT Reserve Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 3 Atherectomy 00535 Reserve history-P | Detailed Discharge summary-C | Doppler / CT / MR Reports-P | Intra & Post
RADIOLOG (ROTA) Ablation procedure clinical photograph-C | Invoice and barcode of ROTA device-C | Procedure
Y Notes-C
INTERVEN IR IR0000143 TEVAR / EVARfor IR0000143300 TEVAR / EVAR for aortic aneurysm/ dissection - Govt 40000 Yes 0 Yes 1 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Surgical No Insurance N N N Graft-250000 Max :1 TEVAR / EVAR for aortic aneurysm/ dissection - Govt Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 3 aortic aneurysm/ 00537 Reserve Reserve Reserve history-P | Detailed Discharge summary-C | Doppler / CT / MR Angio Reports-P | Intra
RADIOLOG dissection & Post procedure clinical photograph-C | Invoice and barcode of AORTIC Graft-C |
Y Procedure Notes-C | Still DSA images of stent graft-C
INTERVEN IR IR0000146 Transjugular IR0000146900 Transjugular intrahepatic portosystemic shunt creation 50000 Yes 0 Yes 1 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Medical No Insurance N N N Covered stent-150000 Max :1 | Transjugular intrahepatic portosystemic shunt creation Admission notes showing vitals and examination findings-P | CT/MRI/ DSA confirming
TIONAL 9 intrahepatic 00538 (TIPSS)/Direct transjugular Intrahepatic Portosystemic Reserve Dedicated TIPS stent-150000 Max (TIPSS)/Direct transjugular Intrahepatic Portosystemic the diagnosis-P | Clinical notes detailing history-P | Detailed Procedure / Operative
RADIOLOG portosystemic shunt(DIPSS) - Govt Reserve :1 | TIPS set-150000 Max :1 | shunt(DIPSS) - Govt Reserve Notes with procedure deployed-C | Detailed discharge summary-C | Intra & Post
Y shunt creation Uncovered stent-150000 Max :1 procedure clinical photograph-C | Invoice / bar code of implants used-C | Showing coil-
(TIPSS)/Direct C
transjugular
Intrahepatic
Portosystemic
shunt(DIPSS)
INTERVEN IR IR0000147 Transjugular IR0000147000 Transjugular Liver/renal biopsy - Govt Reserve 8000 Yes 0 Yes 1 Yes Yes Tertiary 2 No Yes Yes Govt Yes No No Medical No Insurance N N N Transjugular liver / Renal biopsy Transjugular Liver/renal biopsy - Govt Reserve Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL 0 Liver/renal biopsy 00539 Reserve set-30000 Max :1 history-P | Detailed Procedure / Operative Notes with procedure deployed-C | Detailed
RADIOLOG discharge summary-C | Intra & Post procedure clinical photograph-C | Invoice / bar
Y code of implants used-C | Showing coil-C
INTERVEN IR IR0000148 Bone marrow IR0000148000 Bone marrow aspiration / biopsy 1000 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Bone marrow aspiration / biopsy Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL aspiration and 0509 history-P | Detailed Discharge Summary-C | HPE report/ specimen photo-C | Intra &
RADIOLOG biopsy Post Procedure images-C | Procedure / Operative Notes with images-C
Y
INTERVEN IR IR0000148 Tunelled long IR0000148100 Tunelled long term in dwelling catheter for refractory 13000 Yes 0 Yes 1 Yes Yes Tertiary 5 No Yes Yes govt Yes No No Medical No Insurance N N N Pleurex kit-20000 Max :1 Tunelled long term in dwelling catheter for refractory ascites Admission notes showing vitals and examination findings
TIONAL 1 term in dwelling 00540 ascites / pleural effusion Reserve / pleural effusion -P | CT / MRI / USG confirming the diagnosis and need of procedure-P | Clinical notes
RADIOLOG catheter for detailing history-P | Detailed Procedure / Operative Notes-C | Detailed discharge
Y refractory ascites summary-C | Intra & Post procedure clinical photograph-C | Invoices / Barcode of
/ pleural effusion tunnelled catheter-C | Post procedure X-ray-C
INTERVEN IR IR0000148 Tunnelled long- IR0000148200 Tunnelled long-term venous catheter - Govt Reserve 11000 Yes 0 Yes 1 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Medical No Insurance N N N Permcath-14000 Max :1 Tunnelled long-term venous catheter - Govt Reserve Admission notes showing vitals and examination findings-P | CT/MRI/ DSA confirming
TIONAL 2 term venous 00541 Reserve the diagnosis-P | Clinical notes detailing history-P | Detailed Procedure / Operative
RADIOLOG catheter Notes-C | Detailed discharge summary-C | Intra & Post procedure clinical photograph-C
Y | Invoices / Barcode of tunnelled catheter-C
INTERVEN IR IR0000168 Bronchial artery IR0000168000 Bronchial artery Embolisation 30000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Bronchial artery Embolisation Admission notes showing vitals and examination findings-P | Check Angiography of same
TIONAL Embolisation 0510 (for Haemoptysis) (for Haemoptysis) bronchial artery after the procedure-C | Chest X-Ray / CT chest / CT Angiogram-P |
RADIOLOG (for Haemoptysis) Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
Y discharge summary-C | Intra & Post Procedure DSA images,-C | Other investigations-P
INTERVEN IR IR0000186 Carotico- IR0000186000 Carotico-cavernous Fistula (CCF) embolization with coils.( 80000 Yes 0 Yes 5 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Surgical No Insurance N N N General items-120000 Max :5 | Carotico-cavernous Fistula (CCF) embolization with coils.( Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL cavernous Fistula 0502 Upto 5 coils, guide catheter, micro-catheter, micro- Reserve Guide catheter-120000 Max :5 | Upto 5 coils, guide catheter, micro-catheter, micro- | Any investigations done-P | CT /Ct angio/ DSA/ MRI-Brain / Spine-C | Cerebral
RADIOLOG (CCF) embolization guidewire,general items] - Govt Reserve Micro-catheter-120000 Max :5 | guidewire,general items] - Govt Reserve angiography-P | Clincial examination notes-P | Clinical notes detailing history-P |
Y Micro-guidewire-120000 Max :5 Detailed ICPs-C | Detailed discharge summary-C | Intra & Post procedure photograph-C
| Upto 5 coils-120000 Max :5 | Invoice of embolising material-C | Planned line of management-P | Treatment details-
C
INTERVEN IR IR0000197 Central Line ( IR0000197000 Central Line ( Double Lumen / Triple Lumen ) with 0 Yes 1 No 0 Yes No Secondary 0 No Yes Yes Add On Yes No No Medical No Insurance N N N Double Lumen-2000 | Triple Central Line ( Double Lumen / Triple Lumen ) with Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL Double Lumen / 0511 procedure - add on Lumen-2500 procedure - add on history-P | Detail notes & X ray after procedure-C | Detailed Discharge summary-C |
RADIOLOG Triple Lumen ) Intra & Post Procedure images-C | Invoice / bar code-C | Review notes of primary
Y physician for requirent of procedure-P
INTERVEN IR IR0000214 Chemo Port IR0000214000 Chemo Port/PICC Insertion 11000 Yes 0 Yes 1 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Chemo Port - Paediatric-25000 Chemo Port/PICC Insertion
TIONAL Insertion 0512 Max :1 | PICC / Chemo Port - Review notes of primary physician for requirent of procedure-P | Admission notes
RADIOLOG Adult-15000 Max :1 showing vitals and examination findings-P | CT/MRI/ DSA confirming the diagnosis-P |
Y Clinical notes detailing history-P | Detail notes & X ray after procedure-C | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | Intra & Post
Procedure images-C | Invoice / bar code of Chemo Port or PICC-C
INTERVEN IR IR0000216 Chemoport/impla IR0000216000 Chemoport/implantable lines 11000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Chemo Port - Paediatric-25000 Chemoport/implantable lines Admission notes showing vitals and examination findings-P | CT/MRI/ DSA confirming
TIONAL ntable lines 0513 Max :1 | PICC/Chemo Port - the diagnosis-P | Chest X-ray after procedure-C | Clinical notes detailing history-P |
RADIOLOG Adult-15000 Max :1 Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Intra & Post
Y procedure clinical photograph-C
INTERVEN IR IR0000255 Complex IR IR0000255000 Angioplasty/Venoplasty : cutting balloon/drug coated 95000 No 0 No 0 No Yes Tertiary 7 No Yes Yes Govt No No No Medical No Insurance N N N Angioplasty/Venoplasty : cutting balloon/drug coated Admission notes showing vitals and examination findings-P | CT / MRI / Doppler-P |
TIONAL procedure- 0514 balloon/ high pressure balloons/BTK/re-entry device or Reserve balloon/ high pressure balloons/BTK/re-entry device or Clinical notes detailing history-P | Detailed Discharge Summary-C | Intra & Post
RADIOLOG Angioplasty/Veno Stent:venous or SFA stent/two bare metal stents/ covered Stent:venous or SFA stent/two bare metal stents/ covered procedure clinical photograph-C | Procedure / Operative notes with still images /
Y plasty/Stenting/ stent or Embolization: with microcatheter/Drug eluting stent or Embolization: with microcatheter/Drug eluting Angiogram report / USG / CT showing stent / Balloon / Ablation device / post Stent /
Embolisation/Abla beads-TACE/Plug assisted or tumor ablation or Mechanical beads-TACE/Plug assisted or tumor ablation or Mechanical Balloon flow + barcode of the stents / Balloon / Plug / Drug eluting beads / re-entry
tion/Thrombecto thrombectomy device or intraarterial retinoblastome thrombectomy device or intraarterial retinoblastome device/ Mechanical thrombectomy device / Ablation device / microcatheter and guide
my : traetment- Govt Reserve traetment- Govt Reserve wire used-C
INTERVEN IR IR0000495 Diagnostic IR0000495000 Diagnostic Angiography peripheral (DSA - Digital 10000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Medical No Insurance N N N Diagnostic Angiography peripheral (DSA - Digital Admission notes showing vitals and examination findings establishing diagnosis with MRI /
TIONAL Angiography 0515 Substraction Angiography) Substraction Angiography) CT / Doppler-P | Clinical notes detailing history-P | Detailed Procedure / Operative
RADIOLOG peripheral (DSA - Notes-C | Detailed discharge summary-C | Intra & Post procedure clinical photograph-C
Y Digital | Intra procedure clinical CD/ series of still photographs-C
Substraction
Angiography)
INTERVEN IR IR0000524 DVT/Acute IR0000524000 DVT/Acute thrombosis Systemic Thrombolysis and 25000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Systemic Thrombolysis and Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL Thrombosis 0517 anticoagulation ( Including thrombolytic agent expect r - anticoagulation ( Including thrombolytic agent expect r - TPA history-P | FOR Acute thrombosis Systemic : All investigations reports.-C | FOR Acute
RADIOLOG TPA ) ) thrombosis Systemic : Detailed ICPs-C | FOR Acute thrombosis Systemic : Detailed
Y discharge summary-C | FOR Acute thrombosis Systemic : ECHO if Available-C | FOR
Acute thrombosis Systemic : Invoice / barcode of thrombolytic agent used-C | FOR Acute
thrombosis Systemic : Post thrombolysis Doppler report-C | FOR Acute thrombosis
Systemic : Thrombolysis and anticoagulation-C | FOR Acute thrombosis Systemic :
Treatment details-C | For DVT : All investigations reports-C | For DVT : Detailed ICPs-C |
For DVT : Detailed discharge summary-C | For DVT : Invoice / barcode of thrombolytic
agent used-C | For DVT : Lab Investigation-C | For DVT : Post thrombolysis Doppler
report-C | For DVT : Treatment details-C | Intra & Post procedure clinical photograph-C
INTERVEN IR IR0000524 DVT/Acute IR0000524000 DVT/Acute thrombosis Catheter guided Thrombolysis and 30800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Catheter guided Thrombolysis and Admission notes showing vitals and examination findings
TIONAL Thrombosis 0516 anticoagulation ( Including r-TPA ) anticoagulation ( Including r-TPA ) establishing diagnosis with MRI / CT / Doppler-P | Clinical notes detailing history-P |
RADIOLOG FOR Acute thrombosis Systemic : All investigations reports-C | FOR Acute thrombosis
Y Systemic : Detailed discharge summary-C | FOR Acute thrombosis Systemic : Post
thrombolysis Doppler report-C | FOR Acute thrombosis Systemic : Thrombolysis and
anticoagulation Lab Investigation invoice / barcode of thrombolytic agent used-C | FOR
Acute thrombosis Systemic : Treatment details-C | For DVT : All investigations reports-C
| For DVT : Detailed ICPs-C | For DVT : Detailed discharge summary-C | For DVT :
Invoice / barcode of thrombolytic agent and catheter-C | For DVT : Lab Investigation-C |
For DVT : Post thrombolysis Doppler report-C | For DVT : Treatment details-C
INTERVEN IR IR0000524 DVT/Acute IR0000524000 DVT/Acute thrombosis Catheter guided Thrombolysis and 35000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Catheter guided Thrombolysis and Admission notes showing vitals and examination findings-P | Cardiac markers - CPK-MB-P
TIONAL Thrombosis 0536 anticoagulation ( Including r-TPA ) anticoagulation ( Including r-TPA ) | Clinical notes detailing history-P | ECG-C | ECHO-C | Intra & Post procedure clinical
RADIOLOG photograph-C | Invoice / barcode of thrombolytic agent used-C | Lab Investigation
Y (TROP - T report)-C | Post thrombolysis Doppler report-C | Procedure Notes-C | Serial
ECGs showing MI-P | TROP I or TROP T-P
INTERVEN IR IR0000534 Embolization IR0000534000 Arteriovenous Malformation (AVM) in the Limbs 40000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Surgical No Insurance N N N Arteriovenous Malformation (AVM) in the Limbs Admission notes showing vitals and examination findings-P | Admission notes showing
TIONAL 0518 Reserve vitals and examination findings-P | CECT / MRI / Doppler report-P | Clinical notes
RADIOLOG detailing history-P | Clinical notes detailing history-P | Detailed Procedure / Operative
Y Notes-C | Detailed discharge summary-C | Intra & Post procedure clinical photograph-C
| Invoice / bar code of used embolising agent-C | Procedural image with embolising
agent (except Alcohol) in place-C
INTERVEN IR IR0000535 Embolization/ IR0000535000 Embolization / Percutaneous Metallic Stent/ Balloon /Snare 60000 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Medical No Insurance N N N Embolization / Percutaneous Metallic Stent/ Balloon /Snare Admission notes showing vitals and examination findings-P | Admission notes showing
TIONAL Metallic 0519 /Balloon occlusion- govt reserved Reserve /Balloon occlusion- govt reserved vitals and examination findings-P | Angiogram report-C | CECT / MRI / Doppler report-P
RADIOLOG Stenting/Baloonin | Clinical notes detailing history-P | Clinical notes detailing history-P | Detailed
Y g/Snare/Ballon Discharge Summary-C | Intra & Post procedure clinical photograph-C | Procedure /
occulsion Operative notes with still images-C | Showing stent / Balloon & post Stent / Balloon flow
+ barcode of the stents / Balloon / Plug / Snare / re-entry device/ microcatheter and guide
wire used-C
INTERVEN IR IR0000547 Endobronchial IR0000547000 Endobronchial Ultrasound guided fine needle biopsy 10000 No 0 No 0 No No Tertiary 0 No Yes Yes Regular PKG No No No Medical No Insurance N N N Endobronchial Ultrasound guided fine needle biopsy Admission notes showing vitals and examination findings-P | All investigations reports
TIONAL Ultrasound (EBUS) 0520 including EBUS reports-C | Any investigations done-P | Clinical notes detailing history-P
RADIOLOG | Detailed ICPs-C | Detailed discharge summary-C | Intra & Post procedure clinical
Y photograph-C | Planned line of management-P | Treatment details-C
INTERVEN IR IR0000561 Endovascular IR0000561000 intracranial /Spinal aneurysm/AV Malformation or fistula - 70000 Yes 0 Yes 4 Yes Yes Tertiary 7 No Yes Yes Govt Yes No No Surgical No Insurance N N N Balloon / stent-150000 Max :4 | intracranial /Spinal aneurysm/AV Malformation or fistula - Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL therapy for 0503 Govt reserve Reserve Guide catheter-150000 Max :4 | Govt reserve | Any investigations done -P | CT /Ct angio/ DSA/ MRI-Brain / Spine-C | Cerebral
RADIOLOG intracranial/Spinal Micro-catheter-150000 Max :4 | angiography-P | Clincial examination notes-P | Clinical notes detailing history-P |
Y aneurysm/AV Micro-guidewire-150000 Max :4 Detailed ICPs-C | Detailed discharge summary-C | Intra & Post procedure photograph-C
Malformation or | Upto 4 coils-150000 Max :4 | Invoice of embolising material-C | Planned line of management-P | Treatment details-
fistula/angioplasty C
INTERVEN IR IR0000592 EVOH Package IR0000592000 Intracranial AVM - Govt Reserve 69500 Yes 0 Yes 2 Yes Yes Tertiary 7 No Yes Yes Govt Yes No No Surgical No Insurance N N N DMSO Compatible micro-catheter- Intracranial AVM - Govt Reserve Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL 0504 Reserve 150000 Max :2 | Guide catheter- | Any investigations done-P | CT /Ct angio/ DSA/ MRI-Brain / Spine-C | Cerebral
RADIOLOG 150000 Max :2 | Micro- angiography-P | Clincial examination notes -P | Clinical notes detailing history-P |
Y guidewire-150000 Max :2 | Upto Detailed ICPs-C | Detailed discharge summary-C | Intra & Post procedure photograph-C
2 EVOH-150000 Max :2 | Invoice of embolising material-C | Planned line of management-P | Treatment details-
C
INTERVEN IR IR0000641 Extra Coils IR0000641000 Extra Coils add on 0 Yes 0 Yes 2 Yes No Tertiary 0 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Detachable Coil-24000 Max :2 | Extra Coils add on Admission notes showing vitals and examination findings-P | Barcode & invoice of each
TIONAL 0521 Pushable Coil-9000 Max :2 coil used-C | Clinical notes detailing history-P | Detailed Discharge summary-C | Intra &
RADIOLOG Post procedure clinical photograph-C | Still images showing coil in place-C
Y
INTERVEN IR IR0000741 Hepatic venous IR0000741000 Hepatic venous wedge pressure measurement (HVPG) - 8000 No 0 No 0 No Yes Tertiary 3 No Yes Yes Govt No No No Medical No Insurance N N N Hepatic venous wedge pressure measurement (HVPG) - Admission notes showing vitals and examination findings-P | CT/MRI/ DSA confirming
TIONAL wedge pressure 0522 Govt Reserve Reserve Govt Reserve the diagnosis-P | Clinical notes detailing history-P | Detailed Procedure / Operative
RADIOLOG measurement Notes-C | Detailed discharge summary-C | Intra & Post procedure clinical photograph-C
Y (HVPG)
INTERVEN IR IR0000757 High end IR0000757000 High end histopathology (Biopsies) and advanced serology 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL histopathology 0523 investigations - Add on investigations - Add on | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
RADIOLOG (Biopsies) and Detailed discharge summary-C | Intra & Post procedure clinical photograph-C | Planned
Y advanced line of management-P | Treatment details-C
serology
investigations
INTERVEN IR IR0000764 High end IR0000764000 High end radiological diagnostic 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL radiological 0524 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
RADIOLOG diagnostic Detailed discharge summary-C | Intra & Post procedure clinical photograph-C | Planned
Y (CT, MRI, Imaging line of management-P | Treatment details-C
including nuclear
imaging)
INTERVEN IR IR0000805 Image Guided IR0000805000 Image Guided Percutaneous: drainage placement /biliary 12000 No 0 No 0 No No Secondary 3 NO Yes Yes Regular PKG No No No Medical No Insurance N N N Image Guided Percutaneous: drainage placement /biliary Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL Percutaneous 0525 drainage/ cholecystostomy/ sclerotherapy drainage/ cholecystostomy/ sclerotherapy | CT / MRI confirming the diagnosis-P | Clinical notes detailing history-P | Detailed ICPs-
RADIOLOG procedure C | Detailed discharge summary-C | Intra & Post procedure clinical photograph-C |
Y Treatment details-C
INTERVEN IR IR0000830 Intracranial IR0000830000 Intracranial balloon angioplasty with stenting - Govt Reserve 160000 No 0 No 0 No Yes Tertiary 7 No Yes Yes Govt No No No Surgical No Insurance N N N Intracranial balloon angioplasty with stenting - Govt Reserve Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL balloon 0505 Reserve | Any investigations done-P | CT /Ct angio/ DSA/ MRI-Brain / Spine-C | Cerebral
RADIOLOG angioplasty with angiography-P | Clincial examination notes -P | Clinical notes detailing history-P |
Y stenting Detailed ICPs-C | Detailed discharge summary-C | Intra & Post procedure photograph-C
| Invoice of balloon / Stent-C | Planned line of management-P | Treatment details-C
INTERVEN IR IR0000834 Intracranial IR0000834000 Intracranial thrombolysis/ clot retrieval - Govt Reserve 165200 No 0 No 0 No Yes Tertiary 7 Yes Yes Yes Govt No No No Surgical No Insurance N N N Intracranial thrombolysis/ clot retrieval - Govt Reserve Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL thrombolysis/ clot 0506 Reserve | Any investigations done-P | CT /Ct angio/ DSA/ MRI-Brain / Spine-C | Cerebral
RADIOLOG retrieval angiography-P | Clincial examination notes -P | Clinical notes detailing history-P |
Y Detailed ICPs-C | Detailed discharge summary-C | Intra & Post procedure photograph-C
| Invoice of Thrombectomy Device-C | Planned line of management-P | Treatment
details-C
INTERVEN IR IR0000837 Intravascular IR0000837000 Intravascular ultrasound (IVUS) - GOVT Reserve 20000 No 0 No 0 Yes Yes Tertiary 3 Yes Yes Yes Govt Yes No No Medical No Insurance N N N Intravascular ultrasound (IVUS) - GOVT Reserve Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL ultrasound (IVUS) 0526 Reserve | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
RADIOLOG Detailed discharge summary-C | Intra & Post procedure clinical photograph-C | Planned
Y line of management-P | Treatment details-C
INTERVEN IR IR000091 Arteriovenous IR0000910000 AVF/AVM of Brain/Spine - Govt Reserve 86900 No 0 No 0 No Yes Tertiary 7 No Yes Yes Govt No No No Surgical No Insurance N N N AVF/AVM of Brain/Spine - Govt Reserve Admission notes showing vitals and examination findings-P | All investigations reports-C
TIONAL fistula 501 Reserve | Any investigations reports in support of diagnosis-P | CT /Ct angio/ DSA/ MRI-Brain /
RADIOLOG (AVF)/Arterioveno Spine-C | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Y us Malformation summary-C | Intra & Post procedure photograph-C | Invoice of embolising material-C |
(AVM) Brain/Spine Planned line of management-P | Treatment details-C
INTERVEN IR IR0000995 Nephrostomy - IR0000995000 Nephrostomy - Percutaneous Image guided / Fluoroscopic 14000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Nephrostomy - Percutaneous Image guided / Fluoroscopic Admission notes showing vitals and examination findings-P | Clinical notes detailing
TIONAL Percutaneous 0527 Guided Guided history-P | Detailed Discharge summary-C | Detailed Procedure / Operative Notes-C |
RADIOLOG Image guided Detailed discharge summary-C | Intra & Post procedure clinical photograph-C | USG
Y confirming the indication and need of procedure-P
MENTAL MD MD000010 NeuroDevelopMe MD000010090 Autism Spectrum Disorder/Mixed DevelopMental 0 Yes 3 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Autism Spectrum Disorder/Mixed DevelopMental Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 09 ntal Disorderss 000777 Disorders/Tourette Syndrome / Chronic Tic Disorders/Tourette Syndrome / Chronic Tic Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S (NDD) Other than Disorde/Attention Deficit Hyperactivity Disorder Disorde/Attention Deficit Hyperactivity Disorder notes-C | Need for specific treatment and expected results-P
Intellectual (ADHD/Specific DevelopMental Disorderss (ADHD/Specific DevelopMental Disorderss
Disability
MENTAL MD MD000010 Neurotic, stress- MD000010150 Neurotic, stress-related and somatoform disorders 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Neurotic, stress-related and somatoform disorders Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 15 related and 000778 Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S somatoform notes-C | Need for hospitalization-P
disorders
MENTAL MD MD000010 Non- MD000010160 Psychological, Behavioural and Developmental and 3000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Psychological, Behavioural and Developmental and Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 16 Pharmacological 000779 Educational Interventions (Typically Includes Child Educational Interventions (Typically Includes Child Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S Interventions Counselling / Psychotherapy, Family Counselling / Counselling / Psychotherapy, Family Counselling / notes-C | Need for specific treatment and expected results-P
Psychotherapy / Training Such As Parent Management Psychotherapy / Training Such As Parent Management
Training, Behavioral / Cognitive-Behavioral Interventions, Training, Behavioral / Cognitive-Behavioral Interventions,
Developmental Interventions Such As Early Intervention, Developmental Interventions Such As Early Intervention,
Speech / Language Therapy, Occupational Therapy, Speech / Language Therapy, Occupational Therapy,
Physiotherapy, Remediation For Specific Learning Disability Physiotherapy, Remediation For Specific Learning Disability
and Other Rehabilitative / Psychosocial Interventions) and Other Rehabilitative / Psychosocial Interventions)
MENTAL MD MD000010 Package (Cognitive MD000010690 Package (Cognitive Tests, Complete Haemogram, Liver 6000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Package (Cognitive Tests, Complete Haemogram, Liver Admission under empanneled Psychiatrist is a must./ Relavant invetigation reports-P |
DISORDER 69 Tests, Complete 000780 Function Test, Renal Function Test, Serum Electrolytes, Function Test, Renal Function Test, Serum Electrolytes, All investigations done-C | Detailed discharge summary-C | Detailed history with
S Haemogram, Liver Electro Cardiogram (ECG), CT / MRI Brain, Electro Cardiogram (ECG), CT / MRI Brain, chronicity-P | Detailed treatment notes-C | Need for specific treatment and expected
Function Test, Electroencephalogram, Thyroid Function Test, VDRL, HIV Electroencephalogram, Thyroid Function Test, VDRL, HIV results-P
Renal Function Test, Vitamin B12 levels, Folate levels, Lipid Profile, Test, Vitamin B12 levels, Folate levels, Lipid Profile,
Test, Serum Homocysteine levels), serum Lithium level - all test should Homocysteine levels), serum Lithium level - all test should
Electrolytes, be done be done
Electro
Cardiogram (ECG),
CT / MRI Brain,
Electroencephalog
ram, Thyroid
Function Test,
VDRL, HIV Test,
Vitamin B12
levels, Folate
levels, Lipid
Profile,
Homocysteine
levels), serum
Lithium level
MENTAL MD MD000011 Pharmacological MD000011620 Common Medications Used in Management of Child & Adult 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Common Medications Used in Management of Child & Adult Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 62 Interventions 000781 Psycholoigical DisordersiIncluding Anti-ADHD Medication Psycholoigical DisordersiIncluding Anti-ADHD Medication Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S notes-C | Need for specific treatment and expected results-P
MENTAL MD MD000011 Behavioral and MD000011900 Oppositional Defiant Disorder/ Conduct Disorder/Mixed 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Oppositional Defiant Disorder/ Conduct Disorder/Mixed Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 9 motional 00769 Disorder of Conduct and Emotions/Anxiety and Depressive Disorder of Conduct and Emotions/Anxiety and Depressive Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S Disorders of Disorders/Other Internalizing and Externalizing Disorders of Disorders/Other Internalizing and Externalizing Disorders of notes-C | Need for specific treatment and expected results-P
Childhood and Childhood and Adolescence Childhood and Adolescence
Adolescence
MENTAL MD MD000012 Behavioural MD000012000 Behavioural syndromes associated with physiological 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Behavioural syndromes associated with physiological Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 0 syndromes 00770 disturbances and physical factors disturbances and physical factors Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S associated with notes-C | Need for specific treatment and expected results-P
physiological
disturbances and
physical factors
MENTAL MD MD000012 Psychological / MD000012060 Psychological Assessments (Includes IQ Testing, Specific 2500 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Psychological Assessments (Includes IQ Testing, Specific Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 06 Psychosocial 000782 Learning Disability Assessments, Assessments For Autism Learning Disability Assessments, Assessments For Autism Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S Assessment Spectrum Disorder, Developmental Assessments, Projective Spectrum Disorder, Developmental Assessments, Projective notes-C | Need for specific treatment and expected results-P
Package for All Tests and Other Tests Of Psychopathology), Other Tests and Other Tests Of Psychopathology), Other
Child And Psychosocial Assessments (Family, Schooling) Psychosocial Assessments (Family, Schooling)
Adolescent
Psychiatric
Disorders
MENTAL MD MD000013 Schizophrenia, MD000013110 Schizophrenia, schizotypal and delusional disorders 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Schizophrenia, schizotypal and delusional disorders Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 11 schizotypal and 000783 Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S delusional notes-C | Need for hospitalization-P
disorders
MENTAL MD MD000053 Electro Convulsive MD000053000 Electro Convulsive Therapy (ECT) - per session 3000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Electro Convulsive Therapy (ECT) - per session Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 0 Therapy (ECT) - 00771 Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S per session notes-C | Need for specific treatment and expected results-P
MENTAL MD MD000080 Immune mediated MD000080800 Immune mediated CNS disorders 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Immune mediated CNS disorders Admission notes showing vitals and examination findings-P | All investigations reports-C
DISORDER 8 CNS disorders 00772 (without Ventilator)-4700 | | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
S Routine Ward-1800 Detailed discharge summary-C | Planned line of management-P | Treatment details-C
MENTAL MD MD000094 Mental and MD000094900 Mental and Behavioural disorders due to psychoactive 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Mental and Behavioural disorders due to psychoactive Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 9 Behavioural 00773 substance use substance use Detailed discharge summary-C | Detailed history of psychoactive substanec with
S disorders due to chronicity; need for hospitalization. Admission under empanneled Psychiatrist is a must.-P
psychoactive | Detailed treatment notes-C | Need for hospitalization-P
substance use
MENTAL MD MD000095 Mental Disorderss MD000095000 Mental Disorderss - Organic, including symptomatic 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Mental Disorderss - Organic, including symptomatic Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 0 - Organic, 00774 Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S including notes-C | Need for hospitalization-P
symptomatic
MENTAL MD MD000095 Mental MD000095100 Intellectual Disability (ID) 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Intellectual Disability (ID) Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 1 Retardation 00775 Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S (intellectual notes-C | Need for hospitalization-P
disability)
MENTAL MD MD000096 Mood (affective) MD000096400 Mood (affective) disorders 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Mood (affective) disorders Admission under empanneled Psychiatrist is a must-P | All investigations done-C |
DISORDER 4 disorders 00776 Detailed discharge summary-C | Detailed history with chronicity-P | Detailed treatment
S notes-C | Need for hospitalization-P
GENERAL MG MG000010 Neuromuscular MG000010120 Neuromuscular Disorders 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Neuromuscular Disorders Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 12 Disorders 000336 (without Ventilator)-4700 | history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Examination findindgs-P | Investigations done-P | Planned line management-P |
Treatment details-C
GENERAL MG MG000010 Oesophageal MG000010230 Oesophageal Varices Banding 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Oesophageal Varices Banding Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 23 Varices Banding 000337 (without Ventilator)-4700 | history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Endoscopy-C | Examination findindgs-P | Investigations done-P | Planned line
GENERAL MG MG000010 Atrial Fibrillation MG000010400 Atrial Fibrillation 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Atrial Fibrillation All investigations reports-C | Clinical notes with planned line of treatment-P | Detailed
MEDICINE 4 00282 (without Ventilator)-4700 | Discharge Summary-C | Detailed ICPs-C | ECG-P | Post treatment ECG-C | Serum
Routine Ward-1800 Electrolytes-P | Treatment details-C
GENERAL MG MG000010 Optic neuritis MG000010530 Optic neuritis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Optic neuritis Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 53 000338 history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Examination findindgs-P | Investigations done-P | Planned line management-P |
Treatment details-C
GENERAL MG MG000010 Autoimmune MG000010800 Autoimmune encephalitis 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Autoimmune encephalitis Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 8 encephalitis 00283 (without Ventilator)-4700 | reports-C | Any investigations done-P | CT Brain / MRI Brain if done.-C | Detailed ICPs-
Routine Ward-1800 C | Detailed discharge summary-C | Planned line of management-P | Treatment details-
C
GENERAL MG MG000011 Pancreatitis MG000011010 Acute Pancreatitis/ Acute nacrotizing severe pancreatitis / 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute Pancreatitis/ Acute nacrotizing severe pancreatitis / Admission notes showing vitals-P | All investigations reports-C | CBC-P | Clinical notes
MEDICINE 01 000339 Chronic Pancreatitis (without Ventilator)-4700 | Chronic Pancreatitis detailing history including past history-P | Detailed discharge summary-C | Examination
Routine Ward-1800 findindgs-P | Investigations done-P | LFT-C | LFT-P | Lipase-C | Lipase-P | Planned
line management-P | Post treatment Sr Amylase-C | Sr Amylase-P | Treatment details-
C | USG- abdomen-P | USG/CT- abdomen Detailed ICPs-C
GENERAL MG MG000011 Peripheral Arterial MG000011500 Peripheral Arterial Thrombosis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Peripheral Arterial Thrombosis Admission notes showing vitals-P | All investigations reports-C | Arterial Doppler-C |
MEDICINE 50 Thrombosis 000340 (without Ventilator)-4700 | Clinical notes detailing history including past history-P | Detailed ICPs-C | Detailed
Routine Ward-1800 discharge summary-C | Examination findindgs-P | Investigations done-P | Planned line
management-P | Relevant investigations ( Doppler,PT INR,BT CT,etc ) done-P |
Treatment details-C
GENERAL MG MG000011 Peritoneal Dialysis MG000011540 Peritoneal Dialysis 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N PD fluid & disposables per Peritoneal Dialysis Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 54 000341 session-1000 | Pd Catheter history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Insertion per session -1500 Examination findindgs-P | Investigations done-P | Planned line management-P |
Treatment details-C
GENERAL MG MG000011 Plasmapheresis MG000011640 Plasmapheresis - Add on 9000 No 0 No 0 No No Secondary 1 No Yes Yes Add On No Yes No Medical No Insurance N N N Plasmapheresis - Add on Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Treatment details-C
GENERAL MG MG000011 Platelet pheresis MG000011670 Platelet pheresis - Add on 11000 No 0 No 0 No No Tertiary 5 No Yes Yes Add On No No No Medical No Insurance N N N Platelet pheresis - Add on Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Treatment details-C
GENERAL MG MG000011 Pleural Effusion MG000011700 Pleural Effusion 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pleural Effusion Examination findings-P | Admission notes showing vitals-P | All investigations reports-C
MEDICINE 70 000344 (without Ventilator)-4700 | | Any other investigations reports in support of diagnosis-P | CXR-P | Chest X ray/CT
Routine Ward-1800 Chest-C | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
summary-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000011 Pneumonia MG000011790 Pneumonia/Severe pneumonia 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pneumonia/Severe pneumonia Admission notes showing vitals-P | All investigations reports-C | Chest X ray/CT Chest-C
MEDICINE 79 000345 (without Ventilator)-4700 | | Clinical notes detailing history including past history-P | Detailed ICPs-C | Detailed
GENERAL MG MG000011 Pneumothorax MG000011820 Pneumothorax 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pneumothorax Admission notes showing vitals-P | All investigations reports-C | Chest X ray/CT Chest-C
MEDICINE 82 000346 (without Ventilator)-4700 | | Clinical notes detailing history including past history-P | Detailed ICPs-C | Detailed
GENERAL MG MG000011 Poisoning MG000011850 Acute organophosphorus poisoning/Other poisonings 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute organophosphorus poisoning/Other poisonings Admission notes showing vitals-P | Neurological examination findings-P | All
MEDICINE 85 000347 (without Ventilator)-4700 | investigations reports-C | Any investigations done-P | Clinical notes detailing history-P |
Routine Ward-1800 Copy of MLC / FIR-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
GENERAL MG MG000012 Pulmonary MG000012120 Pulmonary thromboembolism 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pulmonary thromboembolism Admission notes showing vitals-P | All investigations reports-C | Any investigations
MEDICINE 12 thromboembolism 000348 (without Ventilator)-4700 | reports in support of diagnosis-P | CT Chest/CT Pulmonary Angio/2D Echo-C | Clinical
Routine Ward-1800 notes detailing history-P | D-Dimer-C | Detailed ICPs-C | Detailed discharge summary-C
| ECG-P | Examination findings-P | Planned line of management-P | Treatment details-
C
GENERAL MG MG000012 Respiratory failure MG000012740 Type 1 respiratory failure/Type 2 respiratory failure/Due to 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N R N ICU (with Ventilator)-6000 | ICU Type 1 respiratory failure/Type 2 respiratory failure/Due to ABG-C | Admission notes showing vitals-P | All investigations reports-C | Clinical notes
MEDICINE 74 000349 any cause (pneumonia, asthma, COPD, ARDS, foreign body, (without Ventilator)-4700 | any cause (pneumonia, asthma, COPD, ARDS, foreign body, detailing history including past history-P | Detailed ICPs-C | Detailed discharge summary-
poisoning, head injury, Acute excaberation of COPD /Acute Routine Ward-1800 poisoning, head injury, Acute excaberation of COPD /Acute C | Examination findindgs-P | Investigations done-P | Planned line management-P |
excaberation of Interstitial Lung Disease/ Bronchiectasis / excaberation of Interstitial Lung Disease/ Bronchiectasis / Treatment details-C
Acute bronchitis/ Acute asthmatic attack / Status Acute bronchitis/ Acute asthmatic attack / Status
asthmaticus etc.) asthmaticus etc.)
GENERAL MG MG000012 Rheumatic fever & MG000012880 Acute rheumatic fever/ Rheumatic valvular heart disease / 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute rheumatic fever/ Rheumatic valvular heart disease / Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 88 Its Complication / 000350 Rheumtoid Arthritis /Septic Arthritis (without Ventilator)-4700 | Rheumtoid Arthritis /Septic Arthritis history-P | Detailed ICPs-C | Detailed discharge summary-C | Examination findings-P |
Septic Arthritis Routine Ward-1800 Planned line of management-P | Relevant investigations ( 2D Echo ,PT INR, etc ) done-P |
Treatment details-C
GENERAL MG MG000013 Scrub Typhus MG000013140 Scrub Typhus 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Scrub Typhus Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Examination findindgs-P | Investigations done-P | Planned line management-P | Scrub
Serology-C | Treatment details-C
GENERAL MG MG000013 Seizure & Epilepsy MG000013200 Seizure (Due to any cause) Status Epileptics / Drug resistant 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Seizure (Due to any cause) Status Epileptics / Drug resistant Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 20 & Epileptic 000352 Epilepsy/Evaluation of drug resistant epilepsy & Ketogenic (without Ventilator)-4700 | Epilepsy/Evaluation of drug resistant epilepsy & Ketogenic history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
encephalopathy diet in Refractory Epilepsy / Epileptic encephalopathy Routine Ward-1800 diet in Refractory Epilepsy / Epileptic encephalopathy EEG/ Brain Imaging-C | Examination findindgs-P | Investigations done-P | Planned line
GENERAL MG MG000013 SEVERE ANEMIA MG000013240 Iron deficiency anemia / Thalessmia / Other anemias 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Iron deficiency anemia / Thalessmia / Other anemias Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 24 000353 (without Ventilator)-4700 | history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Treatment details-C
GENERAL MG MG000013 Severe sepsis MG000013280 Severe sepsis/Septic shock 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Severe sepsis/Septic shock Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Treatment details-C
GENERAL MG MG000013 Sickle cell Anemia MG000013330 Sickle cell Anemia - Govt Reserve 0 Yes 3 No 0 Yes Yes Secondary 5 Yes Yes Yes Govt Yes No No Medical No Insurance N N N Routine Ward-1800 Sickle cell Anemia - Govt Reserve Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 33 000355 Reserve history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Examination findindgs-P | Hb Electrophoresis-C | Investigations done-P | Planned line
GENERAL MG MG000013 Skin and soft MG000013440 Skin and soft tissue infections 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Skin and soft tissue infections Admission notes showing vitals-P | All investigations reports including CBC-C | Clinical
MEDICINE 44 tissue infections 000356 notes detailing history including past history-P | Detailed ICPs-C | Detailed discharge
summary-C | Examination findindgs-P | Investigations done-P | Planned line
GENERAL MG MG000013 Snake bite MG000013490 Snake bite 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Snake bite Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Treatment details-C
GENERAL MG MG000013 Blood transfusion MG000013800 Blood component FFP - Add on 400 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Blood component FFP - Add on Blood Group-P | Clinical notes with planned line of treatment-P | Complete Hemogram-
MEDICINE 8 00284 P | Detailed Discharge Summary-C | Detailed ICPs-C | Post treatment Complete
hemogram-C
GENERAL MG MG000013 Blood transfusion MG000013800 Whole Blood transfusion/Blood component including 2000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Add On Yes Yes No Medical No Insurance N N R N Whole Blood transfusion/Blood component including Blood Group-P | Clinical notes with planned line of treatment-P | Complete Hemogram-
MEDICINE 8 00285 platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and P | Detailed Discharge Summary-C | Detailed ICPs-C | Post treatment Complete
platelet ≤ 40000 - Add on platelet ≤ 40000 - Add on hemogram-C
GENERAL MG MG000014 Blood transfusion- MG000014200 Blood component SDP ( IF platelet ≤ 20000 ) - Add on 9000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Blood component SDP ( IF platelet ≤ 20000 ) - Add on Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 2 Blood component 00286 reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
including platelet C | Planned line of management-P | Treatment details-C
transfusion (SDP)
GENERAL MG MG000014 Systematic lupus MG000014200 Systematic lupus erythematosus (SLE)/ Diffuse alveolar 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Systematic lupus erythematosus (SLE)/ Diffuse alveolar Admission notes showing vitals-P | All investigations reports-C | Any investigations
MEDICINE 20 erythematosus 000358 hemmorhage associated with SLE (without Ventilator)-4700 | hemmorhage associated with SLE done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Routine Ward-1800 summary-C | Examination findings-P | Planned line of management-P | Serum ANA-C
GENERAL MG MG000014 Systemic MG000014230 Systemic Thrombolysis (for MI) 0 Yes 3 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Systemic Thrombolysis (for MI) Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 23 Thrombolysis (for 000359 (without Ventilator)-4700 | history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
MI) Routine Ward-1800 Examination findindgs-P | Investigations done-P | Planned line management-P |
Treatment details-C
GENERAL MG MG000014 Tetanus MG000014310 Tetanus 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Tetanus Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Treatment details-C
GENERAL MG MG000014 Thyrotoxic crisis MG000014460 Thyrotoxic crisis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Thyrotoxic crisis Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
Routine Ward-1800 Examination findindgs-P | Investigations done-P | Planned line management-P | Post
treatment Thyroid Profile-C | Radionuclide Iodine uptake study-C | Throid profile-P |
Treatment details-C | USG- Thyroid Gland-P
GENERAL MG MG000014 Bone marrow MG000014700 Bone marrow aspiration / biopsy 1000 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N Bone marrow aspiration / biopsy All investigations reports-C | Biopsy Specimen photograph-C | Biopsy report-C |
MEDICINE 7 aspiration and 00287 Clinical notes detailing history any investigations done-P | Detailed ICPs-C | Detailed
biopsy discharge summary-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000014 Treatment of MG000014740 Treatment of systemic fungal infections 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Treatment of systemic fungal infections Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 74 systemic fungal 000362 (without Ventilator)-4700 | history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
infections Routine Ward-1800 Examination findindgs-P | Investigations done-P | Planned line management-P |
Treatment details-C
GENERAL MG MG000014 tuberculosis MG000014770 Pericardial tuberculosis / Pleural tuberculosis/ Pulmonary 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pericardial tuberculosis / Pleural tuberculosis/ Pulmonary Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 77 000363 tuberculosis (without Ventilator)-4700 | tuberculosis history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Examination findindgs-P | Investigations done-P | Microbiology/Radiology Evidence-C |
Planned line management-P | Treatment details-C
GENERAL MG MG000014 Unexplained MG000014920 Unexplained hepatosplenomegaly-requiring admission for 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Unexplained hepatosplenomegaly-requiring admission for Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
MEDICINE 92 hepatosplenomeg 000364 Work Up and/or in-patient management Work Up and/or in-patient management history including past history-P | Detailed ICPs-C | Detailed discharge summary-C |
aly Examination findindgs-P | Investigations done-P | Planned line management-P |
Treatment details-C | USG Abdomen and Pelvis-C
GENERAL MG MG000015 Vasculitis/ MG000015320 Vasculitis/ autoimmune disorder 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Vasculitis/ autoimmune disorder ANA/ANCA/Histopath report-C | Admission notes showing vitals-P | All investigations
MEDICINE 32 autoimmune 000365 (without Ventilator)-4700 | reports-C | Clinical notes detailing history including past history-P | Detailed ICPs-C |
disorder Routine Ward-1800 Detailed discharge summary-C | Examination findindgs-P | Investigations done-P |
GENERAL MG MG000015 Viral Encephalitis MG000015450 Viral Encephalitis 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Viral Encephalitis Admission notes showing vitals-P | All investigations reports-C | CSF Examination/Brain
MEDICINE 45 000366 (without Ventilator)-4700 | Imaging-C | Clinical notes detailing history including past history-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Examination findindgs-P | Investigations done-P |
GENERAL MG MG000016 Actue MG000016000 Actue nueroregression/ Acute worsening in neuro 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Actue nueroregression/ Acute worsening in neuro metabolic All investigations reports-C | Any investigations done-P | CT Head / MRI Head-C |
MEDICINE nueroregression/ 0272 metabolic and neurodegenrative conditions (without Ventilator)-4700 | and neurodegenrative conditions Clinical notes detailing history and Admission notes showing vitals and examination
Acute worsening Routine Ward-1800 findings-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
in neuro management-P | Treatment details-C
metabolic and
neuro degenrative
conditions
GENERAL MG MG000018 Cardiac MG000018400 Cardiac Tamponade 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cardiac Tamponade 2D echo-P | All investigations reports-C | Clincal notes-P | Detailed ICPs-C | Detailed
MEDICINE 4 Tamponade 00288 (without Ventilator)-4700 | discharge summary-C | ECG-P | Fluid Aspiration notes-C | ICP notes-C | Post
Routine Ward-1800 treatment 2D echo-C | Treatment details-C
GENERAL MG MG000019 Celiac disease MG000019300 Celiac disease-requiring admission for Work Up and/or in- 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Celiac disease-requiring admission for Work Up and/or in- Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 3 00289 patient management patient management reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
C | Planned line of management-P | Serum Anti tTG/ Upper GI Endoscopy-C |
Treatment details-C
GENERAL MG MG000019 Central Line ( MG000019600 Central Line ( Double Lumen / Triple Lumen ) with 0 Yes 1 No 0 Yes No Secondary 0 No Yes Yes Add On Yes No No Medical No Insurance N N N Triple Lumen-2500 | Double Central Line ( Double Lumen / Triple Lumen ) with Detail notes-C | Invoice / bar code-C | Review notes of primary physician for requirent
MEDICINE 6 Double Lumen / 00290 procedure - add on Lumen-2000 procedure - add on of procedure-P | X ray after procedure-C
Triple Lumen )
GENERAL MG MG000020 ACUTE MG000020000 Acute Febrile encephalopathy/Acute Disseminated 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute Febrile encephalopathy/Acute Disseminated All investigations reports-C | Any investigations done-P | CT Head / MRI Head/ LP (CSF)-
MEDICINE ENCEPHALOPATH 0273 Encephalomyelitis/hypertensive/metabolic/febrile/hepatic (without Ventilator)-4700 | Encephalomyelitis/hypertensive/metabolic/febrile/hepatic C | Clinical notes detailing history and Admission notes showing vitals and examination
Y encephalopathy/Acute meningo encephalitis Routine Ward-1800 encephalopathy/Acute meningo encephalitis findings (incl neurological examination)-P | Detailed ICPs-C | Detailed discharge
pyogenic/Aseptic meningitis tubercular/ Hypertensive pyogenic/Aseptic meningitis tubercular/ Hypertensive summary-C | Planned line of management-P | Treatment details-C
encehalopathy viral/Brain abscess/Intracranial abscess/ encehalopathy viral/Brain abscess/Intracranial abscess/
Aseptic meningitis Aseptic meningitis
GENERAL MG MG000020 cerebral MG000020300 cerebral herniation 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU cerebral herniation Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 3 herniation 00291 (without Ventilator)-4700 | reports-C | Any investigations done-P | CT / MRI brain-C | Detailed ICPs-C | Detailed
Routine Ward-1800 discharge summary-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000020 Cerebral Sino MG000020400 Cerebral Sino Venous thrombosis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cerebral Sino Venous thrombosis Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 4 Venous 00292 (without Ventilator)-4700 | reports-C | Any investigations done-P | CT / MRI brain with Venogram-C | Detailed
thrombosis Routine Ward-1800 ICPs-C | Detailed discharge summary-C | Planned line of management-P | Treatment
details-C
GENERAL MG MG000021 CHD /RHD MG000021200 CHD /RHD 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU CHD /RHD 2D ECHO-C | All investigations reports-C | Any investigations done-P | Clinical notes
MEDICINE 2 00293 (without Ventilator)-4700 | showing vitals and examination findings-P | Detailed Discharge Summary-C | Detailed
Routine Ward-1800 ICPs (daily Treatment details)-C | ECG / 2D ECHO-P | Planned line of management-P
GENERAL MG MG000021 Chikungunya MG000021800 Chikungunya fever 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Chikungunya fever Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 8 fever 00294 reports-C | Any investigations done-P | Chikungunya test report-C | Detailed ICPs-C |
GENERAL MG MG000022 Cholangitis MG000022200 Cholangitis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cholangitis Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 2 00295 (without Ventilator)-4700 | reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
Routine Ward-1800 C | Planned line of management-P | Treatment details-C | USG / MRCP / CT Abdomen-
C
GENERAL MG MG000025 Acute MG000025000 Acute gastroenteritis with moderate dehydration/Acute 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute gastroenteritis with moderate dehydration/Acute All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE gastroenteritis 0274 gastroenteritis with severe dehydration/ Recurrent gastroenteritis with severe dehydration/ Recurrent vomiting and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
with dehydration vomiting with dehydration/Chronic diarrohea /Dysentery with dehydration/Chronic diarrohea /Dysentery Detailed discharge summary-C | Planned line of management-P | Treatment details-C
/ Recurrent
vomiting with
dehydration/
Chronic
diarrohea/
Dysentry
GENERAL MG MG000026 Acute MG000026000 Acute glomerulonephritis 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute glomerulonephritis 24 hour urine protein-C | All investigations reports-C | Clinical notes detailing history
MEDICINE glomerulonephriti 0275 (without Ventilator)-4700 | and Admission notes showing vitals-P | Detailed ICPs-C | Detailed discharge summary-C
s Routine Ward-1800 | Investigations done-P | Planned line management-P | Treatment details-C | USG
Abdomen-C
GENERAL MG MG000026 Congestive heart MG000026500 Congestive heart failure 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Congestive heart failure Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 5 failure 00296 (without Ventilator)-4700 | reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
Routine Ward-1800 C | ECHO if done-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000029 Acute ischemic MG000029000 Acute ischemic stroke 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute ischemic stroke All investigations reports-C | Any investigations done-P | CT Head / CT Angio / MRI Head-
MEDICINE stroke 0276 (without Ventilator)-4700 | C | Clinical notes detailing history and Admission notes showing vitals and examination
Routine Ward-1800 findings-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
GENERAL MG MG000029 Continuous renal MG000029300 Continuous renal replacement therapy (CRRT) in AKI 0 Yes 5 No 0 Yes No Tertiary 5 No Yes Yes Regular Yes No No Medical No Insurance N N N CRRT-6000 Continuous renal replacement therapy (CRRT) in AKI Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 3 replacement 00297 (including cost for disposable) PKG/add on (including cost for disposable) reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
therapy/Continuo C | Planned line of management-P | RFT-C | Treatment details-C | eGFR-C
us veno-venous
hemofiltration
GENERAL MG MG000031 Croup syndrome MG000031500 Acute laryngotracheobronchitis/Acute epiglottitis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute laryngotracheobronchitis/Acute epiglottitis Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 5 00298 (without Ventilator)-4700 | reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
Routine Ward-1800 C | Planned line of management-P | Treatment details-C
GENERAL MG MG000035 Acute severe MG000035000 Acute severe ulcerative colitis 0 Yes 3 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute severe ulcerative colitis Clinical notes with USG or CT Scan / HPE confirming diagnosis, Clinical Photograph-P |
MEDICINE ulcerative colitis 0277 Clinical photograph-C | Detailed discharge summary-C | ICP Chart-C | Sigmoidoscopy /
Colonoscopy if done.-C
GENERAL MG MG000039 Acute transverse MG000039000 Acute transverse myelitis/ Acute demyelinating encephalitis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute transverse myelitis/ Acute demyelinating encephalitis All investigations reports-C | Any investigations reports in support of diagnosis-P | CT /
MEDICINE myelitis/ Acute 0278 (without Ventilator)-4700 | MRI-Brain / Spine-C | Clinical notes detailing history and Admission notes showing vitals
demyelinating Routine Ward-1800 and examination findings-P | Detailed ICPs-C | Detailed discharge summary-C |
encephalitis Planned line of management-P | Treatment details-C
GENERAL MG MG000041 Acute urticaria / MG000041000 Acute urticaria / anaphylaxis / Steven Johnson syndrome 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute urticaria / anaphylaxis / Steven Johnson syndrome All investigations reports-C | Clinical notes detailing history and Admission notes showing
MEDICINE Anaphylaxis 0279 (without Ventilator)-4700 | vitals-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line management-
Routine Ward-1800 P | Specify the trigger-P | Treatment details-C
GENERAL MG MG000044 Addison’s disease MG000044000 Addison’s disease 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Addison’s disease
MEDICINE 0280 (without Ventilator)-4700 | Detailed ICPs-C | All investigations reports-C | Clincal notes, Sr. Cortisol levels, USG-
Routine Ward-1800 abdomen-P | Detailed discharge summary-C | Sr Cortisol levels-C | Treatment details-C
GENERAL MG MG000046 CVA / Stroke MG000046200 Acute hemorrhagic stroke/Acute hemorrhagic stroke- (Extra 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute hemorrhagic stroke/Acute hemorrhagic stroke- (Extra
MEDICINE 2 00271 ventricular drainage)/Acute hemorrhagic stroke- Hematoma (without Ventilator)-4700 | ventricular drainage)/Acute hemorrhagic stroke- Hematoma Detailed ICPs-C | All investigations reports-C | Any investigations done-P | CT Head /
evacuation/ Acute Ischemic Stoke/Acute ischemic stroke- Routine Ward-1800 evacuation/ Acute Ischemic Stoke/Acute ischemic stroke- CT Angio / MRI Head-C | Clinical notes detailing history and Admission notes showing
intravenous thrombolysis intravenous thrombolysis vitals and examination findings-P | Detailed discharge summary-C | Planned line of
GENERAL MG MG000046 Cyanotic spells MG000046400 Cyanotic spells without CHD/Cyanotic spells with CHD 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cyanotic spells without CHD/Cyanotic spells with CHD All investigations reports-C | Clinical notes with planned line of treatment (incl birth &
MEDICINE 4 00299 (without Ventilator)-4700 | past history)-P | Detailed Discharge Summary-C | Detailed ICPs (daily Treatment details)-
Routine Ward-1800 C | Investigation Reports supporting diagnosis (including ABG)-P | Planned line of
treatment-P
GENERAL MG MG000048 Dengue fever MG000048300 Dengue fever/Dengue hemorrhagic fever/Dengue shock 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Dengue fever Dengue fever/Dengue hemorrhagic fever/Dengue shock Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 3 00300 syndrome Dengue hemorrhagic syndrome reports with Dengue test-C | Any investigations done-P | Detailed ICPs-C | Detailed
fever/Dengue shock syndrome discharge summary-C | Planned line of management-P | Treatment details-C
in ICU (without Ventilator) -
-4700 | Dengue fever
Dengue hemorrhagic
fever/Dengue shock syndrome
in
ICU (with Ventilator) - -6000 |
Dengue fever - Routine Ward -
1800
GENERAL MG MG000048 Diabetic foot MG000048900 Diabetic foot 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Diabetic foot Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 9 00301 reports-C | Any investigations done; planned line of management-P | Clinical photo of
diabetic foot-C | Detailed Discharge Summary-C | Detailed ICPs and treatment details-C
| Planned line of management-P
GENERAL MG MG000052 DVT/Acute MG000052300 DVT/Acute thrombosis Systemic Thrombolysis and 21700 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Medical No Insurance N N N DVT/Acute thrombosis Systemic Thrombolysis and Admission notes showing vitals and examination findings-P | Admission notes showing
MEDICINE 3 Thrombosis 00302 anticoagulation ( Including thrombolytic agent expect r - anticoagulation ( Including thrombolytic agent expect r - TPA vitals and examination findings-P | Cardiac markers - CPK-MB-P | Doppler
TPA ) ) -P | ECG-P | FOR Acute thrombosis Systemic : All investigations reports-C | FOR Acute
thrombosis Systemic : Detailed ICPs-C | FOR Acute thrombosis Systemic : Detailed
discharge summary-C | FOR Acute thrombosis Systemic : ECG-C | FOR Acute
thrombosis Systemic : Invoice / barcode of thrombolytic agent used-C | FOR Acute
thrombosis Systemic : Lab Investigation (TROP - T report)-C | FOR Acute thrombosis
Systemic : Post thrombolysis Doppler report-C | FOR Acute thrombosis Systemic :
Thrombolysis and anticoagulation ECHO-C | FOR Acute thrombosis Systemic : Treatment
details-C | For DVT : All investigations reports-C | For DVT : Detailed ICPs-C | For DVT :
Detailed discharge summary-C | For DVT : Lab Investigation-C | For DVT : Post
thrombolysis Doppler report-C | For DVT : Treatment details-C | For DVT : invoice /
barcode of thrombolytic agent used-C | TROP I or TROP T-P
GENERAL MG MG000054 Empyema MG000054400 Empyema 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Empyema Admission /Clinical notes showing vitals -P | All investigations reports-C | Any
MEDICINE 4 00303 (without Ventilator)-4700 | investigations done-P | CBC-P | Detailed Discharge Summary-C | Detailed ICPs and
Routine Ward-1800 treatment details-C | Examination findings-P | Planned line of management-P | Post
Treatment X-ray chest-C | X ray chest-P
GENERAL MG MG000055 Endocarditis MG000055000 Bacterial Endocarditis/Fungal Endocarditis 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Bacterial Endocarditis/Fungal Endocarditis Admission /Clinical notes showing vitals -P | All investigations reports-C | Any
MEDICINE 0 00304 (without Ventilator)-4700 | investigations done-P | Blood culture reports-C | CBC-P | Detailed Discharge Summary-
Routine Ward-1800 C | Detailed ICPs-C | ECG-P | ECHO-P | Examination findings-P | Planned line of
management-P | Post treatment ECHO-C | Treatment details-C
GENERAL MG MG000056 Enteric fever MG000056200 Enteric fever 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Enteric fever Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 2 00305 investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
findings-P | Planned line of management-P | Treatment details-C
GENERAL MG MG000059 AKI / Renal failure MG000059000 AKI / Renal failure 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU AKI / Renal failure Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 0281 (without Ventilator)-4700 | reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
Routine Ward-1800 C | Planned line of management-P | Treatment details-C | USG-C
GENERAL MG MG000065 Febrile illness MG000065100 Acute febrile illness / Pyrexia of unknown origin 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute febrile illness / Pyrexia of unknown origin Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
GENERAL MG MG000066 Fibreoptic MG000066100 Fibreoptic bronchoscopy (FOB) 2500 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Fibreoptic bronchoscopy (FOB) Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 1 bronchoscopy 00307 investigations done-P | Clinical notes detailing indications for bronchoscopy-P |
(FOB) Detailed ICPs-C | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
C | Examination findings-P | Planned line of management-P | Post procedure clinical
photograph with report-C | Treatment details-C
GENERAL MG MG000070 GI bleeding MG000070700 Lower GI bleeding / Upper GI bleeding 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Lower GI bleeding / Upper GI bleeding Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 7 00308 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Endoscopy if
Routine Ward-1800 done-C | Examination findings-P | Planned line of management-P | Treatment details-
C
GENERAL MG MG000071 Gout MG000071500 Gout 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Gout Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
findings-P | Planned line of management-P | Sr.Uric acid-C | Sr.Uric acid-P |
Treatment details-C
GENERAL MG MG000072 Guillain Barre MG000072000 Guillain Barre syndrome 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Guillain Barre syndrome Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 0 syndrome 00310 (without Ventilator)-4700 | investigations done-P | CSF/NCS-C | Detailed ICPs-C | Detailed discharge summary-C |
Routine Ward-1800 Examination findings-P | Planned line of management-P | Report of test blocked-C |
Treatment details-C
GENERAL MG MG000072 Haemodialysis MG000072400 Haemodialysis ± Inj.Erythropoietin - Day care / Add on 1500 Yes 0 Yes 1 Yes No Tertiary 1 No Yes Yes Day care / Yes Yes No Medical Yes Insurance Y N N Inj. Erythropoietin-600 Max :1 Haemodialysis ± Inj.Erythropoietin - Day care / Add on Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 4 Dialysis (ARF / 00311 Add on investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
CRF) findings-P | Planned line of management-P | Treatment details-C
GENERAL MG MG000072 Haemolytic uremic MG000072700 Haemolytic uremic syndrome 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Haemolytic uremic syndrome Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 7 syndrome 00312 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
Routine Ward-1800 findings-P | Planned line of management-P | Treatment details-C
GENERAL MG MG000073 Hemostatic MG000073600 Hemophilia / Platelet disorders - govt reserve 0 Yes 3 No 0 Yes Yes Secondary 3 Yes Yes Yes Govt Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Hemophilia / Platelet disorders - govt reserve Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 6 Disorders 00313 Reserve (without Ventilator)-4700 | reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
Routine Ward-1800 C | Examination findings-P | Planned line of management-P | Treatment details-C
GENERAL MG MG000074 Hepatitis MG000074400 Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 4 00314 /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver (without Ventilator)-4700 | /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
abscess Routine Ward-1800 abscess findings-P | Planned line of management-P | Treatment details-C
GENERAL MG MG000075 High end MG000075600 High end histopathology (Biopsies) and advanced serology 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 6 histopathology 00315 investigations - Add on investigations - Add on investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
(Biopsies) and findings-P | Planned line of management-P | Treatment details-C
advanced
serology
investigations
GENERAL MG MG000076 High end MG000076300 High end radiological diagnostic 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 3 radiological 00316 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
diagnostic C | Examination findings-P | Planned line of management-P | Treatment details-C
(CT, MRI, Imaging
including nuclear
imaging)
GENERAL MG MG000077 HIV with MG000077300 HIV with complications 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU HIV with complications Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 3 complications 00317 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
Routine Ward-1800 findings-P | HIV Report-P | Planned line of management-P | Treatment details-C
GENERAL MG MG000077 Hydrocephalus MG000077600 Hydrocephalus 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Hydrocephalus Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 6 00318 (without Ventilator)-4700 | investigations done-P | CT Brain / MRI brain-C | Detailed ICPs-C | Detailed discharge
Routine Ward-1800 summary-C | Examination findings-P | Planned line of management-P | Treatment
details-C
GENERAL MG MG000079 Idiopathic MG000079400 Idiopathic Thrombocytopenic Purpura 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Idiopathic Thrombocytopenic Purpura Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
MEDICINE 4 Thrombocytopeni 00319 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
c Purpura Routine Ward-1800 findings-P | PBF / Bone Marrow (Aspiration or Biopsy)-C | Planned line of management-
P | Treatment details-C
GENERAL MG MG000079 IHD / CAD / MG000079700 IHD/Arrhythmia/CAD 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU IHD/Arrhythmia/CAD 2D ECHO-C | Admission notes showing vitals and examination findings-P | All
MEDICINE 7 Arrhythmia 00320 (without Ventilator)-4700 | investigations reports-C | Clinical notes detailing history-P | Detailed ICPs-C | Detailed
Routine Ward-1800 discharge summary-C | Examination findings-P | Relevant investigations (ECG) -P |
Treatment details-C
GENERAL MG MG000080 Immune mediated MG000080700 Immune mediated CNS disorders 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Immune mediated CNS disorders Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 7 CNS disorders 00321 (without Ventilator)-4700 | reports-C | Any investigations done-P | CSF / Brain Imagining-C | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000081 Inflammatory MG000081500 Inflammatory Myopathy/ Myaesthenic Crisis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Inflammatory Myopathy/ Myaesthenic Crisis Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 5 Myopathy/ 00322 (without Ventilator)-4700 | report-C | Any investigations done-P | CPK/EMG-C | Detailed ICPs-C | Detailed
Myaesthenic Crisis Routine Ward-1800 discharge summary-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000082 Intestinal MG000082500 Intestinal obstruction- medical managment 6000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Intestinal obstruction- medical managment Admission /Clinical notes showing vitals and examination findings-P | All investigations
MEDICINE 5 obstruction 00323 reports-C | Any investigations done-P | Detailed ICPs-C | Detailed discharge summary-
C | Planned line of management-P | Treatment details-C | Xray FPA/USG abdomen-C
GENERAL MG MG000083 INTRACRANIAL MG000083100 Intracranial hemorrhage/Intracranial space occupying lesion 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Intracranial hemorrhage/Intracranial space occupying lesion All investigations reports-C | Brain Imaging-C | Clinical notes detailing history and
MEDICINE 1 SPACE 00324 tuberculoma/neurocysticercosis, brain tumours (without Ventilator)-4700 | tuberculoma/neurocysticercosis, brain tumours Admission notes showing vitals and examination findings (incl neurological examination);
OCCUPYING Routine Ward-1800 any investigations done; planned line of management-P | Detailed ICPs-C | Detailed
LESIONS discharge summary-C | Treatment details-C
GENERAL MG MG000085 Juvenile MG000085300 Juvenile myasthenia- requiring admission for work-up or in- 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Juvenile myasthenia- requiring admission for work-up or in- All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 3 myasthenia 00325 patient care (without Ventilator)-4700 | patient care and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
GENERAL MG MG000085 Kawasaki Disease MG000085500 Kawasaki Disease 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Kawasaki Disease All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 5 00326 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
GENERAL MG MG000087 Leptospirosis MG000087500 Leptospirosis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Leptospirosis All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 5 00327 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Detailed discharge summary-C | Leptospira Serology-C | Planned line of management-P
GENERAL MG MG000089 Lung abscess MG000089400 Lung abscess 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Lung abscess CBC and any other investigations done-P | CBC-C | Chest X ray/ CT Chest-C | Clinical
MEDICINE 4 00328 (without Ventilator)-4700 | notes with planned line of treatment-P | Detailed Discharge summary-C | Planned line
Routine Ward-1800 of management-P | Post Treatment X-ray chest-C | X-ray chest-P
GENERAL MG MG000090 Malaria MG000090000 Complicated malaria 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Complicated malaria All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 0 00329 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Malaria Serology-C | Planned line of management-P |
Treatment details-C
GENERAL MG MG000093 Medical MG000093800 Raised ICP due to neuro surgical procedures/due to 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Raised ICP due to neuro surgical procedures/due to All investigations reports-C | Any investigations done-P | Brain Imaging-C | Clinical
MEDICINE 8 Management for 00330 trauma/malignancies/ meningo-encephalitis (without Ventilator)-4700 | trauma/malignancies/ meningo-encephalitis notes detailing history and Admission notes showing vitals and examination findings (incl
Raised intracranial Routine Ward-1800 neurological examination)-P | Detailed ICPs-C | Detailed discharge summary-C |
pressure Planned line of management-P | Treatment details-C
GENERAL MG MG000094 Meningitis MG000094500 Chronic meningitis/Partially treated pyogenic 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Chronic meningitis/Partially treated pyogenic All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 5 00331 meningitis/Neuro tuberculosis/Complicated bacterial (without Ventilator)-4700 | meningitis/Neuro tuberculosis/Complicated bacterial and Admission notes showing vitals and examination findings (incl neurological
meningitis/Acute meningitis/Meningitis/ Fungal Routine Ward-1800 meningitis/Acute meningitis/Meningitis/ Fungal examination)-P | Detailed ICPs-C | Detailed discharge summary-C | LP (CSF
Meningitis/ACUTE INFECTIOUS MENINGITIS AND Meningitis/ACUTE INFECTIOUS MENINGITIS AND EXAMINATION)/ Brain Imaging-C | Planned line of management-P | Treatment details-C
MENINGOENCEPHALITIS/Pyogenic Meningitis/Tuberculous MENINGOENCEPHALITIS/Pyogenic Meningitis/Tuberculous
meningitis (Hydrocephalus – VP SHUNT/ EVD/Omaya) meningitis (Hydrocephalus – VP SHUNT/ EVD/Omaya)
GENERAL MG MG000095 Mesenteric MG000095600 Mesenteric Ischemia 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Mesenteric Ischemia All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 6 Ischemia 00332 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings (incl neurological
Routine Ward-1800 examination)-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
management -P | Treatment details-C | USG/CT/MRI abdome-C
GENERAL MG MG000097 Myxedema coma MG000097300 Myxedema coma 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myxedema coma All investigations reports-C | Clinical notes with planned line of treatment-P | Detailed
MEDICINE 3 00333 (without Ventilator)-4700 | ICPs-C | Detailed discharge summary-C | Post treatment Thyroid Profile-C | Throid
Routine Ward-1800 profile-P | Treatment details-C | USG- Thyroid Gland-P
GENERAL MG MG000098 Neonatal/ MG000098000 Neonatal/infantile cholestasis / Choledochal cysts 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Neonatal/infantile cholestasis / Choledochal cysts All investigations reports-C | Any investigations done-P | Clinical notes detailing history
MEDICINE 0 Infantile 00334 (without Ventilator)-4700 | and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
cholestasis Routine Ward-1800 Detailed discharge summary-C | Planned line of management-P | Treatment details-C
GENERAL MG MG000099 NEPHROTIC MG000099800 Nephrotic syndrome with peritonitis/Steroid dependent or 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Nephrotic syndrome with peritonitis/Steroid dependent or Admission notes showing vitals-P | 24 Hr Urine Protein-C | All investigations reports-C
MEDICINE 8 SYNDROME 00335 resistent/Uncomplicated steroid sensitive (without Ventilator)-4700 | resistent/Uncomplicated steroid sensitive | Clinical notes detailing history including past history-P | Detailed ICPs-C | Detailed
management-P | Treatment details-C | USG Abdomen-C
MEDICAL MO MO000010 Oral Metronomic MO000010570 3500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 57 chemotherapy for 000753 Etoposide/ Cyclophosphamide 50 mg/m2 OD D1-D21 every Etoposide/ Cyclophosphamide 50 mg/m2 OD D1-D21 every REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y CA Ovary/ breast 28 days 28 days OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
HPR or cytology suggestive of ovarian adenocarcinoma-P | LFT-P | RBS-P | REPORTS
OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000010 Paediatric- MO000010720 Paediatric-GCT/JEB/PEB Maximum 6 cycles 10000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Paediatric-GCT/JEB/PEB Maximum 6 cycles BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | CBC-P | CECT ABDOMEN
ONCOLOG 72 GCT/JEB 000754 pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
SLIPS-C | TUMOR MARKERS-P
MEDICAL MO MO000010 Palliative and MO000010760 Palliative care end stage disease 0 Yes 3 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Palliative care end stage disease- Palliative care end stage disease Discharge summary with detail treatment & interventions-C | Review notes of primary
ONCOLOG 76 supportive care 000755 3000 physician with referal to Palliative Medicine -P
Y for malignant
disease at
advanced or end
stage
MEDICAL MO MO000010 Palliative Care MO000010810 Hematuria Palliative Interventions 40000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Hematuria Palliative Interventions CBC-P | Clinical notes with planned line of treatment-P | Details of interventions-C |
ONCOLOG 81 Approach to 000756 Discharge summary with detail treatment-C | KFT -P | LFT-P | Procedure done-C | X-
Y managing Ray/USG-P
Haematuria in
advanced cancer
patients-
Endoscopic/
Surgical/
Radiological,
Radiotherpay
MEDICAL MO interventions
MO000010 Palliative MO000010920 Palliative Radiological Interventions. Like- 20000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Palliative Radiological Interventions. Like- CBC-P | Clinical notes with planned line of treatment-P | Discharge summary with detail
ONCOLOG 92 Radiological and 000757 PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc treatment-C | Final bill with payment receipt-C | Interventions-C | KFT -P | LFT-P | X-
Y endoscopical Ray/USG-P
Interventions
MEDICAL MO MO000010 Palliative surgical MO000010950 Palliative surgical interventions 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Palliative surgical interventions CBC-P | CECT/MRI/ x-Ray-P | Clinical notes with planned line of treatment-P | Details
ONCOLOG 95 interventions like- 000758 of interventions-C | Discharge summary with detail treatment-C | KFT-P | LFT-P |
Y Colostomy, Procedure done-C
Tracheostomy,
Feeding
Jejunostomy/Gast
rostomy, Bowel
bypas, Fistulas,
Urinary diversions
etc.in advanced
cancer patients
MEDICAL MO MO000011 PEDIATRIC NON MO000011160 PEDIATRIC NON HODGKINS LYMPHOMA (LMB 89-96) 33100 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N PEDIATRIC NON HODGKINS LYMPHOMA (LMB 89-96) )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 16 HODGKINS 000759 INDUCTION-COPADAM (8 WEEKS, 2 CYCLES)-LMB 89 - 96 - INDUCTION-COPADAM (8 WEEKS, 2 CYCLES)-LMB 89 - 96 - P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y LYMPHOMA (LMB Induction - COPADAM-Duration + Cycle Induction - COPADAM-Duration + Cycle notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
89-96) INDUCTION- DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
COPADAM (8 flow cytometry-P | PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE
WEEKS, 2 CYCLES)- TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
LMB 89 - 96 - C | TRANFUSION SLIPS-C
Induction -
COPADAM-
Duration + Cycle
MEDICAL MO MO000011 PEDIATRIC NON MO000011170 PEDIATRIC NON HODGKINS LYMPHOMA (LMB 89-96) 15400 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N PEDIATRIC NON HODGKINS LYMPHOMA (LMB 89-96) )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 17 HODGKINS 000760 MAINTAINENCE (12 WEEKS)-LMB 89 - 96 - Maintenance MAINTAINENCE (12 WEEKS)-LMB 89 - 96 - Maintenance P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y LYMPHOMA (LMB notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
89-96) and pelvis, +/- Bone marrow studies, Biopsy or fluid, 2D-ECHO, HPE / IHC/ flow cytometry-
MAINTAINENCE P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
(12 WEEKS)-LMB INPATIENT DEPARTMENT-C | HPE / IHC/ flow cytometry-P | PET CT or CECT Chest
89 - 96 - abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Maintenance MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000011 PEDIATRIC NON MO000011180 PEDIATRIC NON HODGKINS LYMPHOMA (MCP-842) 8 cycles- 13200 No 0 No 0 No No Tertiary 30 No Yes Yes Regular PKG No No No Medical No Insurance N N N PEDIATRIC NON HODGKINS LYMPHOMA (MCP-842) 8 cycles- )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 18 HODGKINS 000761 MCP - 842-Cycle MCP - 842-Cycle P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y LYMPHOMA (MCP- notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
842) 8 cycles-MCP - DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
842-Cycle flow cytometry-P | PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE
TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
C | TRANFUSION SLIPS-C
MEDICAL MO MO000011 PET scan MO000011590 PET scan 14000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N PET scan Admission notes showing vitals and examination findings-P | All investigations reports
ONCOLOG 59 000762 including PETs scan report-C | Clinical notes detailing history-P | Detailed ICPs-C |
Y Detailed discharge summary-C | Planned line of management-P | Pny investigations
done-P | Treatment details-C
MEDICAL MO MO000011 Plasmapheresis MO000011650 Plasmapheresis - Add on 8000 No 0 No 0 No No Tertiary 1 No Yes Yes Add On No Yes No Medical No Insurance N N N Plasmapheresis - Add on Admission notes showing vitals and examination findings-P | All investigations reports-C
ONCOLOG 65 000763 | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge summary-C |
Y Planned line of management-P | Pny investigations done-P | Treatment details-C
MEDICAL MO MO000011 Platelet pheresis MO000011680 Platelet pheresis - Add on 11000 No 0 No 0 No No Tertiary 1 No Yes Yes Add On No No No Medical No Insurance N N N Platelet pheresis - Add on Admission notes showing vitals and examination findings-P | All investigations reports-C
ONCOLOG 68 000764 | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge summary-C |
MEDICAL MO MO000013 SEVERE ANEMIA MO000013250 Iron deficiency anemia / Thalessmia / Other anemias 0 Yes 3 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Iron deficiency anemia / Thalessmia / Other anemias Admission notes showing vitals and examination findings-P | All investigations reports-C
ONCOLOG 25 000765 (without Ventilator)-4700 | | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge summary-C |
Y Routine Ward-1800 Planned line of management-P | Pny investigations done-P | Treatment details-C
MEDICAL MO MO000013 Sickle cell Anemia MO000013340 Sickle cell Anemia - Govt Reserve 0 Yes 3 No 0 Yes Yes Secondary 5 Yes Yes Yes Govt Yes No No Medical No Insurance N N N Routine Ward-1800 Sickle cell Anemia - Govt Reserve Admission notes showing vitals and examination findings-P | All investigations reports-C
ONCOLOG 34 000766 Reserve | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge summary-C |
MEDICAL MO MO000013 Blood transfusion MO000013900 Whole Blood transfusion/Blood component including 2000 No 0 No 0 Yes No Secondary 0 Yes Yes Yes Add On Yes Yes No Medical No Insurance N N R N Whole Blood transfusion/Blood component including Blood Group-P | Clinical notes with planned line of treatment-P | Complete Hemogram-
ONCOLOG 9 00545 platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and P | Detailed Discharge Summary-C | Detailed ICPs-C | Post treatment hemogram-C |
Y platelet ≤ 40000 - Add on platelet ≤ 40000 - Add on Review notes of primary physician for requirent of procedure-P
MEDICAL MO MO000013 Blood transfusion MO000013900 Whole Blood transfusion/Blood component SDP ( IF platelet 8000 No 0 No 0 Yes No Secondary 0 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Whole Blood transfusion/Blood component SDP ( IF platelet Blood Group-P | Clinical notes with planned line of treatment-P | Complete Hemogram-
ONCOLOG 9 00546 ≤ 20000 ) - Add on ≤ 20000 ) - Add on P | Detailed Discharge Summary-C | Detailed ICPs-C | Post treatment hemogram-C |
Y Review notes of primary physician for requirent of procedure-P
MEDICAL MO MO000014 Tumor Lysis MO000014800 Rasburicase 24000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Rasburicase BAR CODE OF THE DRUGS-C | BUN-P | Blood Phosphate levels-P | CBC-P | CHARTS OF
ONCOLOG 80 Syndrome 000767 Febuxostat Febuxostat CHEMOTHERAPY REGIMEN-C | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Y Allopurinol Allopurinol DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | REPORTS OF THE TESTS
Sevelamer Sevelamer (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
Serum Electrolytes-P | Serum calcium-P | TRANFUSION SLIPS-C | Uric Acid-P
MEDICAL MO MO000014 Bone marrow MO000014900 Bone marrow aspiration / biopsy 1000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Bone marrow aspiration / biopsy Clinical notes with planned line of treatment-P | Complete Hemogram-P | Detailed
ONCOLOG 9 aspiration and 00547 Discharge Summary-C | Detailed ICPs-C | Post treatment hemogram-C | Review notes
Y biopsy of primary physician for requirent of procedure-P
MEDICAL MO MO000015 Vertebroplasty/Ky MO000015410 Vertebroplasty/Kyphoplasty - Govt reserved 40000 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Medical No Insurance N N N Vertebroplasty/Kyphoplasty - Govt reserved CBC-P | CECT/MRI/ X-Ray-P | Clinical notes with planned line of treatment-P | Details
ONCOLOG 41 phoplasty 000768 Reserve of interventions-C | Discharge summary with detail treatment-C | KFT-P | LFT-P |
Y Procedure done-C
MEDICAL MO MO000020 Central lines in MO000020100 Long term indwelling venous catheter 10000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Long term indwelling venous catheter BT-P | CT-P | Clinical notes with planned line of treatment-P | Complete Hemogram-P
ONCOLOG 1 cancer patients 00548 | Detail notes & X-Ray chest PA view-C | Detailed Discharge Summary-C | Detailed ICPs-
Y for drug therapy - C | HBsAg-P | HCV-P | HIV-P | Invoice copy with bar code-C | PT INR-P | Post
Silicon catheters treatment hemogram-C | Review notes of primary physician for requirent of procedure-
in advanced P
cancer patients-
Long term central
lines
MEDICAL MO MO000032 CT (Induction)for MO000032000 India collaborative childhood leukaemia group 90000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N India collaborative childhood leukaemia group 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or Peripheral
ONCOLOG 0 Paediatric Acute 00549 Berlin- Frankfurt -Munster Berlin- Frankfurt -Munster blood Flow Cytometry / IHC PET-CT or CECT chest abdomen-P | Bone Marrow Aspiration-
Y Lymphoblastic Kill acute lymphocytic leukemia cells Kill acute lymphocytic leukemia cells P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Leukemia/Lympho Mitroxantrone,Chlorambucil,Prednisolone: 841 including Mitroxantrone,Chlorambucil,Prednisolone: 841 including of treatment-P | Complete Hemogram-P | Cytogenetics-C | DISCHARGE SUMMARY OF
blastic lymphoma blood products and antibiotics blood products and antibiotics DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Detailed Discharge Summary-C | Detailed ICPs-C | HBsAg-P | HCV-P | HIV-P |
Molecular-C | NCCT Chest-P | Pelvis(if LBL)-P | Post treatment Complete hemogram-C
| REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
BIOCHEMISTRY,ETC.)-C | Review notes of primary physician for requirent of procedure-P
MEDICAL MO MO000032 CT Consolidation MO000032100 Berlin- Frankfurt -Munster-90 120000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Berlin- Frankfurt -Munster-90 2D ECHO-P | BAR CODE OF THE DRUGS-C | BONE MARROW Aspiration-P |
ONCOLOG 1 for Acute 00551 Berlin- Frankfurt -Munster-95 Berlin- Frankfurt -Munster-95 Biochemistry-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with
Y Lymphoblastic Berlin- Frankfurt -Munster-2000 Berlin- Frankfurt -Munster-2000 planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Leukemia Hyper (cyclophosphamide, Vincristine, Hyper (cyclophosphamide, Vincristine, DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET-CT or CECT chest abdomen-
Adriamycin,Dexamethasone Adriamycin,Dexamethasone P | Pelvis(if LBL)-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
UKALL (United kingdom acute lymphoblastic leukaemia) UKALL (United kingdom acute lymphoblastic leukaemia) MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
GMALL (German multicenter acute lymphoblastic leukemia) - GMALL (German multicenter acute lymphoblastic leukemia) -
Continuation pahse Continuation pahse
MEDICAL MO MO000032 CT Consolidation MO000032200 FAB LMB 89/96 (Max 4 cycles) 0 Yes 1 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N FAB LMB 89/96-40000 FAB LMB 89/96 (Max 4 cycles) 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow
ONCOLOG 2 for Paediatric Non 00550 cytometry / IHC ECG-P | Bone marrow studies-P | CBC-P | CHARTS OF
Y Hodgkins CHEMOTHERAPY REGIMEN-C | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Lymphoma DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or CECT Chest abdomen-
P | Pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000032 CT for Acute MO000032300 Berlin- Frankfurt -Munster-90, Berlin- Frankfurt -Munster- 160000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Berlin- Frankfurt -Munster-90, Berlin- Frankfurt -Munster- BAR CODE OF THE DRUGS-C | CBC BIOCHEM-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 3 Lymphoblastic 00552 95, Berlin- Frankfurt -Munster-2000 95, Berlin- Frankfurt -Munster-2000 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Leukemia Hyper (cyclophosphamide, Vincristine, Hyper (cyclophosphamide, Vincristine, CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
/Lymphoblastic Adriamycin,Dexamethasone Adriamycin,Dexamethasone REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
lymphoma UKALL (United kingdom acute lymphoblastic leukaemia) UKALL (United kingdom acute lymphoblastic leukaemia) BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
GMALL (German multicenter acute lymphoblastic leukemia) GMALL (German multicenter acute lymphoblastic leukemia)
Induction phase Induction phase
include antibiotics, antifungals, blood and platelets include antibiotics, antifungals, blood and platelets
transfusion transfusion
MEDICAL MO MO000032 CT for Acute MO000032400 6 Mercaptopurine 50 mg / M2 daily 4000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N 6 Mercaptopurine 50 mg / M2 daily BAR CODE OF THE DRUGS-C | Biochemistry -P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 4 Lymphoblastic 00553 Methotrexate 25 mg / M2 Weekly / Inj. Vincristine monthly Methotrexate 25 mg / M2 Weekly / Inj. Vincristine monthly REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Leukemia/ for 2 years for 2 years OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Lymphoblastic REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
Lymphoma BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000032 CT for Acute MO000032500 Cytarabine 100 mg / M2 7 days 100000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cytarabine 100 mg / M2 7 days BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration / Biopsy or
ONCOLOG 5 Myeloid Leukemia 00554 Daunomycin 60 mg / M2 3 days ( this include antibiotics, Daunomycin 60 mg / M2 3 days ( this include antibiotics, Peripheral blood flow cytometry / IHC-P | CBC-P | CBC-P | CHARTS OF
Y antifungals, blood and platelets transfusion) antifungals, blood and platelets transfusion) CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | LFT-P | Molecular Genetics. -P | RBS-P | REPORTS OF
THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000032 CT for Acute MO000032600 High dose Cytarabine for 3 cycles Including antibiotics and 70000 No 0 No 0 Yes No Tertiary 20 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N High dose Cytarabine for 3 cycles Including antibiotics and BAR CODE OF THE DRUGS-C | Bone marrow aspiration / IHC-P | CBC-P | CHARTS OF
ONCOLOG 6 Myeloid Leukemia 00555 blood product transfusion Maximum 3 cycles blood product transfusion Maximum 3 cycles CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment, CBC, LFT,
Y Consolidation RFT, RBS, Bone marrow aspiration / IHC, Molecular Genetics. -P | Clinical notes with
planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | Molecular Genetics -P
| RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000032 CT for Acute MO000032700 Arsenic trioxide 100000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Arsenic trioxide 2D ECHO-P | APTT-P | BAR CODE OF THE DRUGS-C | BIOCHEM-P | BONE MARROW
ONCOLOG 7 Promyelocytic 00556 ATRA ATRA Aspirtion / Biopsy Flow Cytometry-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C
Y Leukemia Daunomycin or Idarubcin Daunomycin or Idarubcin | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
(High Risk) Cytarabine - multiagent - vary on protocol Cytarabine - multiagent - vary on protocol DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | FDP / D
Dimer-P | HBsAg-P | HCV-P | HIV-P | PT-P | REPORTS OF THE TESTS (PATHOLOGY,
RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY, CYTOGENETICS ETC.)-C |
RT-PCR / FISH PML RARA-P | TRANFUSION SLIPS-C
MEDICAL MO MO000032 CT for Acute MO000032800 Arsenic trioxide 10000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Arsenic trioxide BONEMARROW-P | BAR CODE OF THE DRUGS-C | BIOCHEM-P | CBC-P | CHARTS OF
ONCOLOG 8 Promyelocytic 00557 ATRA ATRA CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Leukemia Daunomycin or Idarubcin Daunomycin or Idarubcin DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
(High Risk) Cytarabine - multiagent - vary in each protocol include Cytarabine - multiagent - vary in each protocol include INPATIENT DEPARTMENT-C | ECG-P | REPORTS OF THE TESTS (PATHOLOGY,
Induction antibiotics, antifungals, blood and platelets ; FFP transfusion antibiotics, antifungals, blood and platelets ; FFP transfusion RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RQPCR PML
RARA-P | TRANFUSION SLIPS-C
MEDICAL MO MO000032 CT for Acute MO000032900 6 MP 50 mg / day daily 8000 Yes 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N 6 MP 50 mg / day daily BAR CODE OF THE DRUGS-C | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes
ONCOLOG 9 Promyelocytic 00558 Methotrexate 15 mg Weekly Methotrexate 15 mg Weekly with planned line of treatment, CBC,Biochemistry RT-PCR / FISH PML RARA ( Every six
Y Leukemia ATRA 45 mg / M2 for 14 days ATRA 45 mg / M2 for 14 days Months)-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
(High Risk) Every three months for 18 Months Every three months for 18 Months SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
Maintenance RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
SLIPS-C
MEDICAL MO MO000033 CT for Acute MO000033000 ATO: Arsenic trioxide 0.15 mg / kg day 1-45 or 60 80000 Yes 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ATO: Arsenic trioxide 0.15 mg / kg day 1-45 or 60 2D ECHO-P | BAR CODE OF THE DRUGS-C | BIOCHEM-P | BONE MARROW Aspirtion /
ONCOLOG 0 Promyelocytic 00559 ATRA: All trans retinoic acid 45 mg / M2 - day 1-45 or 60 ATRA: All trans retinoic acid 45 mg / M2 - day 1-45 or 60 Biopsy Flow Cytometry-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Leukemia notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
(Low Risk) DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | FDP / D
Induction; include Dimer-P | HBsAg-P | HCV-P | HIV-P | PT-P | PTT-P | REPORTS OF THE TESTS
antibiotics, (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,
antifungals, blood CYTOGENETICS ETC.)-C | RT-PCR / FISH PML RARA-P | TRANFUSION SLIPS-C
and platelet
transfusions
MEDICAL MO MO000033 CT for Acute MO000033100 ATO: Arsenic trioxide 0.15 mg / kg day 1-Day 5, day 8-12, 55000 Yes 0 No 0 Yes No Tertiary 56 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N ATO: Arsenic trioxide 0.15 mg / kg day 1-Day 5, day 8-12, BAR CODE OF THE DRUGS-C | BONE MARROW Aspirtion / Biopsy-P | CBC Biochemistry-
ONCOLOG 1 Promyelocytic 00560 day 15-19, day 22-26 every 56 days for 4 cycles day 15-19, day 22-26 every 56 days for 4 cycles P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Leukemia ATRA : All trans retinoic acid 45 mg / M2 day 1-Day 14 and ATRA : All trans retinoic acid 45 mg / M2 day 1-Day 14 and treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
(Low Risk) Day 29-43 every 56 days for 4 cycles Day 29-43 every 56 days for 4 cycles SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
Consolidation RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RT-PCR / FISH
PML RARA-C | TRANFUSION SLIPS-C
MEDICAL MO MO000033 CT for Anal Cancer MO000033200 5 Fluorouracil (FU)+ Mitomycin C 14000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N 5 Fluorouracil (FU)+ Mitomycin C BAR CODE OF THE DRUGS-C | CBC-P | CECT / MRI abdomen Pelvis-P | CHARTS OF
ONCOLOG 2 00561 5 Fluorouracil(FU) 1000mg/m2 D1-D4 D29-D32 5 Fluorouracil(FU) 1000mg/m2 D1-D4 D29-D32 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Mitomycin 10mg/m2 D1 Mitomycin 10mg/m2 D1 DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | HPE (Squamous Cell carcinoma)-P | LFT-P | RBS-P |
REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | X-Ray Chest-P
MEDICAL MO MO000033 CT for Anal Cancer MO000033200 Capecitabine + Mitomycin C 15000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Capecitabine + Mitomycin C BAR CODE OF THE DRUGS-C | CBC-P | CECT / MRI abdomen Pelvis-P | CHARTS OF
ONCOLOG 2 00562 Capecitabine 825mg/m2 PO twice daily till completion of RT Capecitabine 825mg/m2 PO twice daily till completion of RT CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Mitomycin 10mg/2 D1 Mitomycin 10mg/2 D1 DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000033 CT for Anal Cancer- MO000033300 CT for Anal Cancer-Carboplatin + Paclitaxel-Cycle 14900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Anal Cancer-Carboplatin + Paclitaxel-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT / MRI abdomen Pelvis-P | CHARTS OF
ONCOLOG 3 Carboplatin + 00563 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Paclitaxel-Cycle DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000033 CT for Anal Cancer- MO000033400 CT for Anal Cancer-Cisplatin + Paclitaxel-Cycle 13300 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Anal Cancer-Cisplatin + Paclitaxel-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT / MRI abdomen Pelvis-P | CHARTS OF
ONCOLOG 4 Cisplatin + 00564 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Paclitaxel-Cycle DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000033 CT for B - Cell NHL - MO000033500 Cyclophosphamide + Etoposide + Prednsiolone 7000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cyclophosphamide + Etoposide + Prednsiolone )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biopsy or
ONCOLOG 5 High Grade 00565 Cyclophosphamide 750 mg/m2 Cyclophosphamide 750 mg/m2 fluid-P | CBC,Biochemistry-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y (Except Burkitt's & Vincristine 1.4 mg/m2, on Day1 Vincristine 1.4 mg/m2, on Day1 notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
PCNSL) Etoposide 65mg/m2 Day 1 to 3 Etoposide 65mg/m2 Day 1 to 3 DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
Prednisolone 100 mg Day 1-5 Prednisolone 100 mg Day 1-5 flow cytometry-P | PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE
Total 6 cycles, repeat 21 days Total 6 cycles, repeat 21 days TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
MEDICAL MO MO000033 CT for B - Cell NHL - MO000033600 CT for B - Cell NHL - High Grade 26200 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for B - Cell NHL - High Grade )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 6 High Grade 00566 (Except Burkitt's & PCNSL)-R - CEOP (Except Burkitt's & PCNSL)-R - CEOP P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y (Except Burkitt's & notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
PCNSL)-R - CEOP DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
flow cytometry-P | PET CT or CECT Chest abdomen-P | Pelvis-P | REPORTS OF THE
MEDICAL MO MO000033 CT for B - Cell NHL - MO000033700 CT for B - Cell NHL - High Grade 27000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for B - Cell NHL - High Grade )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 7 High Grade 00567 (Except Burkitt's & PCNSL)-R - CHOP (Except Burkitt's & PCNSL)-R - CHOP P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y (Except Burkitt's & notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
PCNSL)-R - CHOP DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
flow cytometry-P | PET CT or CECT Chest abdomen-P | Pelvis-P | REPORTS OF THE
MEDICAL MO MO000033 CT for B - Cell NHL MO000033800 Cyclophosphamide + Doxorubicin + Prednsiolone 5000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cyclophosphamide + Doxorubicin + Prednsiolone )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 8 (Except Burkitt's & 00568 Cyclophosphamide 750 mg/m2 Cyclophosphamide 750 mg/m2 P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y PCNSL) Doxorubicin 50mg/m2 Doxorubicin 50mg/m2 notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Vincristine 1.4 mg/m2 on Day1 Vincristine 1.4 mg/m2 on Day1 DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
Prednisolone 100 mg Day 1-5 Prednisolone 100 mg Day 1-5 flow cytometry-P | PET CT or CECT Chest abdomen-P | Pelvis-P | REPORTS OF THE
Total 6 cycles, repeat 21 days Total 6 cycles, repeat 21 days TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
MEDICAL MO MO000033 CT for Brain MO000033900 Temozolamide 5000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Temozolamide BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 9 Tumor/ CA Brain 00569 Temozolomide 150 - 200 mg/m2 D1-D5 every 28 days Temozolomide 150 - 200 mg/m2 D1-D5 every 28 days Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology report/ IHC-P | LFT-P | MRI brain-P | RBS-P | REPORTS OF THE TESTS
(PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000034 CT for Burkitt's MO000034000 Codox - M - IVAC- cyclophosphamide, vincristine, 34500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Codox - M - IVAC- cyclophosphamide, vincristine, 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow
ONCOLOG 0 NHL 00570 doxorubicin, high-dose methotrexate / ifosfamide, doxorubicin, high-dose methotrexate / ifosfamide, cytometry-P | Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY
Y etoposide, high-dose cytarabine) etoposide, high-dose cytarabine) REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
GMALL (German multicenter acute lymphoblastic leukemia) GMALL (German multicenter acute lymphoblastic leukemia) OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Berlin- Frankfurt -Munster Berlin- Frankfurt -Munster ECG-P | PET CT or CECT Chest abdomen-P | Pelvis-P | REPORTS OF THE TESTS
Hyper CVAD (cyclophosphamide, Vincristine, Hyper CVAD (cyclophosphamide, Vincristine, (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
Adriamycin,Dexamethasone Adriamycin,Dexamethasone TRANFUSION SLIPS-C
Maximum 6 cycles every 3/4 weekly Maximum 6 cycles every 3/4 weekly
MEDICAL MO MO000034 CT for CA Brain MO000034100 Temozolamide 30000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Temozolamide BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 1 00571 Temozolomide 75mg/m2 once daily Temozolomide 75mg/m2 once daily Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology-P | LFT-P | MRI brain-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000034 CT for CA Breast MO000034200 Cyclophosphamide + Doxorubicin 4500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cyclophosphamide + Doxorubicin 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report
ONCOLOG 2 00572 every 21 days every 21 days of Modified radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen-P | Clinical notes
with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C
| DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | LFT-P | Pelvis in
case of metastatic disease-P | Pelvis-P | REPORTS OF THE TESTS (PATHOLOGY,
RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P |
TRANFUSION SLIPS-C | USG abdomen-P
MEDICAL MO MO000034 CT for CA Breast MO000034200 Docetaxel + Cyclophosphamide 9000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Docetaxel + Cyclophosphamide BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 2 00573 Docetaxel 75mg/m2 D1 Docetaxel 75mg/m2 D1 radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y Cyclophosphamide 600 mg/m2 D1 every 21 days ( Cyclophosphamide 600 mg/m2 D1 every 21 days ( Maximum CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen-P | Clinical notes
Maximum 6 Cycles ) 6 Cycles ) with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C
| DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | Pelvis in case of
metastatic disease-P | Pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
| USG abdomen-P
MEDICAL MO MO000034 CT for CA Breast MO000034200 Fulvestrant 12000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Fulvestrant BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 2 00574 Fulvestrant 500 mg D1 D15 D28 then every 28 days Fulvestrant 500 mg D1 D15 D28 then every 28 days radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest abdomen and pelvis-P |
Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ER or PR
positive-P | LFT-P | Mammography-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C | USG abdomen and pelvis-P
MEDICAL MO MO000034 CT for CA Breast MO000034200 Tamoxifen 1200 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Tamoxifen BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 2 00575 Tamoxifem 20 mg orally daily Tamoxifem 20 mg orally daily radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen and pelvis in case
of metastatic disease-P | Clinical notes with planned line of treatment-P | DISCHARGE
SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
DEPARTMENT-C | ER or PR positive-P | LFT-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C | USG abdomen and pelvis-P
MEDICAL MO MO000034 CT for CA Breast MO000034200 Trastuzumab 21000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Trastuzumab 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report
ONCOLOG 2 00576 Trastuzumab 8 mg/Kg in Cycle 1 D1 Trastuzumab 8 mg/Kg in Cycle 1 D1 of Modified radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y Trastuzumab 6 mg/kg D1 from C2 every 21 days ( Max 17 Trastuzumab 6 mg/kg D1 from C2 every 21 days ( Max 17 CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen and pelvis in case
cycles ) cycles ) of metastatic disease-P | Clinical notes with planned line of treatment-P | DISCHARGE
DEPARTMENT-C | ECG-P | Her-2 neu IHC - 3+ or Her 2-neu positive FISH-P | LFT-P |
BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | USG abdomen and pelvis-P
MEDICAL MO MO000034 CT for CA Breast / MO000034300 Weekly Paclitaxel for Paclitaxel 80mg/m2 every week ( Max 4000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Weekly Paclitaxel for Paclitaxel 80mg/m2 every week ( Max BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 3 Esophagus/ 00577 12 weeks ) 12 weeks ) radical mastectomy or breast conservation surgery-P | CBS-P | CHARTS OF
Y Stomach CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen and pelvis in case
of metastatic disease-P | Clinical notes with planned line of treatment-P | DISCHARGE
DEPARTMENT-C | LFT-P | Pelvis in case of metastatic disease-P | REPORTS OF THE
C | RFT-P | TRANFUSION SLIPS-C | USG abdomen and pelvis-P
MEDICAL MO MO000034 CT for CA Breast/ MO000034400 Capecitabine 7000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Capecitabine BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 4 Head & Neck/ 00578 Capecitabine - 1000mg/m2 orally twice daily D1-D14 every Capecitabine - 1000mg/m2 orally twice daily D1-D14 every radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y Colorectal/ 21 days 21 days CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen-P | Clinical notes
Esophagus/ with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C
Stoamch/ Gall | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | Pelvis in case of
bladder/ metastatic disease-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
pancreas/ MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
cholangiocarcino | USG abdomen and pelvis-P
ma/ Penile cancer
MEDICAL MO MO000034 CT for CA Breast/ MO000034500 Paclitaxel 12000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Paclitaxel BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 5 Lung/Ovary/ Head 00579 Paclitaxel 175 mg/m2 D1 every 21 days Maximum 6 cycles Paclitaxel 175 mg/m2 D1 every 21 days Maximum 6 cycles radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y & Neck/ CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest abdomen and pelvis-P |
Esophagus/Stoma Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
ch DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P |
Mammography-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | USG abdomen
and pelvis-P
MEDICAL MO MO000034 CT for CA MO000034600 Cisplatin/ Carboplatin + Paclitaxel / 15000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin/ Carboplatin + Paclitaxel / BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology report of Modified
ONCOLOG 6 Breast/Head & 00580 Paclitaxel + Carboplatin every 21 days Paclitaxel + Carboplatin every 21 days radical mastectomy or breast conservation surgery-P | CBC-P | CHARTS OF
Y Neck/ Ovary/ CHEMOTHERAPY REGIMEN-C | CXR PA view or CECThest+abdomen-P | Clinical notes
Endometrium/ with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C
Cervix/ Vulvar/ | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | Pelvis in case of
Urinary Bladder/ metastatic disease-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Anal Cancer MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
| USG abdomen and pelvis-P
MEDICAL MO MO000034 CT for CA Breast- MO000034700 CT for CA Breast-Letrozole-Duration + Cycle 3900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Breast-Letrozole-Duration + Cycle BAR CODE OF THE DRUGS-C | Biopsy Report -P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 7 Letrozole- 00581 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Duration + Cycle CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ER / PR
Positive-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000034 CT for CA Head & MO000034800 Carboplatin + Gemcitabine 14000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Carboplatin + Gemcitabine BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 8 Neck 00582 Gemcitabine 1000 mg/m2 D1 D8 Gemcitabine 1000 mg/m2 D1 D8 Carcinoma-P | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Carboplatin AUC 5-6 D1 every 21 days Carboplatin AUC 5-6 D1 every 21 days OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology-squamous-P | LFT-P | Nasopharyngeal carcinoma-P | RBS-P |
BIOCHEMISTRY,ETC.)-C | RFT-P | Salivary gland-P | TRANFUSION SLIPS-C
MEDICAL MO MO000034 CT for CA Head & MO000034800 Docetaxel + Cisplatin + 5 FU 14500 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Docetaxel + Cisplatin + 5 FU BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 8 Neck 00583 Docetaxel 75 mg/m2 D1 Docetaxel 75 mg/m2 D1 Carcinoma-P | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cisplatin 75 mg/m2 D1 Cisplatin 75 mg/m2 D1 OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
5 FU 750 mg/m2 D1- D5 every 21 days 5 FU 750 mg/m2 D1- D5 every 21 days Histopathology-squamous-P | LFT-P | Nasopharyngeal carcinoma-P | RBS-P |
BIOCHEMISTRY,ETC.)-C | RFT-P | Salivary gland-P | TRANFUSION SLIPS-C
MEDICAL MO MO000034 CT for CA Head & MO000034900 Carboplatin/ Cisplatin 3000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Carboplatin/ Cisplatin BAR CODE OF THE DRUGS-C | CBC-P | CECT/MR Face and neck-P | CHARTS OF
ONCOLOG 9 Neck/ Cervix/ 00584 every week every week CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Esophagus/ Vulva DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | Histopathology report-squamous carcinoma-P | LFT-P |
Nasopharyngeal carcinoma-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Head & MO000035000 CT for CA Head & Neck-Docetaxel-Duration + Cycle 14400 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Head & Neck-Docetaxel-Duration + Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT/MR Face and neck-P | CHARTS OF
ONCOLOG 0 Neck-Docetaxel- 00585 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Duration + Cycle DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | Histopathology report-squamous carcinoma-P | LFT-P |
Nasopharyngeal carcinoma-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Lung MO000035100 Docetaxel/ Paclitaxel 8500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Docetaxel/ Paclitaxel Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Biopsy / FNAC-P | CBC-P |
ONCOLOG 1 00586 Docetaxel 75 mg/m2 D1 every 21 days Docetaxel 75 mg/m2 D1 every 21 days CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | RBS-P | REPORTS OF
MEDICAL MO MO000035 CT for CA Lung MO000035100 Gefitnib 2500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Gefitnib Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 1 00587 Gefitinib 250 mg once daily Gefitinib 250 mg once daily CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | EGFR mutation positive-P | LFT-P | RBS-P | REPORTS OF
MEDICAL MO MO000035 CT for CA Lung MO000035100 Gemcitabine + Carboplatin 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Gemcitabine + Carboplatin Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 1 00588 Gemcitabine 1000 mg/m2 D1 D8 Gemcitabine 1000 mg/m2 D1 D8 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Carboplatin AUC 5-6 D1 every 21 days Carboplatin AUC 5-6 D1 every 21 days P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | Histopathology- Non Small cell Lung cancer-P | LFT-P |
RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
MEDICAL MO MO000035 CT for CA Lung MO000035100 Pemetrexed + Carboplatin 10000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Pemetrexed + Carboplatin Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 1 00589 Pemetrexed 500mg/m2 D1 Pemetrexed 500mg/m2 D1 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Carboplatin AUC 5-6 D1 every 21 days Carboplatin AUC 5-6 D1 every 21 days P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | Histopathology report(non small cell - adenocarcinoma or
adenosquamous carcinoma)-P | LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Lung MO000035100 Pemetrexed 7000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Pemetrexed Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 1 00590 Pemetrexed 500mg/m2 D1 every 21 days Pemetrexed 500mg/m2 D1 every 21 days CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
INPATIENT DEPARTMENT-C | Histopathology report(non small cell - adenocarcinoma or
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Lung/ MO000035200 Etoposide + Carboplatin/ Cisplatin 6000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Etoposide + Carboplatin/ Cisplatin Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 2 metastatic 00591 Etoposide 100mg/m2 D1 - D3 Etoposide 100mg/m2 D1 - D3 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Neuroendocrien Carboplatin AUC 5-6 D1 every 21 days Carboplatin AUC 5-6 D1 every 21 days P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
carcinoma INPATIENT DEPARTMENT-C | Histopathology report- Small Cell Lung Carcinoma-P | LFT-
(prostate/ Lung/ P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
GIT) HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Lung- MO000035300 CT for CA Lung-Paclitaxel + Carboplatin-Duration + Cycle 7900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Lung-Paclitaxel + Carboplatin-Duration + Cycle Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 3 Paclitaxel + 00592 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Carboplatin- P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Duration + Cycle INPATIENT DEPARTMENT-C | Histopathology report(non small cell - adenocarcinoma or
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Lung- MO000035300 CT for CA Lung-Paclitaxel + Carboplatin-Duration + Cycle 15100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Lung-Paclitaxel + Carboplatin-Duration + Cycle Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 3 Paclitaxel + 00593 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Carboplatin- P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Duration + Cycle INPATIENT DEPARTMENT-C | Histopathology report(non small cell - adenocarcinoma or
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Ovary MO000035400 Carboplatin/ Gemcitabine 14000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Carboplatin/ Gemcitabine Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT
ONCOLOG 4 00594 Gemcitabine - 1000mg/m2 D1 D8 Gemcitabine - 1000mg/m2 D1 D8 Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Y Carboplatin AUC 5-6 D1 only Repeat every 21 days Carboplatin AUC 5-6 D1 only Repeat every 21 days of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
SUMMARY OF INPATIENT DEPARTMENT-C | HPR or cytology suggestive of ovarian
adenocarcinoma-P | LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C
MEDICAL MO MO000035 CT for CA Ovary MO000035400 Lipodox + Carboplatin 17000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Lipodox + Carboplatin BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT abdomen and Pelvis-P |
ONCOLOG 4 00595 Lipopdox 30 mg/m2 D1 Lipopdox 30 mg/m2 D1 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Carboplatin AUC 5-6 D1 every 28 days maximum 6 cycles Carboplatin AUC 5-6 D1 every 28 days maximum 6 cycles P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | HPR or cytology suggestive of ovarian adenocarcinoma-P |
LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
MEDICAL MO MO000035 CT for CA Ovary MO000035400 Lipodox 18000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Lipodox BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT abdomen and Pelvis-P |
ONCOLOG 4 00596 Lipodox 40 mg/m2 IV every 28 days Maximum 6 cycles Lipodox 40 mg/m2 IV every 28 days Maximum 6 cycles CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
MEDICAL MO MO000035 CT for CA Ovary- MO000035500 CT for CA Ovary-Carboplatin + Paclitaxel-Cycle 14700 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Ovary-Carboplatin + Paclitaxel-Cycle BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT abdomen and Pelvis-P |
ONCOLOG 5 Carboplatin + 00597 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Paclitaxel-Cycle P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000035 CT for CA Ovary- MO000035600 CT for CA Ovary-Cisplatin + Irinotecan-Cycle 10200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Ovary-Cisplatin + Irinotecan-Cycle BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT abdomen and Pelvis-P |
ONCOLOG 6 Cisplatin + 00598 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Irinotecan-Cycle P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000035 CT for CA Ovary- MO000035700 CT for CA Ovary-Etoposide-Duration + Cycle 3400 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Ovary-Etoposide-Duration + Cycle BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT abdomen and Pelvis-P |
ONCOLOG 7 Etoposide- 00599 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
Y Duration + Cycle P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000035 CT for CA Ovary- MO000035800 CT for CA Ovary-Irinotecan-Cycle 8400 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Ovary-Irinotecan-Cycle BAR CODE OF THE DRUGS-C | CA-125-P | CBC-P | CECT abdomen and Pelvis-P |
ONCOLOG 8 Irinotecan-Cycle 00600 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
MEDICAL MO MO000035 CT for CA Penis MO000035900 Capecitabine 7500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Capecitabine BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 9 00601 Capecitabine 1000-1250 mg/m2 PO twice daily D1 -D14 Capecitabine 1000-1250 mg/m2 PO twice daily D1 -D14 Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y every 21 days every 21 days DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P |
BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | abdomen and Pelvis-P |
histopathology report-P
MEDICAL MO MO000036 CT for CA Penis- MO000036000 CT for CA Penis-Cisplatin + Paclitaxel-Cycle 13500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Penis-Cisplatin + Paclitaxel-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 0 Cisplatin + 00602 Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y Paclitaxel-Cycle DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P |
MEDICAL MO MO000036 CT for CA Penis- MO000036100 CT for CA Penis-Paclitaxel + Carboplatin-Cycle 15100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Penis-Paclitaxel + Carboplatin-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 1 Paclitaxel + 00603 Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y Carboplatin-Cycle DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P |
MEDICAL MO MO000036 CT for CA Penis- MO000036200 CT for CA Penis-Paclitaxel-Duration + Cycle 5700 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for CA Penis-Paclitaxel-Duration + Cycle BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 2 Paclitaxel- 00604 Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y Duration + Cycle DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P |
MEDICAL MO MO000036 CT for CA Prostate MO000036300 Etoposide + Carboplatin 8000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Etoposide + Carboplatin Prosate-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen -P | CHARTS OF
ONCOLOG 3 00607 Etoposide 100mg/m2 D1 - D3 Etoposide 100mg/m2 D1 - D3 CHEMOTHERAPY REGIMEN-C | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Y Carboplatin AUC 5-6 D1 every 21 days Carboplatin AUC 5-6 D1 every 21 days DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | LFT-P | PSA-P |
Pelvis / MRI aabdomen-P | Pelvis / PSMA PET / bone scan-P | Prosate-P | REPORTS OF
BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | histopathology report-P
MEDICAL MO MO000036 CT for CA Prostate MO000036300 Docetaxel 8500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Docetaxel BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen -P | CHARTS OF
ONCOLOG 3 00606 Docetaxel 75 mg/m2 D1 every 21 days Docetaxel 75 mg/m2 D1 every 21 days CHEMOTHERAPY REGIMEN-C | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Y DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | LFT-P | PSA-P |
Pelvis / MRI aabdomen -P | Pelvis / PSMA PET / bone scan-P | Prosate-P | Prosate-P |
MEDICAL MO MO000036 CT for CA Prostate MO000036300 Abiraterone 1000 mg + Prednisolone 10mg daily 13000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Abiraterone 1000 mg + Prednisolone 10mg daily BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen -P | CHARTS OF
ONCOLOG 3 00605 Once every month Once every month CHEMOTHERAPY REGIMEN-C | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
MEDICAL MO MO000036 CT for CA Prostate MO000036300 LHRH Agonist 15000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N LHRH Agonist BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen -P | CHARTS OF
ONCOLOG 3 00608 Leuprolide 22.5 ug every 3 months Leuprolide 22.5 ug every 3 months CHEMOTHERAPY REGIMEN-C | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
MEDICAL MO MO000036 CT for CD 20 MO000036400 Rituximab 16000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Rituximab abdomen and pelvis-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid
ONCOLOG 4 Lymphoma B Cell 00609 Rituximab 375mg/m2 Maximum 6 cycles as per protocol Rituximab 375mg/m2 Maximum 6 cycles as per protocol flow cytometry / IHC Report -P | Bone marrow studies-P | CBC-P | CECT Chest-P |
Y NHL / ITP / AIHA CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | HBs Ag-P | HCV-P | REPORTS OF THE TESTS
TRANFUSION SLIPS-C
MEDICAL MO MO000036 CT for Cervical MO000036500 Cisplatin/ Carboplatin 2500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin/ Carboplatin ,histopathology report-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT / MRI abdomen
ONCOLOG 5 /Vulvar Cancer 00610 Cisplatin 40 mg/m2 every week maximum 6 cycles Cisplatin 40 mg/m2 every week maximum 6 cycles and Pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
MEDICAL MO MO000036 CT for Chronic MO000036600 Fludarabine + Cyclophosphamide 18000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Fludarabine + Cyclophosphamide BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies / Biopsy or fluid
ONCOLOG 6 Lymphocytic 00611 Fludarabine 25mg/m2 D1-3 Fludarabine 25mg/m2 D1-3 flow cytometry. -P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Chest X ay and
Y Leukemia Cyclophosphamide 250 mg/m2 D1-3 every 28 days for 6 Cyclophosphamide 250 mg/m2 D1-3 every 28 days for 6 USG abdomen / pelvis-P | Clinical notes with planned line of treatment-P | DISCHARGE
cycles cycles SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
MEDICAL MO MO000036 CT for Chronic MO000036700 CT for Chronic Lymphocytic Leukemia-Lenalidomide- 4800 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Chronic Lymphocytic Leukemia-Lenalidomide- BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies / Biopsy or fluid
ONCOLOG 7 Lymphocytic 00612 Duration + Cycle Duration + Cycle flow cytometry. -P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Chest X ay and
Y Leukemia- USG abdomen / pelvis-P | Clinical notes with planned line of treatment-P | DISCHARGE
Lenalidomide- SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
Duration + Cycle DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
MEDICAL MO MO000036 CT for Chronic MO000036800 CT for Chronic Lymphocytic Leukemia-Rituxmab + 24900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Chronic Lymphocytic Leukemia-Rituxmab + BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 8 Lymphocytic 00613 Chlorambucil-Cycle Chlorambucil-Cycle REGIMEN-C | Chest X ay and USG abdomen / pelvis, Bone marrow studies / Biopsy or
Y Leukemia- fluid flow cytometry. -P | Clinical notes with planned line of treatment-P | DISCHARGE
Rituxmab + SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
Chlorambucil- DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
Cycle HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000036 CT for Chronic MO000036900 Imatinib 2000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Imatinib BAR CODE OF THE DRUGS-C | BIOPSY-P | BONE MARROW-P | CBC-P | CHARTS OF
ONCOLOG 9 Myeloid 00614 Imatinib 400 mg, 600 mg, 800 mg Imatinib 400 mg, 600 mg, 800 mg CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Leukemia/ Ph +ve (per month X 5 years) (per month X 5 years) DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
ALL INPATIENT DEPARTMENT-C | LFT-P | REPORTS OF THE TESTS (PATHOLOGY,
RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | RQ PCR
/ FISH BCR ABL-P | TRANFUSION SLIPS-C
MEDICAL MO MO000037 CT for Chronic MO000037000 Dasatinib 5000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Dasatinib BAR CODE OF THE DRUGS-C | BIOPSY-P | BONE MARROW-P | CBC-P | CHARTS OF
ONCOLOG 0 Myeloid 00615 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Leukemia/ Ph+Ve DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
ALL/ AML (Both INPATIENT DEPARTMENT-C | LFT-P | REPORTS OF THE TESTS (PATHOLOGY,
adult and RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | RQ PCR
Paediatric) / FISH BCR ABL-P | TRANFUSION SLIPS-C
MEDICAL MO MO000037 CT for Colorectal MO000037100 5 FU + Leucovorin + Oxaliplatin 14000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N 5 FU + Leucovorin + Oxaliplatin BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 1 Cancer 00616 5 FU 1200mg/m2 D1 D2 5 FU 1200mg/m2 D1 D2 REGIMEN-C | Clinical notes with planned line of treatment-P | Colonoscopy-P |
Y Leucovorin 400mg/m2 D1 Leucovorin 400mg/m2 D1 DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Oxaliplatin 85 mg/m2 D1 every 14 days Oxaliplatin 85 mg/m2 D1 every 14 days INPATIENT DEPARTMENT-C | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
RFT-P | TRANFUSION SLIPS-C | abdomen-P | histopathology report-P
MEDICAL MO MO000037 CT for Colorectal MO000037100 5FU + Leucovorin + Irinotecan 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N 5FU + Leucovorin + Irinotecan BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
Irinotecan 180mg/m2 85 mg/m2 D1 every 14 days Irinotecan 180mg/m2 85 mg/m2 D1 every 14 days INPATIENT DEPARTMENT-C | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000037 CT for Colorectal MO000037100 5FU + Leucovorin + Oxaliplatin + Irinotecan 18000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N 5FU + Leucovorin + Oxaliplatin + Irinotecan BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
Oxaliplatin 85 mg/m2 D1 Oxaliplatin 85 mg/m2 D1 INPATIENT DEPARTMENT-C | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
Irinotecan 180mg/m2 every 14 days Irinotecan 180mg/m2 every 14 days (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
MEDICAL MO MO000037 CT for Colorectal MO000037100 Capecitabine + Irinotecan 12000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Capecitabine + Irinotecan BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 1 Cancer 00619 Capecitabine 1000mg/m2 D1-D14 Capecitabine 1000mg/m2 D1-D14 REGIMEN-C | Clinical notes with planned line of treatment-P | Colonoscopy-P |
Y Irinotecan 200 mg/m2 D1 every 21 days Irinotecan 200 mg/m2 D1 every 21 days DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000037 CT for Colorectal MO000037100 Capecitabine along with RT 7000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Capecitabine along with RT BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 1 Cancer 00620 Capecitabine 825 mg/m2 twice daily Capecitabine 825 mg/m2 twice daily REGIMEN-C | Clinical notes with planned line of treatment-P | Colonoscopy-P |
Y DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C | abdomen, Pelvis-P | histopathology report-P
MEDICAL MO MO000037 CT for Colorectal MO000037200 Capecitabine + Oxaliplatin 12500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Capecitabine + Oxaliplatin BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 2 Cancer/ 00621 Capecitabine 1000mg/m2 D1-D14 Capecitabine 1000mg/m2 D1-D14 REGIMEN-C | Clinical notes with planned line of treatment-P | Colonoscopy-P |
Y Esophagus/ Oxaliplatin 130 mg/m2 D1 every 21 days Oxaliplatin 130 mg/m2 D1 every 21 days DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Gastric/ Gall INPATIENT DEPARTMENT-C | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
Bladder/ (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
Pancreas/ RFT-P | TRANFUSION SLIPS-C | abdomen-P | histopathology report-P
Cholangiocarcino
ma
MEDICAL MO MO000037 CT for Colorectal MO000037300 CT for Colorectal Cancer-5 FU + Leucovorin-Cycle 4700 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Colorectal Cancer-5 FU + Leucovorin-Cycle Pelvis-P | histopathology report-P | BAR CODE OF THE DRUGS-C | CBC-P | CEA,-P |
ONCOLOG 3 Cancer-5 FU + 00622 CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Leucovorin-Cycle treatment-P | Colonoscopy-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | abdomen,-P
MEDICAL MO MO000037 CT for Colorectal MO000037400 CT for Colorectal Cancer-Capecitabine 7200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Colorectal Cancer-Capecitabine CBC-P | BAR CODE OF THE DRUGS-C | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 4 Cancer- 00623 REGIMEN-C | Clinical notes with planned line of treatment-P | Colonoscopy-P |
Y Capecitabine DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000037 CT for Colorectal MO000037500 CT for Colorectal Cancer-Folfirinox-Cycle 15100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Colorectal Cancer-Folfirinox-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CEA-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 5 Cancer-Folfirinox- 00624 REGIMEN-C | Clinical notes with planned line of treatment-P | Colonoscopy-P |
Y Cycle DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
MEDICAL MO MO000037 CT for MO000037600 Carboplatin + Gemcitabine 14000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Carboplatin + Gemcitabine BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 6 Endometrial 00625 Gemcitabine - 1000mg/m2 D1 D8 Gemcitabine - 1000mg/m2 D1 D8 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Cancer Carboplatin AUC 2 D1 D8 Carboplatin AUC 2 D1 D8 CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P
Gemcitabine - 1000mg/m2 D1 D8 Gemcitabine - 1000mg/m2 D1 D8 | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
Carboplatin AUC 5-6 D1 only every 3 weeks Carboplatin AUC 5-6 D1 only every 3 weeks HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | abdomen and
Pelvis-P | histopathology report-P
MEDICAL MO MO000037 CT for MO000037600 Cisplatin + Doxorubicin 4500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + Doxorubicin BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 6 Endometrial 00626 Doxorubicin 60 mg/m2 D1 Doxorubicin 60 mg/m2 D1 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Cancer Cisplatin 50mg/m2 every 3 weeks Cisplatin 50mg/m2 every 3 weeks CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | abdomen and
MEDICAL MO MO000037 CT for MO000037600 Lipodox + Carboplatin 17000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Lipodox + Carboplatin BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 6 Endometrial 00627 Lipopdox 30 mg/m2 D1 Lipopdox 30 mg/m2 D1 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Cancer Carboplatin AUC 5 D1 every 28 days Carboplatin AUC 5 D1 every 28 days CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | abdomen and
MEDICAL MO MO000037 CT for MO000037700 CT for Endometrial Cancer-Carboplatin + Paclitaxel-Cycle 14900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Endometrial Cancer-Carboplatin + Paclitaxel-Cycle ,RBS-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 7 Endometrial 00628 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cancer- OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Carboplatin + LFT-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
Paclitaxel-Cycle HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | abdomen and
MEDICAL MO MO000037 CT for Esophageal MO000037800 Cisplatin + Docetaxel 14000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + Docetaxel BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 8 / Stomach Cancer 00629 Docetaxel 40mg/m2 D1 Docetaxel 40mg/m2 D1 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cisplatin 40 mg/m2 D1 Cisplatin 40 mg/m2 D1 OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Leucovorin 400mg/m2 D1 Leucovorin 400mg/m2 D1 LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
5FU 1000mg/m2 D1 D2 every 14 days 5FU 1000mg/m2 D1 D2 every 14 days HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | UGI
endoscospy-P | abdomen-P | histopathology report-P
MEDICAL MO MO000037 CT for Esophageal MO000037800 Docetaxel + Oxaliplatin + 5 FU 18500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Docetaxel + Oxaliplatin + 5 FU BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
Y Oxaliplatin 85 mg/m2 D1 Oxaliplatin 85 mg/m2 D1 OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Leucovorin 400mg/m2 D1 Leucovorin 400mg/m2 D1 LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
5FU 1200mg/m2 D1 D2 every 14 days 5FU 1200mg/m2 D1 D2 every 14 days HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | UGI
MEDICAL MO MO000037 CT for Esophageal MO000037800 Docetaxel + Oxaliplatin + Capecitabine 18500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Docetaxel + Oxaliplatin + Capecitabine BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
Y Oxaliplatin 85 mg/m2 D1 Oxaliplatin 85 mg/m2 D1 OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Capecitabine 825 mg/m2 Twice daily every 14 days Capecitabine 825 mg/m2 Twice daily every 14 days LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | UGI
MEDICAL MO MO000037 CT for Esophageal MO000037900 CT for Esophageal / Stomach Cancer-Capecitabine-Cycle 7200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Esophageal / Stomach Cancer-Capecitabine-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 9 / Stomach Cancer- 00632 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Capecitabine- OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Cycle LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
MEDICAL MO MO000038 CT for Esophageal MO000038000 CT for Esophageal / Stomach Cancer-CAPOX-Cycle 16500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Esophageal / Stomach Cancer-CAPOX-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 0 / Stomach Cancer- 00633 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y CAPOX-Cycle OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
MEDICAL MO MO000038 CT for Esophageal MO000038100 CT for Esophageal / Stomach Cancer-Cisplatin + Docetaxel- 12100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Esophageal / Stomach Cancer-Cisplatin + Docetaxel- BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 1 / Stomach Cancer- 00634 Duration + Cycle Duration + Cycle REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cisplatin + OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Docetaxel- LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
Duration + Cycle HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | UGI
MEDICAL MO MO000038 CT for Esophageal MO000038200 CT for Esophageal / Stomach Cancer-Folfox-Cycle 11100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Esophageal / Stomach Cancer-Folfox-Cycle abdomen-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF
ONCOLOG 2 / Stomach Cancer- 00635 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Folfox-Cycle DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY,
TRANFUSION SLIPS-C | UGI endoscospy-P | histopathology report-P
MEDICAL MO MO000038 CT for Esophageal MO000038300 Cisplatin + 5 FU 14000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + 5 FU BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 3 Cancer 00636 Cisplatin 75mg/m2 D1 D29 Cisplatin 75mg/m2 D1 D29 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y 5FU 1000mg/m2 D1-D4 D29 D32 every 35 days 5FU 1000mg/m2 D1-D4 D29 D32 every 35 days OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
MEDICAL MO MO000038 CT for Esophageal MO000038400 CT for Esophageal Cancer-Carboplatin + Paclitaxel-Duration 14900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Esophageal Cancer-Carboplatin + Paclitaxel-Duration BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 4 Cancer- 00637 + Cycle + Cycle REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Carboplatin + OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Paclitaxel- LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
Duration + Cycle HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | UGI
MEDICAL MO MO000038 CT for Esophageal MO000038500 CT for Esophageal Cancer-Paclitaxel + Carboplatin for 25100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Esophageal Cancer-Paclitaxel + Carboplatin for BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 5 Cancer-Paclitaxel 00638 deﬁni ve Non - metasta c deﬁni ve Non - metasta c REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y + Carboplatin for (With RT)-Cycle (With RT)-Cycle OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
definitive Non - LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
metasta c HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | UGI
(With RT)-Cycle endoscospy-P | abdomen-P | histopathology report-P
MEDICAL MO MO000038 CT for Ewing MO000038600 Vincristine + Adriamycin + Cyclophosphamide 25000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Vincristine + Adriamycin + Cyclophosphamide 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | Bone marrow
ONCOLOG 6 Sarcoma 00639 Ifosfamide + Etoposide Ifosfamide + Etoposide studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with
Y Ifosfamide: 1800mg/m2 (days1-5) Ifosfamide: 1800mg/m2 (days1-5) planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Etposide: 100mg/sq.m (days 1-5) Etposide: 100mg/sq.m (days 1-5) DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | IHC-P | PET CT or CT
Vincristine 1.5mg/m2 (day 1 and 8) Vincristine 1.5mg/m2 (day 1 and 8) Chest abdomen pelvis / Bone Scan-P | REPORTS OF THE TESTS (PATHOLOGY,
Adriamyicn: 75mg/m2 (day 1) Adriamyicn: 75mg/m2 (day 1) RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
Cyclophosphamide 1200mg/m2 (day 1) Cyclophosphamide 1200mg/m2 (day 1) SLIPS-C
Given 2-3 weekly Given 2-3 weekly
MEDICAL MO MO000038 CT for Ewing MO000038600 Vincristine + Topotecan + Cyclophosphamide + Irinotecan + 22000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Vincristine + Topotecan + Cyclophosphamide + Irinotecan + 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | Bone marrow
ONCOLOG 6 Sarcoma 00640 Temozolamide Temozolamide studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with
Y Vincristine 1.5mg/m2( day 1) Vincristine 1.5mg/m2( day 1) planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Topotecan 1.5mg/m2 (day 1-5) Topotecan 1.5mg/m2 (day 1-5) DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | IHC-P | PET CT or CT
Cyclophosphamide 250mg/m2 (days 1-5) Cyclophosphamide 250mg/m2 (days 1-5) Chest abdomen pelvis / Bone Scan-P | REPORTS OF THE TESTS (PATHOLOGY,
Given every 3 weeks Given every 3 weeks RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
Irinotecan 10-50 mg/sqM days 1-5 and days 8-12 Irinotecan 10-50 mg/sqM days 1-5 and days 8-12 SLIPS-C
Temozolamide 100mg/m2 days 1-5 of each cycle every 3 Temozolamide 100mg/m2 days 1-5 of each cycle every 3
weeks weeks
MEDICAL MO MO000038 CT for Ewing MO000038700 CT for Ewing Sarcoma-EFT 2001 9700 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Ewing Sarcoma-EFT 2001 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | Bone marrow
ONCOLOG 7 Sarcoma-EFT 2001 00641 studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with
Y planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | IHC-P | PET CT or CT
Chest abdomen pelvis / Bone Scan-P | REPORTS OF THE TESTS (PATHOLOGY,
SLIPS-C
MEDICAL MO MO000038 CT for Gall Bladder MO000038800 Cisplatin + Gemcitabine 12000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + Gemcitabine BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 8 Cancer / 00642 Gemcitabine 1000 mg/m2 D1 D8 Gemcitabine 1000 mg/m2 D1 D8 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Cholangiocarcino Cisplatin 25 mg/m2 D1 D8 every 21 days Cisplatin 25 mg/m2 D1 D8 every 21 days CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
ma Histopathology / FNAC-P | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
RFT-P | TRANFUSION SLIPS-C | abdomen-P
MEDICAL MO MO000038 CT for Gall Bladder MO000038800 Gemcitabine 9000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Gemcitabine BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 8 Cancer / 00643 Gemcitabine 1000mg /m2 D1 D8 every 21 days Gemcitabine 1000mg /m2 D1 D8 every 21 days C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Cholangiocarcino CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
ma Histopathology / FNAC-P | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
RFT-P | TRANFUSION SLIPS-C | abdomen -P
MEDICAL MO MO000038 CT for Gall Bladder MO000038800 Oxaliplatin + Gemcitabine 17000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Oxaliplatin + Gemcitabine Abdomen-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF
ONCOLOG 8 Cancer / 00644 Gemcitabine 1000 mg/m2 D1 Gemcitabine 1000 mg/m2 D1 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Cholangiocarcino Oxaliplatin 100 mg/m2 D1 every 14 days Oxaliplatin 100 mg/m2 D1 every 14 days DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
ma INPATIENT DEPARTMENT-C | Histopathology / FNAC-P | LFT-P | Pelvis-P | RBS-P |
MEDICAL MO MO000038 CT for Gall Bladder MO000038900 CT for Gall Bladder Cancer / Cholangiocarcinoma- 9000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Gall Bladder Cancer / Cholangiocarcinoma- Abdomen-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT-P | CHARTS OF
ONCOLOG 9 Cancer / 00645 Gemcitabine-Duration + Cycle Gemcitabine-Duration + Cycle CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Cholangiocarcino DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
ma-Gemcitabine- INPATIENT DEPARTMENT-C | Histopathology / FNAC-P | LFT-P | Pelvis-P | RBS-P |
Duration + Cycle REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
MEDICAL MO MO000039 CT for MO000039000 Sunitinib 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Sunitinib Abdomen-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF
ONCOLOG 0 Gastointestinal 00646 Sunitinb 37.5 mg once daily Sunitinb 37.5 mg once daily CHEMOTHERAPY REGIMEN-C | Ckit-mutation / PDGFR-P | Clinical notes with planned
Y stromal tumor line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | Histopathology/FNAC-P | LFT-P
| Pelvis-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000039 CT for Germ Cell MO000039100 Etoposide + Cisplatin 11000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Etoposide + Cisplatin AFP-P | Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P |
ONCOLOG 1 Tumor 00647 Cisplatin 20 mg/m2 IV D1-D5 Cisplatin 20 mg/m2 IV D1-D5 CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y Etoposide 100mg/m2 D1-D5 every 21 days Etoposide 100mg/m2 D1-D5 every 21 days line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | Histopathology report-
Ovarian-P | LDH-P | LFT-P | Mediastinal-P | RBS-P | REPORTS OF THE TESTS
(PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,PFT, ETC.)-C
| RFT-P | TRANFUSION SLIPS-C | Testicular-P
MEDICAL MO MO000039 CT for Germ Cell MO000039100 Paclitaxel + Ifosfamide + Cisplatin 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Paclitaxel + Ifosfamide + Cisplatin AFP-P | Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P |
ONCOLOG 1 Tumor 00648 Paclitaxel 240 mg/m2 D1 Paclitaxel 240 mg/m2 D1 CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y Ifosfamide 1500mg/m2 D2-D5 Ifosfamide 1500mg/m2 D2-D5 line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Mesna 300 mg/m2 0h 4h 8h D2-D5 Mesna 300 mg/m2 0h 4h 8h D2-D5 DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | Histopathology report-
Cisplatin 25mg/m2 D2-D5 every 21 days Cisplatin 25mg/m2 D2-D5 every 21 days Ovarian-P | LDH-P | LFT-P | Mediastinal-P | RBS-P | REPORTS OF THE TESTS
RFT-P | TRANFUSION SLIPS-C | Testicular-P
MEDICAL MO MO000039 CT for Germ Cell MO000039100 Vinblastin + Ifosfamide + Cisplatin 13000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Vinblastin + Ifosfamide + Cisplatin AFP-P | Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P |
ONCOLOG 1 Tumor 00649 Vinblastine 0.11 mg/kg IV D1-D2 Vinblastine 0.11 mg/kg IV D1-D2 CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y Mesna 240mg/m2 0h 4h 8h D1-D5 Mesna 240mg/m2 0h 4h 8h D1-D5 line of treatment, CBC, LFT, RFT, RBS, Beta- HCG, AFP, LDH,CECT Thorax, abdomen and
Ifosfamide 1200mg/m2 D1-D5 Ifosfamide 1200mg/m2 D1-D5 Pelvis, ECG, histopathology report-Ovarian, testicular, mediastinal -P | DISCHARGE
Cisplatin 20 mg/m2 D1-D5 every 21 days for 3 months Cisplatin 20 mg/m2 D1-D5 every 21 days for 3 months SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
maximun 6 cycles maximun 6 cycles DEPARTMENT-C | ECG-P | Histopathology report-Ovarian-P | LDH-P | LFT-P |
Mediastinal-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
| Testicular-P
MEDICAL MO MO000039 CT for Germ Cell MO000039200 Bleomycin + Etoposide + Cisplatin 15000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Bleomycin + Etoposide + Cisplatin AFP-P | Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P |
ONCOLOG 2 Tumor (Ovary/ 00650 Bleomycin 30 units D1 D8 D15 Bleomycin 30 units D1 D8 D15 CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y testis/ Cisplatin 20 mg/m2 IV D1-D5 Cisplatin 20 mg/m2 IV D1-D5 line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Mediastinal) Etoposide 100mg/m2 D1-D5 every 21 days Etoposide 100mg/m2 D1-D5 every 21 days DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | Histopathology report-
(PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,PFT, ETC.)-C
| RFT-P | TRANFUSION SLIPS-C | Testicular-P
MEDICAL MO MO000039 CT for Germ Cell MO000039300 CT for Germ Cell Tumor-Carboplatin (AUC 7)-Cycle 5800 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Germ Cell Tumor-Carboplatin (AUC 7)-Cycle AFP-P | Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P |
ONCOLOG 3 Tumor- 00651 CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y Carboplatin (AUC line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
7)-Cycle DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P | Histopathology report-
RFT-P | TRANFUSION SLIPS-C | Testicular-P
MEDICAL MO MO000039 CT for Gestational MO000039400 Etoposide + Methotrexate + Dactinomycin + Cisplatin 13000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Etoposide + Methotrexate + Dactinomycin + Cisplatin Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P | CECT
ONCOLOG 4 Trophoblastic 00652 Etoposide 100mg/m2 IV D1 D2 D8 Etoposide 100mg/m2 IV D1 D2 D8 Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Y Neoplasia Dactinomycin 0.5 mg IV push D1 D2 Methotrexate 300 mg Dactinomycin 0.5 mg IV push D1 D2 Methotrexate 300 mg of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
/m2 D1 /m2 D1 SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | LFT-P | RBS-P | REPORTS OF THE
Leucovorin 15 mg PO every 12 hrs for 4 doses Cisplatin Leucovorin 15 mg PO every 12 hrs for 4 doses Cisplatin TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
75mg/m2 D8 every 2 weeks 75mg/m2 D8 every 2 weeks C | RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000039 CT for Gestational MO000039400 Etoposide + Methotrexate + Dactinomycin- 12000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Etoposide + Methotrexate + Dactinomycin- Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P | CECT
ONCOLOG 4 Trophoblastic 00653 Cyclophosphamide + Vincristine Cyclophosphamide + Vincristine Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Y Neoplasia Etoposide 100mg/m2 IV D1 D2 Etoposide 100mg/m2 IV D1 D2 of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Dactinomycin 0.5 mg IV push D1 D2 Dactinomycin 0.5 mg IV push D1 D2 SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | LFT-P | RBS-P | REPORTS OF THE
Methotrexate 300 mg /m2 D1 Methotrexate 300 mg /m2 D1 TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
Leucovorin 15 mg PO every 12 hrs for 4 doses Leucovorin 15 mg PO every 12 hrs for 4 doses C | RFT-P | TRANFUSION SLIPS-C
Cyclophosphamide 600mg/m2 D8 Cyclophosphamide 600mg/m2 D8
Vincrstine 1 mg/m2 D8 every 2 weeks Vincrstine 1 mg/m2 D8 every 2 weeks
MEDICAL MO MO000039 CT for Gestational MO000039400 Methotrexate 1000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Methotrexate Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P | CECT
ONCOLOG 4 Trophoblastic 00654 Methotrexate 1/mg/kg IM every other day x 4 days D1 3 D5 Methotrexate 1/mg/kg IM every other day x 4 days D1 3 D5 Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Y Neoplasia D7 D7 of treatment, CBC, LFT, RFT, RBS, Beta- HCG, CECT Thorax, abdomen and Pelvis, HPR-P |
Alternating every other day with Alternating every other day with DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Leucovorin 15 mg PO repeat every 14 days Leucovorin 15 mg PO repeat every 14 days INPATIENT DEPARTMENT-C | HPR-P | LFT-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000039 CT for Gestational MO000039500 CT for Gestational Trophoblastic Neoplasia-EMA - EP-Cycle 12200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Gestational Trophoblastic Neoplasia-EMA - EP-Cycle Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P | CECT
ONCOLOG 5 Trophoblastic 00655 Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Y Neoplasia-EMA - of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
EP-Cycle SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | LFT-P | RBS-P | REPORTS OF THE
C | RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000039 CT for Gestational MO000039600 CT for Gestational Trophoblastic Neoplasia-Methotrexate- 1100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Gestational Trophoblastic Neoplasia-Methotrexate- Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | Beta- HCG-P | CBC-P | CECT
ONCOLOG 6 Trophoblastic 00656 Duration + Cycle Duration + Cycle Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line
Y Neoplasia- of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Methotrexate- SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | LFT-P | RBS-P | REPORTS OF THE
Duration + Cycle TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-
MEDICAL MO MO000039 CT for MO000039700 Lenvatinib 4- 12 mg daily 17000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Lenvatinib 4- 12 mg daily AFP-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 7 Hepatocellular 00657 C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Carcinoma CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HBsAg-
P | HCV-P | LFT-P | Pelvis / histopathology report-P | RBS-P | REPORTS OF THE
C | RFT-P | TRANFUSION SLIPS-C | Triphasic CECT abdomen-P
MEDICAL MO MO000039 CT for MO000039700 Sorafenib 6000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Sorafenib AFP-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-
ONCOLOG 7 Hepatocellular 00658 Sorafenib 400mg PO twice daily Sorafenib 400mg PO twice daily C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY
Y Carcinoma CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HBsAg-
P | HCV-P | LFT-P | Pelvis / histopathology report-P | RBS-P | REPORTS OF THE
C | RFT-P | TRANFUSION SLIPS-C | Triphasic CECT abdomen-P
MEDICAL MO MO000039 CT for High - MO000039800 DHAP Dexamethasone + High Dose Cytarabine + Cisplatin 14000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N DHAP Dexamethasone + High Dose Cytarabine + Cisplatin BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 8 Grade NHL - B Cell 00659 Cytarabine 2g/m2 BD on day 2 Cytarabine 2g/m2 BD on day 2 Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Dexamethasone 40 mg Day 1 - 4 Dexamethasone 40 mg Day 1 - 4 notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Cisplatin 75mg/m2 or Cisplatin 75mg/m2 or DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or
Carboplatin AUC-5 on day 1 Carboplatin AUC-5 on day 1 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Cycle to be repeated every 21days maximum cycles-6 Cycle to be repeated every 21days maximum cycles-6 MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000039 CT for High - MO000039900 CT for High - Grade NHL - B Cell-Rituxmab + Dexamethasone 34900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for High - Grade NHL - B Cell-Rituxmab + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 9 Grade NHL - B Cell- 00660 + + Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Rituxmab + High Dose Cytarabine + Cisplatin-Cycle High Dose Cytarabine + Cisplatin-Cycle notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Dexamethasone + DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or
High Dose CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Cytarabine + MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
Cisplatin-Cycle
MEDICAL MO MO000040 CT for Hodgkin's MO000040000 AEVD 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N AEVD BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 0 Lymphoma 00662 Adriamycin 25mg/m2 Adriamycin 25mg/m2 Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Vinblastine 6mg/m2 Vinblastine 6mg/m2 notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Dacarbazine 375 mg/m2 Day 1,15 Dacarbazine 375 mg/m2 Day 1,15 DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or
Etoposide 65mg/m2 Day 1-3, 15-17 Etoposide 65mg/m2 Day 1-3, 15-17 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Every 28 days for 6 cycles Every 28 days for 6 cycles MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000040 CT for Hodgkin's MO000040000 ABVD Adriamycin 25mg/m2 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N ABVD Adriamycin 25mg/m2 BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 0 Lymphoma 00661 Bleomycin 10unit/m2 Bleomycin 10unit/m2 Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Vinblastine 6mg/m2 Vinblastine 6mg/m2 notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
Dacarbazine 375 mg/m2 All drugs Day 1,15 Dacarbazine 375 mg/m2 All drugs Day 1,15 and pelvis, Bone marrow studies, Biopsy or fluid flow cytometry / IHC -P | DISCHARGE
Every 28 days for Maximum 6 cycles Every 28 days for Maximum 6 cycles SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
DEPARTMENT-C | PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE
MEDICAL MO MO000040 CT for Hodgkin's MO000040000 COPP 4000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N COPP BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 0 Lymphoma 00663 Cyclophosphamide 650mg/m2 D1, 8 Cyclophosphamide 650mg/m2 D1, 8 Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Vincristine 1.4mg/m2 D1, 8 Vincristine 1.4mg/m2 D1, 8 notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Procarbazine 100 mg/m2 D1-14 Procarbazine 100 mg/m2 D1-14 DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or
Prednisolone 40mg/m2 D1-14 Prednisolone 40mg/m2 D1-14 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Every 28days. Total 6 - 8 cycles Every 28days. Total 6 - 8 cycles MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000040 CT for Langerhans MO000040100 Langerhans Cell Histiocytosis 18000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Langerhans Cell Histiocytosis BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 1 Cell Histiocytosis 00664 (Histiocytosis Protocol - Maintenance) each cycle 3 months (Histiocytosis Protocol - Maintenance) each cycle 3 months Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y (Maintenance durationn Maximum 2 years durationn Maximum 2 years notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
and pelvis, Bone marrow studies, Biopsy or fluid flow cytometry / IHC -P | DISCHARGE
MEDICAL MO MO000040 CT for Langerhans MO000040200 Langerhans Cell Histiocytosis 25000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Langerhans Cell Histiocytosis BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 2 Cell Histiocytosis 00665 (Histiocytosis Protocol - Induction) Maximum 8 weeks (Histiocytosis Protocol - Induction) Maximum 8 weeks Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Induction notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
and pelvis, Bone marrow studies, Biopsy or fluid flow cytometry / IHC -P | DISCHARGE
MEDICAL MO MO000040 CT for Low Grade MO000040300 Bendamustine + Rituximab 25000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Bendamustine + Rituximab BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 3 B - Cell NHL 00666 Bendamustine 90mg/m2 on day 1, 2 Bendamustine 90mg/m2 on day 1, 2 Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Rituximab 375mg/m2 on day 1 Rituximab 375mg/m2 on day 1 notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
Repeat every 28 days, Total 6 cycles Repeat every 28 days, Total 6 cycles and pelvis, Bone marrow studies, Biopsy or fluid flow cytometry / IHC -P | DISCHARGE
MEDICAL MO MO000040 CT for Low Grade MO000040400 CT for Low Grade B - Cell NHL-Lenalidomide + Rituximab- 27500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Low Grade B - Cell NHL-Lenalidomide + Rituximab- BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 4 B - Cell NHL- 00667 Cycle Cycle Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Lenalidomide + notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
Rituximab-Cycle and pelvis, Bone marrow studies, Biopsy or fluid flow cytometry / IHC -P | DISCHARGE
MEDICAL MO MO000040 CT for Low Grade MO000040500 Vincristine + Carboplatin 0 Yes 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Vincristine + Carboplatin Vincristine + Carboplatin BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF
ONCOLOG 5 Glioma 00668 Vincristine 1.5mg/m2 (day 1, 8 and 15 for first 4 cycles and Vincristine 1.5mg/m2 (day 1, 8 Vincristine 1.5mg/m2 (day 1, 8 and 15 for first 4 cycles and CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y then only day 1 from cycle 5 to 17) and 15 for first 4 cycles and then then only day 1 from cycle 5 to 17) DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Carboplatin 550mg/m2 every 3 weeks (all cycles) Maximum only day 1 from cycle 5 to 17) Carboplatin 550mg/m2 every 3 weeks (all cycles) Maximum INPATIENT DEPARTMENT-C | MRI Brain-P | REPORTS OF THE TESTS (PATHOLOGY,
6 cycles Carboplatin 550mg/m2 every 3 6 cycles RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
weeks (all cycles) Maximum 6 SLIPS-C
cycles -6000
MEDICAL MO MO000040 CT for Low Grade MO000040600 CT for Low Grade NHL / ITP / AIHA -Rituximab-Cycle 24800 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Low Grade NHL / ITP / AIHA -Rituximab-Cycle BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 6 NHL Rituximab- 00669 Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Cycle notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or
CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000040 CT for Low grade MO000040700 Chlorambucil 3500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Chlorambucil BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow cytometry / IHC-P |
ONCOLOG 7 NHL/ Chronic 00670 Chlorambucil Prednisolone Chlorambucil Prednisolone Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Lymphocytic Repeat every 28 days for 12 cycles Repeat every 28 days for 12 cycles notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Leukemia DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | PET CT or
MEDICAL MO MO000040 CT for MO000040800 Berlin- Frankfurt -Munster-90 160000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Berlin- Frankfurt -Munster-90 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow
ONCOLOG 8 Lymphoblastic 00671 Berlin- Frankfurt -Munster- 95 Berlin- Frankfurt -Munster- 95 cytometry / IHC-P | Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY
Y Lymphoma Berlin- Frankfurt -Munster- 2000 Berlin- Frankfurt -Munster- 2000 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Hyper CVAD (cyclophosphamide, Vincristine, Hyper CVAD (cyclophosphamide, Vincristine, OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Adriamycin,Dexamethasone Adriamycin,Dexamethasone PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY,
UKALL (United kingdom acute lymphoblastic leukaemia) UKALL (United kingdom acute lymphoblastic leukaemia) RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
GMALL (German multicenter acute lymphoblastic leukemia) - GMALL (German multicenter acute lymphoblastic leukemia) - SLIPS-C
Induction phase Induction phase
MEDICAL MO MO000040 CT for MO000040900 CT for Medulloblastoma / Brain PNET-PACKER-Cycle 4900 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Medulloblastoma / Brain PNET-PACKER-Cycle BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF
ONCOLOG 9 Medulloblastoma 00672 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y / Brain PNET- DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
PACKER-Cycle INPATIENT DEPARTMENT-C | MRI Brain-P | REPORTS OF THE TESTS (PATHOLOGY,
SLIPS-C
MEDICAL MO MO000041 CT for MO000041000 Cisplatin + Cyclophosphamide + Vincristine + etoposide 8000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + Cyclophosphamide + Vincristine + etoposide BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF
ONCOLOG 0 Medulloblastoma 00673 Cyclophosphamide 1000mg/m2 (2 days every cycles) Cyclophosphamide 1000mg/m2 (2 days every cycles) CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y / CNS PNET Vincristine 1.5mg/m2 (days 1 and 8) Vincristine 1.5mg/m2 (days 1 and 8) DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Cisplatin 100mg/m2 (1 day per cycle) Etoposide Day 3-4 Cisplatin 100mg/m2 (1 day per cycle) Etoposide Day 3-4 INPATIENT DEPARTMENT-C | MRI Brain-P | REPORTS OF THE TESTS (PATHOLOGY,
Cycles given every 3 weekly Maximum 8 cyces Cycles given every 3 weekly Maximum 8 cyces RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION
SLIPS-C
MEDICAL MO MO000041 CT for MO000041100 Pemetrexed + Cisplatin/ Carboplatin 9400 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Pemetrexed + Cisplatin/ Carboplatin BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax + Upper abdomen-P | CHARTS OF
ONCOLOG 1 Mesothelioma 00674 Pemetrexed 500mg/m2 D1 Pemetrexed 500mg/m2 D1 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment,CBC, LFT,
Y Cisplatin 75 mg/m2 D1 every 21 days Cisplatin 75 mg/m2 D1 every 21 days RFT, RBS, CECT Thorax + Upper abdomen, histopathology-P | DISCHARGE SUMMARY OF
DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology-P | LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000041 CT for Metastatic MO000041200 Zoledronic Acid 3500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Zoledronic Acid Any investigation showing Bone Metastasis-P | BAR CODE OF THE DRUGS-C | CHARTS
ONCOLOG 2 bone malignancy 00675 Zoledronic acid 4 mg IV Monthly Zoledronic acid 4 mg IV Monthly OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y and multiple DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
myeloma INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | S. Calcium-P |
TRANFUSION SLIPS-C
MEDICAL MO MO000041 CT for Metastatic MO000041300 Dacarbazine + Cisplatin 7000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Dacarbazine + Cisplatin BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 3 Melanoma 00676 Dacarbazine 250mg/m2 D1-D5 Dacarbazine 250mg/m2 D1-D5 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cisplatin 75 mg/m2 Every 21 days Cisplatin 75 mg/m2 Every 21 days OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology-P | LFT-P | RBS-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000041 CT for Metastatic MO000041300 Tab Imatinib 400/600/800 mg daily 2000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Tab Imatinib 400/600/800 mg daily Abdomen and Pelvis-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Thorax-P |
ONCOLOG 3 Melanoma 00677 CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-
INPATIENT DEPARTMENT-C | Histopathology-P | LFT-P | RBS-P | REPORTS OF THE
MEDICAL MO MO000041 CT for MM / MO000041400 Bortezomib + Lenalidomide + Dexamethasone 18000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Bortezomib + Lenalidomide + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 4 Amyloidosis 00679 Lenalidomide 25 mg daily Day 1 - 21 Lenalidomide 25 mg daily Day 1 - 21 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Dexamethasone 40mg Day 1, 8, 15, 22 Dexamethasone 40mg Day 1, 8, 15, 22 treatment,CBC, Biochemistry, Serum protein electrophoresis, Bone marrow aspiration
Bortezomib 1.3 mg/m2 Day 1, 8, 15, 22 Bortezomib 1.3 mg/m2 Day 1, 8, 15, 22 Biopsy, skeletal survey.-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Every 28 days Every 28 days DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS
Serum protein electrophoresis-P | Skeletal survey-P | TRANFUSION SLIPS-C
MEDICAL MO MO000041 CT for MM / MO000041400 Bortezomib + Cyclophosphamide + Dexamethasone 15000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Bortezomib + Cyclophosphamide + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 4 Amyloidosis 00678 Cyclophosphamide - 300 mg/m2 day 1, 8, 15, 22 Cyclophosphamide - 300 mg/m2 day 1, 8, 15, 22 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Dexamethasone 40mg Day 1, 8, 15, 22 Dexamethasone 40mg Day 1, 8, 15, 22 treatment,CBC, Biochemistry, Serum protein electrophoresis, Bone marrow aspiration
Bortezomib 1.3 mg/m2 Day1, 8, 15, 22 Bortezomib 1.3 mg/m2 Day1, 8, 15, 22 Biopsy, skeletal survey.-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Every 28 days Maximum 12 cycles Every 28 days Maximum 12 cycles DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS
Serum protein electrophoresis-P | Skeletal survey-P | TRANFUSION SLIPS-C
MEDICAL MO MO000041 CT for MM / MO000041400 Bortezomib + Thalidomide + Dexamethasone 15000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Bortezomib + Thalidomide + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 4 Amyloidosis 00680 Thalidomide 100 mg daily Day 1 - 28 Dexamethasone 40 mg Thalidomide 100 mg daily Day 1 - 28 Dexamethasone 40 mg P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Day 1, 8, 15, 22 Day 1, 8, 15, 22 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Bortezomib 1.3 mg/m2 Day 1, 8, 15, 22 Bortezomib 1.3 mg/m2 Day 1, 8, 15, 22 SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
Every 28 days Maximum 8 cycles Every 28 days Maximum 8 cycles RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | Serum protein
electrophoresis-P | Skeletal survey-P | TRANFUSION SLIPS-C
MEDICAL MO MO000041 CT for MM / MO000041400 Melphalan + Thalidomide + Prednisolone 4000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Melphalan + Thalidomide + Prednisolone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 4 Amyloidosis 00682 Melphalan 9mg/m2 D1-D4 Melphalan 9mg/m2 D1-D4 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Thalidomide 100mg D1-28 Thalidomide 100mg D1-28 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Prednisolone 100mg Day1-4 Prednisolone 100mg Day1-4 SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
Every 28days Every 28days RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | Serum protein
MEDICAL MO MO000041 CT for MM / MO000041400 Cyclophosphamide + Thalidomide + Dexamethasone 4000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cyclophosphamide + Thalidomide + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 4 Amyloidosis 00681 Cyclophosphamide 100mg D1-D14 Cyclophosphamide 100mg D1-D14 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Thalidomide 100-200 mg daily Day 1-28 Thalidomide 100-200 mg daily Day 1-28 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Dexamethasone 40mg Day 1, 8, 15, 22 Dexamethasone 40mg Day 1, 8, 15, 22 SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
Every 28 days Maximum 12 cycles Every 28 days Maximum 12 cycles RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | Serum protein
MEDICAL MO MO000041 CT for MM / MO000041500 Lenalidomide + Dexamethasone 5000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Lenalidomide + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 5 Amyloidosis / 00683 Lenalidomide 25 mg daily Day1-21 Lenalidomide 25 mg daily Day1-21 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y POEMS Dexamethasone 40mg Day 1, 8, 15, 22 Dexamethasone 40mg Day 1, 8, 15, 22 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Every 28days Maximum 12 cycles Every 28days Maximum 12 cycles SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | Serum protein
MEDICAL MO MO000041 CT for MM / MO000041500 Pomalidomide + Dexamethasone 7000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Pomalidomide + Dexamethasone BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 5 Amyloidosis / 00684 Pomalidomide 4 mg daily Day 1-21 Pomalidomide 4 mg daily Day 1-21 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y POEMS Dexamethasone 40mg Day 1, 8, 15, 22 Dexamethasone 40mg Day 1, 8, 15, 22 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Every 28 days Maximum 12 cycles Every 28 days Maximum 12 cycles SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
MEDICAL MO MO000041 CT for MM / MO000041600 CT for MM / Amyloidosis-VMP-Duration + Cycle 12600 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for MM / Amyloidosis-VMP-Duration + Cycle BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow aspiration Biopsy-P | CBC-
ONCOLOG 6 Amyloidosis-VMP- 00685 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Duration + Cycle treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS (PATHOLOGY,
MEDICAL MO MO000041 CT for MO000041700 Hydroxurea 2000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Hydroxurea BAR CODE OF THE DRUGS-C | Bone marrow Aspiration / Biopsy-P | CBC-P | CHARTS
ONCOLOG 7 Myeloproliferative 00686 Hydroxurea daily Hydroxurea daily OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Neoplasm (Dose will be based on blood counts) (Dose will be based on blood counts) DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | LFT-P | Molecular-P | REPORTS OF THE TESTS
MEDICAL MO MO000041 CT for MO000041800 13-cis retinoic acid 160mg/m2 per day for 2 weeks 2000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N 13-cis retinoic acid 160mg/m2 per day for 2 weeks BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CECT/ Thorax Abdomen Pelvis-
ONCOLOG 8 Neuroblastoma 00687 Each cycle given 4 weekly (Max cycles6) Each cycle given 4 weekly (Max cycles6) P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | REPORTS OF THE TESTS
TRANFUSION SLIPS-C
MEDICAL MO MO000041 CT for MO000041800 Cabroplatin + Etoposide + Cyclophosphamide + Doxorubicin 8500 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cabroplatin + Etoposide + Cyclophosphamide + Doxorubicin BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CECT/ Thorax Abdomen Pelvis-
ONCOLOG 8 Neuroblastoma 00688 Carboplatin 600mg/m2 Carboplatin 600mg/m2 P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Etoposide 100mg/m2 (days 1-5) Etoposide 100mg/m2 (days 1-5) treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Cyclophosphamide Cyclophosphamide SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | REPORTS OF THE TESTS
Doxorubicin Doxorubicin (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
TRANFUSION SLIPS-C
MEDICAL MO MO000041 CT for MO000041900 Carboplatin or Cisplatin + Cyclophosphamide + Vincristine + 7000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Carboplatin or Cisplatin + Cyclophosphamide + Vincristine + BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CECT/ Thorax Abdomen Pelvis-
ONCOLOG 9 Neuroblastoma 00689 Etoposide + Doxorubicin (maximum 8 cycles) Etoposide + Doxorubicin (maximum 8 cycles) P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y (Low / treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Intermediate Risk) SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P | REPORTS OF THE TESTS
TRANFUSION SLIPS-C
MEDICAL MO MO000042 CT for NHL MO000042000 Cyclophosphamide + Vincristine + Prednisolone 3500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cyclophosphamide + Vincristine + Prednisolone )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 0 00690 Cyclophosphamide 750mg/m2 Cyclophosphamide 750mg/m2 P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Vincristine 1.4mg/m2 Day 1 Vincristine 1.4mg/m2 Day 1 notes with planned line of treatment, CBC,Biochemistry, PET CT or CECT Chest abdomen
Prednisolone 100 mg Day 1 - 5 Prednisolone 100 mg Day 1 - 5 and pelvis, +/- Bone marrow studies, Biopsy or fluid, 2D-ECHO, HPE / IHC/ flow cytometry-
Repeat every 21days. Total 6 cycles Repeat every 21days. Total 6 cycles P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | HPE / IHC/ flow cytometry-P | PET CT or CECT Chest
abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000042 CT for NK - T Cell MO000042100 GELOX 20000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N GELOX )+/- Bone marrow studies-P | 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-
ONCOLOG 1 Lymphoma 00691 Gemcitabine 1000mg/m2 D1 and D8 Gemcitabine 1000mg/m2 D1 and D8 P | Biopsy or fluid-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical
Y Oxaliplatin 130mg/m2 D1 Oxaliplatin 130mg/m2 D1 notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
L- asparginase 6000 U/m2 D1-7 L- asparginase 6000 U/m2 D1-7 DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPE / IHC/
Repeat every 21 days Repeat every 21 days flow cytometry-P | PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE
MEDICAL MO MO000042 CT for Osteogenic MO000042200 Doxorubicin + Cisplatin 12000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Doxorubicin + Cisplatin 2D ECHO-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 2 Sarcoma 00692 Cisplatin 100mg/m2 Cisplatin 100mg/m2 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Doxorubicin 75mg/m2 given every 3 weeks Maximum 6 Doxorubicin 75mg/m2 given every 3 weeks Maximum 6 OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
cycles cycles Histopathology-P | LFT-P | MRI of the involved site-P | RBS-P | REPORTS OF THE
C | RFT-P | TRANFUSION SLIPS-C | X-ray Chest-P
MEDICAL MO MO000042 CT for Osteogenic MO000042200 High dose Methotrexate Osteogenic Sarcoma 0 Yes 1 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N High dose Methotrexate High dose Methotrexate Osteogenic Sarcoma LFT-P | X-ray Chest-P | 2D ECHO-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS
ONCOLOG 2 Sarcoma 00693 Methotrexate 8-12 gram/m2 Osteogenic Sarcoma Methotrexate 8-12 gram/m2 OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Weekly Maximum 12 cycles Methotrexate 8-12 gram/m2 Weekly Maximum 12 cycles DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Weekly Maximum 12 cycles- INPATIENT DEPARTMENT-C | Histopathology-P | MRI of the involved site-P | RBS-P |
20000 REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
MEDICAL MO MO000042 CT for Osteogenic MO000042200 OGS - 12 24000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N OGS - 12 LFT-P | X-ray Chest-P | 2D ECHO-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS
ONCOLOG 2 Sarcoma 00694 Ifosfamide 1800 mg/m2 D1-D5 Ifosfamide 1800 mg/m2 D1-D5 OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Mesna 600mg/m2 0h 3h 6h 9h D1-D5 Mesna 600mg/m2 0h 3h 6h 9h D1-D5 DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Adriamycin 25mg/m2 D1- D3 Adriamycin 25mg/m2 D1- D3 INPATIENT DEPARTMENT-C | Histopathology-P | MRI of the involved site-P | RBS-P |
Cisplatin 33 mg/m2 D1-D3 every 21 days Cisplatin 33 mg/m2 D1-D3 every 21 days REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
MEDICAL MO MO000042 CT for Osteogenic MO000042300 CT for Osteogenic Sarcoma-Methotrexate + Doxorubicin + 27000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Osteogenic Sarcoma-Methotrexate + Doxorubicin + LFT-P | X-ray Chest-P | 2D ECHO-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS
ONCOLOG 3 Sarcoma- 00695 Cisplatin for Relapsed Osteogenic Sarcoma-Duration + Cycle Cisplatin for Relapsed Osteogenic Sarcoma-Duration + Cycle OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Methotrexate + DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
Doxorubicin + INPATIENT DEPARTMENT-C | Histopathology-P | MRI of the involved site-P | RBS-P |
Cisplatin for REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
Relapsed BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C
Osteogenic
Sarcoma-Duration
+ Cycle
MEDICAL MO MO000042 CT for Osteogenic MO000042400 CT for Osteogenic Sarcoma-OGS - 12-Cycle 36200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Osteogenic Sarcoma-OGS - 12-Cycle LFT-P | X-ray Chest-P | 2D ECHO-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS
ONCOLOG 4 Sarcoma-OGS - 12- 00696 OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Cycle DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
INPATIENT DEPARTMENT-C | Histopathology-P | MRI of the involved site-P | RBS-P |
MEDICAL MO MO000042 CT for Paediatric MO000042500 6 - Mercaptopurine 75mg/m2 daily 4000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N 6 - Mercaptopurine 75mg/m2 daily BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 5 Acute 00697 Methotrexate 20mg/m2 weekly Methotrexate 20mg/m2 weekly REGIMEN-C | Clinical notes with planned line of treatment,-P | DISCHARGE SUMMARY
Y Lymphoblastic Vincristine 1.5mg/m2 monthly Vincristine 1.5mg/m2 monthly OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Leukemia Intrathecal methotrexate 12 mg 3 monthly Maximum for 2 Intrathecal methotrexate 12 mg 3 monthly Maximum for 2 REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
years years BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000042 CT for Paediatric MO000042500 Consolidation 240000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Consolidation BAR CODE OF THE DRUGS-C | BIOCHEM-P | CBC-P | Clinical notes with planned line of
ONCOLOG 5 Acute 00698 (Phase II, CNS Therapy Reinduction) Maximum 6 months (Phase II, CNS Therapy Reinduction) Maximum 6 months treatment-P | HBSAG-P | HCV-P | HIV-P | Peripheral Blood / BONE MARROW FLOW
Y Lymphoblastic CYTOMETRY-P
Leukemia
MEDICAL MO MO000042 CT for Paediatric MO000042600 Cytrabine 3 gram/m2 twice a day 57000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cytrabine 3 gram/m2 twice a day BIOCHEM-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with
ONCOLOG 6 Acute Myeloid 00699 Days 1, 3 and 5 (Maximum 4 cycles ) Days 1, 3 and 5 (Maximum 4 cycles ) planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Y Leukemia DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HBSAG-P | HCV-P | HIV-P |
(Consolidation) Peripheral Blood / BONE MARROW FLOW CYTOMETRY-P | REPORTS OF THE TESTS
(PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000042 CT for Paediatric MO000042700 Cytrabine 200mg/m2/day days 1-10 and 100000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Cytrabine 200mg/m2/day days 1-10 and BAR CODE OF THE DRUGS-C | BIOCHEM-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 7 Acute Myeloid 00700 Daunorubicin 50mg/m2 days 1, 3 and 5 Daunorubicin 50mg/m2 days 1, 3 and 5 REGIMEN-C | Clinical notes with planned line of treatment -P | DISCHARGE SUMMARY
Y Leukemia Etposide 100mg/m2 days 1-5 (Etoposide may be omitted) Etposide 100mg/m2 days 1-5 (Etoposide may be omitted) OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
(Induction) HBSAG-P | HCV-P | HIV-P | Molecular-P | Peripheral Blood / BONE MARROW FLOW
CYTOMETRY-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY,
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000042 CT for Paediatric MO000042800 Arsenic trioxide 75000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Arsenic trioxide BAR CODE OF THE DRUGS-C | BIOCHEM-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 8 Acute 00701 ATRA ATRA REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Promyelocytic Daunomycin or Idarubcin Daunomycin or Idarubcin OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Leukemia Cytarabine - multiagent - vary on protocol include Cytarabine - multiagent - vary on protocol include HBSAG-P | HCV-P | HIV-P | Peripheral Blood / BONE MARROW FLOW CYTOMETRY-P |
antibiotics, antifungals, blood and platelets, FFP transfusion antibiotics, antifungals, blood and platelets, FFP transfusion REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
BIOCHEMISTRY,ETC.)-C | RT-PCR / Fish PML RARA-P | TRANFUSION SLIPS-C
MEDICAL MO MO000042 CT for Paediatric MO000042800 Induction Arsenic trioxide ATRA 130000 No 0 No 0 Yes No Tertiary 30 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Induction Arsenic trioxide ATRA BAR CODE OF THE DRUGS-C | BIOCHEM-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 8 Acute 00702 Daunomycin or Idarubcin- multiagent - vary on protocol Daunomycin or Idarubcin- multiagent - vary on protocol REGIMEN-C | Clinical notes with planned line of treatment -P | DISCHARGE SUMMARY
Y Promyelocytic include antibiotics, antifungals, blood and platelets, FFP include antibiotics, antifungals, blood and platelets, FFP OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Leukemia transfusion (Duration 8 weeks maximum) transfusion (Duration 8 weeks maximum) HBSAG-P | HCV-P | HIV-P | Peripheral Blood / BONE MARROW FLOW CYTOMETRY-P |
BIOCHEMISTRY,ETC.)-C | RT-PCR / Fish PML RARA-P
MEDICAL MO MO000042 CT for Paediatric MO000042900 Carboplatin + Cisplatin + Doxorubicin Max 8 cycles 8000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Carboplatin + Cisplatin + Doxorubicin Max 8 cycles 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | CBC-P |
ONCOLOG 9 Hepatoblastoma 00703 CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | CHEST AND ABDOMEN-P | Clinical
Y notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P |
MEDICAL MO MO000042 CT for Paediatric MO000042900 Cisplatin max 4 cycles 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin max 4 cycles -5600 Cisplatin max 4 cycles 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy-P | CBC-P |
ONCOLOG 9 Hepatoblastoma 00704 CECT-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | CHEST AND ABDOMEN-P | Clinical
Y notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECG-P |
MEDICAL MO MO000043 CT for Paediatric MO000043000 Oncovin,Etoposide,Prednisone,doxorubicin hydrochloride 13000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Oncovin,Etoposide,Prednisone,doxorubicin hydrochloride 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 0 Hodgkins 00705 (Maximum 8 cycles) (Maximum 8 cycles) CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Lymphoma treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000043 CT for Paediatric MO000043100 ifosfamide, carboplatin, etoposide (Maximum 4 cycles) 14000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N ifosfamide, carboplatin, etoposide (Maximum 4 cycles) 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 1 Hodgkins 00706 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Relapse SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
MEDICAL MO MO000043 CT for Paediatric MO000043100 IGEV: Ifosfamide, Gemcitabine, Etoposide) Other salvage 34000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N IGEV: Ifosfamide, Gemcitabine, Etoposide) Other salvage 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 1 Hodgkins 00707 regimens can be allowed like DHAP, ESHAP, GVD in the same regimens can be allowed like DHAP, ESHAP, GVD in the same CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Lymphoma code if possible code if possible treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Relapse SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
MEDICAL MO MO000043 CT for Paediatric MO000043200 FAB LMB 89/96 Maintenance 65000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N FAB LMB 89/96 Maintenance 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 2 Non Hodgkins 00708 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
MEDICAL MO MO000043 CT for Paediatric MO000043200 Mitroxantrone,Chlorambucil,Prednisolone: 842 100000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Mitroxantrone,Chlorambucil,Prednisolone: 842 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 2 Non Hodgkins 00709 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
MEDICAL MO MO000043 CT for Panceratic MO000043300 Gemcitabine + Nanopaclitaxel 28000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Gemcitabine + Nanopaclitaxel CECT abdomen-P | BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF
ONCOLOG 3 Cancer 00710 Gemcitabine 1000mg/m2 D1 D8 D15 Gemcitabine 1000mg/m2 D1 D8 D15 CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of treatment-P |
Y Albumin bound Paclitaxel 125mg/m2 D1 D8 D15 every 28 Albumin bound Paclitaxel 125mg/m2 D1 D8 D15 every 28 DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
days days INPATIENT DEPARTMENT-C | Histopathology/FNAC-P | LFT-P | Pelvis-P | RBS-P |
MEDICAL MO MO000043 CT for Panceratic MO000043300 Gemcitabine 9000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Gemcitabine BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 3 Cancer 00711 Gemcitabine 1000mg /m2 D1 D8 every 21 days maximum 6 Gemcitabine 1000mg /m2 D1 D8 every 21 days maximum 6 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y cycles cycles OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology/FNAC-P | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000043 CT for Panceratic MO000043400 CT for Panceratic Cancer-Capecitabine-Cycle 7400 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Panceratic Cancer-Capecitabine-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 4 Cancer- 00712 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Capecitabine- OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Cycle Histopathology/FNAC-P | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000043 CT for Panceratic MO000043500 CT for Panceratic Cancer-Folfirinox-Cycle 15500 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Panceratic Cancer-Folfirinox-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CECT abdomen-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 5 Cancer-Folfirinox- 00713 REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cycle OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Histopathology/FNAC-P | LFT-P | Pelvis-P | RBS-P | REPORTS OF THE TESTS
MEDICAL MO MO000043 CT for Pediatric MO000043600 CT for Pediatric Hodgkins Lymphoma Relapse-DECA-Cycle 17800 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Pediatric Hodgkins Lymphoma Relapse-DECA-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
Relapse-DECA- SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
Cycle CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000043 CT for Pediatric MO000043700 CT for Pediatric Hodgkins Lymphoma-COPDAC-Cycle 7800 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Pediatric Hodgkins Lymphoma-COPDAC-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
Y Lymphoma- treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
COPDAC-Cycle SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
MEDICAL MO MO000043 CT for Peripheral T MO000043800 CHOEP 8000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N CHOEP 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 8 - Cell Lymphoma 00716 Cyclophosphamide 750mg/m2 D1 Cyclophosphamide 750mg/m2 D1 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Vincristine 1.4mg/m2 D1 Vincristine 1.4mg/m2 D1 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Adriamycin 50 mg/m2 D1 Adriamycin 50 mg/m2 D1 SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
Etoposide 100mg/m2 D1-3 Etoposide 100mg/m2 D1-3 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Prednisolone 100 mg D1-5 Prednisolone 100 mg D1-5 MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
Every 21days. Total 6 cycles Every 21days. Total 6 cycles
MEDICAL MO MO000043 CT for Peripheral T MO000043900 CT for Peripheral T - Cell Lymphoma-CHOP-Cycle 4000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Peripheral T - Cell Lymphoma-CHOP-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 9 - Cell Lymphoma- 00717 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y CHOP-Cycle treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
MEDICAL MO MO000044 CT for Peripheral T MO000044000 CT for Peripheral T - Cell Lymphoma-SMILE-Cycle 19300 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Peripheral T - Cell Lymphoma-SMILE-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 0 - Cell Lymphoma- 00718 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y SMILE-Cycle treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
MEDICAL MO MO000044 CT for PMBCL / MO000044100 Etoposide + Prednsiolone + Vincristine + Cyclophosphamide 32000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Etoposide + Prednsiolone + Vincristine + Cyclophosphamide 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 1 Burkitt's 00719 + Doxorubicin + Doxorubicin CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Lymphoma / Rituximab 375mg/m2 Day 1 Rituximab 375mg/m2 Day 1 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Seropositive Etoposide 50mg/m2 Etoposide 50mg/m2 SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
B - Cell NHLR VCR 0.4mg/m2 VCR 0.4mg/m2 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Doxorubicin 10mg/m2 Day1 - 4 Doxorubicin 10mg/m2 Day1 - 4 MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
Cyclophosphamide 750mg/m2 on day 5 Prednisolone 100 Cyclophosphamide 750mg/m2 on day 5 Prednisolone 100
mg day 1-5 mg day 1-5
Every 21 days Every 21 days
Dose adjustment each cycle depending on nadir counts Dose adjustment each cycle depending on nadir counts
Total- 6 cycles Total- 6 cycles
MEDICAL MO MO000044 CT for PMBCL / MO000044200 CT for PMBCL / Burki 's Lymphoma / Seroposi ve 31700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for PMBCL / Burki 's Lymphoma / Seroposi ve 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 2 Burkitt's 00720 B - Cell NHLR-EPOCH-Cycle B - Cell NHLR-EPOCH-Cycle CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Lymphoma / treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Seroposi ve SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
B - Cell NHLR- CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
EPOCH-Cycle MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000044 CT for primary MO000044300 De-Angelis/Methotrexate 36000 No 0 No 0 No No Tertiary 30 No Yes Yes Regular PKG No No No Medical No Insurance N N N De-Angelis/Methotrexate BAR CODE OF THE DRUGS-C | CHARTS OF CHEMOTHERAPY REGIMEN-C | CT/ bone
ONCOLOG 3 CNS lymphoma 00721 marrow biopsy , clincial notes , examinationsdetails-P | Clincial notes-P | DISCHARGE
Y SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT
DEPARTMENT-C | Examinations details-P | REPORTS OF THE TESTS (PATHOLOGY,
SLIPS-C
MEDICAL MO MO000044 CT for relapse MO000044400 Topotecan + Cyclophosphamide 6000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Topotecan + Cyclophosphamide 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 4 Neuroblastoma 00722 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
MEDICAL MO MO000044 CT for Relapsed B - MO000044500 ICE - R 15000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N ICE - R 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 5 Cell NHL - High 00723 Rituximab 375mg/m2 Rituximab 375mg/m2 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Grade Ifosfamide 1.66g/m2 on day 1 - 3 Ifosfamide 1.66g/m2 on day 1 - 3 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
(Except Burkitt's & Mesna 1.66g/m2 day 1 - 3 Mesna 1.66g/m2 day 1 - 3 SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
PCNSL) Carboplatin AUC 5 on day 1 Carboplatin AUC 5 on day 1 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Etoposide 100mg/m2 on day 1 - 3 Etoposide 100mg/m2 on day 1 - 3 MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
Cycle every 21days for 6 cycles Cycle every 21days for 6 cycles
MEDICAL MO MO000044 CT for Relapsed MO000044600 CT for Relapsed Hodgkin Lymphoma-MINE-Cycle 9700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Relapsed Hodgkin Lymphoma-MINE-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 6 Hodgkin 00724 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Lymphoma-MINE- treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Cycle SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
MEDICAL MO MO000044 CT for Relapsed MO000044700 CT for Relapsed Hodgkin Lymphoma-PTCL - GDP-Cycle 12500 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Relapsed Hodgkin Lymphoma-PTCL - GDP-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 7 Hodgkin 00725 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Lymphoma-PTCL - treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
GDP-Cycle SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
MEDICAL MO MO000044 CT for Relapsed MO000044800 ICE 35000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N ICE 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 8 Hodgkins/ Non 00726 Ifosfamide 1.66g/m2 on day 1 - 3 Ifosfamide 1.66g/m2 on day 1 - 3 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Hogkins Mesna 1.66g/m2 day 1 - 3 Mesna 1.66g/m2 day 1 - 3 treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
lymphoma Carboplatin AUC 5 on day 1 Carboplatin AUC 5 on day 1 SUMMARY OF INPATIENT DEPARTMENT-C | HPR + IHC-P | Node Biopsy-P | PET CT or
Etoposide 100mg/m2 on day 1 - 3 Etoposide 100mg/m2 on day 1 - 3 CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
Cycle every 21days for 6 cycles Cycle every 21days for 6 cycles MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000044 CT for Relapsed MO000044900 CT for Relapsed NHL & HL-DHAP-Cycle 11500 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Relapsed NHL & HL-DHAP-Cycle 2D ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Bone marrow studies-P |
ONCOLOG 9 NHL & HL-DHAP- 00727 CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Cycle treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
MEDICAL MO MO000045 CT for Renal Cell MO000045000 Cabozantinib 60 mg od x 1 month 13000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Cabozantinib 60 mg od x 1 month 2 D ECHO-P | Any investigation Showing Metastasis-P | BAR CODE OF THE DRUGS-C |
ONCOLOG 0 Cancer 00728 every 4 weeks every 4 weeks CBC-P | CECT abdomen and Pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
Y Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P |
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | X-Ray Chest-P
MEDICAL MO MO000045 CT for Renal Cell MO000045000 Sunitinib 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Sunitinib 2 D ECHO-P | Any investigation Showing Metastasis-P | BAR CODE OF THE DRUGS-C |
ONCOLOG 0 Cancer 00729 50 mg once daily 4 weeks on 2 weeks off 50 mg once daily 4 weeks on 2 weeks off CBC-P | CECT abdomen and Pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | HPR-P |
HEMATOLOGY, BIOCHEMISTRY,ETC.)-C | RFT-P | TRANFUSION SLIPS-C | X-Ray Chest-P
MEDICAL MO MO000045 CT for MO000045100 Vincristine + Carboplatin + Etoposide 7000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Vincristine + Carboplatin + Etoposide BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 1 Retinoblastoma 00730 Carboplatin 600mg/m2 day 1 Carboplatin 600mg/m2 day 1 REGIMEN-C | CSF STUDIES-P | Clinical notes with planned line of treatment-P |
Y Etoposide 150mg/m2 days 1-3 Vincristine1.5mg/m2 day 1 Etoposide 150mg/m2 days 1-3 Vincristine1.5mg/m2 day 1 DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF
(Max cycles= 8) (Max cycles= 8) INPATIENT DEPARTMENT-C | MRI/CT (BRAIN AND ORBITS)-P | REPORTS OF THE TESTS
TRANFUSION SLIPS-C
MEDICAL MO MO000045 CT for MO000045200 Vincristine + Cyclophosphamide + Dactinomycin 5700 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Vincristine + Cyclophosphamide + Dactinomycin Abdomen-P | BAR CODE OF THE DRUGS-C | BONE MARROW STUDIES,Biopsy-P |
ONCOLOG 2 Rhabdomyosarco 00731 Vincristine 1.5mg/m2 (day 1, 8 and 15) Vincristine 1.5mg/m2 (day 1, 8 and 15) Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
Y ma Cyclophosphamie 1200 - 2200 mg/m2 (day 1) Cyclophosphamie 1200 - 2200 mg/m2 (day 1) Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Dactinomycin 1.5mg / m2 (day 1) Dactinomycin 1.5mg / m2 (day 1) DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | MRI / CECT
3 weekly cycle (maximum 15 cycles) 3 weekly cycle (maximum 15 cycles) thorax-P | Pelvis or PET CT-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000045 CT for MO000045200 Vincristine + Ifosfamide + Etoposide 16000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Vincristine + Ifosfamide + Etoposide Abdomen-P | BAR CODE OF THE DRUGS-C | BONE MARROW STUDIES,Biopsy-P |
ONCOLOG 2 Rhabdomyosarco 00732 Vincristine 1.5mg/m2 (days 1, 8 and 15) Vincristine 1.5mg/m2 (days 1, 8 and 15) Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
Y ma Ifosfamide 1.8gm/m2 (days 1-5) Ifosfamide 1.8gm/m2 (days 1-5) Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Etoposide 100mg/m2 (days 1-5) Etoposide 100mg/m2 (days 1-5) DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | MRI / CECT
Each cycle every 3 weeks (maximum 15 cycles) Each cycle every 3 weeks (maximum 15 cycles) thorax-P | Pelvis or PET CT-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000045 CT for Soft Tissue MO000045300 ifosfamide + Adriamycin 14000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N ifosfamide + Adriamycin Abdomen-P | BAR CODE OF THE DRUGS-C | BONE MARROW STUDIES,Biopsy-P |
ONCOLOG 3 Sarcoma 00733 Doxorubicin 30mg/m2 D1 D2 Doxorubicin 30mg/m2 D1 D2 Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
Y Ifosfamide 2000 to 3000mg/m2 Ifosfamide 2000 to 3000mg/m2 Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Mesna 400 to 600 mg/m2 0h 4h 8h D1 - D3 Mesna 400 to 600 mg/m2 0h 4h 8h D1 - D3 DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | MRI / CECT
Every 21 days Maximum 6 cycles Every 21 days Maximum 6 cycles thorax-P | Pelvis or PET CT-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000045 CT for Soft Tissue MO000045400 Gemcitabine + Docetaxel 24000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Gemcitabine + Docetaxel Abdomen-P | BAR CODE OF THE DRUGS-C | BONE MARROW STUDIES,Biopsy-P |
ONCOLOG 4 Sarcoma/ Ewing 00734 Gemcitabine 900 mg/m2 D1 D8 Gemcitabine 900 mg/m2 D1 D8 Biochemistry-P | Biopsy-P | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
Y Sracoma Docetaxel 100 mg/m2 D8 every 21 days Maximum 6 cycles Docetaxel 100 mg/m2 D8 every 21 days Maximum 6 cycles Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | MRI / CECT
thorax-P | Pelvis or PET CT-P | REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY,
MEDICAL MO MO000045 CT for Thymic MO000045500 Cisplatin + Adriamycin + Cyclophosphamide 6000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + Adriamycin + Cyclophosphamide Abdomen-P | Histopathology report, ECHO-P | BAR CODE OF THE DRUGS-C | CBC-P |
ONCOLOG 5 Carcinoma 00735 Cisplatin 50 mg/m2 D1 Cisplatin 50 mg/m2 D1 CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned
Y Doxorubicin 50 mg/m2 D1 Doxorubicin 50 mg/m2 D1 line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Cyclophosphamide 500 mg/m2 D1 every 21 days Cyclophosphamide 500 mg/m2 D1 every 21 days DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | ECHO-P | LFT-P | RBS-P |
MEDICAL MO MO000045 CT for Thymic MO000045500 Cisplatin + Etoposide 8000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Cisplatin + Etoposide Abdomen-P | ECHO-P | Histopathology report, ECHO-P | BAR CODE OF THE DRUGS-C
ONCOLOG 5 Carcinoma 00736 Etoposide 100mg/m2 D1 - D3 Etoposide 100mg/m2 D1 - D3 | CBC-P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes
Y Cisplatin 75-100 mg/m2 D1 every 21 days Cisplatin 75-100 mg/m2 D1 every 21 days with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C
| DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | RBS-P | REPORTS
OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
MEDICAL MO MO000045 CT for Ureter / MO000045600 Carboplatin/ Cisplatin + Gemcitabine 14000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Carboplatin/ Cisplatin + Gemcitabine Abdomen and Pelvis-P | Histopathology report-P | BAR CODE OF THE DRUGS-C | CBC-
ONCOLOG 6 Bladder / Urethra 00737 Gemcitabine 1000 mg/m2 D1 D8 Gemcitabine 1000 mg/m2 D1 D8 P | CECT Thorax-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with
Y Carboplatin AUC 5-6 D1 every 21 days Carboplatin AUC 5-6 D1 every 21 days planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
MEDICAL MO MO000045 CT for Ureter / MO000045700 CT for Ureter / Bladder / Urethra-Methotrexate + Vinblastin 6600 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Ureter / Bladder / Urethra-Methotrexate + Vinblastin Histopathology report-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Abdomen and
ONCOLOG 7 Bladder / Urethra- 00738 + Doxorubicin + Cisplatin-Cycle + Doxorubicin + Cisplatin-Cycle Pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Methotrexate + treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Vinblastin + SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | RBS-P | REPORTS OF THE TESTS
Doxorubicin + (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
Cisplatin-Cycle RFT-P | TRANFUSION SLIPS-C
MEDICAL MO MO000045 CT for Ureter / MO000045800 CT for Ureter / Bladder / Urethra-Paclitaxel + Carboplatin- 15100 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N CT for Ureter / Bladder / Urethra-Paclitaxel + Carboplatin- Histopathology report-P | BAR CODE OF THE DRUGS-C | CBC-P | CECT Abdomen and
ONCOLOG 8 Bladder / Urethra- 00739 Duration + Cycle Duration + Cycle Pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
Y Paclitaxel + treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C | DISCHARGE
Carboplatin- SUMMARY OF INPATIENT DEPARTMENT-C | LFT-P | RBS-P | REPORTS OF THE TESTS
Duration + Cycle (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
MEDICAL MO MO000045 CT for Wilms MO000045900 Cyclophosphamide + Doxorubicin + Etoposide + Vincristine 100001 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Cyclophosphamide + Doxorubicin + Etoposide + Vincristine + 2D ECHO-P | BAR CODE OF THE DRUGS-C | BIOPSY-P | Biochemistry-P | CBC-P |
ONCOLOG 9 Tumor 00740 + Carboplatin Carboplatin CHARTS OF CHEMOTHERAPY REGIMEN-C | CT ABDOMEN and Pelvis-P | Chest X ray-P |
Y Vincristine + Dactinomycin +Adriamyicn+Cyclophosphamide Vincristine + Dactinomycin +Adriamyicn+Cyclophosphamide Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
+Etoposide +Etoposide DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF
Weekly chemotherapy - varying hybrid regimen (maximum Weekly chemotherapy - varying hybrid regimen (maximum 3 THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
3 days admission each cycle) Maximum duration 34 weeks days admission each cycle) Maximum duration 34 weeks BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
MEDICAL MO MO000045 CT for Wilms MO000045900 Vincristine + Actinomycin D 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Vincristine + Actinomycin D per Vincristine + Actinomycin D 2D ECHO-P | BAR CODE OF THE DRUGS-C | BIOPSY-P | Biochemistry-P | CBC-P |
ONCOLOG 9 Tumor 00741 cycle-2500 CHARTS OF CHEMOTHERAPY REGIMEN-C | CT ABDOMEN and Pelvis-P | Chest X ray-P |
DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF
MEDICAL MO MO000045 CT for Wilms MO000045900 Vincristine + Actinomycin D + Doxorubicin 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Vincristine + Actinomycin D + Vincristine + Actinomycin D + Doxorubicin 2D ECHO-P | BAR CODE OF THE DRUGS-C | BIOPSY-P | Biochemistry-P | CBC-P |
ONCOLOG 9 Tumor 00742 Vincristine 1.5 mg/m2 weekly for 12 weeks and then 3 Doxorubicin Vincristine 1.5 mg/m2 weekly for 12 weeks and then 3 CHARTS OF CHEMOTHERAPY REGIMEN-C | CT CHEST ABDOMEN-P | Clinical notes with
Y weekly Vincristine 1.5 mg/m2 weekly weekly planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE DEPARTMENT-C |
Actinomycin D 45 microgram/kg 3 weekly for 12 weeks and then 3 weekly Actinomycin D 45 microgram/kg 3 weekly DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF THE TESTS
Doxorubicin 60mg/m2 for 24 weeks Actinomycin D 45 microgram/kg Doxorubicin 60mg/m2 for 24 weeks (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C |
3 weekly TRANFUSION SLIPS-C | ULTRASONOGRAPHY-P
Doxorubicin 60mg/m2 for 24
weeks-4500
MEDICAL MO MO000046 CT Induction for MO000046000 FAB LMB 89/96 protcol (2 cycles) Each cycle Duration- 4 0 Yes 1 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N FAB LMB 89/96 protocol-40000 FAB LMB 89/96 protcol (2 cycles) Each cycle Duration- 4 2D-ECHO-P | BAR CODE OF THE DRUGS-C | Biochemistry-P | Biopsy or fluid flow
ONCOLOG 0 Paediatric Non 00743 weeks weeks cytometry / IHC-P | Bone marrow studies-P | CBC-P | CHARTS OF CHEMOTHERAPY
Y Hodgkins REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Lymphoma OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
PET CT or CECT Chest abdomen and pelvis-P | REPORTS OF THE TESTS (PATHOLOGY,
RADIOLOGY, MICROBIOLOGY, HEMATOLOGY, BIOCHEMISTRY,ETC.)-C
MEDICAL MO MO000050 Advanced / high MO000050000 Advanced / high end investigations in oncology 10000 Yes 1 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Advanced / high end investigations in oncology Clinical notes with planned line of treatment-P | Complete Hemogram-P | Detailed
ONCOLOG end investigations 0542 Discharge Summary-C | Detailed ICPs-C | Post treatment hemogram-C | Review notes
Y in oncology of primary physician for requirent of procedure-P
MEDICAL MO MO000065 Febrile MO000065300 Cefoperazone + Sulbactum 30000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Cefoperazone + Sulbactum BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 3 Neutopenia 00744 Piperalicillin + Tazobactum Piperalicillin + Tazobactum REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Cefoperazone Cefoperazone OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Piperacillin Piperacillin REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
Amikacin Amikacin BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
Gentamicin Gentamicin
Cefipime Cefipime
Levofloxacin Levofloxacin
Amoxycillin and clavulanate Amoxycillin and clavulanate
Teicoplanin Teicoplanin
MEDICAL MO MO000065 Febrile Vancomycin
MO000065400 Meropenem 80000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Vancomycin
Meropenem BAR CODE OF THE DRUGS-C | Biochemistry-P | CBC-P | CHARTS OF CHEMOTHERAPY
ONCOLOG 4 Neutopenia High 00745 Imipenem Imipenem REGIMEN-C | Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY
Y Risk Colistin Colistin OF DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Tigecyclin Tigecyclin REPORTS OF THE TESTS (PATHOLOGY, RADIOLOGY, MICROBIOLOGY, HEMATOLOGY,
Linezolid Linezolid BIOCHEMISTRY,ETC.)-C | TRANFUSION SLIPS-C
Voriconazole Voriconazole
Caspfungin Caspfungin
Amphotericin - B Amphotericin - B
MEDICAL MO MO000070 GCT Testis / Ovary MO000070300 SA Carboplatin every 3 weeks 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N SA Carboplatin every 3 weeks- SA Carboplatin every 3 weeks AFP-P | BAR CODE OF THE DRUGS-C | Beta HCG-P | CBC-P | CECT abdomen And
ONCOLOG 3 00746 6000 Pelvis-P | CHARTS OF CHEMOTHERAPY REGIMEN-C | Clinical notes with planned line of
SUMMARY OF INPATIENT DEPARTMENT-C | Histopathology report-P | LDH-P | LFT-P |
MEDICAL MO MO000070 GEP NET MO000070400 Temozolamide 150mg/m2 D9-14 + Capecitabine 1gm/me D1- 8000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Temozolamide 150mg/m2 D9-14 + Capecitabine 1gm/me D1- CBC-P | CECT abdomen And Pelvis-P | Clinical notes with planned line of treatment-P |
ONCOLOG 4 Neuroendocrine 00747 14 every 28 days 14 every 28 days Clinical photo-C | Discharge cusmmary-C | Drug invoice copy-C | IHC-P | LFT-P | RBS-
Y carcinoma P | RFT-P | histopathology report-P
MEDICAL MO MO000071 Granulocyte MO000071600 5 microgram / kg / day 4500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N 5 microgram / kg / day BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 6 Colony Stimulating 00748 (max 300 microgram per day) for 7 days or (max 300 microgram per day) for 7 days or Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y Factor Use PEG - GCSF 6mg one single dose per chemotherapy cycle PEG - GCSF 6mg one single dose per chemotherapy cycle DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF
MEDICAL MO MO000071 Granulocyte MO000071700 Granulocyte Colony Stimulating Factor Use-Cycle 12800 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Granulocyte Colony Stimulating Factor Use-Cycle BAR CODE OF THE DRUGS-C | CBC-P | CHARTS OF CHEMOTHERAPY REGIMEN-C |
ONCOLOG 7 Colony Stimulating 00749 Clinical notes with planned line of treatment-P | DISCHARGE SUMMARY OF DAY CARE
Y Factor Use-Cycle DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C | REPORTS OF
MEDICAL MO MO000083 APML- HIGH RISK - MO000083000 APML- HIGH RISK -CONSOLIDATION X8 CYCLES-High Risk 32000 No 0 No 0 No No Tertiary 30 No Yes Yes Regular PKG No No No Medical No Insurance N N N APML- HIGH RISK -CONSOLIDATION X8 CYCLES-High Risk Clinical notes with planned line of treatment-P | Complete Hemogram-P | Detailed
ONCOLOG CONSOLIDATION 0543 Consolidation Consolidation Discharge Summary-C | Detailed ICPs-C | Post treatment hemogram-C | Review notes
Y X8 CYCLES-High of primary physician for requirent of procedure-P
Risk Consolidation
MEDICAL MO MO000083 Intravesical BCG / MO000083800 Intravesical BCG / Mitomycin - Induction cycles (PC) for max. 2500 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No Yes No Medical No Insurance N N N Intravesical BCG / Mitomycin - Induction cycles (PC) for max. Clinical notes and Histopathology/ biopsy confirming the diagnosis of bladder cancer-P |
ONCOLOG 8 Mitomycin 00750 06 Doses 06 Doses Detailed Procedure-C | Detailed discharge summary-C | Histopathology/ biopsy
Y confirming the diagnosis of bladder cancer-P | Operative Notes-C | Original bills of
medicines administered-C | Urine R/M-P
MEDICAL MO MO000085 Irradiation of MO000085000 Irradiation of blood products (RDP,PRC,SDP) - Add on 1000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Add On No No No Medical No Insurance N N N Irradiation of blood products (RDP,PRC,SDP) - Add on Clinical notes confirming the diagnosis,CBC-P | Detailed Procedure-C | Detailed
ONCOLOG 0 blood products 00751 discharge summary-C | Operative Notes-C | Original bills of medicines administered-C
Y (RDP,PRC,SDP)
MEDICAL MO MO000089 Aromatase MO000089000 Letrozole 0 Yes 3 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Letrozole 2.5 mg orally daily- Letrozole Mammography-P | BAR CODE OF THE DRUGS-C | Biopsy report or surgical pathology
ONCOLOG inhibitor 0544 Letrozole 2.5 mg orally daily 3900 Letrozole 2.5 mg orally daily report of Modified radical mastectomy or breast conservation surgery-P | CHARTS OF
Y CHEMOTHERAPY REGIMEN-C | CXR PA view or CECT chest+abdomen-P | Clinical notes
with planned line of treatment-P | Complete Hemogram-P | DISCHARGE SUMMARY OF
DAY CARE DEPARTMENT-C | DISCHARGE SUMMARY OF INPATIENT DEPARTMENT-C |
Detailed Discharge Summary-C | Detailed ICPs-C | ER or PR positive-P | LFT-P | Pelvis
in case of metastatic disease-P | Post treatment Complete hemogram-C | REPORTS OF
BIOCHEMISTRY,ETC.)-C | RFT-P | Review notes of primary physician for requirent of
procedure-P | TRANFUSION SLIPS-C | USG abdomen and pelvis-P
MEDICAL MO MO000090 Malignant Pleural MO000090200 Pleural effusion & Pleurodesis 5500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N N Pleural effusion & Pleurodesis BT and CT-P | CBC-P | Clinical notes with planned line of treatment-P | Clinical notes
ONCOLOG 2 Effusion for 00752 with planned line of treatment-P | Discharge summary with detail treatment &
Y Pleural tap with interventions-C | KFT-P | LFT-P | PT INR-P | Procedure notes-C
Pig tail
catheter/chest
tube insertion
with Pleurodesis
in advanced
cancer patients
PALLIATIVE MP MP000010 Palliative and MP000010790 Palliative care end stage disease 3000 Yes 3 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Palliative care end stage disease- Palliative care end stage disease Admission notes showing vitals-P | Any investigations done-P | Clinical notes detailing
MEDICINE 79 supportive care 0001347 3000 history-P | Detailed ICPs-C | Discharge summary with detail treatment & interventions
for malignant & Final bill with payment receipt-C | Examination findings-P | Planned line of
disease at management-P | Review notes of primary physician with referal to Palliative Medicine-P
advanced or end | detailed discharge summary-C
stage
PALLIATIVE MP MP000020 Central lines in MP000020200 Long term indwelling venous catheter 10000 No 0 No 0 No No Tertiary 0 No Yes Yes Regular PKG No No No Medical No Insurance N N N Long term indwelling venous catheter Admission notes showing vitals-P | Any investigations done-P | Detailed ICPs-C |
MEDICINE 2 cancer patients 001346 Detailed discharge summary-C | Examination findings-P | Invoice copy with bar code
for drug therapy - venous catheter-C | Planned line of management-P | Review notes of primary physician
Silicon catheters for requirent of procedure-P | Treatment details-C | detail notes & X ray-C
in advanced
cancer patients-
Long term central
lines
NEO - NC NC000011 Basic neonatal NC000011800 A. Neonates 1800-2500g requiring closer monitoring or 0 Yes 1 No 0 Yes No Secondary 4 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N 1500/day-1500 | Mandatory A. Neonates 1800-2500g requiring closer monitoring or Admission under neonatologist in NICU (in major locations) and under Pediatrician in
NATAL 8 care and 00787 short-term care on mother's bedside for conditions like, but screening 1000 (One time only)- short-term care on mother's bedside for conditions like, but smaller locations is a must-P | All investigations reports-C | Detailed ICPs (daily
CARE screening not limited to: 1000 not limited to: Treatment details)-C | Detailed clinical notes (incl trigger for hospitalization and
package o Birth asphyxia (need for positive pressure ventilation at o Birth asphyxia (need for positive pressure ventilation at examiantion findings)-P | Detailed discharge summary-C | Supporting investigations-P
birth; no HIE) birth; no HIE)
o Moderate jaundice requiring phototherapy o Moderate jaundice requiring phototherapy
o Large for dates (>97 percentile) or Small for gestational o Large for dates (>97 percentile) or Small for gestational
age (less than 3rd centile) o Rule-out sepsis age (less than 3rd centile) o Rule-out sepsis
o Investigations warranted because of antenatal scan o Investigations warranted because of antenatal scan
findings. Includes activities listed under Basic Neonatal care findings. Includes activities listed under Basic Neonatal care
package and Kangaroo Mother Care support B .Mandatory package and Kangaroo Mother Care support B .Mandatory
screening to be done as prescribed as below screening to be done as prescribed as below
• Head to toe examination ( Visible birth defect screening) • Head to toe examination ( Visible birth defect screening)
• Red reflex of both eyes • Red reflex of both eyes
• Ortolani and barlow • Ortolani and barlow
• Pulse oximeter screening for CCHD • Pulse oximeter screening for CCHD
• Serum TSH (cord value or day 3) with interpretation of the • Serum TSH (cord value or day 3) with interpretation of the
report report
• OAE examination for hearing screening Universal hearing • OAE examination for hearing screening Universal hearing
screening screening
NEO - NC NC000012 BERA NC000012300 Brainstem Evoked Response Audiometry(BERA) 0 Yes 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N BERA-1500 Brainstem Evoked Response Audiometry(BERA) Bilurubin test-P | Cininical notes explaining indication for Bera, family history, Bilurubin
NATAL 3 00788 test-P | Explaining indication for Bera-P | Family history-P | Test report of BERA, note
CARE on further Management-C
NEO - NC NC000012 ROP screening NC000012990 ROP screening 0 Yes 1 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ROP screening-1500 ROP screening Age of the beneficiaries-P | Clinical notes-P | Screening report from ophalmologist-C |
NATAL 99 000796 examination findings-P
CARE
NEO - NC NC000013 Special Neonatal NC000013540 Neonates with birthweight 1500 g to 1800 g or any weight 3000 Yes 3 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Medical No Insurance N N N Neonates with birthweight 1500 Neonates with birthweight 1500 g to 1800 g or any weight All investigations reports-C | Clinical notes with planned line of treatment (incl birth &
NATAL 54 Care Package 000797 with mild illness like and at least one of the following g to 1800 g or any weight with with mild illness like and at least one of the following past history)-P | Detailed Discharge Summary-C | Detailed ICPs (daily Treatment details)-
CARE conditions: : mild illness like and at least one conditions: : C | Investigation Reports supporting diagnosis-P | Planned line of treatment-P |
• Mild Respiratory Distress/ tachypnea of the following conditions: : • Mild Respiratory Distress/ tachypnea Procedure / Operative Notes (if applicable)-C
• Mild encephalopathy • Mild Respiratory Distress/ • Mild encephalopathy
• Severe jaundice requiring intensive phototherapy tachypnea • Severe jaundice requiring intensive phototherapy
• Unwell baby requiring monitoring • Mild encephalopathy • Unwell baby requiring monitoring
• Some dehydration • Severe jaundice requiring • Some dehydration
• Hypoglycaemia intensive phototherapy • Hypoglycaemia
• Cholestasis requiring investigations and in-hospital • Unwell baby requiring • Cholestasis requiring investigations and in-hospital
management monitoring management
The package includes food and stay for the mother in the • Some dehydration The package includes food and stay for the mother in the
hospital for breastfeeding, Kangaroo Mother Care (KMC) • Hypoglycaemia hospital for breastfeeding, Kangaroo Mother Care (KMC)
and Family centered care • Cholestasis requiring and Family centered care
investigations and in-hospital
management
The package includes food and
stay for the mother in the
hospital for breastfeeding,
Kangaroo Mother Care (KMC)
and Family centered care-3000
NEO - NC NC000015 Ventriculoperiton NC000015390 Ventriculoperitoneal Shunt Surgery (VP) or Omaya 5000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Medical No Insurance N N N Ventriculoperitoneal Shunt Surgery (VP) or Omaya Reservoir CT/ MRI-P | Clinical history-P | Detailed Procedure / Operative Notes-C | Detailed
NATAL 39 eal Shunt Surgery 000798 Reservoir or External Drainage for or External Drainage for discharge summary-C | Intra procedure clinical photograph-C | Pre-op clinical
CARE (VP) or Omaya Hydrocephalus Hydrocephalus photograph-P
Reservoir or
External Drainage
for Hydrocephalus
NEO - NC NC000022 Chronic Care NC000022600 Neonates in Special Neonatal Care, Special Neonatal Care- 3000 Yes 3 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes yes No Medical No Insurance N N N Neonates in Special Neonatal Neonates in Special Neonatal Care, Special Neonatal Care- All investigations reports-C | Claim number of having utilized Package no MN004A or
NATAL 6 Package: If the 00789 Plus, Intensive Neonatal Care or Critical Neonatal Care Care, Special Neonatal Care-Plus, Plus, Intensive Neonatal Care or Critical Neonatal Care MN005A-P | Detailed ICPs (daily Treatment details)-C | Detailed discharge summary-C |
CARE baby requires stay packages (MN002,MN003,MN004, MN005) who have not Intensive Neonatal Care or packages (MN002,MN003,MN004, MN005) who have not Notes mentioning need for stay beyond prescribed upper limit-P
beyond the upper fully recovered and continue to require NICU/SNCU care, Critical Neonatal Care packages fully recovered and continue to require NICU/SNCU care,
limit of usual stay e.g. for respiratory support, gavage feeding, thermal (MN002,MN003,MN004, e.g. for respiratory support, gavage feeding, thermal
in Package no support, etc., MN005) who have not fully support, etc.,
MN004A or recovered and continue to
MN005A for require NICU/SNCU care, e.g.
conditions like for respiratory support, gavage
severe BPD feeding, thermal support, etc., -
requiring 3000
respiratory
support, severe
NEC requiring
prolonged TPN
support
NEO - NC NC000031 Cranial USG - Add NC000031100 Cranial USG - Add on only allow with pkgs of Advanced 500 Yes 2 No 0 Yes No Secondary 0 No Yes Yes Add On Yes No No Medical No Insurance N N N 500 per ultrasound-500 Cranial USG - Add on only allow with pkgs of Advanced Doctor's prescription with indication for USG-P | USG Report-C
NATAL 1 on 00790 Neonatal Care Package / Critical Care Neonatal Package Neonatal Care Package / Critical Care Neonatal Package
CARE
NEO - NC NC000031 Critical Care NC000031400 Neonates <750 g or any weight with at least one of the 7800 Yes 3 No 0 No No Tertiary 35 No Yes Yes Regular PKG No yes No Medical No Insurance N N N Neonates <750 g or any weight Neonates <750 g or any weight with at least one of the Admission under neonatologist in NICU (in major locations) and under Pediatrician in
NATAL 4 Neonatal Package 00791 following conditions: with at least one of the following following conditions: smaller locations is a must-P | All investigations reports-C | Detailed ICPs (daily
CARE • Severe Respiratory Failure requiring High Frequency conditions: • Severe Respiratory Failure requiring High Frequency Treatment details)-C | Detailed clinical notes (incl trigger for hospitalization and
Ventilation or inhaled Nitric Oxide (iNO) • Severe Respiratory Failure Ventilation or inhaled Nitric Oxide (iNO) examiantion findings)-P | Detailed discharge summary-C | Supporting investigations-P
• Multisystem failure requiring multiple organ support requiring High Frequency • Multisystem failure requiring multiple organ support
including mechanical ventilation and multiple inotropes Ventilation or inhaled Nitric including mechanical ventilation and multiple inotropes
• Requiring parenteral nutrition Oxide (iNO) • Requiring parenteral nutrition
• NEC requiring operative intervention • Multisystem failure requiring • NEC requiring operative intervention
The above list is illustrative but not limited to these multiple organ support including The above list is illustrative but not limited to these
conditions. The package includes mandatory stay and food mechanical ventilation and conditions. The package includes mandatory stay and food
of the mother in the hospital for breastfeeding, Kangaroo multiple inotropes of the mother in the hospital for breastfeeding, Kangaroo
Mother Care (KMC) and Family centered care • Requiring parenteral nutrition Mother Care (KMC) and Family centered care
• NEC requiring operative
intervention
The above list is illustrative but
not limited to these conditions.
The package includes mandatory
stay and food of the mother in
the hospital for breastfeeding,
Kangaroo Mother Care (KMC)
and Family centered care-7800
NEO - NC NC000049 Advance NC000049000 Advance screening package ( Can be book only After 8000 Yes 1 No 0 Yes Yes Tertiary 0 Yes Yes Yes Govt Yes No No Medical No Insurance N N N FISH-4000 Max :1 | Karyotype- Advance screening package ( Can be book only After Admission under neonatologist in NICU (in major locations) and under Pediatrician in
NATAL screening 0784 neonatal screening PKG , if any significant finding and Reserve 2500 Max :1 | Urine GCMS & neonatal screening PKG , if any significant finding and smaller locations is a must-P | All investigations reports-C | Detailed ICPs (daily
CARE package - One indications required for more workup) karyotype, FISH, Blood TMS-2400 Max :1 indications required for more workup) karyotype, FISH, Treatment details)-C | Detailed clinical notes (incl trigger for hospitalization and
type only and Urine GCMS & Blood TMS or any other required Genetic, Urine GCMS & Blood TMS or any other required Genetic, examiantion findings)-P | Detailed discharge summary-C | Supporting investigations-P
Govt Reserve metabolic, NGS, biochemical screening investigatons metabolic, NGS, biochemical screening investigatons
NEO - NC NC000052 Echo - Add on NC000052600 Echo - Add on only allow with pkgs of Advanced Neonatal 1000 Yes 2 No 0 Yes No Secondary 0 No Yes Yes Add On Yes No No Medical No Insurance N N N Echo-1000 Echo - Add on only allow with pkgs of Advanced Neonatal Doctor's prescription with indication for ECHO-P | ECHO Report-C
NATAL 6 00792 Care Package / Critical Care Neonatal Package Care Package / Critical Care Neonatal Package
CARE
NEO - NC NC000057 Advanced NC000057000 Neonates between 750 g to 1000 gm or any weight and at 6500 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Neonates between 750 g to 1000 gm or any weight and at Admission under neonatologist in NICU (in major locations) and under Pediatrician in
NATAL Neonatal Care 0785 least one of the following conditions: least one of the following conditions: smaller locations is a must-P | All investigations reports-C | Detailed ICPs (daily
CARE Package • Any condition requiring invasive ventilation longer than • Any condition requiring invasive ventilation longer than Treatment details)-C | Detailed clinical notes (incl trigger for hospitalization and
24 hours 24 hours examiantion findings)-P | Detailed discharge summary-C | Supporting investigations-P
• Moderate to Severe Hypoxic Ischemic encephalopathy • Moderate to Severe Hypoxic Ischemic encephalopathy
• Cardiac rhythm disorders needing intervention (the cost • Cardiac rhythm disorders needing intervention (the cost
of cardiac surgery or implant will be covered under cardiac of cardiac surgery or implant will be covered under cardiac
surgery packages) surgery packages)
• Sepsis with complications such as meningitis or bone and • Sepsis with complications such as meningitis or bone and
joint infection, DIC or shock joint infection, DIC or shock
• Renal failure requiring dialysis • Renal failure requiring dialysis
• Inborn errors of metabolism • Inborn errors of metabolism
•NEC not requiring operative intervention •NEC not requiring operative intervention
The above list is illustrative but not limited to these The above list is illustrative but not limited to these
conditions. The package includes mandatory stay and food conditions. The package includes mandatory stay and food
of the mother in the hospital for breastfeeding, Kangaroo of the mother in the hospital for breastfeeding, Kangaroo
Mother Care (KMC) and Family centered care Mother Care (KMC) and Family centered care
NEO - NC NC000058 Advanced Surgery NC000058000 Advanced Surgery for Retinopathy 15000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Advanced Surgery for Retinopathy Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
NATAL for Retinopathy of 0786 of Prematurity of Prematurity C | Fundoscope reports / stills showing extent of ROP and need for surgery-P | Intra
CARE Prematurity procedure clinical photograph-C
NEO - NC NC000082 Intensive NC000082000 6000 Yes 3 No 0 No No Tertiary 7 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Admission under neonatologist in NICU (in major locations) and under Pediatrician in
NATAL 0 Neonatal Care 00793 Babies of 1000-1499 g birthweight or any weight with at Babies of 1000-1499 g Babies of 1000-1499 g birthweight or any weight with at smaller locations is a must-P | All investigations reports-C | Detailed ICPs (daily
CARE Package least one of the following conditions: birthweight or any weight with least one of the following conditions: Treatment details)-C | Detailed clinical notes (incl trigger for hospitalization and
• Need for mechanical ventilation for less than 24 hours or at least one of the following • Need for mechanical ventilation for less than 24 hours or examiantion findings)-P | Detailed discharge summary-C | Supporting investigations-P
non-invasive respiratory support (CPAP, HFFNC) conditions: non-invasive respiratory support (CPAP, HFFNC)
• Sepsis / pneumonia without complications • Need for mechanical • Sepsis / pneumonia without complications
• Hyperbilirubinemia requiring exchange transfusion ventilation for less than 24 hours • Hyperbilirubinemia requiring exchange transfusion
• Seizures requring anti-convulsants or non-invasive respiratory • Seizures requring anti-convulsants
• Major congenital malformations (pre-surgical support (CPAP, HFFNC) • Major congenital malformations (pre-surgical stabilization)
stabilization) • Sepsis / pneumonia without • Critical congenital heart disease (excluding surgical costs)
• Critical congenital heart disease (excluding surgical costs) complications • Congestive heart failure or shock
• Congestive heart failure or shock • Hyperbilirubinemia requiring •Meconium aspiration syndrome needing only brief
•Meconium aspiration syndrome needing only brief exchange transfusion ventilation of less than 24 hours or requiring CPAP/HFNC
ventilation of less than 24 hours or requiring CPAP/HFNC • Seizures requring anti- The above list is illustrative but not limited to these
The above list is illustrative but not limited to these convulsants conditions.
conditions. • Major congenital The package includes mandatory stay and food of the
The package includes mandatory stay and food of the malformations (pre-surgical mother in the hospital for breastfeeding, Kangaroo Mother
mother in the hospital for breastfeeding, Kangaroo Mother stabilization) Care (KMC) and Family centered care
Care (KMC) and Family centered care • Critical congenital heart
disease (excluding surgical costs)
• Congestive heart failure or
shock
•Meconium aspiration
syndrome needing only brief
ventilation of less than 24 hours
or requiring CPAP/HFNC
The above list is illustrative but
not limited to these conditions.
The package includes mandatory
stay and food of the mother in
NEO - NC NC000086 Laser Therapy for NC000086900 Laser Therapy for Retinopathy of Prematurity -Neo - natal 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N the hospital
Laser Therapyforfor
breastfeeding,
Retinopathy Laser Therapy for Retinopathy of Prematurity -Neo - natal Clinical notes-P | Details of Laser therapy done.-C | Fundoscope reports / stills showing
NATAL 9 Retinopathy of 00794 (Irrespective of no. of eyes affected) of Prematurity -Neo - natal (Irrespective of no. of eyes affected) extent of ROP-P | Need for procedure-P
CARE Prematurity per session (Irrespective of no. of eyes per session
(Irrespective of affected) - per session-1500
no. of eyes
affected) - per
session
NEO - NC NC000097 neonatal NC000097900 Neonates > 2.5 kg nursed with mother : Includes clinical 0 Yes 1 No 0 Yes No Secondary 3 No Yes Yes Day care / Yes No No Medical Yes Insurance Y N N Neonates > 2.5 kg nursed with Neonates > 2.5 kg nursed with mother : Includes clinical Visible birth defect-P | All investigations reports-C | Birth Certificate / Discharge
NATAL 9 screening - Add 00795 monitoring, breastfeeding support, birth vaccination, Add on mother : Includes clinical monitoring, breastfeeding support, birth vaccination, summary of both mother & baby along with reports of various investigations as described
CARE on and day care thyroid screening, universal hearing screening and pre- monitoring, breastfeeding thyroid screening, universal hearing screening and pre- in the package-P | Clinical notes with planned line of treatment (incl birth & past history)-
discharge counselling,visible defect screening ,pulse oxy support, birth vaccination, discharge counselling,visible defect screening ,pulse oxy P | Detailed Discharge Summary-C | Detailed ICPs (daily Treatment details)-C |
meter screening CCHB thyroid screening, universal meter screening CCHB Procedure / Operative Notes (if applicable)-C | Pulse oxy metry screening-P | Thyroid-P
hearing screening and pre- | Vaccination-P | ulse oxy metry screening-P
discharge counselling,visible
defect screening ,pulse oxy
meter screening CCHB-750
NEPHROLO NE NE000010 Palliative and NE0000107700 Palliative care end stage disease 0 Yes 3 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Palliative care end stage disease- Palliative care end stage disease Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
GY 77 supportive care 00805 3000 history -P | Detailed ICPs-C | Detailed discharge summary-C | Final bill with payment
for malignant receip-C | Interventions-C | Review notes of primary physician with referal to Palliative
disease at Medicine-P | Treatment details-C | Treatment-C
advanced or end
stage
NEPHROLO NE NE000011 Peritoneal Dialysis NE0000115500 Peritoneal Dialysis 0 Yes 1 Yes 2 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N PD fluid & disposables-1000 Max Peritoneal Dialysis Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 55 00806 :2 | Pd Catheter Insertion-1500 done-P | Barcode / Invoice of PD catheter (Single use only)-C | Clinical notes detailing
Max :2 history and Admission notes showing vitals and examination findings; any investigations
done; planned line of management-P | Detailed ICPs-C | Detailed discharge summary-C
| Examination findings-P | Planned line of management-P | Treatment details-C
NEPHROLO NE NE000019 Central Line ( NE0000198000 Central Line ( Double Lumen / Triple Lumen ) with 0 Yes 1 No 0 Yes No Secondary 0 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Double Lumen-2000 | Triple Central Line ( Double Lumen / Triple Lumen ) with Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
GY 8 Double Lumen / 0801 procedure - add on Lumen-2500 procedure - add on history-P | Detailed ICPs-C | Detailed discharge summary-C | Invoice / bar code-C |
Triple Lumen ) Review notes of primary physician for requirent of procedure-P | Treatment details-C |
X ray after procedure-C
NEPHROLO NE NE000027 Acute NE0000270000 Acute glomerulonephritis 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute glomerulonephritis Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
GY glomerulonephriti 799 (without Ventilator)-4700 | history-P | Detailed ICPs-C | Detailed discharge summary-C | Investigations done-P |
s Routine Ward-1800 Provide report If Biopsy was done-C | Treatment details-C | planned line of
management-P
NEPHROLO NE NE000029 Continuous renal NE0000294000 Continuous renal replacement therapy (CRRT) in AKI 0 Yes 5 No 0 Yes No Tertiary 5 Yes Yes Yes Regular Yes No No Medical No Insurance N N N CRRT-6000 Continuous renal replacement therapy (CRRT) in AKI Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 4 replacement 0802 (including cost for disposable) PKG/add on (including cost for disposable) done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
therapy/Continuo summary-C | Examination findings-P | Planned line of management-P | RFT-C |
us veno-venous Treatment details-C | eGFR-C
hemofiltration
NEPHROLO NE NE000060 AKI / Renal failure NE0000600000 AKI / Renal failure 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU AKI / Renal failure Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
GY 800 (without Ventilator)-4700 | history-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
Routine Ward-1800 management-P | Provide report If Biopsy was done-C | Treatment details-C
NEPHROLO NE NE000072 Haemodialysis NE0000725000 Haemodialysis ± Inj.Erythropoietin - Day care / Add on 1500 Yes 1 Yes 1 Yes No Tertiary 1 Yes Yes Yes Day care / Yes Yes No Medical Yes Insurance Y N N Inj . Erythropoietin-600 Max :1 Haemodialysis ± Inj.Erythropoietin - Day care / Add on Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 5 Dialysis (ARF / 0803 Add on done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
CRF) summary-C | Examination findings-P | Hemodialyzer barcode / invoice (Single Use Only)-
C | Planned line of management-P | Treatment details-C
NEPHROLO NE NE000099 NEPHROTIC NE0000999000 Nephrotic syndrome with peritonitis/Steroid dependent or 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Nephrotic syndrome with peritonitis/Steroid dependent or Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 9 SYNDROME 0804 resistent/Uncomplicated steroid sensitive (without Ventilator)-4700 | resistent/Uncomplicated steroid sensitive done-P | Clinical notes detailing history including past history-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | Examination findings-P | Planned line of management-
P | Provide report If Biopsy was done-C | Treatment details-C
NEUROSU NS NS000010 Nerve Biopsy NS0000100100 Nerve Biopsy excluding Hansen's 7000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Nerve Biopsy excluding Hansen's Admission notes showing vitals-P | Reports of previous investigations-P | examination
RGERY 01 excluding Hensens 00875 findings-P | planned line of management -P | Clinical notes detailing history -P |
Detailed Proedure notes-C | Detailed discharge summary-C | HPE Report of Nerve
Biopsy-C | any investigations done-P | need for Nerve Biopsy-P | treatment taken
ruling out Hensen's, differentials suspected-P
NEUROSU NS NS000010 Nerve root block NS0000100300 Nerve root block 3000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Nerve root block Admission notes showing vitals -P | any investigations done-P | examination findings-P
RGERY 03 00876 | Clinical notes detailing history -P | Detailed Discharge Summary-C | Procedure /
Operation notes-C | X-ray films with reports -P | planned line of management with
planned line of treatment including planned line of treatment-P
NEUROSU NS NS000010 Nerve NS0000100600 Nerve Transposition/ Nerve Release/ Nerve 13000 No 0 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Nerve Transposition/ Nerve Release/ Nerve Admission notes showing vitals -P | examination findings-P | planned line of
RGERY 06 Transposition / 00877 Neurolysis/Nerve repair surgery Neurolysis/Nerve repair surgery management justifying surgery with evidence of MRI / EMG/ NCV-P | Clinical notes
Release / detailing history -P | Detailed Discharge summary-C | Detailed Procedure / Operative
Neurolysis Notes-C | Intra Procedure still images-C | any investigations done-P
NEUROSU NS NS000010 Palliative NS0000109000 Palliative neurological interventions 60000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Palliative neurological interventions Admission notes showing vital-P | examination findings-P | thyroid profile-P | Clinical
RGERY 90 nerurosurgical 00878 notes detailing history-P | Clinical notes with planned line of treatment-P | Discharge
interventions for summary with detail treatment-C | Interventions-C | KFT-P | LFT-P | Procedure notes-
secondary C | blood sugar-P | management CECT/ x-Ray/USG,/MRI CBC-P
vertebral and
brain metastasis
NEUROSU NS NS000011 AVM NS0000111000 AVM EMBOLISATION/ THROMBECTOMY 175000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N AVM EMBOLISATION/ THROMBECTOMY CT/ MRI/ Cerebral angiography/ trans cranialUSG, clinical examintaion notes.Clinical notes
RGERY 1 EMBOLISATION 0835 detailing history and Admission notes showing vitals and examination findings; any
investigations done; planned line of management-P | Discharge summary-C | OT notes-
C | Post procedure Imaging with film (CT)-C | Relavant invetsigation reports-C
NEUROSU NS NS000011 Peripheral Nerve NS0000115100 Peripheral nerve excision and repair 30000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Peripheral nerve excision and repair Electromyography (EMG) reports-P | Admission notes showing vitals-P | Clinical notes
RGERY 51 Surgery 00879 detailing history -P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Nerve Conduction Velocity (NCV) and Electromyography (EMG) reports-P |
Post procedure Clinical photograph showing scar-C | any investigations done-P |
examination finding-P | planned line of management -P
NEUROSU NS NS000011 Peripheral NS0000115300 Peripheral Neurectomy - Govt Reserve 17300 No 0 No 0 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Surgical No Insurance N N N Peripheral Neurectomy - Govt Reserve examination findings-P | Admission notes showing vitals-P | Clinical notes detailing
RGERY 53 Neurectomy 00880 Reserve history-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Post procedure Clinical photograph showing scar-C | any investigations done-P |
planned line of management justifying the surgery,-P
NEUROSU NS NS000011 Plexus injury along NS0000117500 Plexus injury along with Vascular injury graft 60000 No 0 No 0 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Plexus injury along with Vascular injury graft Admission notes showing vitals-P | MLC/ FIR +/- Nerve conduction velocity (NCV) + /-
RGERY 75 with Vascular 00881 MRI + /- MRA + /- EMG (Electromyography)-P | need of surgery-P | Clinical notes
injury repair / detailing history -P | Detailed discharge summary-C | Detailed operatives notes-C |
graft Intra operative still photograph-C | any investigations done-P | examination findings-P
| planned line of management detailing the injury -P
NEUROSU NS NS000011 Posterior Cervical NS0000119600 Posterior cervical laminoforaminotomy and discectomy- 30000 No 0 No 0 No Yes Tertiary 7 Yes Yes Yes Govt No No No Surgical No Insurance N N R N Posterior cervical laminoforaminotomy and discectomy- Admission notes showing vitals-P | MRI-P | examination findings-P | Clinical notes
RGERY 96 laminoforaminoto 00882 Govt Reserve Reserve Govt Reserve detailing history-P | Detailed Procedure / Operative Notes.-C | Detailed discharge
my and summary-C | Post procedure Clinical photograph showing scar-C | any investigations
discectomy done-P | planned line of management-P
without implant
NEUROSU NS NS000011 Posterior Cervical NS0000119700 Posterior cervical fusion using lateral mass or pedicle screws 40000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cage-2500 Max :10 | Odontoid Posterior cervical fusion using lateral mass or pedicle screws Admission notes showing vitals -P | MRI-P | examination findings-P | planned line of
RGERY 97 Fusion with 00883 and rods screw-6000 Max :10 | Pedicle and rods management -P | Cervical spine X-ray showing implant-C | Clinical notes detailing
implant screw-2500 Max :10 | Plate with history -P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
(Lateral mass screw-2500 Max :10 | Rod -1500 Post procedure Clinical photograph showing scar-C | any investigations done-P
fixation) Max :10
NEUROSU NS NS000011 Posterior cranial NS0000119800 Posterior cranial fossa encephalocele/meningocele repair 50000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exogenous Graft-4000 Max :1 | Posterior cranial fossa encephalocele/meningocele repair Admission notes showing vitals-P | CT/MRI establishing need of surgery-P | any
RGERY 98 fossa 00884 Fibrin Glue-9000 Max :1 investigations done-P | examination findings-P | Clinical notes detailing history -P |
encephalocele / Detailed discharge summary Detailed Procedure / Operative Notes-C | Post procedure
meningocele - Clinical photograph showing scar-C | Post procedure Imaging with film (CT)-C | planned
repair line of management -P
NEUROSU NS NS000012 R. F. Lesioning for NS0000122300 R. F. Lesioning for Trigeminal Neuralgia 17300 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N R. F. Lesioning for Trigeminal Neuralgia Admission notes showing vitals-P | examination findings-P | Clinical notes detailing
RGERY 23 Trigeminal 00885 history -P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Neuralgia Intra procedure-C | Post procedure Imaging with film (CT)-C | Series of still photographs-
C | any investigations done-P | invoice of RF probe-C | justification of local
neurectomy with MRI / CT-P | planned line of management establishing diagnosis of
Trigeminal neuralgia -P
NEUROSU NS NS000012 Reexploration for NS0000125300 Re exploration for Cranial / Spinal surgeries 25000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Re exploration for Cranial / Spinal surgeries Admission notes showing vitals-P | examination findings-P | Clinical notes detailing
RGERY 53 Cranial / Spinal 00886 history-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary.-C |
surgeries MRI / CT-P | Post procedure Imaging with film (CT / MRI)-C | any investigations done-P
| planned line of management-P
NEUROSU NS NS000013 Shunt Surgery NS0000133200 Ventriculo-Peritoneal Shunt (Low/Medium/High Pressure) / 30000 No 0 No 0 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ventriculo-Peritoneal Shunt (Low/Medium/High Pressure) / Admission notes showing vitals-P | CT/MRI-P | examination findings-P | Clinical
RGERY 32 00887 Ventriculo - pleural Shunt (Low/Medium/High Pressure Ventriculo - pleural Shunt (Low/Medium/High Pressure Photograph-C | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-
)/Ventriculo - atrial Shunt (Low/Medium/High Pressure )/Ventriculo - atrial Shunt (Low/Medium/High Pressure C | Detailed discharge summary-C | Post procedure Imaging with film (CT)-C | Sticker/
)/Theco - peritoneal Shunt (Low/Medium/High Pressure ) )/Theco - peritoneal Shunt (Low/Medium/High Pressure ) Barcode of Shunt.-C | any investigations done-P | planned line of management-P
NEUROSU NS NS000013 Spine - Extradural NS0000135600 Extradural hematoma evacuation 30000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Extradural hematoma evacuation Admission notes showing vitals -P | any investigations done-P | examination findings-P
RGERY 56 Haematoma 00888 | planned line of management-P | Clinical notes detailing history -P | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | MRI supporting
surgery-P | Post procedure Clinical photograph showing scar-C
NEUROSU NS NS000013 Spine - Extradural NS0000135700 Excision of extradural spinal tumor 40000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of extradural spinal tumor Admission notes showing vitals -P | MRI supporting surgery-P | examination findings-P
RGERY 57 Tumour 00889 | planned line of management-P | Clinical notes detailing history-P | Detailed discharge
summary Detailed Procedure / Operative Notes.-C | Histopathology/ Biopsy report-C |
Post procedure Clinical photograph showing scar-C | any investigations done-P
NEUROSU NS NS000013 Spine - Extradural NS0000135700 Excision of extradural spinal tumor with fusion and fixation 40000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Cage-2500 Max :10 | Odontoid Excision of extradural spinal tumor with fusion and fixation Admission notes showing vitals-P | MRI supporting surgery-P | examination findings-P
RGERY 57 Tumour 00890 (Cost of implants to be extra) screw-6000 Max :10 | Pedicle (Cost of implants to be extra) | Clinical notes detailing history-P | Detailed discharge summary Detailed Procedure /
screw-2500 Max :10 | Plate with Operative Notes-C | Histopathology/ Biopsy report-C | Post procedure X-ray and clinical
screw-2500 Max :10 | Rod -1500 photograph showing scar-C | any investigations done-P | planned line of management -
Max :10 P
NEUROSU NS NS000013 Spine - Intradural NS0000135800 Excision of Intradural extramedullary tumor 50000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of Intradural extramedullary tumor Admission notes showing vitals-P | MRI supporting surgery-P | examination findings-P
RGERY 58 Tumour 00891 | Biopsy & HPE report-C | Clinical notes detailing history-P | Detailed Procedure /
Operative Notes-C | Detailed discharge summary-C | Post procedure Clinical
photograph showing scar-C | any investigations done-P | planned line of management -
P
NEUROSU NS NS000013 Spine - Intradural NS0000135800 Excision of Intradural extramedullary tumor with fusion and 54000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Cage-2500 Max :10 | Odontoid Excision of Intradural extramedullary tumor with fusion and Admission notes showing vitals -P | MRI supporting surgery-P | any investigations
RGERY 58 Tumour 00892 fixation (Cost of implants to be extra) screw-6000 Max :10 | Pedicle fixation (Cost of implants to be extra) done-P | examination findings-P | Biopsy & HPE report-C | Clinical notes detailing
screw-2500 Max :10 | Plate with history-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
screw-2500 Max :10 | Rod -1500 Post procedure X-ray and clinical photograph showing scar-C | planned line of
Max :10 management-P
NEUROSU NS NS000013 Spine - NS0000135900 Excision of Intramedullary tumor of spine + Neuro 50000 Yes 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of Intramedullary tumor of spine + Neuro Admission notes showing vitals-P | MRI supporting surgery-P | any investigations
RGERY 59 Intramedullar 00893 monitoring Device 15000 monitoring Device 15000 done-P | examination findings-P | planned line of management -P | Clinical notes
Tumour detailing history -P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Histopathology-C | Intraoperative Neuromonitor Images with electrode
placement and wave form recording.-C | Post procedure Clinical photograph showing
scar-C
NEUROSU NS NS000013 Spine - NS0000135900 Excision of Intramedullary tumor with fusion and ficxation 51000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cage-2500 Max :10 | Odontoid Excision of Intramedullary tumor with fusion and ficxation Admission notes showing vitals -P | MRI supporting surgery-P | any investigations
RGERY 59 Intramedullar 00894 (Cost of implants to be extra) screw-6000 Max :10 | Pedicle (Cost of implants to be extra) done-P | examination findings-P | Clinical notes detailing history-P | Detailed
Tumour screw-2500 Max :10 | Plate with Procedure / Operative Notes-C | Detailed discharge summary-C | Histopathology /
screw-2500 Max :10 | Rod -1500 specimen photo-C | Post procedure Clinical photograph showing scar-C | Post
Max :10 procedure Imaging with film (X-ray/ CT)-C | planned line of management-P
NEUROSU NS NS000013 Stereotactic NS0000137700 Stereotactic Lesioning for movement disoders 65200 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Stereotactic Lesioning for movement disoders Admission notes showing vitals-P | Clinical notes detailing history -P | Detailed
RGERY 77 Lesioning 00895 Procedure / Operative Notes-C | Detailed discharge summary,-C | Post procedure
Clinical photograph showing scar & stereotactic frame-C | Post procedure Imaging with
film (CT)-C | any investigations done-P | examination findings-P | planned line of
management from neuorlogist/ psychiatriat / MRI-P
NEUROSU NS NS000013 Superficial NS0000138800 Superficial Temporal Artery (STA): middle cerebral artery 60000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Superficial Temporal Artery (STA): middle cerebral artery Admission notes showing vitals -P | MRA/ DSA report-P | any investigations done-P |
RGERY 88 Temporal Artery 00896 (MCA) or (other EC - IC) Bypass procedure (MCA) or (other EC - IC) Bypass procedure examination findings-P | planned line of management -P | Clinical notes detailing
(STA): middle history -P | Detailed Procedure / Operative Notes.-C | Detailed discharge summary-C |
cerebral artery Post procedure Clinical photograph showing scar-C
(MCA) or (other
EC - IC) Bypass
procedure
NEUROSU NS NS000013 Surgery for NS0000139800 Evacuation of Post-trauamtic EDH/SDH- Intraparenchymal 50000 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Evacuation of Post-trauamtic EDH/SDH- Intraparenchymal Admission notes showing vitals -P | CT/ MRI establishing need of surgery-P |
RGERY 98 Haematoma - 00897 Hematoma, Hematoma, examination findings-P | Clinical notes detailing history -P | Detailed Procedure /
Intracranial Operative Notes-C | Detailed discharge summary-C | Post procedure Clinical
photograph showing scar-C | Post procedure Imaging with film (CT)-C | any
investigations done-P | planned line of management-P
NEUROSU NS NS000013 Surgery for NS0000139800 Spontaneous Intraparenchymal hematoma 50000 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Spontaneous Intraparenchymal hematoma Admission notes showing vitals -P | CT/ MRI establishing need of surgery-P | any
RGERY 98 Haematoma - 00898 evacuation/Evacuation of Post-trauamtic Intraparenchymal evacuation/Evacuation of Post-trauamtic Intraparenchymal investigations done-P | examination findings-P | planned line of management-P |
Intracranial Hematoma in Paediatric Age group Hematoma in Paediatric Age group Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Post procedure Clinical photograph showing scar-C | Post
procedure Imaging with film (CT)-C
NEUROSU NS NS000014 Surgery for NS0000140400 Surgery for supratentorial Extra-axial Tumours (Meningioma 50000 Yes 0 Yes 3 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mini Plate-3000 Max :3 Surgery for supratentorial Extra-axial Tumours (Meningioma Admission notes showing vitals-P | examination findings-P | planned line of
RGERY 04 tumour meninges 00899 etc)/Surgery for infratentorial etc)/Surgery for infratentorial management-P | CT supporting surgery-P | Clinical notes detailing histor-P | Detailed
ExtraaxialTumour(meningioma etc) ExtraaxialTumour(meningioma etc) Procedure / Operative Notes-C | Detailed discharge summary-C | Histopathology /
specimen photo-C | Post procedure Clinical photograph showing scar-C | Post
procedure Imaging with film (CT)-C | any investigations done-P
NEUROSU NS NS000014 Trans oral Surgery NS0000146700 Trans oral Surgery 46900 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Trans oral Surgery Admission notes showing vitals-P | any investigations done-P | examination findings-P
RGERY 67 00900 | planned line of management X ray-P | Clinical notes detailing history-P | Detailed
Procedure / Operative Notes.-C | Detailed discharge summary-C | MRI Spine-P | Post
procedure Imaging with film (X-ray)-C
NEUROSU NS NS000014 Trans Sphenoidal NS0000146800 Endoscpic/Microscopic Trans Sphenoidal Surgery 50000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Endoscpic/Microscopic Trans Sphenoidal Surgery Admission notes showing vitals -P | MRI supporting surgery-P | any investigations
RGERY 68 Surgery 00901 done-P | examination findings-P | planned line of management -P | Clinical notes
detailing history-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Histopathology / specimen photo-C | Post procedure Imaging with film
(CT)-C
NEUROSU NS NS000014 Transoral surgery NS0000147100 Trans oral anterior decompression and Posterior 64300 Yes 0 Yes 1 Yes No Tertiary 12 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for "Transoral surgery Trans oral anterior decompression and Posterior Admission notes showing vitals-P | Any investigations done-P | Clinical notes detailing
RGERY 71 (Anterior) and CV 00902 stabilisation or C V junction (Anterior) and CV Junction stabilisation or C V junction history-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Junction (Posterior Sterlization)-30000 Examination findings-P | Planned line of management-P | Post procedure Imaging with
(Posterior Max :1 film (X-ray)-C | X ray and MRI Spine-P
stabilisation)
NEUROSU NS NS000014 Twist Drill NS0000148800 Twist Drill Craniostomy 15000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Twist Drill Craniostomy Admission notes showing vitals-P | Any investigations done-P | CT scan-P | Clinical
RGERY 88 Craniostomy 00903 notes detailing history-P | Detailed Procedure / Operative Notes-C | Discharge
summary-C | Examination findings-P | Planned line of management-P | Post procedure
Clinical photograph showing scar-C | Post procedure Imaging with film (CT)-C
NEUROSU NS NS000015 Ventricular tap NS0000153700 Ventricular tapping with Omayya reservoir/external 20000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ventricular tapping with Omayya reservoir/external Admission notes showing vitals -P | Any investigations done-P | CT/ MRI clincial
RGERY 37 00904 ventricular drain ventricular drain examination notes-P | Clinical notes detailing history-P | Clinical notes detailing history-
P | Examination findings-P | OT notes-C | Planned line of management -P | Relavant
invetsigation reports-C | Sticker / Barcode of EVD / Omaya resevoir-C | discharge
summary-C
NEUROSU NS NS000015 Ventricular Tap / NS0000153800 Ventricular Tap / Puncture 15000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Ventricular Tap / Puncture Examination findings-P | Admission notes showing vitals -P | Any investigations done-P
RGERY 38 Puncture 00905 | CT justifying procedure-P | Clinical notes detailing history-P | Clinical notes detailing
history-P | Clinical notes-P | Detailed Procedure / Operative Notes.-C | Detailed
discharge summary.-C | Planned line of management -P | Post procedure Clinical
photograph showing scar-C
NEUROSU NS NS000015 Brachial Plexus – NS0000158000 Brachial Plexus repair 31300 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Brachial Plexus repair Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 8 Repair 0836 | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | MRI report-P | Nerve Conduction Study-C | Planned line of
management-P | Post procedure Clinical photograph showing scar-C
NEUROSU NS NS000016 Brain Abscess NS0000162000 Burr hole and Tapping of Brain Abscess 25000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Burr hole and Tapping of Brain Abscess Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 2 Tapping 0837 | CT / MRI Brain.-P | Clinical notes detailing history-P | Clinical photograph showing
scar-C | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Planned line of management -P | Post procedure Imaging with film (CT)-C | Post
procedure-C | Pus C/s-C
NEUROSU NS NS000016 Brain Biopsy NS0000163000 Brain Biopsy- Open/Stereotactic guided 34700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Brain Biopsy- Open/Stereotactic guided Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 3 0838 | CT/MRI-P | Clinical notes detailing history-P | Clinical photograph showing scar-C |
Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
Histopathology / specimen photo-C | Planned line of management-P | Post procedure
Imaging with film (CT)-C | Post procedure-C | Suspected differential diagnosis-P
NEUROSU NS NS000017 Burr hole surgery NS0000172000 Burr hole surgery for evacuation of hematoma/ biopsy/ pus 11000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Burr hole surgery for evacuation of hematoma/ biopsy/ pus Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 2 0839 drainage/Placement of ICP monitoring device drainage/Placement of ICP monitoring device | CT/MRI establishing need of surgery-P | Clinical notes detailing history -P | Clinical
photograph showing scar-C | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Planned line of management-P | Post procedure Imaging with
film (CT)-C | Post procedure-C
NEUROSU NS NS000017 Burr hole surgery NS0000172000 Burr hole surgery with chronic Sub Dural Haematoma - U/ L 0 Yes 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Bilateral - Burr hole surgery with Burr hole surgery with chronic Sub Dural Haematoma - U/ L Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 2 0840 or B/L chronic Sub Dural Haematoma- or B/L | CT/MRI establishing need of surgery-P | Clinical notes detailing history -P | Clinical
30400 | Unilateral - Burr hole photograph showing scar-C | Detailed Procedure / Operative Notes-C | Detailed
surgery with chronic Sub Dural discharge summary-C | Planned line of management -P | Post procedure Imaging with
Haematoma-21700 film (CT)-C | Post procedure-C
NEUROSU NS NS000019 Carpal Tunnel NS0000190000 Carpal tunnel release 13500 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Carpal tunnel release Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 0 Release 0841 | Clinical notes detailing history-P | Clinical photograph showing scar-C | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | MRI / NCV-C | MRI /
NCV-P | Planned line of management-P | Post procedure-C
NEUROSU NS NS000020 Cervical Disc NS0000205000 Anterior cervical discectomy without fusion - Govt Reserve 35000 No 0 No 0 No Yes Tertiary 7 No Yes Yes Govt No No No Surgical No Insurance N N N Anterior cervical discectomy without fusion - Govt Reserve Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 5 Multiple level 0842 Reserve | Clinical notes detailing history-P | Clinical photograph showing scar-C | Detailed
without Fusion Procedure / Operative Notes-C | Detailed discharge summary-C | MRI-P | Planned line
of management.-P | Post procedure-C
NEUROSU NS NS000020 Cervical/Thoracic NS0000206000 Cervical/Thoracic/ Lumbar corpectomy with fusion for 50000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Cage-2500 Max :10 | Odontoid Cervical/Thoracic/ Lumbar corpectomy with fusion for Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 6 / Lumbar 0843 Tumor/Infection/Trauma screw -6000 Max :10 | Pedicle Tumor/Infection/Trauma | Clinical notes detailing history-P | Clinical photograph showing scar-C | Detailed
Corpectomy with screw or Lateral Mass Screw- Procedure / Operative Notes-C | Detailed discharge summary-C | MRI-P | Planned line
fusion 2500 Max :10 | Plate with screw- of management -P | Post procedure Imaging with film (X ray) showing the implants-C |
2500 Max :10 | Rod -1500 Max Post procedure-C
:10
NEUROSU NS NS000027 Conservative NS0000274000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone Admission notes showing vitals and examination findings-P | All investigations reports-C
RGERY 4 Management 0844 stand alone-1800 | Any investigations done-P | Clinical notes detailing history -P | Detailed ICPs-C |
NEUROSU NS NS000028 Conservative NS0000283000 Conservative Management - 0 Yes 3 No 0 Yes No Tertiary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - Admission notes showing vitals and examination findings-P | Any investigations done-P |
RGERY 3 Management of 0845 (Chest/Head/Face/Abdomen)stand alone (Chest/Head/Face/Abdomen)sta (Chest/Head/Face/Abdomen)stand alone Clinical notes detailing history-P | Clinical photograph-C | Detailed discharge summary-C
injury nd alone-1800 | Extent of upto 40% burns visible on photograph (with rule of 9 chart)-P | MLC copy
with number-P | Planned line of management-P | Post Treatment-C | X-rays or other
diagnostic procedures done as a part of treatment-C | lab tests-C
NEUROSU NS NS000029 Conservatively NS0000292000 Conservatively managed Severe spinal injury / Severe Head 0 Yes 3 No 0 Yes No Secondary 30 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N ICU (with Ventilator)-6000 | ICU Conservatively managed Severe spinal injury / Severe Head Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY 2 managed Severe 0846 injury (without Ventilator)-4700 | injury | Clinical Notes-C | Clinical notes detailing history-P | Daily charting-C | Detailed
spinal injury / Routine Ward-1800 Procedure-C | Detailed discharge summary-C | MRI / CT-P | Planned line of
Severe Head management-P
injury
NEUROSU NS NS000031 Cranial Nerve NS0000310000 Cranial nerve anastomosis/Repair - Govt Reserve 25000 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Cranial nerve anastomosis/Repair - Govt Reserve Admission notes showing vitals and examination findings-P | MRI justifying surgery-P |
RGERY 0 Anastomosis 0847 Reserve Clinical notes detailing history-P | Clinical photograph showing scar-C | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | Post procedure-C |
any investigations done-P | planned line of management -P
NEUROSU NS NS000031 CranioPlasty NS0000312000 Cranioplasty with autologus bone graft/Cranioplasty with 23900 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for CranioPlasty with Cranioplasty with autologus bone graft/Cranioplasty with Admission notes showing vitals and examination findings-P | Any investigations done-P |
RGERY 2 0848 exogenous Graft Exogenous graft-20000 Max :1 exogenous Graft Clinical notes detailing history-P | Clinical photograph-C | Detailed Procedure /
Operative Notes-C | Imaging wih film (CT/Xray)-C | Planned line of management.-P |
Post procedure-C | Post procedure-C
NEUROSU NS NS000031 Craniostenosis NS0000313000 Cranial vault remodeling/ surgery for "Craniosynostosis" 32000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Cranial vault remodeling/ surgery for "Craniosynostosis" Admission notes showing vitals and examination findings-P | Any investigations done-P |
RGERY 3 0849 Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Planned line of management.-P | Post procedure Clinical
photograph showing scar-C | Post procedureImaging with film (CT / X-Ray)-C
NEUROSU NS NS000047 Decompressive NS0000476000 Craniectomy/ DECRA for head injury/acute stroke/cerebral 75000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Craniectomy/ DECRA for head injury/acute stroke/cerebral Admission notes showing vitals and examination findings-P | any investigations done-P
RGERY 6 Craniectomy 0850 venous thrombosis venous thrombosis | Clinical notes detailing history-P | Discharge summary-C | OT notes-C | Post
procedure Imaging with film (CT)-C | Relavant invetsigation reports-C | planned line of
management CT/ MRI clincial examination notes-P
NEUROSU NS NS000048 Depressed Skull NS0000487000 Surgery for Depressed Skull fracture 35000 Yes 0 Yes 3 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Mini plate-3000 Max :3 Surgery for Depressed Skull fracture Admission notes showing vitals and examination findings-P | x-ray-P | Any
RGERY 7 Fracture 0851 investigations done-P | Clinical notes detailing history-P | Detailed Procedure /
Operative Notes-C | Detailed discharge summary-C | Invoice-C | Planned line of
management-P | Post procedure Clinical photograph showing scar-C | Post procedure
Imaging with film (X-Ray / CT)-C
NEUROSU NS NS000049 Diagnostic NS0000496000 Diagnostic Cerebral / Spinal Angiography/ peripheral (DSA - 10000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Diagnostic Cerebral / Spinal Angiography/ peripheral (DSA - Admission notes showing vitals and examination findings-P | Clinical notes detailing
RGERY 6 Cerebral / Spinal 0852 Digital Substraction Angiography) Digital Substraction Angiography) history and -P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
Angiography/ C | Intra procedure clinical series of still photographs-C | any investigations done-P |
peripheral (DSA - justification of local neurectomy with MRI / CT-P | planned line of management
Digital establishing diagnosis of Trigeminal neuralgia-P
Substraction
Angiography)
NEUROSU NS NS000050 Discectomy - NS0000501000 Discectomy - Dorsal Govt reserve 33000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Surgical No Insurance N N N Discectomy - Dorsal Govt reserve MRI establishing need of surgery-P | Clinical notes-P | Detailed Procedure / Operative
RGERY 1 Dorsal 0853 Reserve Notes-C | Detailed discharge summary-C | Post op MRI-C | Post procedure Clinical
photograph showing scar-C
NEUROSU NS NS000052 Duroplasty NS0000520000 Duroplasty with Exogenous graft- (May be perfomed as an 12500 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Exogenous graft-20000 Max :1 Duroplasty with Exogenous graft- (May be perfomed as an CT/ MRI establishing need of surgery-P | Admission notes showing vitals -P | Clinical
RGERY 0 0854 add-on procedure) Cost of graft will be extra add-on procedure) Cost of graft will be extra notes detailing history -P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Post procedure Clinical photograph showing scar-C | any investigations
done-P | examination findings-P | planned line of management -P
NEUROSU NS NS000055 Endoscopic Third NS0000559000 Endoscopic Third ventriculostomy 31300 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Endoscopic Third ventriculostomy Admission notes showing vitals and examination findings -P | CT/MRI-P | Any
RGERY 9 Ventriculostomy 0855 investigations done-P | Clinical Photograph-C | Clinical notes detailing history -P |
Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Post
procedure Imaging with film (CT)-C | planned line of management -P
NEUROSU NS NS000057 Epilepsy Surgery NS0000571000 Epilepsy Surgery 50000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N GRID COST -10000 Max :1 Epilepsy Surgery Admission notes showing vitals and examination findings-P | EEG-P | Neurologist
RGERY 1 0856 report-P | planned line of management -P | CT/MRI-P | Clinical notes detailing history-
P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Post
procedure Clinical photograph showing scar-C | Post procedure Imaging with film (CT)-C
| any investigations done-P
NEUROSU NS NS000059 Excision of Brain NS0000597000 Excision of Brain abscess 39100 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Brain abscess Admission notes showing vitals and examination findings-P | CT-P | Clinical notes
RGERY 7 Abscess 0857 detailing history-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Post procedure Clinical photograph showing scar-C | Post procedure
Imaging with film (CT)-C | Pus C/s-C | any investigations done-P | planned line of
management -P
NEUROSU NS NS000059 Excision of Brain NS0000598000 Supratentorial & other Tumours 50000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Supratentorial & other Tumours Admission notes showing vitals and examination findings-P | any investigations done-P
RGERY 8 Tumor 0858 | CT/MRI-P | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C
Supratentorial | Detailed discharge summary-C | Histopathology / Specimen Photo-C | Post procedure
Clinical photograph showing scar-C | Post procedure Imaging with film (CT)-C | planned
line of management -P
NEUROSU NS NS000059 Excision of Brain NS0000599000 Parasagital Tumours/Skull Base Tumours/Surgerey for 50000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Parasagital Tumours/Skull Base Tumours/Surgerey for Admission notes showing vitals and examination findings-P | CT/MRI-P | any
RGERY 9 Tumor 0859 Supratentorial/ Infratentorial intra-axial tumours/Cerebello- Supratentorial/ Infratentorial intra-axial tumours/Cerebello- investigations done-P | Clinical notes detailing history-P | Detailed Procedure /
Supratentorial/Inf pontine angle Angle/ Brainstem pontine angle Angle/ Brainstem Operative Notes-C | Detailed discharge summary-C | Histopathology/ Specimen Photo-
ratentorial C | Post procedure Clinical photograph showing scar-C | Post procedure Imaging with
film (CT)-C | planned line of management-P
NEUROSU NS NS000060 Excision of NS0000601000 Excision of Cervical Ribs 28000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Cervical Ribs Admission notes showing vitals-P | any investigations done-P | examination findings-P
RGERY 1 Cervical Ribs 0860 | planned line of management X-Ray chest/CT/MRI confirming Diagnosis.-P | Clinical
notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Post procedure Imaging with film (X Ray)-C | Post procedure scar photo-C
NEUROSU NS NS000060 Excision of Orbital NS0000605000 Excision of Orbital Tumour 43400 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Orbital Tumour Admission notes showing vitals-P | CT/ MRI report-P | examination findings-P |
RGERY 5 Tumour 0861 Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | HPE report / Specimen Photo-C | Post procedure Clinical
photograph showing scar-C | Post procedure Imaging with film (CT)-C | any
investigations done-P | planned line of management-P
NEUROSU NS NS000063 Extended LOS NS0000631000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 0 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals -P | examination findings-P | All investigations reports-
RGERY 1 care pkg for 0862 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) C | Clinical notes detailing history -P | Detailed ICPs-C | Detailed discharge summary-C
advance sugeries Routine Ward-1800 | Treatment details-C | any investigations done-P | planned line of management-P
NEUROSU NS NS000064 External NS0000640000 External Ventricular Drainage (EVD) 30000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N External Ventricular Drainage (EVD) Admission notes showing vitals -P | any investigations done-P | examination findings-P
RGERY 0 Ventricular 0863 | planned line of management -P | Analysis/ C/S of pus/ fluid removed-C | CT-P |
Drainage (EVD) Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
including discharge summary-C | Patient photograph with EVD-C | Post procedure Clinical
antibiotics photograph showing scar-C | Post procedure Imaging with film (CT)-C | Sticker /
Barcode of EVD-C
NEUROSU NS NS000064 Extra Coils NS0000642000 Extra Coils add on 0 Yes 0 Yes 2 Yes No Tertiary 1 Yes Yes Yes Add On Yes No No Surgical No Insurance N N R N Detachable Coil-24000 Max :2 | Extra Coils add on Admission notes showing vitals-P | any investigations done-P | examination findings-P
RGERY 2 0864 Pushable Coil-9000 Max :2 | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Invoice / Barcode of coil-C | Post procedure Imaging with film
(CT)-C | Procedure DSA Images-C | Procedure Photo with patient's face-C | planned
line of management-P
NEUROSU NS NS000065 Aneurysm NS0000650000 Aneurysm Clipping including DSA or CTA 50000 Yes 0 Yes 3 Yes No Tertiary 12 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Clip for Aneurysm-1500 Max :3 Aneurysm Clipping including DSA or CTA Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY Clipping including 830 | Clinical notes detailing history-P | DSA / CT-angio / MRA.-P | Detailed Procedure /
angiogram Operative Notes-C | Detailed discharge summary-C | Invoice of all the clip(s) used-C |
Planned line of management.-P | Post procedure Clinical photograph showing scar-C |
Post procedure Imaging with film (CT) showing clips-C
NEUROSU NS NS000067 Foramen Magnum NS0000675000 Foramen magnum decompression for Chiari malormation 65200 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Foramen magnum decompression for Chiari malormation Admission notes showing vitals -P | examination findings-P | CT/MRI-P | Clinical notes
RGERY 5 Decompression 0865 with or without duraplasty or tonsillar resection. with or without duraplasty or tonsillar resection. detailing history-P | Detailed Procedure / Operative Notes-C | Detailed discharge
summary-C | Post procedure Clinical photograph showing scar-C | Post procedure
Imaging with film (CT)-C | any investigations done-P | planned line of management -P
NEUROSU NS NS000069 Gamma Knife NS0000697000 Linear accelerator Radiosurgeryor Linear accelerator 75000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Linear accelerator Radiosurgeryor Linear accelerator Admission notes showing vitals-P | examination findings-P | planned line of
RGERY 7 radiosurgery 0866 Radiosurgery for tumors/AVMs/ Trigeminal Neuralgia Radiosurgery for tumors/AVMs/ Trigeminal Neuralgia management and CT/ MRI report-P | planned line of management-P | Clinical notes
(GKRS) / SRS for detailing history-P | Is the EHCP equipped with Gamma Knife?-P | any investigations
tumours / done-P
Arteriovenous
malformation
(AVM)
NEUROSU NS NS000075 Anterior skull base NS0000750000 Anterior skull base surgery-Open 48800 Yes 0 Yes 1 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Fibrin Glue-9000 Max :1 | Mini Anterior skull base surgery-Open MLC/ FIR if traumatic.-P | CT to confirm need of surgery-P | CT to confirm need of
RGERY surgery 831 plate per plate-3000 Max :1 surgery-P | Clinical notes with planned line of treatment detailing aetiology-P | Clinical
notes with planned line of treatment detailing aetiology.-P | MLC/ FIR if traumatic.-P |
Photograph of affected part-C | Post Procedure-C | Post procedure Imaging with film
(CT)-C | Procedure / Operative Notes-C
NEUROSU NS NS000075 Anterior skull base NS0000750000 CSF Rhinorrhea Repair-Endoscopic 26000 Yes 0 Yes 1 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Fibrin Glue-9000 Max :1 | Mini CSF Rhinorrhea Repair-Endoscopic CT to confirm need of surgery-P | Clinical notes with planned line of treatment detailing
RGERY surgery 832 plate per plate-3000 Max :1 aetiology-P | MLC/ FIR if traumatic-P | Photograph of affected part-C | Post Procedure-
C | Post procedure Imaging with film (CT)-C | Procedure / Operative Notes-C
NEUROSU NS NS000085 Laminectomy with NS0000859000 Laminectomy with fusion and fixation for 35000 Yes 0 Yes 10 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cage-2500 Max :10 | Odontoid Laminectomy with fusion and fixation for Admission notes showing vitals -P | MRI establishing need of surgery-P | examination
RGERY 9 fusion and fixation 0867 lumbar/cervical/thoracic canal stenosis or for tumor / screw-6000 Max :10 | Pedicle lumbar/cervical/thoracic canal stenosis or for tumor / findings-P | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C
trauma/Bleed(Cost of implants to be extra) screw-2500 Max :10 | Plate with trauma/Bleed(Cost of implants to be extra) | Detailed discharge summary-C | Post procedure Clinical photograph showing scar-C |
screw-2500 Max :10 | Rod -1500 Post procedure X-ray showing fixation & fusion-C | any investigations done-P | planned
Max :10 line of management -P
NEUROSU NS NS000086 Laminectomy NS0000861000 Laminectomy without fusion for lumbar or dorsal or cervical 25000 No 0 No 0 Yes Yes Tertiary 6 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Laminectomy without fusion for lumbar or dorsal or cervical Admission notes showing vitals -P | any investigations done-P | examination findings-P
RGERY 1 without fusion 0868 canal stenosis - Govt reserve Reserve canal stenosis - Govt reserve | planned line of management -P | Clinical notes detailing history-P | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | MRI establishing need
of surgery-P | Post procedure Clinical photograph showing scar-C
NEUROSU NS NS000089 Lumbar NS0000893000 Microscopic/Endoscopic Lumbar Discectomy (One level) - 30000 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Microscopic/Endoscopic Lumbar Discectomy (One level) - Admission notes showing vitals-P | any investigations done-P | examination findings-P
RGERY 3 Discectomy 0869 Govt Reserve Reserve Govt Reserve | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | MRI establishing need of surgery-P | Post procedure Clinical
photograph showing scar-C | planned line of management -P
NEUROSU NS NS000090 Arterio venous NS0000900000 Craniotmy and excision of arteriovenous 59100 No 0 No 0 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Craniotmy and excision of arteriovenous Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY malformation 833 malformation/Laminectomy/Laminotomy and excision of malformation/Laminectomy/Laminotomy and excision of | Clinical notes and MRA/ DSA report-P | Clinical notes detailing history-P | Detailed
(AVM) excision Intraspinal arteriovenous malformation Intraspinal arteriovenous malformation Procedure / Operative Notes-C | Detailed discharge summary-C | Planned line of
management.-P | Post procedure Clinical photograph showing scar-C | Post procedure
Imaging with film (CT)-C
NEUROSU NS NS000090 Arterio venous NS0000900000 Excision of scalp arteriovenous malformation 34000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of scalp arteriovenous malformation Admission notes showing vitals and examination findings-P | Any investigations done-P
RGERY malformation 834 | Clinical notes detailing history-P | Detailed Procedure / Operative Notes-C | Detailed
(AVM) excision discharge summary-C | MRA/ DSA report-P | Planned line of management -P | Post
procedure Clinical photograph showing scar-C | Post procedure Imaging with film (CT)-C
NEUROSU NS NS000090 Malignant Spinal NS0000907000 Spinal cord Decompression 15000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Spinal cord Decompression Admission notes showing vitals -P | examination findings-P | CBC-P | Clinical notes
RGERY 7 Cord compression 0870 detailing history -P | Clinical notes with planned line of treatment-P | Discharge
with Diagnostics, summary with detail treatment & interventions-C | KFT-P | LFT-P | Postprocedure scar
palliative photo and X-ray-C | Procedure notes-C | any investigations done-P | planned line of
radiotherapy, management CECT/MRI/ x-Ray-P
Brace in advanced
cancer patients
NEUROSU NS NS000094 Meningocele NS0000948000 Encephalocele/meningocele repair 45000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exogenous Graft-4000 Max :1 | Encephalocele/meningocele repair any investigations done-P | examination findings-P | Admission notes showing vitals-P
RGERY 8 0871 Fibrin Glue-9000 Max :1 | CT/MRI establishing need of surgery-P | Clinical notes detailing history-P | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C | Post procedure
Clinical photograph showing scar-C | Post procedure Imaging with film (CT)-C | planned
line of management-P
NEUROSU NS NS000094 Meningocele NS0000948000 Surgery for spina bifida cystica/occulta 36000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exogenous Graft-4000 Max :1 | Surgery for spina bifida cystica/occulta Admission notes showing vitals-P | any investigations done-P | CT/MRI establishing
RGERY 8 0872 Fibrin Glue-9000 Max :1 need of surgery-P | Clinical notes detailing history-P | Detailed Procedure / Operative
Notes-C | Detailed discharge summary-C | Post procedure Clinical photograph showing
scar-C | examination findings-P | planned line of management -P
NEUROSU NS NS000095 Micro discectomy NS0000957000 Anterior Cervical Discectomy with fusion- Govt reserve 35000 No 0 No 0 No Yes Tertiary 10 Yes Yes Yes Govt No No No Surgical No Insurance N N N Anterior Cervical Discectomy with fusion- Govt reserve Admission notes showing vitals-P | any investigations done-P | examination findings-P
RGERY 7 0873 Reserve | Clinical notes detailing history -P | Detailed Procedure / Operative Notes-C | Detailed
discharge summary-C | Intra procedure still photograph-C | MRI-P | Post procedure
Clinical photograph showing scar-C | planned line of management-P
NEUROSU NS NS000096 Muscle Biopsy NS0000965000 Muscle Biopsy 7000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Muscle Biopsy Admission notes showing vitals -P | Electromyography (EMG) reports-P | examination
RGERY 5 0874 findings-P | Clinical notes detailing history -P | Detailed Procedure / Operative Notes-C
| Detailed discharge summary-C | Histopathology / specimen photo-C | Post procedure
Clinical photograph showing scar-C | any investigations done-P | planned line of
management-P
NEUROLO NU NU000010 Neuromuscular NU000010130 Neuromuscular Disorders 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Neuromuscular Disorders Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 13 Disorders 000825 (without Ventilator)-4700 | reports in support of diagnosis-P | Clinical notes detailing history and Admission notes
Routine Ward-1800 showing vitals and examination findings; any investigations done; planned line of
management-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
NEUROLO NU NU000010 Paediatric seizure NU000010700 Status epilepticus 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Status epilepticus Admission notes showing vitals and examination findings-P | All investigations reports-C
GY 70 disorders 000826 (without Ventilator)-4700 | | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | EEG / MRI Brain / CT Head / LP (CSF)-C | Planned line of
NEUROLO NU NU000010 Palliative and NU000010780 Palliative care end stage disease 3000 Yes 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Palliative care end stage disease- Palliative care end stage disease Discharge summary with detail treatment-C | Final bill with payment receipt-C |
GY 78 supportive care 000827 3000 Interventions-C | Review notes of primary physician with referal to Palliative Medicine -P
for malignant
disease at
advanced or end
stage
NEUROLO NU NU000010 Autoimmune NU000010900 Autoimmune encephalitis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Autoimmune encephalitis Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 9 encephalitis 00810 (without Ventilator)-4700 | done-P | CT Brain / MRI Brain / EEG / LP (CSF) .-C | Clinical notes detailing history-P |
Routine Ward-1800 Detailed ICPs-C | Detailed discharge summary-C | Examination findings-P | Planned
line of management-P | Treatment details-C
NEUROLO NU NU000015 Venous sinus NU000015360 Venous sinus thrombosis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Venous sinus thrombosis Admission notes showing vitals and examination findings-P | All investigations reports-C
GY 36 thrombosis 000828 (without Ventilator)-4700 | | Any investigations reports in support of diagnosis-P | Clinical notes detailing history-P
Routine Ward-1800 | Detailed ICPs-C | Detailed discharge summary-C | MRI Brain / CT Head / Venogram
(MR / CT)-C | Planned line of management-P | Treatment details-C
NEUROLO NU NU000015 Viral Encephalitis NU000015460 Viral Encephalitis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Viral Encephalitis Admission notes showing vitals and examination findings-P | All investigations reports-C
GY 46 000829 (without Ventilator)-4700 | | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
Routine Ward-1800 Detailed discharge summary-C | EEG / MRI Brain / CT Head / LP (CSF)-C | Planned line of
NEUROLO NU NU000021 ACUTE NU000021000 Acute Febrile encephalopathy/Acute Disseminated 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute Febrile encephalopathy/Acute Disseminated Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY ENCEPHALOPATH 0808 Encephalomyelitis/hypertensive/metabolic/febrile/hepatic (without Ventilator)-4700 | Encephalomyelitis/hypertensive/metabolic/febrile/hepatic done-P | CT Head / MRI Head/ LP (CSF)-C | Clinical notes detailing history-P | Detailed
Y encephalopathy/Acute meningo encephalitis Routine Ward-1800 encephalopathy/Acute meningo encephalitis ICPs-C | Detailed discharge summary-C | Examination findings (incl neurological
pyogenic/Aseptic meningitis tubercular/ Hypertensive pyogenic/Aseptic meningitis tubercular/ Hypertensive examination)-P | Planned line of management-P | Treatment details-C
NEUROLO NU NU000040 Acute transverse NU000040000 Acute transverse myelitis/ Acute demyelinating encephalitis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute transverse myelitis/ Acute demyelinating encephalitis Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY myelitis/ Acute 0809 (without Ventilator)-4700 | reports in support of diagnosis-P | CT / MRI-Brain / Spine / LP (CSF)-C | Clinical notes
demyelinating Routine Ward-1800 detailing history-P | Detailed ICPs-C | Detailed discharge summary-C | Examination
encephalitis findings-P | Planned line of management-P | Treatment details-C
NEUROLO NU NU000046 CVA / Stroke NU000046300 Acute hemorrhagic stroke/Acute hemorrhagic stroke- (Extra 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute hemorrhagic stroke/Acute hemorrhagic stroke- (Extra Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 3 00807 ventricular drainage)/Acute hemorrhagic stroke- Hematoma (without Ventilator)-4700 | ventricular drainage)/Acute hemorrhagic stroke- Hematoma done-P | CT Head / CT Angio / MRI Head.-C | Clinical notes detailing history-P |
evacuation/ Acute Ischemic Stoke/Acute ischemic stroke- Routine Ward-1800 evacuation/ Acute Ischemic Stoke/Acute ischemic stroke- Detailed ICPs-C | Detailed discharge summary-C | Examination findings-P | Planned
intravenous thrombolysis intravenous thrombolysis line of management-P | Treatment details-C
NEUROLO NU NU000056 epilepsy NU000056900 Drug resistant epilepsy/Evaluation of drug resistant epilepsy 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Drug resistant epilepsy/Evaluation of drug resistant epilepsy Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 9 00811 (without Ventilator)-4700 | done-P | CT Head / MRI Head / EEG-C | Clinical notes detailing history-P | Detailed ICPs-
Routine Ward-1800 C | Detailed discharge summary-C | Examination findings-P | Planned line of
NEUROLO NU NU000072 Guillain Barre NU000072100 Guillain Barre syndrome 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Guillain Barre syndrome Admission notes detailed the need for High end histopathology (Biopsies)-P | Advanced
GY 1 syndrome 00812 (without Ventilator)-4700 | serology investigations-P | All investigations reports-C | Clinical notes-P | Detailed ICPs-
Routine Ward-1800 C | Detailed discharge summary-C | Nerve Conduction Study (NCS) / CSF-C | Report of
test blocked-C | Treatment details-C
NEUROLO NU NU000072 Guillain Barre NU000072300 Guillain Barre syndrome (IVIG) 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Guillain Barre syndrome (IVIG) Admission notes detailed the need for High end histopathology (Biopsies)-P | Advanced
GY 3 syndrome (IVIG) 00813 (without Ventilator)-4700 | serology investigations-P | All investigations reports-C | Clinical notes-P | Detailed ICPs-
Routine Ward-1800 C | Detailed discharge summary-C | Nerve Conduction Study (NCS) / CSF-C | Report of
test blocked-C | Treatment details-C
NEUROLO NU NU000075 High end NU000075800 High end histopathology (Biopsies) and advanced serology 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 8 histopathology 00814 investigations - Add on investigations - Add on done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
(Biopsies) and summary-C | Planned line of management-P | Treatment details-C
advanced
serology
investigations
NEUROLO NU NU000076 High end NU000076500 High end radiological diagnostic 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 5 radiological 00815 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
diagnostic summary-C | Examination findings-P | Planned line of management-P | Treatment
(CT, MRI, Imaging details-C
including nuclear
imaging)
NEUROLO NU NU000081 Inflammatory NU000081600 Inflammatory Myopathy/ Myaesthenic Crisis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Inflammatory Myopathy/ Myaesthenic Crisis Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 6 Myopathy/ 00816 (without Ventilator)-4700 | reports in support of diagnosis-P | Clinical notes detailing history-P | Detailed ICPs-C |
Myaesthenic Crisis Routine Ward-1800 Detailed discharge summary-C | Examination findings-P | Planned line of management-
P | Total CPK / RNST-C | Treatment details-C
NEUROLO NU NU000083 INTRACRANIAL NU000083200 Intracranial hemorrhage/Intracranial space occupying lesion 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Intracranial hemorrhage/Intracranial space occupying lesion Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 2 SPACE 00817 tuberculoma/neurocysticercosis, brain tumours (without Ventilator)-4700 | tuberculoma/neurocysticercosis, brain tumours done-P | CT Head / MRI Brain-C | Clinical notes detailing history and Admission notes
OCCUPYING Routine Ward-1800 showing vitals and examination findings (incl neurological examination); any investigations
LESIONS done; planned line of management-P | Detailed ICPs-C | Detailed discharge summary-C
| Examination findings (incl neurological examination)-P | Planned line of management-P
NEUROLO NU NU000093 Medical NU000093900 Raised ICP due to neuro surgical procedures/due to 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Raised ICP due to neuro surgical procedures/due to Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 9 Management for 00819 trauma/malignancies/ meningo-encephalitis (without Ventilator)-4700 | trauma/malignancies/ meningo-encephalitis done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Raised intracranial Routine Ward-1800 summary-C | Examination findings (incl neurological examination)-P | Planned line of
pressure management-P | Treatment details-C
NEUROLO NU NU000094 Medical/ neuro NU000094300 Comprehensive medical rehabilitation for spinal injury/ 25000 No 0 No 0 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Medical No Insurance N N N Comprehensive medical rehabilitation for spinal injury/ Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 3 rehablitation 00820 traumatic brain injury, CVA, Cerebral palsy with or without Reserve traumatic brain injury, CVA, Cerebral palsy with or without reports in support of diagnosis-P | Clinical notes detailing history and Admission notes
orthosis - govt reserved orthosis - govt reserved showing vitals and examination findings, any investigations reports in support of diagnosis
; planned line of management-P | Clinical notes detailing history-P | Detailed ICPs-C |
Detailed discharge summary-C | Examination findings-P | Planned line of management-
NEUROLO NU NU000094 Medical/ neuro NU000094300 Medical rehabilitation of muscular dystrophy/Medical 7000 No 0 No 0 Yes Yes Tertiary 5 No Yes Yes Govt Yes No No Medical No Insurance N N N Medical rehabilitation of muscular dystrophy/Medical Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 3 rehablitation 00821 Rehabilitation intellectual disability/Medical Rehabilitation Reserve Rehabilitation intellectual disability/Medical Rehabilitation reports in support of diagnosis-P | Clinical notes detailing history-P | Detailed ICPs-C |
special learning disability/Medical Rehabilitation multiple special learning disability/Medical Rehabilitation multiple Detailed discharge summary-C | Examination findings-P | Planned line of management-
disability- govt reserve disability- govt reserve P | Treatment details-C
NEUROLO NU NU000094 Meningitis NU000094600 Chronic meningitis/Partially treated pyogenic 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Chronic meningitis/Partially treated pyogenic Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 6 00822 meningitis/Neuro tuberculosis/Complicated bacterial (without Ventilator)-4700 | meningitis/Neuro tuberculosis/Complicated bacterial done-P | CSF Study-C | Clinical notes detailing history-P | Detailed ICPs-C | Detailed
meningitis/Acute meningitis/Meningitis/ Fungal Routine Ward-1800 meningitis/Acute meningitis/Meningitis/ Fungal discharge summary-C | Examination findings (incl neurological examination)-P | Planned
Meningitis/ACUTE INFECTIOUS MENINGITIS AND Meningitis/ACUTE INFECTIOUS MENINGITIS AND line of management-P | Treatment details-C
NEUROLO NU NU000096 Myasthenia Gravis NU000096600 Myasthenia Gravis requiring admission for work-up or in- 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myasthenia Gravis requiring admission for work-up or in- Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 6 00818 patient care (without Ventilator)-4700 | patient care done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Routine Ward-1800 summary-C | Examination findings-P | Planned line of management-P | Treatment
details-C
NEUROLO NU NU000096 Myasthenic crisis NU000096700 Myasthenic crisis 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myasthenic crisis Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 7 00823 (without Ventilator)-4700 | done-P | Clinical notes detailing history and Admission notes showing vitals and
Routine Ward-1800 examination findings; any investigations done; planned line of management-P | Detailed
ICPs-C | Detailed discharge summary-C | Examination findings-P | Planned line of
NEUROLO NU NU000096 Myasthenic crisis NU000096900 Myasthenic crisis (Plasmapheresis) 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myasthenic crisis (Plasmapheresis) Admission notes showing vitals-P | All investigations reports-C | Any investigations
GY 9 (Plasmapheresis) 00824 (without Ventilator)-4700 | reports in support of diagnosis-P | Clinical notes detailing history and Admission notes
Routine Ward-1800 showing vitals and examination findings, any investigations reports in support of diagnosis
; planned line of management-P | Detailed ICPs-C | Detailed discharge summary-C |
Examination findings-P | Planned line of management-P | Treatment details-C
OBSTETRIC OG OG000010 Overian OG000010680 Overian Cystectomy - govt reserve 20000 No 0 No 0 No Yes Tertiary 2 Yes Yes Yes Govt No No No Surgical No Insurance N N N Overian Cystectomy - govt reserve Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
S& 68 Cystectomy 000953 Reserve together with indication of surgery-C | Examination-P | HPE requesition-C | Progress
GYNAECOL notes-C | Relavant Investigations (establishing diagnosis)-P | USG Abdomen Pelvis/ CT
OGY abdomen.-P | detailed discharge summary.-C
OBSTETRIC OG OG000011 Post coital / Injury OG000011920 Post coital Injury / Perineal injury repair - Govt. Reserve 5000 No 0 No 0 No Yes Secondary 1 Yes Yes Yes Govt No No No Surgical No Insurance N N N Post coital Injury / Perineal injury repair - Govt. Reserve Discharge summary-C | OT notes-C | clincial examination notes, -P
S& 92 Repair 000954 Reserve
GYNAECOL
OGY
OBSTETRIC OG OG000012 Pyometra OG000012220 Pyometra drainage 5000 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pyometra drainage Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 22 drainage 000955 Detailed discharge summary-C | Progress notes-C | Pus Culture sensitivity report-C |
GYNAECOL Relavant Investigations-P | USG (establishing diagnosis)-P | examination with
OGY indications for the procedure-P
OBSTETRIC OG OG000012 Radical OG000012270 Class II - V radical hysterectomy + bilateral 34700 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Class II - V radical hysterectomy + bilateral CECT/ MRI-P | Clinical notes with planned line of treatment and Biopsy-P | Detailed
S& 27 Hysterectomy 000956 salpingoophorectomy + BPLND - Lap./Class I radical salpingoophorectomy + BPLND - Lap./Class I radical Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
GYNAECOL hysterectomy + bilateral salpingoophorectomy + BPLND - hysterectomy + bilateral salpingoophorectomy + BPLND - Procedure / Operative Notes-C
OGY Open Open
OBSTETRIC OG OG000012 Radical OG000012270 Hysterectomy + bilateral salpingoophorectomy + 60800 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hysterectomy + bilateral salpingoophorectomy + CECT/ MRI-P | Clinical notes with planned line of treatment and Biopsy-P | Detailed
S& 27 Hysterectomy 000957 omentectomy + peritonectomy and organ resections ( omentectomy + peritonectomy and organ resections ( Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
GYNAECOL Minimum 2 organs ) Minimum 2 organs ) Procedure / Operative Notes-C
OGY
OBSTETRIC OG OG000012 Radical OG000012340 Radical Retroperitoneal lymph node dissection 52100 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical Retroperitoneal lymph node dissection Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT / Biopsy
S& 34 Retroperitoneal 000958 confirming bilateral testicular cancer-P | detailed Procedure / Operative Notes-C
GYNAECOL lymph node
OGY dissection
OBSTETRIC OG OG000012 Rectovaginal OG000012510 Rectovaginal fistula repair 24000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Rectovaginal fistula repair Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 51 fistula repair 000959 Detailed discharge summary-C | Intraop stills with date & patient ID-C | MRI
GYNAECOL (establishing diagnosis)-P | Progress notes-C | Relavant Investigations-P | USG-P |
OGY examination with indications for the procedure-P
OBSTETRIC OG OG000012 Biopsy OG000012700 D&C (Dilatation&curretage) / Dilation and Evacuation (D&E) 1700 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N D&C (Dilatation&curretage) / Dilation and Evacuation (D&E) Clinical notes with supporting investigations -P | Discharge summary-C | Specimen
S& 7 00910 / day care Photo/ Histopathology report / Requisition form-C
GYNAECOL
OGY
OBSTETRIC OG OG000012 Resection of OG000012710 Resection of accessory mullarian horn (Open/Lap) 13000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Resection of accessory mullarian horn (Open/Lap) Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 71 accessory 000960 Detailed discharge summary-C | Intraop stills with date & patient ID-C | Progress notes-
GYNAECOL mullarian horn C | Relavant Investigations-P | USG /MRI (establishing diagnosis) -P | examination with
OGY indications for the procedure-P
OBSTETRIC OG OG000012 Biopsy- Cervical, OG000012900 Biopsy- Cervical, Endometrial EA/ ECC; Vulvar; 4300 No 0 No 0 No Yes Secondary 0 Yes Yes Yes Govt No No No Surgical Yes Insurance Y N N Biopsy- Cervical, Endometrial EA/ ECC; Vulvar; Biopsy report / HPE specimen photo / HPE requisition form-C | Clincial examination
S& 9 Endometrial EA/ 00911 Polypectomy,Endometrial Aspiration - govt reserve Reserve / Polypectomy,Endometrial Aspiration - govt reserve notes-P | Discharge summary-C | Relavent investigation reports-P
GYNAECOL ECC; Vulvar; Day care
OGY Polypectomy
OBSTETRIC OG OG000013 Abdomino OG000013000 Abdomino Perineal repair for Mullerian Anomaly 29500 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Abdomino Perineal repair for Mullerian Anomaly (USG/ CT/ MRI)-P | Admission Notes comprising of history-P | Detailed Procedure /
S& Perineal repair for 0907 Operative Notes-C | Detailed discharge summary-C | Examination with indications for
GYNAECOL Mullerian the procedure-P | Intraop Stills-C | Progress notes-C | Relavant Investigations
OGY Anomaly (establishing diagnosis)-P
OBSTETRIC OG OG000013 Sacrocolpopexy OG000013060 Sacrocolpopexy (Abdominal) 20000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh - 15 X 15 -5000 Max :1 Sacrocolpopexy (Abdominal) Admission Notes comprising of history-P | Barcode of Mesh/ Tape used-C | Detailed
S& 06 (Abdominal) 000961 Procedure / Operative Notes-C | Detailed discharge summary-C | Intraop stills with date
GYNAECOL & patient ID-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P |
OBSTETRIC OG OG000013 Salpingoophorect OG000013070 Salpingoophorectomy- (B/L or U/L) 14000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Salpingoophorectomy- (B/L or U/L) Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
S& 07 omy 000962 report-C | Planned line of treatment,-P | Post Procedure Photo of surgical site-C |
GYNAECOL Procedure / Operative Notes-C | USG / MRI / CT-P
OGY
OBSTETRIC OG OG000013 Severe anemia OG000013260 Severe anemia HB less 8 gm/dl 0 Yes 3 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Severe anemia HB less 8 gm/dl Admission notes showing vitals-P | All investigations reports.-C | Any investigations
S& 26 000963 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
GYNAECOL Planned line of management-P | Treatment details-C | detailed discharge summary-C
OGY
OBSTETRIC OG OG000013 Sling Surgeries for OG000013480 Surgeries for Prolapse - Sling Surgeries 20000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Sling -5000 Max :1 Surgeries for Prolapse - Sling Surgeries Investigations (establishing diagnosis)-P | Admission Notes comprising of history-P |
S& 48 Prolapse 000964 Barcode of sling used-C | Detailed Procedure / Operative Notes-C | Detailed discharge
GYNAECOL summary-C | Intraop stills-C | Pap smear-P | Photographic documentation of
OGY degree/severity of prolapse with patient’s consent-P | examination with indications for
the procedure-P | progress notes-C
OBSTETRIC OG OG000013 Staging OG000013720 Staging Laparotomy and proceed for Ovarian Cancers. 38000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Staging Laparotomy and proceed for Ovarian Cancers. Clinical notes-P | Detailed Discharge Summary.-C | Detailed Operative notes-C |
S& 72 Laparotomy and 000965 Omentomy with Bilateral Omentomy with Bilateral Histopathology-C | Ovarian tumour marker-P | Pelvis establishing indication-P | USG
GYNAECOL proceed for Salpingo-oophorectomy (BPLND if req ) Salpingo-oophorectomy (BPLND if req ) Abdomen + Pelvis/ CT abdomen-P | pic of specimen removed-C
OGY Ovarian Cancers.
Omentomy with
Bilateral Salpingo-
oophorectomy
OBSTETRIC OG OG000013 Sterilisation OG000013780 Sterilisation - GOVT . Reserve 9000 No 0 No 0 Yes Yes Tertiary 1 Yes Yes Yes Govt Yes No No Surgical Yes Insurance Y N N Sterilisation - GOVT . Reserve Clinical note-P | Detailed Discharge Summary.-C | OT note-C
S& 78 000966 Reserve /
GYNAECOL Day care
OGY
OBSTETRIC OG OG000013 Surgery for OG000013970 Surgery for Endometriosis 14700 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Surgery for Endometriosis USG/ CT/ MRI/ laparoscopy findings-P | Admission Notes comprising of history and
S& 97 Endometriosis 000967 (Other than Hysterectomy) (Other than Hysterectomy) examination, Relavant Investigations (establishing diagnosis) USG/ CT/ MRI/ laparoscopy
GYNAECOL (Other than findings-P | Detailed Procedure / Operative Notes together with indication of surgery-C
OGY Hysterectomy) | HPE-C | Intraop stills with date & patient ID-C | Progress notes-C | detailed discharge
summary.-C | examination, Relavant Investigations (establishing diagnosis)-P | pic off
gross specimen removed-C
OBSTETRIC OG OG000014 Trans - vaginal OG000014660 Trans-vaginal tape/Trans - With obturator tape 26000 Yes 0 No 0 Yes No Tertiary 1 no Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Trans-vaginal tape/Trans - With obturator tape indications for the procedure-P | Admission Notes comprising of history-P | Barcode of
S& 66 tape / Trans- 000968 TVT/TOT tape used-C | Detailed Procedure / Operative Notes-C | Detailed discharge
GYNAECOL obturator tape summary-C | Relavant Investigations (establishing diagnosis)-P | progress notes-C
OGY
OBSTETRIC OG OG000015 Uretero-vaginal / OG000015090 Uretero - vaginal fistula repair - Open/ 26000 No 0 No 0 Yes No Tertiary 3 no Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Uretero - vaginal fistula repair - Open/ Clinical notes and IVP/ CT-IVP-P | Detailed discharge summary-C | Intra procedure still
S& 09 Uterine fistula 000969 Laparoscopic/Uretero - Uterine fistula repair - Open/ Laparoscopic/Uretero - Uterine fistula repair - Open/ photograph-C | cystoscopy and vaginoscopy Scopy confirming the diagnosis for which
GYNAECOL repair Laparoscopic/Urethrovaginal fistula repair ± DJ Stenting Laparoscopic/Urethrovaginal fistula repair ± DJ Stenting the surgery is done-P | detailed Procedure / Operative Notes-C
OGY
OBSTETRIC OG OG000015 Vaginal OG000015190 Vaginal Myomectomy 15000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Vaginal Myomectomy Relevant investigations-P | Ot notes-C | Ultrasonography-P | detail discharge
S& 19 Myomectomy 000970 summary-C | post OP USG-C
GYNAECOL
OGY
OBSTETRIC OG OG000015 Vaginal repair for OG000015210 Vaginal repair for vesico-vaginal fistula (Open) 25000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Vaginal repair for vesico-vaginal fistula (Open) Admission Notes comprising of history-P | Cystoscopy/ Cystourethroscopy-P |
S& 21 vesico-vaginal 000971 Cystourethrogram is optional-P | Detailed Procedure / Operative Notes-C | Intraop stills
GYNAECOL fistula (Repair for with date & patient ID-C | Investigations (establishing diagnosis)-P | Progress notes-C |
OGY VVF) Voiding-P | detailed discharge summary-C | examination with indications for the
procedure-P
OBSTETRIC OG OG000015 Vaginal OG000015220 Vaginal Sacrospinus fixation with repair 15000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Vaginal Sacrospinus fixation with repair Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 22 Sacrospinus 000972 Detailed discharge summary-C | Progress notes-C | Relavant Investigations (establishing
GYNAECOL fixation with diagnosis)-P | examination with indications for the procedure-P
OGY repair
OBSTETRIC OG OG000015 Vaginoplasty OG000015230 Vaginoplasty (McIndoe procedure) 17300 No 0 No 0 No No Secondary 3 NO Yes Yes Regular PKG No No No Surgical No Insurance N N N Vaginoplasty (McIndoe procedure) Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 23 (McIndoe 000973 Detailed discharge summary-C | MR-P | Progress notes-C | Relavant Investigations
GYNAECOL procedure) (establishing diagnosis)-P | examination with indications for the procedure-P | need of
OGY procedure (USG Abdomen + Pelvis)-P
OBSTETRIC OG OG000015 Vulval/ vaginal OG000015500 Vulval/ vaginal Hematoma drainage 3000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Vulval/ vaginal Hematoma drainage Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 50 Hematoma 000974 Detailed discharge summary-C | Examination with indications for the procedure-P |
GYNAECOL drainage Intraop Stills-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P
OGY
OBSTETRIC OG OG000015 Vulvectomy + OG000015510 Vulvectomy - simple (Rs 20000) / Redical (Rs 40000) 0 Yes 1 No 0 Yes No Tertiary 11 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Redical reconstruction Vulvectomy - simple (Rs 20000) / Redical (Rs 40000) Planned line of treatment-P | Biopsy/HPE-P | Clinical notes with planned line of
S& 51 reconstruction 000975 reconstruction procedures procedures-36000 | reconstruction procedures treatment, Biopsy/HPE-P | Detailed Discharge Summary-C | HPE report-C | Procedure
GYNAECOL procedures Vulvectomy - simple-20000 / Operative Notes-C
OGY
OBSTETRIC OG OG000015 Vulvo vaginal / OG000015530 Vulvo vaginal/ bartholin cyst/ abscess enucleation /Vulvo 6000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Vulvo vaginal/ bartholin cyst/ abscess enucleation /Vulvo Admission Notes comprising of history-P | Detailed operative notes-C | Histopathology
S& 53 bartholin cyst/ 000976 vaginal/ bartholin cyst/ abscess drainage vaginal/ bartholin cyst/ abscess drainage report of tissue removed-C | Indications for the procedure-P | Relavant Investigations
GYNAECOL abscess (establishing diagnosis)-P | discharge summary-C
OGY enucleation /
drainage
OBSTETRIC OG OG000017 Burch OG000017000 Abdominal / Laparoscopic -Burch 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abdominal / Laparoscopic -Burch Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 0 00912 Detailed discharge summary-C | Examination with indications for the procedure-P |
GYNAECOL Intraop stills-C | Relavant Investigations (establishing diagnosis)-P | Urodynamic studies
OGY are optional-P | progress notes-C
OBSTETRIC OG OG000017 Caesarean OG000017800 Caesarean Delivery - Govt Reserve 11500 No 0 No 0 No Yes Secondary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Caesarean Delivery - Govt Reserve Admission Notes comprising of history-P | CTG if available-P | Detailed Procedure /
S& 8 Delivery 00913 Reserve Operative Notes-C | Detailed discharge summary-C | Examination with detailed Ante
GYNAECOL natal care records/ reasons for non-availability of ANC records-P | Indications for the
OGY procedure-P | Labor charting-P | Status of the Newborn at the time of delivery and at
the time of discharge-C | USG Obstetrics with Doppler is case specific & optional-P |
progress notes-C
OBSTETRIC OG OG000017 Caesarean OG000017900 Caesarean hysterectomy - Govt Reserve 20000 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Caesarean hysterectomy - Govt Reserve Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 9 hysterectomy 00914 Reserve / Detailed discharge summary-C | Examination detailed Ante natal care records/ reasons
GYNAECOL Regular PKG for non-availability of ANC records-P | Histopath of uterus removed-C | Per op clinical
OGY photo is optional-P | per op pic of specimen removed-C | progress notes-C | status of
the child at the time of delivery and at the time of discharge-C
OBSTETRIC OG OG000023 Closure of Burst OG000023700 Closure of Burst Abdomen 15000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Closure of Burst Abdomen Clinical notes describing the original surgery that led to burst abdomen-P | Detailed
S& 7 Abdomen 00915 Operative notes-C | Detailed discharge summary-C | Intra procedure clinical
GYNAECOL photograph-C | X Ray/USG/ CT Abdomen confirming the diagnosis for which the surgery
OGY is done-P
OBSTETRIC OG OG000024 Colpotomy OG000024800 Colpotomy 4300 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Colpotomy Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 8 00916 Detailed discharge summary-C | Intra procedure clinical photograph/ stills-C | Relavant
GYNAECOL Investigations (establishing diagnosis)-P | USG Abdomen & Pelvis-P | examination with
OGY indications for the procedure-P | progress notes-C
OBSTETRIC OG OG000025 Cone biopsy OG000025700 Cone biopsy 7000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Cone biopsy Biopsy report / HPE specimen photo / HPE requisition form-C | Clincial examination
S& 7 00917 notes-P | Discharge summary.-C | Relavent investigation reports-P
GYNAECOL
OGY
OBSTETRIC OG OG000027 Conservative OG000027500 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone Examination findings-P | Admission notes showing vitals-P | All investigations reports.-
S& 5 Management 00918 stand alone-1800 C | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
GYNAECOL Detailed discharge summary-C | Planned line of management -P | Treatment details-C
OGY
OBSTETRIC OG OG000029 Cordocentesis OG000029600 Cordocentesis 10000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Cordocentesis Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
GYNAECOL Intraop Stills-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P |
OGY Report of cordocentesis-C
OBSTETRIC OG OG000046 Cystocele - OG000046600 Cystocele - Anterior repair 6000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Cystocele - Anterior repair Admission Notes comprising of history-P | Clinical pic if feasible-P | Detailed Procedure
S& 6 Anterior repair 00920 / Operative Notes-C | Detailed discharge summary-C | Examination with findings
GYNAECOL establishing Cystocoele-P | Intraop Stills-C | Progress notes-C
OGY
OBSTETRIC OG OG000047 D&C OG000047200 D&C (Dilatation&curretage) / Dilation and Evacuation (D&E) 5000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N D&C (Dilatation&curretage) / Dilation and Evacuation (D&E) (USG Abdomen + Pelvis)- optional-P | Admission Notes comprising of history-P |
S& 2 (Dilatation&curret 00921 / day care Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
GYNAECOL age) / Dilation and Histopathology of curetted material-C | Intraop Stills-C | Progress notes-C | Relavant
OGY Evacuation (D&E) Investigations (establishing diagnosis)-P | examination with indications for the
procedure-P
OBSTETRIC OG OG000049 Diagnostic OG000049300 Diagnostic laparoscopy (govt reserve) 9000 No 0 No 0 No Yes Secondary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Diagnostic laparoscopy (govt reserve) Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
S& 3 laparoscopy 00922 Reserve together with indication of surgery-C | Detailed discharge summary.-C | Examination
GYNAECOL indication for Laproscopy-P | Intraop stills with patient name date & time-C | Progress
OGY notes-C
OBSTETRIC OG OG000049 Diagnostic OG000049700 Diagnostic Hysteroscopy with / without ± biopsy - govt 7800 No 0 No 0 No Yes Secondary 2 No Yes Yes Govt No No No Surgical No Insurance N N N Diagnostic Hysteroscopy with / without ± biopsy - govt Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
S& 7 Hysteroscopy with 00923 reserve Reserve reserve together with indication of surgery-C | Detailed discharge summary-C | Examination
GYNAECOL / without - govt with indication for hysteroscopy -P | Intraop stills with patient name date & time-C |
OGY reserve Progress notes-C
OBSTETRIC OG OG000052 Electro OG000052900 Electro Cauterisation / Cryo Surgery 3000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N Electro Cauterisation / Cryo Surgery Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 9 Cauterisation / 00924 / day care Detailed discharge summary-C | Examination with indications for the procedure-P |
GYNAECOL Cryo Surgery Intraop Stills-C | Pap smear- optional-P | Progress notes-C | Relavant Investigations
OGY (establishing diagnosis)-P
OBSTETRIC OG OG000058 EUA (Examination OG000058400 EUA(Examination under Anaesthesia) only in GA 3000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N EUA(Examination under Anaesthesia) only in GA Anesthesia Notes-C | Clinical Notes justifying the need for GA-P | Clinical Notes-C |
S& 4 under 00925 Discharge Summary.-C
GYNAECOL Anaesthesia)
OGY
OBSTETRIC OG OG00006 Perineal Tear OG000060000 III and IV degree of Perineal Tear - govt reserve - add on 5000 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N III and IV degree of Perineal Tear - govt reserve - add on (USG/ CT/ MRI)-P | Admission Notes comprising of history-P | Detailed Procedure /
S& 906 Reserve and Operative Notes-C | Detailed discharge summary-C | Examination with indications for
GYNAECOL Add On the procedure-P | Intraop Stills-C | Progress notes-C | Relavant Investigations
OGY (establishing diagnosis)-P
OBSTETRIC OG OG000061 Excision of Vaginal OG000061900 Excision of Vaginal Septum (vaginal route) 21700 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Vaginal Septum (vaginal route) Admission Notes comprising of history and examination with indications for the
S& 9 Septum (vaginal 00926 procedure,Relavant Investigations (establishing diagnosis), need of procedure (USG
GYNAECOL route) Abdomen + Pelvis)-P | Detailed Procedure / Operative Notes-C | Detailed discharge
OGY summary-C | Examination with indications for the procedure-P | Intraop Stills-C |
Need of procedure (USG Abdomen + Pelvis)-P | Progress notes-C | Relavant
Investigations (establishing diagnosis)-P
OBSTETRIC OG OG000062 Amniocentesis / OG000062000 Amniocentesis / Chorionic villus sampling 5000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N Amniocentesis / Chorionic villus sampling Amniotic fluid analysis report-C | Consulting notes giving the indication for
S& Chorionic villus 0908 / day care amniocentesis; does the hospital have fetal medicine expert?-P | Detailed Procedure /
GYNAECOL sampling Operative Notes-C | Detailed discharge summary-C | Intraop Stills-C | Progress notes-C
OGY
OBSTETRIC OG OG000071 Anterior & OG000071000 Anterior & Posterior Colpoperineorrhapy 8000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Anterior & Posterior Colpoperineorrhapy Admission Notes comprising of history-P | Clinical pic if feasible-P | Detailed Procedure
S& Posterior 0909 / Operative Notes-C | Detailed discharge summary-C | Examination with indications for
GYNAECOL Colpoperineorrha the procedure-P | Intraop Stills-C | Progress notes-C | Relavant Investigations
OGY py (establishing diagnosis)-P
OBSTETRIC OG OG000077 High risk delivery OG000077100 Mothers with severe anaemia (<8 g/dL) , Other maternal 11500 No 0 No 0 Yes Yes Secondary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Mothers with severe anaemia (<8 g/dL) , Other maternal and Admission Notes comprising of history-P | Detailed Ante natal care records-P | Detailed
S& 1 00927 and fetal conditions as per guidelines-eg previous caesarean Reserve fetal conditions as per guidelines-eg previous caesarean delivery notes-C | Detailed discharge summary.-C | Investigations supporting the
GYNAECOL section, diabetes, eclampsia, pre-eclampsia, severe growth section, diabetes, eclampsia, pre-eclampsia, severe growth diagnosis/ reasons for non-availability of ANC records-P | Obstetric USG-P | PNC notes
OGY retardation, congenital malformation etc that qualify for retardation, congenital malformation etc that qualify for along with relevant investigation details-C | Progress notes-C | Status of the child at the
high risk delivery - Govt Reserve high risk delivery - Govt Reserve time of delivery and at the time of discharge-C
OBSTETRIC OG OG000077 Hospitalisation for OG000077500 Hospitalisation for Antenatal Complications 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Hospitalisation for Antenatal Complications Admission Notes comprising of history-P | Detailed discharge summary with relevant
S& 5 Antenatal 00928 investigations.-C | Examination with indications for the procedure-P | Progress notes-C
GYNAECOL Complications | Relevant Investigations (establishing diagnosis)-P | USG report-P
OGY
OBSTETRIC OG OG000077 Hymenectomy for OG000077800 Hymenectomy for imperforate hymen - Govt Reserve 3000 No 0 No 0 No Yes Secondary 1 Yes Yes Yes Govt No No No Surgical No Insurance N N N Hymenectomy for imperforate hymen - Govt Reserve USG / CT / MRI-P | Admission Notes comprising of history-P | Detailed Procedure /
S& 8 imperforate 00929 Reserve Operative Notes-C | Detailed discharge summary-C | Progress notes-C | examination
GYNAECOL hymen with indications for the procedure and need of procedure-P
OGY
OBSTETRIC OG OG000078 Hysterectomy OG000078400 Abdominal Hysterectomy ± Salpingo-oophorectomy/ Non 20000 No 0 No 0 Yes Yes Tertiary 4 No Yes Yes Govt Yes No No Surgical No Insurance N N N Abdominal Hysterectomy ± Salpingo-oophorectomy/ Non Admission Notes comprising of history-P | Clinical notes-P | Detailed Procedure /
S& 4 00930 descent vaginal hysterectomy /TLH / LAVH/Vaginal Reserve descent vaginal hysterectomy /TLH / LAVH/Vaginal Operative Notes together with indication of surgery-C | EB/EAC-P | Pap smear-P |
GYNAECOL hysterectomy with anterior and posterior hysterectomy with anterior and posterior Photo of gross specimen removed / HPE-C | Progress notes-C | USG Abdomen + Pelvis/
OGY colpoperineorrhaphy- Govt Reserve colpoperineorrhaphy- Govt Reserve CT/ MRI abdomen+ Pelvis confirming the indication-P | detailed discharge summary.-C |
examination with indications for the procedure-P | lanned line of treatment (clearly
indicating medical management tried and failed or not indicated. If failed documents
proving duration of treatment and failure. The medical management should have been
tried for atleast 4-6 months covering 1 course of hormone cycle) -P
OBSTETRIC OG OG000078 Hysteroscopic OG000078500 Hysteroscopic adhesiolysis / Laparoscopic adhesiolysis - 10400 No 0 No 0 No Yes Secondary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Hysteroscopic adhesiolysis / Laparoscopic adhesiolysis - Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
S& 5 adhesiolysis / 00931 Govt Reserve Reserve Govt Reserve together with indication of surgery-C | Intraop stills with date & patient ID-C | Progress
GYNAECOL Laparoscopic notes-C | Relavant Investigations (establishing diagnosis)-P | USG Abdomen Pelvis /
OGY adhesiolysis CT/MRI Abdomen Pelvis-P | detailed discharge summary-C | examination with
indications for the procedure-P
OBSTETRIC OG OG000078 Hysteroscopic OG000078600 Hysteroscopic cannulation 5000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N Hysteroscopic cannulation Admission Notes comprising of history-P | Detailed Procedure / Operative Notes detailed
S& 6 cannulation 00932 / day care discharge summary-C | Intraop Photo-C | SSG / HSG, USG-P | examination with
GYNAECOL indications for the procedure-P
OGY
OBSTETRIC OG OG000078 Hysteroscopic OG000078700 Hysteroscopic IUCD removal - Govt Reserve 5000 No 0 No 0 No Yes Secondary 1 Yes Yes Yes Govt No No No Surgical Yes Insurance Y N N Hysteroscopic IUCD removal - Govt Reserve Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge
S& 7 IUCD removal 00933 Reserve / summary.-C | Progress notes-C | USG / X-ray showing misplaced IUCD-P | indication
GYNAECOL Day care for removing IUCD-P
OGY
OBSTETRIC OG OG000078 Hysteroscopic OG000078800 Hysteroscopic Myomectomy 10400 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hysteroscopic Myomectomy Detailed Operative notes-C | Detailed discharge summary-C | HPE-C | Intraop stills
S& 8 Myomectomy 00934 with date & patient ID-C | Physical examination findings with indications for the
GYNAECOL procedure-P | USG pelvis / MRI Pelvis / HSG-P
OGY
OBSTETRIC OG OG000078 Hysteroscopic OG000078900 Hysteroscopic polypectomy 7200 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical Yes Insurance Y N N Hysteroscopic polypectomy Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
S& 9 polypectomy 00935 / day care together with indication of surgery-C | Detailed discharge summary.-C | Examination
GYNAECOL with indications for the procedure-P | HPE-C | Intraop stills with date & patient ID-C |
OGY Photo of gross specimen removed-C | Progress notes-C | Relavant Investigations
(establishing diagnosis)-P | USG showing polyp-P
OBSTETRIC OG OG000079 Hysteroscopic OG000079000 Hysteroscopic Septum resection 12000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hysteroscopic Septum resection Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
S& 0 Septum resection 00936 together with indication of surgery-C | Detailed discharge summary.-C | Examination
GYNAECOL with indications for the procedure-P | HPE-C | Intraop stills with date & patient ID-C |
OGY Photo of gross specimen removed-C | Progress notes-C | Relavant Investigations
(establishing diagnosis)-P | USG / MRI-P
OBSTETRIC OG OG000079 Hysterotomy OG000079100 Hysterotomy 8600 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hysterotomy Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
GYNAECOL HPE of specimen-C | Intraop stills with date & patient ID-C | Progress notes-C |
OGY Relavant Investigations (establishing diagnosis)-P | USG - Obstetric confirming the above
package-P
OBSTETRIC OG OG000079 Hysterotomy OG000079100 Hysterotomy - Govt Reserve 8600 No 0 No 0 No Yes secondary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Hysterotomy - Govt Reserve Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 1 00938 Reserve Detailed discharge summary-C | Examination with indications for the procedure-P |
GYNAECOL HPE of specimen-C | Intraop stills with date & patient ID-C | Progress notes-C |
OGY Relavant Investigations (establishing diagnosis)-P | USG - Obstetric confirming the above
package-P
OBSTETRIC OG OG000083 Intrauterine OG000083500 Intrauterine transfusions 10000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Intrauterine transfusions Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 5 transfusions 00939 Detailed discharge summary-C | Examination with indications for the procedure-P |
GYNAECOL Intraop Stills-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P
OGY
OBSTETRIC OG OG000084 Inversion of OG000084100 Inversion of uterus - vaginal reposition/Abdominal 0 Yes 1 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abdominal reposition-8000 | Inversion of uterus - vaginal reposition/Abdominal Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 1 uterus 00940 reposition Vaginal reposition-3000 reposition Detailed discharge summary-C | Examination with indications for the procedure-P |
GYNAECOL Intraop Stills-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P
OGY
OBSTETRIC OG OG000086 Lap / vaginal OG000086300 Abdominal Myomectomy 20000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Abdominal Myomectomy Clinical notes establishing indication-P | Detailed Operative notes-C | Detailed discharge
S& 3 Abdominal 00941 summary-C | HPE / Photo of specimen removed-C | Pap smear-P | USG Abdomen
GYNAECOL Myomectomy Pelvis/ MRI abdomen-P
OGY
OBSTETRIC OG OG000086 Laparoscopic OG000086400 Tubal surgeries 17300 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Tubal surgeries USG uterus-P | Beta HCG-P | Clinical notes establishing indication for the procedure-P
S& 4 tubal surgeries 00942 (for any indication including ectopic pregnancy) (for any indication including ectopic pregnancy) | Detailed Operative notes-C | Detailed discharge summary-C | HPE if ectopic
GYNAECOL (for any indication pregnancy or salpingectomy for any other indication-C | adnexa-P
OGY including ectopic
pregnancy)
OBSTETRIC OG OG000086 Laparotomy for OG000086600 Laparotomy for Broad Ligament Hematoma (+/-internal iliac 30400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Laparotomy for Broad Ligament Hematoma (+/-internal iliac Clinical notes establishing indication for the procedure-P | Detailed discharge summary-C
S& 6 Broad Ligament 00943 ligation) ligation) | Detailed procedure / Operative notes-C | USG-P
GYNAECOL Hematoma
OGY
OBSTETRIC OG OG000088 LLETZ (including OG000088900 LLETZ (including PAP smear and colposcopy) 13000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N LLETZ (including PAP smear and colposcopy) Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 9 PAP smear and 00944 Detailed discharge summary-C | Evidence of cervical pre-cancer (Cervical Cytology)
GYNAECOL colposcopy) Colposcopy-P | HPE / Photo of specimen-C | Intraop stills with date & patient ID-C |
OGY Progress notes-C | Relavant Investigations (establishing diagnosis)-P | examination with
indications for the procedure-P
OBSTETRIC OG OG000092 Manchester OG000092400 Manchester Repair/Sling Surgery for Prolapse uterus 15000 No 0 No 0 No No Secondary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Manchester Repair/Sling Surgery for Prolapse uterus Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 4 Repair/Sling 00945 Detailed discharge summary-C | Intraop Stills-C | Progress notes-C | Relavant
GYNAECOL Surgery for Investigations (establishing diagnosis)-P | examination with indications for the procedure-
OGY Prolapse uterus P
OBSTETRIC OG OG000092 Manual removal OG000092600 Manual removal of placenta - Govt reserve 8500 No 0 No 0 No Yes Secondary 2 Yes Yes Yes Govt No Yes No Surgical No Insurance N N N Manual removal of placenta - Govt reserve Clinical notes documenting need of manual removal of placenta/ use of Active
S& 6 of placenta 00946 Reserve Management of Third Stage of Labor (AMTSL)-P | Detailed Procedure / Operative Notes-
GYNAECOL C | Post natal course-C | Progress note Detailed discharge summary-C | Stills of
OGY placenta-C
OBSTETRIC OG OG000093 McDonald's OG000093200 McDonald's stitch/Shirodkar stitch 6000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N McDonald's stitch/Shirodkar stitch Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
S& 2 stitch/Shirodkar 00947 Detailed discharge summary-C | Progress notes-C | USG / Clinical findings justifying
GYNAECOL stitch cervical incompetence and the procedure-P
OGY
OBSTETRIC OG OG000094 Medical OG000094100 Medical management of ectopic pregnancy 2700 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Medical management of ectopic pregnancy Admission Notes comprising of history-P | Detailed Notes & Progress notes-C | Detailed
S& 1 management of 00948 discharge summary-C | Relavant Investigations (establishing diagnosis)-P | examination
GYNAECOL ectopic pregnancy with indications for the procedure-P
OGY
OBSTETRIC OG OG000094 Medical OG000094200 MTP > 12 weeks - govt reserve 6500 No 0 No 0 Yes Yes Secondary 4 No Yes Yes Govt Yes No No Surgical No Insurance N N N MTP > 12 weeks - govt reserve Admission Notes comprising of history-P | Detailed Procedure notes-C | Detailed
S& 2 Termination of 00949 Reserve discharge summary-C | Relavant Investigations (establishing diagnosis)-P | USG -
GYNAECOL Pregnancy Obstetric confirming the above package. Has medicolegal compliance been done?-P |
OBSTETRIC OG OG000094 Medical OG000094200 MTP 8 to 12 weeks - govt reserve 5000 No 0 No 0 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical No Insurance N N N MTP 8 to 12 weeks - govt reserve Admission Notes comprising of history-P | Detailed Procedure notes-C | Detailed
OBSTETRIC OG OG000094 Medical OG000094200 MTP upto 8 weeks - govt reserve 2000 No 0 No 0 Yes Yes Secondary 1 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N MTP upto 8 weeks - govt reserve Admission Notes comprising of history-P | Detailed Procedure notes-C | Detailed
OBSTETRIC OG OG000096 Molar follow up OG000096300 Molar follow up for chemotherapy 6000 No 0 No 0 No No Tertiary 1 No Yes Yes Follow up / No No No Surgical Yes Insurance Y N N Molar follow up for chemotherapy Dischage advice details-P | Beta HCG & Relevant investigations.-P | Clinical examination
S& 3 for chemotherapy 00952 Day Care notes-P | Detailed discharge summary-C | Post discharge summary-P | Treatment
GYNAECOL details and relevant investgation reports-C
OGY
OPHTHAL OL OL000010 Optic neuritis OL0000105400 Optic neuritis 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Optic neuritis Clinical note with lab reports-P | Detailed discharge summary-C | MRI Report if available-
MOLOGY 54 001015 P | Treatment note-C
OPHTHAL OL OL000010 Orbital fracture OL0000105800 Orbital fracture repair under GA (with or without implant) 10500 Yes 0 Yes 1 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Porous Polyethylene sheet-8000 Orbital fracture repair under GA (with or without implant) Clinical Photograph of the affected eye-P | Admission Notes-P | Clinical notes with
MOLOGY 58 repair 001016 Max :1 indication-P | Detailed Discharge summary-C | Post-op photograph-C | Procedure/
operative notes-C | X-ray / CT / MRI-P
OPHTHAL OL OL000010 Orbitotomy OL0000105900 Orbitotomy 14000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Orbitotomy Clinical Photograph-P | CT Scan-P | Clinical notes detailing indication and CT Scan-P |
MOLOGY 59 001017 HPE Report of actual surgery-C | Lab (Histopath) report / Specimen Photo-C | Stated
plan for lab investigation of host tissue (HPE/ Microbiology/other)-P | Still image of the
the procedure with pt ID and date-C | operative notes-C
OPHTHAL OL OL000012 Pterygium + OL0000120800 Pterygium + Conjunctival Autograft 9300 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pterygium + Conjunctival Autograft Keratometry-P | Clinical Photograph-P | Clinical notes and Retinoscopy-P | Corneal
MOLOGY 08 Conjunctival 001018 topography (not mandatory)-P | Still image of the the procedure with pt. ID and date-C |
Autograft detailed discharge summary-C | detailed operative notes.-C
OPHTHAL OL OL000012 Ptosis Surgery OL0000120900 Ptosis Surgery 8000 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Silicone Rod -1500 Max :1 Ptosis Surgery Clinical Photograph of affected eye (Photographic record of the patient should be
MOLOGY 09 001019 maintained for comparison. Photographs should have be taken in primary position as well
as in lateral gazes)-P | Detailed discharge summary-C | Still image of the the procedure
with pt ID and date-C | detailed operative notes-C
OPHTHAL OL OL000012 Retinal Cryopexy OL0000127800 Retinal Cryopexy 3500 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Retinal Cryopexy Clinical notes with Indication for procedure -P | Detailed Procedure notes and discharge
MOLOGY 78 001020 summary-C | Still image of the the procedure with pt ID and date-C
OPHTHAL OL OL000012 Retinal Laser OL0000127900 For retinal tear repair /Sectrol laser / Barrage laser - Per eye 1500 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes Yes No Surgical No Insurance N N R N For retinal tear repair /Sectrol laser / Barrage laser - Per eye clinical notes-P | Still image of the the procedure with pt ID and date-C | Supportive
MOLOGY 79 Photocoagulation 001021 per sitting per sitting documents-P | clinical notes-C | discharge summary-C
OPHTHAL OL OL000012 Retinal Laser OL0000127900 Pan Retinal Photocoagulation (PRP) - Retinal Laser including 8500 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Pan Retinal Photocoagulation (PRP) - Retinal Laser including clinical notes-P | Still image of the the procedure with pt. ID and date-C | Supportive
MOLOGY 79 Photocoagulation 001022 3 sittings / package of retino laser photocoagulation 3 sittings / package of retino laser photocoagulation documents-P | clinical notes-C | discharge summary-C
(3 sittings per eye for both eyes) (3 sittings per eye for both eyes)
OPHTHAL OL OL000012 ROP Laser - Per OL0000129800 ROP Laser - Per Eye 5000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N ROP Laser - Per Eye Clinical notes-P | Discharge summary-C | Still image of the patient undergoing the
MOLOGY 98 Eye 001023 procedure with date stamp-C
OPHTHAL OL OL000013 ROP screening OL0000130000 ROP screening 0 Yes 1 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N ROP screening-1500 ROP screening Examination findings-P | Clinical notes-P | Screening report from ophalmologist-C |
MOLOGY 00 001024 age of the beneficiaries-P
OPHTHAL OL OL000013 Scleral Buckle OL0000131200 Scleral Buckle Removal 5500 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No Yes No Surgical No Insurance N N N Scleral Buckle Removal Clinical notes with Indication for removal-P | Detailed discharge summary-C | Still image
MOLOGY 12 Removal 001025 of the the procedure with pt ID and date-C | microbiological report-C | operative notes-
C | stated plan for lab investigation of host tissue (Microbiology)-P
OPHTHAL OL OL000013 Scleral buckling OL0000131300 Scleral buckling surgery 19000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Scleral buckling surgery Clinical notes -P | Detailed discharge summary-C | Still image of the the procedure with
MOLOGY 13 surgery 001026 pt. ID and date-C | operative notes-C
OPHTHAL OL OL000013 Secondary IOL / OL0000131600 Secondary IOL / IOL Exchange / Explant 4000 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N IOL-3000 Max :1 Secondary IOL / IOL Exchange / Explant Barcode of IOL-C | Clinical notes-P | Detailed discharge summary-C | Pre operative
MOLOGY 16 IOL Exchange / 001027 documentation of indication for intervention and Clinical Photograph of affected part-P |
Explant Still image of the patient undergoing the procedure with date stamp-C | operative notes-
C
OPHTHAL OL OL000013 SFIOL (inclusive of OL0000133000 SFIOL (inclusive of Vitrectomy) 15000 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Glue for Scleral fixated IOL-3000 SFIOL (inclusive of Vitrectomy) Barcode of SFIOL.-C | Clinical notes-P | Detailed discharge summary-C | Pre operative
MOLOGY 30 Vitrectomy) 001028 Max :1 Clinical Photograph of affected part-P | Still image of the patient undergoing the
procedure with date stamp operative notes-C | planned line of treatment-P
OPHTHAL OL OL000013 Socket OL0000135100 Socket Reconstruction including Amniotic Membrane Graft 11000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Socket Reconstruction including Amniotic Membrane Graft Clinical Photograph of affected part-P | Clinical notes-P | Detailed discharge summary-C
MOLOGY 51 Reconstruction 001029 | Showing Indication for socket reconstruction-P | Still image of the the procedure with
including Amniotic pt. ID and date-C | operative notes-C
Membrane Graft
OPHTHAL OL OL000013 SOR (Silicon Oil OL0000135200 SOR (Silicon Oil Removal) 9000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No Yes No Surgical No Insurance N N N SOR (Silicon Oil Removal) Clinical notes with Previous retinal surgery notes with mention of silicon oil. -P | Detailed
MOLOGY 52 Removal) 001030 discharge summary-C | Mention of silicon oil-P | Previous retinal surgery notes-P | Still
image of the the procedure with pt ID and date-C | operative notes-C
OPHTHAL OL OL000013 Squint correction OL0000136900 Major - 3 or more muscles (complex surgery involving four 12000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Major - 3 or more muscles (complex surgery involving four Indication justifying the need for GA (if required)-P | Clinical Photograph-P | Clinical
MOLOGY 69 001031 muscles or oblique muscles) muscles or oblique muscles) notes detailing which muscles affected-P | Detailed discharge summary-C | Procedure /
Operative Notes-C | Still image of the the procedure with pt ID and date-C
OPHTHAL OL OL000013 Squint correction OL0000136900 Minor - upto 2 muscles 6900 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Minor - upto 2 muscles Indication justifying the need for GA (if required)-P | Clinical Photograph-P | Clinical
MOLOGY 69 001032 notes detailing which muscles affected-P | Detailed discharge summary-C | Procedure /
Operative Notes-C | Still image of the the procedure with pt ID and date-C
OPHTHAL OL OL000014 Surgery for OL0000140100 Paediatric lensectomy/Paediatric lens aspiration with 9200 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Foldable Hydrophobic intraocular Paediatric lensectomy/Paediatric lens aspiration with Barcode of IOL used-C | Clinical Photograph-P | Clinical notes detailing Indication for
MOLOGY 01 Paediatric Cataract 001033 posterior capsulotomy & anterior vitrectomy lens-3000 Max :1 posterior capsulotomy & anterior vitrectomy Lensectomy /pediatric lens aspiration/ membranectomy-P | Detailed discharge summary-
C | Still image of the the procedure with pt ID and date-C | detailed operative notes
with visual outcomes-C | supporting investigation-P
OPHTHAL OL OL000014 Surgery for OL0000140100 Paediatric Membranectomy & anterior vitrectomy 8000 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Foldable Hydrophobic intraocular Paediatric Membranectomy & anterior vitrectomy Barcode of IOL used-C | Clinical Photograph-P | Clinical notes detailing Indication for
MOLOGY 01 Paediatric Cataract 001034 lens-3000 Max :1 Lensectomy /pediatric lens aspiration/ membranectomy-P | Detailed discharge summary-
C | Still image of the the procedure with pt ID and date-C | detailed operative notes
with visual outcomes-C | supporting investigation-P
OPHTHAL OL OL000015 Vitreoretinal OL0000154800 Vitreoretinal Surgery (with Silicon Oil Insertion) 25000 Yes 0 Yes 1 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for "Vitreoretinal Vitreoretinal Surgery (with Silicon Oil Insertion) B Scan-P | Clinical documents-P | Clinical notes-P | Detailed discharge summary-C |
MOLOGY 48 Surgery (with 001035 Surgery" (IOL & Per flouro carbon IOL sticker-C | Silicon oil / gas(Per flouro carbon liquid) Invoice-C | Still image of the the
Silicon Oil liquid)-6000 Max :1 procedure with pt. ID and date-C | operative notes-C
Insertion)
OPHTHAL OL OL000018 Capsulotomy OL0000182000 Capsulotomy (YAG)/Peripheral Iridotomy(PI) 1500 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No Yes No Surgical No Insurance N N N Capsulotomy (YAG)/Peripheral Iridotomy(PI) Clinical notes detailing when was cataract surgery was done-P | Clinical photo of patient
MOLOGY 2 (YAG) 0977 before procedure-P | Detailed discharge summary-C | Still image of the the procedure
with pt ID and date-C | notes mentioning indication for this procedure with vision and
fundus-P | procedure notes-C
OPHTHAL OL OL000019 Cataract surgery OL0000192000 Phaco emulsification with foldable hydrophobic acrylic IOL - 4500 Yes 0 Yes 1 Yes Yes Secondary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Foldable Hydrophobic intraocular Phaco emulsification with foldable hydrophobic acrylic IOL - Barcode of IOL used-C | Clinical notes detailing visual impairment (Best corrected visual
MOLOGY 2 0978 GOVT Reserve Reserve lens-3000 Max :1 GOVT Reserve acquity- BCVA) of cataract and Clinical photo of affected part-P | Detailed discharge
summary-C | Still image of the the procedure with pt ID and date Ocular Biometry (A
scan and ketometry)-C | operative notes-C
OPHTHAL OL OL000019 Cataract surgery OL0000192000 SICS with non-foldable IOL - GOVT Reserve 4000 Yes 0 Yes 1 Yes Yes Secondary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Non foldable IOL -1000 Max :1 SICS with non-foldable IOL - GOVT Reserve Barcode of IOL used-C | Clinical notes detailing visual impairment (Best corrected visual
MOLOGY 2 0979 Reserve acquity- BCVA) of cataract and Clinical photo of affected part-P | Detailed discharge
summary-C | Still image of the the procedure with pt ID and date Ocular Biometry (A
scan and ketometry)-C | operative notes-C
OPHTHAL OL OL000020 Chalazion OL0000208000 Chalazion Removal 2000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Chalazion Removal Clinical Notes with Patient details & diagnosis.-P | Discharge summary-C | Still image of
MOLOGY 8 Removal 0980 the patient undergoing the procedure with date stamp-C
OPHTHAL OL OL000026 Conjunctival OL0000268000 Conjunctival tumour excision including Amniotic Membrane 7000 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Tissue graft- amniotic membrane - Conjunctival tumour excision including Amniotic Membrane Clinical Photograph of affected part-P | Clinical notes-P | HPE report / Specimen Photo-
MOLOGY 8 tumour excision 0981 Graft 2700 Max :1 Graft C | Still image of the the procedure with pt. ID and date-C | detailed Procedure /
including Amniotic Operative Notes-C | detailed discharge summary-C
Membrane Graft
OPHTHAL OL OL000028 Conservative OL0000284000 Conservative Management - 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - MLC copy with number if available, Only for burn patient - Extent of upto 40% burns
MOLOGY 4 Management of 0982 (Chest/Head/Face/Abdomen)stand alone (Chest / Head / Face / Abdomen) (Chest/Head/Face/Abdomen)stand alone visible on photograph (with rule of 9 chart)-P | Clinical Notes-P | Detailed discharge
injury stand alone-1800 summary.-C | Post Treatment clinical photograph-C | X-rays or other diagnostic
procedures done as a part of treatment-C | lab tests-C
OPHTHAL OL OL000029 Corneal / Scleral OL0000298000 Corneal / Scleral Patch Graft 5500 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Corneal / Scleral Patch Graft Detailed discharge summary.-C | Doctor's Prescription with Preoperative clinical photo
MOLOGY 8 Patch Graft 0983 and indication for surgery-P | Intra & Post Treatment clinical photograph-C | Still image
of the patient undergoing the procedure with date stamp-C
OPHTHAL OL OL000029 Corneal Collagen OL0000299000 Corneal Collagen Crosslinking 14000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Corneal Collagen Crosslinking Detailed discharge summary.-C | Intra & Post Treatment clinical photograph-C |
MOLOGY 9 Crosslinking 0984 PENTACAM PROGRESSION MAPS 3 to 6 months apart -P | Still image of the patient
undergoing the procedure with date stamp-C
OPHTHAL OL OL000030 Corneal Grafting OL0000300000 Corneal Grafting ( Kerotoplasty) 10000 Yes 0 Yes 1 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Corneal graft -9000 Max :1 Corneal Grafting ( Kerotoplasty) Clinical Photograph-P | Clinical notes detailing Indication for corneal grafting and
MOLOGY 0 0985 supporting investigation-P | Detailed discharge summary-C | Details of donor cornea-P
| Intra & Post Treatment clinical photograph-C | Microbiology investigation-P | Stated
plan for lab investigation of host tissue-P | Still image of the the procedure with pt ID and
date-C | operative notes-C
OPHTHAL OL OL000030 Corneal Grafting OL0000300000 Lamellar Keratoplasty 11300 Yes 0 Yes 1 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Corneal graft -9000 Max :1 Lamellar Keratoplasty Clinical Photograph-P | Clinical notes detailing Indication for corneal grafting and
MOLOGY 0 0986 supporting investigation-P | Detailed discharge summary-C | Details of donor cornea-P
| Intra & Post Treatment clinical photograph-C | Microbiology investigation-P | Stated
plan for lab investigation of host tissue-P | Still image of the the procedure with pt ID and
date-C | operative notes-C
OPHTHAL OL OL000030 Corneal Ulcer OL0000301000 Corneal Ulcer Management 4000 No 0 No 0 No No Secondary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Corneal Ulcer Management Detailed discharge summary-C | Doctor's Prescription-P | Preoperative clinical photo-P
MOLOGY 1 Management 0987
OPHTHAL OL OL000030 Corneo / Scleral / OL0000302000 Tear repair-corneal/scleral/corneo scleral/with or without 8000 No 0 No 0 No No secondary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tear repair-corneal/scleral/corneo scleral/with or without Clinical notes, X-ray orbit /CT orbit, Clinical Photograph-P | Detailed discharge summary-
MOLOGY 2 Corneo scleral 0988 iris prolapse repair iris prolapse repair C | Still image of the the procedure with pt ID and date-C | operative notes.-C
tear repair
OPHTHAL OL OL000047 Dacryocystorhinos OL0000473000 Canaliculo Dacryocystorhinostomy with Silicon Tube / Stent 10000 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Silicon Tube / Silicon stent -2000 Canaliculo Dacryocystorhinostomy with Silicon Tube / Stent Dye disappearance test-P | Probing and irrigation-P | Still image of the the procedure
MOLOGY 3 tomy 0989 Max :1 with pt. ID and date, operative notes, Detailed discharge summary-C | Tear meniscus
height measurement-P
OPHTHAL OL OL000047 Dacryocystorhinos OL0000473000 Canaliculo Dacryocystorhinostomy without Silicon Tube / 8000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Canaliculo Dacryocystorhinostomy without Silicon Tube / Detailed discharge summary-C | Dye disappearance test-P | Probing and irrigation-P |
MOLOGY 3 tomy 0990 Stent Stent Still image of the the procedure with pt ID and date-C | Tear meniscus height
measurement-P | operative notes-C
OPHTHAL OL OL000049 Diabetic OL0000491000 Vision refraction,fundus photo and OCT (day care) 1500 No 0 No 0 No No Secondary 0 No Yes Yes Day care No No No Surgical Yes Insurance Y N N Vision refraction,fundus photo and OCT (day care) Tonometry-P | Detail Fundus examination report. Detailed discharge summary-C |
MOLOGY 1 Retinopathy 0991 Doctor's Prescription-P | Fundus Photo / ophthalmoscopy-P | HBA1c-P | OCT Photos-C
Screening | OCT-P
OPHTHAL OL OL000055 Endophthalmitis OL0000552000 Endophthalmitis (excluding Vitrectomy) 5000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Endophthalmitis (excluding Vitrectomy) Clinical notes-P | Detailed discharge summary-C | Planned line of treatment-P | Pre
MOLOGY 2 (excluding 0992 operative Clinical Photograph of affected part-P | Still image of the patient undergoing
Vitrectomy) the procedure with date stamp-C | operative notes-C
OPHTHAL OL OL000056 Entropion OL0000564000 Entropion correction / Ectropion correction - GOVT Reserve 6500 No 0 No 0 No Yes Secondary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Entropion correction / Ectropion correction - GOVT Reserve Clinical Photograph-P | Clinical notes-P | Detailed discharge summary-C | Still image of
MOLOGY 4 correction/Ectropi 0993 Reserve the the procedure with pt ID and date-C | operative notes.-C
on correction
OPHTHAL OL OL000056 Enucleation OL0000565000 Enucleation With implant 6000 Yes 0 Yes 1 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for "Enucleation" Enucleation With implant Clinical Photograph-P | Clinical notes establishing Indication and justifying enucleation
MOLOGY 5 0994 (Conformers + Plastic / silicon and supporting investigation-P | Invoice of implant-C | Recommendation/opinion of 2
ball type implant)-2000 Max :1 | ophthalmologists for the procedure-P | Still image of the the procedure with pt ID and
Porous Polyethylene implant- date-C | confirmation/ declaration that the specimen has been sent for histopathology
6000 Max :1 and report will be sent for filing later-C | detailed discharge summary-C | operative
notes-C
OPHTHAL OL OL000056 Enucleation OL0000565000 Enucleation Without implant 6000 No 0 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Enucleation Without implant Clinical Photograph-P | Clinical notes establishing Indication and justifying enucleation
MOLOGY 5 0995 and supporting investigation-P | Intra procedure clinical photograph-C |
Recommendation/opinion of 2 ophthalmologists for the procedure-P | confirmation that
specimen was sent for histopathology.-C | detailed discharge summary-C | operative
notes-C
OPHTHAL OL OL000058 EUA for OL0000585000 EUA for Confirmation of Paediatric Glaucoma 3000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N EUA for Confirmation of Paediatric Glaucoma Clinical notes-P | Corneal diameter-C | Detailed discharge summary with IOP-C |
MOLOGY 5 Confirmation of 0996 Fundus Report-C | Still image of the patient undergoing the procedure with date stamp-
Paediatric C | documentary evidence -P | operative notes-C
Glaucoma
OPHTHAL OL OL000058 EUA separate add OL0000588000 EUA only in GA separate - add on package 3000 No 0 No 0 No No Secondary 1 No Yes Yes Add On No No No Surgical No Insurance N N R N EUA only in GA separate - add on package Clinical Notes for the associated surgery / disease along with Pre OP-C | Clinical Notes
MOLOGY 8 on package 0997 justifying the need for GA in the associated surgery-P | Operative and Anesthesia-C |
Post OP notes-C
OPHTHAL OL OL000059 Evisceration OL0000591000 Evisceration 6000 Yes 0 Yes 1 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for "Evisceration" Evisceration Clinical Photograph-P | Clinical notes establishing Indication and justifying enucleation
MOLOGY 1 0998 (Conformers + Plastic / silicon ball and supporting investigation-P | Detailed discharge summary-C |
type implant)-1000 Max :1 Recommendation/opinion of 2 ophthalmologists for the procedure-P | Still image of the
the procedure with pt ID and date-C | operative notes.-C
OPHTHAL OL OL000062 Exenteration OL0000620000 Exenteration 23000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Exenteration (Biopsy / CT / MRI establishing indication for Exenteration)-P | Clinical Photograph-P |
MOLOGY 0 0999 Detailed discharge summary-C | Histopathological exam report-C | Indication for
Exenteration and supporting investigation-P | Recommendation/opinion of 2
ophthalmologists for the procedure-P | Still image of the the procedure with pt. ID and
date-C | confirmation/ declaration that the specimen has been sent for histopathology
and report will be sent for filing later-C | operative notes-C
OPHTHAL OL OL000063 Extended LOS OL0000632000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals-P | All investigations reports-C | Any investigations
MOLOGY 2 care pkg for 01000 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
advance sugeries Routine Ward-1800 summary-C | Examination findings-P | Pllnned line of management-P | Treatment
details-C
OPHTHAL OL OL000069 Fundus OL0000696000 Fundus Fluorescein Angiography (FFA) - GOVT Reserve and 1000 No 0 No 0 No Yes Secondary 0 Yes Yes Yes Govt No No No Surgical Yes Insurance Y N N Fundus Fluorescein Angiography (FFA) - GOVT Reserve and Doctor's prescription with indication of FFA-P | FFA Reports & Discharge Notes(On
MOLOGY 6 Fluorescein 01001 Day care Reserve / Day care Doctor's Prescription).-C
Angiography (FFA) Day care
OPHTHAL OL OL000071 Glaucoma OL0000710000 Vision Refraction-IOP & Fundus 750 No 0 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Vision Refraction-IOP & Fundus Admission notes showing vitals and examination findings-P | All investigations reports.-C
MOLOGY 0 Screening 01002 | Clinical notes detailing history-P | Detailed discharge summary-C
OPHTHAL OL OL000071 Glaucoma OL0000710000 Vision Refraction-IOP & Fundus OCT & Visual Fields 2000 No 0 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Vision Refraction-IOP & Fundus OCT & Visual Fields Examination findings-P | Admission notes showing vitals -P | All investigations reports-
MOLOGY 0 Screening 01003 C | Any investigations done-P | Clinical notes detailing history-P | Clinical notes
detailing history-P | Detailed discharge summary-C | Gonioscopy-P | Ophthalmoscopy-
P | Perimetry / OCT-P | Planned line of management -P | Refraction report,-C |
Tonometry-P
OPHTHAL OL OL000071 Glaucoma Surgery OL0000711000 Glaucoma Surgery (Trabeculectomy only) with or without 11000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Glaucoma Surgery (Trabeculectomy only) with or without Clinical notes-P | Detailed discharge summary-C | Documentary evidence supporting
MOLOGY 1 01004 Mitomycin C, including postoperative medications for 12 Mitomycin C, including postoperative medications for 12 chronicity-P | IOP measurement-P | Still image of the the procedure with pt ID and date-
weeks weeks C | ensure that post op medicine for 12 weeks is given-C | operative notes-C
(and wherever surgical or laser procedures required for (and wherever surgical or laser procedures required for bleb
bleb augmentation and anterior chamber maintenance) augmentation and anterior chamber maintenance)
OPHTHAL OL OL000071 Glaucoma Surgery OL0000712000 Cyclocryotherapy / Cyclophotocoagulation 3500 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cyclocryotherapy / Cyclophotocoagulation Clinical notes establishing long standing history of Glaucoma with recent documentation
MOLOGY 2 01005 of vision-P | Detailed Procedure / Operative Notes-C | Reports of field of vision-P |
discharge summary-C
OPHTHAL OL OL000071 Glaucoma Surgery OL0000712000 Glaucoma Shunt Surgery 11000 Yes 0 Yes 1 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Non Valved Glaucoma tube - Glaucoma Shunt Surgery Clinical notes and IOP measurement-P | Detailed discharge summary-C | Documentary
MOLOGY 2 01006 shunt-9000 Max :1 | Valved evidence supporting chronicity/ Failed Trabeculectomy-P | Still image of the patient
Glaucoma tube - shunt-9000 Max undergoing the procedure with date stamp-C | operative notes-C
:1
OPHTHAL OL OL000071 Glaucoma Surgery OL0000712000 Paediatric Glaucoma Surgery 15000 No 0 No 0 Yes No Secondary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Paediatric Glaucoma Surgery Clinical notes and IOP measurement-P | Detailed discharge summary-C | Documentary
MOLOGY 2 01007 evidence of paediatric glaucoma with confirmation of diagnosis under GA/Examination
under anaesthesia (EUA)-P | Still image of the patient undergoing the procedure with
date stamp-C | operative notes-C
OPHTHAL OL OL000081 Indocyanine OL0000814000 Indocyanine Green Angiography (ICGA) - GOVT Reserve and 3000 No 0 No 0 No Yes Secondary 0 Yes Yes Yes Govt No No No Surgical Yes Insurance Y N N Indocyanine Green Angiography (ICGA) - GOVT Reserve and Discharge summary-C | Doctor's prescription with indication-P | ICGA report-C
MOLOGY 4 Green 01008 Day care Reserve / Day care
Angiography Day care
(ICGA)
OPHTHAL OL OL000084 Iridectomy OL0000849000 Iridectomy 2000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Iridectomy Anterior segment OCT report-P | Clinical notes showing Indication for Iridectomy(Laser)-
MOLOGY 9 01009 P | Detailed discharge summary-C | Gonioscopy-P | Still image of the the procedure
with pt. ID and date-C | Tonometry-P | procedure notes-C
OPHTHAL OL OL000087 Laser Therapy for OL0000870000 Laser Therapy for Retinopathy of Prematurity -Neo - natal 0 Yes 2 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Laser Therapy for Retinopathy Laser Therapy for Retinopathy of Prematurity -Neo - natal Clinical notes-P | Details of Laser therapy done-C | Fundoscope reports / stills showing
MOLOGY 0 Retinopathy of 01010 (Irrespective of no. of eyes affected) of Prematurity -Neo - natal (Irrespective of no. of eyes affected) extent of ROP and need for procedure-P
Prematurity per session (Irrespective of no. of eyes per session
(Irrespective of affected) - per session-1500
no. of eyes
affected) - per
session
OPHTHAL OL OL000087 Lid Abscess OL0000877000 Lid Abscess Drainage 5500 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Lid Abscess Drainage C/S report.-C | Clinical photo-P | Diagnosis-P | Discharge notes-C | Doctors notes-P |
MOLOGY 7 Drainage 01011 Patient details-P | Still image of the patient undergoing the procedure with date-C |
microbiology report-C
OPHTHAL OL OL000087 Lid Tear Repair OL0000878000 Lid Tear Repair 7500 Yes 0 Yes 1 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Canalicular Stent-3500 Max :1 Lid Tear Repair Clinical Photograph-P | Clinical notes-P | Detailed discharge summary-C | FIR/MLC in
MOLOGY 8 01012 case of accident-P | Still image of the the procedure with pt. ID and date-C | operative
notes-C
OPHTHAL OL OL000087 Lid Tumor excision OL0000879000 Lid Tumor excision + Lid Reconstruction 12100 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Lid Tumor excision + Lid Reconstruction Clinical Photograph of affected part-P | Clinical notes-P | Detailed discharge summary-C
MOLOGY 9 + Lid 01013 | HPE report / Specimen Photo-C | Procedure / Operative Notes-C | Still image of the
Reconstruction the procedure with pt ID and date-C | stated plan for lab investigation of host tissue (HPE
/ Microbiology/other)-P
OPHTHAL OL OL000088 Limbal Dermoid OL0000881000 Limbal Dermoid Removal - GOVT Reserve 3000 Yes 0 Yes 1 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical No Insurance N N N Mniotic membrane graft (AMG)- Limbal Dermoid Removal - GOVT Reserve Clinical Photograph-P | Clinical notes and Indication for Limbal Dermoid Removal like
MOLOGY 1 Removal 01014 Reserve 2700 Max :1 increase in dermoid size-P | Detailed discharge summary-C | Still image of the the
procedure with pt. ID and date-C | detailed operative notes.-C
ORTHOPAE OP OP00001 Closed reduction OP000010000 Hip / Knee / shoulder / elbow / Any small joint 0 Yes 3 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N GA / RA-5000 | Under Short- Hip / Knee / shoulder / elbow / Any small joint Clinical notes-P | Clinical photograph of affected part-P | Intra & Post op clinical
DICS of joint dislocation 1056 2000 photgraph-C | Post Procedure clinical photgraph-C | Post procedure imaging study (X
Ray)-C | X-ray confirming the diagnosis-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000010 Nerve root block OP000010040 Nerve root block 3000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Nerve root block Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 04 0001095 Scar Photo-C | MRI / NCV-P | Planned line of treatment-P | Post procedure-C |
Procedure / Operation notes-C
ORTHOPAE OP OP000010 Nerve OP000010070 Nerve Transposition/ Nerve Release/ Nerve 13000 No 0 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Nerve Transposition/ Nerve Release/ Nerve Clinical notes justifying surgery with evidence of MRI / EMG/ NCV-P | Detailed Discharge
DICS 07 Transposition / 0001096 Neurolysis/Nerve repair surgery Neurolysis/Nerve repair surgery summary-C | Intra & Post op clinical photgraph and Scar Photo-C | Intra Procedure still
Release / images-C | detailed Procedure / Operative Notes-C
Neurolysis
ORTHOPAE OP OP000010 NPWT OP000010180 NPWT 0 Yes 7 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N NPWT-1500 NPWT Clinical notes detailing events that led to chronic/ non healing woulds-P | Clinical
DICS 18 0001097 photograph-P | Detailed Procedure / Operative Notes-C | Intra & Post op clinical
photgraph and Scar Photo-C | Photo with tube and pump-C | detailed discharge
summary-C
ORTHOPAE OP OP000010 Open Reduction OP000010340 Open Reduction of CDH 20000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Open Reduction of CDH Clinical and radiological investigations confirming the diagnosis (X-ray of both hips)-P |
DICS 34 of CDH 0001098 Clinical photograph-P | Detailed discharge summary-C | Intra & Post op clinical
photgraph and Scar Photo-C | Post procedure imaging study (X Ray)-C | detailed
ORTHOPAE OP OP000010 Open Reduction OP000010350 Hip / Knee / shoulder / elbow / Any small joint 8000 Yes 0 Yes 10 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N k-wire-300 Max :10 Hip / Knee / shoulder / elbow / Any small joint Clinical and radiological investigations confirming the diagnosis (X-ray of affected joint)-P
DICS 35 of Joint 0001099 | Clinical photograph-P | Detailed discharge summary-C | Intra & Post op clinical
photgraph and Scar Photo-C | Invoice / barcode of implant-C | Post procedure imaging
study (X Ray)-C | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000010 Osteotomy OP000010670 Long & small Bone (Govt. reserved) 10000 Yes 0 Yes 2 Yes Yes Secondary 5 No Yes Yes Govt Yes No No Surgical No Insurance N N N Plate with Screw - Long & small Long & small Bone (Govt. reserved) Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 67 0001100 Reserve Bone (Govt. reserved)-5000 Max | Intra & Post op clinical photgraph and Scar Photo-C | Post procedure clinical
:2 photgraph-C | Post procedure imaging study (X Ray)-C | X-ray of the affected bone
justifying the procedure-P | detailed Procedure / Operative Notes-C | invoice / barcode
of implant-C
ORTHOPAE OP OP000011 Pelvic Osteotomy OP000011220 Pelvic Osteotomy and fixation 20000 Yes 0 Yes 3 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N CC-screw - Pelvic Osteotomy and Pelvic Osteotomy and fixation Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 22 and fixation 0001101 fixation-1500 Max :3 | Recon | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant used-
plate-4000 Max :3 | k-wire-300 C | Post procedure imaging study (X Ray)-C | X-ray-P | detailed Procedure / Operative
Max :3 Notes-C | showing the implant-C
ORTHOPAE OP OP000011 Percutaneous - OP000011290 Percutaneous - Fixation of Fracture 0 Yes 0 Yes 5 Yes No Secondary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw - Percutaneous - LA - Percutaneous - Fixation of Percutaneous - Fixation of Fracture Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 29 Fixation of 0001102 Fixation of Fracture-1500 Max :5 Fracture-5000 | RA/GA - Scar Photo-C | Planned line of treatment-P | Post procedure X-ray with reports-C |
Fracture | k-wire-300 Max :5 Percutaneous - Fixation of Procedure / Operation notes-C | Stickers of implants used-C | X-ray with reports-P
Fracture-10000
ORTHOPAE OP OP000011 Plexus injury along OP000011760 Plexus injury along with Vascular injury graft 60000 No 0 No 0 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Plexus injury along with Vascular injury graft )+ /- EMG (Electromyography)-P | )+ /- MRA-P | )+ /- MRI-P | )+/- Nerve conduction
DICS 76 with Vascular 0001103 velocity (NCV)-P | Clinical notes detailing the injury and need of surgery-P | Detailed
injury repair / operatives notes-C | Intra & Post op clinical photgraph and Scar Photo-C | Intra
graft operative still photograph-C | MLC/ FIR-P | detailed discharge summary-C
ORTHOPAE OP OP000012 Reconstruction of OP000012460 ACL/PCL(Tear / Avulsion) / Shoulder tendon injuries/ 40000 Yes 0 Yes 4 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Brace-1000 Max :4 | Crutch- ACL/PCL(Tear / Avulsion) / Shoulder tendon injuries/ Clinical notes-P | Clinical photograph of affected part-P | Detailed Discharge summary-C
DICS 46 Cruciate Ligament 0001104 Shoulder Dislocation 1000 Max :4 | Screw / Shoulder Dislocation | Ensure brace is provided in package cost-C | Intra & Post op clinical photgraph and
with implant and endobutton / Anchor / Sture Scar Photo-C | Invoice / Barcode of Implant.-C | MRI scan of affected knee-P | Post
brace / shoulder disc+ethibond-17000 Max :4 proedure X-ray-C | detailed Procedure / Operative Notes-C
tendon repair
surgeries
including Bankart
& latarjet repair
with implant and
brace
ORTHOPAE OP OP000013 Sequestectomy / OP000013220 Sequestectomy / Curettage 10000 Yes 0 Yes 1 Yes No Secondary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Antibiotic cement beads -5000 Sequestectomy / Curettage Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 22 Curettage 0001105 Max :1 Scar Photo-C | Planned line of treatment-P | Post procedure X-ray with reports-C |
Procedure / Operation notes-C | X-ray with reports-P
ORTHOPAE OP OP000013 Single Stage OP000013420 Below Elbow/Above Elbow/Below Knee/Above 20000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Below Elbow/Above Elbow/Below Knee/Above Clinical Photograph of affected part justifying the indication-P | Clinical notes-P |
DICS 42 Amputation 0001106 Knee/Foot/Hand/Wrist/Disarticulation Knee/Foot/Hand/Wrist/Disarticulation Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C | X
Ray of affected limb-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000013 Spine deformity OP000013600 Spine deformity correction/Combined spinal segment - 30400 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Per pedicle screw/ odontoid Spine deformity correction/Combined spinal segment - Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 60 correction 0001107 front and back (anterior/posterior/ combined anterior and screw / plate with screw / cage - front and back (anterior/posterior/ combined anterior and Scar Photo-C | Invoice / barcode of implant-C | Planned line of treatment-P | Post
posterior) 2500 Max :10 | Rod -1500 Max posterior) procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray with reports-P
:10
ORTHOPAE OP OP000013 Split thickness skin OP000013660 small (< 4% TBSA) 10000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N small (< 4% TBSA) Clinical Photograph-P | Clinical notes detailing time of Burns-P | Detailed Operative
DICS 66 grafts 0001108 notes-C | Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar
Photo-C
ORTHOPAE OP OP000014 AC Joint OP000014000 Rockwood Type - I to VI 20500 Yes 0 Yes 3 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Brace-1000 Max :3 | Per Fibre Rockwood Type - I to VI Clinical notes detailing Rockwood type of fracture-P | Detailed Discharge summary-C |
DICS reconstruction / 01039 wire -3000 Max :3 | Per plate/ Intra & Post op clinical photgraph and Scar Photo-C | Invoice and barcode of implant-C |
Stabilization Nail-5000 Max :3 | Per screw- Post-op X-ray of operated limb-C | X-ray and justification of surgery done-P | detailed
1000 Max :3 | Reconstruction by Procedure / Operative Notes-C
tendon-3000 Max :3
ORTHOPAE OP OP000014 Tendon Grafting / OP000014260 Tendon Grafting / Tendon Repair / Tendon transfer 15000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Tendon Grafting / Tendon Repair / Tendon transfer Justifying need of surgery-P | Clinical notes-P | Clinical photograph of affected part-P |
DICS 26 Repair 0001109 Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo /
Photo of donor and receipent sites-C | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000014 Tendon Release / OP000014280 Tendon Release / Tenotomy / Tenolysis 5000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tendon Release / Tenotomy / Tenolysis Justifying need of surgery-P | Clinical notes-P | Clinical photograph of affected part-P |
DICS 28 Tenotomy 0001110 Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C |
detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000014 Tension Band OP000014300 Tension Band Wiring - Stand alone 12000 Yes 0 Yes 5 Yes No Secondary 3 Yes Yes Yes Stand alone Yes Yes No Surgical No Insurance N N R N Tension band-1000 Max :5 | k- Tension Band Wiring - Stand alone Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 30 Wiring 0001111 wire-300 Max :5 Scar Photo-C | Invoice / barcode of implant-C | Planned line of treatment-P | Post
procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray with reports-P
ORTHOPAE OP OP000014 Bone grafting for OP000014500 Bone grafting for Fracture Non union 10000 No 0 No 0 No No Secondary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone grafting for Fracture Non union Clinical notes detailing earlier surgery that resulted in non-union and radiological
DICS 5 Non union 001048 investigations confirming the diagnosis (X-ray of affected joint)-P | Clinical photograph-P
| Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C |
Post Procedure clinical photgraphof donor and recipient sites-C | Post procedure
imaging study (X Ray)-C | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000014 Total Hip OP000014550 Cemented 35000 Yes 0 Yes 2 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Crutch-1000 Max :2 | Implant Cemented Barcode / invoice of implant & cement used-C | Clinical notes-P | Detailed discharge
DICS 55 Replacement 0001112 for Total Hip Replacement - summary-C | Intra & Post op clinical photgraph and Scar Photo-C | Post Procedure X-ray
Cemented -27000 Max :2 showing implant-C | X-ray/ CT justifying the surgery-P | detailed Procedure / Operative
Notes-C
ORTHOPAE OP OP000014 Total Hip OP000014550 Cementless 35000 Yes 0 Yes 2 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Crutch-1000 Max :2 | Implant Cementless Barcode / invoice of implant used-C | Clinical notes-P | Detailed discharge summary-C |
DICS 55 Replacement 0001113 for Total Hip Replacement - Intra & Post op clinical photgraph and Scar Photo-C | Post Procedure X-ray showing
Cementless -47000 Max :2 implant-C | X-ray/ CT justifying the surgery-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000014 Total Hip OP000014550 Hybrid 40000 Yes 0 Yes 2 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Crutch-1000 Max :2 | Implant Hybrid Barcode / invoice of implant / cement used-C | Clinical notes-P | Detailed discharge
DICS 55 Replacement 0001114 for Total Hip Replacement - summary-C | Intra & Post op clinical photgraph and Scar Photo-C | Post Procedure X-ray
Hybrid-40000 Max :2 showing implant-C | X-ray/ CT justifying the surgery-P | detailed Procedure / Operative
Notes-C
ORTHOPAE OP OP000014 Total Hip OP000014550 Revision - Total Hip Replacement 40000 Yes 0 Yes 2 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Crutch-1000 Max :2 | Implant Revision - Total Hip Replacement Bar code of implant / cement used-C | Clinical notes-P | Detailed discharge summary-C
DICS 55 Replacement 0001115 for Revision Total Hip | Intra & Post op clinical photgraph and Scar Photo-C | Post Procedure X-ray showing
Replacement -70000 Max :2 implant-C | X-ray/ CT justifying the surgery-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000014 Total Knee OP000014560 Primary - Total Knee Replacement 40000 Yes 0 Yes 2 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Brace-1000 Max :2 | Crutch- Primary - Total Knee Replacement Clinical notes-P | Intra & Post op clinical photgraph and Scar Photo-C | Post op X-ray
DICS 56 Replacement 0001116 1000 Max :2 | Implant for Total showing the implant-C | X-ray/ CT justifying the surgery-P | detailed Procedure /
Knee Replacement - Poly base- Operative Notes-C | detailed discharge summary-C | invoice / bar code of implant.-C
35000 Max :2 | Metal base -
47000 Max :2
ORTHOPAE OP OP000014 Total Knee OP000014560 Revision - Total Knee Replacement 45000 Yes 0 Yes 2 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Brace-1000 Max :2 | Crutch- Revision - Total Knee Replacement Clinical notes-P | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / bar
DICS 56 Replacement 0001117 1000 Max :2 | Implant for code of implant.-C | Post op X-ray showing the implant-C | X-ray/ CT justifying the
Revision Total Knee Replacement- surgery-P | detailed Procedure / Operative Notes-C | detailed discharge summary-C
65000 Max :2
ORTHOPAE OP OP000014 Two Stage OP000014890 Above Elbow/Below Elbow/Above Knee/Below 23000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes Yes No Surgical No Insurance N N R N Above Elbow/Below Elbow/Above Knee/Below Clinical notes-P | Clinical photograph of affected part justifying the indication-P |
DICS 89 Amputation 0001118 Knee/Foot/Hand/Wrist/Disarticulation Knee/Foot/Hand/Wrist/Disarticulation Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C | X
Ray of affected limb-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000015 Bone tumors / OP000015100 Bone tumors / soft tissue sarcomas: surgery 34700 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone tumors / soft tissue sarcomas: surgery Clinical notes-P | HPE-P | HPE/specimen photograph-C | Intra & Post op clinical
DICS 1 soft tissue 001049 photgraph and Scar Photo-C | Planned line of treatment-P | Post Procedure
sarcomas: surgery Photographs of surgical site-C | Procedure / Operative Notes-C
ORTHOPAE OP OP000015 Bone Tumour OP000015300 Bone Tumour (benign) curettage / Excision and bone 22100 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone Tumour (benign) curettage / Excision and bone Clinical photograph of affected part-P | Biopsy-P | Clinical notes justifying need of this
DICS 3 (benign) curettage 001050 grafting grafting surgery-P | Detailed Discharge summary-C | X-ray/ MRI of affected part-P
/ Excision
and bone grafting
ORTHOPAE OP OP000015 Bone Tumour OP000015400 Bone Tumour Excision (malignant) including GCT + Joint 60000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Brace-1000 Max :1 | Crutch- Bone Tumour Excision (malignant) including GCT + Joint Biopsy-P | Clinical notes-P | Clinical photograph of affected part-P | Detailed Discharge
DICS 4 Excision 001051 replacement 1000 Max :1 | Modular Custom replacement summary-C | HPE/specimen photograph-C | Intra & Post op clinical photgraph and Scar
(malignant) (depending upon type of joint and implant) Prosthesis -Mega prosthesis- (depending upon type of joint and implant) Photo-C | Post Procedure with implant-C | Post procedure imaging study (X Ray)-C |
including GCT + 85000 Max :1 detailed Procedure / Operative Notes-C | invoice and barcode of implant-C | justifying
Joint replacement need of this surgery and X-ray/ MRI of affected part-P
(depending upon
type of joint and
implant)
ORTHOPAE OP OP000015 Vertebroplasty/Ky OP000015420 Vertebroplasty/Kyphoplasty - Govt reserved 40000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Surgical No Insurance N N N Vertebroplasty/Kyphoplasty - Govt reserved CBC-P | CECT/MRI/ x-Ray-P | Clinical notes-P | Discharge summary with detail
DICS 42 phoplasty 0001119 Reserve treatment & interventions-C | Intra & Post op clinical photgraph and Scar Photo-C | KFT-
P | LFT-P | Planned line of treatment-P | Procedure notes.-C
ORTHOPAE OP OP000015 Bone Tumour OP000015500 Bone Tumour Excision + reconstruction 40000 Yes 0 Yes 1 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Brace-1000 Max :1 | Crutch- Bone Tumour Excision + reconstruction Biopsy-P | Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge
DICS 5 Excision + 001052 1000 Max :1 | Mega prosthesis - summary-C | Intra & Post op clinical photgraph and Scar Photo-C | Post procedure
reconstruction 75000 Max :1 | Plate-5000 Max imaging study (X Ray)-C | detailed Procedure / Operative Notes-C | invoice and barcode
:1 of implant-C | justifying need of this surgery and X-ray/ MRI of affected part-P
ORTHOPAE OP OP000019 Carpal Tunnel OP000019100 Carpal tunnel release 13500 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Carpal tunnel release Clinical history-P | Detailed Procedure / Operative Notes-C | Detailed discharge
DICS 1 Release 001053 summary-C | Intra & Post op clinical photgraph and Scar Photo-C | Post procedure
Clinical photgraph showing scar-C
ORTHOPAE OP OP000020 Cervical/Thoracic OP000020700 Cervical/Thoracic/ Lumbar corpectomy with fusion for 50000 Yes 0 Yes 10 Yes Yes Tertiary 7 No Yes Yes Govt Yes No No Surgical No Insurance N N R N Odontoid screw-6000 Max :10 | Cervical/Thoracic/ Lumbar corpectomy with fusion for Clinical notes-P | Detailed discharge summary-C | Intra & Post op clinical photgraph and
DICS 7 / Lumbar 001054 Tumor/Infection/Trauma -Govt Reserve Reserve Pedicle screw/ plate with screw / Tumor/Infection/Trauma -Govt Reserve Scar Photo-C | MRI-P | Post procedure Imaging with film (X ray) showing the implants-C
Corpectomy with cage -2500 Max :10 | Rod -1500 | Post procedure-C
fusion -Govt Max :10
Reserve
ORTHOPAE OP OP000023 Closed reduction / OP000023300 Closed reduction for fracture of 5000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Closed reduction for fracture of X Ray/CT Clinical history-P | Intra & Post op clinical photgraph and Scar Photo-C | Post
DICS 3 intermaxillary 001055 maxilla/mandible/zygoma/Closed reduction and maxilla/mandible/zygoma/Closed reduction and Procedure Photograph of affected part-C | Procedure / Operative Notes-C
fixation for Intermaxillary fixation for fracture of mandible Intermaxillary fixation for fracture of mandible
fracture of maxilla
/ mandible /
zygoma
ORTHOPAE OP OP000026 Congenital Hand OP000026200 Per stage of Syndactyle/Polydactyle/Macrotodactyle 20000 Yes 0 Yes 5 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Per wire-300 Max :5 Per stage of Syndactyle/Polydactyle/Macrotodactyle Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 2 Anomaly 001057 | X-ray confirming the diagnosis-P
(Syndactyle,
Polydactyle,
Macrotodactyle)
ORTHOPAE OP OP000029 Core OP000029700 Core Decompression, Excision Arthoplasty of Femur head - 14000 No 0 No 0 No Yes Secondary 6 Yes Yes Yes Govt No No No Surgical No Insurance N N N Core Decompression, Excision Arthoplasty of Femur head - Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
DICS 7 Decompression, 001058 govt reserve Reserve govt reserve C | Intra & Post op clinical photgraph and Scar Photo-C | MRI supporting surgery-P |
Excision Post op X-ray-C
Arthoplasty of
Femur head
ORTHOPAE OP OP000030 Correction of club OP000030700 POP cast (daycare) / JESS fixator 0 Yes 2 Yes 1 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N JESS Fixator-7000 Max :1 Cast correction-3000 | Surgical POP cast (daycare) / JESS fixator Clinical notes-P | Clinical photograph of affected part-P | Detailed Discharge summary-C
DICS 7 foot 001059 procedure-12000 | Intra & Post op clinical photgraph and Scar Photo-C | X-ray confirming the diagnosis-P
| cast Photo-C | detailed Procedure / Operative Notes-C | xray-C
ORTHOPAE OP OP000030 Corrective Surgery OP000030900 Vertical Talus / Other foot deformities 15000 Yes 0 Yes 3 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N CC-screw-1000 Max :3 | Herbert Vertical Talus / Other foot deformities Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 9 for foot 001060 screw -2500 Max :3 | Per Plate/ Scar Photo-C | Planned line of treatment-P | Post procedure X-ray with reports-C |
deformities Nail -5000 Max :3 | k-wire-300 Procedure / Operation notes-C | X-ray with reports-P
Max :3
ORTHOPAE OP OP000047 Debridement & OP000047400 Anti-biotic + dressing - minimum of 2 sessions 3000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes Yes No Surgical No Insurance N N R N Anti-biotic + dressing - minimum of 2 sessions )+/- X-ray confirming the diagnosis-P | Clinical notes-P | Clinical photograph of affected
DICS 4 Closure of injuries - 001061 part-P | Detailed discharge summary-C | Evidence of 2 sessions dressing-C | Intra &
contused Post op clinical photgraph and Scar Photo-C | detailed Procedure / Operative Notes-C |
lacerated wounds, xray-C
I&D of abcess
ORTHOPAE OP OP000050 Displaced Clavicle OP000050200 Open / Closed Reduction with Internal Fixation 17000 Yes 0 Yes 2 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Plate/elastic nail-300 Max :2 | Open / Closed Reduction with Internal Fixation Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 2 Fracture 001062 kwire-300 Max :2 Scar Photo-C | Post procedure X-ray with reports-C | Procedure / Operation notes-C |
Stickers of implants used-C | X-ray with reports-P | planned line of treatment-P
ORTHOPAE OP OP000051 Duputryen’s OP000051800 Duputryen’s Contracture release + rehabilitation 9500 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Duputryen’s Contracture release + rehabilitation Clinical notes-P | Clinical photograph of affected part confirming the diagnosis-P |
DICS 8 Contracture 001063 Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C |
release + Post Procedure clinical photgraph-C | detailed Procedure / Operative Notes.-C
rehabilitation
ORTHOPAE OP OP000052 Elastic nailing / OP000052700 Humerus / forearm / Across elbow / Across Knee / femur / 16000 Yes 0 Yes 3 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :3 | External Humerus / forearm / Across elbow / Across Knee / femur / Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 7 External fixator 001064 shaft tibia / Across ankle / pelvis fixator / Elastic Nail -5000 Max :3 shaft tibia / Across ankle / pelvis Scar Photo-C | Planned line of treatment-P | Post procedure X-ray with reports-C |
for fracture | k-wire -300 Max :3 Procedure / Operation notes-C | Stickers & invoiceof implants used-C | X-ray with
fixation reports-P
ORTHOPAE OP OP000052 Elbow / Shoulder OP000052800 Elbow / Shoulder replacement 25000 Yes 0 Yes 2 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Brace-1000 Max :2 | Implant for Elbow / Shoulder replacement Clinical notes-P | Detailed discharge summary-C | Intra & Post op clinical photgraph and
DICS 8 replacement 001065 Elbow / Shoulder Replacement - Scar Photo-C | Post op X-ray invoice / bar code of implant.-C | X-ray/ CT justifying the
30000 Max :2 surgery-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000060 Excision of Bursa OP000060000 Excision of Bursa / cyst / Ganglion 0 Yes 3 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N LA - Excision of Bursa / cyst / Excision of Bursa / cyst / Ganglion Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 0 001066 Ganglion-3000 | RA/GA - | Detailing findings confirming the diagnosis-P | Intra & Post op clinical photgraph and
Excision of Bursa / cyst / Scar Photo-C | Post Procedure clinical photgraph-C | detailed Procedure / Operative
Ganglion-6900 Notes.-C
ORTHOPAE OP OP000060 Excision of OP000060600 Osteochondroma / Exostosis / Patellectomy 12100 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Osteochondroma / Exostosis / Patellectomy Clinical notes-P | Clinical photograph of affected part-P | Detailed Discharge summary-C
DICS 6 Osteochondroma 001067 | Histopath / Specimen photo / xray-C | Intra & Post op clinical photgraph and Scar
/ Exostosis / Photo-C | Justifying surgery with evidence from X-ray / MRI scan of affected part-P |
Patellectomy detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000063 Amputation - OP000063000 Finger(s)/Toe(s) 0 Yes 1 No 0 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N >3 toes / fingers-8000 | upto 3 Finger(s)/Toe(s) Clinical notes-P | Clinical photograph of affected part justifying the indication-P |
DICS Fingers / Toes 01040 fingers/ toes-5000 Detailed discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C |
Post xray detailed Procedure / Operative Notes-C | X Ray of affected limb-P
ORTHOPAE OP OP000063 External fixation OP000063900 Small bone (MC,carpal, tarsal, MT, Calcaneum, Talus, 9000 Yes 0 Yes 1 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N External Fixator -5000 Max :1 Small bone (MC,carpal, tarsal, MT, Calcaneum, Talus, Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 9 of Fracture 001068 Phalanx) Phalanx) | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
X-ray confirming the diagnosis-P | detailed Procedure / Operative Notes-C | xray
-C
ORTHOPAE OP OP000064 Fasciotomy / OP000064900 Anti-biotic + dressing - minimum of 5 sessions 9000 No 0 No 0 Yes No Tertiary 6 Yes Yes Yes Regular PKG Yes Yes No Surgical No Insurance N N R N Anti-biotic + dressing - minimum of 5 sessions )+/- X-ray confirming the diagnosis-P | Clinical notes-P | Clinical photograph of affected
DICS 9 Debridement & 001069 part-P | Detailed discharge summary-C | Evidence of 5 sessions dressing-C | Intra &
Closure of injuries - Post op clinical photgraph and Scar Photo-C | detailed Procedure / Operative Notes-C
contused
lacerated wounds
ORTHOPAE OP OP000066 Ankle Fractures OP000066000 ORIF/ CRIF of medial / lateral malleolus or bimalleolar 16000 Yes 0 Yes 5 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Calcaneum plate-5000 Max :5 | ORIF/ CRIF of medial / lateral malleolus or bimalleolar Clinical notes -P | Detailed discharge summary Post Procedure clinical photgraph-C |
DICS 01041 fracture or Trimalleolar fracture or talus or calcaneum Per CC-screw-1000 Max :5 | Per fracture or Trimalleolar fracture or talus or calcaneum Invoice and barcode of implant-C | X-ray / CT of ankle joint-P | X-ray-C | clinical
plate/ Nail-5000 Max :5 | Per photograph of affected part-P | detailed Procedure / Operative Notes-C
tension band-1000 Max :5 | k-
wire-300 Max :5
ORTHOPAE OP OP000066 Fixation of OP000066300 Open / Closed Reduction & Internal Fixation of long bones 21000 Yes 0 Yes 4 Yes No Secondary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :4 | Crutch- Open / Closed Reduction & Internal Fixation of long bones Clinical notes-P | Clinical photograph of affected part-P | Intra & Post op clinical
DICS 3 Diaphyseal 001070 (femur shaft / tibia shaft / Fibula / Humerus) 1000 Max :4 | Herbert screw - (femur shaft / tibia shaft / Fibula / Humerus) photgraph and Scar Photo-C | Invoice / barcode of implant-C | Post Procedure clinical
Fracture - Long 2500 Max :4 | Per Plate/ Nail - photograph-C | Post procedure imaging study (X Ray)-C | Radiological investigations
Bone 5000 Max :4 | k-wire-300 Max :4 confirming the diagnosis (X-ray)-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000066 Fixation of OP000066500 Closed reduction (1 jaw) using wires - under LA/GA 5000 Yes 0 Yes 3 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Tension band wire-1000 Max :3 | Closed reduction (1 jaw) using wires - under LA/GA Clinical Photograph-P | Clinical notes-P | Detailed Discharge Summary-C | Intra & Post
DICS 5 fracture of jaw 001071 k-wire-300 Max :3 op clinical photgraph and Scar Photo-C | Post procedure X ray mandible-C | X Ray
Mandible-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000066 Fixation of OP000066500 Open reduction (1 jaw) and fixing of plates / wire - under LA 12000 Yes 0 Yes 3 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Plate-5000 Max :3 | Wire-300 Open reduction (1 jaw) and fixing of plates / wire - under LA Clinical Photograph-P | Clinical notes-P | Detailed Discharge Summary-C | Intra & Post
DICS 5 fracture of jaw 001072 / GA Max :3 / GA op clinical photgraph and Scar Photo-C | Post procedure X ray mandible-C | X Ray
Mandible-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000068 Fracture - OP000068300 ORIF THROUGH combined Approach PLATING 33000 Yes 0 Yes 3 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N CC-screw - ORIF THROUGH ORIF THROUGH combined Approach PLATING X-ray with reports -P | Clinical notes-P | Detailed Discharge Summary-C | Intra & Post
DICS 3 Acetabulum 001073 combined Approach PLATING- op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C | Planned line
1500 Max :3 | Plate-5000 Max :3 of treatment-P | Post procedure X-ray with reports-C | Procedure / Operation notes-C
ORTHOPAE OP OP000068 Fracture - OP000068300 ORIF THROUGH Single Approach PLATING 28000 Yes 0 Yes 3 Yes No Tertiary 7 no Yes Yes Regular PKG Yes No No Surgical No Insurance N N N CC-screw - ORIF THROUGH Single ORIF THROUGH Single Approach PLATING X-ray with reports -P | Clinical notes-P | Detailed Discharge Summary-C | Intra & Post
DICS 3 Acetabulum 001074 Approach PLATING-1500 Max :3 op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C | Planned line
| Plate-5000 Max :3 of treatment-P | Post procedure X-ray with reports-C | Procedure / Operation notes-C
ORTHOPAE OP OP000068 Fracture - Both OP000068400 Fracture - Both Bones - Forearm - ORIF/CRIF - Plating / 16000 Yes 0 Yes 3 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :3 | Herbert Fracture - Both Bones - Forearm - ORIF/CRIF - Plating / Clinical notes-P | Clinical photograph of affected part-P | Detailed Discharge Summary-C
DICS 4 Bones - Forearm - 001075 Nailing / JESS screw-2500 Max :3 | Per Plate Nailing / JESS | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
ORIF/CRIF - Plating with screws/ JESS-3000 Max :3 | Post procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray
/ Nailing / JESS Per nail-2000 Max :3 | k-wire- confirming the diagnosis-P
300 Max :3
ORTHOPAE OP OP000068 Fracture - Long OP000068500 Fracture - Long Bones - Metaphyseal - ORIF (excludes 19000 Yes 0 Yes 2 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :2 | Herbert Fracture - Long Bones - Metaphyseal - ORIF (excludes Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 5 Bones - 001076 forearm bones) screw-2500 Max :2 | Per Plate- forearm bones) Scar Photo-C | Post procedure X-ray with reports-C | Procedure / Operation notes-C |
Metaphyseal - 7000 Max :2 | k-wire-300 Max :2 Stickers of implants used-C | X-ray with reports-P | planned line of treatment-P
ORIF
ORTHOPAE OP OP000068 Fracture - Neck/ IT OP000068600 Closed Reduction and Percutaneous CC-Screw Fixation / 19000 Yes 0 Yes 3 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Angle plate / DHS-5000 Max :3 | Closed Reduction and Percutaneous CC-Screw Fixation / Clinical notes-P | Clinical photograph of affected part-P | Intra & Post op clinical
DICS 6 Femur 001077 DHS / PFN / Angle plate CC-screw - Closed Reduction and DHS / PFN / Angle plate photgraph and Scar Photo-C | Invoice / barcode of implant-C | Post Procedure clinical
Percutaneous CC-Screw Fixation / photgraph-C | Post procedure imaging study (X Ray)-C | X-ray confirming the diagnosis-
DHS / PFN / Angle plate-1500 Max P | detailed Procedure / Operative Notes-C
:3 | PFN-7000 Max :3 | k-wire-
300 Max :3
ORTHOPAE OP OP000068 Fracture - Single OP000068800 Fracture - Single Bone - Forearm - ORIF - Plating / Nailing / 12000 Yes 0 Yes 2 Yes No Secondary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :2 | Herbert Fracture - Single Bone - Forearm - ORIF - Plating / Nailing / Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 8 Bone - Forearm - 001078 JESS screw-2500 Max :2 | Per Plate JESS | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant.-C |
ORIF / CRIF- with screws / JESS-3000 Max :2 | Post procedure X-rayshowing implant-C | X-ray confirming the diagnosis-P | detailed
Plating / Nailing / Per nail-2000 Max :2 Procedure / Operative Notes-C
JESS
ORTHOPAE OP OP000068 Fracture Condyle - OP000068900 ORIF of Medial / lateral Condyle / ORIF with screw of 10000 Yes 0 Yes 4 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :4 | Herbert ORIF of Medial / lateral Condyle / ORIF with screw of Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 9 Humerus - ORIF 001079 proximal/distal humerus screw-2500 Max :4 | k-wire-300 proximal/distal humerus | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant.-C |
Max :4 Post procedure X-rayshowing implant-C | X-ray confirming the diagnosis-P | detailed
ORTHOPAE OP OP000069 Fracture Head OP000069000 Excision / Fixation / radial head prosthesis / Comminuted 10000 Yes 0 Yes 3 Yes No Secondary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Herbert screw-2500 Max :3 | Excision / Fixation / radial head prosthesis / Comminuted Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 0 radius/ distal end 001080 Fracture Olecranon of Ulna/ distal end intra-articular radius Nail / Plate and Screw-5000 Max Fracture Olecranon of Ulna/ distal end intra-articular radius | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
intra-articular fracture :3 | Radial head prosthesis- fracture Post Procedure clinical photgraph-C | Post procedure imaging study (X Ray)-C | X-ray
radius fracture / 10000 Max :3 | k-wire-300 Max confirming the diagnosis-P | detailed Procedure / Operative Notes-C
Comminuted :3
Fracture
Olecranon of Ulna
ORTHOPAE OP OP000069 Fracture OP000069100 ORIF Fracture intercondylar Humerus +/- olecranon 15000 Yes 0 Yes 3 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :3 | Herbert ORIF Fracture intercondylar Humerus +/- olecranon Clinical notes-P | Clinical photograph of affected part-P | Detailed Procedure /
DICS 1 intercondylar 001081 osteotomy +/- TBW screw-2500 Max :3 | Plate with osteotomy +/- TBW Operative Notes-C | Detailed discharge summary-C | Intra & Post op clinical photgraph
Humerus +/- screws-5000 Max :3 | Tension and Scar Photo-C | Invoice / barcode of implant-C | Post Procedure X-ray-C | X-ray
olecranon band-1000 Max :3 | k-wire-300 showing the need of procedure-P
osteotomy Max :3
ORTHOPAE OP OP00007 Spine fixation OP000070000 Cervical including odontoid / Dorsal / lumbar spine fixation 30000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for cervical / Dorsal and Cervical including odontoid / Dorsal / lumbar spine fixation Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS (Cervical / Dorsal / 1037 THROUGH Anterior approach lumbar spine fixation Odontoid THROUGH Anterior approach Scar Photo-C | Invoice / barcode of implant-C | Planned line of treatment-P | Post
lumbar) screw -6000 Max :10 | Implant procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray / CT / MRI with
for cervical / Dorsal and lumbar reports-P
spine fixation Pedicle screw/
plate with screw / cage-2500 Max
:10 | Implant for cervical /
Dorsal and lumbar spine fixation
Rod-1500 Max :10
ORTHOPAE OP OP00007 Spine fixation OP000070000 Cervical including odontoid / Dorsal / lumbar spine fixation 28000 Yes 0 Yes 10 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for cervical / Dorsal and Cervical including odontoid / Dorsal / lumbar spine fixation Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS (Cervical / Dorsal / 1038 THROUGH posterior approach lumbar spine fixation Odontoid THROUGH posterior approach Scar Photo-C | Invoice / barcode of implant-C | Planned line of treatment-P | Post
lumbar) screw-6000 Max :10 | Implant procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray / CT / MRI with
for cervical / Dorsal and lumbar reports-P
spine fixation Pedicle screw/
plate with screw / cage-2500 Max
:10 | Implant for cervical /
Dorsal and lumbar spine fixation
Rod-1500 Max :10
ORTHOPAE OP OP000073 Hemiarthroplasty OP000073400 Unipolar/Bipolar (Non - Modular/ Modular) (cemented/non 17000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bipolar modular-15000 Max :1 | Unipolar/Bipolar (Non - Modular/ Modular) (cemented/non Clinical notes-P | Intra & Post op clinical photgraph and Scar Photo-C | Post op X-ray
DICS 4 001082 cemented) Crutch-1000 Max :1 | Unipolar cemented) showing the implant-C | X-ray/ CT justifying the surgery-P | detailed Procedure /
Hemiarthroplasty-4000 Max :1 | Operative Notes-C | detailed discharge summary-C | invoice / bar code of implant-C
simple Bipolar-10000 Max :1
ORTHOPAE OP OP000077 High Tibial OP000077200 High Tibial Osteotomy 16000 Yes 0 Yes 2 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fixator-5000 Max :2 | Plate for High Tibial Osteotomy Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 2 Osteotomy 001083 High Tibial Osteotomy-5000 Max | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
:2 Post procedure clinical photgraph-C | Post procedure imaging study (X Ray)-C | X-ray
confirming the diagnosis-P | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000080 Ilizarov Fixation OP000080400 Ilizarov Fixation 17300 Yes 0 Yes 2 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Crutch-1000 Max :2 | Implant Ilizarov Fixation Clinical and radiological investigations confirming the indication-P | Clinical photograph
DICS 4 001084 for Ilizarov fixation-12000 Max :2 of affected part-P | Detailed discharge summary-C | Intra & Post op clinical photgraph
and Scar Photo-C | Invoice / barcode of implant-C | Post procedure X-ray showing
implant-C | detailed Procedure / Operative Notes-C
ORTHOPAE OP OP000081 Implant Removal OP000081000 K - Wire/Screw/External fixator 0 Yes 1 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N LA-2000 | RA/GA - K - K - Wire/Screw/External fixator Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 0 under LA / RA / 001085 Wire/Screw/External fixator- Scar Photo-C | Planned line of treatment including planned line of treatment-P | Post
GA 5000 procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray-P
ORTHOPAE OP OP000081 Implant Removal OP000081200 Nail/ Plate / TBW / cc-screw from NOF 15000 No 0 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nail/ Plate / TBW / cc-screw from NOF Clinical notes-P | Detailed Discharge Summary-C | Intra & Post op clinical photgraph and
DICS 2 under RA / GA 001086 Scar Photo-C | Planned line of treatment including planned line of treatment-P | Post
procedure X-ray with reports-C | Procedure / Operation notes-C | X-ray-P
ORTHOPAE OP OP000082 Internal Fixation OP000082100 CRIF/ORIF Small Bones (Patella / carpal /tarsal /phalanx 11000 Yes 0 Yes 10 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :10 | CRIF/ORIF Small Bones (Patella / carpal /tarsal /phalanx Clinical notes-P | Clinical photograph of affected part-P | Detailed discharge summary-C
DICS 1 of Small Bones 001087 /metatarsal /metacarpal /calcaneum /tarsal) Calcaneum plate-5000 Max :10 | /metatarsal /metacarpal /calcaneum /tarsal) | Intra & Post op clinical photgraph and Scar Photo
Herbert screw-2500 Max :10 | -C | Invoice / barcode of implant-C | Post procedure X-ray showing implant-C | X-ray
Plate with screws - CRIF/ORIF confirming the diagnosis-P | detailed Procedure / Operative Notes-C
Small Bones (Patella / carpal
/tarsal /phalanx /metatarsal
/metacarpal /calcaneum /tarsal)-
1500 Max :10 | k-wire-300 Max
:10
ORTHOPAE OP OP000086 Laminectomy with OP000086000 Laminectomy with fusion and fixation for 35000 Yes 0 Yes 10 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cage-2500 Max :10 | Odontoid Laminectomy with fusion and fixation for Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
DICS 0 fusion and fixation 001088 lumbar/cervical/thoracic canal stenosis or for tumor / screw-6000 Max :10 | Pedicle lumbar/cervical/thoracic canal stenosis or for tumor / C | Intra & Post op clinical photgraph and Scar Photo-C | MRI establishing need of
trauma/Bleed screw-2500 Max :10 | Plate with trauma/Bleed surgery-P | Post procedure Clinical photgraph showing scar-C | Post procedure X-ray
screw-2500 Max :10 | Rod -1500 showing fixation & fusion-C
Max :10
ORTHOPAE OP OP000086 Laminectomy OP000086200 Laminectomy without fusion for lumbar or dorsal or cervical 25000 No 0 No 0 Yes Yes Tertiary 6 No Yes Yes Govt Yes No No Surgical No Insurance N N N Laminectomy without fusion for lumbar or dorsal or cervical MRI establishing need of surgery-P | Clinical notes-P | Detailed discharge summary-C |
DICS 2 without fusion 001089 canal stenosis - Govt reserve Reserve canal stenosis - Govt reserve Intra & Post op clinical photgraph and Scar Photo
Post procedure X-ray showing fixation & fusion, Post procedure Clinical photgraph
showing scar, Detailed discharge summary Detailed Procedure / Operative Notes.-C |
Intra & Post op clinical photgraph and Scar Photo-C | Post procedure Clinical photgraph
showing scar-C | Post procedure X-ray showing fixation & fusion-C
ORTHOPAE OP OP000087 Application of OP000087000 P.O.P slab / cast / Spikas / Jackets - Day care 0 Yes 4 No 0 Yes No Secondary 0 Yes Yes Yes Day care Yes No No Surgical Yes Insurance Y N R N POP cast-2000 | POP slab-1000 P.O.P slab / cast / Spikas / Jackets - Day care Clinical photograph of affected part-P | X-ray showing the need of procedure-P | .
DICS P.O.P slab / cast / 01042 | Spika/ jacket-2500 Detailed discharge summary Post-C | Clinical notes-P | Invoice and barcode of implant-C
Spikas / Jackets | Post op clinical photgraph-C | Procedure clinical photgraph-C | X-ray-C | detailed
ORTHOPAE OP OP000088 Application of OP000088000 skin / Skeletal Tractions with pin / crutchfiled tong cervical 0 Yes 0 Yes 2 Yes No Secondary 1 Yes Yes Yes Day care Yes No No Surgical Yes Insurance Y N R N Crutchfiled tong cervical spine skin / Skeletal Tractions with pin / crutchfiled tong cervical Clinical photograph of affected part-P | X-ray showing the need of procedure-P |
DICS Traction 01043 spine traction - Day care traction-4300 Max :2 | Skeletal spine traction - Day care Clinical notes-P | Detailed discharge summary-C | Intra & Post op clinical photgraph and
Tractions with pin-2500 Max :2 | Scar Photo-C | Photo with pins-C | detailed Procedure / Operative Notes-C
Skin Traction-700 Max :2
ORTHOPAE OP OP000088 Limb Lengthening OP000088000 Limb Lengthening / Bone Transport by Ilizarov / LRS 25000 Yes 0 Yes 2 Yes No Tertiary 8 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Crutch-1000 Max :2 | Implant Limb Lengthening / Bone Transport by Ilizarov / LRS Clinical and radiological investigations confirming the diagnosis-P | Clinical photograph of
DICS 0 / Bone Transport 001090 for Limb Lengthening / Bone affected part showing short limb as compared to other limb-P | Detailed Procedure /
by Ilizarov / LRS Transport by Ilizarov / LRS-12000 Operative Notes-C
Max :2
ORTHOPAE OP OP000091 Management of OP000091600 Management of Chest injury with fixation of 2 or more LIMB 45000 Yes 0 Yes 5 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :5 | Management of Chest injury with fixation of 2 or more LIMB Clinical notes detailing the injury and need of surgery-P | Detailed operatives notes-C |
DICS 6 Chest injury with 001091 Calcaneum plate-5000 Max :5 | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
fracture of Long Herbert screw-2500 Max :5 | Post OP X-rays-C | X-ray/ CT/ MRI (of both chest & affected long bone)-P | detailed
bone Plate with screw - Management discharge summary-C
of Chest injury with fixation of 2
or more LIMB-1500 Max :5 | k-
wire-300 Max :5
ORTHOPAE OP OP000091 Management of OP000091600 Management of Chest injury with fixation of Single LIMB 30000 Yes 0 Yes 5 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :5 | Management of Chest injury with fixation of Single LIMB Clinical notes detailing the injury and need of surgery-P | Detailed operatives notes-C |
DICS 6 Chest injury with 001092 Calcaneum plate-5000 Max :5 | Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
fracture of Long Herbert screw-2500 Max :5 | Post OP X-rays-C | X-ray/ CT/ MRI (of both chest & affected long bone)-P | detailed
bone Plate with screw - Management discharge summary-C
of Chest injury with fixation of
Single LIMB-1500 Max :5 | k-
wire-300 Max :5
ORTHOPAE OP OP000092 Arthrodesis OP000092000 Knee / Ankle / foot / Triple arthrodesis / Shoulder / elbow/ 17000 Yes 0 Yes 4 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Herbert screw-2500 Max :4 | Per Knee / Ankle / foot / Triple arthrodesis / Shoulder / elbow/ Clinical photograph of affected part-P | Clinical notes detailing indication-P | Detailed
DICS 01044 Wrist / Hand +/-implant plate/ Nail-5000 Max :4 | cc- Wrist / Hand +/-implant Discharge summary-C | Intra & Post op clinical photgraph and Scar Photo-C | Invoice
screw-1000 Max :4 | k-wire -300 /barcode of implant-C | Post procedure X-ray-C | X-ray of ankle and foot-P | detailed
Max :4 Procedure / Operative Notes-C
ORTHOPAE OP OP000092 Management of OP000092200 Surgical intervention for Visceral injury and fixation of 52100 Yes 0 Yes 3 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :3 | Surgical intervention for Visceral injury and fixation of Clinical notes detailing the injury and need of surgery-P | Detailed operatives notes-C |
DICS 2 Visceral injury and 001093 fracture of 2 or more llmb Calcaneum plate-5000 Max :3 | fracture of 2 or more llmb Intra & Post op clinical photgraph and Scar Photo-C | X-ray/ CT/ MRI (of both affected
fracture long bone Herbert screw-2500 Max :3 | viscera & affected long bone)-P | X-rays showing visceral injury repair and implant for
Plate with screw - Surgical fixation-C | detailed discharge summary-C
intervention for Visceral injury
and fixation of fracture of 2 or
more llmb-1500 Max :3 | k-wire-
300 Max :3
ORTHOPAE OP OP000092 Management of OP000092200 Surgical intervention for Visceral injury and fixation of 39100 Yes 0 Yes 3 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :3 | Surgical intervention for Visceral injury and fixation of Clinical notes detailing the injury and need of surgery-P | Detailed operatives notes-C |
DICS 2 Visceral injury and 001094 fracture of single limb Calcaneum plate-5000 Max :3 | fracture of single limb Intra & Post op clinical photgraph and Scar Photo-C | Invoice / barcode of implant-C |
fracture long bone Herbert screw-2500 Max :3 | Post OP X-rays-C | X-ray/ CT/ MRI (of both chest & affected long bone)-P | detailed
Plate with screw - Surgical discharge summary-C
intervention for Visceral injury
and fixation of fracture of single
limb-1500 Max :3 | k-wire-300
Max :3
ORTHOPAE OP OP000093 Arthrolysis of joint OP000093000 Elbow/Knee/Ankle - govt reserve 10000 No 0 No 0 Yes Yes Secondary 2 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Elbow/Knee/Ankle - govt reserve Clinical photograph of affected part-P | Clinical notes-P | Intra & Post op clinical
DICS 01045 Reserve photgraph and Scar Photo-C | Post Procedure clinical photgraph-C | Post procedure
imaging study-C | X-ray confirming the diagnosis-P | detailed Procedure / Operative
Notes-C
ORTHOPAE OP OP000094 Arthroscopic OP000094000 Arthroscopic Meniscus Repair / Meniscectomy / MPFL 12000 Yes 0 Yes 3 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Arthroscopic meniscal repair with Arthroscopic Meniscus Repair / Meniscectomy / MPFL Clinical notes-P | Detailed Discharge summary.-C | Intra & Post op clinical photgraph
DICS Meniscus Repair / 01046 Repair fibre wire for inside out Repair and Scar Photo-C | Intra operative still image-C | MRI justifying procedure-P | detailed
Meniscectomy technique-3000 Max :3 | Brace- Procedure / Operative Notes-C | post procedure clinical photgraph-C
1000 Max :3 | Crutch-1000 Max
:3
ORTHOPAE OP OP000095 Arthroscopy / OP000095000 Arthroscopy / open - synovectomy - govt reserve 10000 No 0 No 0 No Yes Secondary 2 No Yes Yes Govt No No No Surgical No Insurance N N N Arthroscopy / open - synovectomy - govt reserve Clinical photograph of affected part-P | Clinical notes-P | Detailed Discharge summary-
DICS open - 01047 Reserve C | Intra & Post op clinical photgraph and Scar Photo-C | Intra operative still image-C |
synovectomy MRI justifying procedure-P | detailed Procedure / Operative Notes-C | post procedure
clinical photgraph-C
ORTHOPAE OP OP000096 Arthrotomy OP000096000 Arthorotomy of any joint - govt reserve 10000 No 0 No 0 No Yes Secondary 7 Yes Yes Yes Govt No No No Surgical No Insurance N N N Arthorotomy of any joint - govt reserve X-ray / USG / MRI confirming the diagnosis-P | Clinical notes and X-ray / USG / MRI
DICS 01036 Reserve confirming the diagnosis-P | Clinical photograph of affected part-P | Detailed Discharge
summary-C | Intra & Post op clinical photgraph and Scar Photo-C | detailed Procedure /
Operative Notes-C
ORGAN OTS OTS1500 Heart/Lung OTS150010005 (Lung / Heart- Lung Combo)Lung / Heart- Lung 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Lung / Heart- Lung Combo)Lung / Heart- Lung 2D ECHO-P | Blood Investigations-P | CT Chest-P | Cath study-P | Detailed Clinical
TRANSPLA Transplant ComboTransplant Surgery ComboTransplant Surgery report justifying line of tretament-P | Discharge summaries-C | Doctor prescription-P |
NT OPD/IPD/day care Records-C | OPD/IPD/day care Records-C | PFT-P | Relavent
SURGERY invetigation reports to be submitted at the end of the 12 month follow up or Post -op
death-C | VO2 Max-P | X-Ray Chest-P
NT OPD/IPD/day care Records-C | PFT-P | Relavent invetigation reports to be submitted at
SURGERY the end of the 6 month follow up or Post -op death-C | VO2 Max-P | X-Ray Chest-P
NT OPD/IPD/day care Records-C | PFT-P | Relavent invetigation reports to be submitted at
SURGERY the end of the 3 month follow up or Post -op death-C | VO2 Max-P | X-Ray Chest-P
ORGAN OTS OTS1500 Heart/Lung OTS150010002 (Lung / Heart- Lung Combo)Lung / Heart- Lung 800000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Lung / Heart- Lung Combo)Lung / Heart- Lung 2D ECHO-P | Blood Investigations-P | CT Chest-P | Cath study-P | Colour doppler-C |
TRANSPLA Transplant ComboTransplant Surgery ComboTransplant Surgery Detailed Clinical report justifying line of tretament-P | Discharge summary and relavent
NT invetigation reports-C | Doctor prescription-P | Invoice/barcode of Implant-C |
SURGERY Myocardial biopsy if done-C | OT notes-C | PFT-P | Post oprative ICU care detail-C |
VO2 Max-P | X-Ray Chest-P
ORGAN OTS OTS1500 Heart/Lung OTS150010000 (Lung / Heart-Lung Combo)Transplant Surgery pre 100000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Lung / Heart-Lung Combo)Transplant Surgery pre Operative 2D ECHO-P | 2D ECHO-P | Blood Investigations-P | CAG / MRI/ HRCT-C | CD4 count-C
TRANSPLA Transplant Operative evaluation evaluation | CT /Doppler-C | CT Chest-P | Clinical photo of patient-C | Discharge summary-C |
NT HLA phenotype-C | Hospital authorization letter, Patient Consent-P | Invoice of Implant-
SURGERY C | MV02 Stress test-C | NOTTO / SOTTO registration-P | Other supporting
investigation-C | PFT-P | Panal rective antibody-C | VO2 Max-P | VO2 Max-P |
Vaccination certificate-C | Viral serology-C | X-Ray Chest Detailed Clinical report
justifying line of tretament-P
ORGAN OTS OTS1500 Heart/Lung OTS150010006 (Lung / Heart- Lung Combo)Donor for Multiorgan 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Lung / Heart- Lung Combo)Donor for Multiorgan Brain Death Certificate with notification-P | Detailed Death summary and relavent
TRANSPLA Transplant supporting invetigations-C | Detailed Operation notes-C | Doctor prescription including
NT donor details-P | Donation document, Relevent clinical notes-P
SURGERY
ORGAN OTS OTS1501 ECMO OTS150110008 (Heart Transplant Packages) -ECMO Period - per day 10000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Heart Transplant Packages) -ECMO Period - per day Ascertaining need for ECMO-P | Circuit details-C | Clinical photograph-C | Detailed
TRANSPLA clinical notes per day notes-P | Oxygenrater-C | Physiotherapy detail-C | Transfusion
NT details-C | supportive investigation-C
SURGERY
ORGAN OTS OTS1501 ECMO OTS150110007 VA/VV ECMO Initiation 250000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N VA/VV ECMO Initiation 2D Echo-P | CT Chest-P | Clinical photograph -C | Detailed clinical notes ascertaining
TRANSPLA need for ECMO-P | Discharge summary and relavent invetigation reports-C | Doctor
NT prescription-P | ECG-P | OT notes-C | Supportive investigation-C | X-ray Chest-P
SURGERY
ORGAN OTS OTS1501 ECMO OTS150110001 (Lung / Heart- Lung Combo)Short term. ECMO Bridge 300000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Lung / Heart- Lung Combo)Short term. ECMO Bridge 2D ECHO-P | Blood Investigations-P | CT Chest-P | Detail pre cardiac tansplant
TRANSPLA totransplant totransplant evalution details-P | Detailed Clinical report, justifying line of tretament-P | Discharge
NT summary and relavent invetigation reports-C | ECG-P | Invoice/barcode of Implant-C |
SURGERY OT notes-C | PFT-P | VO2 Max-P | X-Ray Chest-P
ORGAN OTS OTS1502 Cochlear Implant OTS150210012 (Cochlear Implant Packages ) - Post-Operative Audio 70000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Cochlear Implant Packages ) - Post-Operative Audio Complete details of session-C | Doctor Prescription with plan of post operative audio
TRANSPLA Verbal(speech) Therapy Verbal(speech) Therapy verbal therapy-P | Patient attendent/ parents feed back form-C | Quarterly post-op
NT Audio linguistic scales (CAP /SIR/MAIS)-C | Quarterly post-op video op swtich on
SURGERY (Showing improvment)-C | Speech therapy card (OPD card/ day care/ IPD)-C
ORGAN OTS OTS1502 Cochlear Implant OTS150210011 (Cochlear Implant Packages ) - Cochlear Implant - ADD ON 409500 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Cochlear Implant Packages ) - Cochlear Implant - ADD ON This is implant package - it will be added with Cochlear Implant surgery package-C | This
TRANSPLA is implant package - it will be added with Cochlear Implant surgery package-P
NT
SURGERY
ORGAN OTS OTS1502 Cochlear Implant OTS150210010 (Cochlear Implant Packages ) - Cochlear Implant Surgery 30000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Cochlear Implant Packages ) - Cochlear Implant Surgery (Acctual cost as per the RC/ Tender)-C | Barcode of Implant-C | Bera Roport-P | Detail
TRANSPLA in indoor chartt papers-C | Detailed Discharge Summary-C | Doctor Prescription with
NT Indications-P | E cap threshold details-C | Implant model-C | Intra Operative Picture-C
SURGERY | Invoice of Implant-C | Picture-C | Post operative-C | Pre operative evaluation &
Investigation dtails-P | Supproting investigations-C | Surgical notes-C | X-ray with
cochlear view-C
ORGAN OTS OTS1502 Cochlear Implant OTS150210009 (Cochlear Implant Packages ) - Preoperative evaluation for 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Cochlear Implant Packages ) - Preoperative evaluation for Bera Roport-P | Discharge Card/evaluation chart (OPD /Day care/ IPD )-C | Doctor
TRANSPLA cochlear Implant cochlear Implant Prescription with Indications-P | Hearing Aid Trial details,Bar code/invoice of Hearing
NT Aids-C | MRI Brain/ Temporal lobe Psychological (devlopment) assessment report-C |
SURGERY Otoacaustic emission (OAE) HRCT Temporal bone
-C | Patient birth certificate-P | Pedicatric workup Details-C | Pre-anaesthesia
investigation Report-C | Pre-operative audio-verbal therapy sessions details-C |
Vaccination details-C
ORGAN OTS OTS1502 Cochlear Implant OTS150210013 (Cochlear Implant Packages ) - Maintenance for cochlear 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Cochlear Implant Packages ) - Maintenance for cochlear AMC documents/complete details of maintened parts-P | Doctor Prescription-P |
TRANSPLA implant implant Maintenance card mentioning details of implant maintenance done-C
NT
SURGERY
ORGAN OTS OTS1503 Bone Marrow OTS150310020 (Bone Marrow Tansplant Packages) - Allogenic Bone marrow 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Allogenic Bone marrow Details of vaccination done-C | Doctor prescription with vaccination required-P
TRANSPLA Tansplant transplant - Immunization/Vaccination transplant - Immunization/Vaccination
NT
SURGERY
ORGAN OTS OTS1503 Bone Marrow OTS150310019 (Bone Marrow Tansplant Packages) - Allogenic Bone marrow 250000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Allogenic Bone marrow Admission Notes Showing Vitals-P | Chimerism testing report-P | Clinical notes detailing
TRANSPLA Tansplant transplant chronic GVHD. transplant chronic GVHD. history-P | Detailed Discharge Summary-C | Detailed Icps-C | Detailed Treatment
NT Notes-C | Disease status-P | Evidence Of All Investigations Done-C | Examination
SURGERY finding-P | Planned line of management-P | Stem cell infusion details-P
ORGAN OTS OTS1503 Bone Marrow OTS150310018 (Bone Marrow Tansplant Packages) - Allogenic Bone marrow 1100000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Allogenic Bone marrow Admission Notes Showing Vitals-P | Clinical notes detailing history-P | Detailed
TRANSPLA Tansplant transplant (Haplo) - Allogenic Bone marrow transplant transplant (Haplo) - Allogenic Bone marrow transplant Discharge Summary-C | Detailed Icps-C | Detailed Treatment Notes-C | Disease status-
NT (Haplo) (Haplo) P | Evidence Of All Investigations Done-C | Examination finding-P | HLA reports-P |
SURGERY Indication for transplant-P | Planned line of management-P | Pre transplant donor
workup-P | Pre transplant receipient workup, Histopathological diagnosis of disease
(BMA/ tissue Biopsy with/ without IHC /Immunophenotyping )-P
ORGAN OTS OTS1503 Bone Marrow OTS150310017 (Bone Marrow Tansplant Packages) - Allogenic Bone marrow 900000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Allogenic Bone marrow Admission Notes Showing Vitals-P | Clinical notes detailing history-P | Detailed
TRANSPLA Tansplant transplant (MSD) - Allogenic Bone marrow transplant (MSD) transplant (MSD) - Allogenic Bone marrow transplant (MSD) Discharge Summary-C | Detailed Icps-C | Detailed Treatment Notes-C | Disease status-
NT P | Evidence Of All Investigations Done-C | Examination finding-P | HLA reports-P |
SURGERY Indication for transplant-P | Planned line of management-P | Pre transplant recipient
workup Histopathological diagnosis of disease (BMA/tissue Biopsy with/ without IHC/
immunophenotyping) Pre transplant receipient/donor workup-P
ORGAN OTS OTS1503 Bone Marrow OTS150310016 (Bone Marrow Tansplant Packages) - Allogenic Bone marrow 100000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Allogenic Bone marrow Admission notes showing vitals-P | Blood group-C | Bone marrow aspiration/ biopsy/
TRANSPLA Tansplant transplant (MSD/Haplo) - Pre-evaluation/Work up transplant (MSD/Haplo) - Pre-evaluation/Work up flowcytometry-C | Clinical notes detailing history-P | Detailed Discharges Summary-C |
NT Detailed ICPS-C | Examination finding-P | Indication for transplant-P | Planned line of
SURGERY management-P | Supporting investigation-C | etailed Treatment notes-C
ORGAN OTS OTS1503 Bone Marrow OTS150310015 (Bone Marrow Tansplant Packages) - ASCT (Autologous 450000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - ASCT (Autologous Bone Admission notes showing vitals-P | Clinical notes detailing history-P | Detailed ICPs-C |
TRANSPLA Tansplant Bone marrow transplant) marrow transplant) Detailed procedure Notes-C | Details Discharges summary-C | Disease status-P |
NT Evidence of All investigations Done-C | Examination finding-P | Histopathological
SURGERY diagnossis of disease (BMA/ Tissue Biospy with/ without IHC with/ without
Immunophenotyping)-P | Indication for transplant-P | Planned line of management-P |
Pre transplant recipiet workup details-P
ORGAN OTS OTS1503 Bone Marrow OTS150310014 (Bone Marrow Tansplant Packages) - ASCT (Autologous 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - ASCT (Autologous Bone Admission notes showing vitals-P | Blood group-C | Bone marrow aspiration/ biopsy /
TRANSPLA Tansplant Bone marrow transplant) - Pre-evaluation/Work up marrow transplant) - Pre-evaluation/Work up flowcytometry-C | Clinical notes detailing history-P | Detailed ICPS-C | Detailed
NT discharge summary -C | Detial treatment notes-C | Examination findings-P | Indication
SURGERY for transplant-P | Planned line of management-P | Supporting investigation-C
ORGAN OTS OTS1503 Bone Marrow OTS150310021 (Bone Marrow Tansplant Packages) - Post Autologous / 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Post Autologous / Admission Notes Showing Vitals-P | Chimerism testing report-C | Clinical notes detailing
TRANSPLA Tansplant Allogenic (Haplo/MSD) Transplant follow up (upto 6 Allogenic (Haplo/MSD) Transplant follow up (upto 6 history-P | Cyclosporine/ tacrolimus level-C | Detailed Discharge Summary-C | Detailed
NT months) - months) - Treatment Notes-C | Discharge summary-P | Disease status-P | Examination finding-P
SURGERY | Number of visits-P | Other relavent Investigations Done to be submitted at the end of
the 6 month follow up or Post -op death-C | Planned line of management-P
ORGAN OTS OTS1503 Bone Marrow OTS150310022 (Bone Marrow Tansplant Packages) - Post Autologous / 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Bone Marrow Tansplant Packages) - Post Autologous / Admission Notes Showing Vitals-P | Chimerism testing report-C | Clinical notes detailing
TRANSPLA Tansplant Allogenic (Haplo/MSD) Transplant follow up (6-12 months) - Allogenic (Haplo/MSD) Transplant follow up (6-12 months) - history-P | Cyclosporine/ tacrolimus level-C | Detailed Discharge Summary-C | Detailed
NT Treatment Notes-C | Discharge summary-P | Disease status-P | Examination finding-P
SURGERY | Number of visits-P | Other relavent Investigations Done to be submitted at the end of
the 12 month follow up or Post -op death-C | Planned line of management-P
ORGAN OTS OTS1504 Liver Transplant OTS150410023 (Liver Transplant Packages) -Transplant surgery - 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Liver Transplant Packages) -Transplant surgery - Clinical photograph-C | Clinical photograph-P | Consent of donor(live)-P | Detailed
TRANSPLA Investigation of donor - Pre-evaluation/Work up Investigation of donor - Pre-evaluation/Work up Clinical Notes-C | Detailed Clinical Notes-P | Donor Work up Details-C | Hospital
NT authorization letter-P | NOTTO /SOTTO registration-P | Relavent supportive
SURGERY investigations-C | USG Abbdomen-C
ORGAN OTS OTS1504 Liver Transplant OTS150410024 (Liver Transplant Packages) -Transplant surgery - 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Liver Transplant Packages) -Transplant surgery - Clinical photograph-C | Clinical photograph-P | Dcotor prescription with indications for
TRANSPLA Investigation of Recipient - Pre-evaluation/Work up Investigation of Recipient - Pre-evaluation/Work up liver transplant-P | Detailed Clinical Notes-C | Detailed Clinical Notes-P | Hospital
NT authorization letter-P | NOTTO/SOTTO registration-P | Other supprotive investigation-C
SURGERY | Recipient Work up Details-C | Registration for Cadaveric/Live liver Transplant-P | USG
Abdomen-P | USG abdomen-C
ORGAN OTS OTS1504 Liver Transplant OTS150410025 (Liver Transplant Packages) -Transplant surgery, including 1000000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Liver Transplant Packages) -Transplant surgery, including Clinical Photograph-C | Cross Match Report with donor-P | Details discharge summary-
TRANSPLA donor hepatectomy - for cadaveric donor donor hepatectomy - for cadaveric donor C | Detiails clinical notes-C | Doctor prescription-P | Hospital authorization letter on
NT recipient and donor with details-P | NOTTO ID of the recipient and/or donor-P | Post
SURGERY operative investigations-C | Procedure / Operative Notes Detailed,-C | Recipient &
Donor work up summary Sheet-P | Recipient Photo ID proof-P | USG-C | Work up
summary sheet-P | of the surgery-P
ORGAN OTS OTS1504 Liver Transplant OTS150410026 (Liver Transplant Packages) -Transplant surgery, including 1100000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Liver Transplant Packages) -Transplant surgery, including CBC-C | Calcium-C | Clinical Photograph-C | Cross Match Report with donor and
TRANSPLA donor hepatectomy - for Live donor donor hepatectomy - for Live donor Recipient Photo ID proof-P | Detailed Clinical Notes-C | Detailed Discharge summary-C
NT | Detailed Procedure /Operative Notes-C | Doctor prescription-P | Donor Work up
SURGERY summary sheet-P | Electrolyte-C | Hospital authorization letter on recipient and donor
with details of the surgery-P | KFT-C | LFT-C | Magnesium-C | NOTTO ID of the
recipient and/or donor-P | Other supporting investigations-C | PT INR-C | Post
operative CBC-C | Recipient & Donor work up summary Sheet-P | USG-C | Under
taking signed by donor (In living Donor Transplant-P
ORGAN OTS OTS1504 Liver Transplant OTS150410027 (Liver Transplant Packages) -Post-Transplant Medication – 50000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Liver Transplant Packages) -Post-Transplant Medication – Clinical notes-C | Clinical notes-P | Details of the Drug-C | Details of transplant surgery-
TRANSPLA Month 1-3 months - Month 1-3 months - P | Dosage used for treatment-C | Planned line of management-P | Supporting
NT investigation,to be submitted at the end of the 3 month follow up or Post -op death-C
SURGERY
SURGERY
SURGERY
ORGAN OTS OTS1504 Liver Transplant OTS150410030 (Liver Transplant Packages) -Interventions for acute 150000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N (Liver Transplant Packages) -Interventions for acute Detailed discharge summary-C | Details of the Drug-C | Detalles of the transplant
TRANSPLA rejection/early graft dysfunction rejection/early graft dysfunction surgery-P | Doctor notes with Reason for acute rejection/ early graft-P | Dosage used
NT for rejection-C | Indoor chart papers-C | Other suppoting investigations-C | Planned
SURGERY line of treatment-P | Procedure details if done-C | Supporting investigation-P | USG-C
| USG-P
ORGAN OTS OTS1505 Renal Transplant OTS150510031 Renal Transplant-Transplant surgery, including donor 319500 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N Renal Transplant-Transplant surgery, including donor Admission notes-P | Clinical photograph-C | Cross-match report with donor and
TRANSPLA nephrectomy nephrectomy recipient photo-ID proof-P | Detailed Clinical Notes-C | Detailed Discharge Summary-C
NT | Detailed Procedure/ Operative Notes-C | Donor with details of the surgery-C | Donor
SURGERY work-up summary sheet-P | Hospital authorization letter on recipient and donor with
details of the surgery-P | Hospital authorization letter on recipient-C | NOTTO ID of the
recipient and donor-P | Recipient work-up summary sheet-P | Undertakingsigned by
donor (in living donor transplant)-P
ORGAN OTS OTS1505 Renal Transplant OTS150510032 Renal Transplant – induction /Intervention for acute 147000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N Renal Transplant – induction /Intervention for acute Clinical notes-P | Detailed Discharge Summary-C | Details of the Drug -C | Dosage used
TRANSPLA rejection rejection for induction/Intervention done for acute rejection-C | Hospital authorization letter on
NT recipient and donor with details of the surgery-P | Supporting investigation-C |
SURGERY indication for induction-P
ORGAN OTS OTS1505 Renal Transplant OTS150510033 Renal Transplant – Intervention for acute graft rejection 147000 No 0 No 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N Renal Transplant – Intervention for acute graft rejection Biopsy report-P | Clinical notes-P | Detailed Discharge Summary-C | Details of R-ATG
TRANSPLA used-C | Details of the Drug-C | Hospital authorization letter on recipient-P |
NT Supporting investigation-C | donor with details of the surgery-P | dosage used for
SURGERY Intervention done for acute graft rejection-C
ORGAN OTS OTS1505 Renal Transplant OTS150510034 Renal Transplant-Post-Transplant Medication – Month 1-3 50000 No 0 0 No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Trust N Y N Renal Transplant-Post-Transplant Medication – Month 1-3 Clinical notes-P | Detailed Clinical Notes-C | Details of the Drug-C | Details of the
TRANSPLA transplant surgery-P | Dosage used for treatment-C | Planned line of management-P
NT
SURGERY
NT
SURGERY
NT
SURGERY
PAEDIATRI PM PM000010 NEPHROTIC PM000010000 Nephrotic syndrome with peritonitis/Steroid dependent or 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Nephrotic syndrome with peritonitis/Steroid dependent or Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 00 SYNDROME 0001184 resistent/Uncomplicated steroid sensitive (without Ventilator)-4700 | resistent/Uncomplicated steroid sensitive done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE Routine Ward-1800 Planned line of management-P | Treatment details-C | USG Abdomen-C | Urine
MENT Protein-C | detailed discharge summary-C
PAEDIATRI PM PM000010 Neuromuscular PM000010140 Neuromuscular Disorders 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Neuromuscular Disorders .CPK- NAC-C | Admission notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 14 Disorders 0001185 (without Ventilator)-4700 | investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
MANAGE Routine Ward-1800 Examination findings-P | Planned line of management-P | Treatment details-C |
MENT detailed discharge summary-C
PAEDIATRI PM PM000010 Oesophageal PM000010240 Oesophageal Varices Banding 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Oesophageal Varices Banding Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 24 Varices Banding 0001186 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Endoscopy-C |
PAEDIATRI PM PM000010 Atrial Fibrillation PM000010500 Atrial Fibrillation 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Atrial Fibrillation All investigations reports-C | Clinical notes-P | Detailed Discharge Summary-C |
C MEDICAL 5 001130 (without Ventilator)-4700 | Detailed ICPs-C | ECG-P | Planned line of treatment-P | Post treatment ECG-C | Serum
MANAGE Routine Ward-1800 Electrolytes-P | Treatment details-C
MENT
PAEDIATRI PM PM000010 Optic neuritis PM000010550 Optic neuritis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Optic neuritis Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL 55 0001187 history-P | Detailed ICPs-C | Examination findings-P | Planned line of management-P |
MANAGE Treatment details-C | detailed discharge summary-C | investigations done-P
MENT
PAEDIATRI PM PM000010 Paediatric seizure PM000010710 Febrile seizures / Acute non-febrile seizures 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Febrile seizures / Acute non-febrile seizures 1st seizure or past history-P | Admission notes showing vitals-P | All investigations
C MEDICAL 71 disorders 0001188 reports.-C | Clinical notes detailing history-P | Detailed ICPs-C | Planned line of
MANAGE management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000010 Paediatric seizure PM000010710 Status epilepticus 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Status epilepticus Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 71 disorders 0001189 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE Routine Ward-1800 Planned line of management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000011 Pancreatitis PM000011020 Acute necrotizing severe pancreatitis / Pancreatitis 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute necrotizing severe pancreatitis / Pancreatitis All investigations reports.-C | Clinical notes-P | Detailed ICPs-C | Investigation Reports
C MEDICAL 02 0001190 (without Ventilator)-4700 | supporting diagnosis (including ABG)-P | Planned line of treatment-P | Treatment
MANAGE Routine Ward-1800 details-C | detailed discharge summary-C | planned line of treatment (incl birth & past
MENT history)-P
PAEDIATRI PM PM000011 Plasmapheresis PM000011660 Plasmapheresis - Add on 8000 No 0 No 0 No No Secondary 1 No Yes Yes Add On No Yes No Medical No Insurance N N N Plasmapheresis - Add on Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 66 0001191 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE Planned line of management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000011 Platelet pheresis PM000011690 Platelet pheresis - Add on 11000 No 0 No 0 No No Tertiary 5 No Yes Yes Add On No No No Medical No Insurance N N N Platelet pheresis - Add on Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MENT
PAEDIATRI PM PM000011 Pleural Effusion PM000011710 Pleural Effusion 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pleural Effusion Admission notes showing vitals-P | All investigations reports.-C | CXR-P | Chest X
C MEDICAL 71 0001193 (without Ventilator)-4700 | ray/CT Chest-C | Clinical notes detailing history-P | Detailed ICPs-C | Examination
MANAGE Routine Ward-1800 findings-P | Planned line of management-P | Treatment details-C | any other
MENT investigations reports in support of diagnosis-P | detailed discharge summary-C
PAEDIATRI PM PM000011 Pneumonia PM000011800 Pneumonia/Severe pneumonia 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pneumonia/Severe pneumonia Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 80 0001194 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MENT
PAEDIATRI PM PM000011 Pneumothorax PM000011830 Pneumothorax 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pneumothorax Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 83 0001195 (without Ventilator)-4700 | done-P | Chest X ray/CT Chest-C | Clinical notes detailing history-P | Detailed ICPs-C |
PAEDIATRI PM PM000011 Poisoning PM000011860 Acute organophosphorus poisoning/Other poisonings 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute organophosphorus poisoning/Other poisonings Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 86 0001196 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Copy of MLC / FIR-P | Detailed ICPs-C |
MANAGE Routine Ward-1800 Neurological examination findings-P | Planned line of management-P | Treatment
MENT details-C | detailed discharge summary-C
PAEDIATRI PM PM000012 Respiratory failure PM000012750 Type 1 respiratory failure/Type 2 respiratory failure/Due to 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N R N ICU (with Ventilator)-6000 | ICU Type 1 respiratory failure/Type 2 respiratory failure/Due to ABG-C | Admission notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 75 0001197 any cause (pneumonia, asthma, COPD, ARDS, foreign body, (without Ventilator)-4700 | any cause (pneumonia, asthma, COPD, ARDS, foreign body, investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
MANAGE poisoning, head injury, Acute excaberation of COPD /Acute Routine Ward-1800 poisoning, head injury, Acute excaberation of COPD /Acute Examination findings-P | Planned line of management-P | Treatment details-C |
MENT excaberation of Interstitial Lung Disease/ Bronchiectasis / excaberation of Interstitial Lung Disease/ Bronchiectasis / detailed discharge summary-C
PAEDIATRI PM PM000012 Rheumatic fever PM000012870 Acute rheumatic fever/ Rheumatic valvular heart disease 0 Yes 3 No 0 Yes No Secondary 10 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute rheumatic fever/ Rheumatic valvular heart disease Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL 87 0001198 (without Ventilator)-4700 | history-P | Detailed ICPs-C | Examination findings-P | Planned line of management-P |
MANAGE Routine Ward-1800 Relevant investigations ( 2D Echo, etc ) done-P | Treatment details-C | detailed
MENT discharge summary-C
PAEDIATRI PM PM000012 Rickets - requiring PM000012920 Rickets - requiring admission for Work Up and/or in-patient 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Rickets - requiring admission for Work Up and/or in-patient Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 92 admission for 0001199 management management done-P | Clinical notes detailing history-P | Detailed ICPs-C | Planned line of
MANAGE Work Up management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000013 Scrub Typhus PM000013150 Scrub Typhus 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Scrub Typhus Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 15 0001200 done-P | Clinical notes detailing history including past history-P | Detailed ICPs-C |
MANAGE Examination findings-P | Planned line of management-P | Scrub Serology-C |
MENT Treatment details-C | detailed discharge summary-C
PAEDIATRI PM PM000013 SEVERE ANEMIA PM000013270 Iron deficiency anemia / Thalessmia / Other anemias 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Iron deficiency anemia / Thalessmia / Other anemias Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MENT
PAEDIATRI PM PM000013 SEVERE ANEMIA PM000013270 Severe anemia HB less 8 gm/dl 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Severe anemia HB less 8 gm/dl Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MENT
PAEDIATRI PM PM000013 Severe sepsis PM000013290 Severe sepsis/Septic shock 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Severe sepsis/Septic shock Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MENT
PAEDIATRI PM PM000013 Short stature PM000013310 Short stature- requiring admission for Work Up 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Short stature- requiring admission for Work Up Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL 31 0001204 history-P | Detailed ICPs-C | Growth Chart-P | Parent's height-P | Planned line of
MENT
PAEDIATRI PM PM000013 Sickle cell Anemia PM000013350 Sickle cell Anemia - Govt Reserve 0 Yes 3 No 0 Yes Yes Secondary 5 Yes Yes Yes Govt Yes No No Medical No Insurance N N N Routine Ward-1800 Sickle cell Anemia - Govt Reserve Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 35 0001205 Reserve done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE Hb Electrophoresis-C | Planned line of management-P | Treatment details-C | detailed
PAEDIATRI PM PM000013 Skin and soft PM000013460 Skin and soft tissue infections 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Skin and soft tissue infections Admission notes showing vitals-P | All investigations reports including CBC-C | Any
C MEDICAL 46 tissue infections 0001206 investigations done-P | Clinical notes detailing history including past history-P | Detailed
MANAGE ICPs-C | Examination findings-P | Planned line of management-P | Treatment details-C
MENT | detailed discharge summary-C
PAEDIATRI PM PM000013 Snake bite PM000013500 Snake bite 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Snake bite Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 50 0001207 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Neurological examination
MANAGE Routine Ward-1800 findings-P | Planned line of management-P | Treatment details-C | detailed discharge
MENT summary-C
PAEDIATRI PM PM000013 Staphylococcal PM000013760 Staphylococcal scalded skin syndrome 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Staphylococcal scalded skin syndrome Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 76 scalded skin 0001208 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Planned line of
MANAGE syndrome Routine Ward-1800 management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000014 Blood transfusion PM000014000 Blood component FFP - Add on 400 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Blood component FFP - Add on Blood Group-P | Clinical notes-P | Complete Hemogram-P | Detailed Discharge
C MEDICAL 0 001131 Summary-C | Detailed ICPs-C | Planned line of treatment-P | Post treatment Complete
MANAGE hemogram-C
MENT
PAEDIATRI PM PM000014 Blood transfusion PM000014000 Whole Blood transfusion/Blood component including 2000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Day care / Yes Yes No Medical Yes Insurance Y N R N Whole Blood transfusion/Blood component including Blood Group-P | Clinical notes-P | Complete Hemogram-P | Detailed Discharge
C MEDICAL 0 001132 platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and Add on platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and Summary-C | Detailed ICPs-C | Planned line of treatment-P | Post treatment Complete
MANAGE platelet ≤ 40000 - Add on platelet ≤ 40000 - Add on hemogram-C
MENT
PAEDIATRI PM PM000014 Blood transfusion PM000014000 Blood transfusion-Blood component SDP (IF platelet ≤ 8000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Add On Yes No No Medical No Insurance N N R N Blood transfusion-Blood component SDP (IF platelet ≤ 20000 Blood Group (Allow for Govt. Hospital Only)-P | Clinical notes-P | Complete Hemogram-
C MEDICAL 0 001133 20000 )- Add on )- Add on P | Detailed Discharge Summary-C | Detailed ICPs-C | Post treatment Complete
MANAGE hemogram-C | planned line of treatment-P
MENT
PAEDIATRI PM PM000014 Blood transfusion- PM000014100 Blood transfusion-Blood component platelet transfusion 9000 No 0 No 0 No No Secondary 1 Yes Yes Yes Add On No No No Medical No Insurance N N N Blood transfusion-Blood component platelet transfusion Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 1 Blood component 001134 (SDP) (SDP) investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE platelet management (Allow pvt. Hospitals only)-P | Treatment details-C | detailed discharge
MENT transfusion (SDP) summary-C
PAEDIATRI PM PM000014 Systematic lupus PM000014210 Systematic lupus erythematosus (SLE)/ Diffuse alveolar 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Systematic lupus erythematosus (SLE)/ Diffuse alveolar Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 21 erythematosus 0001209 hemmorhage associated with SLE (without Ventilator)-4700 | hemmorhage associated with SLE done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE Routine Ward-1800 Planned line of management-P | Serum ANA-C | Treatment details-C | detailed
PAEDIATRI PM PM000014 Tetanus PM000014320 Tetanus 0 Yes 3 No 0 Yes No Secondary 14 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Tetanus Admission notes showing vitals-P | All investigations reports-C | Any investigations
MENT
PAEDIATRI PM PM000014 Thyrotoxic crisis PM000014470 Thyrotoxic crisis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Thyrotoxic crisis Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 47 0001211 (without Ventilator)-4700 | done-P | Clinical notes detailing history including past history-P | Detailed ICPs-C |
MANAGE Routine Ward-1800 Examination findings-P | Planned line of management-P | Post treatment Thyroid
MENT Profile-C | Radionuclide Iodine uptake study-C | Throid profile-P | Treatment details-C
| USG- Thyroid Gland-P | detailed discharge summary-C
PAEDIATRI PM PM000014 Treatment of PM000014750 Treatment of systemic fungal infections 0 Yes 3 No 0 Yes No Secondary 21 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Treatment of systemic fungal infections Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 75 systemic fungal 0001212 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE infections Routine Ward-1800 Planned line of management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000014 tuberculosis PM000014780 Pericardial tuberculosis / Pleural tuberculosis 0 Yes 3 No 0 Yes No Secondary 10 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pericardial tuberculosis / Pleural tuberculosis Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 78 0001213 (without Ventilator)-4700 | done-P | CB NAT report if available-C | Chest X-Ray-P | Clinical notes detailing history-
MANAGE Routine Ward-1800 P | Detailed ICPs-C | Examination findings-P | Treatment details-C | detailed discharge
MENT summary-C
PAEDIATRI PM PM000014 Unexplained PM000014930 Unexplained hepatosplenomegaly-requiring admission for 0 Yes 3 No 0 Yes No Secondary 5 no Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Unexplained hepatosplenomegaly-requiring admission for Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 93 hepatosplenomeg 0001214 Work Up and/or in-patient management Work Up and/or in-patient management done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE aly Planned line of management-P | Treatment details-C | USG Abdomen and Pelvis-C |
PAEDIATRI PM PM000015 Vasculitis/ PM000015330 Vasculitis/ autoimmune disorder 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Vasculitis/ autoimmune disorder ANA/ANCA/Histopath report-C | Admission notes showing vitals-P | All investigations
C MEDICAL 33 autoimmune 0001215 (without Ventilator)-4700 | reports-C | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-
MANAGE disorder Routine Ward-1800 C | Examination findings-P | Planned line of management-P | Treatment details-C |
PAEDIATRI PM PM000015 Viral Encephalitis PM000015470 Viral Encephalitis 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Viral Encephalitis Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 47 0001216 (without Ventilator)-4700 | done-P | CSF Examination/Brain Imaging-C | Clinical notes detailing history-P | Detailed
MANAGE Routine Ward-1800 ICPs-C | Examination findings-P | Planned line of management-P | Treatment details-C
PAEDIATRI PM PM000015 Wilson’s disease PM000015570 Wilson’s disease-requiring admission for work-up and/or 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Wilson’s disease-requiring admission for work-up and/or Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 57 0001217 inpatient care inpatient care done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MENT
PAEDIATRI PM PM000019 Acute ataxia PM000019000 Acute ataxia 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute ataxia Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL 01120 (without Ventilator)-4700 | history-P | Detailed ICPs-C | Examination findings (incl neurological examination)-P |
MENT
PAEDIATRI PM PM000019 Celiac disease PM000019400 Celiac disease-requiring admission for Work Up and/or in- 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Celiac disease-requiring admission for Work Up and/or in- Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 4 001135 patient management patient management investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE management-P | Serum Anti tTG/ Upper GI Endoscopy-C | Treatment details-C |
PAEDIATRI PM PM000019 Central Line ( PM000019900 Central Line ( Double Lumen / Triple Lumen ) with 0 Yes 1 No 0 Yes No Secondary 0 Yes Yes Yes Add On Yes No No Medical No Insurance N N N Double Lumen-2000 | Triple Central Line ( Double Lumen / Triple Lumen ) with Invoice / bar code-C | Review notes of primary physician for requirent of procedure-P |
C MEDICAL 9 Double Lumen / 001136 procedure - add on Lumen-2500 procedure - add on detail notes & X ray after procedure-C
MANAGE Triple Lumen )
MENT
PAEDIATRI PM PM000021 CHD /RHD PM000021300 CHD /RHD 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU CHD /RHD 2D ECHO-C | All investigations reports-C | Any investigations done-P | Clinical notes
C MEDICAL 3 001137 (without Ventilator)-4700 | showing vitals-P | Detailed Discharge Summary-C | Detailed ICPs (daily Treatment
MANAGE Routine Ward-1800 details)-C | ECG / 2D ECHO-P | Examination findings-P | Planned line of management-P
MENT
PAEDIATRI PM PM000021 Chikungunya PM000021900 Chikungunya fever 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Chikungunya fever Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 9 fever 001138 investigations done-P | Chikungunya test report-C | Detailed ICPs-C | Examination
MANAGE findings-P | Planned line of management-P | Treatment details-C | detailed discharge
MENT summary-C
PAEDIATRI PM PM000022 ACUTE PM000022000 Acute Febrile encephalopathy/Acute Disseminated 0 Yes 3 No 0 Yes No Secondary 14 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute Febrile encephalopathy/Acute Disseminated Admission notes showing vitals-P | All investigations reports-C | CT Head / MRI Head/
C MEDICAL ENCEPHALOPATH 01121 Encephalomyelitis/hypertensive/metabolic/febrile/hepatic (without Ventilator)-4700 | Encephalomyelitis/hypertensive/metabolic/febrile/hepatic LP (CSF)-C | Clinical notes detailing history-P | Detailed ICPs, Treatment details-C |
MANAGE Y encephalopathy/Acute meningo encephalitis Routine Ward-1800 encephalopathy/Acute meningo encephalitis Examination findings (incl neurological examination)-P | Planned line of management-P |
MENT pyogenic/Aseptic meningitis tubercular/ Hypertensive pyogenic/Aseptic meningitis tubercular/ Hypertensive detailed discharge summary-C
PAEDIATRI PM PM000022 Children with PM000022000 Children with dysmorphic features- requiring admission for 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Children with dysmorphic features- requiring admission for Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL 0 dysmorphic 001139 work-up work-up history-P | Detailed ICPs-C | Investigations done-P | Planned line of management-P |
MANAGE features Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000024 Acute PM000024000 Acute gastroenteritis with moderate dehydration/Acute 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute gastroenteritis with moderate dehydration/Acute Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL gastroenteritis 01122 gastroenteritis with severe dehydration/ Recurrent gastroenteritis with severe dehydration/ Recurrent vomiting done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE with dehydration vomiting with dehydration/Chronic diarrohea/Persistent with dehydration/Chronic diarrohea/Persistent Planned line of management-P | Treatment details-C | detailed discharge summary-C
MENT diarrohea/Dysentery diarrohea/Dysentery
PAEDIATRI PM PM000026 Congestive heart PM000026600 Congestive heart failure 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Congestive heart failure Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 6 failure 001140 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | ECHO-C | Examination findings-P | Planned
MANAGE Routine Ward-1800 line of management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000028 Acute PM000028000 Acute glomerulonephritis 0 Yes 3 No 0 Yes No Secondary 10 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute glomerulonephritis Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL glomerulonephriti 01123 (without Ventilator)-4700 | history-P | Detailed ICPs-C | Planned line of management-P | Treatment details-C |
MANAGE s Routine Ward-1800 detailed discharge summary-C | nvestigations done-P
MENT
PAEDIATRI PM PM000029 Continuous renal PM000029500 Continuous renal replacement therapy (CRRT) in AKI 0 Yes 5 No 0 Yes No Tertiary 5 No Yes Yes Regular Yes No No Medical No Insurance N N N CRRT-6000 Continuous renal replacement therapy (CRRT) in AKI Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 5 replacement 001141 (including cost for disposable) PKG/add on (including cost for disposable) done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE therapy/Continuo Treatment details-C | detailed discharge summary-C | eGFR / RFT-C
MENT us veno-venous
hemofiltration
PAEDIATRI PM PM000030 Acute ischemic PM000030000 Acute ischemic stroke 0 Yes 3 No 0 Yes No Secondary 14 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute ischemic stroke Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL stroke 01124 (without Ventilator)-4700 | done-P | CECT Head / CT Angio / MRI Head.-C | Clinical notes detailing history-P |
MANAGE Routine Ward-1800 Detailed ICPs-C | Examination findings-P | Planned line of management-P | Treatment
MENT details-C | detailed discharge summary-C
PAEDIATRI PM PM000031 Croup syndrome PM000031600 Acute laryngotracheobronchitis/Acute epiglottitis 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute laryngotracheobronchitis/Acute epiglottitis Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 6 001142 (without Ventilator)-4700 | investigations done-P | Detailed ICPs.-C | Examination findings-P | Planned line of
MANAGE Routine Ward-1800 management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000033 Acute severe PM000033000 Acute severe malnutrition 0 Yes 3 No 0 Yes No Secondary 21 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute severe malnutrition Admission notes showing vitals-P | All investigations reports.-C | Any investigation done-
C MEDICAL malnutrition 01125 (without Ventilator)-4700 | P | Clinical notes detailing history (WHO SAM Criteria)-P | Detailed ICPs-C |
PAEDIATRI PM PM000038 Acute transverse PM000038000 Acute transverse myelitis 0 Yes 3 No 0 Yes No Secondary 14 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute transverse myelitis Admission notes showing vitals-P | All investigations reports-C | Any investigation
C MEDICAL myelitis 01126 (without Ventilator)-4700 | reports in support of diagnosis-P | CECT / MRI-Brain / Spine.-C | Clinical notes detailing
MANAGE Routine Ward-1800 history-P | Detailed ICPs-C | Examination findings-P | Planned line of management-P |
MENT Treatment details-C | detailed discharge summary-C
PAEDIATRI PM PM000042 Acute urticaria / PM000042000 Acute urticaria / anaphylaxis / Steven Johnson syndrome 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute urticaria / anaphylaxis / Steven Johnson syndrome Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL Anaphylaxis 01127 (without Ventilator)-4700 | history-P | Detailed ICPs-C | Planned line of management-P | Specify the trigger-P |
MANAGE Routine Ward-1800 Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000045 Addison’s disease PM000045000 Addison’s disease 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Addison’s disease
C MEDICAL 01128 (without Ventilator)-4700 | Detailed ICPs-C | All investigations reports,-C | Blood Sugar-P | Clincal notes-P | Sr
MANAGE Routine Ward-1800 Cortisol levels-C | Sr. Electrolyte-P | Treatment details-C | detailed discharge summary-
MENT C
PAEDIATRI PM PM000046 Cyanotic spells PM000046500 Cyanotic spells without CHD/Cyanotic spells with CHD 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Cyanotic spells without CHD/Cyanotic spells with CHD All investigations reports.-C | Clinical notes-P | Detailed Discharge Summary-C |
C MEDICAL 5 001143 (without Ventilator)-4700 | Detailed ICPs (daily Treatment details)-C | Investigation Reports supporting diagnosis
MANAGE Routine Ward-1800 (including ABG)-P | Planned line of treatment (incl birth & past history)-P | Planned line
MENT of treatment-P
PAEDIATRI PM PM000048 Dengue fever PM000048400 Dengue fever/Dengue hemorrhagic fever/Dengue shock 0 Yes 3 No 0 Yes No Secondary 7 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Dengue fever - Routine Ward- Dengue fever/Dengue hemorrhagic fever/Dengue shock Admission /Clinical notes showing vitals-P | All investigations reports with Dengue tes-C
C MEDICAL 4 001144 syndrome 1800 | Dengue hemorrhagic syndrome | Any investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line
MANAGE fever/Dengue shock syndrome of management-P | Treatment detailst-C | detailed discharge summary-C
MENT in ICU (without Ventilator) - -
4700 | ICU (with Ventilator)-
6000
PAEDIATRI PM PM000048 Developmental PM000048800 Developmental and behavioral disorders for Work Up / in- 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Developmental and behavioral disorders for Work Up / in- Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 8 and behavioral 001145 patient management patient management done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MANAGE disorders Planned line of management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000054 Empyema PM000054500 Empyema 0 Yes 3 No 0 Yes No Secondary 21 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Empyema Admission /Clinical notes showing vitals-P | All investigations reports,-C | Any
C MEDICAL 5 001146 (without Ventilator)-4700 | investigations done-P | CBC-P | Detailed Discharge Summary-C | Detailed ICPs and
MANAGE Routine Ward-1800 treatment details-C | Examination findings-P | Planned line of management-P |
MENT Planned line of management-P | Post Treatment X-ray chest-C | X ray chest-P
PAEDIATRI PM PM000055 Endocarditis PM000055100 Bacterial Endocarditis/Fungal Endocarditis 0 Yes 3 No 0 Yes No Secondary 21 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Bacterial Endocarditis/Fungal Endocarditis Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 1 001147 (without Ventilator)-4700 | investigations done-P | Blood culture reports-C | CBC-P | Detailed Discharge Summary-
MANAGE Routine Ward-1800 C | Detailed ICPs-C | ECG-P | ECHO-P | Examination findings-P | Planned line of
MENT management-P | Post treatment ECHO-C | Treatment details-C
PAEDIATRI PM PM000056 Enteric fever PM000056300 Enteric fever 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Enteric fever Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 3 001148 investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MENT
PAEDIATRI PM PM000057 epilepsy PM000057000 Drug resistant epilepsy/Evaluation of drug resistant epilepsy 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Drug resistant epilepsy/Evaluation of drug resistant epilepsy Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 0 001149 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MENT
PAEDIATRI PM PM000057 Epileptic PM000057200 Epileptic encephalopathy 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Epileptic encephalopathy Admission notes showing vitals-P | All investigations reports-C | Clinical notes detailing
C MEDICAL 2 encephalopathy 001150 (without Ventilator)-4700 | history-P | Detailed ICPs-C | EEG if available-C | Past h/o epilpesy-P | Planned line of
MENT
PAEDIATRI PM PM000061 AKI / Renal failure PM000061000 AKI / Renal failure 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU AKI / Renal failure Admission /Clinical notes showing vitals-P | All investigations reports-C | Any
C MEDICAL 01129 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE Routine Ward-1800 management-P | Treatment details-C | USG-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000065 Febrile illness PM000065200 Acute febrile illness / Pyrexia of unknown origin 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Acute febrile illness / Pyrexia of unknown origin Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MENT
PAEDIATRI PM PM000067 Floppy infant PM000067100 Floppy infant syndrome requiring admission for work-up 0 Yes 3 No 0 Yes No Secondary 7 no Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Floppy infant syndrome requiring admission for work-up Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 1 syndrome 001152 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MENT
PAEDIATRI PM PM000070 GI bleeding PM000070800 Lower GI bleeding / Upper GI bleeding 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Lower GI bleeding / Upper GI bleeding Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 8 001153 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Endoscopy if done-C | Examination findings
MANAGE Routine Ward-1800 (incl neurological examination)-P | Planned line of management-P | Treatment details-C
PAEDIATRI PM PM000071 Global PM000071300 Global developmental delay/Intellectual disability-requiring 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Global developmental delay/Intellectual disability-requiring Admission notes showing vitals-P | All investigations reports.-C | Clinical notes detailing
C MEDICAL 3 developmental 001154 admission for Work Up and/or in-patient management admission for Work Up and/or in-patient management birth and subsequent history-P | Detailed ICPs-C | Planned line of management-P |
MANAGE delay / Intellectual Subsequent history-P | Treatment details-C | detailed discharge summary-C
MENT disability of
unknown etiology
PAEDIATRI PM PM000072 Guillain Barre PM000072200 Guillain Barre syndrome / AFP 0 Yes 3 No 0 Yes No Secondary 14 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Guillain Barre syndrome / AFP Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 2 syndrome 001155 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE Routine Ward-1800 management-P | Report of test blocked-C | Treatment details-C | detailed discharge
MENT summary-C
PAEDIATRI PM PM000072 Haemodialysis PM000072600 Haemodialysis ± Inj.Erythropoietin - Day care / Add on 1500 Yes 0 Yes 1 Yes No Tertiary 1 No Yes Yes Day care / Yes Yes No Medical Yes Insurance Y N N Inj. Erythropoietin-600 Max :1 Haemodialysis ± Inj.Erythropoietin - Day care / Add on Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 6 Dialysis (ARF / 001156 Add on investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE CRF) management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000072 Haemolytic uremic PM000072800 Haemolytic uremic syndrome 0 Yes 3 No 0 Yes No Secondary 14 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Haemolytic uremic syndrome Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 8 syndrome 001157 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MENT
PAEDIATRI PM PM000073 Hemostatic PM000073700 Hemophilia / Platelet disorders - govt reserve 0 Yes 3 No 0 Yes Yes Secondary 3 Yes Yes Yes Govt Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Hemophilia / Platelet disorders - govt reserve Admission /Clinical notes showing vitals-P | Any investigations done-P | Detailed ICPs-C
C MEDICAL 7 Disorders 001158 Reserve (without Ventilator)-4700 | | Examination findings-P | Planned line of management-P | Treatment details-C |
MANAGE Routine Ward-1800 detailed discharge summary / day care format,.-C
MENT
PAEDIATRI PM PM000074 Hepatitis PM000074500 Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 5 001159 /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver (without Ventilator)-4700 | /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE abscess Routine Ward-1800 abscess management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000075 High end PM000075900 High end histopathology (Biopsies) and advanced serology 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 9 histopathology 001160 investigations - Add on investigations - Add on investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE (Biopsies) and management-P | Treatment details-C | detailed discharge summary-C
MENT advanced
serology
investigations
PAEDIATRI PM PM000076 High end PM000076600 High end radiological diagnostic 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 6 radiological 001161 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE diagnostic management-P | Treatment details-C | detailed discharge summary-C
MENT (CT, MRI, Imaging
including nuclear
imaging)
PAEDIATRI PM PM000077 HIV with PM000077400 HIV with complications 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU HIV with complications Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 4 complications 001162 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Examination findings-P | HIV Report-P |
MENT
PAEDIATRI PM PM000077 Hydrocephalus PM000077700 Hydrocephalus 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Hydrocephalus Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 7 001163 (without Ventilator)-4700 | investigations done-P | CT Brain / MRI brain-C | Detailed ICPs-C | Examination findings-
MANAGE Routine Ward-1800 P | Planned line of management-P | Treatment details-C | detailed discharge summary-
MENT C
PAEDIATRI PM PM000079 Idiopathic PM000079500 Idiopathic Thrombocytopenic Purpura 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Idiopathic Thrombocytopenic Purpura Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 5 Thrombocytopeni 001164 (without Ventilator)-4700 | investigations done-P | Detailed ICPs-C | Examination findings-P | PBF / Bone Marrow
MANAGE c Purpura Routine Ward-1800 (Aspiration or Biopsy)-C | Planned line of management-P | Treatment details-C |
PAEDIATRI PM PM000079 IHD / CAD / PM000079800 IHD/Arrhythmia/CAD 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU IHD/Arrhythmia/CAD 2D ECHO-C | Admission notes showing vitals-P | All investigations reports.-C | Clinical
C MEDICAL 8 Arrhythmia 001165 (without Ventilator)-4700 | notes detailing history-P | Detailed ICPs-C | Examination findings-P | Relevant
MANAGE Routine Ward-1800 investigations (ECG)-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000080 Immune mediated PM000080900 Immune mediated CNS disorders 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Immune mediated CNS disorders Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 9 CNS disorders 001166 (without Ventilator)-4700 | investigations done-P | CSF / Brain Imagining-C | Detailed ICPs-C | Examination
MANAGE Routine Ward-1800 findings-P | Planned line of management-P | Treatment details-C | detailed discharge
MENT summary-C
PAEDIATRI PM PM000081 Inborn errors of PM000081300 Inborn errors of metabolism-requiring admission for work- 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Inborn errors of metabolism-requiring admission for work- Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 3 metabolism 001167 up and/or inpatient care up and/or inpatient care done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MENT
PAEDIATRI PM PM000081 Inflammatory PM000081700 Inflammatory Myopathy / Myaesthenic Crisis 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Inflammatory Myopathy / Myaesthenic Crisis Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 7 Myopathy/ 001168 (without Ventilator)-4700 | investigations done-P | CPK/EMG-C | Detailed ICPs-C | Examination findings-P |
MANAGE Myaesthenic Crisis Routine Ward-1800 Planned line of management-P | Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000082 Intestinal PM000082700 Intestinal obstruction- medical managment 6000 No 0 No 0 No No secondary 10 No Yes Yes Regular PKG No No No Medical No Insurance N N N Intestinal obstruction- medical managment Admission /Clinical notes showing vitals-P | All investigations reports.-C | Any
C MEDICAL 7 obstruction 001169 investigations done-P | Detailed ICPs-C | Examination findings-P | Planned line of
MANAGE management-P | Treatment details-C | Xray FPA/USG abdomen-C | detailed discharge
MENT summary-C
PAEDIATRI PM PM000083 INTRACRANIAL PM000083300 Intracranial hemorrhage/Intracranial space occupying lesion 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Intracranial hemorrhage/Intracranial space occupying lesion Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 3 SPACE 001170 tuberculoma/neurocysticercosis, brain tumours (without Ventilator)-4700 | tuberculoma/neurocysticercosis, brain tumours done-P | Brain Imaging-C | Clinical notes detailing history-P | Detailed ICPs-C |
MANAGE OCCUPYING Routine Ward-1800 Examination findings (incl neurological examination)-P | Planned line of management-P |
MENT LESIONS Treatment details-C | detailed discharge summary-C
PAEDIATRI PM PM000085 Juvenile Arthritis PM000085200 Juvenile Arthritis 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Juvenile Arthritis Admission notes showing vitals-P | Any investigations done-P | Clinical notes detailing
C MEDICAL 2 001171 history-P | Detailed ICPs-C | Examination findings-P | Planned line of management-P |
MANAGE Treatment details-C | detailed discharge summary-C
MENT
PAEDIATRI PM PM000085 Juvenile PM000085400 Juvenile myasthenia- requiring admission for work-up or in- 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Juvenile myasthenia- requiring admission for work-up or in- Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 4 myasthenia 001172 patient care (without Ventilator)-4700 | patient care done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
MENT
PAEDIATRI PM PM000085 Kawasaki Disease PM000085600 Kawasaki Disease 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Kawasaki Disease Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MENT
PAEDIATRI PM PM000085 Ketogenic diet PM000085700 Ketogenic diet initiation in refractory epilepsy 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Ketogenic diet initiation in refractory epilepsy Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 7 initiation in 001174 (without Ventilator)-4700 | done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings (incl
MANAGE refractory Routine Ward-1800 neurological examination)-P | Planned line of management-P | Treatment details-C |
MENT epilepsy detailed discharge summary-C
PAEDIATRI PM PM000087 Leptospirosis PM000087600 Leptospirosis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Routine Ward-1800 Leptospirosis Admission notes showing vitals-P | All investigations reports-C | Any investigations
MANAGE Leptospira Serology-C | Planned line of management-P | Treatment details-C |
PAEDIATRI PM PM000089 Lung abscess PM000089500 Lung abscess 0 Yes 3 No 0 Yes No Secondary 14 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Lung abscess CBC-C | Chest X ray / CT Chest-C | Clinical notes-P | Detailed Discharge summary-C |
C MEDICAL 5 001176 (without Ventilator)-4700 | Planned line of management-P | Planned line of treatment-P | Post Treatment X-ray
MANAGE Routine Ward-1800 chest-C | X-ray chest-P | any other investigations done-P
MENT
PAEDIATRI PM PM000090 Malaria PM000090100 malaria / Complicated malaria 0 Yes 3 No 0 Yes No Secondary 7 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU malaria / Complicated malaria Admission notes showing vitals-P | All investigations reports-C | Any investigations
MANAGE Routine Ward-1800 Malaria Serology / PBF-C | Planned line of management-P | Treatment details-C |
PAEDIATRI PM PM000094 Medical PM000094000 Raised ICP due to neuro surgical procedures/due to 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Raised ICP due to neuro surgical procedures/due to Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 0 Management for 001178 trauma/malignancies/ meningo-encephalitis (without Ventilator)-4700 | trauma/malignancies/ meningo-encephalitis done-P | Brain Imaging-C | Clinical notes detailing history-P | Detailed ICPs-C |
MANAGE Raised intracranial Routine Ward-1800 Examination findings (incl neurological examination)-P | Planned line of management-P |
MENT pressure Treatment details-C | detailed discharge summary-C
PAEDIATRI PM PM000094 Meningitis PM000094700 Chronic meningitis/Partially treated pyogenic 0 Yes 3 No 0 Yes No Secondary 14 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Chronic meningitis/Partially treated pyogenic Admission notes showing vitals-P | All investigations reports-C | Any investigations
C MEDICAL 7 001179 meningitis/Neuro tuberculosis/Complicated bacterial (without Ventilator)-4700 | meningitis/Neuro tuberculosis/Complicated bacterial done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings (incl
MANAGE meningitis/Acute meningitis/Meningitis/ Fungal Routine Ward-1800 meningitis/Acute meningitis/Meningitis/ Fungal neurological examination)-P | LP (CSF EXAMINATION)/ Brain Imaging-C | Planned line of
MENT Meningitis/ACUTE INFECTIOUS MENINGITIS AND Meningitis/ACUTE INFECTIOUS MENINGITIS AND management-P | Treatment details-C | detailed discharge summary-C
PAEDIATRI PM PM000096 Myasthenic crisis PM000096800 Myasthenic crisis 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myasthenic crisis Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 8 001180 (without Ventilator)-4700 | reports in support of diagnosis-P | Clinical notes detailing history-P | Detailed ICPs-C |
PAEDIATRI PM PM000097 Myasthenic crisis PM000097000 Myasthenic crisis (Plasmapheresis) 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myasthenic crisis (Plasmapheresis) Admission notes showing vitals-P | All investigations reports.-C | Any investigations
C MEDICAL 0 (Plasmapheresis) 001181 (without Ventilator)-4700 | reports in support of diagnosis-P | Clinical notes detailing history-P | Detailed ICPs-C |
PAEDIATRI PM PM000097 Myxedema coma PM000097400 Myxedema coma 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Myxedema coma USG- Thyroid Gland-P | Clinical notes-P | Detailed Discharge Summary-C | Post
C MEDICAL 4 001182 (without Ventilator)-4700 | treatment Thyroid Profile-C | Throid profile-P | planned line of treatment-P
MANAGE Routine Ward-1800
MENT
PAEDIATRI PM PM000098 Neonatal/ PM000098100 Neonatal/infantile cholestasis / Choledochal cysts 0 Yes 3 No 0 Yes No Secondary 10 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Neonatal/infantile cholestasis / Choledochal cysts Admission notes showing vitals-P | Alkaline phosphate report USG report-C | All
C MEDICAL 1 Infantile 001183 (without Ventilator)-4700 | investigations reports.-C | Any investigations done-P | Clinical notes detailing history-P
MANAGE cholestasis Routine Ward-1800 | Detailed ICPs-C | Examination findings-P | GGT Report-C | Planned line of
MENT management-P | Treatment details-C | detailed discharge summary-C
PULMONO PO PO000010 aspiration/ PO000010200 aspiration/ Intercostal drainage Only 4800 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Medical No Insurance N N R N aspiration/ Intercostal drainage Only Analysis report of drained fluid-C | Chest X-Ray PA-P | Clinical notes-P | Detailed
LOGY 2 Intercostal 001410 Reserve and Operative notes-C | Detailed discharge summary-C | Detailing need of ICD-P | post
drainage Only Add On procedure clinical photograph-C
PULMONO PO PO000010 Palliative and PO000010800 Palliative care end stage disease 3000 Yes 3 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Palliative care end stage disease- Palliative care end stage disease Discharge summary with detail treatment & interventions & Final bill with payment receip-
LOGY 80 supportive care 0001418 3000 C | Review notes of primary physician with referal to Palliative Medicine -P
for malignant
disease at
advanced or end
stage
PULMONO PO PO000011 Pleural Effusion PO000011720 Pleural Effusion 0 Yes 3 No 0 Yes No Secondary 5 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pleural Effusion Admission notes showing vitals-P | All investigations reports.-C | Any other
LOGY 72 0001419 (without Ventilator)-4700 | investigations reports in support of diagnosis-P | CXR-P | Chest X ray/CT Chest-C |
Routine Ward-1800 Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge summary-C |
Examination findings-P | Planned line of management-P | Treatment details-C
PULMONO PO PO000011 Pneumonia PO000011810 Pneumonia/Severe pneumonia 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pneumonia/Severe pneumonia Admission notes showing vitals-P | All investigations reports.-C | Any investigations
LOGY 81 0001420 (without Ventilator)-4700 | done-P | Chest X ray/CT Chest-C | Clinical notes detailing history-P | Detailed ICPs-C |
PULMONO PO PO000011 Pneumothorax PO000011840 Pneumothorax 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pneumothorax Admission notes showing vitals-P | All investigations reports.-C | Any investigations
LOGY 84 0001421 (without Ventilator)-4700 | done-P | Chest X ray/CT Chest-C | Clinical notes detailing history-P | Detailed ICPs-C |
PULMONO PO PO000012 Pulmonary PO000012130 Pulmonary thromboembolism 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pulmonary thromboembolism Admission notes showing vitals-P | All investigations reports.-C | Any investigations
LOGY 13 thromboembolism 0001422 (without Ventilator)-4700 | done-P | CT Chest/CT Pulmonary Angio/2D Echo-C | Clinical notes detailing history-P |
Routine Ward-1800 D-Dimer-C | Detailed ICPs-C | Detailed discharge summary-C | Examination findings-P
| Planned line of management-P | Treatment details-C
PULMONO PO PO000012 Respiratory failure PO000012760 Type 1 respiratory failure/Type 2 respiratory failure/Due to 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N R N ICU (with Ventilator)-6000 | ICU Type 1 respiratory failure/Type 2 respiratory failure/Due to ABG-C | Admission notes showing vitals-P | All investigations reports.-C | Any
LOGY 76 0001423 any cause (pneumonia, asthma, COPD, ARDS, foreign body, (without Ventilator)-4700 | any cause (pneumonia, asthma, COPD, ARDS, foreign body, investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed
poisoning, head injury, Acute excaberation of COPD /Acute Routine Ward-1800 poisoning, head injury, Acute excaberation of COPD /Acute discharge summary-C | Examination findings-P | Planned line of management-P |
excaberation of Interstitial Lung Disease/ Bronchiectasis / excaberation of Interstitial Lung Disease/ Bronchiectasis / Treatment details-C
PULMONO PO PO000012 Rigid laryngoscopy PO000012960 Rigid laryngoscopy / Thoracoscopy / bronchoscopy / 0 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N with biopsy-7000 | without Rigid laryngoscopy / Thoracoscopy / bronchoscopy / Planned line of treatment-P | Clinical notes-P | Histopathology report-C | Post
LOGY 96 / Thoracoscopy / 0001424 oesophagoscopy - Diagnostic + / - biopsy biopsy-2000 oesophagoscopy - Diagnostic + / - biopsy Procedure Photograph of affected part-C | Procedure / Operative Notes-C
bronchoscopy /
oesophagoscopy -
Diagnostic + / -
biopsy
PULMONO PO PO000014 tuberculosis PO000014790 Pericardial tuberculosis / Pleural tuberculosis/ Pulmonary 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Pericardial tuberculosis / Pleural tuberculosis/ Pulmonary Admission notes showing vitals-P | All investigations reports.-C | Any investigations
LOGY 79 0001425 tuberculosis (without Ventilator)-4700 | tuberculosis done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Routine Ward-1800 summary-C | Examination findings-P | Treatment details-C
PULMONO PO PO000054 Empyema PO000054600 Empyema 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Empyema CBC-P | Clinical notes-P | Detailed Discharge Summary-C | Planned line of treatment-P
LOGY 6 001411 (without Ventilator)-4700 | | Post Treatment X-ray chest-C | X ray chest-P
Routine Ward-1800
PULMONO PO PO000054 Endobronchial PO000054800 Endobronchial Ultrasound guided fine needle biopsy 10000 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Medical No Insurance N N N Endobronchial Ultrasound guided fine needle biopsy Admission notes showing vitals-P | All investigations reports including EBUS reports.-C |
LOGY 8 Ultrasound (EBUS) 001412 Reserve and Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
Add On Detailed discharge summary-C | Examination findings-P | Planned line of management-
PULMONO PO PO000066 Fibreoptic PO000066200 Fibreoptic bronchoscopy (FOB) 2500 No 0 No 0 No Yes Tertiary 2 No Yes Yes Govt No No No Medical No Insurance N N N Fibreoptic bronchoscopy (FOB) Clinical notes-P | Detailing need for FOB-P | FOB reports F2001-C | Post procedure-C |
LOGY 2 bronchoscopy 001413 Reserve and detailed Procedure / Operative Notes-C
(FOB) Add On
PULMONO PO PO000076 High end PO000076000 High end histopathology (Biopsies) and advanced serology 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N N High end histopathology (Biopsies) and advanced serology Admission notes showing vitals-P | All investigations reports.-C | Any investigations
LOGY 0 histopathology 001414 investigations - Add on investigations - Add on done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
(Biopsies) and summary-C | Examination findings-P | Planned line of management-P | Treatment
advanced details-C
serology
investigations
PULMONO PO PO000076 High end PO000076700 High end radiological diagnostic 5000 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Add On Yes Yes No Medical No Insurance N N R N High end radiological diagnostic Admission notes showing vitals-P | All investigations reports.-C | Any investigations
LOGY 7 radiological 001415 (CT, MRI, nuclear imaging) - Add on (CT, MRI, nuclear imaging) - Add on done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
diagnostic summary-C | Examination findings-P | Planned line of management-P | Treatment
(CT, MRI, Imaging details-C
including nuclear
imaging)
PULMONO PO PO000089 Lung abscess PO000089600 Lung abscess 0 Yes 3 No 0 Yes No Secondary 5 Yes Yes Yes Regular PKG Yes No No Medical No Insurance N N N ICU (with Ventilator)-6000 | ICU Lung abscess CBC and any other investigations done-P | CBC-C | Clinical notes-P | Detailed Discharge
LOGY 6 001416 (without Ventilator)-4700 | summary-C | Planned line of management-P | Planned line of treatment-P | Post
Routine Ward-1800 Treatment X-ray chest-C | X-ray chest-P
PULMONO PO PO000090 Malignant Pleural PO000090300 Pleural effusion / Pleurodesis 5500 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Pleural effusion / Pleurodesis CECT/ x-Ray/USG-P | Clinical notes-P | Discharge summary with detail treatment &
LOGY 3 Effusion for 001417 interventions-C | Planned line of management-P | Procedure notes.-C
Pleural tap with
Pig tail
catheter/chest
tube insertion
with Pleurodesis
in advanced
cancer patients
PMR PR PR0000100 Nerve root block PR0000100500 Nerve root block 3000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Medical No Insurance N N R N Nerve root block Procedure photo-P | Clinical notes-P | Clinical notes-P | Detailed Discharge Summary-
5 001398 C | Planned line of treatment-P | Post procedure X-ray films with reports-C |
Procedure / Operation notes-C | X-ray films with reports-P
PMR PR PR0000120 Pressure sore- PR0000120200 Palliative Care approach to managing Pressure sore in 25000 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Medical No Insurance N N N Palliative Care approach to managing Pressure sore in Admission notes-P | All investigations reports.-C | Any investigation reports in support
2 Interventions 001399 advanced chronic diseases who are bed ridden-Surgical- Reserve advanced chronic diseases who are bed ridden-Surgical- of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
Govt Reserve Govt Reserve Intra & Post procedure photo-C | Photo showing detailing history-P | Planned line of
PMR PR PR0000120 PRP Injection For PR0000120500 PRP Injection For MSK Disorder - Govt reserve 2500 No 0 No 0 No Yes Secondary 1 No Yes Yes Govt No No No Medical No Insurance N N N PRP Injection For MSK Disorder - Govt reserve Procedure photo-P | Admission notes-P | All investigations reports.-C | Any
5 MSK Disorder - 001400 Reserve investigation reports in support of diagnosis-P | Clinical notes-P | Detailed ICPs-C |
Govt reserve Detailed discharge summary-C | Photo showing detailing history-P | Planned line of
PMR PR PR0000128 RF Ablation of PR0000128500 RF Ablation of Peripheral nerve / spinal nerve - Govt 10000 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Medical No Insurance N N N RF Ablation of Peripheral nerve / spinal nerve - Govt Reserve Procedure photo-P | Admission notes-P | All investigations reports.-C | Any
5 Peripheral nerve / 001401 Reserve Reserve investigation reports in support of diagnosis-P | Clinical notes-P | Detailed ICPs-C |
spinal nerve - Detailed discharge summary-C | Photo showing detailing history-P | Planned line of
Govt Reserve management-P | Treatment details-C
PMR PR PR0000134 Single event multi PR0000134100 Single event multi level surgery (SEMLS) for spasticity 15000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Medical No Insurance N N N Single event multi level surgery (SEMLS) for spasticity Admission notes-P | All investigations reports.-C | Any investigation reports in support
1 level surgery 001402 management ( more than 4 level) (CP) management ( more than 4 level) (CP) of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
(SEMLS) for Intra & Post procedure photo-C | Photo showing detailing history-P | Planned line of
spasticity management-P | Treatment details-C
management (
more than 4 level)
PMR PR PR0000136 Spine Pain PR0000136100 Spine Pain relieving procedures ( Caudal / facet/ stellate 3000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Medical No Insurance N N N Spine Pain relieving procedures ( Caudal / facet/ stellate Admission notes-P | All investigations reports.-C | Any investigation reports in support
1 relieving 001403 ganglion block) ganglion block) of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
procedures MRI of concern part / Spine / Brain-P | Photo showing detailing history-P | Planned line
(Caudal / facet/ of management-P | Treatment details-C
stellate ganglion
block)
PMR PR PR0000290 Conservative PR0000290000 Conservative managment of pressure ucler (NPUP grade 25000 No 0 No 0 No No Tertiary 30 No Yes Yes Regular PKG No No No Medical No Insurance N N N Conservative managment of pressure ucler (NPUP grade Admission notes-P | All investigations reports.-C | Any investigation reports in support
managment of 01392 >=3) in spinal cord injury patients including NPWT (Vac >=3) in spinal cord injury patients including NPWT (Vac of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
pressure ucler in Therapy ) In Spinal Cord Injury (Min LOS 15 Days) Therapy ) In Spinal Cord Injury (Min LOS 15 Days) Photo showing detailing history-P | Planned line of management-P | Treatment details-
spinal cord injury C
patients including
NPWT (Vac
Therapy ) In Spinal
Cord Injury
PMR PR PR0000291 Conservative PR0000291000 Comprehensive medical rehabilitation for spinal injury/ 0 Yes 30 No 0 Yes Yes Tertiary 30 No Yes Yes Govt Yes No No Medical No Insurance N N N Comprehensive medical Comprehensive medical rehabilitation for spinal injury/ Admission notes-P | All investigations reports.-C | Any investigation reports in support
Rehabilitaion 01393 traumatic brain injury, CVA, Cerebral palsy with or without Reserve rehabilitation for spinal injury/ traumatic brain injury, CVA, Cerebral palsy with or without of diagnosis-P | CT/ MRI of concern part / Spine / Brain-P | Clinical notes-P | Detailed
Packages ( cardio- orthosis - govt reserved traumatic brain injury, CVA, orthosis - govt reserved ICPs-C | Detailed discharge summary-C | Photo showing detailing history-P | Planned
pulmonary;Neurol Cerebral palsy with or without line of management-P | Treatment details-C
ogical;Orthopaedi orthosis - govt reserved-1000
c Rehabilitaion )
Including spinal
cord injury
PMR PR PR0000730 HALO cervical PR0000730000 HALO cervical traction in upper cervical spine injury 40000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Medical No Insurance N N R N HALO cervical traction in upper cervical spine injury Admission notes-P | All investigations reports.-C | Any investigation reports in support
traction in upper 01394 of diagnosis-P | CT/ MRI of concern part / Spine / Brain-P | Clinical notes-P | Detailed
cervical spine ICPs-C | Detailed discharge summary-C | Photo showing detailing history-P | Planned
injury line of management-P | Treatment details-C
PMR PR PR0000823 Interventional PR0000823000 Interventional Rehabilation of spasticity in storke/ TBI / CP / 0 Yes 1 No 0 Yes Yes Tertiary 7 No Yes Yes Govt Yes No No Medical No Insurance N N N Interventional Rehabilation of Interventional Rehabilation of spasticity in storke/ TBI / CP / Admission notes-P | All investigations reports.-C | Any investigation reports in support
Rehabilation of 01395 SCI With Bot. Toxin - Govt Reserve (Spasticity >=3) Reserve spasticity in storke/ TBI / CP / SCI SCI With Bot. Toxin - Govt Reserve (Spasticity >=3) of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
spasticity in With Bot. Toxin - Govt Reserve Max 300 IU Adult / 200 IU Child-P | Photo showing detailing history-P | Planned line of
storke/ TBI / CP / (Spasticity >=3)-50000 management-P | Procedural photo-C | Treatment details-C
SCI With Bot.
Toxin - Govt
Reserve
PMR PR PR0000829 Intra Articular PR0000829000 Intra Articular Injections for MSK disorder - Govt reserve 2500 No 0 No 0 No Yes Secondary 7 No Yes Yes Govt No No No Medical No Insurance N N N Intra Articular Injections for MSK disorder - Govt reserve Admission notes-P | All investigations reports.-C | Any investigation reports in support
Injections for MSK 01396 Reserve of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
disorder - Govt Photo showing detailing history-P | Planned line of management-P | Treatment details-
reserve C
PMR PR PR0000944 Medical/ neuro PR0000944000 Medical rehabilitation of muscular dystrophy/Medical 7000 No 0 No 0 Yes Yes Secondary 7 No Yes Yes Govt Yes No No Medical No Insurance N N N Medical rehabilitation of muscular dystrophy/Medical Admission notes-P | All investigations reports.-C | Any investigation reports in support
rehablitation 01397 Rehabilitation intellectual disability/Medical Rehabilitation Reserve Rehabilitation intellectual disability/Medical Rehabilitation of diagnosis-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge summary-C |
special learning disability/Medical Rehabilitation multiple special learning disability/Medical Rehabilitation multiple Photo showing detailing history-P | Planned line of management-P | Treatment details-
disability (Min 7 Days Stay)- govt reserve disability (Min 7 Days Stay)- govt reserve C
PAEDIATRI PS PS0000101 aspiration/ PS0000101000 aspiration/ Intercostal drainage Only 5000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N aspiration/ Intercostal drainage Only Analysis report of drained fluid-C | Chest X-Ray PA-P | Clinical notes-P | Clinical
C SURGERY Intercostal 01227 photograph-P | Detailed discharge summary-C | Detailing need of ICD-P | Intra & Post
drainage Only OP Photo and scar Photo-C | detailed Procedure / Operative Notes-C | post procedure
clinical photograph-C
PAEDIATRI PS PS0000101 Neurogenic PS0000101000 Neurogenic bladder - Package for evaluation / investigation 18200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Surgical No Insurance N N R N Neurogenic bladder - Package for evaluation / investigation Clinical notes detailing the case history with previous work up / initial diagnosis-P |
C SURGERY 0 bladder - Package 001292 (catheter + ultrasound + culture + RGU/ MCU) for 1 month (catheter + ultrasound + culture + RGU/ MCU) for 1 month Evidence of all investigations done and still images of RGU/ MCU done with patient name
for evaluation / (medicines - antibiotics) including cystoscopy, Uro dynamics (medicines - antibiotics) including cystoscopy, Uro dynamics & date-C | Intra & Post OP Photo and scar Photo-C
investigation
(catheter +
ultrasound +
culture + RGU/
MCU) for 1 month
(medicines -
antibiotics)
PAEDIATRI PS PS0000102 Open bladder PS0000102800 Open bladder diverticulectomy with / without ureteric re- 26250 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Open bladder diverticulectomy with / without ureteric re- Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-
C SURGERY 8 diverticulectomy 001293 implantation ± DJ Stenting implantation ± DJ Stenting C | USG/CT/MRI+/-Cystoscopy confirming bladder diverticulum and need for surgery-P
with / without | detailed Procedure / Operative Notes-C
ureteric re-
implantation
PAEDIATRI PS PS0000104 Operation for PS0000104100 Operation for Duplication of Intestine 18000 No 0 No 0 No No Secondary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Operation for Duplication of Intestine Any one test confirming the diagnosis-P | Clinical notes-P | Detailed Operative notes-C
C SURGERY 1 Duplication of 001294 | Detailed discharge summary-C | Histopath of removed part-C | Intra & Post OP Photo
Intestine and scar Photo-C | X-ray / USG Abd/ CT/MRI /Endoscopic Ultrasound.-P
PAEDIATRI PS PS0000104 Operation for PS0000104300 Operation for Hydrocele (B/L) / herniotomy- Govt reserved 10000 No 0 No 0 No Yes Secondary 3 Yes Yes Yes Govt No No No Surgical No Insurance N N N Operation for Hydrocele (B/L) / herniotomy- Govt reserved Clinical notes-P | Intra & Post OP Photo and scar Photo-C | Photo-P | detailed
C SURGERY 3 Hydrocele (B/L) / 001295 Reserve Procedure / Operative Notes-C | detailed discharge summary-C
herniotomy- Govt
reserved
PAEDIATRI PS PS0000104 Operation for PS0000104500 Operation for Hydrocele (U/L) / herniotomy - Govt reserved 8000 No 0 No 0 Yes Yes Secondary 3 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Operation for Hydrocele (U/L) / herniotomy - Govt reserved )+/- Scrotal USG confirming the diagnosis-P | Clinical notes-P | Detailed Operative notes-
C SURGERY 5 Hydrocele (U/L) / 001296 Reserve C | Detailed discharge summary-C | Histopath / Specimen photo-C | Intra & Post OP
herniotomy - Photo and scar Photo-C
Govt reserved
PAEDIATRI PS PS0000104 Operation PS0000104700 Operation forAbdominal/Lung Hydatid Cyst (Single Organ) - 21700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operation forAbdominal/Lung Hydatid Cyst (Single Organ) - Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
C SURGERY 7 forAbdominal 001297 Change in Name Change in Name Histopath / Specimen photo-C | Intra & Post OP Photo and scar Photo-C | USG/CT/MRI
/Lung Hydatid report confirming the diagnosis-P
Cyst (Single
Organ) - Change in
Name
PAEDIATRI PS PS0000104 Operation of PS0000104900 Operation of Choledochal Cyst 30400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operation of Choledochal Cyst Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
C SURGERY 9 Choledochal Cyst 001298 Histopath / Specimen photo-C | Intra & Post OP Photo and scar Photo-C | USG/CT
Abdomen-P
PAEDIATRI PS PS0000105 Operations for PS0000105100 Operations for Replacement of Oesophagus by 43400 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operations for Replacement of Oesophagus by Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra &
C SURGERY 1 Replacement of 001299 Colon/ileal/jejunal/Stomach Colon/ileal/jejunal/Stomach Post OP Photo and scar Photo-C | Relevent investigation if done-P | Scar photo (should
Oesophagus by be two scars or one huge thoracolumbar scar coverin both colon removal & esopagus
Colon replacement)-C
PAEDIATRI PS PS0000106 Augmentation PS0000106000 Augmentation cystoplasty 39100 No 0 No 0 Yes No Tertiary 14 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Augmentation cystoplasty )+/- Cystoscopy/, confirming the indication for which the surgery is done-P | Clinical
C SURGERY cystoplasty 01228 notes-P | Cystogram-P | Detailed discharge summary-C | IVP/CT IVP/MRI-P | Intra &
Post OP Photo and scar Photo-C | Intraoperative still images-C | Post procedure Imaging-
C | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000106 Orchidectomy PS0000106100 Orchidectomy BL / UL - Govt reserved 11200 No 0 No 0 No Yes Tertiary 3 Yes Yes Yes Govt No No No Surgical No Insurance N N N Orchidectomy BL / UL - Govt reserved Clinical notes-P | Describing Swelling in scrotum-P | Detailed Operative notes-C |
C SURGERY 1 001300 Reserve Detailed discharge summary-C | Histopath / Specimen photo-C | Intra & Post OP Photo
and scar Photo-C | Justification of orchidectmy-P | USG of scrotum / tumour markers (if
cancer of testis,etc is the indication)-P
PAEDIATRI PS PS0000106 Orchiopexy PS0000106300 Orchiopexy with laparoscopyto be cross checked with pead 0 Yes 1 No 0 Yes Yes Tertiary 2 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Bilateral - Orchiopexy with Orchiopexy with laparoscopyto be cross checked with pead Clinical Photograph of affected part-P | Clinical notes-P | Detailed discharge summary-C
C SURGERY 3 001301 surgery - U/L OR B/L - Govt Reserve Reserve laparoscopyto be cross checked surgery - U/L OR B/L - Govt Reserve | Intra & Post OP Photo and scar Photo-C | detailed Procedure / Operative Notes-C
with pead surgery-35000 |
Unilateral - Orchiopexy with
laparoscopyto be cross checked
with pead surgery-30000
PAEDIATRI PS PS0000106 Orchiopexy PS0000106300 Orchiopexy without laparoscopy - U/L or B/L - Govt Reserve 0 Yes 1 No 0 Yes Yes Tertiary 2 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Bilateral-21700 | Unilateral- Orchiopexy without laparoscopy - U/L or B/L - Govt Reserve Clinical Photograph of affected part-P | Clinical notes-P | Detailed discharge summary-C
C SURGERY 3 001302 Reserve 15000 | Intra & Post OP Photo and scar Photo-C | Post Procedure Clinical Photograph of
affected part-C | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000110 Partial Cystectomy PS0000110800 Partial Cystectomy 26000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Cystectomy )+/-FNAC/Biopsy-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge
C SURGERY 8 001303 summary-C | Histopathology / Specimen photo-C | Intra & Post OP Photo and scar
Photo-C | USG / CT / MRI confirming the indication and need of this surgery with
supporting Evidence of the same-P
PAEDIATRI PS PS0000113 Perineal PS0000113600 Perineal Urethrostomy without closure 20000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Perineal Urethrostomy without closure )+/- MCU-P | Clinical notes detailing the pathology for which performed with supporting
C SURGERY 6 Urethrostomy 001304 Evidence of RGU (Retrograde urethrography)-P | Detailed discharge summary-C | Intra
without closure & Post OP Photo and scar Photo-C | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000118 PORTAL PS0000118800 NON-SHUNTS 45000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N NON-SHUNTS Endoscopy/ USG/ CT/ MRI -P | Intra op endoscopy image-C | detailed discharge
C SURGERY 8 HYPERTENSION 001305 summary-C
PAEDIATRI PS PS0000119 Post. Urethral PS0000119400 Post. Urethral Valve fulguration 14000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Post. Urethral Valve fulguration )+/- uroflowmetry-P | Clinical notes-P | Confirmation of stenosis of posterir urethral
C SURGERY 4 Valve fulguration 001306 valve by Voiding cystourethrogram (preferred)-P | Detailed discharge summary-C |
Intra & Post OP Photo-C | USG-P | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000120 POSTERIOR PS0000120000 VESICOSTOMY 41000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N VESICOSTOMY Clinical notes -P | Intra & Post OP Photo and scar Photo-C | OT note-C | Scar photo-C |
C SURGERY 0 URETHERAL 001307 USG-P | cystourethrogram-P | discharge summary-C
VALVES
PAEDIATRI PS PS0000121 Pyelolithotomy PS0000121400 Pyelolithotomy - Open/Lap. ± DJ Stenting 28000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pyelolithotomy - Open/Lap. ± DJ Stenting X-ray / USG / IVP / NCCT-P | CT-IVP confirming the indication -P | Clinical notes-P |
C SURGERY 4 001308 Detailed Procedure / Operative Notes-C | Detailed discharge summary-C | Intra & Post
OP Photo and scar Photo-C | Post procedure Imaging (X Ray/USG)-C | Showing stone
removed-C
PAEDIATRI PS PS0000121 Pyeloplasty / PS0000121600 Pyeloplasty - Laparoscopic/Pyeloureterostomy - 30400 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pyeloplasty - Laparoscopic/Pyeloureterostomy - )+/-DTPA renal scan, confirming indication and the need for surgery-P | Clinical notes-P
C SURGERY 6 Pyeloureterostom 001309 Laparoscopic/Pyelopyelostomy - Laparoscopic ± DJ Stenting Laparoscopic/Pyelopyelostomy - Laparoscopic ± DJ Stenting | Detailed Operative notes-C | Detailed discharge summary-C | Histopathology /
y/ Specimen photo-C | Intra & Post OP Photo and scar Photo-C | USG / IVP/CT/ CT-IVP -P
Pyelopyelostomy
PAEDIATRI PS PS0000121 Pyeloplasty / PS0000121600 Pyeloplasty - Open/Pyeloureterostomy - 27500 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pyeloplasty - Open/Pyeloureterostomy - )+/-DTPA renal scan, confirming indication and the need for surgery-P | Clinical notes-P
C SURGERY 6 Pyeloureterostom 001310 Open/Pyelopyelostomy - Open ± DJ Stenting Open/Pyelopyelostomy - Open ± DJ Stenting | Detailed Procedure/ Operative notes-C | Detailed discharge summary-C |
y/ Histopathology / Specimen photo-C | Intra & Post OP Photo and scar Photo-C | USG /
Pyelopyelostomy IVP/CT/ CT-IVP -P
PAEDIATRI PS PS0000121 Pyloromyotomy PS0000121900 Pyloromyotomy 27800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pyloromyotomy Clinical notes-P | Detailed Procedure/ Operative notes-C | Detailed discharge summary-
C SURGERY 9 001311 C | Intra & Post OP Photo and scar Photo-C | USG report confirming the diagnosis of
nfantile hypertrophic pyloric stenosis-P
PAEDIATRI PS PS0000122 Pyloroplasty PS0000122100 Pyloroplasty 14300 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pyloroplasty Clinical notes-P | Detailed Procedure/ Operative notes-C | Detailed discharge summary-
C SURGERY 1 001312 C | Endoscopy / Dye study confirming the diagnosis for which the surgery is done-P |
Intra & Post OP Photo and scar Photo-C
PAEDIATRI PS PS0000124 Rectal PS0000124900 Rectal Polypectomy, +/-Sigmoiescopic Under GA 10000 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Rectal Polypectomy, +/-Sigmoiescopic Under GA )+/- sigmoidoscopy confirming polyp-P | Clinical notes-P | Detailed Procedure/
C SURGERY 9 Polypectomy, +/- 001313 Operative notes-C | Histopathology / Specimen photo-C | Intra & Post OP Photo and
Sigmoiescopic scar Photo-C
Under GA
PAEDIATRI PS PS0000126 Repair of PS0000126500 Repair of macrostomia 39000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Repair of macrostomia Clinical photo-P | Discharge summery-C | Examination notes-P | Intra & Post OP Photo
C SURGERY 5 macrostomia 001314 and scar Photo-C | Investigation reports-P | OT Notes-C | Preoperative-P
PAEDIATRI PS PS0000126 Repair of tongue PS0000126800 Repair of tongue laceration 14000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Repair of tongue laceration Clinical notes-P | Clinical photo-P | Detailed Procedure/ Operative notes-C | Detailed
C SURGERY 8 laceration 001315 discharge summary-C | Examination details -P | Intra & Post OP Photo and scar Photo-C
PAEDIATRI PS PS0000127 Resection PS0000127000 Resection Anastomosis 25000 No 0 No 0 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Resection Anastomosis Clinical notes-P | Detailed Operative notes-C | Histopath of resected part-C | Intra &
C SURGERY 0 Anastomosis 001316 Post OP Photo and scar Photo-C | Intra procedure clinical photograph-C | X Ray
Abdomen Erect/USG / CT confirming the diagnosis-P | detailed discharge summary-C
PAEDIATRI PS PS0000128 Retro - Peritoneal PS0000128000 Retro - Peritoneal Lymphangioma Excision 25000 No 0 No 0 No No Tertiary 5 no Yes Yes Regular PKG No No No Surgical No Insurance N N N Retro - Peritoneal Lymphangioma Excision Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
C SURGERY 0 Lymphangioma 001317 C | Histopathology-C | Intra & Post OP Photo and scar Photo-C | Intra procedure
Excision clinical photograph-C | USG / CT/ MRI Abd-P
PAEDIATRI PS PS0000128 Retroperitoneal PS0000128200 Retroperitoneal Tumor – Excision 26900 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Retroperitoneal Tumor – Excision Clinical notes-P | Detailed Operative notes-C | Histopath-C | Intra & Post OP Photo and
C SURGERY 2 Tumor – Excision 001318 scar Photo-C | Intra procedure clinical photograph-C | X Ray/USG/CT Abdomen
confirming the diagnosis-P | detailed discharge summary-C
PAEDIATRI PS PS0000129 Rib Resection & PS0000129100 Rib Resection & Drainage 17300 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Rib Resection & Drainage Clinical notes-P | Clinical photograph-P | Detailed Operative notes-C | Detailed
C SURGERY 1 Drainage 001319 discharge summary-C | Intra & Post OP Photo and scar Photo-C | Pus C/S Post
procedure X Ray-C | X Ray / USG/ CT/ MRI confirming the diagnosis for which the
surgery is done-P
PAEDIATRI PS PS0000129 Rigid laryngoscopy PS0000129500 Rigid laryngoscopy / bronchoscopy / 0 Yes 1 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N with biopsy-7000 | without Rigid laryngoscopy / bronchoscopy / Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo-C | Planned
C SURGERY 5 / bronchoscopy / 001320 oesophagoscopy - Diagnostic + / - biopsy biopsy-2000 oesophagoscopy - Diagnostic + / - biopsy line of treatment-P | Procedure / Operative Notes-C
oesophagoscopy -
Diagnostic + / -
biopsy
PAEDIATRI PS PS0000133 Bladder injury PS0000133000 Bladder injury repair 25500 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Bladder injury repair )+/- cystogram confirming the diagnosis of bladder injury-P | Clinical notes-P | Detailed
C SURGERY repair 01229 (with or without urethral injury) (with or without urethral injury) discharge summary-C | Intra & Post OP Photo and scar Photo-C | USG/CT/MRI-P |
(with or without detailed Procedure / Operative Notes-C
urethral injury)
PAEDIATRI PS PS0000135 Bladder injury PS0000135000 Bladder injury repair with colostomy 34700 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Bladder injury repair with colostomy )+/- cystogram confirming the diagnosis of bladder injury-P | Clinical notes-P | Detailed
C SURGERY repair with 01230 (with or without urethral injury) (with or without urethral injury) discharge summary of both surgeries-C | Intra & Post OP Photo and scar Photo-C | Post
colostomy procedue pic of Colostomy-C | USG/CT/MRI-P | detailed Procedure / Operative Notes-C
(with or without
urethral injury)
PAEDIATRI PS PS0000135 Sphinecterotomy - PS0000135500 Sphinecterotomy - for Hirschsprung’s Disease 15000 No 0 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Sphinecterotomy - for Hirschsprung’s Disease Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 5 for Hirschsprung’s 001321 C | Intra & Post OP Photo and scar Photo-C | X-ray / Dye test-P
Disease
PAEDIATRI PS PS0000136 Splenectomy PS0000136300 Splenectomy 25000 No 0 No 0 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Splenectomy USG/CT-P | Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed
C SURGERY 3 001322 discharge summary-C | Histopath-C | Intra & Post OP Photo and scar Photo-C | Scan
and Lab investigations confirming the diagnosis and justifying the surgery-P
PAEDIATRI PS PS0000136 SPLENORRHAPHY PS0000136400 Splenorapphy 31000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Splenorapphy CBC-P | Clinical examinationnotes-P | Discharge summary-C | Intra & Post OP Photo
C SURGERY 4 001323 and scar Photo-C | OT notes-C | Scar photo-C | USG/CT scan-P
PAEDIATRI PS PS0000137 Staging PS0000137300 Staging Laparotomy and proceed for Ovarian Cancers. 38000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Staging Laparotomy and proceed for Ovarian Cancers. Pelvis/ CT abdomen-P | Clinical notes-P | Detailed Procedure/Operative notes-C |
C SURGERY 3 Laparotomy and 001324 Omentomy with Bilateral Omentomy with Bilateral Detailed discharge summary-C | Histopathology / Specimen photo-C | Intra & Post OP
proceed for Salpingo-oophorectomy (BPLND if req ) Salpingo-oophorectomy (BPLND if req ) Photo and scar Photo-C | Pelvis establishing indication / Tumour marker-P | USG
Ovarian Cancers. Abdomen -P
Omentomy with
Bilateral Salpingo-
oophorectomy
PAEDIATRI PS PS0000138 SUPERNUMMERY PS0000138900 Excision of supernumerary digit 14000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of supernumerary digit Clinical photo of the part,-P | HPE / Specimen photo-C | Intra & Post OP Photo and scar
C SURGERY 9 DIGIT EXISION 001325 Photo-C | X-Ray-C | X-ray-P
PAEDIATRI PS PS0000139 Suprapubic PS0000139000 Suprapubic Drainage - Closed / Trocar 5000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Suprapubic Drainage - Closed / Trocar Clinical notes-P | Detailed Procedure / Operative Notes detailing how mcuh urine was
C SURGERY 0 Drainage - Closed 001326 drained-C | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-C |
/ Trocar USG/CT confirming the diagnosis for which the surgery is done-P
PAEDIATRI PS PS0000139 Surgery for PS0000139400 Surgery for Congenital Lobar Emphysema 27800 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Surgery for Congenital Lobar Emphysema Clinical notes-P | HPE / Specimen photo-C | Intra & Post OP Photo and scar Photo-C |
C SURGERY 4 Congenital Lobar 001327 Post procedure X-ray stills-C | X Ray/CT Scan stills confirming the diagnosis-P | detailed
Emphysema Procedure / Operative Notes-C | detailed discharge summary-C
PAEDIATRI PS PS0000139 Surgery for PS0000139900 Myectomy 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Myectomy Clinical notes-P | Intra & Post OP Photo and scar Photo-C | Post procedure X-ray stills-C
C SURGERY 9 Hirschsprung’s 001328 | X-ray /Anorectal manometry / Dye test-P | detailed Procedure / Operative Notes-C |
Disease detailed discharge summary-C
PAEDIATRI PS PS0000139 Surgery for PS0000139900 Rectal Biopsy - Punch 10400 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Rectal Biopsy - Punch Clinical notes-P | HPE / Specimen photo-C | Intra & Post OP Photo and scar Photo-C |
C SURGERY 9 Hirschsprung’s 001331 Post procedure X-ray stills-C | X-ray /Anorectal manometry / Dye test-P | detailed
Disease Procedure / Operative Notes-C | detailed discharge summary-C
PAEDIATRI PS PS0000139 Surgery for PS0000139900 Rectal Biopsy – Open 11300 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Rectal Biopsy – Open Clinical notes-P | HPE / Specimen photo-C | Intra & Post OP Photo and scar Photo-C |
PAEDIATRI PS PS0000139 Surgery for PS0000139900 Pull Through 20800 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pull Through Clinical notes-P | HPE / Specimen photo-C | Intra & Post OP Photo and scar Photo-C |
PAEDIATRI PS PS0000140 Surgery for PS0000140300 Surgery for Sacrococcygeal Teratoma 20800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Surgery for Sacrococcygeal Teratoma CT / MRI / USG / Tumour marker confirming the diagnosis.-P | Clinical notes-P |
C SURGERY 3 Sacrococcygeal 001332 Detailed Procedure/Operative notes-C | Detailed discharge summary-C |
Teratoma Histopathology / Specimen photo-C | Intra & Post OP Photo and scar Photo-C
PAEDIATRI PS PS0000141 Surgical PS0000141300 CystoJejunostomy /Cystogastrostomy 21700 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N CystoJejunostomy /Cystogastrostomy Clinical Notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 3 Management of 001333 C | Endoscopic image-C | Intra & Post OP Photo and scar Photo-C | Ultrasound / CT/
PseudoCyst MRI-P
PAEDIATRI PS PS0000141 Syndactyly repair PS0000141900 Syndactyly repair 35000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Syndactyly repair Clinical notes-P | Discharge summery.-C | Intra & Post OP Photo and scar Photo-C | OT
C SURGERY 9 001334 notes-C | Preoperative clincial photo, -P
PAEDIATRI PS PS0000143 Thoracoscopic PS0000143600 Thoracoscopic Segmental Resection 26000 Yes 0 Yes 1 Yes No Tertiary 5 no Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Linear Cutter 3 cartidges-15000 Thoracoscopic Segmental Resection )+/- Biopsy report-P | CT / MRI Thorax confirming the diagnosis-P | Clinical notes-P |
C SURGERY 6 Segmental 001335 Max :1 Detailed Operative notes-C | Detailed discharge summary.-C | Intra & Post OP Photo
Resection and scar Photo-C | histopath-C
PAEDIATRI PS PS0000145 TORTICOLLIS - PS0000145400 TORTICOLLIS - Sternomastoid division 15000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N TORTICOLLIS - Sternomastoid division Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 4 Sternomastoid 001336 C | Intra & Post OP Photo and scar Photo-C | clinical Photo-P
division
PAEDIATRI PS PS0000146 Tracheostomy / PS0000146400 Tracheostomy/Tracheotomy 9500 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular Yes No No Surgical No Insurance N N R N Tracheostomy/Tracheotomy Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 4 Tracheotomy 001337 PKG/add on C | Intra & Post OP Photo and scar Photo-C | Planned line of treatment justifying
indication-P
PAEDIATRI PS PS0000149 Ureteric PS0000149700 Ureteric reimplantation 23000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ureteric reimplantation CT-IVP/MRI Urogram / MCU confirming reflux and need of surgery-P | Clinical notes-P |
C SURGERY 7 reimplantation 001338 Detailed Procedure/Operative notes-C | Detailed discharge summary-C | Intra & Post
OP Photo and scar Photo-C
PAEDIATRI PS PS0000150 Ureterostomy PS0000150500 Ureterostomy (Cutaneous) ± DJ Stenting 20000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ureterostomy (Cutaneous) ± DJ Stenting Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 5 001339 C | Intra & Post OP Photo and scar Photo-C | Post Procedure Clinical Photograph stoma-
C | USG / MCU / CT / MRI / Renal Scan confirming the diagnosis for ureterostomy-P
PAEDIATRI PS PS0000150 Uretero- PS0000150700 Uretero-ureterostomy- Open / Lap. ± DJ Stenting 26000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Uretero-ureterostomy- Open / Lap. ± DJ Stenting Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 7 ureterostomy 001340 C | Intra & Post OP Photo and scar Photo-C | Need for creating a stoma for ureter-P |
Post Procedure Clinical Photograph stoma-C | USG / MCU / CT / MRI / Renal Scan
confirming the diagnosis for ureterostomy-P
PAEDIATRI PS PS0000151 Urethral Dilatation PS0000151100 Endocopic as an independent procedure - Stand Alone 5000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Endocopic as an independent procedure - Stand Alone Investigation reports confirming urethral stricture (RGU+/- MCU)-P | Clinical notes-P |
C SURGERY 1 001341 Detailed Procedure / Operative Notes-C | Endoscopic Intra procedure still photograph-C
| detailed discharge summary-C
PAEDIATRI PS PS0000151 Urethral Dilatation PS0000151100 Non endocopic as an independent procedure - Stand Alone 2000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Non endocopic as an independent procedure - Stand Alone Investigation reports confirming urethral stricture (RGU+/- MCU)-P | Clinical notes-P |
C SURGERY 1 001342 Detailed Procedure / Operative Notes-C | Detailing size of dilators used-C | detailed
discharge summary-C
PAEDIATRI PS PS0000151 Urethrorectal PS0000151400 Urethrorectal fistula repair 40000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Urethrorectal fistula repair )+/-RGU+MCU / Distal cologram-P | Clinical notes-P | Confirmation of fistula and it's
C SURGERY 4 fistula repair 001343 tract by Cystoscopy / Sigmoidoscopy-P | Detailed Procedure / Operative Notes-C |
Detailed discharge summary-C
PAEDIATRI PS PS0000151 Urethrovaginal PS0000151600 Urethrovaginal fistula repair 30400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Urethrovaginal fistula repair Clinical notes-P | Detailed Procedure/Operative notes-C | Detailed discharge summary-
C SURGERY 6 fistula repair 001344 C | Intra & Post OP Photo and scar Photo-C | Urethro Cystos vaginoscopy / USG / Dye
Study confirming the diagnosis-P
PAEDIATRI PS PS0000155 Wilms tumors: PS0000155500 Wilms tumors: surgery / Neuroblastoma 39100 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Wilms tumors: surgery / Neuroblastoma
C SURGERY 5 surgery / 001345 Procedure / Operative Notes-C | Clinical notes-P | Detailed Discharge Summary-C |
Neuroblastoma HPE report-C | Intra & Post OP Photo and scar Photo-C | Post Procedure Photographs of
surgical site-C | USG / CT abdomen-P | planned line of treatment-P
PAEDIATRI PS PS0000224 Cholecystectomy PS0000224000 Cholecystectomy 20000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cholecystectomy USG confirming the diagnosis-P | Clinical notes-P | Detailed Operative Notes-C |
C SURGERY 01231 Detailed discharge summary of both surgeries-C | Intra & Post OP Photo and scar Photo-
C
PAEDIATRI PS PS0000238 Closure of Burst PS0000238000 Closure of Burst Abdomen 15000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Closure of Burst Abdomen Clinical notes-P | Detailed Operative Notes-C | Detailed discharge summary of both
C SURGERY Abdomen 01232 surgeries-C | Intra & Post OP Photo and scar Photo-C | Photo describing the original
surgery that led to burst abdomen -P
PAEDIATRI PS PS0000242 Closure of stoma PS0000242000 Closure of stoma 14500 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Closure of stoma Clinical notes-P | Clinical photograph-P | Detailed Operative Notes-C | Detailed
C SURGERY 01233 discharge summary of both surgeries-C | Intra & Post OP Photo and scar Photo-C
PAEDIATRI PS PS0000246 Colostomy PS0000246000 Defunctioning Colostomy - Stand Alone 15000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N Defunctioning Colostomy - Stand Alone Clinical notes-P | Detailed Operative notes & detailed surgery notes.-C | Intra & Post OP
C SURGERY 01234 Photo and scar Photo-C | X-ray abdomen-P
PAEDIATRI PS PS0000246 Colostomy PS0000246000 Exploratory laprotomy with colostomy 21700 No 0 No 0 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exploratory laprotomy with colostomy CT Scan/ X-ray / USG confirming the diagnosis and need of surgery-P | Clinical notes-P |
C SURGERY 01235 Detailed Operative notes-C | Intra & Post OP Photo and scar Photo-C | detailed
discharge summary-C
PAEDIATRI PS PS0000252 Complete Excision PS0000252000 Complete Excision of Growth from Tongue only 14300 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Complete Excision of Growth from Tongue only Clinical Photograph-P | Clinical notes confirming the diagnosis-P | Detailed Operative
C SURGERY of Growth from 01236 (inclusive of Histopathology) (inclusive of Histopathology) notes-C | FNAC if done-P | Histopath-C | Intra & Post OP Photo and scar Photo-C |
Tongue only detailed discharge summary-C
(inclusive of
Histopathology)
PAEDIATRI PS PS0000259 Congenital Atresia PS0000259000 Congenital Atresia & Stenosis of Small/ large Intestine 26000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Congenital Atresia & Stenosis of Small/ large Intestine Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra &
C SURGERY & Stenosis of 01237 Post OP Photo and scar Photo-C | Intra procedure clinical stills-C | X ray abdomen-P
Small / large
Intestine
PAEDIATRI PS PS0000260 Congenital PS0000260000 Congenital Diaphragmatic Hernia - Govt Reserve 34700 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Congenital Diaphragmatic Hernia - Govt Reserve Chest X-ray / USG/CT scan stills-P | Clinical notes-P | Detailed Procedure / Operative
C SURGERY Diaphragmatic 01238 Reserve Notes-C | Intra & Post OP Photo and scar Photo-C | Xray Chest.-C | detailed discharge
Hernia summary-C
PAEDIATRI PS PS0000267 CONJOINED PS0000267000 Separation of twins 95000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Separation of twins Clinical photo-P | Examination details-P | Intra & Post OP Photo and scar Photo-C |
C SURGERY TWINS 01239 Investigation photos-P | OT notes-C | discharge summry and other relavant
investigation-C
PAEDIATRI PS PS0000276 Conservative PS0000276000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone Admission notes showing vitals-P | All investigations reports-C | Any investigations
C SURGERY Management 01240 stand alone-1800 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
Planned line of management-P | Treatment details-C | detailed discharge summary-C
PAEDIATRI PS PS0000285 Conservative PS0000285000 Conservative Management - 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - Clinical notes-P | Detailed discharge summary.-C | Post Treatment clinical photograph-C
C SURGERY Management of 01241 (Chest/Head/Face/Abdomen)stand alone (Chest / Head / Face / Abdomen) (Chest/Head/Face/Abdomen)stand alone | X-rays or other diagnostic procedures done as a part of treatment-C | lab tests-C
injury stand alone-1800
PAEDIATRI PS PS000031 Acute PS0000310000 Acute management of upper urinary tract trauma – 8600 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Acute management of upper urinary tract trauma – Circumstances that led to trauma-P | Circumstances that led to trauma-P |
C SURGERY management of 1218 conservative conservative Circumstances that led to trauma-P | Detailed discharge summary-C | Detailing the case
upper urinary history-P | Detailing the case history-P | Injuries sustained as result of trauma-P |
tract trauma – Injuries sustained as result of trauma-P | Local examination findings-P | Local
conservative examination findings-P | Local examination findings-P | Presenting complaints-P |
Presenting complaints-P | Presenting complaints-P | Reports of all investigations done
and consultation paper of treating doctor mentioning the final diagnosis and line of
treatment-C | USG/CT Abdomen-P | USG/CT Abdomen-P | injuries sustained as result
of trauma-P
PAEDIATRI PS PS0000467 Cystolithotomy - PS0000467000 Cystolithotomy - Open - including cystoscopy 18500 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Cystolithotomy - Open - including cystoscopy Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-
C SURGERY Open, including 01242 C | X ray KUB/USG/IVP/NCCT confirming the diagnosis of stone-P | detailed Procedure /
cystoscopy Operative Notes-C
PAEDIATRI PS PS0000469 Cystolithotripsy / PS0000469000 Cystolithotripsy including cystoscopy 18500 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cystolithotripsy including cystoscopy Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-
C SURGERY Urethral Stone 01243 C | X ray KUB/USG/IVP/NCCT confirming the diagnosis of stone-P | detailed Procedure /
endoscopic, Operative Notes-C
including
cystoscopy
PAEDIATRI PS PS0000469 Cystolithotripsy / PS0000469000 Urethral Stone removal endoscopic, including cystoscopy 18500 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Urethral Stone removal endoscopic, including cystoscopy Clinical notes-P | Detailed discharge summary-C | Intra OP Photo-C | X ray
C SURGERY Urethral Stone 01244 KUB/USG/IVP/NCCT confirming the diagnosis of stone-P | detailed Procedure /
endoscopic, Operative Notes-C
including
cystoscopy
PAEDIATRI PS PS000047 Adrenalectomy PS0000470000 Adrenalectomy 30000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Adrenalectomy )+/- FNAC/Biopsy-P | 24 hr urinary catacholamine level / sr. or urinary metanephrine
C SURGERY 1219 normetanephrine-P | Clinical notes confirming diagnosis with Evidence of /CT/MRI-P |
Detailed discharge summary-C | Histopathology-C | Intra & Post OP Photo and scar
Photo-C | MIBG Scan/ DOTONOC scan-P | Sr. Cortisol-P | Sr. electrolytes-P | detailed
PAEDIATRI PS PS0000478 Decortication PS0000478000 Decortication (Pleurectomy) 33000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Decortication (Pleurectomy) Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
C SURGERY (Pleurectomy) 01245 Histopathology-C | Intra & Post OP Photo and scar Photo-C
PAEDIATRI PS PS0000481 Deep neck PS0000481000 Deep neck abscess drainage/Post trauma neck exploration 16000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Deep neck abscess drainage/Post trauma neck exploration C/S of pus-C | Clinical notes-P | Clinical photgraph/ investigation supporting diagnosis-P
C SURGERY abscess drainage/ 01246 | Intra & Post OP Photo and scar Photo
Post trauma neck -C | detailed Procedure / Operative Notes-C | detailed discharge summary-C
exploration
PAEDIATRI PS PS0000505 Distal PS0000505000 Distal Pancreatectomy/Pancreatico Jejunostomy 30800 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Distal Pancreatectomy/Pancreatico Jejunostomy CT/ USG / ERCP justifying the surgery-P | Clinical notes-P | Detailed Operative notes-C |
C SURGERY Pancreatectomy 01247 with/without spleenlectomy with/without spleenlectomy Histopath-C | Intra & Post OP Photo and scar Photo-C | Sr Amylase-P | detailed
with discharge summary-C
Pancreatico
Jejunostomy
PAEDIATRI PS PS0000510 Diverticulectomy PS0000510000 Excision Meckel's Diverticulum/ Duodenal Diverticulum 19100 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision Meckel's Diverticulum/ Duodenal Diverticulum Clinical notes-P | Detailed Operative notes-C | Histopath-C | Intra & Post OP Photo and
C SURGERY 01248 scar Photo-C | USG/CT/MRI report confirming the diagnosis-P | detailed discharge
summary-C
PAEDIATRI PS PS0000512 DJ stenting PS0000512000 DJ stenting including cystoscopy, ureteric catheterization, 10000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N DJ stenting including cystoscopy, ureteric catheterization, Clinical notes and X-ray / USG / CT-IVP/ IVP confirming the diagnosis and the need of this
C SURGERY including 01249 retrograde pyelogram - Stand Alone retrograde pyelogram - Stand Alone surgery is done-P | Post Procedure x-ray showing stent-C | detailed Procedure /
cystoscopy, Operative Notes detailing findings of cystoscopy/ Retrogradepyelogram and ureteric
ureteric catheterization-C | detailed discharge summary-C
catheterization,
retrograde
pyelogram
PAEDIATRI PS PS0000517 Duplication Cyst PS0000517000 Duplication Cyst Excision 26000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Duplication Cyst Excision )+/- Endoscopic USG-P | Clinical notes-P | Histopathology-C | Intra & Post OP Photo
C SURGERY Excision 01250 and scar Photo-C | Intra procedure clinical photograph-C | USG/CT Abd-P | detailed
Procedure / Operative Notes-C | detailed discharge summary-C
PAEDIATRI PS PS0000536 Emergency PS0000536000 Emergency management of Acute retention of Urine 2000 No 0 No 0 No No Secondary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Emergency management of Acute retention of Urine Clinical notes.-P | Detailed discharge summary giving aetiology of retention-C |
C SURGERY management of 01251 Evidence of simple catheterization and details of how much urine drained-C
Acute retention of
Urine
PAEDIATRI PS PS0000540 Emergency PS0000540000 Emergency management of Hematuria 0 Yes 3 No 0 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Routine Ward-1800 Emergency management of Hematuria Clinical notes detailing the hematuria with urine report showing frank or microscopic?-P |
C SURGERY management of 01252 Evidence of investigations done treatment given-C | detailed discharge summary-C
Hematuria
PAEDIATRI PS PS0000542 Emergency PS0000542000 Emergency management of Ureteric stone - Package for 0 Yes 3 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Emergency management of Ureteric stone - Package for Clinical notes-P | Detailed reports of all investigations done and consultation paper of
C SURGERY management of 01253 evaluation / investigation (ultrasound + culture) for 3 weeks evaluation / investigation (ultrasound + culture) for 3 weeks treating doctor-C | Previous work up / initial diagnosis-P | Stills of ureteric stone and
Ureteric stone - (medicines). (medicines). treatment done so far-P | culture & Evidence of 3 weeks medicines-C
Package for
evaluation /
investigation
(ultrasound +
culture) for 3
weeks
(medicines).
PAEDIATRI PS PS0000568 Epididymal Cyst / PS0000568000 Epididymal Cyst excision/Epididymal Nodule excision Govt 4600 No 0 No 0 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical No Insurance N N N Epididymal Cyst excision/Epididymal Nodule excision Govt Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
C SURGERY Nodule Excision 01254 reserved Reserve reserved Histopath-C | Intra & Post OP Photo and scar Photo-C | USG report confirming the
diagnosis-P
PAEDIATRI PS PS0000578 ESOPHAGEAL PS0000578000 PRIMARY REPAIR / esophagostomy & gastrostomy / gastric 65000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N PRIMARY REPAIR / esophagostomy & gastrostomy / gastric Clinical Notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra &
C SURGERY ATRESIA / TEF 01255 pull-up pull-up Post OP Photo and scar Photo-C | X-Ray-P
PAEDIATRI PS PS0000579 ESOPHAGEAL PS0000579000 Esophageal dilatation 10000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Esophageal dilatation Discharge summary-C | Examination details, Other relevant investigations-P | OT notes-
C SURGERY DILATATION 01256 C | X-Ray-P | clinical notes-P | other relavant investigation-C
PAEDIATRI PS PS0000596 Excision of PS0000596000 Excision of accessory auricle 19000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of accessory auricle Clincial examination notes-P | Intra & Post OP Photo and scar Photo-C | OT notes-C |
C SURGERY accessory auricle 01257 Preoperative clinical photo-P | Relavent investigation reports-P | discharge summery-C
PAEDIATRI PS PS0000623 Exomphalos / PS0000623000 Exomphalos/Gastroschisis 39100 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exomphalos/Gastroschisis Clinical Photograph-P | Clinical notes-P | Detailed discharge summary-C | Post
C SURGERY Gastroschisis 01258 procedure clinical photograph-C | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000625 Exploratory PS0000625000 Exploratory Laparotomy - Stand alone 25000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Stand alone No Yes No Surgical No Insurance N N R N Exploratory Laparotomy - Stand alone Clinical notes-P | Detailed Operative notes.-C | Detailed discharge summary-C | Intra &
C SURGERY Laparotomy 01259 Post OP Photo and scar Photo-C | X Ray/USG/CT Scan Abdomen-P
PAEDIATRI PS PS0000626 exploratory PS0000626000 exploratory laparotomy / Ileostomy / colostomy 30000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N exploratory laparotomy / Ileostomy / colostomy Clinical notes-P | Detailed Operative notes.-C | Detailed discharge summary-C | Intra &
C SURGERY laparotomy / 01260 Post OP Photo and scar Photo-C | X Ray/USG/CT Scan Abdomen-P
Ileostomy /
colostomy
PAEDIATRI PS PS0000633 Extended LOS PS0000633000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals-P | All investigations reports-C | Any investigations
C SURGERY care pkg for 01261 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) done-P | Clinical notes detailing history-P | Detailed ICPs-C | Examination findings-P |
advance sugeries Routine Ward-1800 Intra & Post OP Photo and scar Photo-C | Planned line of management-P | Treatment
details-C | detailed discharge summary-C
PAEDIATRI PS PS0000647 Extrophy Bladder PS0000647000 Extrophy Bladder repair including osteotomy if needed + 78200 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Extrophy Bladder repair including osteotomy if needed + Clinical Photograph of affected part-P | Clinical notes-P | Intra & Post OP Photo and scar
C SURGERY repair including 01262 epispadias repair + ureteric reimplant epispadias repair + ureteric reimplant Photo-C | USG/CT/MRI confirming the diagnosis of extrophy of bladder/ epispadias-P |
osteotomy if detailed Procedure / Operative Notes-C
needed +
epispadias repair
+ ureteric
reimplant
PAEDIATRI PS PS0000655 Fecal Fistula PS0000655000 Fecal Fistula Closure 25000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Fecal Fistula Closure Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-
C SURGERY Closure 01263 C | X-ray / USG / CT abdomen-P | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000657 Feeding PS0000657000 Feeding Jejunostomy 13600 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Feeding Jejunostomy Clinical notes-P | Detailed Operative notes-C | Intra & Post OP Photo and scar Photo-C
C SURGERY Jejunostomy 01264 | X-ray / USG / CT-P | detailed discharge summary-C
PAEDIATRI PS PS0000677 Foreign Body PS0000677000 Foreign Body Removal ( Airway) 10000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Foreign Body Removal ( Airway) Clinical notes-P | Detailed Operative notes-C | X-ray.-P | detailed discharge summary
C SURGERY Removal ( Airway) 01265 and relevant imaging study for comparison-C
PAEDIATRI PS PS000068 Ankyloglossia PS0000680000 Ankyloglossia Major 15000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ankyloglossia Major Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-
C SURGERY 1220 C | Pre-op photograph-P | detailed Procedure / Operative Notes-C | post procedure
PAEDIATRI PS PS000068 Ankyloglossia PS0000680000 Ankyloglossia Minor 3000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Ankyloglossia Minor Clinical notes-P | Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-
C SURGERY 1221 / day care C | Pre-op photograph-P | detailed Procedure / Operative Notes-C | post procedure
PAEDIATRI PS PS0000680 Foreign Body PS0000680000 Foreign Body Removal ( Esophageal) 6000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Foreign Body Removal ( Esophageal) Clinical notes-P | Detailed Operative notes-C | X-ray-P | detailed discharge summary
C SURGERY Removal ( 01266 and relevant imaging study for comparison-C
Esophageal)
PAEDIATRI PS PS000069 Ano Rectal PS0000690000 Ano Rectal Malformation Redo - Pullthrough 21700 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ano Rectal Malformation Redo - Pullthrough CT / USG Abdomen-P | Clinical Photograph-P | Clinical notes-P | Detailed discharge
C SURGERY Malformation 1222 summary-C | Intra & Post OP Photo and scar Photo-C | detailed Procedure / Operative
Notes-C | post procedure clinical photograph-C
PAEDIATRI PS PS000069 Ano Rectal PS0000690000 Abd - Perineal PSARP / PSARP 0 Yes 1 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abd - Perineal PSARP-39100 | Abd - Perineal PSARP / PSARP Clinical Photograph-P | Clinical notes-P | Detailed discharge summary-C | Distal
C SURGERY Malformation 1223 PSARP-21700 Cologram / CT / USG Abdomen / Xray Lumbosacral spine (inverted position)-P | Intra &
Post OP Photo and scar Photo-C | detailed Procedure / Operative Notes-C | post
procedure clinical photograph-C
PAEDIATRI PS PS000069 Ano Rectal PS0000690000 Anoplasty 20000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Anoplasty Clinical Photograph-P | Clinical notes-P | Detailed discharge summary-C | Distal
C SURGERY Malformation 1224 Cologram / CT / USG Abdomen / Xray Lumbosacral spine (inverted position)-P | Intra &
Post OP Photo and scar Photo-C | detailed Procedure / Operative Notes-C | post
procedure clinical photograph-C
PAEDIATRI PS PS0000702 Gastrostomy + PS0000702000 Gastrostomy + Esophagoscopy + Threading 20000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Gastrostomy + Esophagoscopy + Threading Intra & Post OP Photo and scar Photo
C SURGERY Esophagoscopy + 01267 detailed Procedure / Operative Notes-C | Post procedure clinical photograph-C | X-ray /
Threading Esophagogram / USG/CT Abd / Endoscopy-P
PAEDIATRI PS PS0000709 GI Tumor Excision PS0000709000 GI Tumor Excision 30000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N GI Tumor Excision Clinical notes-P | Detailed Procedure / Operative Notes-C | HPR / Speciment Photo-C |
C SURGERY 01268 Intra procedure clinical photograph-C | USG/ CT / biopsy-P | detailed Procedure /
Operative Notes-C | detailed discharge summary-C
PAEDIATRI PS PS0000719 Groin Hernia PS0000719000 Groin Hernia Repair Obturator - GOVT RESERVED 21700 Yes 0 Yes 2 Yes Yes Secondary 2 No Yes Yes Govt Yes No No Surgical No Insurance N N N Mesh 15X15-2000 Max :2 Groin Hernia Repair Obturator - GOVT RESERVED Clinical notes-P | Clinical photograph-P | Intra & Post OP Photo and scar Photo
C SURGERY Repair 01269 Reserve detailed discharge summary Detailed Operative notes-C | Invoice of Mesh if used-C
PAEDIATRI PS PS0000739 Hepatic Resection PS0000739000 Hepatic Resection 32100 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hepatic Resection Clinical notes-P | Detailed Operative notes-C | Intra & Post OP Photo and scar Photo
C SURGERY 01270 Histopath /Specimen photo-C | USG/CT/MRI / confirming the justification of surgery-P |
detailed discharge summary-C
PAEDIATRI PS PS0000746 Hepatoblastoma PS0000746000 Hepatoblastoma Excision 59100 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hepatoblastoma Excision CT/ MRI-P | Clinical notes-P | Detailed Discharge Summary-C | HPE report-C | Intra &
C SURGERY Excision 01271 Post OP Photo and scar Photo
Procedure / Operative Notes-C | Planned line of treatment-P | Post Procedure
Photographs of surgical site-C
PAEDIATRI PS PS0000749 Hernia PS0000749000 Umbilical/Paraumbilical/Spigelian/Incisional hernia 22400 Yes 0 Yes 2 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh 15X15-2000 Max :2 Umbilical/Paraumbilical/Spigelian/Incisional hernia Clinical notes-P | Intra & Post OP Photo and scar Photo-C | detailed discharge summary
C SURGERY 01272 Detailed Operative notes +/- Invoice of Mesh if used-C | linical photograph-P
PAEDIATRI PS PS0000751 Hernia - PS0000751000 Hernia - Epigastric/ Ventral 20000 Yes 0 Yes 2 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh 15X15-2000 Max :2 Hernia - Epigastric/ Ventral Clinical notes-P | Intra & Post OP Photo and scar Photo, detailed discharge summary
C SURGERY Epigastric/ Ventral 01273 Detailed Operative notes +/- Invoice of Mesh if used-C
PAEDIATRI PS PS0000753 Hiatus Hernia PS0000753000 Hiatus Hernia Repair - Open/Hiatus Hernia Repair - 30400 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hiatus Hernia Repair - Open/Hiatus Hernia Repair - Clinical notes-P | Detailed Operative notes & discharge summary-C | Intra & Post OP
C SURGERY Repair / 01274 Lap/Fundoplication - Open(+/- Hiatus Hernia repair) /Anti Lap/Fundoplication - Open(+/- Hiatus Hernia repair) /Anti Photo and scar Photo-C | X-ray/ USG / UGI Endoscopy-P
Fundoplication GERD Surgery GERD Surgery
PAEDIATRI PS PS0000768 High inguinal PS0000768000 High inguinal Orchiectomy 13800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N High inguinal Orchiectomy Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT / Biopsy
C SURGERY Orchiectomy 01275 confirming testicular cancer-P | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000781 Hypospadias PS0000781000 Single stage Hypospadias repair - govt reserve 28000 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Single stage Hypospadias repair - govt reserve Clinical Photograph-P | Clinical notes-P | Intra & Post OP Photo and scar Photo-C |
C SURGERY repair 01276 Reserve detailed Procedure / Operative Notes-C | detailed discharge summary-C
PAEDIATRI PS PS0000781 Hypospadias PS0000781000 Two or more stage (Final Stage) / Fistula repair- govt reserve 20000 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes Yes No Surgical No Insurance N N N Two or more stage (Final Stage) / Fistula repair- govt reserve Clinical Photograph-P | Clinical notes-P | Evidence of stage 1 / 2 (Discharge Summary)-P
C SURGERY repair 01277 Reserve | Intra & Post OP Photo and scar Photo-C | detailed Procedure / Operative Notes-C |
PAEDIATRI PS PS0000781 Hypospadias PS0000781000 Two or more stage (First Stage) Hypospadias repair 13500 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Two or more stage (First Stage) Hypospadias repair Clinical Photograph-P | Clinical notes-P | Intra & Post OP Photo and scar Photo-C |
C SURGERY repair 01278 independently - govt reserve Reserve independently - govt reserve detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000801 Ileostomy PS0000801000 Ileostomy-Stand alone 14300 No 0 No 0 No No Tertiary 6 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N Ileostomy-Stand alone X-ray / USG / Endoscopy / Biopsy/ CT Scan confirming the diagnosis for which this
C SURGERY 01279 surgery is done-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge
summary-C | Intra & Post OP Photo and scar Photo-C
PAEDIATRI PS PS0000828 Intestinal PS0000828000 Intestinal obstruction- medical managment 6000 No 0 No 0 No No Secondary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Intestinal obstruction- medical managment Admission notes showing vitals-P | All investigations reports.-C | Any investigation
C SURGERY obstruction 01280 reports in support of diagnosis-P | Clinical notes detailing history-P | Detailed ICPs-C |
Detailed discharge summary-C | Examination findings-P | Intra & Post OP Photo and
scar Photo-C | Planned line of management-P | Treatment details-C
PAEDIATRI PS PS0000840 Intussusception PS0000840000 Non – Operative Reduction in infants 20000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Non – Operative Reduction in infants Clinical notes-P | Detailed discharge summary-C | Stills of: X-ray Abdomen/USG
C SURGERY 01281 Abdomen-P
PAEDIATRI PS PS0000840 Intussusception PS0000840000 Operative in infants 25000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Operative in infants Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
C SURGERY 01282 C | Stills of: X-ray Abdomen/USG Abdomen-P
PAEDIATRI PS PS000085 Appendicectomy PS0000850000 Appendicectomy 18000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Appendicectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
C SURGERY 1225 Histopathology report / Specimen Photo-C | Intra procedure clinical photograph of
removed appendix-C | USG confirming the diagnosis-P | post procedure clinical
photograph-C
PAEDIATRI PS PS000086 APPENDICO- PS0000860000 Appendicovesicostomy or Monti procedure 43000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Appendicovesicostomy or Monti procedure Clinical Notes-P | Clinical photograph-C | Detailed Discharge Summary-C | Examination
C SURGERY VESICOSTOMY/Mi 1226 details and relevant other investigations-P | Intra & Post OP Photo and scar Photo-C |
traffanof USG-P | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000888 LIVER / Spleen PS0000888000 Non-operative management of LIVER / Spleen trauma 40000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Non-operative management of LIVER / Spleen trauma Clinical notes-P | Detailed discharge summary-C | Stills of: X-ray Abdomen/USG
C SURGERY TRAUMA NON-OP 01283 Abdomen / CT abdomen-P
PAEDIATRI PS PS0000909 MALROTATION PS0000909000 Ladd's procedure 39000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ladd's procedure Detailed discharge summary-C | Intra & Post OP Photo and scar Photo-C | X-ray
C SURGERY 01284 abdomen or Ultrasound abdomen-P
PAEDIATRI PS PS0000933 Meatotomy / PS0000933000 Meatotomy/Meatoplasty 3500 Yes 1 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N GA-4400 Meatotomy/Meatoplasty Clinical notes-P | Confirmed diagnosis of meatal stenosis-P | Detailed discharge
C SURGERY Meatoplasty 01285 summary-C | detailed Procedure / Operative Notes-C
PAEDIATRI PS PS0000954 Mesenteric Cyst – PS0000954000 Mesenteric Cyst – Excision 17900 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Mesenteric Cyst – Excision Clinical notes-P | Histopath / Specimen Photo-C | Intra & Post OP Photo and scar Photo-
C SURGERY Excision 01286 C | X-ray / USG / CT / MRI report confirming the diagnosis-P | detailed discharge
summary and Detailed Operative notes-C
PAEDIATRI PS PS0000982 Nephrectomy PS0000982000 Nephrectomy For Benign pathology /Nephrectomy- Radical 28600 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrectomy For Benign pathology /Nephrectomy- Radical )+/- FNAC/Biopsy-P | Clinical notes-P | Histopath / Specimen Photo-C | Intra & Post OP
C SURGERY 01287 (Renal tumor) (Renal tumor) Photo and scar Photo-C | USG/CT confirming the need for surgery-P | detailed
discharge summary and Detailed Operative notes-C
PAEDIATRI PS PS0000985 Nephrectomy - PS0000985000 Nephrectomy - Partial or Hemi 40000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrectomy - Partial or Hemi CT/MRI confirming the need for surgery-P | Clinical notes-P | Histopathology /
C SURGERY Partial or Hemi 01288 Specimen Photo-C | Intra & Post OP Photo and scar Photo-C | detailed discharge
summary and Detailed Operative notes-C
PAEDIATRI PS PS0000988 Nephro PS0000988000 Nephro ureterectomy (Benign) 28600 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephro ureterectomy (Benign) Clinical notes-P | Histopathology / Specimen Photo-C | Intra & Post OP Photo and scar
C SURGERY ureterectomy 01289 Photo-C | USG / CT/ CT-IVP/MRI confirming the need for surgery-P | detailed discharge
(Benign) summary and Detailed Operative notes-C
PAEDIATRI PS PS0000991 Nephro PS0000991000 Nephro ureterectomy with cuff of bladder 29500 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephro ureterectomy with cuff of bladder Clinical notes-P | Detailed Operative notes-C | Histopathology / Specimen Photo-C |
C SURGERY ureterectomy 01290 Intra & Post OP Photo and scar Photo-C | USG / CT/ CT-IVP/MRI/MRI Urogram
with cuff of confirming the need for surgery-P | detailed discharge summary-C
bladder
PAEDIATRI PS PS0000996 Nephrostomy - PS0000996000 Nephrostomy - Percutaneous Image guided / Fluoroscopic 14000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Nephrostomy - Percutaneous Image guided / Fluoroscopic Clinical notes-P | Intra & Post OP Photo and scar Photo-C | USG confirming the
C SURGERY Percutaneous 01291 Guided Guided indication and need of procedure-P | detailed Procedure / Operative Notes-C | detailed
Image guided discharge summary-C
POLYTRAU PT PT0000117 Plexus injury along PT0000117700 Plexus injury along with Vascular injury graft/ Repair 60000 No 0 No 0 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Plexus injury along with Vascular injury graft/ Repair ) + /- EMG (Electromyography)-P | )+ /- MRA-P | )+ /- MRI-P | )+/- Nerve conduction
MA 7 with Vascular 001409 velocity (NCV)-P | Clinical notes-P | Detailed operatives notes-C | Detailing the injury
injury repair / and need of surgery-P | Intra operative still photograph-C | detailed discharge summary-
graft C
POLYTRAU PT PT0000289 Conservative PT0000289000 Conservative management of 0 Yes 0 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N ICU (with Ventilator)-6000 | ICU Conservative management of Admission notes showing vitals-P | All investigations reports.-C | Any investigations
MA management 01404 Chest/Abdomen/HNF/Pelvis(Blood transfusion and (without Ventilator)-4700 | Chest/Abdomen/HNF/Pelvis(Blood transfusion and done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Investigations included) Routine Ward-1800 Investigations included) summary-C | Examination findings-P | Planned line of management-P | Treatment
details-C
POLYTRAU PT PT0000917 Management of PT0000917000 Management of Chest injury with fixation of Single LIMB 30000 Yes 0 Yes 5 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :5 | Herbert Management of Chest injury with fixation of Single LIMB Clinical notes-P | Detailed operatives notes-C | Detailing the injury and need of surgery-
MA Chest injury with 01406 screw -2500 Max :5 | Per Plate/ P | Intra- op Clinical Photograph & X-rays showing chest injury repair and implant for
fracture of Long Nail -5000 Max :5 | k-wire-300 fixation-C | X-ray/ CT/ MRI (of both chest & affected long bone)-P | detailed discharge
bone Max :5 summary-C
POLYTRAU PT PT0000917 Management of PT0000917000 Management of Chest injury with fixation of 2 or more LIMB 45000 Yes 0 Yes 5 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :5 | Herbert Management of Chest injury with fixation of 2 or more LIMB Clinical notes-P | Detailed operatives notes-C | Detailing the injury and need of surgery-
MA Chest injury with 01405 screw -2500 Max :5 | Per Plate/ P | Intra- op Clinical Photograph & X-rays showing chest injury repair and implant for
fracture of Long Nail -5000 Max :5 | k-wire-300 fixation-C | X-ray/ CT/ MRI (of both chest & affected long bone)-P | detailed discharge
bone Max :5 summary-C
POLYTRAU PT PT0000923 Management of PT0000923000 Surgical intervention for Visceral injury and fixation of 39100 Yes 0 Yes 5 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :5 | Herbert Surgical intervention for Visceral injury and fixation of Clinical notes-P | Detailed operatives notes-C | Detailing the injury and need of surgery-
MA Visceral injury and 01408 fracture of single limb screw -2500 Max :5 | Per Plate/ fracture of single limb P | Intra- op Clinical Photograph & X-rays showing chest injury repair and implant for
fracture long bone Nail -5000 Max :5 | k-wire-300 fixation-C | X-ray/ CT/ MRI (of both affected viscera & affected long bone)-P | detailed
Max :5 discharge summary-C
POLYTRAU PT PT0000923 Management of PT0000923000 Surgical intervention for Visceral injury and fixation of 52100 Yes 0 Yes 5 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N CC-screw-1000 Max :5 | Herbert Surgical intervention for Visceral injury and fixation of Clinical notes-P | Detailed operatives notes-C | Detailing the injury and need of surgery-
MA Visceral injury and 01407 fracture of 2 or more llmb screw -2500 Max :5 | Per Plate/ fracture of 2 or more llmb P | Intra- op Clinical Photograph & X-rays showing chest injury repair and implant for
fracture long bone Nail -5000 Max :5 | k-wire-300 fixation-C | X-ray/ CT/ MRI (of both affected viscera & affected long bone)-P | detailed
Max :5 discharge summary-C
RADIATIO RO RO000010 2D External Beam RO000010000 Additional fractions - 18 Max upto (Every additional fraction 9000 Yes 0 Yes 20 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 18 Fraction - 2D External Additional fractions - 18 Max upto (Every additional fraction (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N Radiotherapy 01429 at Rs.500 per Fraction) Beam Radiotherapy (Telecobalt / at Rs.500 per Fraction) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG (Telecobalt / Strock LA) HPE report-P | Planned line of treatment-P
Y Strock LA) (6 Fractions)-500 Max :20
(6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000010 Palliative Care RO000010820 Hematuria Palliative Interventions 40000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Hematuria Palliative Interventions CBC-P | CECT/ x-Ray/USG-P | Clinical notes-P | Discharge summary with detail
N 82 Approach to 0001460 treatment and details of interventions and procedure done.-C | KFT-P | LFT-P |
ONCOLOG managing Planned line of treatment-P | Urine Culture-P
Y Haematuria in
advanced cancer
patients-
Endoscopic/
Surgical/
Radiological,
Radiotherpay
RADIATIO RO interventions
RO000010 Palliative Care RO000010880 Osteoradionecrosis -Surgical intervention 40000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Osteoradionecrosis -Surgical intervention CBC-P | CECT/ x-Ray/USG-P | Clinical notes-P | Discharge summary with detail
N 88 Management of 0001461 treatment & interventions-C | KFT-P | LFT-P | Planned line of treatment-P |
ONCOLOG Osteoradionecrosi Procedure notes.-C
Y s -Surgical
intervention
RADIATIO RO RO000010 Palliative RO000010910 Palliative neurological interventions 60000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Palliative neurological interventions CBC-P | CECT/ x-Ray/USG-P | Clinical notes-P | Discharge summary with detail
N 91 nerurosurgical 0001462 treatment & interventions-C | KFT-P | LFT-P | MRI-P | Planned line of treatment-P |
ONCOLOG interventions for Procedure notes.-C | blood sugar-P | thuroid profile-P
Y secondary
vertebral and
brain metastasis
RADIATIO RO RO000010 Palliative RO000010930 Palliative Radiological Interventions. Like- 20000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Palliative Radiological Interventions. Like- CBC-P | CECT/ X-Ray-P | Clinical notes-P | Discharge summary with detail treatment &
N 93 Radiological and 0001463 PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc interventions & Final bill with payment receipt.-C | KFT-P | LFT-P | Planned line of
ONCOLOG endoscopical treatment-P
Y Interventions
RADIATIO RO RO000010 Palliative surgical RO000010960 Palliative surgical interventions 40000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Palliative surgical interventions CBC-P | CECT/MRI/ x-Ray-P | Clinical notes with planned line of treatment-P |
N 96 interventions like- 0001464 Discharge summary with detail treatment & interventions-C | KFT-P | LFT-P |
ONCOLOG Colostomy, Procedure notes.-C
Y Tracheostomy,
Feeding
Jejunostomy/Gast
rostomy, Bowel
bypas, Fistulas,
Urinary diversions
etc.in advanced
cancer patients
RADIATIO RO RO000011 2D External Beam RO000011000 Adjuvant/Neoadjuvant 11000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Adjuvant/Neoadjuvant (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N Radiotherapy 01430 Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG (Telecobalt / HPE report-P | Planned line of treatment-P
Y Strock LA)
(6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000011 2D External Beam RO000011000 Radical 11000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Radical (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N Radiotherapy 01431 Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG (Telecobalt / HPE report-P | Planned line of treatment-P
Y Strock LA)
(6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000011 PET scan RO000011600 PET scan 14000 Yes 1 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N PET scan Admission notes showing vitals-P | All investigations reports including PETs scan report.-
N 60 0001465 C | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
ONCOLOG Detailed discharge summary-C | Examination findings-P | Planned line of management-
Y P | Treatment details-C
RADIATIO RO RO000012 Respiratory Gating RO000012770 Additional fractions - 10 Max upto 35000 Yes 0 Yes 20 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 10 Fraction - Respiratory Additional fractions - 10 Max upto (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 77 along with Linear 0001466 Every additional fraction at Rs.3500 per Fraction Gating along with Linear Every additional fraction at Rs.3500 per Fraction Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Accelerator Accelerator planning (5 Fractions)- HPE report-P | Planned line of treatment-P
Y planning (5 3500 Max :20
Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000012 Respiratory Gating RO000012770 Respiratory Gating along with Linear Accelerator planning 65000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Respiratory Gating along with Linear Accelerator planning Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
N 77 along with Linear 0001467 Documentary evidence confirming the need of Respiratory-gated radiotherapy (tumours
ONCOLOG Accelerator that move with respiration during radiotherapy (lung, breast and upper abdominal
Y planning (5 tumpurs)-P
Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000013 SRS with IGRT RO000013700 SRS with IGRT (Stereotacatic radiotherapy) 70000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N SRS with IGRT (Stereotacatic radiotherapy) Biopsy/ HPE report of malignancy-P | Detailed Discahrge Summary (with RT treatment
N 70 (Stereotacatic 0001468 and doses given)-C | Justification of SRS?-P
ONCOLOG radiotherapy)
Y (Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000013 SRT / SBRT with RO000013710 Additional fractions - 4 44000 Yes 0 Yes 10 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 4 Fraction - SRT / SBRT with Additional fractions - 4 Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
N 71 IGRT 0001469 Every additional fraction at Rs.11000 per Fraction IGRT Every additional fraction at Rs.11000 per Fraction HPE report-P | Planned line of treatment-P | documents confirming the Procedure
ONCOLOG (Stereotacatic (Stereotacatic radiotherapy) (4 indicated and details of RT treatment plan)-P
Y radiotherapy) Fractions)-11000 Max :10
(4 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000013 SRT / SBRT with RO000013710 SRT / SBRT with IGRT 82000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N SRT / SBRT with IGRT Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
N 71 IGRT 0001470 (Stereotacatic radiotherapy) (Stereotacatic radiotherapy) HPE report-P | Planned line of treatment-P | documents confirming the Procedure
ONCOLOG (Stereotacatic indicated and details of RT treatment plan)-P
Y radiotherapy)
(4 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000015 Vertebroplasty/Ky RO000015430 Vertebroplasty/Kyphoplasty - Govt reserved 40000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Medical No Insurance N N N Vertebroplasty/Kyphoplasty - Govt reserved CBC-P | CECT/MRI/ x-Ray-P | Clinical notes-P | Discharge summary with detail
N 43 phoplasty 0001471 Reserve treatment & interventions-C | KFT-P | LFT-P | Planned line of treatment-P |
ONCOLOG Procedure notes-C
Y
RADIATIO RO RO000016 Brachytherapy RO000016000 Intracavitory/Intraluminal/Endobiliary/Endobronchial/CVS 3500 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N Intracavitory/Intraluminal/Endobiliary/Endobronchial/CVS (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 0 High Dose 001433 Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiation (2D/X- HPE report-P | Planned line of treatment-P
Y ray)
(Maximum of 4
session)
RADIATIO RO RO000016 Brachytherapy RO000016100 Additional fractions - 11 Max upto 18000 Yes 0 Yes 15 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 11 Fraction - Brachytherapy Additional fractions - 11 Max upto (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 1 High Dose 001434 Every additional fraction at Rs.1600 per Fraction High Dose Radiation (5 doses)- Every additional fraction at Rs.1600 per Fraction Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiation (5 1600 Max :15 HPE report-P | Planned line of treatment-P
Y doses)
(Inclusive of
Simulation,
Planning Cost, OT
& other charges )
RADIATIO RO RO000016 Brachytherapy RO000016100 Interstitial / Intracavitary complex planning like CT or 42000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Interstitial / Intracavitary complex planning like CT or (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 1 High Dose 001435 MR/Surface Mould / Intracavitary complex planning like CT MR/Surface Mould / Intracavitary complex planning like CT Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiation (5 or MR or MR HPE report-P | Planned line of treatment-P
Y doses)
(Inclusive of
Simulation,
Planning Cost, OT
& other charges )
RADIATIO RO RO000051 Advanced / high RO000051000 Advanced / high end investigations in oncology 0 Yes 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical Yes Insurance Y N N Advanced / high end Advanced / high end investigations in oncology Clinical notes with indication for highend investigations.-P | Detailed Discahrge Summary-
N end investigations 01432 / day care investigations in oncology-10000 C | Highend investigation Reports.-C
ONCOLOG in oncology
Y
RADIATIO RO RO000058 EUA separate add RO000058900 EUA only in GA separate - add on package 3000 No 0 No 0 No No Secondary 0 No Yes Yes Add On No No No Surgical No Insurance N N N EUA only in GA separate - add on package Clinical Notes for the associated surgery / disease along with Pre OP-C | Clinical Notes
N 9 on package 001436 justifying the need for GA in the associated surgery-P | Operative and Anesthesia-C |
ONCOLOG Post OP notes-C
Y
RADIATIO RO RO00008 2D External Beam RO000080000 Palliative 10000 No 0 No 0 No No Tertiary 30 No Yes Yes Regular PKG No Yes No Medical No Insurance N N N Palliative (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N Radiotherapy - 1426 Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Palliative HPE report-P | Planned line of treatment-P
Y (Telecobalt /
Strock LA)
(Upto 10
Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000084 Iodine treatment RO000084200 Iodine treatment 100 mCi 20000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Iodine treatment 100 mCi Clinical Photograph-P | Clinical notes confirming the diagnosis Clinical Photograph; -P |
N 2 100 mCi 001437 Detailed Operative notes-C | FNAC if done-P | Histopath-C | Post procedure clinical
ONCOLOG photograph-C | detailed discharge summary-C
Y
RADIATIO RO RO000084 Iodine treatment RO000084300 Iodine treatment 150 mCi 27000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Iodine treatment 150 mCi Clinical Photograph-P | Clinical notes detailing the original pathology thet has led to this
N 3 150 mCi 001438 surgery -P | Detailed Operative notes-C | Detailed discharge summary-C | Intra
ONCOLOG procedure clinical photograph-C | Post procedure clinical photograph (if flap taken from
Y other site; even of donor site)-C | suporting investigation reports-P
RADIATIO RO RO000084 Iodine treatment RO000084400 Iodine treatment 200 mCi 31000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Iodine treatment 200 mCi Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Histopath-C |
N 4 200 mCi 001439 Post procedure clinical photograph-C | USG/CT/MRI report confirming the diagnosis-P |
ONCOLOG detailed discharge summary-C
Y
RADIATIO RO RO000084 Iodine treatment RO000084500 Iodine treatment 250 mCi 36000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Iodine treatment 250 mCi Clinical notes-P | Detailed Operative notes-C | FNAC/ Biopsy/ Thyroid Function
N 5 250 mCi 001440 Test/USG confirming the diagnosis and need for surgery-P | Histopath report-C | Post
ONCOLOG procedure clinical photograph-C | detailed discharge summary-C
Y
RADIATIO RO RO000084 iodine treatment 3 RO000084600 large Dose scan/ Pre Ablation - calculation of treatment 10000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N large Dose scan/ Pre Ablation - calculation of treatment Biopsy of the lsoion-P | CT Scan/ Colonoscopy confirming the diagnosis and need of
N 6 mCi 001441 surgery-P | Clinical notes-P | Detailed Operative notes-C | Histopathology-C | Intra
ONCOLOG procedure clinical photograph-C | detailed discharge summary-C
Y
RADIATIO RO RO000084 iodine treatment RO000084700 Ablation residual disease any risk 15000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Ablation residual disease any risk Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Detailed
N 7 30 mCi 001442 discharge summary-C | FIR/MLC in case of traumatic aetiology-P | Post procedure
ONCOLOG clinical photograph-C | detailing the original pathology thet has led to this surgery-P |
Y suporting investigation reports-P
RADIATIO RO RO000084 Iodine treatment RO000084800 Ablation of residual neck disease low/intermediate 16000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Ablation of residual neck disease low/intermediate Admission notes showing vitals-P | All investigations reports.-C | Any investigations
N 8 50 mCi 001443 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
ONCOLOG summary-C | Examination findings-P | Planned line of management-P | Treatment
Y details-C
RADIATIO RO RO000088 Linear Accelerator RO000088200 Additional fractions - 15 Max upto 37500 Yes 0 Yes 20 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 15 Fraction - Linear Additional fractions - 15 Max upto (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 2 External Beam 001444 (Every additional fraction at Rs.2500 per Fraction) Accelerator External Beam (Every additional fraction at Rs.2500 per Fraction) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiotherapy Radiotherapy IGRT (Image HPE report-P | Planned line of treatment-P
Y IGRT (Image Guided radiotherapy) with 3D
Guided CRT or IMRT-2500 Max :20
radiotherapy) with
3D CRT or IMRT
(20 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear Accelerator RO000088200 Linear Accelerator External Beam Radiotherapy IGRT (Image 90000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Linear Accelerator External Beam Radiotherapy IGRT (Image (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 2 External Beam 001445 Guided radiotherapy) with 3D CRT or IMRT Guided radiotherapy) with 3D CRT or IMRT Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiotherapy (20 Fractions) (20 Fractions) HPE report-P | Planned line of treatment-P
Y IGRT (Image (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost)
Guided
radiotherapy) with
3D CRT or IMRT
(20 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear Accelerator RO000088300 Additional fractions - 18 Max upto 45000 Yes 0 Yes 20 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 18 Fraction - Linear Additional fractions - 18 Max upto (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 3 External Beam 001446 Every additional fraction at Rs.2500 per Fraction Accelerator External Beam Every additional fraction at Rs.2500 per Fraction Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiotherapy Radiotherapy IGRT (Image HPE report-P | Planned line of treatment-P
Y IGRT (Image Guided radiotherapy) with 3D
Guided CRT or IMRT-2500 Max :20
radiotherapy) with
3D CRT or IMRT
(6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear Accelerator RO000088300 Linear Accelerator External Beam Radiotherapy IGRT (Image 55000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Linear Accelerator External Beam Radiotherapy IGRT (Image (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 3 External Beam 001447 Guided radiotherapy) with 3D CRT or IMRT Guided radiotherapy) with 3D CRT or IMRT Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG Radiotherapy (6 Fractions) (6 Fractions) HPE report-P | Planned line of treatment-P
Y IGRT (Image (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost)
Guided
radiotherapy) with
3D CRT or IMRT
(6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear RO000088400 Additional fractions - 10 Max upto (Every additional fraction 10000 Yes 0 Yes 12 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 10 Fraction - Linear Additional fractions - 10 Max upto (Every additional fraction (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 4 Accelerator, 001448 at Rs.1000 per Fraction) Accelerator, External Beam at Rs.1000 per Fraction) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam Radiotherapy 3D CRT (25 HPE report-P | Planned line of treatment-P
Y Radiotherapy 3D Fractions)-1000 Max :12
CRT (25 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear RO000088400 Linear Accelerator, External Beam Radiotherapy 3D CRT (25 40000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Linear Accelerator, External Beam Radiotherapy 3D CRT (25 (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 4 Accelerator, 001449 Fractions) Fractions) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost) HPE report-P | Planned line of treatment-P
Y Radiotherapy 3D
CRT (25 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear RO000088500 Additional fractions - 18 Max upto (Every additional fraction 18000 Yes 0 Yes 20 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 18 Fraction - Linear Additional fractions - 18 Max upto (Every additional fraction (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 5 Accelerator, 001450 at Rs.1000 per Fraction) Accelerator, External Beam at Rs.1000 per Fraction) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam Radiotherapy 3D CRT (6 HPE report-P | Planned line of treatment-P
Y Radiotherapy 3D Fractions)-1000 Max :20
CRT (6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear RO000088500 Linear Accelerator, External Beam Radiotherapy 3D CRT (6 21000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Linear Accelerator, External Beam Radiotherapy 3D CRT (6 (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 5 Accelerator, 001451 Fractions) Fractions) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost) HPE report-P | Planned line of treatment-P
Y Radiotherapy 3D
CRT (6 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000088 Linear RO000088600 Additional fractions - 15 (Every additional fraction at 30000 Yes 0 Yes 20 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 15 Fraction - Linear Additional fractions - 15 (Every additional fraction at Rs.2000 (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 6 Accelerator, 001452 Rs.2000 per Fraction) Accelerator, External Beam per Fraction) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam Radiotherapy IMRT (Intensity HPE report-P | Planned line of treatment-P
Y Radiotherapy Modulated Radiotherapy)
IMRT (Intensity (20 Fractions)-2000 Max :20
Modulated
Radiotherapy)
(20 Fractions)
(Inclusive of
Simulation &
RADIATIO RO RO000088 Planning
Linear Cost) RO000088600 Linear Accelerator, External Beam Radiotherapy IMRT 70000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Linear Accelerator, External Beam Radiotherapy IMRT (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 6 Accelerator, 001453 (Intensity Modulated Radiotherapy) (Intensity Modulated Radiotherapy) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam (20 Fractions) (20 Fractions) HPE report-P | Planned line of treatment-P
Y Radiotherapy (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost)
IMRT (Intensity
Modulated
Radiotherapy)
(20 Fractions)
(Inclusive of
Simulation &
RADIATIO RO Planning Cost)
RO000088 Linear RO000088700 Additional fractions - 18 Max upto (Every additional fraction 36000 Yes 0 Yes 25 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 18 Fraction - Linear Additional fractions - 18 Max upto (Every additional fraction Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
N 7 Accelerator, 001454 at Rs.2000 per Fraction) Accelerator, External Beam at Rs.2000 per Fraction) HPE report-P | Planned line of treatment-P
ONCOLOG External Beam Radiotherapy IMRT (Intensity
Y Radiotherapy Modulated Radiotherapy)
IMRT (Intensity (6 Fractions)-2000 Max :25
Modulated
Radiotherapy)
(6 Fractions)
(Inclusive of
Simulation &
RADIATIO RO Planning Cost)
RO000088 Linear RO000088700 Linear Accelerator, External Beam Radiotherapy IMRT 36500 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N Linear Accelerator, External Beam Radiotherapy IMRT (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N 7 Accelerator, 001455 (Intensity Modulated Radiotherapy) (Intensity Modulated Radiotherapy) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG External Beam (6 Fractions) (6 Fractions) HPE report-P | Planned line of treatment-P
Y Radiotherapy (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost)
IMRT (Intensity
Modulated
Radiotherapy)
(6 Fractions)
(Inclusive of
Simulation &
RADIATIO RO RO00009 Planning
2D Cost)
External Beam RO000090000 2D External Beam Radiotherapy (Telecobalt / Strock LA) 20000 No 0 No 0 Yes No Tertiary 100 No Yes Yes Regular PKG Yes No No Medical No Insurance N N N 2D External Beam Radiotherapy (Telecobalt / Strock LA) (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N Radiotherapy 1427 (25 Fractions) (25 Fractions) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG (Telecobalt / (Inclusive of Simulation & Planning Cost) (Inclusive of Simulation & Planning Cost) HPE report-P | Planned line of treatment-P
Y Strock LA)
(25 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO00009 2D External Beam RO000090000 Additional fractions - 10 Max upto (additional fraction at 5000 Yes 0 Yes 15 Yes No Tertiary 100 No Yes Yes Regular PKG Yes Yes No Medical No Insurance N N N After 10 Fraction - 2D External Additional fractions - 10 Max upto (additional fraction at (documents confirming the Procedure indicated and details of RT treatment plan)-P |
N Radiotherapy 1428 Rs.500 per Fraction upto a max) Beam Radiotherapy (Telecobalt / Rs.500 per Fraction upto a max) Clinical notes-P | Detailed Discahrge Summary (with RT treatment and doses given)-C |
ONCOLOG (Telecobalt / Strock LA) (25 Fractions) -500 HPE report-P | Planned line of treatment-P
Y Strock LA) Max :15
(25 Fractions)
(Inclusive of
Simulation &
Planning Cost)
RADIATIO RO RO000090 Malignant Pleural RO000090400 Pleural effusion & Pleurodesis 5500 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Pleural effusion & Pleurodesis CBC-P | CECT/ x-Ray/USG-P | Clinical notes-P | Discharge summary with detail
N 4 Effusion for 001456 treatment & interventions-C | KFT-P | LFT-P | Planned line of treatment-P |
ONCOLOG Pleural tap with Procedure notes.-C
Y Pig tail
catheter/chest
tube insertion
with Pleurodesis
in advanced
cancer patients
RADIATIO RO RO000090 Malignant Spinal RO000090800 Malignant Spinal cord compression 15000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Malignant Spinal cord compression CBC-P | CECT/MRI/ x-Ray-P | Clinical notes-P | Discharge summary with detail
N 8 Cord compression 001457 treatment & interventions-C | KFT-P | LFT-P | Planned line of treatment-P |
ONCOLOG with Diagnostics, Procedure notes.-C
Y palliative
radiotherapy,
Brace in advanced
cancer patients
RADIATIO RO RO000091 Management of RO000091000 Trans arterial Embolization 60000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Trans arterial Embolization CBC-P | CT Angio-P | Clinical notes-P | Discharge summary with detail treatment &
N 0 bleeding in 001458 interventions-C | KFT-P | LFT-P | Planned line of treatment-P | Procedure notes.-C
ONCOLOG malignant head
Y and neck /
inguinal
malignancies
RADIATIO RO RO000091 Management of RO000091300 Haemostatic Surgery in advance cancer patient/Haemostatic 40000 No 0 No 0 No No Tertiary 100 No Yes Yes Regular PKG No No No Medical No Insurance N N N Haemostatic Surgery in advance cancer patient/Haemostatic CBC-P | CT Angio-P | Clinical notes-P | Discharge summary with detail treatment &
N 3 bleeding 001459 Radiotherapy Radiotherapy interventions-C | KFT-P | LFT-P | Planned line of treatment-P | Procedure notes.-C
ONCOLOG malignant head
Y and neck /
inguinal lesions
PLASTIC & RP RP0000100 Nerve RP0000100800 Nerve Transposition/ Nerve Release/ Nerve 13000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Nerve Transposition/ Nerve Release/ Nerve Clinical notes justifying surgery with evidence of MRI / EMG/ NCV-P | Detailed Discharge
RECONSTR 8 Transposition / 001373 Neurolysis/Nerve repair surgery Neurolysis/Nerve repair surgery summary-C | Intra & Post Procedure still images-C | detailed Procedure / Operative
UCTIVE Release / Notes-C
SURGERY Neurolysis
PLASTIC & RP RP0000101 NPWT RP0000101900 NPWT 0 Yes 7 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N NPWT-1500 NPWT Clinical notes-P | Daily patient Photo-C | Detailed Procedure / Operative Notes-C |
RECONSTR 9 001374 Detailing events that led to chronic/ non healing woulds-P | Post procedure clinical
UCTIVE photograph with tube and pump-C | clinical photograph-P | detailed discharge
SURGERY summary-C
PLASTIC & RP RP0000103 Open reduction RP0000103300 Open reduction and internal fixation of maxilla/Open 14000 Yes 0 Yes 3 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Implant for Open reduction and Open reduction and internal fixation of maxilla/Open Clinical Photograph or relevent investigations-P | Clinical notes-P | Intra & Post
RECONSTR 3 and internal 001375 reduction and internal fixation of mandible/Open reduction internal fixation of maxilla / reduction and internal fixation of mandible/Open reduction Procedure Photograph of affected part-C | Procedure / Operative Notes-C | X Ray / CT-
UCTIVE fixation of maxilla and internal fixation of zygoma mandible / zygoma (Plates / and internal fixation of zygoma P | X-ray-C
SURGERY / mandible / Screws) -4000 Max :3
zygoma
PLASTIC & RP RP0000108 Palliative Care RP0000108600 Pressure sore-Interventions 21700 No 0 No 0 No No Secondary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pressure sore-Interventions Clinical Photograph or relevent investigations-P | Clinical notes and Clinical Photograph
RECONSTR 6 approach to 001376 or relevent investigations-C | Clinical notes-P | Wound Photo-P | scar photo-C
UCTIVE managing
SURGERY Pressure sore in
advanced chronic
diseases who are
bed ridden-
Surgical
PLASTIC & RP RP0000119 Post Burn RP0000119100 Post Burn Contracture surgeries for Functional 40000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Post Burn Contracture surgeries for Functional Clinical history detailing the burns - etiology, treatment given and resultant contractures
RECONSTR 1 Contracture 001377 Improvement (Package including splints, pressure garments, Improvement (Package including splints, pressure garments, left-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C |
UCTIVE surgeries for silicone - gel sheet and physiotherapy): Contracture release silicone - gel sheet and physiotherapy): Contracture release Functional disability to be detailed and expected functional improvement to be shared-P
SURGERY Functional with - Split thickness Skin Graft (STSG) / Full Thickness Skin with - Split thickness Skin Graft (STSG) / Full Thickness Skin | Post Treatment clinical photograph-C | Pre-op clinical photograph-P | X-ray-P
Improvement Graft (FTSG) / Flap cover is done for each joint with post - Graft (FTSG) / Flap cover is done for each joint with post -
operative regular dressings for STSG / FTSG / Flap cover. operative regular dressings for STSG / FTSG / Flap cover.
PLASTIC & RP RP0000124 Reconstruction RP0000124400 Tissue Reconstruction Flap / Flap Reconstructive Surgery / 25000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tissue Reconstruction Flap / Flap Reconstructive Surgery / Biopsy report in case of Malignancy-C | Biopsy report in case of Malignancy-P | Clinical
RECONSTR 4 Flap 001378 Rotation flap Rotation flap notes-P | Clinical photograph of affected part justifying surgery-P | Detailed Operative
UCTIVE notes-C | Detailed discharge summary-C | Intra procedure clinical photograph-C | Post
SURGERY procedure clinical photograph (if flap taken from other site; even of donor site)-C
PLASTIC & RP RP0000125 Regional flap RP0000125400 Myocutaneous flap/Fasciocutaneous flap - add on 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Add On Yes No No Surgical No Insurance N N N Myocutaneous flap/Fasciocutaneous flap - add on Biopsy report in case of Malignancy-C | Biopsy report in case of Malignancy-P | Clinical
RECONSTR 4 001379 notes-P | Clinical photograph of affected part justifying surgery-P | Detailed Operative
UCTIVE notes-C | Detailed discharge summary-C | Intra procedure clinical photograph-C | Post
SURGERY procedure clinical photograph (if flap taken from other site; even of donor site)-C
PLASTIC & RP RP0000126 Repair of tongue RP0000126900 Repair of tongue laceration 14000 No 0 No 0 No No tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Repair of tongue laceration Clinical notes-P | Clinical photo-P | Detailed Discharge summary-C | Examination
RECONSTR 9 laceration 001380 details-P | Post op clinical photgraph-C | detailed Procedure / Operative Notes-C
UCTIVE
SURGERY
PLASTIC & RP RP0000128 Revascularization RP0000128400 Revascularization of limb / digit (single digit) 20000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Revascularization of limb / digit (single digit) Investigation-P | Clinical Photograph-P | Clinical notes-P | Detailed Procedure /
RECONSTR 4 of limb / digit 001381 Operative Notes-C | Detailed discharge summary-C | Doppler / CT Angio-P | Intra
UCTIVE procedure clinical photograph-C
SURGERY
PLASTIC & RP RP0000128 Revascularization RP0000128400 Revascularization of limb / digit(more than one digit) 60000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Revascularization of limb / digit(more than one digit) Investigation-P | Clinical Photograph-P | Clinical notes-P | Detailed Procedure /
RECONSTR 4 of limb / digit 001382 Operative Notes-C | Detailed discharge summary-C | Doppler / CT Angio-P | Intra
SURGERY
PLASTIC & RP RP0000130 Scalp avulsion RP0000130900 Scalp avulsion reconstruction 40000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Scalp avulsion reconstruction Investigation detailing how avulsion occurred-P | Clinical Photograph-P | Clinical notes-
RECONSTR 9 reconstruction 001383 P | Detailed Procedure / Operative Notes-C | Intra procedure clinical photograph-C |
UCTIVE Post procedure clinical photograph-C | detailed discharge summary-C
SURGERY
PLASTIC & RP RP0000136 Split thickness skin RP0000136700 Large (>4% TBSA) 13500 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Large (>4% TBSA) Clinical Photograph-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
RECONSTR 7 grafts 001384 Detailing time of Burns /Truma-P | Post procedure clinical photograph-C | detailed
UCTIVE discharge summary-C
SURGERY
PLASTIC & RP RP0000136 Split thickness skin RP0000136700 small (< 4% TBSA) 10000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N small (< 4% TBSA) Clinical Photograph-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
RECONSTR 7 grafts 001385 Detailing time of Burns /Truma-P | Post procedure clinical photograph-C | detailed
UCTIVE discharge summary-C
SURGERY
PLASTIC & RP RP0000142 Tendon Grafting / RP0000142700 Tendon Grafting / Tendon Repair / Tendon transfer 15000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Tendon Grafting / Tendon Repair / Tendon transfer Clinical notes-P | Clinical photograph of affected part with damaged tendon-P | Detailed
RECONSTR 7 Repair 001386 discharge summary-C | Detailing jusification of surgery-P | Intra & Post Procedure
UCTIVE clinical photgraph of donor and receipent sites-C | detailed Procedure / Operative Notes-
SURGERY C
PLASTIC & RP RP0000142 Tendon Release / RP0000142900 Tendon Release / Tenotomy / Tenolysis 5000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tendon Release / Tenotomy / Tenolysis Clinical notes -P | Clinical photograph of affected part with damaged tendon-P |
RECONSTR 9 Tenotomy 001387 Detailed discharge summary-C | Detailing jusification of surgery-P | Intra & Post
UCTIVE Procedure clinical photgraph of donor and receipent sites-C | detailed Procedure /
SURGERY Operative Notes-C
PLASTIC & RP RP0000144 Tissue Expander RP0000144800 Tissue Expander for disfigurement following burns / trauma 50000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Tissue Expander for disfigurement following burns / trauma Clinical Photograph-P | Detailed Clinical notes of original clinical event having led to
RECONSTR 8 for disfigurement 001388 / congenital deformity / congenital deformity disfigurement or confirming details / invetsigations of congenital event-P | Detailed
UCTIVE following burns / (including cost of expander / implant) (including cost of expander / implant) discharge summary-C | Intra & Post Procedure clinical photgraph of donor and receipent
SURGERY trauma / sites-C | Invoice of expander/Implant used-C | detailed Procedure / Operative Notes-C
congenital
deformity
(including cost of
expander /
implant)
PLASTIC & RP RP0000145 TM joint ankylosis RP0000145000 TM joint ankylosis of both jaws - under GA 0 Yes 1 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N TM joint ankylosis of both jaws - TM joint ankylosis of both jaws - under GA Clinical Photograph-P | Detailed discharge summary-C | Intra & Post Procedure clinical
RECONSTR 0 of both jaws - 001389 (Unilateral) / (Bilateral) under GA - Bilateral-25000 | (Unilateral) / (Bilateral) photgraph of donor and receipent sites-C | X-Ray of affected area / CT-P | X-Ray-C |
UCTIVE under GA Unilateral-15000 detailed Procedure / Operative Notes-C
SURGERY
PLASTIC & RP RP0000146 Bone grafting for RP0000146000 Bone grafting for Fracture Non union 10000 No 0 No 0 No No Secondary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone grafting for Fracture Non union Clinical notes detailing earlier surgery that resulted in non-union and radiological-P |
RECONSTR Non union 01348 Clinical photograph-P | Detailed Procedure / Operative Notes-C | Detailed discharge
UCTIVE summary-C | Post Procedure clinical photgraphof donor and recipient sites-C | Post
SURGERY procedure imaging study (X Ray)-C | investigations confirming the diagnosis (X-ray of
affected joint)-P
PLASTIC & RP RP0000152 Vascular RP0000152700 Vascular reconstruction with or without vein graft 50000 No 0 No 0 No No Tertiary 9 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Vascular reconstruction with or without vein graft CT Angio-P | Clinical notes-P | Clinical photograph of affected part-P | Detailed
RECONSTR 7 reconstruction 001390 discharge summary-C | Detailing jusification of surgery-P | Intra & Post Procedure
UCTIVE clinical photgraph of donor and receipent sites-C | detailed Procedure / Operative Notes-
SURGERY C | vein graft donner site photo-C
PLASTIC & RP RP0000153 Vascular RP0000153000 Vascular reconstruction with Graft/Patch 35000 Yes 0 Yes 1 Yes No Tertiary 9 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N PTFE Graft Large (>8mm)-50000 Vascular reconstruction with Graft/Patch CT Angio-P | Clinical notes-P | Clinical photograph of affected part-P | Detailed
RECONSTR 0 reconstruction 001391 Max :1 | PTFE Patch - Thin- discharge summary-C | Detailing jusification of surgery-P | Intra & Post Procedure
UCTIVE with graft/patch 30000 Max :1 | PTFE graft small clinical photgraph of donor and receipent sites-C | detailed Procedure / Operative Notes-
SURGERY (upto 8 mm ) -30000 Max :1 C | vein graft donner site photo-C
PLASTIC & RP RP0000159 Brachial Plexus – RP0000159000 Brachial Plexus repair 31300 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Brachial Plexus repair MRI / EMG / NCV report-P | Clinical notes-P | Detailed Procedure /Operative Notes.-C
RECONSTR Repair 01349 | Detailed discharge summary-C | Intra & Post procedure and clinical photo showing
UCTIVE scarm-C | Investigation report-P | Pre OP Photo-P
SURGERY
PLASTIC & RP RP0000166 Breast Lump RP0000166000 Breast Lump Excision (Benign) under GA/RA 10000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Breast Lump Excision (Benign) under GA/RA )+/- FNAC report-P | Clinical notes, -P | Detailed Operative notes-C | Detailed
RECONSTR Excision (Benign) 01350 discharge summary.-C | Histopathology report-C | Sono mammogram OR Mamography
UCTIVE showing breast lump-P | intra operative clinical photograph-C
SURGERY
PLASTIC & RP RP0000229 Cleft Lip and RP0000229000 Cleft Lip and Palate Surgery (per stage) 15000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Cleft Lip and Palate Surgery (per stage) Clinical Photograph-P | Clinical notes and investigation-P | Detailed Procedure /
RECONSTR Palate Surgery 01351 Operative Notes-C | Detailed discharge summary-C | Post procedure clinical
UCTIVE (per stage) photograph-C
SURGERY
PLASTIC & RP RP0000235 Closed reduction / RP0000235000 Closed reduction / intermaxillary fixation for fracture of 5000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Closed reduction / intermaxillary fixation for fracture of Intra & Post Procedure Photograph of affected part-C | MLC/FIR for traumatic injuries
RECONSTR intermaxillary 01352 maxilla / mandible / zygoma/ Nasal maxilla / mandible / zygoma/ Nasal and circumstances of the incident which led to fracture-P | Procedure / Operative Notes-
UCTIVE fixation for C | X Ray/CT-P | X-ray-C
SURGERY fracture of maxilla
/ mandible /
zygoma/ Nasal
PLASTIC & RP RP0000263 Congenital Hand RP0000263000 Per stage of Syndactyly/Polydactyly/Macrodactyly 20000 Yes 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Per wire-300 Max :10 Per stage of Syndactyly/Polydactyly/Macrodactyly Admission notes showing vitals-P | Any investigations done-P | Clinical notes detailing
RECONSTR Anomaly 01353 history-P | Examination findings-P | Intra & Post Procedure Photograph of affected part-
UCTIVE (Syndactyly, C | Procedure / Operative Notes-C
SURGERY Polydactyly,
Macrodactyly)
PLASTIC & RP RP0000277 Conservative RP0000277000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone Admission notes showing vitals-P | All investigations reports-C | Any investigations
RECONSTR Management 01354 stand alone-1800 done-P | Clinical notes detailing history-P | Daily patient Photo-C | Detailed ICPs-C |
UCTIVE Detailed discharge summary-C | Examination findings-P | Planned line of management-
SURGERY P | Treatment details-C
PLASTIC & RP RP0000286 Conservative RP0000286000 Conservative Management - 0 Yes 3 No 0 Yes No Tertiary 3 Yes Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - Admission notes showing vitals-P | All investigations reports-C | Any investigations
RECONSTR Management of 01355 (Chest/Head/Face/Abdomen)stand alone (Chest / Head / Face / Abdomen) (Chest/Head/Face/Abdomen)stand alone done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
UCTIVE injury stand alone-1800 summary-C | Examination findings-P | Planned line of management-P | Treatment
SURGERY details-C
PLASTIC & RP RP0000486 Dentoalveolar RP0000486000 Dentoalveolar trauma - wiring (dental /trauma wiring- one 3000 Yes 0 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Dentoalveolar trauma - wiring (dental /trauma wiring- one Clinical Photograph-P | Dental IOPA-Xray / OPG (Orthopantomogram) /CT-P | Detailed
RECONSTR trauma - wiring 01356 jaw) jaw) Procedure / Operative Notes-C | Detailed discharge summary-C | Post procedure
UCTIVE clinical photograph-C | X-ray-C
SURGERY
PLASTIC & RP RP0000519 Duputryen’s RP0000519000 Duputryen’s Contracture release + rehabilitation 9500 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Duputryen’s Contracture release + rehabilitation Clinical notes-P | Clinical photograph of affected part confirming the diagnosis-P |
RECONSTR Contracture 01357 Detailed discharge summary-C | Intra & Post Procedure clinical photgraph-C | detailed
UCTIVE release + Procedure / Operative Notes.-C
SURGERY rehabilitation
PLASTIC & RP RP0000525 Ear RP0000525000 Stage-1 & Subsequent stages 0 Yes 1 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Stage-1-35000 | Subsequent Stage-1 & Subsequent stages Clinical notes-P | Clinical photograph of affected part confirming the diagnosis-P |
RECONSTR Reconstruction 01358 stages-20000 Detailed Operative notes-C | Detailed discharge summary-C | Intra & Post procedure
UCTIVE clinical photograph-C | Scar Photo-C
SURGERY
PLASTIC & RP RP0000582 Estlander RP0000582000 Estlander Operation (lip) 14000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Estlander Operation (lip) Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Detailed
RECONSTR Operation (lip) 01359 discharge summary-C | Detailing the original pathology thet has led to this surgery-P |
UCTIVE Intra & Post procedure clinical photograph-C | Suporting investigation reports-P
SURGERY
PLASTIC & RP RP0000634 Extended LOS RP0000634000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals-P | All investigations reports-C | Any investigations
RECONSTR care pkg for 01360 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) done-P | Clinical notes detailing history-P | Daily patient photo-C | Detailed ICPs-C |
UCTIVE advance sugeries Routine Ward-1800 Examination findings-P | Planned line of management-P | Treatment details-C |
SURGERY detailed discharge summary-C
PLASTIC & RP RP0000650 Fasciotomy / RP0000650000 Anti-biotic + dressing - minimum of 5 sessions 9000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes Yes No Surgical No Insurance N N R N Anti-biotic + dressing - minimum of 5 sessions )+/- X-ray confirming the diagnosis-P | Clinical notes-P | Clinical photograph of affected
RECONSTR Debridement & 01361 part-P | Detailed discharge summary Evidence of 5 sessions dressing-C | Intra & Post
UCTIVE Closure of injuries - Procedure clinical photgraph-C | detailed Procedure / Operative Notes-C
SURGERY contused
lacerated wounds
PLASTIC & RP RP0000666 Fixation of RP0000666000 Closed reduction (1 jaw) using wires -under LA/GA 5000 Yes 0 Yes 3 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Tension band-1000 Max :3 | k- Closed reduction (1 jaw) using wires -under LA/GA ) +/- MLC copy with number-P | Circumstances that led to fracture,, Clinical Photograph,
RECONSTR fracture of jaw 01362 wire-300 Max :3 X-Ray Mandible,-P | Clinical Photograph-P | Detailed Discharge Summary-C | Intra &
UCTIVE Post procedure X-ray mandible showing wires used-C | X-Ray Mandible-P | detailed
SURGERY Procedure / Operative Notes-C
PLASTIC & RP RP0000670 Flame / scald / RP0000670000 % Total Body Surface Area Burns (TBSA) - any % (not 7000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA) - any % (not Clinical Notes-P | Detailed discharge summary.-C | Extent of burns visible on
RECONSTR thermal / 01363 requiring admission). Needs at least 5-6 dressing requiring admission). Needs at least 5-6 dressing photograph (with rule of 9 chart)-P | Post Treatment clinical photograph-C | X-rays or
UCTIVE electrical burns other diagnostic procedures done as a part of treatment-C | lab tests-C
SURGERY
PLASTIC & RP RP0000670 Flame / scald / RP0000670000 % Total Body Surface Area Burns (TBSA): < 40 %; Includes % 50000 No 0 No 0 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA): < 40 %; Includes % Clinical Notes-P | Detailed discharge summary.-C | MLC copy with number, Extent of
RECONSTR thermal / 01364 TBSA skin grafted, flap cover, follow-up dressings etc. as TBSA skin grafted, flap cover, follow-up dressings etc. as upto 40% - 60% burns visible on photograph (with rule of 9 chart)-P | Post Treatment
UCTIVE electrical burns deemed necessary; Surgical procedures are required for deemed necessary; Surgical procedures are required for clinical photograph-C | X-rays or other diagnostic procedures done as a part of
SURGERY deep burns that are not amenable to heal with dressings deep burns that are not amenable to heal with dressings treatment-C | lab tests-C
alone. alone.
PLASTIC & RP RP0000670 Flame / scald / RP0000670000 % Total Body Surface Area Burns (TBSA): > 40 %; Includes % 80000 No 0 No 0 Yes No Tertiary 15 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA): > 40 %; Includes % Clinical Notes-P | Detailed discharge summary.-C | MLC copy with number, Extent >
RECONSTR thermal / 01365 TBSA skin grafted, flap cover, follow-up dressings etc. as TBSA skin grafted, flap cover, follow-up dressings etc. as 60% burns visible on photograph (with rule of 9 chart)-P | Post Treatment clinical
UCTIVE electrical burns deemed necessary; Surgical procedures are required for deemed necessary; Surgical procedures are required for photograph-C | X-rays or other diagnostic procedures done as a part of treatment-C |
SURGERY deep burns that are not amenable to heal with dressings deep burns that are not amenable to heal with dressings lab tests-C
alone. alone.
PLASTIC & RP RP0000693 Free Grafts - RP0000693000 Free Grafts - Wolfe Grafts 14000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Free Grafts - Wolfe Grafts Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Detailed
RECONSTR Wolfe Grafts 01366 discharge summary-C | Detailing original pathology, with suporting reports-P | Post
SURGERY
PLASTIC & RP RP0000731 Hemangioma RP0000731000 Debulking / Excision 35000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Debulking / Excision Clinical Photograph-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
RECONSTR 01367 Detailed discharge summary-C | Intra & Post procedure clinical photograph-C |
UCTIVE Relevent Investigation USG / MRI Angio / CT Angio-P | Specimen photo / HPE-C
SURGERY
PLASTIC & RP RP0000731 Hemangioma RP0000731000 Sclerotherapy under GA - govt reserve 15000 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Sclerotherapy under GA - govt reserve Clinical Photograph-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
RECONSTR 01368 Reserve Detailed discharge summary-C | Invoice of sclerosing agent used-C | Post procedure
UCTIVE clinical photograph.-C
SURGERY
PLASTIC & RP RP0000782 Hypospadias RP0000782000 Single stage Hypospadias repair - govt reserve 28000 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Single stage Hypospadias repair - govt reserve Clinical Photograph or relevent investigations-P | Clinical notes-P | Detailed Procedure /
RECONSTR repair 01369 Reserve Operative Notes-C | Detailed discharge summary-C | Invoice of sclerosing agent used-C
UCTIVE | Pre procedure clinical photograph.-C
SURGERY
PLASTIC & RP RP0000782 Hypospadias RP0000782000 Two or more stage (Final Stage) / Fistula repair- govt reserve 20000 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes Yes No Surgical No Insurance N N N Two or more stage (Final Stage) / Fistula repair- govt reserve Clinical Photograph; evidence of stage 1 / 2 (Discharge Summary)-P | Clinical notes-P |
RECONSTR repair 01370 Reserve Post Procedure Clinical Photograph of affected part-C | detailed Procedure / Operative
UCTIVE Notes-C
SURGERY
PLASTIC & RP RP0000782 Hypospadias RP0000782000 Two or more stage (First Stage) Hypospadias repair 13500 No 0 No 0 Yes Yes Tertiary 3 No Yes Yes Govt Yes No No Surgical No Insurance N N N Two or more stage (First Stage) Hypospadias repair Clinical Photograph or relevent investigations-P | Clinical notes-P | Post Procedure
RECONSTR repair 01371 independently - govt reserve Reserve independently - govt reserve Clinical Photograph of affected part-C | detailed Procedure / Operative Notes-C
UCTIVE
SURGERY
PLASTIC & RP RP0000960 Microvascular RP0000960000 Microvascular reconstruction (free flaps) 45000 Yes 0 Yes 1 Yes No Tertiary 7 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for Microvascular Microvascular reconstruction (free flaps) Biopsy of primary (in case of Malignancy)-P | Clinical Photograph showing scar-C |
RECONSTR reconstruction 01372 reconstruction-15000 Max :1 Clinical notes-P | Details of earlier surgery done and establishing need of microvascular
UCTIVE (free flaps) reconstruction-P | HPE in case of Malignancy-C | X-ray for bony reconstruction-C |
SURGERY detailed Procedure / Operative Notes-C | detailed discharge summary-C
GENERAL SG SG000010 NPWT SG0000101700 NPWT 0 Yes 7 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N NPWT-1500 NPWT Clinical notes detailing events that led to chronic/ non healing woulds-P | Clinical
SURGERY 17 00448 photograph-P | Daily procedure clinical photograph with tube and pump-C | Detailed
Procedure / Operative Notes-C | Detailed discharge summary-C
GENERAL SG SG000010 Oesophagectomy SG0000102500 Oesophagectomy Open / lap / VATS / Transthorasic/2F/3F 52100 Yes 0 Yes 5 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Catridge-3000 Max :5 Oesophagectomy Open / lap / VATS / Transthorasic/2F/3F Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 25 00449 Histopath / Specimen Photo-C | Intra procedure clinical photograph-C | Scar Photo-C |
USG/CT/MRI/ Biopsy report confirming the diagnosis for which the surgery is done-P
GENERAL SG SG000010 Operation for SG0000103800 Wedge Excision 19000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Wedge Excision Biopsy report-P | Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C
SURGERY 38 Carcinoma Lip 00450 | Detailed discharge summary-C | Histopath / Specimen Photo-C | Post procedure
clinical photograph-C | Relevent investigations-P
GENERAL SG SG000010 Operation for SG0000103800 Wedge Excision and Vermilionectomy/Cheek advancement 26000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Wedge Excision and Vermilionectomy/Cheek advancement Biopsy report-P | Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C
SURGERY 38 Carcinoma Lip 00451 | Detailed discharge summary-C | Histopath-C | Post procedure clinical photograph-C
| Relevent investigations-P
GENERAL SG SG000010 Operation for SG0000104000 Operation for Duplication of Intestine 18000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operation for Duplication of Intestine CT/MRI /Endoscopic Ultrasound - any one test confirming the diagnosis.-P | Clinical
SURGERY 40 Duplication of 00452 notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra operative
Intestine clinical photograph-C | Scar Photo-C | histopath of removed part-C
GENERAL SG SG000010 Operation for SG0000104200 Operation for Hydrocele (B/L) / herniotomy- Govt reserved 10000 No 0 No 0 No Yes Secondary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Operation for Hydrocele (B/L) / herniotomy- Govt reserved Any one test confirming the diagnosis.-P | Ultrasound-P | Clinical notes-P | Detailed
SURGERY 42 Hydrocele (B/L) / 00453 Reserve Operative notes-C | Detailed discharge summary-C | Intra operative clinical photograph-
herniotomy- Govt C
reserved
GENERAL SG SG000010 Operation for SG0000104400 Operation for Hydrocele (U/L) / herniotomy - Govt reserved 8000 No 0 No 0 Yes Yes Secondary 1 No Yes Yes Govt Yes No No Surgical No Insurance N N N Operation for Hydrocele (U/L) / herniotomy - Govt reserved Ultrasound-P | Any one test confirming the diagnosis.-P | Clinical notes-P | Detailed
SURGERY 44 Hydrocele (U/L) / 00454 Reserve Operative notes-C | Detailed discharge summary-C | Intra operative clinical photograph-
herniotomy - C
Govt reserved
GENERAL SG SG000010 Operation SG0000104600 Operation forAbdominal/Lung Hydatid Cyst (Single Organ) - 21700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operation forAbdominal/Lung Hydatid Cyst (Single Organ) - Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 46 forAbdominal 00455 Change in Name Change in Name Histopath-C | Intra procedure clinical photograph-C | Scar Photo-C | USG/CT/MRI
/Lung Hydatid report confirming the diagnosis-P
Cyst (Single
Organ) - Change in
Name
GENERAL SG SG000010 Operation of SG0000104800 Operation of Choledochal Cyst 30400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operation of Choledochal Cyst USG/CT Abdomen-P | Clinical notes-P | Detailed Operative notes-C | Detailed
SURGERY 48 Choledochal Cyst 00456 discharge summary-C | Histopath-C | Scar Photo-C
GENERAL SG SG000010 Operations for SG0000105000 Operations for Replacement of Oesophagus by 43400 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Operations for Replacement of Oesophagus by Biospy-P | CT/MRI/ UGIE findings confirming the diagnosis for which the surgery is done-
SURGERY 50 Replacement of 00457 Colon/ileal/jejunal Colon/ileal/jejunal P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
Oesophagus by Picture of removed esopahgus (Intra procedure clinical photograph)-C | Scar photo
Colon (should be two scars or one huge thoracolumbar scar coverin both colon removal &
esopagus replacement)-C | X-ray-P
GENERAL SG SG000010 Operative SG0000105200 Operative Management of Volvulus of Large Bowel 25000 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Operative Management of Volvulus of Large Bowel Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Scar
SURGERY 52 Management of 00459 Photo-C | X Ray Abdomen / CT Contrast confirming the diagnosis-P | X Ray Abdomen-C
Volvulus of Large
Bowel
GENERAL SG SG000010 Orchidectomy SG0000106000 Orchidectomy BL / UL - Govt reserved 10400 No 0 No 0 No Yes Tertiary 2 No Yes Yes Govt No No No Surgical No Insurance N N N Orchidectomy BL / UL - Govt reserved Clinical notes describing Swelling in scrotum-P | Detailed Operative notes-C | Detailed
SURGERY 60 00460 Reserve discharge summary-C | Histopath-C | Intra operative clinical photograph-C |
Justification of orchidectmy-P | USG of scrotum / FNAC / tumour markers (if cancer of
prostate/testis,etc is the indication)-P
GENERAL SG SG000010 Palliative Care SG0000108500 Pressure sore-Interventions 9000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pressure sore-Interventions CBC-P | CECT/ x-Ray/USG-P | Clinical notes with planned line of treatment-P | Dialy
SURGERY 85 approach to 00461 dressing photo-C | Discharge summary with detail treatment & interventions-C | KFT-P
managing | LFT-P | Procedure notes-C | Wound Photo-P
Pressure sore in
advanced chronic
diseases who are
bed ridden-
Surgical
GENERAL SG SG000010 PancreaticoDuode SG0000109800 PancreaticoDuodenectomy (Whipple's) 70000 Yes 0 Yes 4 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Catridge-3000 Max :4 PancreaticoDuodenectomy (Whipple's) CT/ USG-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge
SURGERY 98 nectomy 00462 summary-C | ERCP confirming the diagnosis-P | Histopath-C | Intra procedure clinical
(Whipple's) photograph-C | Scar Photo-C
GENERAL SG SG000011 AV Fistula without SG0000110000 AV Fistula without prosthesis 18000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N AV Fistula without prosthesis Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 0 prosthesis 0373 Detailing need for AV shunt with supporting Evidence of Creatinine/ RFT-P | Post
Procedure clinical photograph-C
GENERAL SG SG000011 Parotidectomy SG0000110600 Superficial Parotidectomy 23000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Superficial Parotidectomy CT Scan / MRI-P | Clinical Notes-P | Detailed Procedure / Operative Notes-C | Detailed
SURGERY 06 00463 discharge summary-C | FNAC-P | Histopathology report-C | Photograph of affected
part-P | Post procedure clinical photograph of affected part-C
GENERAL SG SG000011 Parotidectomy SG0000110600 Total Parotidectomy 28000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Parotidectomy CT Scan / MRI-P | Clinical Notes-P | Detailed Procedure / Operative Notes-C | Detailed
SURGERY 06 00464 discharge summary-C | FNAC-P | Histopathology report-C | Photograph of affected
part-P | Post procedure clinical photograph of affected part-C
GENERAL SG SG000011 Perineal SG0000113500 Perineal Procedure for Rectal Prolapse 16700 No 0 No 0 No No Secondary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Perineal Procedure for Rectal Prolapse Clinical notes-P | Colonoscopy / CT confirming the diagnosis-P | Detailed Operative
SURGERY 35 Procedure for 00465 notes-C | Detailed discharge summary-C | Photo-P
Rectal Prolapse
GENERAL SG SG000011 Plexus injury along SG0000117400 Plexus injury along with Vascular injury graft 60000 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Plexus injury along with Vascular injury graft )+ /- EMG (Electromyography)-P | )+ /- EMG (Electromyography)-P | )+ /- MRA-P | )+ /-
SURGERY 74 with Vascular 00466 MRA-P | )+ /- MRI-P | )+ /- MRI-P | )+/- CT Angio-P | )+/- CT Angio-P | )+/- Nerve
injury repair / conduction velocity (NCV)-P | )+/- Nerve conduction velocity (NCV)-P | Clinical notes
graft detailing the injury and need of surgery-P | Clinical notes detailing the injury and need of
surgery-P | Detailed discharge summary-C | Detailed operatives notes-C | Intra
operative still photograph-C | MLC/ FIR-P | MLC/ FIR-P | Post operative color doppler-
C
GENERAL SG SG000011 Porto Caval SG0000118900 Porto Caval Anastomosis 34700 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Porto Caval Anastomosis Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra
SURGERY 89 Anastomosis 00467 procedure clinical photograph-C | Scar Photo-C | USG-doppler /CT/MRI report
confirming the diagnosis for which the surgery is done-P
GENERAL SG SG000012 Abdominal SG0000120000 Abdominal Procedure for Rectal Prolapse 25000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abdominal Procedure for Rectal Prolapse Admission notes showing vitals-P | Clinical notes detailing history-P | Colonoscopy
SURGERY Procedure for 370 /picture of prolapse confirming the diagnosis of prolapse-P | Detailed Operative notes-C
Rectal Prolapse | Detailed discharge summary-C | Examination findings-P | Intra procedure clinical
photograph-C
GENERAL SG SG000012 Procedure for SG0000120300 Procedure for Fissure in Ano/ anal Fistula / hemorrhoid 8600 No 0 No 0 No Yes Tertiary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Procedure for Fissure in Ano/ anal Fistula / hemorrhoid Proctoscpic findings confirming the diagnosis for which this surgery is done-P | Clinical
SURGERY 03 Fissure in Ano 00468 (Govt reserve) Reserve (Govt reserve) notes-P | Detailed Operative notes-C | Detailed discharge summary-C
GENERAL SG SG000012 Pyloromyotomy SG0000121800 Pyloromyotomy 27800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pyloromyotomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 18 00469 Endoscopic still Photograph-C | Endoscopy report confirming the diagnosis of nfantile
hypertrophic pyloric stenosis-P
GENERAL SG SG000012 Pyloroplasty SG0000122000 Pyloroplasty 14300 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pyloroplasty Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 20 00470 Endoscopy confirming the diagnosis for which the surgery is done-P | Intra procedure
GENERAL SG SG000012 Radical Neck SG0000123100 Radical / comprehensive Neck Dissection 22600 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical / comprehensive Neck Dissection Biopsy-P | CT Scan/MRI Neck confirming the diagnosis-P | Clinical Photograph-P |
SURGERY 31 Dissection 00471 Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
Histopath-C | Intra procedure clinical photograph-C | Post procedure clinical
photograph-C
GENERAL SG SG000012 Reconstruction SG0000124300 Tissue Reconstruction Flap / Flap Reconstructive Surgery / 25000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tissue Reconstruction Flap / Flap Reconstructive Surgery / Clinical notes-P | Clinical photograph of affected part justifying surgery-P | Detailed
SURGERY 43 Flap 00472 Rotation flap Rotation flap Operative notes-C | Detailed discharge summary-C | Intra procedure clinical
photograph-C | Post procedure clinical photograph (if flap taken from other site; even of
donor site)-C
GENERAL SG SG000012 Rectal Polyp SG0000124700 Rectal Polyp Excision 9600 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Rectal Polyp Excision Biopsy justifying surgery-P | Clinical notes-P | Colonoscopy-P | Detailed Operative
SURGERY 47 Excision 00473 notes-C | Detailed discharge summary-C | Histopath-C | Intra procedure clinical
photograph-C
GENERAL SG SG000012 Rectovaginal SG0000125000 Rectovaginal fistula repair 24000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Rectovaginal fistula repair Admission Notes comprising of history -P | Contrast Study-P | Detailed Procedure /
SURGERY 50 fistula repair 00474 Operative Notes-C | Detailed discharge summary-C | Examination with indications for
the procedure-P | Intraop. stills with date & patient ID-C | Progress notes-C | Relavant
Investigations (establishing diagnosis)-P
GENERAL SG SG000012 Repair of Renal SG0000126600 Repair of Renal Artery Stenosis 60000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Repair of Renal Artery Stenosis Admission Notes comprising of history -P | CT / MR Angio-P | Detailed Procedure /
SURGERY 66 Artery Stenosis 00475 Operative Notes-C | Detailed discharge summary-C | Examination with indications for
Investigations (establishing diagnosis)-P | Scar Photo-C
GENERAL SG SG000012 Retroperitoneal SG0000128100 Retroperitoneal Tumor – Excision 26900 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Retroperitoneal Tumor – Excision Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 81 Tumor – Excision 00476 Histopath-C | Intra procedure clinical photograph-C | Scar Photo-C | X Ray/USG/CT
Abdomen confirming the diagnosis-P
GENERAL SG SG000012 Rib Resection & SG0000129000 Rib Resection & Drainage 17300 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Rib Resection & Drainage CT/ MRI confirming the diagnosis for which the surgery is done-P | Clinical notes-P |
SURGERY 90 Drainage 00477 Clinical photograph-P | Detailed Operative notes-C | Detailed discharge summary-C |
Post procedure X Ray-C | Post procedure clinical photograph-C | Pus C/S-C | X Ray-P
GENERAL SG SG000013 Biopsy under GA SG0000130000 Biopsy under GA 5000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Biopsy under GA )+/- FNAC report / USG-P | Clinical Photograph of Enlarged lymph nodes-P | Clinical
SURGERY 0 0374 notes-P | Detailed Operative notes-C | Histopathology report-C | Post procedure
GENERAL SG SG000013 Sigmoid Resection SG0000133600 Sigmoid Resection 21500 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Sigmoid Resection Contrast X-rays / CT scan/ sigmoidoscopy-P | Clinical notes-P | Confirming the
SURGERY 36 00478 diagnosis-P | Detailed Operative notes-C | Detailed discharge summary-C |
Histopathology-C | Intra procedure clinical photograph-C | Scar Photo-C
GENERAL SG SG000013 Skin and soft SG0000134500 Skin and soft tissue infections 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Skin and soft tissue infections Other Investigation-P | Planned line of treatment-P | All investigations reports
SURGERY 45 tissue infections 00479 including CBC-C | CBC-P | Clinical notes-P | Detailed ICPs-C | Detailed discharge
summary-C | Photo-P | Treatment details-C
GENERAL SG SG000013 Splenectomy SG0000136200 Splenectomy 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Splenectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 62 00480 Histopath-C | Lab investigations confirming the diagnosis and justifying the surgery.-P |
Scar Photo-C | USG/CT Scan-P
GENERAL SG SG000013 Split thickness skin SG0000136500 Large (>4% TBSA) 13500 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Large (>4% TBSA) Admission notes showing vitals-P | Any investigations done-P | Clinical Photograph-P |
SURGERY 65 grafts 00481 Clinical notes detailing history-P | Detailed Operative notes-C | Detailed discharge
summary-C | Detailing time of Burns-P | Examination findings-P | Post procedure
GENERAL SG SG000013 Split thickness skin SG0000136500 small (< 4% TBSA) 10000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N small (< 4% TBSA) Admission notes showing vitals-P | Any investigations done-P | Clinical Photograph-P |
SURGERY 65 grafts 00482 Clinical notes detailing history-P | Detailed Operative notes-C | Detailed discharge
summary-C | Detailing time of Burns-P | Examination findings-P | Post procedure
GENERAL SG SG000013 Stoma SG0000137900 Stoma Management follow up of Ileostomy/Stoma 4500 No 0 No 0 Yes No Secondary 2 No Yes Yes follow up Yes Yes No Surgical No Insurance N N N Stoma Management follow up of Ileostomy/Stoma All investigations reports-C | Clinical Notes-P | Detailed ICPs-C | Detailed discharge
SURGERY 79 Management 00483 Management follow up of Colostomy Management follow up of Colostomy summary-C | Earlier discharge summary-P | Invoice / Receipt of drugs and consumables-
C | Stoma Photo-P | Treatment details-C
GENERAL SG SG000013 Submandibular SG0000138400 Submandibular swelling Excision 18200 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Submandibular swelling Excision Biopsy/FNAC-P | Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C
SURGERY 84 swelling Excision 00484 | Detailed discharge summary-C | Histopath-C | Post procedure clinical photograph-C
| USG/CT Scan confirming the diagnosis for which the surgery is done-P
GENERAL SG SG000013 Subtotal SG0000138600 Subtotal Colectomy 45000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Subtotal Colectomy Admission notes showing vitals-P | All investigations reports-C | Any investigations
SURGERY 86 Colectomy 00485 done-P | Biopsy-P | CT colonoscopy report with film-P | Clinical Photograph showing
scar + HPE report-C | Clinical notes detailing history-P | Detailed ICPs-C | Detailed
discharge summary-C | Examination findings-P | Scar Photo-C | Treatment details-C
GENERAL SG SG000014 Surgical SG0000141100 Surgical management of Lower GI bleed (inclusive of 20000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Surgical management of Lower GI bleed (inclusive of Admission notes showing vitals-P | All investigations reports & Colonoscopy report
SURGERY 11 management of 00486 sigmoidoscopy / colonoscopy) - Colonoscopic management sigmoidoscopy / colonoscopy) - Colonoscopic management Intraprocedure photo-C | Any investigations done-P | Clinical notes detailing history-P
Lower GI bleed only excluding local perineal conditions only excluding local perineal conditions | Detailed ICPs-C | Detailed discharge summary-C | Examination findings-P | Planned
(inclusive of line of management-P | Treatment details-C
sigmoidoscopy /
colonoscopy) -
Colonoscopic
management only
excluding local
perineal
GENERAL SG conditions
SG000014 Surgical SG0000141200 CystoJejunostomy /Cystogastrostomy 21700 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N CystoJejunostomy /Cystogastrostomy Admission notes showing vitals-P | Any investigations done-P | Clinical notes detailing
SURGERY 12 Management of 00487 history-P | Detailed Operative notes-C | Detailed discharge summary-C | Examination
PseudoCyst findings-P | Planned line of management-P | Post procedure clinical photograph-C |
Scar photo-C | Ultrasound / CT-P
GENERAL SG SG000014 Surgical SG0000141500 Cyst / biopsy / FNAC/ I&D- Day care 1500 No 0 No 0 Yes No Secondary 1 No Yes Yes Day care Yes No No Surgical Yes Insurance Y N N Cyst / biopsy / FNAC/ I&D- Day care Admission notes showing vitals-P | Any investigations done-P | Clinical notes detailing
SURGERY 15 procedure under 00488 history-P | Detailed Operative notes-C | Detailed discharge summary-C | Examination
LA findings-P | Intra operative clinical notes & photograph-C | Planned line of
management.-P | Scar Photo-C
GENERAL SG SG000014 Surgical removal SG0000141700 Surgical removal of Branchial Cyst/Sinus/Fistula 17300 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Surgical removal of Branchial Cyst/Sinus/Fistula Admission notes showing vitals-P | Any investigations done with USG or CT Scan
SURGERY 17 of Branchial 00489 confirming diagnosis-P | Clinical notes detailing history-P | Detailed Operative notes-C |
Cyst/Sinus/Fistula Detailed discharge summary-C | Examination findings-P | Histopathology report-C |
Post procedure clinical photograph-C | Pre-op Clinical Photograph-P
GENERAL SG SG000014 Sympathectomy SG0000141800 Sympathectomy-Bilateral (B/L) / Unilateral (U/L) 0 Yes 1 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral-21700 | Unilateral- Sympathectomy-Bilateral (B/L) / Unilateral (U/L) Admission notes showing vitals-P | Examination findings-P | 2D ECHO (in Thoracic
SURGERY 18 00490 15000 Sympathectomy) Report + stills of ECHO + Post Op X-ray-C | Any investigations-P | CT
report-P | Clinical notes detailing history-P | Detailed Operative notes-C | Detailed
discharge summary-C | Photo of scar-C | Port insertion-C
GENERAL SG SG000014 Thoracoplasty SG0000143400 Thoracoplasty 20800 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Thoracoplasty CT/MRI Chest confirming the indication for this surgery-P | Clinical Photograph-P |
SURGERY 34 00491 Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra
procedure clinical photograph-C | Post procedure clinical photograph-C | X Ray-P
GENERAL SG SG000014 Thoracoscopic SG0000143500 Thoracoscopic Segmental Resection 26000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Linear Cutter 3 cartidges-15000 Thoracoscopic Segmental Resection )+/- Biopsy report-P | CT Thorax confirming the diagnosis-P | Clinical notes-P | Detailed
SURGERY 35 Segmental 00492 Max :1 Operative notes-C | Detailed discharge summary-C | Histopath-C | Intra procedure
Resection clinical photograph-C | Scar Photo-C
GENERAL SG SG000014 Thymectomy SG0000144000 Thymectomy 41700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Thymectomy Clinical notes-P | Clinical photograph-P | Detailed Operative notes-C | Detailed
SURGERY 40 00493 discharge summary-C | Histopath-C | Investigation report confirming the need for
surgery (CT/MRI)-P | Post procedure clinical photograph-C | Single-fiber
electromyography in case of myasthenia gravis-P
GENERAL SG SG000014 Thyroidectomy SG0000144300 Total thyroidectomy 20000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total thyroidectomy Thyroid Function Test-P | Clinical notes-P | Detailed Operative notes-C | Detailed
SURGERY 43 00495 discharge summary-C | FNAC/USG confirming the diagnosis and justifying the surgery.-P
| Histopath report-C | Post procedure clinical photograph-C
GENERAL SG SG000014 Thyroidectomy SG0000144300 Hemi thyroidectomy 20000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hemi thyroidectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 43 00494 FNAC/USG confirming the diagnosis and justifying the surgery-P | Histopath report-C |
Post procedure clinical photograph-C | Thyroid Function Test-P
GENERAL SG SG000014 Thyroidectomy SG0000144300 Total Thyroidectomy with central neck Dissection 26000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Thyroidectomy with central neck Dissection FNAC/ Biopsy/ Thyroid Function Test / USG / CT confirming the diagnosis and need for
SURGERY 43 00496 surgery-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-
C | Histopath report-C | Post procedure clinical photograph-C | Scar Photo-C
GENERAL SG SG000014 Tracheostomy / SG0000146300 Tracheostomy/Tracheotomy 9500 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular Yes No No Surgical No Insurance N N R N Tracheostomy/Tracheotomy Clinical notes-P | Planned line of treatment justifying indication-P | Post Procedure
SURGERY 63 Tracheotomy 00497 PKG/add on photo of affected part-C | Procedure / Operative Notes-C
GENERAL SG SG000015 Vaginal repair for SG0000152000 Vaginal repair for vesico-vaginal fistula (Open) 25000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Vaginal repair for vesico-vaginal fistula (Open) Admission Notes comprising of history and examination with indications for the
SURGERY 20 vesico-vaginal 00498 procedure-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C
fistula (Repair for | Detailed discharge summary-C | Intraop. stills with date & patient ID-C | Progress
VVF) notes-C | Relavant Investigations (establishing diagnosis) and Cystoscopy/
Cystourethroscopy-P | Voiding Cystourethrogram is optional. -P
GENERAL SG SG000015 Vagotomy SG0000152400 Gastro Jejunostomy +/- Vagotomy/Vagotomy +/- 23500 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Gastro Jejunostomy +/- Vagotomy/Vagotomy +/- Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 24 00499 Pyloroplasty Pyloroplasty Endoscopic intra & Post operative Photograph-C | Endoscopy report with confirming the
diagnosis for which this surgery is done-P | Histopathology report-C
GENERAL SG SG000015 Vasovasostomy SG0000153400 Vasovasostomy Govt reserved 12000 No 0 No 0 No Yes Secondary 1 No Yes Yes Govt No No No Surgical No Insurance N N N Vasovasostomy Govt reserved Clinical notes detailing need of surgery after vasectomy-P | Detailed Operative notes-C |
SURGERY 34 00500 Reserve Detailed discharge summary-C | Evidence of When and where was vasectomy done-P |
Is the EHCP equipped for microsurgery;-P | Since this is microsurgery evaluate time
taken (2 hours+)-C
GENERAL SG SG000016 Breast Lump SG0000165000 Breast Lump Excision (Benign) under GA/RA 10000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Breast Lump Excision (Benign) under GA/RA (USG) or Mamography showing breast lump-P | )+/- FNAC report-P | Clinical notes-P |
SURGERY 5 Excision (Benign) 0375 Detailed Operative notes-C | Detailed discharge summary-C | Histopathology report-C
| Intra operative clinical photograph-C | Sono mammogram-P
GENERAL SG SG000017 Bypass - SG0000173000 Bypass - Inoperable Pancreas 46600 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Bypass - Inoperable Pancreas Clinical and Radiological evidence of inoperability (biopsy, ERCP, MRCP)-P | Detailed
SURGERY 3 Inoperable 0376 Operative notes-C | Detailed discharge summary-C | Histopathology report-C | Intra
Pancreas operative clinical photograph-C
GENERAL SG SG000017 Caecopexy SG0000177000 Caecopexy 20000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Caecopexy Admission Notes comprising of history -P | Detailed Procedure / Operative Notes-C |
SURGERY 7 0377 Detailed discharge summary-C | Examination with indications for the procedure-P |
Intraop stills with date & patient ID-C | Photographic documentation-P | Progress notes-
C | Relavant Investigations (establishing diagnosis)-P | X-Ray Showing obstruction-P
GENERAL SG SG000018 Carotid Body SG0000187000 Carotid Body tumour - Excision 26000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Carotid Body tumour - Excision USG Neck/ Colour doppler confirming the diagnosis-P | Clinical notes-P | Detailed
SURGERY 7 tumour - Excision 0378 Operative notes-C | Detailed discharge summary-C | Histopathology-C | Intra
procedure clinical photograph-C | Scar Photo-C
GENERAL SG SG00002 Gastrectomy SG0000200003 Total Gastrectomy 56500 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Gastrectomy Admission notes showing vitals-P | Examination findings-P | Any investigations done-P
SURGERY 67 | Clinical notes detailing history-P | Clinical photograph-P | Detailed Operative notes-C
| Detailed discharge summary-C | Endoscopy report +/- Video /Biopsy/ CT Scan
confirming the diagnosis for which this surgery is done-P | Histopathology report-C |
Intra procedure clinical photograph-C | Post procedure clinical photograph-C
GENERAL SG SG000022 Cholecystectomy SG0000223000 Cholecystectomy 20000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cholecystectomy USG confirming the diagnosis-P | Clinical notes-P | Detailed Operative notes-C |
SURGERY 3 0379 Detailed discharge summary-C | Intra procedure clinical photograph-C | Scar Photo-C
GENERAL SG SG000022 Choledochoduode SG0000225000 Choledochoduodenostomy Or Choledocho Jejunostomy 30500 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Choledochoduodenostomy Or Choledocho Jejunostomy Blood tests-P | CT / USG / MRCP/ ERCP-P | Detailed Operative notes-C | Detailed
SURGERY 5 nostomy Or 0380 discharge summary-C | Intra procedure clinical photograph-C | Scar Photo-C
Choledocho
Jejunostomy
GENERAL SG SG000022 Circumcision SG0000227000 Circumcision - Phimosis / Paraphimosis or any other clinical 3000 No 0 No 0 No Yes Secondary 1 Yes Yes Yes Govt No No No Surgical No Insurance N N N Circumcision - Phimosis / Paraphimosis or any other clinical Admission notes showing vitals-P | All investigations reports-C | Any investigations
SURGERY 7 0381 condition Govt reserve Reserve condition Govt reserve done-P | Clinical notes detailing history-P | Clinical photograph-P | Detailed ICPs-C |
Detailed discharge summary-C | Examination findings-P | Post-operative photograph-C
GENERAL SG SG000023 Closure of Burst SG0000236000 Closure of Burst Abdomen 15000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Closure of Burst Abdomen Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra
SURGERY 6 Abdomen 0382 procedure clinical photograph-C | Photo describing the original surgery-P | Scar photo-
C
GENERAL SG SG000024 Closure of stoma SG0000241000 Closure of stoma 14500 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Closure of stoma CT-P | Clinical notes detailing why colostomy was done-P | Clinical photograph-P |
SURGERY 1 0383 Detailed Operative notes-C | Detailed discharge summary-C | Loopogram-P | Post
GENERAL SG SG000024 Colostomy SG0000245000 Defunctioning Colostomy - Stand Alone 15000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N Defunctioning Colostomy - Stand Alone CT/ MRI/ Colonoscopy evidence of need of surgery-P | Clinical notes-P | Detailed
SURGERY 5 0384 Operative notes-C | Detailed surgery notes-C | Post procedure clinical photograph-C |
Stoma Photo-C
GENERAL SG SG000024 Colostomy SG0000245000 Exploratory laprotomy with colostomy 21700 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exploratory laprotomy with colostomy Biopsy of the lsoion-P | Clinical notes-P | Detailed Operative notes-C | Detailed
SURGERY 5 0385 discharge summary-C | Histopathology-C | Intra procedure clinical photograph-C |
Scar Photo + Stoma Photo-C | X-Ray / USG/ CT Scan/ Colonoscopy confirming the
diagnosis and need of surgery-P
GENERAL SG SG000025 Complete Excision SG0000251000 Complete Excision of Growth from Tongue only 14300 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Complete Excision of Growth from Tongue only Clinical Photograph-P | Clinical notes confirming the diagnosis-P | Detailed Operative
SURGERY 1 of Growth from 0386 (inclusive of Histopathology) (inclusive of Histopathology) notes-C | Detailed discharge summary-C | FNAC / Biopsy if done-P | Histopath-C |
Tongue only Post procedure clinical photograph-C | Scar photo-C
(inclusive of
Histopathology)
GENERAL SG SG000025 Congenital Atresia SG0000258000 Congenital Atresia & Stenosis of Small/ large Intestine 26000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Congenital Atresia & Stenosis of Small/ large Intestine CT/MRI Abd confirming the diagnosis-P | Clinical notes-P | Detailed Operative notes-C |
SURGERY 8 & Stenosis of 0387 Detailed discharge summary-C | Intra procedure clinical stills-C | X ray-P
Small / large
Intestine
GENERAL SG SG000027 Conservative SG0000273000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone Admission notes showing vitals-P | All investigations reports-C | Any investigations
SURGERY 3 Management 0388 stand alone-1800 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
summary-C | Examination findings-P | Planned line of management-P | Treatment
details-C
GENERAL SG SG000028 Conservative SG0000282000 Conservative Management - 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - Clinical Notes-P | Detailed discharge summary-C | Extent of upto 40% burns visible on
SURGERY 2 Management of 0389 (Chest/Head/Face/Abdomen)stand alone (Chest/Head/Face/Abdomen)sta (Chest/Head/Face/Abdomen)stand alone photograph (with rule of 9 chart)-P | Lab tests-C | MLC copy with number-P | Post
injury nd alone-1800 Treatment clinical photograph-C | X-rays or other diagnostic procedures done as a part
of treatment-C
GENERAL SG SG000047 Debridement of SG0000475000 Debridement of Ulcer 3500 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Debridement of Ulcer Clinical notes-P | Clinical photograph of affected part-P | Detailed Operative notes-C |
SURGERY 5 Ulcer 0390 Detailed discharge summary-C | Post procedure clinical photograph-C
GENERAL SG SG000047 Decortication SG0000477000 Decortication (Pleurectomy) 33000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Decortication (Pleurectomy) Biopsy-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-
SURGERY 7 (Pleurectomy) 0391 C | Histopathology-C | X-Ray / USG / CT Scan confirming the diagnosis for which the
surgery is done-P
GENERAL SG SG000048 Deep neck SG0000480000 Deep neck abscess drainage/Post trauma neck exploration 16000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Deep neck abscess drainage/Post trauma neck exploration C/S of pus-C | CT-P | Clinical notes-P | Clinical photgraph/ investigation supporting
SURGERY 0 abscess drainage/ 0392 diagnosis-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C
Post trauma neck | Post procedure clinical photograph of affected part-C
exploration
GENERAL SG SG000049 Diagnostic SG0000492000 Diagnostic laparoscopy (govt reserve) 12000 No 0 No 0 No Yes Secondary 3 Yes Yes Yes Govt No No No Surgical No Insurance N N N Diagnostic laparoscopy (govt reserve) )+/- photo of gross specimen / HPE-C | Admission Notes comprising of history and
SURGERY 2 laparoscopy 0393 Reserve examination-P | CT Abdomen-P | Detailed Procedure / Operative Notes together with
indication of surgery-C | Detailed discharge summary-C | Intraop. stills with date &
patient ID;-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P
GENERAL SG SG00005 Pancreatic SG0000500003 Pancreatic Necrosectomy 60000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pancreatic Necrosectomy Admission notes showing vitals-P | All investigations CT/ MRI -P | Clinical notes
SURGERY Necrosectomy 68 detailing history-P | Detailed Operative notes-C | Detailed discharge summary-C |
Examination findings-P | Histopathology / culture report-C | Intra procedure clinical
photograph-C | Post procedure clinical photograph-C | Scar photo-C
GENERAL SG SG000050 Distal SG0000503000 Distal Pancreatectomy + Splenectomy 52100 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N R N Distal Pancreatectomy + Splenectomy Admission Notes comprising of history and examination-P | CT / MRI-P | Detailed
SURGERY 3 Pancreatectomy + 0394 Procedure / Operative Notes together with indication of surgery-C | Detailed discharge
Splenectomy summary-C | Intraop. stills with date & patient ID-C | Photo of gross specimen / HPE-C
| Progress notes-C | Relavant Investigations
(establishing diagnosis)-P | Scar Photo-C
GENERAL SG SG000050 Distal SG0000504000 Distal Pancreatectomy/Pancreatico Jejunostomy 30800 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Distal Pancreatectomy/Pancreatico Jejunostomy CT/ USG-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge
SURGERY 4 Pancreatectomy 0395 with/without spleenlectomy with/without spleenlectomy summary-C | ERCP justifying the surgery-P | Histopath-C | Intra procedure clinical
with photograph-C | Photo of gross specimen / HPE-C | Scar Photo-C | Sr Amylase-P
Pancreatico
Jejunostomy
GENERAL SG SG000050 Diverticulectomy SG0000509000 Excision Meckel's Diverticulum/ Duodenal / Colonic 20000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision Meckel's Diverticulum/ Duodenal / Colonic Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 9 0396 Diverticulum Diverticulum Endoscopy / Colonoscopy /CT/MRI report confirming the diagnosis-P | Histopath-C |
Intra operative clinical photograph-C | Scar photo-C
GENERAL SG SG000053 Emergency SG0000539000 Emergency management of Hematuria 0 Yes 3 No 0 Yes No Secondary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Routine Ward-1800 Emergency management of Hematuria Clinical notes detailing the hematuria with urine report showing frank or microscopic?-P |
SURGERY 9 management of 0397 Detailed discharge summary-C | Evidence of investigations done treatment given-C
Hematuria
GENERAL SG SG000056 Epididymal Cyst / SG0000567000 Epididymal Cyst excision/Epididymal Nodule excision Govt 4600 No 0 No 0 Yes Yes Tertiary 1 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Epididymal Cyst excision/Epididymal Nodule excision Govt Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 7 Nodule Excision 0398 reserved Reserve reserved Histopath-C | Intra operative clinical photograph-C | USG report confirming the
diagnosis-P
GENERAL SG SG000057 ERCP SG0000577000 ERCP 15000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N ERCP Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
SURGERY 7 0399 Detailed discharge summary-C | ERCP photograph Report-C | Examination with
indications for the procedure-P | Intraop. stills with date & patient ID-C | Progress notes-
C | Relavant Investigations -P | Report-C
GENERAL SG SG000057 ERCP SG0000577000 ERCP + Stenting/Stone removal 15000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N ERCP + Stenting/Stone removal Admission Notes comprising of history-P | Detailed Procedure / Operative Notes-C |
SURGERY 7 0400 Detailed discharge summary-C | ERCP photograph-C | Examination with indications for
Investigations (establishing diagnosis)-P | Report-C
GENERAL SG SG000058 Estlander SG0000581000 Estlander Operation (lip) 12100 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Estlander Operation (lip) Clinical Photograph-P | Clinical notes detailing the original pathology that has led to this
SURGERY 1 Operation (lip) 0401 surgery with suporting investigation reports-P | Detailed Operative notes-C | Detailed
discharge summary-C | FIR/MLC in case of traumatic aetiology -P | Post procedure
GENERAL SG SG000058 EUA separate add SG0000587000 EUA only in GA separate - add on package 3000 No 0 No 0 No No Secondary 2 No Yes Yes Add On No No No Surgical No Insurance N N N EUA only in GA separate - add on package )+/- Intraprocedure photo-C | Clinical Notes for the associated surgery / disease along
SURGERY 7 on package 0402 with Pre OP-C | Clinical Notes justifying the need for GA in the associated surgery-P |
Operative and Anesthesia-C | Post OP notes-C
GENERAL SG SG000059 Excision SG0000594000 Excision Mammary Fistula 12000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision Mammary Fistula Sonomammogram report confirming the diagnosis-P | Clinical notes-P | Detailed
SURGERY 4 Mammary Fistula 0403 Operative notes-C | Detailed discharge summary-C | Histopath-C | Scar Photo-C
GENERAL SG SG000059 Excision of any SG0000595000 Excision of any benign swelling 3000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of any benign swelling Deailed Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 5 benign swelling 0404 Intra operative clinical photograph-C | Photo-P | Scar Photo-C
GENERAL SG SG000060 Excision of SG0000603000 Excision of Growth from Tongue with neck node dissection 26900 No 0 No 0 No No Tertiary 3 No Yes Yes Stand alone No No No Surgical No Insurance N N N Excision of Growth from Tongue with neck node dissection Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Detailed
SURGERY 3 Growth from 0405 Stand alone Stand alone discharge summary-C | Histopath-C | Post procedure clinical photograph-C | Scar
Tongue with neck Photo-C | USG/CT/MRI / Biopsy report confirming the diagnosis-P
node dissection
GENERAL SG SG000060 Excision of SG0000607000 Excision of Parathyroid Adenoma/Carcinoma 21700 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Parathyroid Adenoma/Carcinoma Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 7 Parathyroid 0406 Histopathology-C | Intra procedure clinical photograph-C | Scar Photo-C | USG/CT
Adenoma / Scan/Nuclear Imaging confirming the diagnosis-P
Carcinoma
GENERAL SG SG000062 Exicision of Sinus SG0000622000 Exicision of Sinus and Curettage 5000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Exicision of Sinus and Curettage )+/- Histopath of surreted material-C | Clinical Photograph-P | Clinical notes-P |
SURGERY 2 and Curettage 0407 Detailed Operative notes-C | Detailed discharge summary-C | Post procedure clinical
photograph-C | Scar Photo-C | Some imaging to show tract of sinus confirming the
diagnosis-P
GENERAL SG SG000062 Exploratory SG0000624000 Emergency Exploratory Laparotomy -Stand alone 25000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Stand alone No Yes No Surgical No Insurance N N R N Emergency Exploratory Laparotomy -Stand alone Clinical notes detailing original pathology that led to peritonitis supported by X
SURGERY 4 Laparotomy 0408 Ray/USG/CT Scan Abdomen-P | Detailed Operative notes describing management done
of pathology that led to peritonitis-C | Detailed discharge summary-C | Intra procedure
clinical photograph-C | Scar Photo-C
GENERAL SG SG000063 Extended LOS SG0000630000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals-P | All investigations reports-C | Any investigations
SURGERY 0 care pkg for 0409 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
advance sugeries Routine Ward-1800 summary-C | Documentation of all Consents by patient / attendent-P | Examination
findings-P | Patient's Daily photo with attacehed instruments & supportive machine-P |
GENERAL SG SG000065 Feeding SG0000656000 Feeding Jejunostomy 13600 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Feeding Jejunostomy Clinical notes-P | Detailed Operative notes-C | Endoscopy report-P | Intra procedure-C
SURGERY 6 Jejunostomy 0410 | Post OPclinical photograph detailed discharge summary-C | Video /Biopsy/ CT Scan
confirming the diagnosis for which this surgery is done-P
GENERAL SG SG000065 Femoral Groin SG0000659000 Femoral Groin Hernia Repair 20000 No 0 Yes 2 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh - 15 X 15 Polypropylene - Femoral Groin Hernia Repair Clinical notes-P | Clinical photograph-P | Detailed Operative notes-C | Detailed
SURGERY 9 Hernia Repair 0411 2000 Max :2 discharge summary-C | Invoice of Mesh used-C | Post procedure clinical photograph-C
| Scar Photo-C | USG (specifying size of defect)-P
GENERAL SG SG000066 Flame / scald / SG0000669000 % Total Body Surface Area Burns (TBSA) - any % (not 7000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N % Total Body Surface Area Burns (TBSA) - any % (not Clinical Notes-P | Detailed discharge summary-C | Extent of burns visible on photograph
SURGERY 9 thermal / 0412 requiring admission). Needs at least 5-6 dressing requiring admission). Needs at least 5-6 dressing (with rule of 9 chart)-P | Lab tests-C | MLC copy with number-P | Post Treatment
electrical burns clinical photograph-C | X-rays or other diagnostic procedures done as a part of
treatment-C
GENERAL SG SG000067 Foreign Body SG0000676000 Foreign Body Removal ( Airway) 8600 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Foreign Body Removal ( Airway) Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Post
SURGERY 6 Removal ( Airway) 0413 procedure clinical photograph-C | Relevant imaging study for comparison-C | Still
Photograph of the imaging-P | X-ray/ USG report of the affected part confirming the
diagnosis-P
GENERAL SG SG000067 Foreign Body SG0000679000 Foreign Body Removal ( Esophageal) 6000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Foreign Body Removal ( Esophageal) CT Scan / USG / X-ray-P | Clinical Photograph of affected part-P | Detailed Procedure /
SURGERY 9 Removal ( 0414 Operative Notes-C | Detailed discharge summary-C | Post / Intra procedure clinical
Esophageal) photograph of affected part-C
GENERAL SG SG000069 Free Grafts - SG0000692000 Free Grafts - Wolfe Grafts 14000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Free Grafts - Wolfe Grafts Clinical Photograph-P | Clinical notes detailing original pathology with suporting reports-
SURGERY 2 Wolfe Grafts 0415 P | Detailed Operative notes-C | Detailed discharge summary-C | Post procedure
clinical photograph-C | Scar Photo-C
GENERAL SG SG000069 Gastrectomy SG0000698000 Bleeding Peptic Ulcer - Partial Gastrectomy without 30400 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bleeding Peptic Ulcer - Partial Gastrectomy without Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 8 0416 Vagotomy/Bleeding Ulcer - Partial Gastrectomy with Vagotomy/Bleeding Ulcer - Partial Gastrectomy with Histopathology report-C | Intra Operative Photograph-C | Scar Photo-C | UGI
Vagotomy Vagotomy Endoscopy confirming the diagnosis-P
GENERAL SG SG000069 Gastrectomy SG0000698000 Partial Gastrectomy for Carcinoma/Subtotal Gastrectomy 29500 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Gastrectomy for Carcinoma/Subtotal Gastrectomy for Clinical notes-P | Clinical photograph-P | Detailed Operative notes-C | Detailed
SURGERY 8 0417 for Carcinoma Carcinoma discharge summary-C | Endoscopy/ CT Scan confirming the diagnosis-P |
Histopathology report-C | Intra procedure clinical photograph-C | Mandatory Biopsy-P
| Post procedure clinical photograph-C | Scar Photo-C
GENERAL SG SG000071 Groin Hernia SG0000718000 Groin Hernia Repair Inguinal 18000 Yes 0 Yes 2 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh - 6 X 3 Polypropylene-1500 Groin Hernia Repair Inguinal USG (specifying size of defect)-P | Clinical notes-P | Clinical photograph-P | Detailed
SURGERY 8 Repair 0418 Max :2 Operative notes-C | Detailed discharge summary-C | Invoice of Mesh used-C | Post
GENERAL SG SG000071 Groin Hernia SG0000718000 Groin Hernia Repair Obturator - GOVT RESERVED 21700 Yes 0 Yes 2 Yes Yes Tertiary 2 No Yes Yes Govt Yes No No Surgical No Insurance N N N Mesh - 15 X 15-2000 Max :2 Groin Hernia Repair Obturator - GOVT RESERVED Clinical notes-P | Clinical photograph-P | Detailed Operative notes-C | Detailed
SURGERY 8 Repair 0419 Reserve discharge summary-C | Invoice of Mesh used-C | Post procedure clinical photograph-C
| USG (specifying size of defect)-P
GENERAL SG SG000072 Anterior Resection SG0000720000 Anterior Resection of rectum 43400 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Anterior Resection of rectum Admission notes showing vitals-P | All investigations-P | All investigations intra op
SURGERY of rectum 369 Biopsy / CT Abdomen + Pelvis / MRI Abdomen + Pelvis-C | Biopsy / Colonoscopy / CT
Abdomen-P | Clinical notes detailing history-P | Detailed Operative notes-C | Detailed
discharge summary-C | Examination findings-P | Histopathology report-C | Pelvis -P |
Pelvis / MRI Abdomen-P | Post procedure clinical photograph-C
GENERAL SG SG000072 Haemorroidectom SG0000729000 Haemorroidectomy-with Stapler (govt reserve) 12000 No 0 No 0 Yes Yes Secondary 1 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Haemorroidectomy-with Stapler (govt reserve) Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Post
SURGERY 9 y 0420 Reserve procedure clinical photograph-C | Proctoscopy notes confirming the diagnosis-P
GENERAL SG SG000073 Hemi colectomy SG0000732000 Hemi colectomy Right /Hemi colectomy Left 25000 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hemi colectomy Right /Hemi colectomy Left Biopsy-P | CT Scan/Colonoscopy confirming the diagnosis for which the surgery is done-
SURGERY 2 0421 P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
Histopathology report-C | Intra procedure Clinical photograp of removed colon-C | Scar
Photo-C
GENERAL SG SG000073 Hepatic Resection SG0000738000 Hepatic Resection 32100 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hepatic Resection Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 8 0422 Histopath-C | Intra procedure clinical photograph-C | Scar Photo-C | USG/CT/MRI /
Biopsy report confirming the justification of surgery-P
GENERAL SG SG000074 Hepatico SG0000742000 Hepatico Jejunostomy for biliary stricture 45000 No 0 No 0 No No Tertiary 0 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hepatico Jejunostomy for biliary stricture USG/CT/MRI /MRCP Biopsy report confirming the justification of surgery-P | Clinical
SURGERY 2 Jejunostomy for 0423 notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Histopathology
biliary stricture report-C | Intra procedure Clinical photograp of removed colon-C | Scar Photo-C
GENERAL SG SG000074 Hernia SG0000748000 Umbilical/Paraumbilical/Spigelian/Incisional hernia 22400 Yes 0 Yes 2 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh - 15 X 15-2000 Max :2 Umbilical/Paraumbilical/Spigelian/Incisional hernia )+/- Invoice of Mesh used-C | Clinical notes-P | Clinical photograph-P | Detailed
SURGERY 8 0424 Operative notes-C | Detailed discharge summary-C | Post procedure clinical
photograph-C | Scar Photo-C | USG (specifying size of defect)-P
GENERAL SG SG000075 Hernia - SG0000750000 Hernia - Epigastric/ Ventral 20000 Yes 0 Yes 2 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mesh - 15 X 15-2000 Max :2 Hernia - Epigastric/ Ventral )+/- Invoice of Mesh used-C | Clinical notes-P | Clinical photograph-P | Detailed
SURGERY 0 Epigastric/ Ventral 0425 Operative notes-C | Detailed discharge summary-C | Post procedure clinical
photograph-C | Scar Photo-C | USG (specifying size of defect)-P
GENERAL SG SG000075 Hiatus Hernia SG0000752000 Hiatus Hernia Repair - Open/Hiatus Hernia Repair - 30400 No 0 No 0 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hiatus Hernia Repair - Open/Hiatus Hernia Repair - X-ray/ USG-P | Clinical notes-P | Detailed Operative notes-C | Discharge summary-C |
SURGERY 2 Repair / 0426 Lap/Fundoplication - Open(+/- Hiatus Hernia repair) /Anti Lap/Fundoplication - Open(+/- Hiatus Hernia repair) /Anti Intra procedure clinical photograph-C | Scar photo-C | UGI Endoscopy-P
Fundoplication GERD Surgery GERD Surgery
GENERAL SG SG000079 I Stage- Sub Total SG0000792000 I Stage- Sub Total Colectomy + Ileostomy + J - Pouch 70000 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N I Stage- Sub Total Colectomy + Ileostomy + J - Pouch Admission Notes comprising of history and examination with indications for the
SURGERY 2 Colectomy + 0427 procedure-P | CT-P | Colonoscopy-P | Detailed Operative notes-C | Discharge
Ileostomy + J - summary-C | HPE-C | Intra procedure clinical photograph-C | Relavant Investigations
Pouch (establishing diagnosis)-P | Scar photo-C
GENERAL SG SG000079 I Stage-Sub Total SG0000793000 I Stage- Total/Sub Total Colectomy + Ileostomy 35000 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N I Stage- Total/Sub Total Colectomy + Ileostomy Admission Notes comprising of history and examination with indications for the
SURGERY 3 Colectomy + 0428 procedure-P | CT-P | Colonoscopy-P | Detailed Operative notes-C | Discharge
Ileostomy summary-C | HPE-C | Intra procedure clinical photograph-C | Relavant Investigations
(establishing diagnosis)-P | Scar photo-C
GENERAL SG SG000080 Ileostomy SG0000800000 Ileostomy-Stand alone 14300 No 0 No 0 No No Tertiary 3 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N Ileostomy-Stand alone Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 0 0429 Endoscopy / Biopsy/ CT Scan confirming the diagnosis for which this surgery is done-P |
Histopath-C | Post procedure clinical photograph-C
GENERAL SG SG000081 Inguinal Node SG0000818000 Inguinal Node (dissection) - U/L and B/L 0 Yes 1 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral-21700 | Unilateral - Inguinal Node (dissection) - U/L and B/L Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 8 (dissection) 0430 Inguinal Node (dissection)-17700 Histopath-C | Intra procedure clinical photograph-C | USG/ Biopsy/ FNAC report
confirming the diagnosis for which the surgery is done-P
GENERAL SG SG000082 Intestinal SG0000826000 Intestinal obstruction- medical management (2days) 6000 No 0 No 0 No No Secondary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Intestinal obstruction- medical management (2days) Admission notes showing vitals-P | All investigations reports-C | Any investigations
SURGERY 6 obstruction 0431 reports in support of diagnosis-P | Clinical Photo-C | Clinical photo-P | Detailed ICPs-C
| Detailed discharge summary-C | Examination findings-P | Notes detailing history-P |
Planned line of management-P | Treatment details-C | X-ray-C | X-ray-P
GENERAL SG SG000084 Appendicectomy SG0000840000 Appendicectomy 15600 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Appendicectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 371 Histopathology report-C | Intra procedure clinical photograph of removed appendix-C |
Post procedure clinical photograph-C | USG / CT abdomen confirming the diagnosis-P
GENERAL SG SG000089 Lobectomy SG0000890000 LUNG Lobectomy-Open/Thoracoscopic 27800 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N LUNG Lobectomy-Open/Thoracoscopic Biopsy-P | CT Thorax confirming the diagnosis-P | Clinical notes-P | Detailed Operative
SURGERY 0 0432 notes-C | Detailed discharge summary-C | Histopath-C | Intra procedure clinical
photograph-C | Scar Photo-C | }+-Cytology-P
GENERAL SG SG000089 Lymphatics SG0000899000 Lymphatics Excision of Subcutaneous Tissues In 13000 No 0 No 0 No No Secondary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Lymphatics Excision of Subcutaneous Tissues In Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Detailed
SURGERY 9 Excision of 0433 Lymphoedema Lymphoedema discharge summary-C | Detailing history-P | Histopathology report-C | Post procedure
Subcutaneous clinical photograph-C | Scar Photo-C
Tissues In
Lymphoedema
GENERAL SG SG000091 Management of SG0000912000 Haemostatic Surgery in advance cancer patient/Haemostatic 20000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Haemostatic Surgery in advance cancer patient/Haemostatic Planned line of treatment-P | CBC-P | CT Angio-P | Discharge summary with detail
SURGERY 2 bleeding 0434 Radiotherapy Radiotherapy treatment & interventions-C | KFT-P | LFT-P | Photo-C | Photo-P | Procedure notes-
malignant head C | Relevent investigation confirming existing malignancy Clinical notes-P
and neck /
inguinal lesions
GENERAL SG SG000091 Management of SG0000915000 Management of Chest injury with fixation of Single LIMB 30000 Yes 0 Yes 5 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for One fracture of long Management of Chest injury with fixation of Single LIMB X-ray/ CT/ MRI (of both chest & affected long bone)-P | Clinical notes detailing the injury
SURGERY 5 Chest injury with 0436 (Min 5 Days LOS) bone-5000 Max :5 (Min 5 Days LOS) and need of surgery-P | Detailed discharge summary-C | Detailed operatives notes-C |
fracture of Long Intra- op Clinical Photograph-C | MLC/ FIR-P | Scar Photo-C | X-rays showing chest
bone injury repair and implant for fixation-C
GENERAL SG SG000091 Management of SG0000915000 Management of Chest injury with fixation of 2 or more LIMB 45000 Yes 0 Yes 5 Yes No Tertiary 5 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for One fracture of long Management of Chest injury with fixation of 2 or more LIMB X-ray/ CT/ MRI (of both chest & affected long bone)-P | Clinical notes detailing the injury
SURGERY 5 Chest injury with 0435 (Min 5 Days LOS) bone-5000 Max :5 (Min 5 Days LOS) and need of surgery-P | Detailed discharge summary-C | Detailed operatives notes-C |
fracture of Long Intra- op Clinical Photograph-C | MLC/ FIR-P | Scar Photo-C | X-rays showing chest
bone injury repair and implant for fixation-C
GENERAL SG SG000091 management of GI SG0000918000 Operative management of GI perforation / Operative 13000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Operative management of GI perforation / Operative Admission notes showing vitals-P | Any investigations reports in support of diagnosis-P |
SURGERY 8 perforation / 0458 drainage of Appendicular Abscess drainage of Appendicular Abscess Clinical photo-P | Detailed Operative notes-C | Discharge summary-C | Examination
Appendicular findings-P | Intra Operative clinical photograph-C | Notes detailing history-P | Scar
Abscess photo-C | USG / X-ray / CT-P
GENERAL SG SG000091 Management of SG0000919000 Management of Pilonidal Sinus Under RA/GA (Pre op MRI) 12000 No 0 No 0 No No Secondary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Management of Pilonidal Sinus Under RA/GA (Pre op MRI) Clinical photo-P | Detailed Operative notes-C | Histopath-C | Intra-operative clinical
SURGERY 9 Pilonidal Sinus 0437 photograph-C | Notes confirmation of Pilonidal sinus on examination-P
GENERAL SG SG000092 Management of SG0000920000 Minor sclerotherapy 5000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Minor sclerotherapy Clinical photo-P | Detailed Operative notes-C | Detailed discharge summary-C | Notes
SURGERY 0 Varicose Veins 0439 confirmation of Varicose Veins on examination-P | Post procedure clinical photograph-C
| Relevent investigations reports in support of diagnosis.-P
GENERAL SG SG000092 Management of SG0000920000 Management of Varicose Veins-Operative management 14300 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Management of Varicose Veins-Operative management Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Duplex
SURGERY 0 Varicose Veins 0438 ultrasonography/ Colour Doppler confirming the diagnosis-P | Post procedure clinical
photograph-C | Pre-op Clinical photograph-P | Scar photo-C
GENERAL SG SG000092 Management of SG0000921000 Surgical intervention for Visceral injury and fixation of 39100 Yes 0 Yes 5 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for One fracture of long Surgical intervention for Visceral injury and fixation of X-ray/ CT/ MRI (of both affected viscera & affected long bone)-P | Clinical notes
SURGERY 1 Visceral injury and 0441 fracture of single limb bone-5000 Max :5 fracture of single limb detailing the injury and need of surgery-P | Detailed discharge summary-C | Detailed
fracture long bone operatives notes-C | Intra- op Clinical Photograph-C | MLC/ FIR-P | Scar Photo-C | X-
rays showing chest injury repair and implant for fixation-C
GENERAL SG SG000092 Management of SG0000921000 Surgical intervention for Visceral injury and fixation of 52100 Yes 0 Yes 5 Yes No Tertiary 10 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for One fracture of long Surgical intervention for Visceral injury and fixation of Clinical notes detailing the injury and need of surgery-P | Detailed discharge summary-C
SURGERY 1 Visceral injury and 0440 fracture of 2 or more llmb bone-5000 Max :5 fracture of 2 or more llmb | Detailed operatives notes-C | Intra- op Clinical Photograph-C | MLC/ FIR-P | Scar
fracture long bone Photo-C | X-ray/ CT/ MRI (of both affected viscera & affected long bone)-P | X-rays
showing chest injury repair and implant for fixation-C
GENERAL SG SG000092 Mastectomy SG0000927000 Simple Mastectomy 20000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Simple Mastectomy Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Detailed
SURGERY 7 0443 discharge summary-C | FNAC / Biopsy confirming the diagnosis-P | Histopath /
Specimen Photo-C | Mammography / USG-P | Post procedure clinical photograph-C
GENERAL SG SG000092 Mastectomy SG0000927000 Radical / Modified Radical Mastectomy 25000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical / Modified Radical Mastectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 7 0442 Histopath / Specimen Photo-C | Mammography / USG and FNAC / Biopsy justifying
surgery-P
GENERAL SG SG000095 Mesenteric Caval SG0000952000 Mesenteric Caval Anastomosis 33900 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Mesenteric Caval Anastomosis Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | Intra
SURGERY 2 Anastomosis 0444 procedure clinical photograph-C | Scar photo-C | USG/CT/MRI/ Endoscopy report
confirming the diagnosis for which the anastomosis is done-P
GENERAL SG SG000095 Mesenteric Cyst – SG0000953000 Mesenteric Cyst – Excision 17900 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Mesenteric Cyst – Excision Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
SURGERY 3 Excision 0445 Histopath-C | Intra procedure clinical photograph-C | Scar Photo-C | USG/CT/MRI
report confirming the diagnosis-P
GENERAL SG SG000097 Neck dissection SG0000976000 Selective Benign neck tumour 18000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Selective Benign neck tumour Clinical Photograph-P | Detailed Procedure / Operative Notes-C | Detailed discharge
SURGERY 6 0446 excision/Comprehensive Benign neck tumour excision/Comprehensive Benign neck tumour summary-C | FNAC / Biospy in case of tumours-P | Histopathology report-C |
excision/Selective Pharyngeal diverticulum excision/Selective Pharyngeal diverticulum Indication for surgery with supporting investigation reports (X-ray/ CT/MRI)-P | Post
excision/Comprehensive Pharyngeal excision/Comprehensive Pharyngeal procedure Imaging-C | Post procedure clinical photograph of affected part-C
diverticulum excision diverticulum excision
GENERAL SG SG000097 Necrotising SG0000978000 Necrotising fasciitis / Fournier Gangrene 11000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Necrotising fasciitis / Fournier Gangrene Clinical notes detailing findings confirming the diagnosis-P | Clinical photograph of
SURGERY 8 fasciitis / Fournier 0447 affected part-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
Gangrene C | Post Procedure clinical photgraph-C
GENERAL SG SG000099 aspiration/ SG0000990000 aspiration/ Intercostal drainage Only 4800 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N aspiration/ Intercostal drainage Only Analysis report of drained fluid-C | Chest X-Ray PA-P | Clinical notes-P | Clinical
SURGERY Intercostal 372 photograph-P | Detailed Operative notes-C | Detailed discharge summary-C | Detailing
drainage Only need of ICD-P | Post procedure clinical photograph-C
SURGICAL SO SO000010 Oesophageal / SO0000102000 Oesophageal stenting/Tracheal stenting 63500 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Oesophageal stenting/Tracheal stenting Barcode of Stent; Detailed Procedure / Operative Notes, Detailed Discharge summary.-C
ONCOLOG 20 Tracheal stenting 001564 | CECT-P | Clinical notes-P | OGD Scopy-P
Y
SURGICAL SO SO000010 Oesophagectomy SO0000102600 Oesophagectomy Open / lap / VATS / Transthorasic/2F/3F 86900 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Oesophagectomy Open / lap / VATS / Transthorasic/2F/3F Clinical notes-P | Detailed Operative notes-C | Histopath-C | Intra procedure clinical
ONCOLOG 26 001565 photograph-C | USG/CT/MRI/ Biopsy report confirming the diagnosis for which the
Y surgery is done-P | detailed discharge summary-C
SURGICAL SO SO000010 Omentectomy SO0000102700 Omentectomy - Govt Reserve 28000 No 0 No 0 No Yes Tertiary 6 No Yes Yes Govt No No No Surgical No Insurance N N N Omentectomy - Govt Reserve Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 27 001566 Reserve report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000010 Open laryngeal SO0000103100 Open laryngeal framework surgery / Thyroplasty 18000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Open laryngeal framework surgery / Thyroplasty Clinical Photograph-P | Clinical notes to establish indication and justification of surgery-P
ONCOLOG 31 framework 001567 | Detailed discharge summary-C | Evidence through CT/ MRI/ Biopsy-P |
Y surgery / Histopathology report in case of tumours-C | detailed Procedure / Operative Notes-C |
Thyroplasty post procedure clinical photograph of affected part-C
SURGICAL SO SO000010 Operation for SO0000103900 Wedge Excision 19000 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Wedge Excision Clinical Photograph-P | Clinical notes and Biopsy report-P | Detailed Operative notes-C
ONCOLOG 39 Carcinoma Lip 001568 | Detailed discharge summary-C | Histopath-C | Post procedure clinical photograph-C
Y
SURGICAL SO SO000010 Operation for SO0000103900 Wedge Excision and Vermilionectomy/Cheek advancement 26000 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Wedge Excision and Vermilionectomy/Cheek advancement Clinical Photograph-P | Clinical notes and Biopsy report-P | Detailed Operative notes-C
ONCOLOG 39 Carcinoma Lip 001569 | Detailed discharge summary-C | Histopath-C | Post procedure clinical photograph-C
Y
SURGICAL SO SO000010 Orchidectomy SO0000106200 Orchidectomy BL / UL - Govt reserved 10400 No 0 No 0 No Yes Tertiary 2 No Yes Yes Govt No No No Surgical No Insurance N N N Orchidectomy BL / UL - Govt reserved Clinical notes and describing Swelling in scrotum, USG of scrotum, tumour markers (if
ONCOLOG 62 001570 Reserve cancer of prostate/testis,etc is the indication)-P | Detailed Operative notes-C | Detailed
Y discharge summary-C | Histopath-C | Intra procedure clinical photograph-C |
Justification of orchidectmy-P
SURGICAL SO SO000010 Palatectomy SO0000107500 Soft palate / Hard palate 20000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Soft palate / Hard palate )+/- CT/ MRI-P | Biopsy and clinical photograph-P | Clinical notes-P | Clinical photgraph
ONCOLOG 75 001571 showing scar-C | HPE-C | detailed Procedure / Operative Notes-C | detailed discharge
Y summary-C
SURGICAL SO SO000010 Palliative Care SO0000108300 Hematuria Palliative Interventions 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hematuria Palliative Interventions CBC-P | CECT/ x-Ray/USG-P | Discharge summary with detail treatment and details of
ONCOLOG 83 Approach to 001572 interventions and procedure done.-C | KFT-P | LFT-P | Urine Culture Clinical notes
Y managing with planned line of treatment-P
Haematuria in
advanced cancer
patients-
Endoscopic/
Surgical/
Radiological,
Radiotherpay
SURGICAL SO SO000010 interventions
Palliative Care SO0000108700 Pressure sore-Interventions 25000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pressure sore-Interventions CBC-P | CECT/ x-Ray/USG-P | Clinical notes with planned line of treatment-P |
ONCOLOG 87 approach to 001573 Discharge summary with detail treatment & interventions-C | KFT-P | LFT-P |
Y managing Procedure notes-C
Pressure sore in
advanced chronic
diseases who are
bed ridden-
Surgical
SURGICAL SO SO000010 Palliative Care SO0000108900 Osteoradionecrosis -Surgical intervention 40000 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Osteoradionecrosis -Surgical intervention CBC-P | CECT/ x-Ray/USG-P | Clinical notes with planned line of treatment-P |
ONCOLOG 89 Management of 001574 Discharge summary with detail treatment & interventions-C | KFT-P | LFT-P |
Y Osteoradionecrosi Procedure notes-C
s -Surgical
intervention
SURGICAL SO SO000010 Palliative SO0000109400 Palliative Radiological Interventions. Like- 20000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Palliative Radiological Interventions. Like- CBC-P | CECT/ X-Ray-P | Clinical notes with planned line of treatment-P | Discharge
ONCOLOG 94 Radiological and 001575 PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc summary with detail treatment & interventions & Final bill with payment receipt-C | KFT-
Y endoscopical P | LFT-P
Interventions
SURGICAL SO SO000010 Palliative surgical SO0000109700 Palliative surgical interventions 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Palliative surgical interventions CBC-P | CECT/MRI/ x-Ray-P | Clinical notes with planned line of treatment-P |
ONCOLOG 97 interventions like- 001576 Discharge summary with detail treatment & interventions-C | KFT-P | LFT-P |
Y Colostomy, Procedure notes-C
Tracheostomy,
Feeding
Jejunostomy/Gast
rostomy, Bowel
bypas, Fistulas,
Urinary diversions
etc.in advanced
cancer patients
SURGICAL SO SO000010 PancreaticoDuode SO0000109900 PancreaticoDuodenectomy (Whipple's) 86900 No 0 No 0 No No Tertiary 15 No Yes Yes Regular PKG No No No Surgical No Insurance N N N PancreaticoDuodenectomy (Whipple's) CT/ USG-P | Clinical notes-P | Detailed Operative notes-C | ERCP confirming the
ONCOLOG 99 nectomy 001577 diagnosis-P | Histopath-C | Intra procedure clinical photograph-C | detailed discharge
Y (Whipple's) summary-C
SURGICAL SO SO000011 Parapharyngeal SO0000110300 Parapharyngeal Tumour Excision 33000 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Parapharyngeal Tumour Excision CT / MRI-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 03 Tumour Excision 001578 Summary-C | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C |
Y Procedure / Operative Notes-C
SURGICAL SO SO000011 Parotidectomy SO0000110700 Superficial Parotidectomy 23000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Superficial Parotidectomy CT Scan-P | Clinical Photograph of affected part-P | FNAC-P | Histopathology report-C
ONCOLOG 07 001579 | and detailed discharge summary-C | detailed Procedure / Operative Notes-C | post
Y procedure clinical photograph of affected part-C
SURGICAL SO SO000011 Parotidectomy SO0000110700 Total Parotidectomy 28000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Parotidectomy CT Scan-P | Clinical Photograph of affected part-P | FNAC-P | Histopathology report-C
ONCOLOG 07 001580 | detailed Procedure / Operative Notes-C | detailed discharge summary-C | post
Y procedure clinical photograph of affected part-C
SURGICAL SO SO000011 Partial Cystectomy SO0000110900 Partial Cystectomy 26000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Cystectomy CT/MRI confirming the indication and need of this surgery with supporting Evidence of
ONCOLOG 09 001581 the same (FNAC/Biopsy)-P | Clinical notes-P | Histopathology report-C | detailed
Y Procedure / Operative Notes-C | detailed discharge summary-C
SURGICAL SO SO000011 Pelvic SO0000111900 Pelvic Exenteration Anterior - Open/Pelvic Exenteration 103000 No 0 No 0 Yes No Tertiary 15 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pelvic Exenteration Anterior - Open/Pelvic Exenteration CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 19 Exenteration 001582 Anterior - Lap/Pelvic Exenteration Total - Open/Pelvic Anterior - Lap/Pelvic Exenteration Total - Open/Pelvic | HPE report-C | HPE-P | Procedure / Operative Notes-C
Y Exenteration Total - Lap. Exenteration Total - Lap.
SURGICAL SO SO000011 Axillary dissection SO0000112000 Axillary dissection 21700 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Axillary dissection FNAC/ BIOPSY-P | CECT/ Chest X-ray-P | Clinical Photograph showing scar-C | Clinical
ONCOLOG 2 01480 notes-P | HPE report-C | USG Axilla + Breast-P | detailed Procedure / Operative Notes-
Y C | detailed discharge summary-C
SURGICAL SO SO000011 Pelvic SO0000112000 Pelvic lymphadenectomy, after prior cancer surgery- 30000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pelvic lymphadenectomy, after prior cancer surgery- Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT / Biopsy
ONCOLOG 20 lymphadenectom 001583 Open/Laparoscopic Open/Laparoscopic confirming bilateral testicular cancer-P | detailed Procedure / Operative Notes-C
Y y, after prior
cancer surgery
SURGICAL SO SO000011 Penectomy SO0000112300 Partial Penectomy 17300 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Penectomy Biopsy findings-P | Clinical notes-P | Detailed discharge summary-C | Histopathology-C
ONCOLOG 23 001584 | detailed Procedure / Operative Notes-C
Y
SURGICAL SO SO000011 Penectomy SO0000112300 Total Penectomy + Perineal Urethrostomy 26000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Penectomy + Perineal Urethrostomy Biopsy findings-P | Clinical notes-P | Detailed discharge summary-C | Histopathology-C
ONCOLOG 23 001585 | Notes detailing urethrostomy-C | detailed Procedure / Operative Notes-C
Y
SURGICAL SO SO000011 Penile preserving SO0000112600 Penile preserving surgery 25000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Penile preserving surgery Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 26 surgery 001586 (WLE, Glansectomy, Laser) (WLE, Glansectomy, Laser) report-C | HPE-P | Procedure / Operative Notes-C
Y (WLE,
Glansectomy,
Laser)
SURGICAL SO SO000011 Axillary Sampling / SO0000113000 Axillary Sampling / Sentinel Node Biopsy 15000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Axillary Sampling / Sentinel Node Biopsy Clinical notes-P | Detailed Discharge Summary-C | FNAC-P | HPE report-C | Planned
ONCOLOG 3 Sentinel Node 01481 line of treatment-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Biopsy Operative Notes-C | USG Axilla + Breast-P
SURGICAL SO SO000011 PET scan SO0000116100 PET scan 14000 Yes 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes yes No Surgical No Insurance N N N PET scan Admission notes showing vitals and examination findings-P | All investigations reports
ONCOLOG 61 001587 including PETs scan report-C | Any investigations done-P | Clinical notes detailing
Y history-P | Detailed ICPs-C | Detailed discharge summary-C | Planned line of
SURGICAL SO SO000011 Pleurectomy SO0000117300 Pleurectomy Decortication 44300 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pleurectomy Decortication CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 73 Decortication 001588 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000011 Pneumonectomy SO0000117800 Pneumonectomy 66000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pneumonectomy Biopsy-P | CT Thorax-P | Clinical notes with planned line of treatment-P | Detailed
ONCOLOG 78 001589 Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000011 Posterior SO0000119900 Posterior Exenteration (Gynaec) 80000 No 0 No 0 No No Tertiary 15 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Posterior Exenteration (Gynaec) CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 99 Exenteration 001590 | HPE report-C | HPE-P | Procedure / Operative Notes-C
Y (Gynaec)
SURGICAL SO SO000012 Procedure on SO0000120400 Procedure on Fallopian Tube for 11500 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Procedure on Fallopian Tube for Detailed Operative notes-C | Detailed discharge summary-C | Indication of the
ONCOLOG 04 Fallopian Tube for 001591 establishing Tubal Patency establishing Tubal Patency procedure preferably with record of previous sterilization/ reason for non-availability-P |
Y establishing Tubal Intra procedure clinical photograph-C
Patency
SURGICAL SO SO000012 Benign Soft Tissue SO0000122000 Benign Soft Tissue Tumour - Excision - govt reserve 10000 No 0 No 0 No Yes Tertiary 3 No Yes Yes Govt No No No Surgical No Insurance N N N Benign Soft Tissue Tumour - Excision - govt reserve Biopsy report-P | Clinical notes-P | Detailed Discharge Summary-C | HPE report-C |
ONCOLOG 2 Tumour - Excision 01482 Reserve HPE-P | Planned line of treatment-P | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000012 Radical / Revision SO0000122400 Radical / Revision Cholecystectomy 60000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical / Revision Cholecystectomy CECT/MRI reports-P | Clinical Photograph showing scar-C | Clinical notes-P | HPE
ONCOLOG 24 Cholecystectomy 001592 report-C | detailed Procedure / Operative Notes-C | detailed discharge summary-C
Y
SURGICAL SO SO000012 Radical SO0000122500 Radical cystectomy With continent diversion - Open + 113000 No 0 No 0 Yes No Tertiary 8 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy With continent diversion - Open + CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 25 cystectomy 001594 BPLND BPLND | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000012 Radical SO0000122500 Radical cystectomy - With ureterosigmoidostomy + BPLND - 75000 No 0 No 0 Yes No Tertiary 8 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy - With ureterosigmoidostomy + BPLND - CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 25 cystectomy 001593 Open/Lap. Open/Lap. | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000012 Radical SO0000122500 Radical cystectomy With continent diversion + BPLND - 113000 No 0 No 0 Yes No Tertiary 8 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy With continent diversion + BPLND - CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 25 cystectomy 001595 Open Open | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000012 Radical SO0000122500 Radical cystectomy Without Ileal Conduit + BPLND 100000 No 0 No 0 Yes No Tertiary 8 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy Without Ileal Conduit + BPLND CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 25 cystectomy 001598 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000012 Radical SO0000122500 Radical cystectomy With Ileal Conduit + BPLND 110400 No 0 No 0 Yes No Tertiary 8 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy With Ileal Conduit + BPLND CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
Y Operative Notes-C
SURGICAL SO SO000012 Radical SO0000122500 Radical cystectomy- With neobladder + BPLND 128000 No 0 No 0 Yes No Tertiary 11 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy- With neobladder + BPLND CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
Y Operative Notes-C
SURGICAL SO SO000012 Radical SO0000122800 Class II - V radical hysterectomy + bilateral 40000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Class II - V radical hysterectomy + bilateral Biopsy-P | CECT/ MRI-P | Clinical notes with planned line of treatment-P | Detailed
ONCOLOG 28 Hysterectomy 001599 salpingoophorectomy + BPLND - Lap./Class I radical salpingoophorectomy + BPLND - Lap./Class I radical Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
Y hysterectomy + bilateral salpingoophorectomy + BPLND - hysterectomy + bilateral salpingoophorectomy + BPLND - Procedure / Operative Notes-C
Open Open
SURGICAL SO SO000012 Radical SO0000122800 Hysterectomy + bilateral salpingoophorectomy + 60800 No 0 No 0 Yes No Tertiary 13 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hysterectomy + bilateral salpingoophorectomy + Biopsy-P | CECT/ MRI-P | Clinical notes with planned line of treatment-P | Detailed
ONCOLOG 28 Hysterectomy 001600 omentectomy + peritonectomy and organ resections ( omentectomy + peritonectomy and organ resections ( Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
Y Minimum 2 organs ) Minimum 2 organs ) Procedure / Operative Notes-C
SURGICAL SO SO000012 Radical Neck SO0000123200 Radical / comprehensive Neck Dissection 22600 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical / comprehensive Neck Dissection Biopsy-P | CT Scan/MRI Neck confirming the diagnosis-P | Clinical Photograph-P |
ONCOLOG 32 Dissection 001601 Clinical notes-P | Detailed Operative notes-C | Histopath-C | Intra procedure clinical
Y photograph OR Post procedure clinical photograph-C | detailed discharge summary-C
SURGICAL SO SO000012 Radical SO0000123500 Radical Retroperitoneal lymph node dissection 52100 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical Retroperitoneal lymph node dissection Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
ONCOLOG 35 Retroperitoneal 001602 C | Histopathology-C | USG/CT / Biopsy confirming bilateral testicular cancer-P
Y lymph node
dissection
SURGICAL SO SO000012 Radical Small SO0000123700 Radical Small Bowel Resection 60000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical Small Bowel Resection CECT-P | Clinical notes with planned line of treatment -P | Detailed Discharge Summary-
ONCOLOG 37 Bowel Resection 001603 C | FNAC/ BIOPSY-P | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000012 Radical SO0000123800 Radical Urethrectomy 30400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical Urethrectomy CT KUB-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 38 Urethrectomy 001604 Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000012 Bilateral SO0000124000 Bilateral Orchidectomy for hormone ablation 10000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bilateral Orchidectomy for hormone ablation USG/CT / Biopsy-P | CA prostate-P | Clinical notes-P | Detailed discharge summary-C
ONCOLOG 4 Orchidectomy for 01483 | Histopathology-C | detailed Procedure / Operative Notes-C
Y hormone ablation
SURGICAL SO SO000012 Radical SO0000124000 Radical vaginectomy 33000 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical vaginectomy Biopsy-P | CECT-P | Clinical notes-P | Detailed discharge summary-C | HPE report-C |
ONCOLOG 40 vaginectomy 001605 detailed Procedure / Operative Notes-C
Y
SURGICAL SO SO000012 Radical SO0000124100 Radical Vulvectomy with Inguinal and Pelvic lymph node 38500 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical Vulvectomy with Inguinal and Pelvic lymph node Admission Notes comprising of history and examination with indications for the
ONCOLOG 41 Vulvectomy with 001606 disection disection procedure-P | CT/MRI for staging-P | Detailed Procedure / Operative Notes together
Y Inguinal and Pelvic with indication of surgery-C | HPE-C | Intraop-C | Progress notes-C | Relavant
lymph node Investigations (establishing diagnosis)-P | Vulval biopsy-P | detailed discharge summary.-
disection C | pic off gross specimen removed-C | stills with date & patient ID-C
SURGICAL SO SO000012 Reconstruction SO0000124500 Tissue Reconstruction Flap / Flap Reconstructive Surgery / 25000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N R N Tissue Reconstruction Flap / Flap Reconstructive Surgery / Clinical notes-P | Clinical photograph of affected part justifying surgery-P | Detailed
ONCOLOG 45 Flap 001607 Rotation flap Rotation flap Operative notes-C | Detailed discharge summary-C | Evidence of confirmed diagnosis
Y of Leprosy-P | Intra procedure clinical photograph-C | Post procedure clinical
photograph (if flap taken from other site; even of donor site)-C
SURGICAL SO SO000012 Rectal Polyp SO0000124800 Rectal Polyp Excision 9600 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Rectal Polyp Excision Clinical notes-P | Colonoscopy +/- Biopsy justifying surgery-P | Detailed Operative notes-
ONCOLOG 48 Excision 001608 C | Histopath-C | Intra procedure clinical photograph-C | detailed discharge summary-
Y C
SURGICAL SO SO000012 Regional flap SO0000125500 Myocutaneous flap/Fasciocutaneous flap - add on 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Add On Yes No No Surgical No Insurance N N N Myocutaneous flap/Fasciocutaneous flap - add on Biopsy of primary-P | Clinical notes-P | Clinical photgraph showing scar-C | detailed
ONCOLOG 55 001609 Procedure / Operative Notes-C | detailed discharge summary-C
Y
SURGICAL SO SO000012 Removal of Chest SO0000125900 Chest Wall malignant Tumour Excision 75600 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Chest Wall malignant Tumour Excision CT-P | Clinical notes with planned line of treatment and HPE-P | Detailed Discharge
ONCOLOG 59 Wall Tumour 001610 Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000012 Bilateral pelvic SO0000126000 Bilateral pelvic lymph Node Dissection (BPLND) - add on 44000 No 0 No 0 No No Tertiary 7 No Yes Yes Add On No No No Surgical No Insurance N N N Bilateral pelvic lymph Node Dissection (BPLND) - add on Admission Notes comprising of history-P | CT/MRI for staging-P | Detailed Procedure /
ONCOLOG 6 lymph Node 01484 (excluded with hysterectomy) (excluded with hysterectomy) Operative Notes together with indication of surgery-C | Examination with indications for
Y Dissection the procedure-P | HPE Progress notes-C | Intraop stills with date & patient ID-C |
(BPLND) Relavant Investigations (establishing diagnosis)-P | biopsy of primary-P | detailed
discharge summary.-C | pic off gross specimen removed-C
SURGICAL SO SO000012 Removal of SO0000126200 Removal of Submandibular SalivaryGland / Salivary Ranula- 15000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Removal of Submandibular SalivaryGland / Salivary Ranula- Biopsy-P | Clinical examination notes-P | OT notes-C | USG/color doppler if done -P |
ONCOLOG 62 Submandibular 001611 with or without Lymph Node with or without Lymph Node discharge summary-C | relavant invetsigation reports-C
Y SalivaryGland /
Salivary Ranula-
with or without
Lymph Node
SURGICAL SO SO000012 Resection of SO0000127300 Resection of nasopharyngeal tumour 48600 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Resection of nasopharyngeal tumour Biopsy of primary CECT/MRI-P | Clinical Photograph showing scar-C | Clinical notes-P |
ONCOLOG 73 nasopharyngeal 001612 HPE report-C | MRI-P | detailed Procedure / Operative Notes-C | detailed discharge
Y tumour summary-C
SURGICAL SO SO000012 Biopsy SO0000128000 Cervix Cancer screening (PAP + Colposcopy+VIA) 2000 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cervix Cancer screening (PAP + Colposcopy+VIA) Clinical notes-P | Histopathology report-C | Pic of specimen-C | discharge summary-C
ONCOLOG 8 01485
Y
SURGICAL SO SO000012 Retroperitoneal SO0000128300 Retroperitoneal Tumor – Excision 26900 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Retroperitoneal Tumor – Excision Clinical notes-P | Detailed Operative notes-C | Histopath-C | Intra procedure clinical
ONCOLOG 83 Tumor – Excision 001613 photograph-C | X Ray/USG/CT Abdomen confirming the diagnosis-P | detailed
Y discharge summary-C
SURGICAL SO SO000013 Sacral Tumour SO0000130500 Sacral Tumour Excision 93300 No 0 No 0 Yes No Tertiary 13 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Sacral Tumour Excision Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 05 Excision 001614 report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000013 Salpingoophorect SO0000130800 Salpingoophorectomy- (B/L or U/L) 14000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Salpingoophorectomy- (B/L or U/L) Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 08 omy 001615 report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000013 Biopsy under GA SO0000131000 Biopsy under GA 5000 No 0 No 0 Yes No Secondary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Biopsy under GA )+/- FNAC report-P | Clinical Photograph of Enlarged lymph nodes-P | Clinical notes-P |
ONCOLOG 1 01486 Detailed Operative notes.-C | Histopathology report-C | post procedure clinical
Y photograph-C
SURGICAL SO SO000013 Scalp tumour SO0000131000 Scalp tumour excision with skull bone excision 30400 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Scalp tumour excision with skull bone excision Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 10 excision with skull 001616 report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y bone excision Operative Notes-C
SURGICAL SO SO000013 Secondary SO0000131700 Secondary suturing in operated Head and Neck Cancer 15000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Secondary suturing in operated Head and Neck Cancer cases Clinical Notes-P | Detailed Discharge Summary-C | Post Procedure Photographs of
ONCOLOG 17 suturing in 001617 cases - LA / GA - LA / GA surgical site-C | Previous surgery notes-P | Procedure / Operative Notes-C
Y operated Head
and Neck Cancer
cases - LA / GA
SURGICAL SO SO000013 Segmental SO0000131800 Segmental resection of lung-Open /Thoracoscopic 67700 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Segmental resection of lung-Open /Thoracoscopic Biopsy-P | Clinical notes with planned line of treatment and CT Thorax-P | Detailed
ONCOLOG 18 resection of lung 001618 Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000013 Segmentectomy - SO0000131900 Segmentectomy - hepatobiliary system 50000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Segmentectomy - hepatobiliary system Biopsy-P | CECT/ MRI-P | Clinical Photograph showing scar-C | Clinical notes-P | HPE
ONCOLOG 19 hepatobiliary 001619 report-C | detailed Procedure / Operative Notes-C | detailed discharge summary-C
Y system
SURGICAL SO SO000013 Sleeve resection SO0000134700 Sleeve resection of lung cancer 79100 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Sleeve resection of lung cancer CECT-P | Clinical Photograph showing scar-C | Clinical notes-P | FNAC/ BIOPSY-P |
ONCOLOG 47 of lung cancer 001620 HPE report-C | detailed Procedure / Operative Notes-C | detailed discharge summary-C
Y
SURGICAL SO SO000013 Split thickness skin SO0000136800 Large (>4% TBSA) 15000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Large (>4% TBSA) Clinical Photograph-P | Clinical notes detailing time of Burns-P | Detailed Operative
ONCOLOG 68 grafts 001621 notes-C | Detailed discharge summary-C | Post procedure clinical photograph-C
Y
SURGICAL SO SO000013 Split thickness skin SO0000136800 small (< 4% TBSA) 10000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N small (< 4% TBSA) Clinical Photograph-P | Clinical notes detailing time of Burns-P | Detailed Operative
ONCOLOG 68 grafts 001622 notes-C | Detailed discharge summary-C | Post procedure clinical photograph-C
Y
SURGICAL SO SO000013 Staging SO0000137400 Staging Laparotomy and proceed for Ovarian Cancers. 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Staging Laparotomy and proceed for Ovarian Cancers. Pelvis establishing indication-P | Clinical notes-P | Detailed Discharge Summary.-C |
ONCOLOG 74 Laparotomy and 001623 Omentomy with Bilateral Omentomy with Bilateral Detailed Operative notes-C | Histopathology-C | Pelvis/ CT abdomen-P | USG
Y proceed for Salpingo-oophorectomy (BPLND if req ) Salpingo-oophorectomy (BPLND if req ) Abdomen-P | per op pic of specimen removed-C
Ovarian Cancers.
Omentomy with
Bilateral Salpingo-
oophorectomy
SURGICAL SO SO000013 Stress SO0000138000 Stress incontinence surgery - Open 23000 Yes 0 Yes 1 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N TVT /TOT/Sling -15000 Max :1 Stress incontinence surgery - Open Clinical notes-P | Cystoscopy/ USG/ Uro Dynamic study to confirm the dignosis-P |
ONCOLOG 80 incontinence 001624 Detailed Procedure / Operative Notes-C | detailed discharge summary-C
Y surgery
SURGICAL SO SO000013 Submandibular SO0000138500 Submandibular swelling Excision 20000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Submandibular swelling Excision Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Histopath-C |
ONCOLOG 85 swelling Excision 001625 Post procedure clinical photograph-C | USG/CT Scan confirming the diagnosis for which
Y the surgery is done +/- Biopsy/FNAC-P | detailed discharge summary-C
SURGICAL SO SO000013 Subtotal SO0000138700 Subtotal Colectomy 45000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Subtotal Colectomy Biopsy-P | CT report with film-P | Clinical Photograph showing scar + HPE report-C |
ONCOLOG 87 Colectomy 001626 Endoscopy with film-P
Y
SURGICAL SO SO000013 Surgery for SO0000139200 Abdominal wall tumour resection 40000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abdominal wall tumour resection Biopsy-P | Clinical Photograph showing scar-C | Clinical notes and CT abdomen reports-
ONCOLOG 92 Abdominal wall 001627 P | HPE report-C | detailed Procedure / Operative Notes-C | detailed discharge
Y tumour summary-C
SURGICAL SO SO000013 Surgery for SO0000139200 Abdominal wall tumour resection with reconstruction 64300 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abdominal wall tumour resection with reconstruction Biopsy-P | Clinical Photograph showing scar-C | Clinical notes and CT abdomen reports-
ONCOLOG 92 Abdominal wall 001628 P | HPE report-C | detailed Procedure / Operative Notes-C | detailed discharge
Y tumour summary-C
SURGICAL SO SO000013 Surgery for Cyst & SO0000139600 Enucleation / excision of cyst / tumour of jaws under LA 2500 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Enucleation / excision of cyst / tumour of jaws under LA Biopsy/FNAC if tumour-P | Clinical Photograph-P | Detailed Procedure / Operative
ONCOLOG 96 tumour of Maxilla 001629 Notes-C | HPE-C | Histopath-C | OPG/ CT Scan confirming the diagnosis-P | Post
Y / Mandible procedure clinical photograph-C | detailed discharge summary-C
SURGICAL SO SO000013 Surgery for Cyst & SO0000139600 5000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Biopsy/FNAC if tumour-P | Clinical Photograph-P | Detailed Procedure / Operative
ONCOLOG 96 tumour of Maxilla 001630 Notes-C | HPE-C | Histopath-C | OPG/ CT Scan confirming the diagnosis-P | Post
Y / Mandible Enucleation / excision of cyst / tumour of jaws under GA Enucleation / excision of cyst / tumour of jaws under GA procedure clinical photograph-C | detailed discharge summary-C
SURGICAL SO SO000014 Surgical SO0000141600 Cyst / biopsy / FNAC/ I&D/ In growing toe nail - Day care 700 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Day care Yes No No Surgical Yes Insurance Y N N Cyst / biopsy / FNAC/ I&D/ In growing toe nail - Day care Deailed Clinical notes-P | Detailed Operative notes-C | Intra operative clinical
ONCOLOG 16 procedure under 001631 photograph-C | detailed discharge summary.-C
Y LA
SURGICAL SO SO000014 Thoracostomy SO0000143700 Thoracostomy 20000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Thoracostomy Clinical notes with planned line of treatment-P | Clinical photograph-P | Detailed
SURGICAL SO SO000014 Thyroidectomy SO0000144400 Hemi thyroidectomy 20000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hemi thyroidectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
ONCOLOG 44 001633 FNAC/USG confirming the diagnosis and justifying the surgery-P | Histopath report-C |
Y Post procedure clinical photograph-C | Thyroid Function Test-P
SURGICAL SO SO000014 Thyroidectomy SO0000144400 Total thyroidectomy 23000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total thyroidectomy Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
ONCOLOG 44 001634 FNAC/USG confirming the diagnosis and justifying the surgery-P | Histopath report-C |
Y Post procedure clinical photograph-C | Thyroid Function Test-P
SURGICAL SO SO000014 Thyroidectomy SO0000144400 Total Thyroidectomy with central neck Dissection 26000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Thyroidectomy with central neck Dissection Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C | FNAC/
ONCOLOG 44 001635 Biopsy/ Thyroid Function Test/USG confirming the diagnosis and need for surgery-P |
Y Histopath report-C | Post procedure clinical photograph-C | Scar Photo-C
SURGICAL SO SO000014 Total SO0000145700 Total Pharyngectomy 43400 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Total Pharyngectomy CT / MRI-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 57 Pharyngectomy 001636 Summary-C | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000014 Tracheal / Carinal SO0000145900 Tracheal / Carinal resection 52000 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Tracheal / Carinal resection CT / MRI-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 59 resection 001637 Summary-C | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000014 Tracheal Stenosis SO0000146000 Tracheal Stenosis (End to end Anastamosis) (Throat) 36000 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Tracheal Stenosis (End to end Anastamosis) (Throat) CT / MRI-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 60 (End to end 001638 Summary-C | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C |
Y Anastamosis) Procedure / Operative Notes-C
(Throat)
SURGICAL SO SO000014 TURBT - Restage SO0000148300 TURBT - Restage 18000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N TURBT - Restage Clinical notes-P | Detailed discharge summary-C | Intra procedure still photograph
ONCOLOG 83 001639 Histopathology-C | USG/CT/ MRI confirming the diagnosis bladder tumour-P | detailed
SURGICAL SO SO000014 TURBT SO0000148500 TURBT 27500 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N TURBT Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT/ MRI
ONCOLOG 85 (Transurethral 001640 (Transurethral Resection of the Bladder Tumor) (Transurethral Resection of the Bladder Tumor) confirming the diagnosis bladder tumour-P | detailed Procedure / Operative Notes-C
Y Resection of the
Bladder Tumor)
SURGICAL SO SO000014 Ureteric end to SO0000149600 Ureteric end to end anastomosis 30400 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Ureteric end to end anastomosis CT KUB-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 96 end anastomosis 001641 Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000015 Bone marrow SO0000150000 Bone marrow aspiration / biopsy 1000 No 0 No 0 No No Secondary 1 no Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone marrow aspiration / biopsy Clinical notes-P | Detailed Operative notes.-C | Histopathology report-C | Investigation-
ONCOLOG 0 aspiration and 01487 P | post procedure clinical photograph-C
Y biopsy
SURGICAL SO SO000015 Bone tumors / SO0000152000 Bone tumors / soft tissue sarcomas: surgery 34700 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bone tumors / soft tissue sarcomas: surgery CT Scan / MRI-P | Clinical notes-P | Detailed Discharge Summary-C | HPE report-C |
ONCOLOG 2 soft tissue 01488 HPE-P | Planned line of treatment-P | Post Procedure Photographs of surgical site-C |
Y sarcomas: surgery Procedure / Operative Notes-C
SURGICAL SO SO000015 Vascular SO0000152800 Vascular reconstruction with or without vein graft 50000 No 0 No 0 No No Tertiary 9 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Vascular reconstruction with or without vein graft Clincal notes-P | Detailed Discharge Summary-C
ONCOLOG 28 reconstruction 001642
Y
SURGICAL SO SO000015 Vascular SO0000153100 Vascular reconstruction with Graft/Patch 35000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N PTFE Graft Large (>8mm)-50000 Vascular reconstruction with Graft/Patch Barcode / Invoice of Graft or patch.-C | Clincal notes-P | Detailed Discharge Summary-C
ONCOLOG 31 reconstruction 001643 Max :1 | PTFE Patch - Thin- | Post Procedure Photographs of surgical site-C | Procedure / Operative Notes-C |
Y with graft/patch 30000 Max :1 | PTFE graft small Relevent Investigations-P | USG / CT Scan-P
(upto 8 mm ) -30000 Max :1
SURGICAL SO SO000015 Vertebral Tumour SO0000154000 Vertebral Tumour Excision and Reconstruction 68600 No 0 No 0 No No Tertiary 11 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Vertebral Tumour Excision and Reconstruction Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 40 Excision and 001644 report-C | Post Procedure Photographs of surgical site-C | Procedure / Operative Notes-
Y Reconstruction C | Radiological evidence for indication-P
SURGICAL SO SO000015 Vertebroplasty/Ky SO0000154400 Vertebroplasty/Kyphoplasty - Govt reserved 40000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Surgical No Insurance N N N Vertebroplasty/Kyphoplasty - Govt reserved CECT/MRI/ x-Ray,CBC,LFT,KFT-P | Clinical notes with planned line of treatment-P |
ONCOLOG 44 phoplasty 001645 Reserve Discharge summary with detail treatment & interventions-C | Procedure notes.-C
Y
SURGICAL SO SO000015 Vulvectomy + SO0000155200 Vulvectomy - simple (Rs 20000) / Redical (Rs 40000) 0 Yes 1 No 0 Yes No Tertiary 11 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Redical reconstruction Vulvectomy - simple (Rs 20000) / Redical (Rs 40000) Biopsy/HPE-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 52 reconstruction 001646 reconstruction procedures procedures-36000 | reconstruction procedures Summary-C | HPE report-C | Procedure / Operative Notes-C
Y procedures Vulvectomy - simple-20000
SURGICAL SO SO000015 Wedge resection SO0000155400 Wedge resection lung- Open/Thoracoscopic 60000 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Wedge resection lung- Open/Thoracoscopic Biopsy-P | Clinical notes with planned line of treatment and CT Thorax-P | Detailed
ONCOLOG 54 lung 001647 Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000015 Wilms tumors: SO0000155600 Wilms tumors: surgery / Neuroblastoma 39100 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Wilms tumors: surgery / Neuroblastoma Biopsy/HPE-P | CT abdomen-P | Clinical notes with planned line of treatment-P |
ONCOLOG 56 surgery / 001648 Detailed Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical
Y Neuroblastoma site-C | Procedure / Operative Notes-C
SURGICAL SO SO000015 Bone Tumour SO0000156000 Bone Tumour Excision + reconstruction 40000 Yes 0 Yes 2 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Megaprothesis-75000 Max :2 | Bone Tumour Excision + reconstruction Biopsy-P | Clinical notes justifying need of this surgery-P | Clinical photograph of
ONCOLOG 6 Excision + 01489 Plate-5000 Max :2 affected part-P | Detailed discharge summary-C | Invoice and barcode of implant-C |
Y reconstruction Post procedure clinical photgraph-C | Post procedure imaging study (X Ray)-C | X-ray/
MRI of affected part-P | detailed Procedure / Operative Notes-C
SURGICAL SO SO000016 Breast conserving SO0000164000 Breast conserving surgery 40000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Breast conserving surgery Clinical notes-P | HPE report-C | Mammography / USG, FNAC/ BIOPSY-P | detailed
ONCOLOG 4 surgery 01490 (lumpectomy + axillary surgery) (lumpectomy + axillary surgery) Procedure / Operative Notes-C | detailed discharge summary-C
Y
SURGICAL SO SO000016 Breast Lump SO0000167000 Breast Lump Excision (Benign) under GA/RA 10000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Breast Lump Excision (Benign) under GA/RA )+/- FNAC report-P | Clinical notes-P | Detailed Operative notes-C | Histopathology
ONCOLOG 7 Excision (Benign) 01491 report-C | Sono mammogram OR Mamography showing breast lump-P | detailed
Y discharge summary.-C | intra operative clinical photograph-C
SURGICAL SO SO000017 Bypass - SO0000174000 Bypass - Inoperable Pancreas 46600 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Bypass - Inoperable Pancreas Clinical and radiological evidence of inoperability (biopsy, ERCP, MRCP /CT Scan)-P |
ONCOLOG 4 Inoperable 01492 Detailed Operative notes-C | Histopathology report-C | detailed discharge summary.-C
Y Pancreas | intra operative clinical photograph-C
SURGICAL SO SO000018 Carotid Body SO0000188000 Carotid Body tumour - Excision 26000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Carotid Body tumour - Excision Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
ONCOLOG 8 tumour - Excision 01493 Histopathology-C | Intra procedure clinical photograph-C | USG Neck/ Colour doppler
Y confirming the diagnosis-P
SURGICAL SO SO000020 Chamberlain SO0000209000 Chamberlain procedure 22200 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Chamberlain procedure CT Thorax-P | Clinical notes-P | Detailed Discharge Summary-C | HPE report-C |
ONCOLOG 9 procedure 01494 Planned line of treatment-P | Post Procedure Photographs of surgical site-C | Procedure
Y / Operative Notes-C
SURGICAL SO SO000021 Channel TURP SO0000210000 Channel TURP 26000 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Channel TURP Clinical notes-P | Detailed Discharge Summary-C | HPE report-C | PSA-P | Planned line
ONCOLOG 0 01495 of treatment-P | Procedure / Operative Notes-C | USG- prostate-P
Y
SURGICAL SO SO000021 Chemo Port SO0000215000 Chemo Port/PICC Insertion 11000 Yes 0 Yes 1 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Chemo Port - Paediatric-25000 Chemo Port/PICC Insertion Clinical notes-P | Invoice of Chemo port used-C | Planned line of treatment-P | Post
ONCOLOG 5 Insertion 01496 Max :1 | PICC / Chemo Port - Procedure X-ray which Shows Port-C | Procedure / Operative Notes-C | discharge
Y Adult -15000 Max :1 summary-C
SURGICAL SO SO000021 Chemoport/impla SO0000217000 Chemoport/implantable lines 11000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Chemo Port - Paediatric-25000 Chemoport/implantable lines CT/MRI/ DSA confirming the diagnosis-P | Clinical notes-P | Intra procedure clinical
ONCOLOG 7 ntable lines 01497 Max :1 | PICC / Chemo Port - photograph-C | Invoice of Chemo port used-C | Post Procedure X-ray which Shows Port-
Y Adult -15000 Max :1 C | discharge summary-C
SURGICAL SO SO000023 Closure of Burst SO0000239000 Closure of Burst Abdomen 15000 No 0 No 0 No No Tertiary 10 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Closure of Burst Abdomen X Ray/USG/ CT Abdomen confirming the diagnosis for which the surgery is done-P |
ONCOLOG 9 Abdomen 01498 Clinical notes describing the original surgery that led to burst abdomen-P | Detailed
Y Operative notes-C | Detailed discharge summary-C | Intra procedure clinical
photograph-C
SURGICAL SO SO000024 Closure of stoma SO0000243000 Closure of stoma 14500 No 0 No 0 No No Tertiary 10 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Closure of stoma Clinical notes detailing why colostomy was done? -P | Clinical photograph-P | Detailed
ONCOLOG 3 01499 Operative notes-C | Detailed discharge summary-C | Intra procedure clinical
Y photograph-C
SURGICAL SO SO000024 Colostomy SO0000247000 Defunctioning Colostomy - Stand Alone 15000 No 0 No 0 No No Tertiary 7 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N Defunctioning Colostomy - Stand Alone CT/ MRI/ Colonoscopy evidence of need of surgery-P | Clinical notes-P | Detailed
ONCOLOG 7 01500 Operative notes-C | Detailed surgery notes.-C | Post procedure clinical photograph-C
Y
SURGICAL SO SO000024 Colostomy SO0000247000 Exploratory laprotomy with colostomy 25000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Exploratory laprotomy with colostomy Biopsy of the lsoion-P | CT Scan/ Colonoscopy confirming the diagnosis and need of
ONCOLOG 7 01501 surgery-P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-
Y C | Histopathology-C | Intra procedure clinical photograph-C
SURGICAL SO SO000025 Complete - SO0000250000 Complete -Endoprosthesis Revision 72800 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Complete -Endoprosthesis Revision Clinical notes-P | Detailed Discharge Summary-C | Planned line of treatment-P | Post
ONCOLOG 0 Endoprosthesis 01502 Procedure Photographs of surgical site-C | Procedure / Operative Notes-C | Radiological
Y Revision evidence for indication-P
SURGICAL SO SO000025 Complete Excision SO0000253000 Complete Excision of Growth from Tongue only 14300 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Complete Excision of Growth from Tongue only Clinical Photograph-P | Clinical notes confirming the diagnosis-P | Detailed Operative
ONCOLOG 3 of Growth from 01503 (inclusive of Histopathology) (inclusive of Histopathology) notes-C | Detailed discharge summary-C | FNAC if done-P | Histopathology-C | Post
Y Tongue only procedure clinical photograph-C
(inclusive of
Histopathology)
SURGICAL SO SO000025 Composite SO0000256000 Composite resection (Oral Cavity) 40000 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Composite resection (Oral Cavity) Biopsy-P | CT reports -P | Clinical Photograph showing scar-C | Clinical notes-P |
ONCOLOG 6 resection (Oral 01504 Clinical photograp-P | Detailed discharge summary-C | HPE report-C | detailed
Y Cavity) Procedure / Operative Notes-C
SURGICAL SO SO000027 Conservative SO0000278000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone Admission notes showing vitals-P | All investigations reports.-C | Any investigations
ONCOLOG 8 Management 01505 stand alone-1800 done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Y summary-C | Examination findings-P | Planned line of management-P | Treatment
details-C
SURGICAL SO SO000028 Conservative SO0000287000 Conservative Management - 0 Yes 3 No 0 Yes No Secondary 19 No Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - MLC copy with number-P | Clinical Notes-P | Detailed discharge summary.-C | Extent
ONCOLOG 7 Management of 01506 (Chest/Head/Face/Abdomen)stand alone (Chest / Head / Face / Abdomen) (Chest/Head/Face/Abdomen)stand alone of upto 40% burns visible on photograph (with rule of 9 chart)-P | Post Treatment clinical
Y injury stand alone-1800 photograph-C | X-rays or other diagnostic procedures done as a part of treatment-C |
lab tests-C
SURGICAL SO SO00003 Gastrectomy SO0000300001 Total Gastrectomy 56500 No 0 No 0 Yes No Tertiary 15 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Gastrectomy ) +/- Video /Biopsy/ CT Scan confirming the diagnosis for which this surgery is done-P |
ONCOLOG 472 Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
Y Endoscopy report-P | Histopathology report-C | Intra procedure clinical photograph-C
| post procedure clinical photograph-C
SURGICAL SO SO00004 Intersphincteric SO0000400001 Intersphincteric resection/Abdominoperineal resection . 65500 No 0 No 0 Yes No Tertiary 15 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Intersphincteric resection/Abdominoperineal resection . Clinical notes-P | Detailed Discharge Summary-C | HPE report-C | HPE-P | Planned
ONCOLOG resection/Abdomi 473 line of treatment-P | Procedure / Operative Notes-C
Y noperineal
resection .
SURGICAL SO SO000046 Curopsy / SO0000461000 Curopsy / Sclerotherapy - govt reserve 19200 No 0 No 0 No Yes Tertiary 3 No Yes Yes Govt No No No Surgical No Insurance N N N Curopsy / Sclerotherapy - govt reserve Clincal notes-P | Detailed Discharge Summary-C | USG / relevent Images-P
ONCOLOG 1 Sclerotherapy 01507 Reserve
Y
SURGICAL SO SO000047 Cytoreductive SO0000471000 Cytoreductive surgery for ovarian cancer with multi organ 72000 No 0 No 0 No No Tertiary 15 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Cytoreductive surgery for ovarian cancer with multi organ Clinical notes-P | Detailed Discharge Summary.-C | Detailed Operative notes-C |
ONCOLOG 1 surgery for 01508 resection ( Minimum 2 organ's) resection ( Minimum 2 organ's) Histopathology-C | Relevent Tumor marker-P | USG Abdomen + Pelvis/ CT abdomen+
Y ovarian cancer Pelvis establishing indication-P | per op pic of specimen removed-C
SURGICAL SO SO000049 Diagnostic SO0000494000 Diagnostic laparoscopy (govt reserve) 10400 No 0 No 0 No Yes Tertiary 3 Yes Yes Yes Govt No No No Surgical No Insurance N N N Diagnostic laparoscopy (govt reserve) Admission Notes comprising of history-P | Detailed Procedure / Operative Notes
ONCOLOG 4 laparoscopy 01509 Reserve together with indication of surgery-C | Examination-P | Intraop stills with date & patient
Y ID-C | Progress notes-C | Relavant Investigations (establishing diagnosis)-P | detailed
discharge summary-C | pic off gross specimen if removed-C
SURGICAL SO SO000049 Diagnostic SO0000498000 Diagnostic thoracoscopy - govt reserve 17300 No 0 No 0 No Yes Tertiary 3 No Yes Yes Govt No No No Surgical No Insurance N N N Diagnostic thoracoscopy - govt reserve Cinical notes-P | Detailed Discharge Summary-C | HPE report-C | Post Procedure
ONCOLOG 8 thoracoscopy 01510 Reserve Photographs of surgical site-C | Procedure / Operative Notes-C | Radiological evidence
Y for indication-P
SURGICAL SO SO000049 Diagnostic/Staging SO0000499000 Diagnostic/Staging Mediastinoscopy - govt reserve 43000 No 0 No 0 Yes Yes Tertiary 2 No Yes Yes Govt Yes No No Surgical No Insurance N N N Diagnostic/Staging Mediastinoscopy - govt reserve Cinical notes-P | Detailed Discharge Summary-C | Post Procedure Photographs of
ONCOLOG 9 Mediastinoscopy 01511 Reserve surgical site-C | Procedure / Operative Notes-C | Radiological evidence for indication-P
Y
SURGICAL SO SO000050 Distal SO0000506000 Distal Pancreatectomy/Pancreatico Jejunostomy 30800 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Distal Pancreatectomy/Pancreatico Jejunostomy Clinical notes and Sr Amylase, CT/ USG, ERCP justifying the surgery,-P | Detailed
ONCOLOG 6 Pancreatectomy 01512 with/without spleenlectomy with/without spleenlectomy Operative notes-C | Histopath-C | Intra procedure clinical photograph-C | detailed
Y with discharge summary-C
Pancreatico
Jejunostomy
SURGICAL SO SO000050 Distal SO0000507000 Distal ureterectomy with reimplantation 30400 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Distal ureterectomy with reimplantation CT KUB, Clinical notes with -P | Detailed Discharge Summary-C | HPE Report-C | Post
ONCOLOG 7 ureterectomy 01513 Procedure Photographs of surgical site-C | Procedure / Operative Notes-C
Y with
reimplantation
SURGICAL SO SO000052 Advanced / high SO0000520000 Advanced / high end investigations in oncology 0 Yes 0 No 0 Yes No Tertiary 0 No Yes Yes Regular PKG Yes No No Surgical Yes Insurance Y N N Advanced / high end Advanced / high end investigations in oncology Clinical notes-P | Detailed Discharge Summary-C | Procedure / Operative Notes-C
ONCOLOG end investigations 1474 / day care investigations in oncology-10000
Y in oncology
SURGICAL SO SO000054 Advanced anterior SO0000540000 Endoscopic Hypophysectomy/Clival tumour excision 39000 Yes 1 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fibrin Glue-9000 Max :3 Endoscopic Hypophysectomy/Clival tumour excision Clinical notes-P | Coronal CT/MRI establishing diagnosis and establishing need of surgery-
ONCOLOG skull base surgery 1475 P | Histopathology report-C | Planned line of treatment-P | Post Procedure
Y Photograph of affected part-C | Procedure / Operative Notes-C
SURGICAL SO SO000055 Endoprosthesis SO0000553000 Partial Endoprosthesis Revision 50000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Endoprosthesis Revision Clinical notes-P | Detailed Discharge Summary-C | Post Procedure Photographs of
ONCOLOG 3 Revision 01514 surgical site-C | Procedure / Operative Notes-C | Radiological evidence for indication-P
Y | planned line of treatment-P
SURGICAL SO SO000056 Advanced lateral SO0000560000 Fisch approach/Translabyrinthine approach/Transcochlear 40000 Yes 1 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fibrin Glue-9000 Max :3 Fisch approach/Translabyrinthine approach/Transcochlear )+/- CT- TEMPORAL BONE of affected side /X-RAY BOTH MASTOIDS-P | Audiogram
ONCOLOG skull base surgery 1476 approach/Temporal Bone resection approach/Temporal Bone resection report justfying surgery-P | Clinical notes -P | Histopathology report-C | Planned line
Y of treatment-P | Post Procedure Photograph of affected part-C | Procedure / Operative
Notes-C
SURGICAL SO SO000056 Enucleation of SO0000566000 Enucleation of pancreatic neoplasm 40800 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Enucleation of pancreatic neoplasm CECT/ MRI-P | Clinical Photograph showing scar-C | Clinical notes-P | HPE report-C |
ONCOLOG 6 pancreatic 01515 detailed Procedure / Operative Notes-C | detailed discharge summary-C
Y neoplasm
SURGICAL SO SO000058 Estlander SO0000583000 Estlander Operation (lip) 12100 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Estlander Operation (lip) Clinical Photograph-P | Clinical notes detailing the original pathology thet has led to this
ONCOLOG 3 Operation (lip) 01516 surgery-P | Detailed Operative notes-C | Detailed discharge summary-C | FIR/MLC in
Y case of traumatic aetiology-P | Post procedure clinical photograph-C | Suporting
investigation reports-P
SURGICAL SO SO000059 EUA separate add SO0000590000 EUA only in GA separate - add on package 3000 No 0 No 0 No No Secondary 1 No Yes Yes Add On No No No Surgical No Insurance N N N EUA only in GA separate - add on package Clinical Notes for the associated surgery / disease along with Pre OP-C | Clinical Notes
ONCOLOG 0 on package 01517 justifying the need for GA in the associated surgery-P | Operative and Anesthesia-C |
Y Post OP notes-C
SURGICAL SO SO000060 Excision of SO0000604000 Excision of Growth from Tongue with neck node dissection 26900 No 0 No 0 No No Tertiary 7 No Yes Yes Stand alone No No No Surgical No Insurance N N N Excision of Growth from Tongue with neck node dissection Clinical Photograph-P | Clinical notes-P | Detailed Operative notes-C | Histopath-C |
ONCOLOG 4 Growth from 01518 Stand alone Stand alone Post procedure clinical photograph-C | USG/CT Scan/Nuclear Imaging confirming the
Y Tongue with neck diagnosis-P | detailed discharge summary-C
node dissection
SURGICAL SO SO000060 Excision of SO0000608000 Excision of Parathyroid Adenoma/Carcinoma 21700 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Parathyroid Adenoma/Carcinoma Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
ONCOLOG 8 Parathyroid 01519 Histopathology-C | Intra procedure clinical photograph-C | USG/CT Scan/Nuclear
Y Adenoma / Imaging confirming the diagnosis-P
Carcinoma
SURGICAL SO SO000061 Excision of Pinna SO0000611000 Growth - Squamous/ Basal/ Injury 20000 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Growth - Squamous/ Basal/ Injury Clinical notes-P | Detailed Discharge Summary-C | HPE report-C | HPE-P | Planned
ONCOLOG 1 for Growths / 01520 line of treatment-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Injuries - Total Operative Notes-C
Amputation &
Excision of
External Auditory
Meatus
SURGICAL SO SO000061 Excision of SO0000616000 Excision of tumour of oral cavity / paranasal sinus / 10000 Yes 0 Yes 1 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for Excision of tumour of Excision of tumour of oral cavity / paranasal sinus / Biopsy-P | CT Scan-P | Clinical notes-P | Histopathology report-C | Implant barcode /
ONCOLOG 6 tumour of oral 01522 laryngopharynx laryngopharynx-20000 Max :1 | laryngopharynx Invoice-C | Planned line of treatment-P | Post Procedure Photograph of affected part-C
Y cavity / paranasal without reconstruction Implant for Excision of tumour of without reconstruction | Post op images show implant.-C | Pre operative Clinical Photograph of affected part-P
sinus / oral cavity-20000 Max :1 | | Procedure / Operative Notes-C
laryngopharynx Implant for Excision of tumour of
with or without paranasal sinus -20000 Max :1
reconstruction
SURGICAL SO SO000061 Excision of SO0000616000 Excision of tumour of oral cavity / paranasal sinus 20000 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of tumour of oral cavity / paranasal sinus Biopsy-P | CT Scan-P | Clinical Photograph of affected part-P | Histopathology report-C
ONCOLOG 6 tumour of oral 01521 | Post Procedure Photograph of affected part-C | Procedure / Operative Notes-C
Y cavity / paranasal
sinus /
laryngopharynx
with or without
reconstruction
SURGICAL SO SO000061 Excision of SO0000616000 Excision of tumour of oral cavity / 36500 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Excision of tumour of oral cavity / Biopsy-P | CT Scan-P | Clinical Photograph of affected part-P | Histopathology report-C
ONCOLOG 6 tumour of oral 01523 paranasal sinus / laryngopharynx with free flap paranasal sinus / laryngopharynx with free flap | Post Procedure Photograph of affected part-C | Procedure / Operative Notes-C
Y cavity / paranasal reconstruction reconstruction
sinus /
laryngopharynx
with or without
reconstruction
SURGICAL SO SO000061 Excision of SO0000617000 Excision of undescended testicular mass 24300 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of undescended testicular mass CT/USG, Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 7 undescended 01524 | HPE report-C | Procedure / Operative Notes-C
Y testicular mass
SURGICAL SO SO000062 Exenteration SO0000621000 Exenteration 23000 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Exenteration (Biopsy / CT / MRI establishing indication for Exenteration)-P | Clinical Photograph-P |
ONCOLOG 1 01525 Detailed discharge summary-C | Histopathological exam report-C | Indication for
Y Exenteration and supporting investigation-P | Still image of the the procedure with pt. ID
and date-C | confirmation/ declaration that the specimen has been sent for
histopathology and report will be sent for filing laterx-C | operative notes-C
SURGICAL SO SO000063 Extended LOS SO0000635000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals-P | All investigations reports.-C | Any investigations
ONCOLOG 5 care pkg for 01526 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go)
done-P | Clinical notes detailing history-P | Detailed ICPs-C | Detailed discharge
Y advance sugeries Routine Ward-1800 summary-C | Examination findings-P | Planned line of management-P | Treatment
details-C
SURGICAL SO SO000064 Extrapleural SO0000646000 Extrapleural pneumonectomy 74700 No 0 No 0 No No Tertiary 7 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Extrapleural pneumonectomy Planned line of treatment-P | CT-P | Clinical notes-P | Detailed Discharge Summary-C
ONCOLOG 6 pneumonectomy 01527 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000065 Feeding SO0000658000 Feeding Jejunostomy 13600 No 0 No 0 No No Tertiary 6 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Feeding Jejunostomy ) +/- Video /Biopsy/ CT Scan confirming the diagnosis for which this surgery is done-P |
ONCOLOG 8 Jejunostomy 01528 Clinical notes-P | Detailed Operative notes-C | Endoscopy report-P | Intra procedure
Y clinical photograph-C | detailed discharge summary-C
SURGICAL SO SO000069 Gastrectomy SO0000699000 Partial Gastrectomy for Carcinoma/Subtotal Gastrectomy 29500 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Gastrectomy for Carcinoma/Subtotal Gastrectomy for Clinical notes-P | Clinical photograph-P | Detailed Operative notes-C | Detailed
ONCOLOG 9 01529 for Carcinoma Carcinoma discharge summary-C | Endoscopy/ CT Scan confirming the diagnosis-P |
Y Histopathology report-C | Intra procedure clinical photograph-C | Mandatory Biopsy-P
| post procedure clinical photograph-C
SURGICAL SO SO000070 Gastric pull-up / SO0000700000 Gastric pull-up / Jejunal Graft 70400 No 0 No 0 No No Tertiary 11 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Gastric pull-up / Jejunal Graft CECT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-
ONCOLOG 0 Jejunal Graft 01530 C | FNAC/ BIOPSY-P | HPE report-C | Post Procedure Photographs of surgical site-C |
SURGICAL SO SO000070 Gastrojejunostom SO0000701000 Gastrojejunostomy 26000 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Gastrojejunostomy Clinical notes-P | Detailed Operative notes-C | Endoscopy report OR Biopsy OR CT Scan
ONCOLOG 1 y 01531 confirming the diagnosis for which this surgery is done-P | detailed discharge summary-C
Y | intra operative photograph-C
SURGICAL SO SO000070 Germ Cell Tumour SO0000705000 Germ Cell Tumour Excision 30400 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Germ Cell Tumour Excision AFP-P | Beta HCG-P | CT-P | Clinical notes with planned line of treatment-P | Detailed
ONCOLOG 5 Excision 01532 Discharge Summary-C | HPE report-C | Procedure / Operative Notes-C | USG-P
Y
SURGICAL SO SO000071 Glossectomy SO0000714000 Hemiglossectomy 40000 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hemiglossectomy CECT-P | Clinical notes with planned line of treatment and FNAC/ BIOPSY-P | Detailed
SURGICAL SO SO000071 Glossectomy SO0000714000 Total Glossectomy 80000 No 0 No 0 Yes No Tertiary 11 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Glossectomy CECT-P | Clinical notes with planned line of treatment and FNAC/ BIOPSY-P | Detailed
SURGICAL SO SO000073 Anterior Resection SO0000730000 Anterior Resection of rectum 43400 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Anterior Resection of rectum Biopsy-P | CT scan-P | Clinical notes-P | Colonoscopy-P | Detailed Operative notes-C
ONCOLOG of rectum 1477 | Detailed discharge summary-C | Histopathology report-C | post procedure clinical
Y photograph-C
SURGICAL SO SO000073 Hemi colectomy SO0000733000 Hemi colectomy Right /Hemi colectomy Left 25000 No 0 No 0 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hemi colectomy Right /Hemi colectomy Left Biopsy-P | CT Scan/Colonoscopy confirming the diagnosis for which the surgery is done-
ONCOLOG 3 01535 P | Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
Y Histopathology report and Intra procedure Clinical photograp of removed colon-C
SURGICAL SO SO000073 Hemipelvectomy - SO0000735000 Hemipelvectomy - Internal 64300 No 0 No 0 No No Tertiary 11 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hemipelvectomy - Internal CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 5 Internal 01536 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000074 Hepatic Resection SO0000740000 Hepatic Resection 32100 No 0 No 0 Yes No Tertiary 7 no Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Hepatic Resection Clinical notes-P | Detailed Operative notes-C | Histopath-C | Intra procedure clinical
ONCOLOG 0 01537 photograph-C | USG/CT/MRI / Biopsy report confirming the justification of surgery-P |
Y detailed discharge summary-C
SURGICAL SO SO000074 Hepatoblastoma SO0000747000 Hepatoblastoma Excision 59100 No 0 No 0 No No Tertiary 8 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hepatoblastoma Excision CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
ONCOLOG 7 Excision 01538 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Y Operative Notes-C
SURGICAL SO SO000076 Anterior skull base SO0000760000 CSF Rhinorrhea Repair - open / Endoscopic 26000 Yes 0 Yes 3 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Fibrin Glue-9000 Max :3 CSF Rhinorrhea Repair - open / Endoscopic CT to confirm need of surgery-P | Clinical notes-P | Detailing aetiology-P | MLC/ FIR if
ONCOLOG surgery 1478 traumatic-P | Planned line of treatment-P | Post Procedure Photograph of affected part-
Y C | Procedure / Operative Notes-C
SURGICAL SO SO000076 Anterior skull base SO0000760000 Optic nerve decompression/Orbital 25500 Yes 0 Yes 3 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mini plate-3000 Max :3 Optic nerve decompression/Orbital CT to confirm need of surgery-P | Clinical notes-P | Detailing aetiology-P | MLC/ FIR if
ONCOLOG surgery 1479 decompression/Craniofacial resection/Maxillary swing decompression/Craniofacial resection/Maxillary swing traumatic-P | Planned line of treatment-P | Post Procedure Photograph of affected part-
Y C | Procedure / Operative Notes-C
SURGICAL SO SO000076 High inguinal SO0000769000 High inguinal Orchiectomy 13800 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N High inguinal Orchiectomy Clinical notes-P | Detailed discharge summary-C | Histopathology-C | Operative Notes-
ONCOLOG 9 Orchiectomy 01539 C | USG/CT / Tumor Marker -P | detailed Procedure-C
Y
SURGICAL SO SO000080 Ilio-Inguinal SO0000802000 Ilio-Inguinal lymphadenectomy - U/L OR B/L 0 Yes 1 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral - Ilio-Inguinal Ilio-Inguinal lymphadenectomy - U/L OR B/L Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT/MRI /
ONCOLOG 2 lymphadenectom 01540 lymphadenectomy-34700 | Biopsy confirming the diagnosis for which the surgery is done-P | detailed Procedure /
Y y Unilateral - Ilio-Inguinal Operative Notes-C
lymphadenectomy-23500
SURGICAL SO SO000081 Inguinal Node SO0000819000 Inguinal Node (dissection) - U/L and B/L 0 Yes 1 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral-21700 | Unilateral - Inguinal Node (dissection) - U/L and B/L Clinical notes-P | Detailed Operative notes-C | Detailed discharge summary-C |
ONCOLOG 9 (dissection) 01541 Inguinal Node (dissection)-17700 Histopath-C | Intra procedure clinical photograph-C | USG/ Biopsy report confirming
Y the diagnosis for which the surgery is done-P
SURGICAL SO SO000086 Laparoscopic SO0000865000 tubal surgeries 20000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N tubal surgeries Beta HCG-P | Clinical notes establishing indication for the procedure-P | Detailed
ONCOLOG 5 tubal surgeries 01542 (for any indication including ectopic pregnancy) (for any indication including ectopic pregnancy) Operative notes-C | Detailed discharge summary-C | HPE if ectopic pregnancy or
Y (for any indication salpingectomy for any other indication-C | USG uterus & adnexa-P
including ectopic
pregnancy)
SURGICAL SO SO000086 Laryngectomy SO0000867000 Partial laryngectomy (voice preserving)/Total Laryngectomy 75000 Yes 0 Yes 1 Yes No Tertiary 10 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Voice prosthesis-30000 Max :1 Partial laryngectomy (voice preserving)/Total Laryngectomy Biopsy-P | CECT film and report-P | Clinical Photograph showing scar-C | Clinical notes-
ONCOLOG 7 01543 P | Detailed Discharge summary-C | HPE report-C | detailed Procedure / Operative
Y Notes-C
SURGICAL SO SO000087 Lateral skull base SO0000872000 Subtotal petrosectomy/Post-traumatic facial nerve 24000 Yes 0 Yes 1 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Fibrin Glue-9000 Max :1 Subtotal petrosectomy/Post-traumatic facial nerve Barcode / Invoice of Fibrin Glue-C | CT/MRI/ biopsy to establish the indication and justify
ONCOLOG 2 procedures 01544 decompression/CSF Otorrhoea repair decompression/CSF Otorrhoea repair the surgery.-P | Clinical notes with planned line of treatment-P | Histopathology report-
Y C | Post Procedure Photograph of affected part-C | Procedure / Operative Notes-C
SURGICAL SO SO000087 Leiomyoma SO0000874000 Leiomyoma excision- Open/MIS - Govt reserve 67800 No 0 No 0 Yes Yes Tertiary 6 No Yes Yes Govt Yes No No Surgical No Insurance N N N Leiomyoma excision- Open/MIS - Govt reserve Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
ONCOLOG 4 excision 01545 Reserve report-C | Post Procedure Photographs of surgical site-C | Procedure / Operative Notes-
Y C | USG / CT/ MRI-P
SURGICAL SO SO000089 Lobectomy SO0000891000 LUNG Lobectomy-Open/Thoracoscopic 27800 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N LUNG Lobectomy-Open/Thoracoscopic )+/- Cytology-P | Biopsy-P | CT Thorax confirming the diagnosis-P | Clinical notes-P |
ONCOLOG 1 01546 Detailed Operative notes-C | Detailed discharge summary-C | Intra procedure clinical
Y photograph-C | Scar Photo-C | histopath-C
SURGICAL SO SO000089 Lung SO0000897000 Lung metastectomy- Open/VATS 51300 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Lung metastectomy- Open/VATS CECT-P | Clinical Photograph showing scar-C | Clinical notes-P | Detailed discharge
ONCOLOG 7 metastectomy 01547 summary-C | FNAC/ BIOPSY-P | HPE report-C | detailed Procedure / Operative Notes-C
Y
SURGICAL SO SO000090 Malignant Pleural SO0000905000 Pleural effusion & Pleurodesis 5500 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Pleural effusion & Pleurodesis CBC-P | CECT/ x-Ray/USG -P | Clinical notes with planned line of treatment-P |
ONCOLOG 5 Effusion for 01548 Discharge summary with detail treatment & interventions-C | KFT-P | LFT-P |
Y Pleural tap with Procedure notes-C
Pig tail
catheter/chest
tube insertion
with Pleurodesis
in advanced
cancer patients
SURGICAL SO SO000090 Malignant Soft SO0000906000 Malignant Soft Tissue Tumour - Excision 34700 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Malignant Soft Tissue Tumour - Excision CT / MRI-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ONCOLOG 6 Tissue Tumour - 01549 Summary-C | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C |
Y Excision Procedure / Operative Notes-C
SURGICAL SO SO000091 Management of SO0000911000 Trans arterial Embolization 60000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Trans arterial Embolization CBC-P | CT Angio-P | Clinical notes with planned line of treatment-P | Discharge
ONCOLOG 1 bleeding in 01550 summary with detail treatment & interventions-C | KFT-P | LFT-P | Procedure notes.-C
Y malignant head
and neck /
inguinal
malignancies
SURGICAL SO SO000091 Management of SO0000914000 Haemostatic Surgery in advance cancer patient/Haemostatic 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Haemostatic Surgery in advance cancer patient/Haemostatic CBC-P | CT Angio-P | Clinical notes with planned line of treatment-P | Discharge
ONCOLOG 4 bleeding 01551 Radiotherapy Radiotherapy summary with detail treatment & interventions-C | KFT-P | LFT-P | Procedure notes.-C
Y malignant head
and neck /
inguinal lesions
SURGICAL SO SO000092 Mastectomy SO0000928000 Radical / Modified Radical Mastectomy 25000 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical / Modified Radical Mastectomy Biopsy justifying surgery-P | Clinical notes-P | Detailed Operative notes-C | Histopath-
ONCOLOG 8 01552 C | Mammography / USG Breast-P | detailed discharge summary-C
Y
SURGICAL SO SO000092 Mastectomy SO0000928000 Simple Mastectomy 20000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Simple Mastectomy Biopsy confirming the diagnosis-P | Clinical Photograph-P | Clinical notes-P | Detailed
ONCOLOG 8 01553 Operative notes-C | Histopath-C | Mammography / USG Breast-P | Post procedure
Y clinical photograph-C | detailed discharge summary-C
SURGICAL SO SO000093 Maxillectomy SO0000931000 Partial / Total Maxillectomy 47800 No 0 No 0 Yes No Tertiary 6 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial / Total Maxillectomy CECT-P | Clinical Photograph showing scar-C | Clinical notes and Biopsy-P | Detailed
ONCOLOG 1 01554 discharge summary-C | HPE report-C | detailed Procedure / Operative Notes-C
Y
SURGICAL SO SO000093 Mediastinal SO0000935000 Mediastinal lymphadenectomy- Open/Video - assisted 72200 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Mediastinal lymphadenectomy- Open/Video - assisted Clinical notes with planned line of treatment, CT-P | Detailed Discharge Summary-C |
ONCOLOG 5 lymphadenectom 01555 HPE report-C | Post Procedure Photographs of surgical site-C | Procedure / Operative
Y y Notes-C
SURGICAL SO SO000093 Mediastinal mass SO0000936000 Mediastinal mass excision with lung resection 69500 No 0 No 0 No No Tertiary 10 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Mediastinal mass excision with lung resection Biopsy-P | Clinical notes with planned line of treatment and CT Thorax-P | Detailed
ONCOLOG 6 excision with lung 01556 Discharge Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
Y resection Procedure / Operative Notes-C
SURGICAL SO SO000095 Microlaryngoscopi SO0000959000 Microlaryngoscopic Surgery 15000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Microlaryngoscopic Surgery Clinical notes-P | Detailed Operative notes-C | Nasal Endoscopy confirming the
ONCOLOG 9 c Surgery 01557 diagnosis for which this surgery is done-P | Post procedure Nasal Endoscopy and post
Y procedure clinical photograph OR Intra procedure clinical photograph-C | detailed
discharge summary-C
SURGICAL SO SO000096 Microvascular SO0000961000 Microvascular reconstruction (free flaps) 45000 Yes 0 Yes 1 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Implant for Microvascular Microvascular reconstruction (free flaps) Biopsy of primary with details of earlier / Primary surgery done and establishing need of
ONCOLOG 1 reconstruction 01558 reconstruction-15000 Max :1 microvascular reconstruction-P | Clinical Photograph showing scar-C | Clinical notes-P |
Y (free flaps) detailed Procedure / Operative Notes-C | detailed discharge summary-C
SURGICAL SO SO000097 Neck dissection SO0000977000 Selective Benign neck tumour 47800 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Selective Benign neck tumour Clinical Photograph-P | FNAC / Biospy in case of tumours-P | Histopathology report-C |
ONCOLOG 7 01559 excision/Comprehensive Benign neck tumour excision/Comprehensive Benign neck tumour Indication for surgery with supporting investigation reports (X-ray/ CT/MRI)-P | Package
Y excision/Selective Pharyngeal diverticulum excision/Selective Pharyngeal diverticulum can be booked after tumor board recomandation.-P | Post procedure Imaging-C |
excision/Comprehensive Pharyngeal excision/Comprehensive Pharyngeal detailed Procedure / Operative Notes-C | detailed discharge summary-C | post
diverticulum excision diverticulum excision procedure clinical photograph of affected part-C
SURGICAL SO SO000098 Nephrectomy SO0000983000 Nephrectomy For Benign pathology /Nephrectomy- Radical 28600 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrectomy For Benign pathology /Nephrectomy- Radical )+/- FNAC/Biopsy-P | Clinical notes-P | Detailed discharge summary-C | Histopathology-
ONCOLOG 3 01560 (Renal tumor) (Renal tumor) C | Intra operative photograph-C | USG/CT confirming the need for surgery-P |
Y detailed Procedure / Operative Notes-C
SURGICAL SO SO000098 Nephrectomy - SO0000986000 Nephrectomy - Partial or Hemi 40000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrectomy - Partial or Hemi CT/MRI confirming the need for surgery-P | Clinical notes-P | Detailed discharge
ONCOLOG 6 Partial or Hemi 01561 summary-C | Histopathology-C | Intra operative photograph-C | detailed Procedure /
Y Operative Notes-C
SURGICAL SO SO000098 Nephro SO0000989000 Nephro ureterectomy (Benign) 33000 No 0 No 0 Yes No Tertiary 7 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephro ureterectomy (Benign) CT/ CT-IVP/MRI confirming the need for surgery-P | Clinical notes-P | Detailed
ONCOLOG 9 ureterectomy 01562 discharge summary-C | Histopathology-C | Intra operative photograph-C | detailed
Y (Benign) Procedure / Operative Notes-C
SURGICAL SO SO000099 Nephro SO0000992000 Nephro ureterectomy with cuff of bladder 29500 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephro ureterectomy with cuff of bladder CT/ CT-IVP/MRI/MRI Urogram confirming the need for surgery-P | Clinical notes-P |
ONCOLOG 2 ureterectomy 01563 Detailed discharge summary-C | Histopathology-C | Intra operative photograph-C |
Y with cuff of detailed Procedure / Operative Notes-C
bladder
UROLOGY UL UL0000101 Neurogenic UL0000101100 Neurogenic bladder - Package for evaluation / investigation 18200 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Surgical No Insurance N N N Neurogenic bladder - Package for evaluation / investigation Clinical notes detailing the case history with previous work up / initial diagnosis-P |
1 bladder - Package 001697 (catheter + ultrasound + culture + RGU/ MCU) for 1 month (catheter + ultrasound + culture + RGU/ MCU) for 1 month Evidence of all investigations done and still images of RGU/ MCU done with patient name
for evaluation / (medicines - antibiotics) including cystoscopy, Uro dynamics (medicines - antibiotics) including cystoscopy, Uro dynamics & date-C
investigation
(catheter +
ultrasound +
culture + RGU/
MCU) for 1 month
(medicines -
antibiotics)
UROLOGY UL UL0000102 Open bladder UL0000102900 Open bladder diverticulectomy with / without ureteric re- 25000 No 0 No 0 No No Tertiary 3 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Open bladder diverticulectomy with / without ureteric re- Clinical notes-P | Detailed discharge summary-C | Intra procedure clinical photograph-C
9 diverticulectomy 001698 implantation ± DJ Stenting implantation ± DJ Stenting | USG/CT/MRI+/-Cystoscopy confirming bladder diverticulum and need for surgery-P |
with / without detailed Procedure / Operative Notes-C
ureteric re-
implantation
UROLOGY UL UL0000103 Open simple UL0000103600 Open simple prostatetctomy for BPH 27500 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Open simple prostatetctomy for BPH Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG with
6 prostatetctomy 001699 prostate size and Post Void Volume / PSA / uroflometry-P | detailed Procedure /
for BPH Operative Notes-C
UROLOGY UL UL0000106 Orchiopexy UL0000106400 Orchiopexy with laparoscopyto be cross checked with pead 0 Yes 1 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral - Orchiopexy with Orchiopexy with laparoscopyto be cross checked with pead Clinical Photograph of affected part-P | Clinical notes and USG confirming that
4 001700 surgery - U/L OR B/L laparoscopyto be cross checked surgery - U/L OR B/L laparoscopy is needed for locating the testes-P | Detailed discharge summary-C | Post
with pead surgery-35000 | Procedure Clinical Photograph of affected part-C | detailed Procedure / Operative Notes-
Unilateral - Orchiopexy with C
laparoscopyto be cross checked
with pead surgery-30000
UROLOGY UL UL0000106 Orchiopexy UL0000106400 Orchiopexy without laparoscopy - U/L or B/L 0 Yes 1 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Orchiopexy without laparoscopy Orchiopexy without laparoscopy - U/L or B/L Clinical Photograph of affected part-P | Clinical notes and USG confirming location of
4 001701 - Bilateral-21700 | Unilateral- undescended testis-P | Detailed discharge summary-C | Post Procedure Clinical
15000 Photograph of affected part-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000107 Augmentation UL0000107000 Augmentation cystoplasty 39100 No 0 No 0 Yes No Tertiary 4 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Augmentation cystoplasty Clinical notes-P | Detailed discharge summary-C | IVP/CT IVP/MRI +Cystogram +/-
cystoplasty 01651 Cystoscopy confirming the indication for which the surgery is done-P | Intra operative
still images-C | Post procedure Imaging-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000108 Palliative Care UL0000108400 Hematuria Palliative Interventions 40000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Hematuria Palliative Interventions CECT/ x-Ray/USG, CBC,LFT,KFT, Urine Culture-P | Clinical notes with planned line of
4 Approach to 001702 treatment-P | Discharge summary with detail treatment and details of interventions and
managing procedure done.-C
Haematuria in
advanced cancer
patients-
Endoscopic/
Surgical/
Radiological,
Radiotherpay
UROLOGY UL interventions
UL0000111 Partial Cystectomy UL0000111000 Partial Cystectomy 27500 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Cystectomy CT/MRI confirming the indication and need of this surgery with supporting Evidence of
0 001703 the same (FNAC/Biopsy)-P | Clinical notes-P | Detailed discharge summary-C |
Histopathology-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000111 PCNL UL0000111200 PCNL (Percutaneous Nephrolithotomy) ± DJ Stenting 0 Yes 1 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral - PCNL (Percutaneous PCNL (Percutaneous Nephrolithotomy) ± DJ Stenting Clinical notes-P | Detailed discharge summary-C | IVP / NCCT / CT Urogram confirming
2 (Percutaneous 001704 Nephrolithotomy) ± DJ Stenting- the indication and need for PCNL-P | Intra operative photograph-C | Post procedure
Nephrolithotomy) 30000 | Unilateral - PCNL Imaging (X Ray/USG).-C | detailed Procedure / Operative Notes-C
(Percutaneous
Nephrolithotomy) ± DJ Stenting-
24000
UROLOGY UL UL0000112 Pelvic UL0000112100 Pelvic lymphadenectomy, after prior cancer surgery- 30000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pelvic lymphadenectomy, after prior cancer surgery- Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT / Biopsy
1 lymphadenectom 001705 Open/Laparoscopic Open/Laparoscopic confirming bilateral testicular cancer-P | detailed Procedure / Operative Notes-C
y, after prior
cancer surgery
UROLOGY UL UL0000112 Penectomy UL0000112400 Partial Penectomy 17300 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Partial Penectomy Biopsy findings-P | Clinical notes-P | Detailed discharge summary-C | Histopathology-C
4 001706 | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000112 Penectomy UL0000112400 Total Penectomy + Perineal Urethrostomy 26000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Total Penectomy + Perineal Urethrostomy Biopsy findings-P | Clinical notes-P | Detailed discharge summary-C | Histopathology-C
4 001707 | detailed Procedure / Operative Notes detailing urethrostomy-C
UROLOGY UL UL0000112 Penile Fracture UL0000112500 Penile Fracture - Govt Reserve 20000 No 0 No 0 No Yes Tertiary 4 Yes Yes Yes Govt No No No Surgical No Insurance N N N Penile Fracture - Govt Reserve Clinical notes -P | Detailed discharge summary-C | detailed Procedure / Operative Notes-
5 001708 Reserve C
UROLOGY UL UL0000112 Penile preserving UL0000112700 Penile preserving surgery 25000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Penile preserving surgery Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C | HPE
7 surgery 001709 (WLE, Glansectomy, Laser) (WLE, Glansectomy, Laser) report-C | HPE-P | Procedure / Operative Notes-C
(WLE,
Glansectomy,
Laser)
UROLOGY UL UL0000112 Penile prosthesis UL0000112800 Penile prosthesis insertion - Govt Reserve 35000 No 0 No 0 No Yes Tertiary 2 Yes Yes Yes Govt No No No Surgical No Insurance N N N Penile prosthesis insertion - Govt Reserve Bar code of implant used-C | Clinical notes with Previous medical reports showing the
8 insertion 001710 Reserve panectomy and its indication-P | Detailed discharge summary-C | detailed Procedure /
Operative Notes-C
UROLOGY UL UL0000113 Perineal UL0000113700 Perineal Urethrostomy without closure 20000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Perineal Urethrostomy without closure Clinical notes detailing the pathology for which performed with supporting Evidence of
7 Urethrostomy 001711 RGU (Retrograde urethrography)-P | Detailed discharge summary-C | Intra procedure
without closure clinical photograph-C | MCU-P | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000113 Perinephric UL0000113800 Percutaneous abscess drainage Endoscopic 14000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Percutaneous abscess drainage Endoscopic Clinical notes-P | Intra procedure still photograph-C | USG/CT confirming the diagnosis
8 Abscess drainage 001712 of perinephric abscess-P | detailed Procedure / Operative Notes-C | detailed discharge
summary-C
UROLOGY UL UL0000113 Perinephric UL0000113800 Perinephric Abscess drainage -Open 17300 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Perinephric Abscess drainage -Open Clinical notes-P | Intra procedure still photograph-C | USG/CT confirming the diagnosis
8 Abscess drainage 001713 of perinephric abscess-P | detailed Procedure / Operative Notes-C | detailed discharge
summary-C
UROLOGY UL UL0000115 Permanent UL0000115700 Permanent tunnelled catheter placement as substitute for 30000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Permanent tunnelled catheter placement as substitute for Clinical notes detailing need for AV shunt with supporting Evidence of Creatinine/ RFT-P |
7 tunnelled catheter 001714 AV fistula in long term dialysis AV fistula in long term dialysis Detailed Operative notes-C | Detailed discharge summary-C | Post Procedure clinical
placement as photograph-C
substitute for AV
fistula in long term
dialysis
UROLOGY UL UL0000119 Post TURBT - UL0000119300 Post TURBT - Check Cystoscopy (Per sitting) with / without 10000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Post TURBT - Check Cystoscopy (Per sitting) with / without Clinical notes-P | Histopathology/ biopsy confirming the diagnosis of bladder cancer-P |
3 Check Cystoscopy 001715 cold-cup biopsy cold-cup biopsy Intra procedure still photograph-C | detailed Procedure / Operative Notes-C | detailed
(Per sitting) with discharge summary-C
cold-cup biopsy
UROLOGY UL UL0000119 Post. Urethral UL0000119500 Post. Urethral Valve fulguration 14000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Post. Urethral Valve fulguration )+/- uroflowmetry-P | Clinical notes-P | Confirmation of stenosis of posterir urethral
5 Valve fulguration 001716 valve by Voiding cystourethrogram (preferred)-P | Detailed discharge summary-C |
Intra procedure clinical photograph-C | Post procedure Imaging (USG)-C | USG-P |
UROLOGY UL UL0000121 Pyelolithotomy UL0000121500 Pyelolithotomy - Open/Lap. ± DJ Stenting 30000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pyelolithotomy - Open/Lap. ± DJ Stenting Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-IVP, confirming indication
5 001717 and the need for surgery-P | Post procedure Imaging (X Ray/USG)-C | detailed
Procedure / Operative Notes-C | showing stone removed-C
UROLOGY UL UL0000121 Pyeloplasty / UL0000121700 Pyeloplasty - Laparoscopic/Pyeloureterostomy - 30400 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pyeloplasty - Laparoscopic/Pyeloureterostomy - Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-IVP / DTPA renal scan,
7 Pyeloureterostom 001718 Laparoscopic/Pyelopyelostomy - Laparoscopic ± DJ Stenting Laparoscopic/Pyelopyelostomy - Laparoscopic ± DJ Stenting confirming indication and the need for surgery-P | Intra operative photograph-C |
y/ detailed Procedure / Operative Notes-C
Pyelopyelostomy
UROLOGY UL UL0000121 Pyeloplasty / UL0000121700 Pyeloplasty - Open/Pyeloureterostomy - 27500 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Pyeloplasty - Open/Pyeloureterostomy - Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-IVP / DTPA renal scan,
7 Pyeloureterostom 001719 Open/Pyelopyelostomy - Open ± DJ Stenting Open/Pyelopyelostomy - Open ± DJ Stenting confirming indication and the need for surgery-P | Intra operative photograph-C |
y/ detailed Procedure / Operative Notes-C
Pyelopyelostomy
UROLOGY UL UL0000122 Radical UL0000122600 Radical cystectomy - With ureterosigmoidostomy + BPLND - 75000 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy - With ureterosigmoidostomy + BPLND - CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
6 cystectomy 001720 Open/Lap. Open/Lap. | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Operative Notes-C
UROLOGY UL UL0000122 Radical UL0000122600 Radical cystectomy With continent diversion - Open + 113000 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy With continent diversion - Open + CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
6 cystectomy 001721 BPLND BPLND | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Operative Notes-C
UROLOGY UL UL0000122 Radical UL0000122600 Radical cystectomy With continent diversion + BPLND - 126100 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy With continent diversion + BPLND - CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
6 cystectomy 001722 Open Open | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Operative Notes-C
UROLOGY UL UL0000122 Radical UL0000122600 Radical cystectomy With Ileal Conduit + BPLND 110400 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy With Ileal Conduit + BPLND CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
6 cystectomy 001723 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Operative Notes-C
UROLOGY UL UL0000122 Radical UL0000122600 Radical cystectomy- With neobladder + BPLND 126100 No 0 No 0 Yes No Tertiary 11 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy- With neobladder + BPLND CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
6 cystectomy 001724 | HPE report-C | HPE-P | Post Procedure Photographs of surgical site-C | Procedure /
Operative Notes-C
UROLOGY UL UL0000122 Radical UL0000122600 Radical cystectomy Without Ileal Conduit + BPLND 100000 No 0 No 0 Yes No Tertiary 8 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical cystectomy Without Ileal Conduit + BPLND CT-P | Clinical notes with planned line of treatment-P | Detailed Discharge Summary-C
6 cystectomy 001725 | HPE report / speciman photo-C | HPE-P | Post Procedure Photographs of surgical site-
UROLOGY UL UL0000123 Radical UL0000123300 Radical prostatectomy 52100 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical prostatectomy Biopsy-P | Clinical notes-P | Detailed discharge summary-C | Histopathology of
3 prostatectomy 001726 prostate-C | MRI /CT prostrate-P | PSA-P | detailed Procedure / Operative Notes with
details of nodes removed.-C
UROLOGY UL UL0000123 Radical UL0000123600 Radical Retroperitoneal lymph node dissection 52100 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Radical Retroperitoneal lymph node dissection Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT / Biopsy
6 Retroperitoneal 001727 confirming bilateral testicular cancer-P | detailed Procedure / Operative Notes-C
lymph node
dissection
UROLOGY UL UL0000123 Radical UL0000123900 Radical Urethrectomy 30400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Radical Urethrectomy CT KUB-P | Clinical notes with planned line of treatment-P | Detailed Discharge
9 Urethrectomy 001728 Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
UROLOGY UL UL0000125 Bilateral UL0000125000 Bilateral Orchidectomy for hormone ablation 10000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bilateral Orchidectomy for hormone ablation Clinical notes-P | Detailed discharge summary-C | Histopathology report/ specimen
Orchidectomy for 01652 photo-C | PSA Report confirming prostate-P | USG/CT / Biopsy-P | detailed Procedure
hormone ablation / Operative Notes-C
UROLOGY UL UL0000126 Repair for VVF UL0000126400 Repair for VVF -Laparoscopic/open 37500 No 0 No 0 No No Tertiary 4 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Repair for VVF -Laparoscopic/open Admission Notes comprising of history and examination with indications for the
4 001729 procedure-P | CT Urography / IVP-P | Detailed Procedure / Operative Notes-C |
Detailed discharge summary.-C | Progress notes-C | Relavant Investigations
(establishing diagnosis) and Cystoscopy/ Cystourethroscopy-P
UROLOGY UL UL0000134 Bladder injury UL0000134000 Bladder injury repair 23000 No 0 No 0 No No Tertiary 3 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Bladder injury repair Clinical notes-P | Detailed discharge summary-C | MLC/ FIR if traumatic-P |
repair 01653 (with or without urethral injury) (with or without urethral injury) USG/CT/MRI+/- cystogram confirming the diagnosis of bladder injury-P | detailed
(with or without Procedure / Operative Notes-C
urethral injury)
UROLOGY UL UL0000136 Bladder injury UL0000136000 Bladder injury repair with colostomy 34700 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Bladder injury repair with colostomy Clinical notes-P | Detailed discharge summary of both surgeries-C | MLC/ FIR if
repair with 01654 (with or without urethral injury) (with or without urethral injury) traumatic-P | Post procedue pic of Colostomy-C | USG/CT/MRI+/- cystogram
colostomy confirming the diagnosis of bladder injury-P | detailed Procedure / Operative Notes-C
(with or without
urethral injury)
UROLOGY UL UL0000137 Bladder Neck UL0000137000 Bladder Neck incision - Endoscopic - Stand Alone 15000 No 0 No 0 No No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Insurance N N N Bladder Neck incision - Endoscopic - Stand Alone Clinical notes-P | Detailed discharge summary of both surgeries-C | Endoscopic picture-
incision - 01655 C | USG-KUB/PVR-P | Uroflometry-P | detailed Procedure / Operative Notes-C
Endoscopic
UROLOGY UL UL0000138 Stress UL0000138100 Stress incontinence surgery - Open 23000 Yes 0 Yes 1 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N TVT /TOT/Sling-15000 Max :1 TVT / TOT / Sling-1500 Stress incontinence surgery - Open Clinical notes-P | Cystoscopy/ USG/ Uro Dynamic study to confirm the dignosis-P |
1 incontinence 001730 Detailed Procedure / Operative Notes-C | detailed discharge summary-C
surgery
UROLOGY UL UL0000139 Suprapubic UL0000139100 Suprapubic Drainage - Closed / Trocar 5000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Suprapubic Drainage - Closed / Trocar Clinical notes-P | Detailed Procedure / Operative Notes detailing how mcuh urine was
1 Drainage - Closed 001731 drained-C | USG/CT confirming the diagnosis for which the surgery is done-P | detailed
/ Trocar discharge summary-C
UROLOGY UL UL0000140 Surgery for UL0000140200 Priapism Aspiration 7000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Priapism Aspiration Color-flow penile Doppler imaging/ USG (patients with high-flow priapism)-P | Detailed
2 Priapism 001732 discharge summary-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000140 Surgery for UL0000140200 Priapism Shunt 15000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Priapism Shunt Color-flow penile Doppler imaging/ USG (patients with high-flow priapism)-P | Detailed
2 Priapism 001733 discharge summary-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000140 Surgical UL0000140900 Non Micro surgical / Microsurgical 15000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Non Micro surgical / Microsurgical Clinical notes-P | Detailed discharge summary-C | USG Scrotum color doppler-P |
9 Correction of 001734 detailed Procedure / Operative Notes-C
Varicocele
UROLOGY UL UL0000143 Boari flap for UL0000143000 Boari flap for ureteric stricture -Open / Lap. ± DJ Stenting 30000 No 0 No 0 Yes No Tertiary 3 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Boari flap for ureteric stricture -Open / Lap. ± DJ Stenting
Clinical notes-P | Detailed discharge summary-C | IVP/CT-IVP+/-MCU confirming the
ureteric stricture 01656 stricture for which the surgery is done-P | Intra procedure still photograph-C | detailed
UROLOGY UL UL0000145 Torsion of testis UL0000145300 Torsion of testis 15000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Torsion of testis Clinical notes-P | Discharge summary-C | Examination details-P | OT Notes-C |
3 001735 Relavent investigations-P
UROLOGY UL UL0000147 Transrectal UL0000147200 Transrectal Ultrasound guided prostate biopsy (minimum 12 14000 No 0 No 0 No No Secondary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Transrectal Ultrasound guided prostate biopsy (minimum 12 )+/- PSA-P | Clinical notes-P | Detailed discharge summary-C | Histopathology showing
2 Ultrasound guided 001736 core) core) reporting of minimum 6 core samples of prostate-C | USG with prostate size and Post
prostate biopsy Void Volume establishing suspicion of malignancy-P | detailed Procedure / Operative
(minimum 12 Notes.-C
core)
UROLOGY UL UL0000148 TURBT - Restage UL0000148400 TURBT - Restage 18000 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N TURBT - Restage Clinical notes-P | Confirming the diagnosis bladder tumour-P | Detailed discharge
4 001737 summary-C | Intra procedure still photograph Histopathology-C | Previous biopsy
report-P | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000148 TURBT UL0000148600 TURBT 27500 No 0 No 0 No No Tertiary 2 No Yes Yes Regular PKG No No No Surgical No Insurance N N N TURBT CT / MRI if needed confirming the diagnosis bladder tumour-P | Clinical notes-P |
6 (Transurethral 001738 (Transurethral Resection of the Bladder Tumor) (Transurethral Resection of the Bladder Tumor) Detailed discharge summary-C | Histopathology-C | USG-P | detailed Procedure /
Resection of the Operative Notes-C
Bladder Tumor)
UROLOGY UL UL0000148 TURP- UL0000148700 Monopolar/Bipolar/ Laser Surgery 27500 No 0 No 0 Yes No Tertiary 2 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Monopolar/Bipolar/ Laser Surgery )+/-uroflometry-P | Clinical notes-P | Detailed discharge summary-C | Histopathology-
7 Transurethral 001739 C | PSA-P | USG with prostate size-P | detailed Procedure / Operative Notes-C
Resection of the
Prostate, BPH
UROLOGY UL UL0000149 Undescended UL0000149100 Bilateral /Unilateral - Palpable/ Nonpalpable - Govt Reserve 15000 No 0 No 0 Yes Yes Tertiary 4 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Bilateral /Unilateral - Palpable/ Nonpalpable - Govt Reserve Clinical Photograph-P | Clinical notes-P | Post procedure clinical photograph showing
1 Testis 001740 Reserve scar-C | USG-P | detailed Procedure / Operative Notes-C | detailed Procedure /
Operative Notes-C
UROLOGY UL UL0000149 Urachal Cyst UL0000149500 Urachal Cyst excision - Open / Lap. 20000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Urachal Cyst excision - Open / Lap. Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT/MRI
5 excision 001741 confirming the diagnosis of Urachus-P | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000149 Ureteric UL0000149800 Ureteric reimplantation 23000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ureteric reimplantation CT-IVP/MRI Urogram-P | Clinical notes-P | Detailed discharge summary-C | Intra
8 reimplantation 001742 procedure clinical photograph-C | MCU confirming reflux and need of surgery-P |
UROLOGY UL UL0000149 Ureteric sampling UL0000149900 Ureteric sampling including cystoscopy, ureteric 13000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ureteric sampling including cystoscopy, ureteric Clinical diagnosis suspected for this procedure-P | Clinical notes-P | Detailed discharge
9 including 001743 catheterization, retrograde pyelogram ± URS ± DJ Stenting catheterization, retrograde pyelogram ± URS ± DJ Stenting summary-C | Evidence of cystoscopy-C | Reports of all previous work up done
cystoscopy, (Xray/USG/CT Scan)-P | detailed Procedure / Operative Notes-C | retrograde pyelogram
ureteric and the diagnosis arrived at-C | ureteric catheterization-C
catheterization,
retrograde
pyelogram
UROLOGY UL UL0000150 Ureterocalycosto UL0000150000 Ureterocalycostomy - Laparoscopic ± DJ Stenting 30400 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ureterocalycostomy - Laparoscopic ± DJ Stenting )+/-DTPA renal scan-P | Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-
0 my 001744 IVP,+/-DTPA renal scan-P | Intra operative photograph-C | detailed Procedure /
Operative Notes-C
UROLOGY UL UL0000150 Ureterocalycosto UL0000150000 Ureterocalycostomy - Open ± DJ Stenting 26900 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ureterocalycostomy - Open ± DJ Stenting )+/-DTPA renal scan-P | Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-
0 my 001745 IVP-P | Intra operative photograph-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000150 Ureterocele UL0000150100 Ureterocele incision including cystoscopy, ureteric 17300 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ureterocele incision including cystoscopy, ureteric Clinical notes-P | Detailed discharge summary-C | Evidence of cystoscopy-C | IVP/CT-
1 incision including 001746 catheterization, retrograde pyelogram ± DJ Stenting catheterization, retrograde pyelogram ± DJ Stenting IVP confirming the diagnosis for which the surgery is done-P | detailed Procedure /
cystoscopy, Operative Notes-C | retrograde pyelogram-C | ureteric catheterization-C
ureteric
catheterization,
retrograde
pyelogram
UROLOGY UL UL0000150 Ureterolithotomy UL0000150200 Ureterolithotomy -Open/Lap. ± DJ Stenting 20000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Ureterolithotomy -Open/Lap. ± DJ Stenting Clinical notes-P | Detailed discharge summary-C | IVP / NCCT / CT-Urography
2 001747 confirming the indication -P | Post procedure Imaging (X Ray/USG)-C | detailed
Procedure / Operative Notes-C | showing stone removed-C
UROLOGY UL UL0000150 Ureterolysis for UL0000150300 Open - Ureterolysis for retroperitoneal fibrosis 28000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Open - Ureterolysis for retroperitoneal fibrosis CT-IVP/ MRI Urogram confirming the diagnosis for which the surgery is done-P | Clinical
3 retroperitoneal 001748 (with or without omental wrapping)/Ureterolysis for (with or without omental wrapping)/Ureterolysis for notes-P | Detailed discharge summary-C | Intra procedure still photograph-C |
fibrosis (with or retroperitoneal fibrosis (with or without omental wrapping- retroperitoneal fibrosis (with or without omental wrapping- detailed Procedure / Operative Notes including details of omental wrapping if done-C
without omental Lap. ± DJ Stenting Lap. ± DJ Stenting
wrapping)
UROLOGY UL UL0000150 Ureteroscopy + UL0000150400 Lower Ureter/Upper Ureter/ RIRS/URSL - stand alone 25000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Stand alone Yes No No Surgical No Insurance N N N Lower Ureter/Upper Ureter/ RIRS/URSL - stand alone Clinical notes-P | Detailed discharge summary-C | IVP / NCCT / CT-Urography
4 Stone removal 001749 confirming the indication -P | Post procedure Imaging (X Ray/USG)-C | detailed
with lithotripsy Procedure / Operative Notes-C
UROLOGY UL UL0000150 Ureterostomy UL0000150600 Ureterostomy (Cutaneous) ± DJ Stenting 20000 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ureterostomy (Cutaneous) ± DJ Stenting CT/MRI confirming the diagnosis for ureterostomy and need for creating a stoma for
6 001750 ureter-P | Clinical notes-P | Detailed discharge summary-C | Post Procedure Clinical
Photograph stoma-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000150 Uretero- UL0000150800 Uretero-ureterostomy- Open / Lap. ± DJ Stenting 26000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Uretero-ureterostomy- Open / Lap. ± DJ Stenting Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-IVP,+/-DTPA renal scan-P
8 ureterostomy 001751 | Intra operative photograph-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000151 Uretero-vaginal / UL0000151000 Uretero - vaginal fistula repair - Open/Uretero - vaginal 26000 No 0 No 0 Yes No Tertiary 3 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Uretero - vaginal fistula repair - Open/Uretero - vaginal Clinical notes-P | Cystoscopy and vaginoscopy Scopy confirming the diagnosis for which
0 Uterine fistula 001752 fistula repair - Laparoscopic/Uretero - Uterine fistula repair - fistula repair - Laparoscopic/Uretero - Uterine fistula repair - the surgery is done-P | Detailed discharge summary-C | IVP/ CT-IVP-P | Intra
repair Open/Uretero - Uterine fistula repair - Laparoscopic ± DJ Open/Uretero - Uterine fistula repair - Laparoscopic ± DJ procedure still photograph-C | detailed Procedure / Operative Notes-C
Stenting Stenting
UROLOGY UL UL0000151 Urethral Dilatation UL0000151200 Endocopic as an independent procedure - Stand Alone 5000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Endocopic as an independent procedure - Stand Alone Clinical notes-P | Detailed Procedure / Operative Notes-C | Endoscopic Intra procedure
2 001753 still photograph-C | Investigation reports confirming urethral stricture (RGU+/- MCU)-P |
UROLOGY UL UL0000151 Urethral Dilatation UL0000151200 Non endocopic as an independent procedure - Stand Alone 2000 No 0 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Non endocopic as an independent procedure - Stand Alone Clinical notes-P | Detailed Procedure / Operative Notes detailing size of dilators used-C |
2 001754 Detailed discharge summary-C | Investigation reports confirming urethral stricture
(RGU+/- MCU)-P
UROLOGY UL UL0000151 Urethroplasty UL0000151300 Stage Urethroplasty Stage I ± Endoscopy 20000 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Stage Urethroplasty Stage I ± Endoscopy Clinical notes and ACU (Anterograde urethrography)/micturating cysto-urethrogram
3 001755 (MCU)-P | Detailed discharge summary-C | Intra procedure clinical photograph-C |
Retrograde urethrography justifying the surgery-P | detailed Procedure / Operative
Notes-C
UROLOGY UL UL0000151 Urethroplasty UL0000151300 Stage Urethroplasty Stage II ± Endoscopy 25000 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Stage Urethroplasty Stage II ± Endoscopy Clinical notes and ACU (Anterograde urethrography)/micturating cysto-urethrogram
Notes-C
UROLOGY UL UL0000151 Urethroplasty UL0000151300 Urethroplasty - End to end ± Endoscopy 28000 No 0 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Urethroplasty - End to end ± Endoscopy Clinical notes and ACU (Anterograde urethrography)/micturating cysto-urethrogram
Notes-C
UROLOGY UL UL0000151 Urethroplasty UL0000151300 Urethroplasty - Transpubic ± Endoscopy 34700 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Urethroplasty - Transpubic ± Endoscopy Clinical notes and ACU (Anterograde urethrography)/micturating cysto-urethrogram
Notes-C
UROLOGY UL UL0000151 Urethrorectal UL0000151500 Urethrorectal fistula repair 40000 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Urethrorectal fistula repair /+-RGU-P | Clinical notes-P | Confirmation of fistula and it's tract by Cystoscopy-P |
5 fistula repair 001759 Confirmation of fistula and it's tract by Sigmoidoscopy+/-RGU+MCU-P | Detailed
discharge summary-C | MCU-P | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000151 Urethrovaginal UL0000151700 Urethrovaginal fistula repair 30400 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Urethrovaginal fistula repair Clinical notes and urethro Cystoscopy-P | Detailed Procedure / Operative Notes-C |
7 fistula repair 001760 USG confirming the diagnosis-P | Vaginoscopy-P | detailed discharge summary-C
UROLOGY UL UL0000153 Vasovasostomy UL0000153500 Vasovasostomy Govt reserved 12000 No 0 No 0 No Yes Tertiary 2 Yes Yes Yes Govt No No No Surgical No Insurance N N N Vasovasostomy Govt reserved Clinical notes detailing need of surgery after vasectomy-P | Detailed Operative notes-C |
5 001761 Reserve Detailed discharge summary-C | Evidence of When and where was vasectomy done-P |
Is the EHCP equipped for microsurgery-P | Since this is microsurgery evaluate time taken
(2 hours+)-C
UROLOGY UL UL0000157 Botulinum toxin UL0000157000 Botulinum toxin injection for Neuropathic bladder 10000 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Botulinum toxin injection for Neuropathic bladder Clinical notes-P | Detailed discharge summary-C | USG / CT / Uro dynamic study
injection for 01657 confirming -P | detailed Procedure / Operative Notes-C
Neuropathic
bladder
UROLOGY UL UL0000171 Burch UL0000171000 Abdominal / Laparoscopic -Burch 25000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Abdominal / Laparoscopic -Burch Admission Notes comprising of history and examination with indications for the
01658 procedure-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-C
| Intraop-C | Relavant Investigations (establishing diagnosis)-P | Urodynamic studies
are optional.-P | progress notes-C | stills-C
UROLOGY UL UL0000240 Closure of Burst UL0000240000 Closure of Burst Abdomen 15000 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Closure of Burst Abdomen Clinical notes-P | Clinical picture-P | Describing the original surgery that led to burst
Abdomen 01659 abdomen-P | Detailed Operative notes-C | Intra procedure clinical photograph-C | X
Ray/USG/ CT Abdomen confirming the diagnosis for which the surgery is done-P |
UROLOGY UL UL0000261 Congenital UL0000261000 Congenital Diaphragmatic Hernia - Govt Reserve 40000 No 0 No 0 No Yes Tertiary 5 No Yes Yes Govt No No No Surgical No Insurance N N N Congenital Diaphragmatic Hernia - Govt Reserve Chest X-ray AP/Lat-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
Diaphragmatic 01660 Reserve Foetal Cardiogram-C | USG/CT scan stills-P | Xray Chest AP/Lat stills-C | detailed
Hernia discharge summary-C
UROLOGY UL UL0000279 Conservative UL0000279000 Conservative Management - stand alone 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Stand alone Yes No No Surgical No Insurance N N N Conservative Management - Conservative Management - stand alone All investigations reports.-C | Any investigations done-P | Clinical notes detailing history
Management 01661 stand alone-1800 and Admission notes showing vitals and examination findings-P | Detailed ICPs-C |
Planned line of management-P | Treatment details-C | detailed discharge summary-C
UROLOGY UL UL0000288 Conservative UL0000288000 Conservative Management - 0 Yes 3 No 0 Yes No Secondary 19 No Yes Yes Stand alone Yes No No Surgical No Insurance N N R N Conservative Management - Conservative Management - Clinical Notes-P | Detailed discharge summary.-C | Extent of upto 40% burns visible on
Management of 01662 (Chest/Head/Face/Abdomen)stand alone (Chest / Head / Face / Abdomen) (Chest/Head/Face/Abdomen)stand alone photograph (with rule of 9 chart)-P | MLC copy with number-P | Post Treatment clinical
injury stand alone-1800 photograph-C | X-rays or other diagnostic procedures done as a part of treatment-C |
lab tests-C
UROLOGY UL UL000032 Acute UL0000320000 Acute management of upper urinary tract trauma – 8600 No 0 No 0 No No Tertiary 5 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Acute management of upper urinary tract trauma – Circumstances that led to trauma-P | Clinical notes detailing the case history-P |
management of 1649 conservative conservative Detailed discharge summary.-C | Injuries sustained as result of trauma-P | Local
upper urinary examination findings-P | Presenting complaints-P | Reports of all investigations done
tract trauma – and consultation paper of treating doctor mentioning the final diagnosis and line of
conservative treatment-C | USG/CT Abdomen-P
UROLOGY UL UL0000468 Cystolithotomy - UL0000468000 Cystolithotomy - Open - including cystoscopy 18500 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Cystolithotomy - Open - including cystoscopy Clinical notes-P | X ray KUB and USG/IVP/NCCT confirming the diagnosis of bladder stone-
Open, including 01663 P | X ray KUB post op-C | detailed Procedure / Operative Notes-C
cystoscopy
UROLOGY UL UL0000470 Cystolithotripsy / UL0000470000 Cystolithotripsy including cystoscopy 18500 No 0 No 0 Yes No Tertiary 1 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Cystolithotripsy including cystoscopy Clinical notes-P | Detailed discharge summary-C | X ray KUB and USG/IVP/NCCT
Urethral Stone 01664 confirming the diagnosis of bladder stone-P | detailed Procedure / Operative Notes-C
endoscopic,
including
cystoscopy
UROLOGY UL UL0000470 Cystolithotripsy / UL0000470000 Urethral Stone removal endoscopic, including cystoscopy 18500 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Urethral Stone removal endoscopic, including cystoscopy Clinical notes-P | Detailed discharge summary-C | X ray KUBand USG/IVP/NCCT
Urethral Stone 01665 confirming the diagnosis of bladder stone-P | detailed Procedure / Operative Notes-C
endoscopic,
including
cystoscopy
UROLOGY UL UL000048 Adrenalectomy UL0000480000 Adrenalectomy 30000 No 0 No 0 Yes No Tertiary 5 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Adrenalectomy Clinical notes confirming diagnosis with Evidence of CT/MRI +/- FNAC/Biopsy / Sr. Cortisol
1650 / 24 hr urinary catacholamine level / sr. / urinary metanephrine / Nor metanephrine-P |
Detailed discharge summary detailed Procedure / Operative Notes-C | Histopathology
report/ specimen photo-C
UROLOGY UL UL0000482 Deflux for VUR UL0000482000 Deflux for VUR(only procedure charge) 3400 No 0 No 0 No No Tertiary 5 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Deflux for VUR(only procedure charge) Clinical notes with planned line of treatment-P | Detailed discharge summary-C | IVU-C
01666 | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000508 Distal UL0000508000 Distal ureterectomy with reimplantation 30400 No 0 No 0 No No Tertiary 6 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Distal ureterectomy with reimplantation CT KUB-P | Clinical notes with planned line of treatment-P | Detailed Discharge
ureterectomy 01667 Summary-C | HPE report-C | Post Procedure Photographs of surgical site-C |
with Procedure / Operative Notes,-C
reimplantation
UROLOGY UL UL0000511 DJ Stent Removal UL0000511000 DJ Stent Removal 3000 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No Yes No Surgical No Insurance N N N DJ Stent Removal Clinical notes with planned line of treatment including planned line of treatment-P |
01668 Detailed Procedure / Operative Notes-C | Discharge Summary of DJ Stenting if available -
P | X-ray films-P | discharge summary-C
UROLOGY UL UL0000513 DJ stenting UL0000513000 DJ stenting including cystoscopy, ureteric catheterization, 10000 No 0 No 0 No No Tertiary 1 No Yes Yes Stand alone No No No Surgical No Insurance N N N DJ stenting including cystoscopy, ureteric catheterization, Clinical notes-P | NCCT/ IVP/ CT urography confirming the diagnosis and the need of this
including 01669 retrograde pyelogram - Stand Alone retrograde pyelogram - Stand Alone surgery is done-P | Post Procedure x-ray showing stent-C | detailed Procedure /
cystoscopy, Operative Notes detailing findings of cystoscopy/ Retrogradepyelogram and ureteric
ureteric catheterization-C | detailed discharge summary.-C
catheterization,
retrograde
pyelogram
UROLOGY UL UL0000537 Emergency UL0000537000 Emergency management of Acute retention of Urine 0 Yes 3 No 0 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Emergency management of Acute retention of Urine Clinical notes detailing chroniciy-P | Detailed discharge summary giving aetiology of
management of 01670 retention-C | Evidence of simple catheterization and details of how much urine drained-
Acute retention of C | USG proving retention of urine-P
Urine
UROLOGY UL UL0000541 Emergency UL0000541000 Emergency management of Hematuria 0 Yes 3 No 0 Yes No Secondary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N R N Routine Ward-1800 Emergency management of Hematuria Clinical notes detailing the hematuria with urine report showing frank or microscopic-P |
management of 01671 Evidence of investigations done treatment given-C | detailed discharge summary-C
Hematuria
UROLOGY UL UL0000543 Emergency UL0000543000 Emergency management of Ureteric stone - Package for 0 Yes 3 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Routine Ward-1800 Emergency management of Ureteric stone - Package for +/- X-ray and Evidence of 3 weeks medicines-C | Clinical notes detailing the case history
management of 01672 evaluation / investigation (ultrasound + culture) for 3 weeks evaluation / investigation (ultrasound + culture) for 3 weeks with previous work up / initial diagnosis with stills of ureteric stone and treatment done
Ureteric stone - (medicines). (medicines). so far-P | Detailed reports of all investigations done and consultation paper of treating
Package for doctor-C | USG report-C
evaluation /
investigation
(ultrasound +
culture) for 3
weeks
(medicines).
UROLOGY UL UL0000554 Endopyelotomy UL0000554000 Retrograde with laser / bugbee/Antegrade with laser / 26000 No 0 No 0 Yes No Tertiary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Retrograde with laser / bugbee/Antegrade with laser / )+/-DTPA renal scan.-P | Clinical notes-P | Detailed discharge summary-C | IVP/CT/ CT-
01673 bugbee With Endopyelotomy Stent bugbee With Endopyelotomy Stent IVP-P | If bugbee electrode is billed-C | Intra operative photograph-C | detailed
Procedure / Operative Notes-C | insist on invoice/ barcode.-C
UROLOGY UL UL0000573 Epispadias UL0000573000 Epispadias Extrophy Complex surgery three stage surgery - 0 Yes 1 No 0 Yes Yes Tertiary 7 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Epispadias Extrophy Complex Epispadias Extrophy Complex surgery three stage surgery - Clinical notes detailing the case history with previous work up / initial diagnosis-P |
Extrophy Complex 01674 Govt Reserve Reserve surgery three stage surgery - Govt Reserve Detailed OT Notes-C | Detailed discharge summary.-C
surgery Govt Reserve-30000
UROLOGY UL UL0000574 Epispadias Repair UL0000574000 Epispadias Repair - Govt Reserve 30000 No 0 No 0 No Yes Tertiary 5 Yes Yes Yes Govt No No No Surgical No Insurance N N N Epispadias Repair - Govt Reserve Clinical notes detailing the case history with previous work up / initial diagnosis-P |
01675 Reserve Detailed OT Notes-C | Detailed discharge summary.-C
UROLOGY UL UL0000618 Excision of UL0000618000 Excision of Urethral Caruncle 8600 No 0 No 0 No No Tertiary 1 No Yes Yes Regular PKG No No No Surgical No Insurance N N N Excision of Urethral Caruncle Clinical notes-P | Confirmed diagnosis of urethral carunclule-P | Detailed discharge
Urethral Caruncle 01676 summary-C | HPE Report / Specimen Photo-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000636 Extended LOS UL0000636000 Extended LOS care pkg for advance sugeries after 6 days 0 Yes 3 No 0 Yes No Secondary 0 No Yes Yes Regular PKG Yes No No Surgical No Insurance N N Y ICU (with Ventilator)-6000 | ICU Extended LOS care pkg for advance sugeries after 6 days Admission notes showing vitals and examination findings-P | All investigations reports.-C
care pkg for 01677 (allowed after pre auth, if justifies max 3 days in single go) (without Ventilator)-4700 | (allowed after pre auth, if justifies max 3 days in single go) | Any investigations done-P | Clinical notes detailing history-P | Detailed ICPs-C |
advance sugeries Routine Ward-1800 Planned line of management-P | Treatment details-C | detailed discharge summary-C
UROLOGY UL UL0000643 Extracoporeal UL0000643000 Extracoporeal shock - wave Lithotripsy (ESWL) stone, with 15000 Yes 0 Yes 5 Yes No Tertiary 1 Yes Yes Yes Stand alone Yes No No Surgical No Insurance N N N DJ Stent-200 Max :5 Extracoporeal shock - wave Lithotripsy (ESWL) stone, with or Clinical notes -P | Detailed discharge summary-C | IVP / NCCT / CT-IVP confirming the
shock - wave 01678 or without stent (one side) - stand alone without stent (one side) - stand alone indication and need for ESWL-P | Intra operative photograph-C | detailed Procedure /
Lithotripsy (ESWL) Operative Notes;-C
UROLOGY UL UL0000648 Extrophy Bladder UL0000648000 Extrophy Bladder repair including osteotomy if needed + 78200 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Extrophy Bladder repair including osteotomy if needed + Clinical Photograph of affected part-P | Clinical notes-P | Post Procedure Clinical
repair including 01679 Epispadias repair + ureteric reimplant Epispadias repair + ureteric reimplant Photograph of affected part-C | USG/CT/MRI confirming the diagnosis of extrophy of
osteotomy if bladder/ epispadias-P | detailed Procedure / Operative Notes-C
needed +
Epispadias repair
+ ureteric
reimplant
UROLOGY UL UL0000674 Follow up for UL0000674000 Follow up for urological procedures 1500 No 0 No 0 No No Secondary 2 No Yes Yes follow up No No No Surgical No Insurance N N N Follow up for urological procedures Clinical examination notes-P | Dischage advice details-P | Post discharge summary-P |
urological 01680 Treatment details and relevant investgation reports-C
procedures
UROLOGY UL UL0000770 High inguinal UL0000770000 High inguinal Orchiectomy 13800 No 0 No 0 No No Tertiary 2 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N High inguinal Orchiectomy Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT / Biopsy
Orchiectomy 01681 confirming testicular cancer-P | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000783 Hypospadias UL0000783000 Two or more stage (Final Stage) / Fistula repair- govt reserve 20000 No 0 No 0 Yes Yes Tertiary 3 Yes Yes Yes Govt Yes Yes No Surgical No Insurance N N N Two or more stage (Final Stage) / Fistula repair- govt reserve Clinical Photograph; evidence of stage 1 / 2 (Discharge Summary)-P | Clinical notes-P |
repair 01683 Reserve Post Procedure Clinical Photograph of affected part-C | detailed Procedure / Operative
Notes-C
UROLOGY UL UL0000783 Hypospadias UL0000783000 Single stage Hypospadias repair - govt reserve 28000 No 0 No 0 Yes Yes Tertiary 3 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Single stage Hypospadias repair - govt reserve Clinical Photograph-P | Clinical notes-P | Detailed Procedure / Operative Notes-C |
repair 01682 Reserve Post Procedure Clinical Photograph of affected part-C | detailed Procedure / Operative
Notes-C
UROLOGY UL UL0000783 Hypospadias UL0000783000 Two or more stage (First Stage) Hypospadias repair 15000 No 0 No 0 Yes Yes Tertiary 3 Yes Yes Yes Govt Yes No No Surgical No Insurance N N N Two or more stage (First Stage) Hypospadias repair Clinical Photograph-P | Clinical notes-P | Post Procedure Clinical Photograph of affected
repair 01684 independently - govt reserve Reserve independently - govt reserve part-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000799 Ileal replacement UL0000799000 Ileal replacement for ureteric stricture 46000 No 0 No 0 No No Tertiary 4 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Ileal replacement for ureteric stricture )+/-MCU confirming the stricture-P | Clinical notes-P | Detailed discharge summary-C |
for ureteric 01685 IVP/CT-IVP-P | Intra procedure still photograph of cut intestinal segment-C | detailed
stricture Procedure / Operative Notes including details-C
UROLOGY UL UL0000803 Ilio-Inguinal UL0000803000 Ilio-Inguinal lymphadenectomy - U/L OR B/L 0 Yes 1 No 0 Yes No Tertiary 2 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Bilateral - Ilio-Inguinal Ilio-Inguinal lymphadenectomy - U/L OR B/L Clinical notes-P | Detailed discharge summary-C | Histopathology-C | USG/CT/MRI /
lymphadenectom 01686 lymphadenectomy-34700 | Biopsy confirming the diagnosis for which the surgery is done-P | detailed Procedure /
y Unilateral - Ilio-Inguinal Operative Notes-C
lymphadenectomy-23500
UROLOGY UL UL0000822 Internal UL0000822000 Internal Uretherotomy including cystoscopy as an 10000 No 0 No 0 No No Secondary 1 Yes Yes Yes Stand alone No No No Surgical No Insurance N N N Internal Uretherotomy including cystoscopy as an Clinical notes-P | Detailed Procedure / Operative Notes-C | Endoscopic Intra procedure
Ureterotomy 01687 independent procedure /Laser internal uretherotomy - independent procedure /Laser internal uretherotomy - still photograph-C | Investigation reports confirming urethral stricture (RGU+/- MCU)-P |
including Stand ALONE Stand ALONE detailed discharge summary-C
cystoscopy as an
independent
procedure
UROLOGY UL UL0000839 Intravesical BCG / UL0000839000 Intravesical BCG / Mitomycin - Induction cycles (PC) for max. 2500 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No Yes No Surgical No Insurance N N N Intravesical BCG / Mitomycin - Induction cycles (PC) for max. Clinical notes-P | Detailed Procedure / Operative Notes-C | Detailed discharge summary-
Mitomycin 01688 06 Doses 06 Doses C | Histopathology/ biopsy confirming the diagnosis of bladder cancer-P | original bills
of medicines administered-C
UROLOGY UL UL0000934 Meatotomy / UL0000934000 Meatotomy/Meatoplasty 3500 Yes 1 No 0 Yes No Secondary 1 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N GA-4400 Meatotomy/Meatoplasty Clinical notes-P | Confirmed diagnosis of meatal stenosis-P | Detailed discharge
Meatoplasty 01689 summary-C | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000962 Mitropfanoff UL0000962000 Mitropfanoff procedure For Urinary divertion - Govt 40000 No 0 No 0 No Yes Tertiary 7 No Yes Yes Govt No No No Surgical No Insurance N N N Mitropfanoff procedure For Urinary divertion - Govt Clinical notes-P | Confirmed diagnosis-P | Detailed discharge summary-C | detailed
procedure For 01690 Reserve Reserve Reserve Procedure / Operative Notes-C
Urinary divertion
UROLOGY UL UL0000984 Nephrectomy UL0000984000 Nephrectomy For Benign pathology /Nephrectomy- Radical 28600 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrectomy For Benign pathology /Nephrectomy- Radical )+/- FNAC/Biopsy.-P | Clinical notes-P | Detailed discharge summary-C |
01691 (Renal tumor) (Renal tumor) Histopathology-C | Intra operative photograph-C | USG/CT confirming the need for
surgery-P | detailed Procedure / Operative Notes-C
UROLOGY UL UL0000987 Nephrectomy - UL0000987000 Nephrectomy - Partial or Hemi 40000 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrectomy - Partial or Hemi CT/MRI confirming the need for surgery-P | Clinical notes-P | Detailed discharge
Partial or Hemi 01692 summary-C | Histopathology-C | Intra operative photograph-C | detailed Procedure /
Operative Notes-C
UROLOGY UL UL0000990 Nephro UL0000990000 Nephro ureterectomy (Benign) 28600 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephro ureterectomy (Benign) CT/ CT-IVP/MRI confirming the need for surgery-P | Clinical notes-P | Detailed
ureterectomy 01693 discharge summary-C | Histopathology-C | Intra operative photograph-C | detailed
(Benign) Procedure / Operative Notes-C
UROLOGY UL UL0000993 Nephro UL0000993000 Nephro ureterectomy with cuff of bladder 29500 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephro ureterectomy with cuff of bladder CT/ CT-IVP/MRI/MRI Urogram confirming the need for surgery-P | Clinical notes-P |
ureterectomy 01694 Detailed discharge summary-C | Histopathology-C | Intra operative photograph-C |
with cuff of detailed Procedure / Operative Notes-C
bladder
UROLOGY UL UL0000994 Nephrolithotomy UL0000994000 Nephrolithotomy- Open/Anatrophic 30000 No 0 No 0 Yes No Tertiary 4 Yes Yes Yes Regular PKG Yes No No Surgical No Insurance N N N Nephrolithotomy- Open/Anatrophic Clinical notes-P | Detailed discharge summary-C | IVP / NCCT+ CT-IVP confirming the
01695 indication -P | Post procedure Imaging (X Ray/USG)-C | detailed Procedure / Operative
Notes-C | showing stone removed-C
UROLOGY UL UL0000997 Nephrostomy - UL0000997000 Nephrostomy - Percutaneous Image guided / Fluoroscopic 14000 No 0 No 0 No No Tertiary 1 Yes Yes Yes Regular PKG No No No Surgical No Insurance N N N Nephrostomy - Percutaneous Image guided / Fluoroscopic Clinical notes-P | Intra procedure clinical photograph-C | USG confirming the indication
Percutaneous 01696 Guided Guided and need of procedure-P | detailed Procedure / Operative Notes-C | detailed discharge
Image guided summary-C

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