| Specialty code |
Package Code |
Package name |
Package Amount |
Preauth Required or Not (Y/N) |
Mandatory investigations for pre-auth |
Post-Op investigations for claims submission |
Average length of Stay (Including Days in intensive care units) |
Govt Reserved Procedure (Y/N) |
Medical (M) or Surgical (S) |
| S11 |
0001 |
% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns) - any % (not requiring admission). Needs at least 5-6 dressing |
7,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
D |
N |
S |
| S11 |
0002 |
% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): Upto 40 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
40,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0003 |
% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): 40 % - 60 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
50,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0004 |
% Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): > 60 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
80,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0005 |
Electrical contact burns: Low voltage- without part of limb/limb loss; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
30,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0006 |
Electrical contact burns: Low voltage- with part of limb/limb loss; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
40,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0007 |
Electrical contact burns: High voltage- without part of limb/limb loss; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
50,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0008 |
Electrical contact burns: High voltage- with part of limb/limb loss; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
60,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0009 |
Chemical burns: Without significant facial scarring and/or loss of function; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
40,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0010 |
Chemical burns: With significant facial scarring and/or loss of function; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone. |
60,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
Moderate to severe burns need initial ICU stay ranging from 2 – 5 days and then 10 - 14 days of ward stay with alternate day dressings |
N |
S |
| S11 |
0011 |
Post Burn Contracture surgeries for Functional Improvement (Package including splints, pressure garments, silicone-gel sheet and physiotherapy): Excluding Neck contracture; Contracture release with - Split thickness Skin Graft (STSG) / Full Thickness Skin Graft (FTSG)/ Flap cover is done for each joint with post-operative regular dressings for STSG / FTSG / Flap cover. |
50,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
|
N |
S |
| S11 |
0012 |
Post Burn Contracture surgeries for Functional Improvement (Package including splints, pressure garments, silicone-gel sheet and physiotherapy): Neck contracture; Contracture release with - Split thickness Skin Graft (STSG) /
Full Thickness Skin Graft (FTSG)/ Flap cover is done for each joint with post-operative regular dressings for STSG / FTSG / Flap cover. |
50,000 |
Y |
Clinical photograph and diagram with Rule of 9/ L & B Chart for extent of burns |
Clinical photograph |
|
N |
S |