| 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) |
| M4 |
0001 |
Acute lymphoblastic leukemia (chemotherapy including diagnostics): induction |
55,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0002 |
Acute lymphoblastic leukemia (chemotherapy including diagnostics): consolidation |
40,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0003 |
Acute lymphoblastic leukemia (chemotherapy including diagnostics): maintainence |
15,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0004 |
Acute lymphoblastic leukemia: radiation |
5,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0005 |
Acute lymphoblastic leukemia: Supportive care/ rehabilitation |
20,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0006 |
Acute myeloid leukemia (chemotherapy including diagnostics): induction |
55,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0007 |
Acute myeloid leukemia (chemotherapy including diagnostics): consolidation |
40,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0008 |
Acute myeloid leukemia: Supportive care/ rehabilitation |
20,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0009 |
Hodgkin Lymphoma (Favorable group) (chemotherapy including diagnostics): induction |
45,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0010 |
Hodgkin Lymphoma (Favorable group): radiation |
10,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0011 |
Hodgkin Lymphoma (Favorable group): Supportive care/ rehabilitation |
15,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0012 |
Hodgkin Lymphoma (unfavorable group): chemotherapy including diagnostics |
70,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0013 |
Hodgkin Lymphoma (unfavorable group): radiation |
15,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0014 |
Hodgkin Lymphoma (unfavorable group): Supportive care/ rehabilitation |
25,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0015 |
Non-Hodgkin Lymphoma: chemotherapy including diagnostics |
100,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0016 |
Non-Hodgkin Lymphoma: Supportive care/ rehabilitation |
50,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0017 |
Retinoblastoma (Intraocular): chemotherapy including diagnostics |
45,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0018 |
Retinoblastoma (Intraocular): radiation |
10,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0019 |
Retinoblastoma (Intraocular): surgery |
10,000 |
Y |
Clinical Reports |
|
|
N |
S |
| M4 |
0020 |
Retinoblastoma (Intraocular): supportive care/ rehabilitation |
20,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0021 |
Retinoblastoma (extraocular): chemotherapy including diagnostics |
65,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0022 |
Retinoblastoma (extraocular): radiation |
10,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0023 |
Retinoblastoma (extraocular): supportive care/ rehabilitation |
35,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0024 |
Brain tumors: chemotherapy including diagnostics |
40,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0025 |
Brain tumors: radiation |
30,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0026 |
Brain tumors: surgery |
40,000 |
Y |
Clinical Reports |
|
|
N |
S |
| M4 |
0027 |
Brain tumors: supportive care/ rehabilitation |
25,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0028 |
Wilms tumors: chemotherapy including diagnostics |
20,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0029 |
Wilms tumors: radiation |
5,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0030 |
Wilms tumors: surgery |
20,000 |
Y |
Clinical Reports |
|
|
N |
S |
| M4 |
0031 |
Histiocytosis: chemotherapy including diagnostics |
45,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0032 |
Histiocytosis: supportive care/ rehabilitation |
5,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0033 |
Bone tumors/soft tissue sarcomas : chemotherapy including diagnostics |
80,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0034 |
Bone tumors/soft tissue sarcomas : radiation |
25,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0035 |
Bone tumors/soft tissue sarcomas : surgery (inlcuding prosthesis) |
80,000 |
Y |
Clinical Reports |
|
|
N |
S |
| M4 |
0036 |
Bone tumors/soft tissue sarcomas : supportive care/ rehabilitation |
50,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0037 |
Chronic Myeloid Leukemia : chemotherapy including diagnostics |
80,000 |
Y |
Clinical Reports |
|
|
N |
M |
| M4 |
0038 |
Chronic Myeloid Leukemia : supportive care/ rehabilitation |
20,000 |
Y |
Clinical Reports |
|
|
N |
M |