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)
S12 0001 Balloon Atrial Septostomy 18,000 Y 2D ECHO report 2D ECHO report    N S
S12 0002 Balloon Aortic Valvotomy 25,000 Y 2D ECHO report 2D ECHO report    N S
S12 0003 Balloon Mitral Valvotomy 27,500 Y 2D ECHO report 2D ECHO report    N S
S12 0004 Balloon Pulmonary Valvotomy 25,000 Y 2D ECHO report 2D ECHO report    N S
S12 0005 Vertebral Angioplasty with single stent (medicated) 50,000 Y 2D ECHO  Post op. Angiogram report  2 N S
Angiogram report Carton of the stent used approved by FDA/DCGI only
S12 0006 Vertebral Angioplasty with double stent(medicated) 65,000 Y 2D ECHO  Post op. Angiogram report  2 N S
Angiogram report Carton of the stents used approved by FDA/DCGI only
S12 0007 Carotid angioplasty with stent (medicated) 130,000 Y Angiogram report & film showing the lesion Post lesion  2 N S
X Ray
Doppler
carton of the stent used approved by FDA/DCGI only
S12 0008 Renal Angioplasty with single stent (medicated) 50,000 Y ECG Post op. Angiogram report, showing stent & post Stent flow  2 N S
2D ECHO carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & Reports  
S12 0009 Renal Angioplasty with double stent (medicated) 65,000 Y ECG Post op. Angiogram report, showing stent & post Stent flow  2 N S
2D ECHO carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & Reports  
S12 0010 Peripheral Angioplasty with balloon 25,000 Y 2D ECHO Post procedure Angio stills 2 N S
CAG stills showing blocks & Reports  
S12 0011 Peripheral Angioplasty with stent (medicated) 50,000 Y 2D ECHO  Post procedure Angio stills  2 N S
Angiogram report & stills carton of the stents used approved by FDA/DCGI only
S12 0012 Coarctation dilatation 25,000 Y 2D ECHO report 2D ECHO report + stills of ECHO   N S
S12 0013 Medical treatment of Acute MI with Thrombolysis /Stuck Valve Thrombolysis 10,000 Y 2D ECHO 2D ECHO   N S
CPK-MB ECG
CAG Lab Investigation (Troponine - T report)
ECG with report  
TROPONINE-T report  
S12 0014 ASD Device Closure 80,000 Y 2D ECHO report - TRPG 2D ECHO stills showing the device + Report   N S
S12 0015 VSD Device Closure 80,000 Y 2D ECHO report - TRPG 2D ECHO stills showing the device + Report   N S
S12 0016 PDA Device Closure 40,000 Y 2D ECHO report  2D ECHO stills showing the device + Report   N S
S12 0017 PDA  multiple Coil insertion 20,000 Y 2D ECHO report  2D ECHO stills showing the coil + Report   N S
S12 0018 PDA Coil (one) insertion 15,000 Y 2D ECHO report  2D ECHO stills showing the coil + Report   N S
S12 0019 PDA stenting 40,000 Y 2D ECHO Post procedure Angio stills   N S
Angiogram report & stills  
S12 0020 Pericardiocentesis 4,000 Y 2D ECHO report 2D ECHO report   N S
S12 0021 Temporary Pacemaker implantation 10,000 Y ECG  X Ray showing the pacemaker in situ   N S
Report by cardiologist    
S12 0022 Permanent pacemaker implantation (only VVI) including Pacemaker value/pulse generator replacement (DOUBLE CHAMBER) 60,000 Y ECG  X Ray showing the pacemaker in situ 7 (2-day ICU stay) N S
Report by cardiologist   
Anigiogram report if done  
S12 0023 Permanent pacemaker implantation (only VVI) including Pacemaker value/pulse generator replacement (SINGLE CHAMBER) 50,000 Y ECG  X Ray showing the pacemaker in situ 7 (2-day ICU stay) N S
Report by cardiologist   
Anigiogram report if done  
S12 0024 PTCA - single stent (medicated, inclusive of diagnostic angiogram) 65,000 Y ECG  Post op. Angiogram report, showing stent & post Stent flow  3 N S
2D ECHO carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & Reports  
S12 0025 PTCA - double stent (medicated, inclusive of diagnostic angiogram) 90,000 Y ECG  Post op. Angiogram report, showing stent & post Stent flow  3 N S
2D ECHO carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & Reports  
S12 0026 PTCA - additonal stent (linked to package no:0025) 28,849 Y CAG stills showing blocks & Reports carton of the stents used approved by FDA/DCGI only   N S
S12 0027 PTSMA 25,000 Y ECG Post op. Angiogram report, showing stent & post Stent flow 3 N S
2D ECHO Carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & reports  
S12 0028 Pulmonary artery stenting 40,000 Y 2D ECHO Post procedure Angio stills   N S
Angiogram report & stills  
S12 0029 Pulmonary artery stenting (double) 65,000 Y 2D ECHO Post procedure Angio stills   N S
Angiogram report & stills  
S12 0030 Right ventricular outflow tract (RVOT) stenting 40,000 Y 2D ECHO Post procedure Angio stills   N S
Angiogram report & stills  
S12 0032 Rotablation+ Balloon Angioplasty + 1 stent (medicated) 100,000 Y ECG Post op. Angiogram report, showing stent & post Stent flow    N S
2D ECHO carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & Reports  
S12 0033 Rotablation+ Balloon Angioplasty + 2 stent (medicated) 125,000 Y ECG Post op. Angiogram report, showing stent & post Stent flow    N S
2D ECHO carton of the stents used approved by FDA/DCGI only
CAG stills showing blocks & Reports  
S12 0034 Thrombolysis for peripheral ischemia 10,000 Y Peripheral Angiogram /Doppler Report with Stills Post procedure Angio stills   N S
S12 0035 Bronchial artery Embolisation (for Haemoptysis) 25,000 Y Chest x-Ray/CT Scan Chest x-Ray/CT Scan 2 N S
Hb Hb
Serum Creatinine Serum Creatinine
S12 0036 Percutaneous Transluminal Tricuspid Commissurotormy (PTTC) 25,000 Y 2D ECHO 2D ECHO 2 N S
S12 0037 Coiling - Pseudoaneurysms of Abdomen 55,000 Y Prothrombin Time (PT) CT 2 N S
International normalized ratio (INR) Prothrombin Time (PT)
Hb International normalized ratio (INR) 
Serum Creatinine Hb
  Serum Creatinine
S12 0038 Embolization - Arteriovenous Malformation (AVM) in the Limbs 40,000 Y Ultrasound Ultrasound 2 N S
CT CT
Prothrombin Time (PT) Prothrombin Time (PT)
INR INR
Hb Hb
Serum Creatinine Serum Creatinine
S12 0039 Catheter directed Thrombolysis for: Deep vein thrombosis (DVT), Mesenteric Thrombosis & Peripheral vessels with Tenecteplase 50,000 Y CT/MRI CT/MRI 2 N S
Prothrombin Time (PT) Prothrombin Time (PT)
International normalized ratio (INR)   International normalized ratio (INR) 
Hb Hb
Serum Creatinine Serum Creatinine
S12 0040 Peripheral Embolectomy without Graft 30000 Y ANGIOGRAM , Spiral CT Angiogram Color Doppler   N S
S12 0041 Small Arterial Aneurysms -Repair 18000 Y ANGIOGRAM , Spiral CT Angiogram Color Doppler   N S
S12 0042 Medium size Arterial Aneurysms-Repair 60000 Y  ANGIOGRAM , Spiral CT Angiogram Color Doppler   N S
S12 0043 Medium size Arterial Aneurysms with synthetic graft 90000 Y  ANGIOGRAM , Spiral CT Angiogram Color Doppler   N S