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) |
S9 |
0001 |
Coil embolization for aneurysms (includes cost of first 3 coils + balloon and/ or stent if used) 1 to 20 coils may be required as per need. |
1,00,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0002 |
Additional coil for coil embolization for aneurysms |
24000 |
Y |
CT Angio |
|
|
N |
|
S9 |
0003 |
Dural AVMs/AVFs (per sitting) with glue |
70,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0004 |
Dural AVMs/AVFs (per sitting) with onyx |
1,50,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0005 |
Carotico-cavernous Fistula (CCF) embolization with coils. [includes 5 coils, guide catheter, micro-catheter, micro-guidewire, general items] |
1,50,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0006 |
Carotid-cavernous Fistula (CCF) embolization with balloon (includes one balloon, guide catheter, micro-catheter, micro-guidewire, general items) |
75,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0007 |
Cerebral & Spinal AVM embolization (per sitting). Using Histoacryl |
1,00,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0008 |
Parent vessel occlusion |
Basic – 30,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0009 |
Additonal coil for Parent Vessel Occlusion |
24000 |
Y |
CT Angio |
|
|
N |
|
S9 |
0010 |
Additonal balloon for Parent Vessel Occlusion |
11000 |
Y |
CT Angio |
|
|
N |
|
S9 |
0011 |
Balloon test occlusion |
70,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0012 |
Intracranial balloon angioplasty with stenting |
1,60,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0013 |
Intracranial thrombolysis / clot retrieval |
1,60,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0014 |
Pre-operative tumour embolization (per session) |
40,000 |
Y |
CT Angio |
|
|
N |
S |
S9 |
0015 |
Vertebroplasty |
40,000 |
Y |
CT Angio |
|
|
N |
S |