Specialty code |
Package Code |
Package name |
Package Amount per day (drop down) for admission type: Routine ward (Rs 1800)/ HDU (Rs (Rs 2700)/ ICU (without ventilator) (Rs 3600)/ ICU (with ventilator)(Rs 4500) |
Preauth Required or Not (Y/N): after 1st day, 5th day, 10 th day and every 5 day intervals |
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) |
M1 |
0001 |
Acute gastroenteritis with moderate dehydration |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0002 |
Recurrent vomiting with dehydration |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0003 |
Dysentery |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0004 |
Renal colic |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0005 |
Acute bronchitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0006 |
Pneumothroax |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0007 |
Accelerated hypertension |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0008 |
Congestive heart failure |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0009 |
Severe anemia |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0010 |
Diabetic ketoacidosis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0011 |
Acute febrile illness |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0012 |
Acutre excaberation of COPD |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0013 |
UTI |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0014 |
Malaria |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0015 |
Dengue fever |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0016 |
Chikungunya fever |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0017 |
Leptospirosis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0018 |
Enteric fever |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0019 |
Pneumonia |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0020 |
Acute excaberation of ILD |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0021 |
Liver abscess |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0022 |
Acute viral hepatitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0023 |
Snake bite |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0024 |
Acute organophosphorus poisoning |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0025 |
Other poisoning |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0026 |
Pyrexia of unknown origin |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0027 |
Pericardial/ Pleural tuberculosis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0028 |
Systematic lupus erythematosus |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0029 |
Vasculitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0030 |
Seizures |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0031 |
Bacterial/ fungal endocarditis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0032 |
Acute inflammatory demyelinating polyneuropathy |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0033 |
Lung abscess/ Empyema |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0034 |
Acute and chronic meningitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0035 |
Viral encephalitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0036 |
Persistent/ Chronic diarrohea |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0037 |
Acute and chronic pancreatitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0038 |
Visceral leishmaniasis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0039 |
HIV with complications |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0040 |
Neuromuscular disorders |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0041 |
Metabolic encephalopathy |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0042 |
Sickle cell Anemia |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0043 |
Poisonings with unstable vitals |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0044 |
Type 1/2 respiratory failure |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0045 |
Acute asthmatic attack |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0046 |
Acutre excaberation of COPD |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0047 |
Severe pneumonia |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0048 |
Acute gastroenteritis with severe dehydration |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0049 |
Hypertensive emergencies |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0050 |
Dengue hemorrhagic fever/Dengue shock syndrome |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0051 |
Complicated malaria |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0052 |
Heat stroke |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0053 |
Hyperosmolar Non-Ketotic coma |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0054 |
Cerebrovascular accident |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0055 |
Severe sepsis/Septic shock |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0056 |
Upper GI bleeding (conservative) |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0057 |
Upper GI bleeding (endoscopic) |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0058 |
Lower GI hemorrhage |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0059 |
Immune mediated CNS disorders such as autoimmune encephalitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0060 |
Acute transverse myelitis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0061 |
Guillian Barre Syndrome |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0062 |
Hydrocephalus |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0063 |
Cerebral sino-venous thrombosis |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0064 |
AKI/ renal failure(dialysis payable separately as an add on package for ) |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0065 |
Status epilepticus |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0066 |
Status asthmaticus |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0067 |
Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, poisoning, head injury etc.) |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0068 |
Blood and blood component transfusion (admission for a diagnostic procedure leading to treatment requiring admission, e.g. bone marrow and bone biopsy, endoscopy, liver biopsy, bronchoscopy, CT/MRI under GA, broncho-alveolar lavage, lumbar puncture, muscle biopsy, pleural aspiration, ascitic tapping etc.) |
|
N |
|
clinical notes |
|
N |
M |
M1 |
0069 |
Plasmapheresis (pre-auth) |
|
Y |
clinical notes |
clinical notes |
|
N |
M |
M1 |
0070 |
Haemodialysis/Peritoneal Dialysis (only for ARF) |
|
|
clinical notes |
clinical notes |
|
N |
M |
M1 |
0071 |
Unspecified Medical Package |
|
on pre-auth from day 1 |
clinical notes |
clinical notes |
|
N |
M |
M1 |
0072 |
High end radiological diagnostic (CT, MRI, Imaging including nuclear imaging) - can only be clubbed with medical package. Rs 5000 per annum limit to a family |
5000 |
Y |
clinical notes |
clinical notes |
|
N |
M |
M1 |
0073 |
High end histopathology (Biopsies) and advanced serology investigations - can only be clubbed with medical package. Rs 5000 per annum limit to a family |
5000 |
Y |
clinical notes |
clinical notes |
|
N |
M |