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) |
S8 |
0001 |
Anterior Encephalocele |
50,000 |
Y |
Clinical Record |
|
8 |
N |
S |
S8 |
0002 |
Burr hole |
7,000 |
N |
|
|
2 |
N |
S |
S8 |
0003 |
Burr hole with chronic Sub Dural Haematoma (including pre and post Op. CT) |
20,000 |
Y |
CT |
|
|
N |
S |
S8 |
0004 |
Carpal Tunnel Release including pre and post Op. MRI |
10,000 |
Y |
MRI |
|
3 |
N |
S |
S8 |
0005 |
Cervical Ribs – Bilateral |
35,000 |
Y |
X Ray |
|
7 |
N |
S |
S8 |
0006 |
Cervical Ribs – Unilateral |
20,000 |
Y |
X Ray |
|
5 |
N |
S |
S8 |
0007 |
CranioPlasty - Endogenous graft |
20,000 |
Y |
CT Brain |
CT |
7 |
N |
S |
|
Clinical photograph showing scar |
|
S8 |
0008 |
CranioPlasty - Exogenous graft |
20,000+ cost of implant |
Y |
CT Brain |
CT |
7 |
N |
S |
|
Clinical photograph showing scar |
S8 |
0009 |
Craniostenosis |
28,000 |
Y |
Clinical Record |
|
7 |
N |
S |
S8 |
0010 |
Duroplasty - Endogenous |
12,500 |
N |
|
|
5 |
N |
S |
S8 |
0011 |
Duroplasty - Exogenous |
12,500+ implant cost |
N |
|
|
5 |
N |
S |
S8 |
0012 |
Haematoma - Brain (head injuries) (including pre and post Op. CT) |
55,000 |
N |
|
|
8 |
N |
S |
S8 |
0013 |
Haematoma - Brain (hypertensive) |
50,000 |
N |
|
|
8 |
N |
S |
S8 |
0014 |
Haematoma (Child subdural) inclusive of General anaesthesia, pre and post Op. CT |
50,000 |
N |
|
|
10 |
N |
S |
S8 |
0015 |
Laminectomy with Fusion and fixation |
50,000 |
Y |
CT |
|
|
N |
S |
S8 |
0016 |
Laminectomy with Fusion |
40,000 |
Y |
CT |
|
6 |
|
S |
S8 |
0017 |
Local Neurectomy |
16,000 |
Y |
Clinical Record |
|
5 |
N |
S |
S8 |
0018 |
Lumbar Disc including pre and post Op. MRI |
30,000 |
Y |
CT |
|
5 |
N |
S |
S8 |
0019 |
Meningocele – Anterior |
36,000 |
Y |
Brain and spinal cord MRI |
X-Ray/ Post.op scar |
10 (2 day ICU stay) |
N |
S |
S8 |
0020 |
Meningocele – Lumbar |
36000 |
Y |
Brain and spinal cord MRI |
X-Ray/ Post.op scar |
10 (2 day ICU stay) |
N |
S |
S8 |
0021 |
Meningococcal – Occipital |
50,000 |
Y |
CT |
|
10 |
N |
S |
S8 |
0022 |
Micro discectomy – Cervical |
40,000 |
Y |
CT |
|
10 |
N |
S |
S8 |
0023 |
Micro discectomy – Lumbar |
40,000 |
Y |
CT |
|
10 |
N |
S |
S8 |
0024 |
Brachial Plexus – Repair |
27,000 |
Y |
Clinical Record |
|
7 |
N |
S |
S8 |
0025 |
Shunt (peritoneal, ventriculo-atrial/ peritoneal, theco peritoneal) |
30,000 |
Y |
Clinical Record |
|
7 |
N |
S |
S8 |
0026 |
Skull Traction |
8,000 |
Y |
Clinical Record |
|
4 |
N |
S |
S8 |
0027 |
Spine - Canal Stenosis |
40,000 |
Y |
CT |
|
6 |
N |
S |
S8 |
0028 |
Spine - Decompression & Fusion |
40,000 |
Y |
CT |
|
6 |
N |
S |
S8 |
0029 |
Spine - Decompression & Fusion with fixation |
50,000 |
Y |
CT |
|
|
N |
S |
S8 |
0030 |
Spine - Extradural Tumour |
30,000 |
Y |
CT |
|
7 |
N |
S |
S8 |
0031 |
Spine - Extradural Tumour with fixation |
40,000 |
Y |
CT |
|
|
N |
S |
S8 |
0032 |
Spine - Extradural Haematoma |
30,000 |
N |
|
|
7 |
N |
S |
S8 |
0033 |
Spine - Extradural Haematoma with fixation |
40,000 |
N |
|
|
|
N |
S |
S8 |
0034 |
Spine - Intradural Tumour |
40,000 |
Y |
CT |
|
7 |
N |
S |
S8 |
0035 |
Spine - Intradural Tumour with fixation |
50,000 |
Y |
CT |
|
|
N |
S |
S8 |
0036 |
Spine - Intradural Haematoma |
40,000 |
N |
|
|
7 |
N |
S |
S8 |
0037 |
Spine - Intradural Haematoma with fixation |
50,000 |
N |
|
|
|
N |
S |
S8 |
0038 |
Spine - Intramedullar Tumour |
50,000 |
Y |
CT |
|
7 |
|
S |
S8 |
0039 |
Spine - Intramedullar Tumour - fixation |
60,000 |
Y |
CT |
|
|
N |
S |
S8 |
0040 |
Trans Sphenoidal including pre and post Op. MRI |
50,000 |
Y |
CT |
|
6 |
N |
S |
S8 |
0041 |
Tumours – Supratentorial |
50,000 |
Y |
CT |
CT |
7 |
N |
S |
Histopathological report |
S8 |
0042 |
Tumours Meninges – Gocussa |
50,000 |
Y |
CT |
CT |
7 |
N |
S |
Histopathological report |
S8 |
0043 |
Tumours Meninges – Posterior |
50,000 |
Y |
CT |
CT |
7 |
N |
S |
Histopathological report |
S8 |
0044 |
Ventricular Puncture |
15,000 |
N |
|
|
3 |
N |
S |
S8 |
0045 |
Brain Biopsy |
15,000 |
N |
|
|
3 |
N |
S |
S8 |
0046 |
Cranial Nerve Anastomosis |
32,000 |
Y |
Clinical Record |
|
5 |
N |
S |
S8 |
0047 |
Depressed Fracture |
40,000 |
N |
|
|
7 |
N |
S |
S8 |
0048 |
Nerve Biopsy excluding Hensens |
7,000 |
Y |
Clinical Record |
|
2 |
N |
S |
S8 |
0049 |
Peripheral Neurectomy (Trigeminal) |
16,500 |
Y |
Clinical Record |
|
5 |
N |
S |
S8 |
0050 |
R.F. Lesion for Trigeminal Neuralgia |
16,500 |
Y |
CT |
|
3 |
N |
S |
S8 |
0051 |
Twist Drill Craniostomy |
15,000 |
N |
|
|
2 |
N |
S |
S8 |
0052 |
Excision of Brain TumorSupratentorial-Parasagital |
50,000 |
Y |
CT |
CT |
10 |
N |
S |
Histopathological report |
S8 |
0053 |
Excision of Brain TumorSupratentorial-Basal |
50,000 |
Y |
CT |
CT |
10 |
N |
S |
Histopathological report |
S8 |
0054 |
Excision of Brain TumorSupratentorial-Brainstem |
50,000 |
Y |
CT |
CT |
10 |
N |
S |
Histopathological report |
S8 |
0055 |
Excision of Brain TumorSupratentorial-C P Angle |
50,000 |
Y |
CT |
CT |
10 |
N |
S |
Histopathological report |
S8 |
0056 |
Excision of Brain TumorSupratentorial& others |
55,000 |
Y |
CT |
CT |
10 |
N |
S |
Histopathological report |
S8 |
0057 |
Abscess Tapping single |
20,000 |
N |
|
|
7 |
N |
S |
S8 |
0058 |
Abscess Tapping multiple |
30,000 |
N |
|
|
7 |
N |
S |
S8 |
0059 |
Excision of Brain Abscess |
36,000 |
Y |
CT Brain |
CT |
|
N |
S |
|
Clinical photograph showing scar |
S8 |
0060 |
Aneurysm Clipping including angiogram |
65,000 |
Y |
MRA/ DSA report |
CT/ X-RAY |
12 |
N |
S |
|
clinical photograph showing scar |
S8 |
0061 |
Additonal clip for Aneurysm Clipping |
15,000 |
Y |
MRA/ DSA report |
CT/ X-RAY |
|
N |
S |
clinical photograph showing scar |
S8 |
0062 |
External Ventricular Drainage (EVD) including antibiotics |
30,000 |
Y |
CT Brain |
Post.op CT |
|
N |
S |
|
Clinical photograph showing scar |
S8 |
0063 |
Spinal Fusion Procedure with implant |
40,000 |
Y |
MRI |
Post.op X-RAY |
|
N |
S |
S8 |
0064 |
Spina Bifida Surgery |
36,000 |
Y |
CT |
|
10 |
N |
S |
S8 |
0065 |
Stereotactic Lesioning |
60,000 |
Y |
CT/ MRI brain |
CT/ MRI brain |
|
N |
S |
|
Clinical photograph showing scar |
S8 |
0066 |
Posterior Cervical Discetomy without implant |
30,000 |
Y |
CT |
|
|
N |
S |
S8 |
0067 |
Posterior Cervical Fusion with implant (Lateral mass fixation) |
50,000 |
Y |
MRI spine |
X-RAY cervical spine |
|
N |
S |
|
clinical photograph showing scar |
S8 |
0068 |
Cervical Disc Multiple level without Fusion |
40,000 |
Y |
MRI spine |
X-RAY cervical spine |
|
N |
S |
|
clinical photograph showing scar |
S8 |
0069 |
Thoracic/Lumbar Corpectomy with fusion inclusive of implant |
60,000 |
Y |
CT/ MRI |
Clinical photograph showing scar |
|
N |
S |
|
X ray |
S8 |
0070 |
Transoral surgery (Anterior) and CV Junction (Posterior Sterlization) |
55,000+ cost of implant |
Y |
MRI spine |
Post.op MRI |
12 (2 day ICU stay) |
N |
S |
X Ray |
X Ray |
S8 |
0071 |
Trans oral Surgery |
40,000 |
Y |
Clinical Record |
|
|
N |
S |
S8 |
0072 |
Foramen Magnum Decompression |
45,000 |
N |
|
|
|
N |
S |
S8 |
0073 |
Endoscopic CSF Rhinorrhea Repair |
30,000+ cost of glue |
N |
|
|
|
N |
S |
S8 |
0074 |
Muscle Biopsy with report |
7,000 |
Y |
Clinical Record |
|
|
N |
S |
S8 |
0075 |
Nerve Decompression |
16,000 |
N |
|
|
|
N |
S |
S8 |
0076 |
Peripheral Nerve Surgery Major |
30,000 |
Y |
Neuro-diagnostic studies (NCV/ EMG) |
Clinical photograph showing scar |
5 |
N |
S |
S8 |
0077 |
Peripheral Nerve Surgery Minor |
15,000 |
Y |
Neuro-diagnostic studies (NCV/ EMG) |
Clinical photograph showing scar |
3 |
N |
S |
S8 |
0078 |
Epilepsy Surgery |
50,000 |
Y |
CT/ MRI |
CT |
|
N |
S |
Neuro-diagnostic studies (EEG) |
Clinical photograph showing scar |
S8 |
0079 |
Arterio venous malformation (AVM) excision (whatever size and location) |
50000 |
Y |
MRA/ DSA report |
X-RAY |
|
N |
S |
|
Clinical photograph showing scar |
S8 |
0080 |
Scalp Arterio venous malformation (AVM) |
25,000 |
Y |
CT/ MRI |
Histopathological report |
|
N |
S |
|
Clinical photograph showing scar |
S8 |
0081 |
Superficial Temporal Artery (STA): middle cerebral artery (MCA) or (other EC - IC) Bypass procedure |
60,000 |
Y |
MRA/ DSA report |
X-RAY |
|
N |
S |
Clinical photograph showing scar |
S8 |
0082 |
Excision of Orbital Tumour |
40,000 |
Y |
CT/ MRI |
CT |
|
N |
S |
|
Histopathological report |
|
Clinical photograph showing scar |
S8 |
0083 |
Gamma Knife radiosurgery (GKRS)/ SRS for tumours/ Arteriovenous malformation (AVM) |
75,000 |
Y |
CT/ MRI |
Clinical photographs |
|
N |
S |