T3 - Pack Code Details

Speciality Name
Package Code
Package Name Procedure Code Procedure Name
BURNS MANAGEMENT
BM00001190Post Burn Contracture
BM0000119000009 surgeries forPost
Functional
Burn Contracture
Improvement surgeries for Functional Improvement (Package in
BURNS MANAGEMENT
BM0000269Conservative BM000026900001
Management Conservative Management - stand alone
BURNS MANAGEMENT
BM0000280Conservative BM000028000002
Management of injuryConservative Management - (Chest/Head/Face/Abdomen) stand alone
BURNS MANAGEMENT
BM0000637Extended LOS BM000063700003
care pkg for advanceExtended
surgeriesLOS care pkg for advance surgeries after 6 days (allowed after
BURNS MANAGEMENT
BM0000667Flame / scald BM000066700004
/ thermal / Chemical Burn/% Total Electrical
Body Surface
burns Area Burns (TBSA) - any % (not requiring admission
BURNS MANAGEMENT
BM0000667Flame / scald BM000066700006
Body Surface
burns Area Burns (TBSA): Upto 40 %; Includes % TBSA ski
BURNS MANAGEMENT
BM0000667Flame / scald BM000066700005
Body Surface
burns Area Burns (TBSA): 40 % - 60 %; Includes % TBSA sk
BURNS MANAGEMENT
BM0000668Flame / scald BM000066800007
/ thermal / electrical burns
Criteria 3: % Total Body Surface Area Burns (TBSA): 25-40 %; Includes %
BURNS MANAGEMENT
BM0000668Flame / scald BM000066800008
% Total Body Surface Area Burns (TBSA): > 60 %; Includes % TBSA skin gr
CARDIOLOGY CA0000103Atrial Fibrillation
CA0000103000011 Atrial Fibrillation
CARDIOLOGY CA00001056Optical coherence
CA00001056000039
tomography (OCT) Optical coherence tomography (OCT) - GOVT Reserve add on
CARDIOLOGY CA00001113PDA DeviceCA00001113000040
Closure PDA Device Closure with PDA device
CARDIOLOGY CA00001114PDA stenting CA00001114000041 PDA stenting
CARDIOLOGY CA00001131Percutaneous CA00001131000042
Transluminal Septal Myocardial
Percutaneous Ablation
Transluminal Septal Myocardial Ablation
CARDIOLOGY CA00001134Pericardiocentesis
CA00001134000043 Pericardiocentesis
CARDIOLOGY CA00001139Peripheral Angioplasty
CA00001139000044 Peripheral Angioplasty - Subclavian , Mesenteric , Femoral, iliac - Poplite
CARDIOLOGY CA0000114Balloon Dilatation
CA0000114000012 Coarctation of Aorta/Pulmonary Artery Stenosis /aortic aneurysm repair
CA00001141000045- carotid withPeripheral
filter Angioplasty - carotid with filter
CA00001142000046- POBA Peripheral Angioplasty - POBA
CA00001144000047- Renal Peripheral Angioplasty - Renal
CARDIOLOGY CA00001149Peripheral Arterial
CA00001149000048
Thrombosis Peripheral Arterial Thrombosis
CARDIOLOGY CA0000116Balloon MitralCA0000116000013
Valvotomy Balloon Mitral Valvotomy
CARDIOLOGY CA0000117Balloon Pulmonary
CA0000117000014
/ Aortic ValvotomyBalloon Pulmonary Valvotomy/Balloon Aortic Valvotomy
CARDIOLOGY CA00001207PTCA, inclusive
CA00001207000049
of diagnostic angiogramPTCA, inclusive of diagnostic angiogram ( if coronary angiography pkg bo
CARDIOLOGY CA00001286Rheumatic CA00001286000050
fever Acute rheuma c fever/ Rheuma c valvular heart disease
CARDIOLOGY CA00001293Right / Left CA00001293000051
Heart Catheterization Right Heart Catheterization/Left Heart Catheterization
CARDIOLOGY CA00001302Rotational Atherectomy
CA00001302000052 (ROTA) Ablation
Rotational Atherectomy (ROTA) Ablation - GOVT Reserve
CARDIOLOGY CA00001304Ruptured sinus
CA00001304000053
of Valsalva aneurysm Ruptured
(RSOV) sinus of Valsalva aneurysm (RSOV) - GOVT Reserve
CARDIOLOGY CA00001338Single chamber
CA00001338000054
AICD Single chamber AICD - GOVT Reserve
CARDIOLOGY CA00001339Single Chamber
CA00001339000055
Permanent Pacemaker Permanent
Implantation
Pacemaker Implanta on - Single Chamber - Single chamber V
CARDIOLOGY CA00001422Systemic Thrombolysis
CA00001422000057 (for MI) Systemic Thrombolysis (for MI)
CARDIOLOGY CA00001424Temporary CA00001424000058
Pacemaker implantationTemporary Pacemaker implantation
CARDIOLOGY CA00001549VSD DeviceCA00001549000059
Closure VSD Device Closure with VSD device
CARDIOLOGY CA0000169Bronchial artery
CA0000169000015
Embolisa on Bronchial artery Embolisa on (for Hemoptysis)
CARDIOLOGY CA0000183Cardiac Tamponade
CA0000183000016 Cardiac Tamponade
CARDIOLOGY CA0000195Central LineCA0000195000017
( Double Lumen / TripleCentralLumenLine) ( Double Lumen / Triple Lumen ) with procedure - add on
CARDIOLOGY CA0000211CHD /RHD CA0000211000018 CHD / RHD
CARDIOLOGY CA0000264Congestive CA0000264000019
heart failure Congestive heart failure
CARDIOLOGY CA0000303Coronary Angiography
CA0000303000020 Coronary Angiography
CARDIOLOGY CA0000317CRT - D ( Quadripolar
CA0000317000021
lead) MRI Compatible
CRT - D ( Quadripolar lead) MRI Compatible - GOVT Reserve
CARDIOLOGY CA0000318CRT - P ( Quadripolar
CA0000318000022
lead) MRI Compatible
CRT - P ( Quadripolar lead) MRI Compatible - GOVT Reserve
CARDIOLOGY CA0000319CRT With Physiological
CA0000319000023 pacemaker aCRT With Physiological pacemaker - add on with CRT / DDD Pacemaker P
CARDIOLOGY CA000036 Acute thrombosis
CA000036000056
Systemic Thrombolysis
Acute thrombosis
and anticoagulation
Systemic Thrombolysis and anticoagulation ( Including
CARDIOLOGY CA0000514Double ChamberCA0000514000024
Implantation
Pacemaker Implantation - Double Chamber
CARDIOLOGY CA0000521DVT/Acute CA0000521000025
Thrombosis DVT/Acute thrombosis Catheter guided Thrombolysis and anticoagulatio
CARDIOLOGY CA0000521DVT/Acute CA0000521000026
Thrombosis DVT/Acute thrombosis Systemic Thrombolysis and anticoagulation ( Incl
CARDIOLOGY CA0000532Electrophysiological
CA0000532000027
Study Electrophysiological Study with/ without Radio Frequency Ablation
CARDIOLOGY CA0000533Embolization CA0000533000028 Arteriovenous Malformation (AVM) in the Limbs
CARDIOLOGY CA0000549EndocarditisCA0000549000029 Bacterial Endocarditis / Fungal Endocarditis
CARDIOLOGY
CA0000638Extended LOS CA0000638000030
surgeriesLOS care pkg for advance surgeries after 6 days (allowed after
CARDIOLOGY
CA0000672follow up -Cardiology
CA0000672000031
/ CTVS First Follow-up 15-90 days after discharge
CARDIOLOGY
CA0000672000032
/ CTVS quarterly Follow-up - After 6 month of discharge date
CARDIOLOGY
CA0000672000033
/ CTVS Second Follow-up- 3 - 6 months after discharge date
CARDIOLOGY
CA0000682Fractional flow
CA0000682000034
reserve (FFR) -Govt Reserve
Fractional flow reserve (FFR) - GOVT Reserve - add on
CARDIOLOGY
CA0000754High end histopathology
CA0000754000035 (Biopsies) and
Highadvanced
end histopathology
serology investigations
(Biopsies) and advanced serology investigation
CARDIOLOGY
CA0000761High end radiological
CA0000761000036
diagnos c High end radiological diagnos c (CT, MRI, nuclear imaging) - Add on
CARDIOLOGY
CA0000796IHD / CAD /CA0000796000037
Arrhythmia IHD / Arrhythmia / CAD
CARDIOLOGY
CA0000836IntravascularCA0000836000038
ultrasound (IVUS) Intravascular ultrasound (IVUS) - GOVT Reserve add on
CARDIOLOGY
CA000097 ASD DeviceCA000097000010
Closure ASD Device Closure with ASD device
CTVS CT00001111Patent Ductus
CT00001111000095
Arteriosus (PDA) ClosurePatentviaDuctus
thoracotomy
Arteriosus (PDA) Closure via thoracotomy
CTVS CT00001115Pectus excavation
CT00001115000096 Pectus excavation
CTVS CT00001132Pericardial CT00001132000097
window (via thoracotomy) Pericardial window (via thoracotomy)
CTVS CT00001133Pericardiectomy
CT00001133000098 Pericardiectomy
CTVS CT00001146Peripheral arterial
CT000011460000100
injury repair (withPeripheral
Interpostionarterial
vaininjury
graft)repair (with Interpostion vain graft)
CTVS CT00001147Peripheral arterial
CT00001147000099
injury repair (without
Peripheral
bypass) arterial injury repair (without bypass/interposition graft)
CTVS CT00001148Peripheral Arterial
CT000011480000101
Surgeries Femoro - Femoral Bypass /Carotid - endearterectomy/Carotid Body Tum
CTVS CT00001210Pulmonary CT000012100000102
Embolectomy / Thromboendarterectomy
Pulmonary Embolectomy/Pulmanary Thromboendarterectomy
CTVS CT00001211Pulmonary CT000012110000103
Resection Pulmonary Resection
CTVS CT00001252Re-do sternotomy
CT000012520000104 Re-do sternotomy - ADD On PKG
CTVS CT00001289Rib Resection
CT000012890000105
& Drainage Rib Resection & Drainage
CTVS CT00001301Ross Procedure
CT000013010000106 Ross Procedure
CTVS CT00001340Single Chamber
CT000013400000107
Implantation
Pacemaker Implanta on - Single Chamber - Single chamber V
CTVS CT00001343Single ValveCT000013430000108
Procedure Aortic valve / Mitral valve / Tricuspid valve - replacement /repair
CTVS CT00001353Space - Occupying
CT000013530000109
Lesion (SOL) mediastinum
Space - Occupying Lesion (SOL) mediastinum
CTVS CT00001393Surgery for CT000013930000111
Cardiac Tumour Surgery for Cardiac Tumour
CTVS CT00001400Surgery for CT000014000000112
Hypertrophic Obstructive Surgery
Cardiomyopathy
for Hypertrophic
(HOCM) Obstructive Cardiomyopathy (HOCM)
CTVS CT00001405Surgical Correction
CT000014050000113
of Bronchopleural Surgical
FistulaCorrection of Bronchopleural Fistula
CT000014060000114
of Category - I Congenital
Isolated Secundum
Heart Disease
Atrial Septal Defect (ASD) Repair/Glenn procedure/P
CT000014070000115
of Category - II Congenital
ASD closureHeart + Partial
Disease
Anomalous Venous Drainage Repair/ASD Closure +
CT000014080000116
of Category - III ALCAPA
Congenital repair
Heart/ Unifocalization
Disease of MAPCA with intercardiac repair / Arte
CT000014080000117
of Category - III TOF
Congenital
Repair/Ebstien
Heart Disease
anomoly repair/Double switch operation/Rastelli Pro
CTVS CT00001425Temporary CT000014250000118
Pacemaker implantationTemporary Pacemaker implantation
CTVS CT00001438Thoracotomy CT000014380000119
/ Thoraco Abdominal Thoracotomy
Approach / Thoraco Abdominal Approach
CTVS CT00001439Thromboembolectomy
CT000014390000120 Peripheral Thromboembolectomy
CTVS CT00001458Tracheal / Bronchial
CT000014580000121
repair Tracheal / Bronchial repair
CTVS CT00001476Triple valveCT000014760000122
procedure Triple valve replacement / repair
CTVS CT00001525Varicose vein:
CT000015250000123
endovenous treatment Varicose
(for onevein:
limb)endovenous treatment (for one limb) - Govt Reserve
CTVS CT00001526Vascular reconstruction
CT000015260000124 Vascular reconstruction with or without vein graft
CTVS CT00001529Vascular reconstruction
CT000015290000125
with graft/patch
Vascular reconstruction with Graft/Patch
CTVS CT0000175CABG + Ischemic
CT0000175000067
Mitral Valve Repair/Replacement
CABG + Ischemic Mitral Valve Repair/Replacement
CTVS CT0000176CABG + Ischemic
CT0000176000068
VSR/ Rupture repair CABG + Ischemic VSR / wall Rupture repair / ventricular Rupture repair /
CTVS CT0000189Carotid Body CT0000189000069
tumour - Excision / Carotid
CarotidEndarteractomy
Body tumour - Excision / Carotid Endarteractomy
CTVS CT0000200Central LineCT0000200000070
( Double Lumen / TripleCentral
LumenLine / Single
( Double
LumenLumen
) with/ Triple
procedure
Lumen
- add
) with
on procedure - add on
CTVS CT0000231Closed MitralCT0000231000071
Valvotomy including thoracotomy
Closed mitral valvotomy
CTVS CT0000270Conservative CT0000270000072
CTVS CT0000304Coronary Angiography
CT0000304000073 Coronary Angiography
CTVS CT0000305Coronary artery
CT0000305000074
bypass gra ing (CABG) Coronary artery bypass grafting (CABG), Off Pump
CTVS CT0000306Coronary artery
CT0000306000075
bypass gra ing (CABG),Coronary artery bypass grafting (CABG), On Pump
CTVS CT000037 Acute thrombosis
CT0000370000110
Acute thrombosis
and anticoagulation
Systemic Thrombolysis and anticoagulation ( Including
CTVS CT0000500DiaphragmaticCT0000500000076
Repair Diaphragmatic Repair
CTVS CT0000515Double Chamber
CT0000515000077
Permanent PacemakerPermanent
Implantation
Pacemaker Implanta on - Double Chamber
CTVS CT0000516Double Valve CT0000516000078
Procedure Double valve replacement / repair
CTVS CT0000522DVT/Acute CT0000522000079
CTVS CT0000522DVT/Acute CT0000522000080
CTVS CT0000593Excessive bleeding
CT0000593000081
requiring re-exploration
Excessive bleeding requiring re-exploration - ADD On PKG
CTVS CT0000627Extended LOS CT0000627000082
sugeries LOS care pkg for advance sugeries after 6 days (allowed after p
CTVS CT0000673follow up -Cardiology
CT0000673000083
/ CTVS First Follow-up 15-90 days after discharge
CT0000673000084
/ CTVS quarterly Follow-up - After 6 month of discharge date
CT0000673000085
/ CTVS Second Follow-up- 3 - 6 months after discharge date
CTVS CT000077 Aortic Aneurysm
CT000077000060
Repair Aortic Aneurysm Repair using Cardiopulmonary bypass (CPB)/Aortic Ane
CTVS CT000077 Aortic Aneurysm
CT000077000061
Repair Aortic Aneurysm Repair without using Cardiopulmonary bypass (CPB)/Ao
CTVS CT000078 Aortic ArchCT000078000062
Replacement / Thoracoabdominal
Aortic Archaneurysm
Replacement
Repair
using
using
cardiopulmonary
bypass bypass/Thoracoabdom
CTVS CT000079 Aortic RootCT000079000063
Replacement Surgery Bental Procedure/Aortic Dissection/Aortic Aneurysm ( Root Ascending )/
CTVS CT000080 Aortic stenting
CT000080000064 Aortic stenting
CTVS CT0000806Immediate CT0000806000086
reoperation (within 5 days)Aortic valve / Mitral valve / Tricuspid valve - replacement /repair- Add O
reoperation (within 5 days)Double valve replacement / repair -Add On
reoperation (within 5 days)Tetralogy of Fallot Repair (immediate re operation) - Add ON
reoperation (within 5 days)Triple valve replacement / repair - Add On
CTVS CT000081 Aorto Iliac /CT000081000065
Aorto femoral bypass (Uni Aorto
andIliac
Bi) bypass - U/L/Aorto femoral bypass - U/L/Aorto Iliac bypass - B
CTVS CT0000851Isolated Intercostal
CT0000851000090
Drainage and Management
Isolated Intercostal
of ICD, Intercostal
Drainage andBlock,
Management
Antibioticsof& ICD,
Physiotherapy
Intercostal Block,
CTVS CT0000873Left ventricular
CT0000873000091
aneurysm repair Left ventricular aneurysm repair
CTVS CT0000892Low CardiacCT0000892000092
Output syndrome requiringLow Cardiac
IABP insertion
Output Pre/Intra/post
syndrome requiring
- operatively
IABP insertion Pre/Intra/post -
CTVS CT0000898Lung surgery CT0000898000093
including ThoracotomyLung cyst exision/Decortication/ Thorcoplasty/Hydatid cyst/Other simple
CTVS CT0000937Mediastinotomy
CT0000937000094 Mediastinotomy
CTVS CT000098 aspiration/ CT000098000066
Intercostal drainage Only aspiration/ Intercostal drainage Only
DENTAL & ORAL
DO00001002
MAXILLOFACIAL
Nerve root SURGERY
DO000010020000151
block Nerve root block
DENTAL & ORAL
DO00001066
MAXILLOFACIAL
Osteoradionecrosis
SURGERY
DO000010660000152
management byOsteoradionecrosis
excision of Jaws management by excision and reconstruction
DENTAL & ORAL
DO00001066
MAXILLOFACIAL
Osteoradionecrosis
SURGERY
DO000010660000153
management byOsteoradionecrosis
excision of jaws management by excision under LA
DENTAL & ORAL
DO00001073
MAXILLOFACIAL
Palatectomy SURGERY
DO000010730000154 Soft palate / Hard palate Under GA
DENTAL & ORAL
DO00001104
MAXILLOFACIAL
Parotid sialolithotomy
SURGERY
DO000011040000155 Extraoral parotid sialolithotomy under GA
DENTAL & ORAL
DO00001104
MAXILLOFACIAL
Parotid sialolithotomy
SURGERY
DO000011040000156 Intraoral parotid sialolithotomy
DENTAL & ORAL
DO00001152
MAXILLOFACIAL
Peripheral Neurectomy
SURGERY
DO000011520000157 Peripheral Neurectomy - Govt Reserve
DENTAL & ORAL
DO00001229
MAXILLOFACIAL
Radical NeckSURGERY
DO000012290000158
Dissection Radical / comprehensive Neck Dissection
DENTAL & ORAL
DO00001256
MAXILLOFACIAL
Re-implantation
SURGERY
DO000012560000159
of Avulsed tooth with
Re-implanta
wiring on of Avulsed tooth with wiring (1-3 teeth)
DENTAL & ORAL
DO00001257
MAXILLOFACIAL
Release of fibrous
SURGERY
DO000012570000160
bands & grafting Release
- in (OSMF)
of fibrous
treatment
release
under
bands
GA & coronoidectomy with gra ing - under
DENTAL & ORAL
DO00001258
MAXILLOFACIAL
Release of fibrous
SURGERY
DO000012580000161
bands & grafting Release
- in (OSMF)
of fibrous
treatment
bands under
& graGA/LA
ing under GA/LA
DENTAL & ORAL
DO00001260
MAXILLOFACIAL
Removal ofSURGERY
DO000012600000162
Submandibular SalivaryGland
Removal / Salivary
of Submandibular
Ranula- withSalivaryGland
or without Lymph
/ Salivary
Node Ranula- with or with
DENTAL & ORAL
DO00001267
MAXILLOFACIAL
Repair of tongue
SURGERY
DO000012670000163
laceration Repair of tongue laceration
DENTAL & ORAL
DO00001297
MAXILLOFACIAL
Root canal SURGERY
treatment
DO000012970000164
per - tooth Root canal treatment per tooth - govt reserve
DENTAL & ORAL
DO0000132
MAXILLOFACIAL
Biopsy underSURGERY
DO00001320000129
LA Biopsy under LA
DENTAL & ORAL
DO00001323
MAXILLOFACIAL
Sequestrectomy
SURGERY
DO000013230000165
/ Curettage Sequestrectomy / Curettage
DENTAL & ORAL
DO00001382
MAXILLOFACIAL
Submandibular
SURGERY
DO000013820000166
duct stone removal Submandibular duct stone removal LA/GA
DENTAL & ORAL
DO00001395
MAXILLOFACIAL
Surgery forSURGERY
DO000013950000167
Cyst & tumour of Maxilla Enucleation
/ Mandible/ excision of cyst / tumour of jaws under GA
DENTAL & ORAL
DO00001395
MAXILLOFACIAL
Surgery forSURGERY
DO000013950000168
/ Mandible/ excision of cyst / tumour of jaws under LA
DENTAL & ORAL
DO00001414
MAXILLOFACIAL
Surgical procedure
SURGERY
DO000014140000169
under LA Cyst / biopsy / FNAC/ I&D/ In growing toe nail - Day care
DENTAL & ORAL
DO0000144
MAXILLOFACIAL
Bone grafting
SURGERY
DO00001440000130
for Non union Bone grafting for Fracture Non union Under GA
DENTAL & ORAL
DO00001449
MAXILLOFACIAL
TM joint ankylosis
SURGERY
DO000014490000170
of both jaws - under
TM joint
GA ankylosis of both jaws - under GA (Unilateral) / (Bilateral)
DENTAL & ORAL
DO00001461
MAXILLOFACIAL
TracheostomySURGERY
DO000014610000171
/ Tracheotomy Tracheostomy/Tracheotomy
DENTAL & ORAL
DO00001473
MAXILLOFACIAL
Treatment SURGERY
of
DO000014730000172
early childhood cariesTreatment
under GA of early childhood caries under GA
DENTAL & ORAL
DO0000228
MAXILLOFACIAL
Cleft Lip and
SURGERY
DO00002280000131
Palate Surgery (per stage)Cleft Lip and Palate Surgery (per stage) Under GA
DENTAL & ORAL
DO0000234
MAXILLOFACIAL
Closed reduction
SURGERY
DO00002340000132
/ intermaxillary fixation
Closedforreduction
fracture/of intermaxillary
maxilla / mandible
fixation/ for
zygoma/
fracture
Nasal
of maxilla / mandi
DENTAL & ORAL
DO0000249
MAXILLOFACIAL
Complete denture
SURGERY
DO00002490000133 Complete denture - govt reserve
DENTAL & ORAL
DO0000254
MAXILLOFACIAL
Complete Excision
SURGERY
DO00002540000134
of Growth from Tongue
Complete only
Excision
(inclusive
of Growth
of Histopathology)
from Tongue- Govt
only (inclusive
Reserve of Histopathol
DENTAL & ORAL
DO0000271
MAXILLOFACIAL
ConservativeSURGERY
DO00002710000135
DENTAL & ORAL
DO0000308
MAXILLOFACIAL
Correction SURGERY
of
DO00003080000136
oro-antral Fistula- Govt Correction
Reserve of oro-antral Fistula- Govt Reserve
DENTAL & ORAL
DO0000485
MAXILLOFACIAL
Dentoalveolar
SURGERY
DO00004850000137
trauma - wiring Dentoalveolar trauma - wiring (dental /trauma wiring- one jaw)
DENTAL & ORAL
DO0000580
MAXILLOFACIAL
Estlander Operation
SURGERY
DO00005800000138
(lip) Estlander Operation (lip) Under GA only
DENTAL & ORAL
DO0000602
MAXILLOFACIAL
Excision of SURGERY
Growth
DO00006020000139
from Tongue with Excision
neck node
of Growth
dissection
from Tongue with neck node dissection Stand alone
DENTAL & ORAL
DO0000609
MAXILLOFACIAL
Excision of SURGERY
Partial
DO00006090000140
mandible Excision of Partial mandible Under GA only
DENTAL & ORAL
DO0000612
MAXILLOFACIAL
Excision of SURGERY
tumour
DO00006120000141
of oral cavity / paranasal
Excision ofsinus
tumour
/ laryngopharynx
of oral cavity / paranasal sinus/ Laryngopharynx with
DENTAL & ORAL
DO0000612
MAXILLOFACIAL
Excision of SURGERY
tumour
DO00006120000142
Excision ofsinus
tumour
/ laryngopharynx
of oral cavity /paranasal sinus / laryngopharynx with
DENTAL & ORAL
DO0000614
MAXILLOFACIAL
Excision of SURGERY
tumour
DO00006140000143
Excision ofsinus
tumour
/ laryngopharynx
of oral cavity / paranasal sinus / laryngopharynx
DENTAL & ORAL
DO0000628
MAXILLOFACIAL
Extended LOSSURGERY
DO00006280000144
DENTAL & ORAL
DO0000644
MAXILLOFACIAL
Extraction in
SURGERY
DO00006440000145
mentally retarded / Patient
Extraction
with insystemic
mentally diseases
retarded
/ patient
/ Patient
with
with
special
systemic
needdiseases
- under GA
/ patien
DENTAL & ORAL
DO0000645
MAXILLOFACIAL
Extraction of
SURGERY
DO00006450000146
impacted tooth underExtraction
LA of impacted tooth under LA
DENTAL & ORAL
DO0000664
MAXILLOFACIAL
Fixation of SURGERY
fracture
DO00006640000147
of jaw Open reduction and fixing of plates / wire - under LA / GA. Cost of impla
DENTAL & ORAL
DO000067
MAXILLOFACIAL
Ankyloglossia
SURGERY
DO0000670000126 Ankyloglossia Major Under GA
DENTAL & ORAL
DO000067
MAXILLOFACIAL
Ankyloglossia
SURGERY
DO0000670000127 Ankyloglossia Minor
DENTAL & ORAL
DO0000811
MAXILLOFACIAL
Implant Removal
SURGERY
DO00008110000148
under RA / GA Nail/ Plate / TBW / cc-screw from NOF
DENTAL & ORAL
DO000082
MAXILLOFACIAL
Apicoectomy SURGERY
DO0000820000128
Tooth Apicoectomy 1 to 6 teeth
DENTAL & ORAL
DO0000925
MAXILLOFACIAL
Mandible Tumour
SURGERY
DO00009250000149
Resection and reconstruction
Maxilla / Mandible
/ Cancerneoplastic
surgery Tumour Resection and reconstruction (Ca
DENTAL & ORAL
DO0000930
MAXILLOFACIAL
MaxillectomySURGERY
DO00009300000150 Partial / Total Maxillectomy
ENDOCRINOLOGY
EN00001445Thyrotoxic crisis
EN000014450000187 Thyrotoxic crisis
ENDOCRINOLOGY
EN000043 Addison’s disease
EN0000430000185 Addison’s disease
ENDOCRINOLOGY
EN0000972MyxedemaEN00009720000186
coma Myxedema coma
EMERGENCYER00001263
ROOM PACKAGES
Renal colic ER000012630000184 Renal colic
EMERGENCYER000015
ROOM PACKAGES
AcceleratedER0000150000173
hypertension Accelerated hypertension/Hypertensive emergencies
EMERGENCYER000017
ROOM PACKAGES
Acute abdomenER0000170000174
Pain Acute abdomen pain
EMERGENCYER000018
ROOM PACKAGES
Acute asthma ER0000180000175 Acute asthma/Status asthmaticus
EMERGENCYER0000185Cardiopulmonary
ROOM PACKAGES ER00001850000177emergency Emergency with stable/ unstable cardiopulmonary status with resuscitat
EMERGENCYER0000490Diabetic
ROOM PACKAGESketoacidosis
ER00004900000178 Diabetic ketoacidosis
EMERGENCYER0000531Electrolyte
ROOM PACKAGES ER00005310000179
Imbalance Hypercalcemia/ /Hypocalcaemia/ Hyponatremia/ Hypernatremia/ Hyper
EMERGENCYER0000538Emergency
management of Hematuria Emergency management of Hematuria
EMERGENCYER000064
ROOM PACKAGES
AnaphylaxisER0000640000176 Anaphylaxis
EMERGENCYER0000779Hyperosmolar
Non-Ketotic coma Hyperosmolar Non-Ketotic coma
EMERGENCYER0000780Hypoglycemia
ROOM PACKAGES ER00007800000182 Hypoglycemia
EMERGENCYER0000858Laceration
ROOM PACKAGES -ER00008580000183
Suturing / Dressing Laceration - Suturing / Dressing
ENT ET00001030Open laryngeal
ET000010300000221
framework surgery Open / Thyroplasty
laryngeal framework surgery / Thyroplasty
ENT ET00001032Open reduction
ET000010320000222
and internal fixationOpen
of maxilla
reduction
/ mandible
and internal
/ zygoma
fixation of maxilla/Open reduction and inte
ENT ET00001037Open sinus ET000010370000223
surgery Open Sinus Surgery (Single/Multiple Sinuses)
ENT ET00001065Oroantral fistula
ET000010650000224
Repair Oroantral fistula Repair - Govt. reserve
ENT ET00001074Palatectomy ET000010740000225 Soft palate / Hard palate
ENT ET00001105ParotidectomyET000011050000226 Superficial Parotidectomy
ENT ET00001105ParotidectomyET000011050000227 Total Parotidectomy
ENT ET00001156PeritonsillarET000011560000228
abscess drainage / intraoral
Peritonsillar
calculusabscess drainage/Intraoral calculus removal
ENT ET00001163Pinna surgeryET000011630000229 Pinna surgery for benign tumor/ trauma
ENT ET00001201Pre auricularET000012010000230
sinus Pre auricular sinus
ENT ET0000121Benign Head ET00001210000194
and Neck Lesion Excision Benign
LA/GAHead and Neck Lesion Excision/ Sclerotheraphy- LA or GA
ENT ET00001230Radical Neck ET000012300000231
ENT ET00001261Removal ofET000012610000232
Submandibular SalivaryGlandRemoval / Salivary
of Submandibular
or without Lymph
/ Salivary
NodeRanula- with or with
ENT ET00001272Resection ofET000012720000233
nasopharyngeal tumour Resection of nasopharyngeal tumour
ENT ET00001294Rigid laryngoscopy
ET000012940000234
/ bronchoscopy /Rigid laryngoscopy / bronchoscopy /oesophagoscopy - Diagnos c + / - b
ENT ET00001321SeptoplastyET000013210000235 Septoplasty - Govt. reserve
ENT ET00001375StapedectomyET000013750000236
/ tympanotomy Stapedectomy / tympanotomy/stapedotomy - Govt. reserve
ENT ET00001383Submandibular
ET000013830000237
duct stone removal Submandibular duct stone removal LA/GA
ENT ET00001441ThyroglossalET000014410000238
/ Branchial cyst / sinusThyroglossal
/ fistula excision
cyst excision/Thyroglossal sinus excision/Thyroglossal fistul
ENT ET00001442Thyroidectomy
ET000014420000239 Hemi thyroidectomy
ET000014420000240 Total thyroidectomy
ET000014420000241 Total Thyroidectomy with central neck Dissection
ENT ET00001451Tongue Tie ET000014510000242 Tongue Tie
ENT ET00001452Tonsillectomy
ET000014520000243 Tonsillectomy - U/L tonsillectomy (unilateral/bilateral)/Tonsillectomy - B
ENT ET00001462TracheostomyET000014620000244
ENT ET00001465TracheostomyET000014650000245
Closer Tracheostomy Closer
ENT ET00001490Tympanoplasty
ET000014900000246 Tympanoplasty (can be stratified (GA/LA) and price adjusted accordingly
ENT ET00001518Uvulopalatopharyngoplasty
ET000015180000247 (UPPP) Uvulopalatopharyngoplasty (UPPP)
ENT ET0000180CanalopastyET00001800000195
For EAC Atresia Canalopasty For EAC Atresia - Govt. reserve
ENT ET0000230Clinic basedET00002300000196
therapeutic interventions Biopsy/Intratympanic
of ENT injections/Wide bore aspiration/ Turbinate reduct
ENT ET0000232Closed reduction
ET00002320000197
Closedfor reduction
fracturefor
of maxilla
fracture/of mandible
maxilla/mandible/zygoma/Closed
/ zygoma reduc
ENT ET0000272Conservative ET00002720000198
ENT ET0000281Conservative ET00002810000199
Management of injuryConservative Management - (Chest/Head/Face/Abdomen)stand alone
ENT ET000046 AdenoidectomyET0000460000188 Adenoidectomy - Govt. reserve
ENT ET0000479Deep neck abscess
ET00004790000200
drainage/ Post trauma
Deep neckneckabscess
exploration
drainage/Post trauma neck exploration
ENT ET000053 Advanced anterior
ET0000530000189
skull base surgery Endoscopic Hypophysectomy/ Clival tumour excision
ENT ET000055 Advanced lateral
ET0000550000190
skull base surgery Fisch approach/ Translabyrinthine approach/ Transcochlear approach/ T
ENT ET0000555EndoscopicET00005550000201
DCR Endoscopic DCR
ENT ET0000575Epistaxis treatment
ET00005750000202
- packing Epistaxis treatment - packing
ENT ET0000586EUA separate ET00005860000203
add on package EUA only in GA separate - add on package
ENT ET0000610Excision of Pinna
ET00006100000204
for Growths / Injuries
Growth- Total
- Squamous/
Amputation Basal/
& Excision
Injury of External Auditory Meatus
ENT ET0000613Excision of tumour
ET00006130000205
Excision of sinus
tumour
/ laryngopharynx
of oral cavity /paranasal sinus / laryngopharynx with
ET00006150000206
Excision of sinus
tumour
/ laryngopharynx
of oral cavity / paranasal sinus / laryngopharynx
ET00006150000207
Excision of sinus
tumour
/ laryngopharynx
of oral cavity / paranasal sinus/ laryngopharynx with
ENT ET0000629Extended LOS ET00006290000208
ENT ET0000660Fibreoptic bronchoscopy
ET00006600000209 (FOB) Fibreoptic bronchoscopy (FOB)
ENT ET0000678Foreign Body ET00006780000211
Removal ( Esophageal) Foreign Body Removal ( Esophageal)
ENT ET0000681Foreign Body ET00006810000210
Removal (Airway) Foreign Body Removal (Airway)
ENT ET0000687Fracture - setting
ET00006870000212
nasal bone Fracture - setting nasal bone - Regular PKG / Day care
ENT ET0000694Functional Endoscopic
ET00006940000213
Sinus (FESS) Functional Endoscopic Sinus (FESS)stratified as U/L or B/L and cost adjus
ENT ET0000695Functional septo
ET00006950000214
rhinoplasty Septo rhinoplasty - Govt. reserve
ENT ET000070 Ant. Ethmoidal
ET0000700000191
/ sphenopalatine arteryAnt. ligation
Ethmoidal artery ligation - Open/Ant. Ethmoidal artery ligation - En
ENT ET000074 Anterior skull
ET0000740000192
base surgery CSF Rhinorrhea Repair - open / Endoscopic
ENT ET000074 Anterior skull
ET0000740000193
base surgery Optic nerve decompression/Orbital decompression/Craniofacial resectio
ENT ET0000868LaryngoceleET00008680000215 Laryngocele
ENT ET0000871Lateral skullET00008710000216
base procedures Subtotal petrosectomy/Post-trauma c facial nerve decompression/CSF O
ENT ET0000929MastoidectomyET00009290000217 Simple/modified Radical Mastoidectomy - Govt. reserve
ENT ET0000958Microlaryngoscopic
ET00009580000218
Surgery Microlaryngoscopic Surgery
ENT ET0000971Myringotomy ET00009710000219
with or without Grommet Unilateral/Bilateral
ENT ET0000975Neck dissection
ET00009750000220 Selec ve Benign neck tumourexcision/Comprehensive Benign neck tumo
GASTROENTEROLOGY
GL00001022Oesophageal GL000010220000265
Varices Banding Oesophageal Varices Banding
GASTROENTEROLOGY
GL00001100PancreatitisGL000011000000266 Acute necrotizing severe pancreatitis / Pancreatitis
GASTROENTEROLOGY
GL00001187PORTAL HYPERTENSION
GL000011870000267 NON-SHUNTS
GASTROENTEROLOGY
GL00001337Sigmoidoscopy
GL000013370000268 Sigmoidoscopy - ADD ON
GASTROENTEROLOGY
GL00001410Surgical management
GL000014100000269
of Lower GI bleed
Surgical
(inclusive
management
of sigmoidoscopy
of Lower GI/ bleed
colonoscopy)
(inclusive
- Colonoscopic
of sigmoidoscopy
manage
/ co
GASTROENTEROLOGY
GL00001494Upper GI Endoscopy
GL000014940000270 Upper GI Endoscopy - ADD ON
GASTROENTEROLOGY
GL0000181Capsule Endoscopy
GL00001810000250 Capsule Endoscopy - ADD ON
GASTROENTEROLOGY
GL0000221CholangitisGL00002210000251 Cholangitis
GASTROENTEROLOGY
GL000023 Acute gastroenteritis
GL0000230000248
with dehydrationAcute gastroenteritis with moderate dehydration/Acute gastroenteritis
GASTROENTEROLOGY
GL0000244Colonoscopy GL00002440000252 Colonoscopy- ADD ON
GASTROENTEROLOGY
GL000034 Acute severe GL0000340000249
ulcerative colitis Acute severe ulcerative colitis
GASTROENTEROLOGY
GL0000556EndoscopicGL00005560000253
Glue injection Endoscopic Glue injection - ADD ON
GASTROENTEROLOGY
hemoclip application Endoscopic hemoclip application - ADD ON
GASTROENTEROLOGY
Sclerotherapy Endoscopic Sclerotherapy - ADD ON
GASTROENTEROLOGY
Variceal band ligation (EVL)Endoscopic
includingVariceal
band band ligation (EVL) including band - ADD ON
GASTROENTEROLOGY
GL0000576ERCP GL00005760000257 ERCP
GASTROENTEROLOGY
GL0000576ERCP GL00005760000258 ERCP + Stenting/Stone removal
GASTROENTEROLOGY
GL0000706GI bleedingGL00007060000259 Lower GI bleeding / Upper GI bleeding
GASTROENTEROLOGY
GL0000743Hepatitis GL00007430000260 Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis /Alcoholic
GASTROENTEROLOGY
GL0000755High end histopathology
GL00007550000261 (Biopsies) and
Highadvanced
end histopathology
GASTROENTEROLOGY
GL0000762High end radiological
GL00007620000262
GASTROENTEROLOGY
GL0000824Intestinal obstruction
GL00008240000263 Intestinal obstruction- medical managment
GASTROENTEROLOGY
GL0000955MesentericGL00009550000264
Ischemia Mesenteric Ischemia
INTERVENTIONAL
IR0000100
RADIOLOGY
aspiration/ IR00001000000507
INTERVENTIONAL
IR00001021
RADIOLOGY
Oesophageal IR000010210000528
/gastric / duodenal / colonic
Oesophageal
stenting/balloon
/gastric / duodenal
dilatation/ colonic stenting/balloon dilatation
INTERVENTIONAL
IR00001130
RADIOLOGY
PercutaneousIR000011300000529
cholangioplasty/Gastrostomy/
Percutaneousvacuumcholangioplasty/Gastrostomy/
assisted biopsy/thrombin injection
vacuum assisted biopsy/thr
INTERVENTIONAL
IR00001140
RADIOLOGY
Peripheral Angioplasty
IR000011400000530 Peripheral Angioplasty - Subclavian , Mesenteric , Femoral, iliac - Poplite
INTERVENTIONAL
IR00001143
RADIOLOGY
IR000011430000531
- POBA Peripheral Angioplasty - POBA
INTERVENTIONAL
IR00001145
RADIOLOGY
IR000011450000532
- Renal Peripheral Angioplasty - Renal
INTERVENTIONAL
IR0000115
RADIOLOGY
Balloon Dilatation
IR00001150000508 Coarctation of Aorta/Pulmonary Artery Stenosis /aortic aneurysm repair
INTERVENTIONAL
IR00001158
RADIOLOGY
PET scan IR000011580000533 PET scan
INTERVENTIONAL
IR00001242
RADIOLOGY
Radiofrequency/Laser
IR000012420000534
ablation -Trigeminal
Radiofrequency/Laser
nerve/Genicular ablation
nerve/Celiac
-Trigeminal
plexus/stellate
nerve/Genicular
ganglion/Symphath
nerve/Celia
INTERVENTIONAL
IR00001303
RADIOLOGY
Rotational Atherectomy
IR000013030000535(ROTA) Ablation
Rotational Atherectomy (ROTA) Ablation - GOVT Reserve
INTERVENTIONAL
IR00001433
RADIOLOGY
TEVAR / EVARfor
IR000014330000537
aortic aneurysm/ dissection
TEVAR / EVAR for aortic aneurysm/ dissection - Govt Reserve
INTERVENTIONAL
IR00001469
RADIOLOGY
TransjugularIR000014690000538
intrahepatic portosystemicTransjugular
shunt creation
intrahepatic
(TIPSS)/Direct
portosystemic
transjugular
shunt creation
Intrahepatic
(TIPSS)/Direct
Portosystemtr
INTERVENTIONAL
IR00001470
RADIOLOGY
TransjugularIR000014700000539
Liver/renal biopsy Transjugular Liver/renal biopsy - Govt Reserve
INTERVENTIONAL
IR0000148
RADIOLOGY
Bone marrow IR00001480000509
aspiration and biopsyBone marrow aspiration / biopsy
INTERVENTIONAL
IR00001481
RADIOLOGY
Tunelled long
IR000014810000540
term in dwelling catheter
Tunelled
for refractory
long termascites
in dwelling
/ pleural
catheter
effusion
for refractory ascites / pleural e
INTERVENTIONAL
IR00001482
RADIOLOGY
Tunnelled long-term
IR000014820000541
venous catheter Tunnelled long-term venous catheter - Govt Reserve
INTERVENTIONAL
IR0000168
RADIOLOGY
Bronchial artery
IR00001680000510
Embolisa on Bronchial artery Embolisa on (for Haemoptysis)
INTERVENTIONAL
IR0000186
RADIOLOGY
Carotico-cavernous
IR00001860000502
Fistula (CCF) embolization
Carotico-cavernous Fistula (CCF) embolization with coils.( Upto 5 coils, g
INTERVENTIONAL
IR0000197
RADIOLOGY
Central LineIR00001970000511
LumenLine
) ( Double Lumen / Triple Lumen ) with procedure - add on
INTERVENTIONAL
IR0000214
RADIOLOGY
Chemo PortIR00002140000512
Insertion Chemo Port/PICC Insertion
INTERVENTIONAL
IR0000216
RADIOLOGY
Chemoport/implantable
IR00002160000513 lines Chemoport/implantable lines
INTERVENTIONAL
IR0000255
RADIOLOGY
Complex IRIR00002550000514
procedure- Angioplasty/Venoplasty/Stenting/
Angioplasty/VenoplastyEmbolisation/Ablation/Thrombectomy
: cutting balloon/drug coated balloon/: high pres
INTERVENTIONAL
IR0000495
RADIOLOGY
Diagnostic Angiography
IR00004950000515peripheral (DSA
Diagnostic
- Digital
Angiography
Substractionperipheral
Angiography)
(DSA - Digital Substraction Angiograp
INTERVENTIONAL
IR0000524
RADIOLOGY
DVT/Acute IR00005240000517
INTERVENTIONAL
IR0000524
RADIOLOGY
DVT/Acute IR00005240000516
INTERVENTIONAL
IR0000524
RADIOLOGY
DVT/Acute IR00005240000536
INTERVENTIONAL
IR0000534
RADIOLOGY
EmbolizationIR00005340000518 Arteriovenous Malformation (AVM) in the Limbs
INTERVENTIONAL
IR0000535
RADIOLOGY
Embolization/
IR00005350000519
Metallic Stenting/Balooning/Snare/Ballon
Embolization / Percutaneous
occulsion Metallic Stent/ Balloon /Snare /Balloon oc
INTERVENTIONAL
IR0000547
RADIOLOGY
Endobronchial
IR00005470000520
Ultrasound (EBUS) Endobronchial Ultrasound guided fine needle biopsy
INTERVENTIONAL
IR0000561
RADIOLOGY
Endovascular IR00005610000503
therapy for intracranial/Spinal
intracranial
aneurysm/AV
/Spinal aneurysm/AV
Malformation
Malformation
or fistula/angioplasty
or fistula - Govt reserve
INTERVENTIONAL
IR0000592
RADIOLOGY
EVOH Package IR00005920000504 Intracranial AVM - Govt Reserve
INTERVENTIONAL
IR0000641
RADIOLOGY
Extra Coils IR00006410000521 Extra Coils add on
INTERVENTIONAL
IR0000741
RADIOLOGY
Hepatic venous
IR00007410000522
wedge pressure measurement
Hepatic venous(HVPG)wedge pressure measurement (HVPG) - Govt Reserve
INTERVENTIONAL
IR0000757
RADIOLOGY
High end histopathology
IR00007570000523 (Biopsies) and
Highadvanced
end histopathology
INTERVENTIONAL
IR0000764
RADIOLOGY
High end radiological
IR00007640000524
INTERVENTIONAL
IR0000805
RADIOLOGY
Image Guided IR00008050000525
Percutaneous procedure Image Guided Percutaneous: drainage placement /biliary drainage/ cho
INTERVENTIONAL
IR0000830
RADIOLOGY
IntracranialIR00008300000505
balloon angioplasty withIntracranial
stenting balloon angioplasty with stenting - Govt Reserve
INTERVENTIONAL
IR0000834
RADIOLOGY
IntracranialIR00008340000506
thrombolysis/ clot retrieval Intracranial thrombolysis/ clot retrieval - Govt Reserve
INTERVENTIONAL
IR0000837
RADIOLOGY
IntravascularIR00008370000526
ultrasound (IVUS) Intravascular ultrasound (IVUS) - GOVT Reserve
INTERVENTIONAL
IR000091
RADIOLOGY
ArteriovenousIR0000910000501
fistula (AVF)/Arteriovenous
AVF/AVM Malformation
of Brain/Spine (AVM)
- Govt
Brain/Spine
Reserve
INTERVENTIONAL
IR0000995
RADIOLOGY
Nephrostomy IR00009950000527
- Percutaneous ImageNephrostomy
guided - Percutaneous Image guided / Fluoroscopic Guided
MENTAL DISORDERS
MD00001009NeuroDevelopMental
MD000010090000777
Disorderss (NDD)
Autism
Other
Spectrum
than Intellectual
Disorder/Mixed
Disability
DevelopMental Disorders/Tourette Sy
MENTAL DISORDERS
MD00001015Neurotic, stress-related
MD000010150000778 and somatoform
Neurotic,
disorders
stress-related and somatoform disorders
MENTAL DISORDERS
MD00001016Non-Pharmacological
MD000010160000779
InterventionsPsychological, Behavioural and Developmental and Educational Interven
MENTAL DISORDERS
MD00001069Package (Cognitive
MD000010690000780
Tests, CompletePackage
Haemogram,
(Cognitive
Liver Tests,
FunctionComplete
Test, Renal
Haemogram,
Function Liver
Test, Serum
Function
Electrolyte
Test, Re
MENTAL DISORDERS
MD00001162Pharmacological
MD000011620000781
Interventions Common Medications Used in Management of Child & Adult Psycholoig
MENTAL DISORDERS
MD0000119Behavioral andMD00001190000769
motional Disorders of Oppositional
Childhood and Defiant
Adolescence
Disorder/ Conduct Disorder/Mixed Disorder of Con
MENTAL DISORDERS
MD0000120BehaviouralMD00001200000770
syndromes associated with Behavioural
physiological
syndromes
disturbances
associated
andwith
physical
physiological
factors disturbances and p
MENTAL DISORDERS
MD00001206PsychologicalMD000012060000782
/ Psychosocial Assessment Psychological
Package Assessments
for All Child And
(Includes
Adolescent
IQ Testing,
Psychiatric
Specific
Disorders
Learning Disabil
MENTAL DISORDERS
MD00001311Schizophrenia,
MD000013110000783
schizotypal and delusional
Schizophrenia,
disordersschizotypal and delusional disorders
MENTAL DISORDERS
MD0000530Electro Convulsive
MD00005300000771
Therapy (ECT) - perElectro
session
Convulsive Therapy (ECT) - per session
MENTAL DISORDERS
MD0000808Immune mediated
MD00008080000772
CNS disorders Immune mediated CNS disorders
MENTAL DISORDERS
MD0000949Mental andMD00009490000773
Behavioural disorders due Mental
to psychoactive
and Behaviouralsubstance
disorders
use due to psychoactive substance use
MENTAL DISORDERS
MD0000950Mental Disorderss
MD00009500000774
- Organic, including
Mental
symptomatic
Disorderss - Organic, including symptomatic
MENTAL DISORDERS
MD0000951Mental Retardation
MD00009510000775
(intellectual disability)
Intellectual Disability (ID)
MENTAL DISORDERS
MD0000964Mood (affective)
MD00009640000776
disorders Mood (affective) disorders
GENERAL MEDICINE
MG00001012NeuromuscularMG000010120000336
Disorders Neuromuscular Disorders
GENERAL MEDICINE
MG00001023Oesophageal MG000010230000337
GENERAL MEDICINE
MG0000104Atrial Fibrillation
MG00001040000282 Atrial Fibrillation
GENERAL MEDICINE
MG00001053Optic neuritis
MG000010530000338 Optic neuritis
GENERAL MEDICINE
MG0000108Autoimmune MG00001080000283
encephalitis Autoimmune encephalitis
GENERAL MEDICINE
MG00001101PancreatitisMG000011010000339 Acute Pancreatitis/ Acute nacrotizing severe pancreatitis / Chronic Panc
GENERAL MEDICINE
MG00001150Peripheral Arterial
MG000011500000340
Thrombosis Peripheral Arterial Thrombosis
GENERAL MEDICINE
MG00001154Peritoneal Dialysis
MG000011540000341 Peritoneal Dialysis
GENERAL MEDICINE
MG00001164Plasmapheresis
MG000011640000342 Plasmapheresis - Add on
GENERAL MEDICINE
MG00001167Platelet pheresis
MG000011670000343 Platelet pheresis - Add on
GENERAL MEDICINE
MG00001170Pleural Effusion
MG000011700000344 Pleural Effusion
GENERAL MEDICINE
MG00001179PneumoniaMG000011790000345 Pneumonia/Severe pneumonia
GENERAL MEDICINE
MG00001182Pneumothorax MG000011820000346 Pneumothorax
GENERAL MEDICINE
MG00001185Poisoning MG000011850000347 Acute organophosphorus poisoning/Other poisonings
GENERAL MEDICINE
MG00001212Pulmonary MG000012120000348
thromboembolism Pulmonary thromboembolism
GENERAL MEDICINE
MG00001274RespiratoryMG000012740000349
failure Type 1 respiratory failure/Type 2 respiratory failure/Due to any cause (p
GENERAL MEDICINE
MG00001288Rheumatic MG000012880000350
fever & Its ComplicationAcute / Septic
rheumatic
Arthritis fever/ Rheumatic valvular heart disease / Rheumtoid A
GENERAL MEDICINE
MG00001314Scrub Typhus MG000013140000351 Scrub Typhus
GENERAL MEDICINE
MG00001320Seizure & Epilepsy
MG000013200000352
& Epileptic encephalopathy
Seizure (Due to any cause) Status Epileptics / Drug resistant Epilepsy/Ev
GENERAL MEDICINE
MG00001324SEVERE ANEMIAMG000013240000353 Iron deficiency anemia / Thalessmia / Other anemias
GENERAL MEDICINE
MG00001328Severe sepsisMG000013280000354 Severe sepsis/Septic shock
GENERAL MEDICINE
MG00001333Sickle cell Anemia
MG000013330000355 Sickle cell Anemia - Govt Reserve
GENERAL MEDICINE
MG00001344Skin and softMG000013440000356
tissue infections Skin and soft tissue infections
GENERAL MEDICINE
MG00001349
Snake bite MG000013490000357 Snake bite
GENERAL MEDICINE
MG0000138Blood transfusion
MG00001380000284 Blood component FFP - Add on
GENERAL MEDICINE
MG0000138Blood transfusion
MG00001380000285 Whole Blood transfusion/Blood component including platelet transfusio
GENERAL MEDICINE
MG0000142Blood transfusion-Blood
MG00001420000286 componentBlood
including
component
plateletSDP
transfusion
( IF platelet
(SDP)
≤ 20000 ) - Add on
GENERAL MEDICINE
MG00001420
Systematic MG000014200000358
lupus erythematosus Systematic lupus erythematosus (SLE)/ Diffuse alveolar hemmorhage as
GENERAL MEDICINE
MG00001423
MG000014230000359
(for MI) Systemic Thrombolysis (for MI)
GENERAL MEDICINE
MG00001431
Tetanus MG000014310000360 Tetanus
GENERAL MEDICINE
MG00001446
Thyrotoxic crisis
MG000014460000361 Thyrotoxic crisis
GENERAL MEDICINE
MG0000147Bone marrow MG00001470000287
GENERAL MEDICINE
MG00001474
Treatment of MG000014740000362
systemic fungal infections
Treatment of systemic fungal infections
GENERAL MEDICINE
MG00001477
tuberculosisMG000014770000363 Pericardial tuberculosis / Pleural tuberculosis/ Pulmonary tuberculosis
GENERAL MEDICINE
MG00001492
Unexplained MG000014920000364
hepatosplenomegaly Unexplained hepatosplenomegaly-requiring admission for Work Up and
GENERAL MEDICINE
MG00001532
Vasculitis/ autoimmune
MG000015320000365
disorder Vasculitis/ autoimmune disorder
GENERAL MEDICINE
MG00001545
Viral Encephalitis
MG000015450000366 Viral Encephalitis
GENERAL MEDICINE
MG000016Actue nueroregression/
MG0000160000272 Acute worsening
Actue in
nueroregression/
neuro metabolicAcuteand neuro
worsening
degenrative
in neuroconditions
metabolic and neurod
GENERAL MEDICINE
MG0000184Cardiac Tamponade
MG00001840000288 Cardiac Tamponade
GENERAL MEDICINE
MG0000193Celiac disease
MG00001930000289 Celiac disease-requiring admission for Work Up and/or in-patient manag
GENERAL MEDICINE
MG0000196Central LineMG00001960000290
LumenLine
GENERAL MEDICINE
MG000020ACUTE ENCEPHALOPATHY
MG0000200000273 Acute Febrile encephalopathy/Acute Disseminated Encephalomyelitis/h
GENERAL MEDICINE
MG0000203cerebral herniation
MG00002030000291 cerebral herniation
GENERAL MEDICINE
MG0000204Cerebral SinoMG00002040000292
Venous thrombosis Cerebral Sino Venous thrombosis
GENERAL MEDICINE
MG0000212CHD /RHD MG00002120000293 CHD /RHD
GENERAL MEDICINE
MG0000218Chikungunya MG00002180000294
fever Chikungunya fever
GENERAL MEDICINE
MG0000222CholangitisMG00002220000295 Cholangitis
GENERAL MEDICINE
MG000025Acute gastroenteritis
MG0000250000274
with dehydration
Acute
/ Recurrent
gastroenteritis
vomiting
withwith
moderate
dehydration/
dehydration/Acute
Chronic diarrohea/
gastroenteritis
Dysentry
GENERAL MEDICINE
MG000026Acute glomerulonephritis
MG0000260000275 Acute glomerulonephritis
GENERAL MEDICINE
MG0000265Congestive MG00002650000296
GENERAL MEDICINE
MG000029Acute ischemicMG0000290000276
stroke Acute ischemic stroke
GENERAL MEDICINE
MG0000293ContinuousMG00002930000297
renal replacement therapy/Continuous
Continuous renalveno-venous
replacementhemofiltration
therapy (CRRT) in AKI (including cost for d
GENERAL MEDICINE
MG0000315Croup syndrome
MG00003150000298 Acute laryngotracheobronchitis/Acute epiglottitis
GENERAL MEDICINE
MG000035Acute severe MG0000350000277
ulcerative colitis Acute severe ulcerative colitis
GENERAL MEDICINE
MG000039Acute transverse
MG0000390000278
myelitis/ Acute demyelinating
Acute transverse
encephalitis
myelitis/ Acute demyelinating encephalitis
GENERAL MEDICINE
MG000041Acute urticaria
MG0000410000279
/ Anaphylaxis Acute urticaria / anaphylaxis / Steven Johnson syndrome
GENERAL MEDICINE
MG000044Addison’s disease
MG0000440000280 Addison’s disease
GENERAL MEDICINE
MG0000462CVA / Stroke MG00004620000271 Acute hemorrhagic stroke/Acute hemorrhagic stroke- (Extra ventricular
GENERAL MEDICINE
MG0000464Cyanotic spells
MG00004640000299 Cyanotic spells without CHD/Cyanotic spells with CHD
GENERAL MEDICINE
MG0000483Dengue fever MG00004830000300 Dengue fever/Dengue hemorrhagic fever/Dengue shock syndrome
GENERAL MEDICINE
MG0000489Diabetic footMG00004890000301 Diabetic foot
GENERAL MEDICINE
MG0000523DVT/Acute MG00005230000302
GENERAL MEDICINE
MG0000544Empyema MG00005440000303 Empyema
GENERAL MEDICINE
MG0000550EndocarditisMG00005500000304 Bacterial Endocarditis/Fungal Endocarditis
GENERAL MEDICINE
MG0000562Enteric feverMG00005620000305 Enteric fever
GENERAL MEDICINE
MG000059AKI / Renal MG0000590000281
failure AKI / Renal failure
GENERAL MEDICINE
MG0000651Febrile illness
MG00006510000306 Acute febrile illness / Pyrexia of unknown origin
GENERAL MEDICINE
MG0000661Fibreoptic bronchoscopy
MG00006610000307 (FOB) Fibreoptic bronchoscopy (FOB)
GENERAL MEDICINE
MG0000707GI bleedingMG00007070000308 Lower GI bleeding / Upper GI bleeding
GENERAL MEDICINE
MG0000715Gout MG00007150000309 Gout
GENERAL MEDICINE
MG0000720Guillain Barre
MG00007200000310
syndrome Guillain Barre syndrome
GENERAL MEDICINE
MG0000724HaemodialysisMG00007240000311
Dialysis (ARF / CRF) Haemodialysis ± Inj.Erythropoietin - Day care / Add on
GENERAL MEDICINE
MG0000727HaemolyticMG00007270000312
uremic syndrome Haemolytic uremic syndrome
GENERAL MEDICINE
MG0000736HemostaticMG00007360000313
Disorders Hemophilia / Platelet disorders - govt reserve
GENERAL MEDICINE
MG0000744Hepatitis MG00007440000314 Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis /Alcoholic
GENERAL MEDICINE
MG0000756High end histopathology
MG00007560000315
(Biopsies) and
Highadvanced
end histopathology
GENERAL MEDICINE
MG0000763High end radiological
MG00007630000316
GENERAL MEDICINE
MG0000773HIV with complications
MG00007730000317 HIV with complications
GENERAL MEDICINE
MG0000776HydrocephalusMG00007760000318 Hydrocephalus
GENERAL MEDICINE
MG0000794Idiopathic Thrombocytopenic
MG00007940000319 Purpura
Idiopathic Thrombocytopenic Purpura
GENERAL MEDICINE
MG0000797IHD / CAD /MG00007970000320
Arrhythmia IHD/Arrhythmia/CAD
GENERAL MEDICINE
MG0000807Immune mediated
MG00008070000321
GENERAL MEDICINE
MG0000815Inflammatory MG00008150000322
Myopathy/ Myaesthenic Inflammatory
Crisis Myopathy/ Myaesthenic Crisis
GENERAL MEDICINE
MG0000825Intestinal obstruction
MG00008250000323 Intestinal obstruction- medical managment
GENERAL MEDICINE
MG0000831INTRACRANIAL MG00008310000324
SPACE OCCUPYING LESIONS
Intracranial hemorrhage/Intracranial space occupying lesion tuberculom
GENERAL MEDICINE
MG0000853Juvenile myasthenia
MG00008530000325 Juvenile myasthenia- requiring admission for work-up or in-patient care
GENERAL MEDICINE
MG0000855Kawasaki Disease
MG00008550000326 Kawasaki Disease
GENERAL MEDICINE
MG0000875LeptospirosisMG00008750000327 Leptospirosis
GENERAL MEDICINE
MG0000894Lung abscess MG00008940000328 Lung abscess
GENERAL MEDICINE
MG0000900Malaria MG00009000000329 Complicated malaria
GENERAL MEDICINE
MG0000938Medical Management
MG00009380000330
for Raised intracranial
Raised ICPpressure
due to neuro surgical procedures/due to trauma/malignancie
GENERAL MEDICINE
MG0000945Meningitis MG00009450000331 Chronic meningitis/Partially treated pyogenic meningitis/Neuro tubercu
GENERAL MEDICINE
MG0000956MesentericMG00009560000332
Ischemia Mesenteric Ischemia
GENERAL MEDICINE
MG0000973MyxedemaMG00009730000333
coma Myxedema coma
GENERAL MEDICINE
MG0000980Neonatal/ Infantile
MG00009800000334
cholestasis Neonatal/infantile cholestasis / Choledochal cysts
GENERAL MEDICINE
MG0000998NEPHROTICMG00009980000335
SYNDROME Nephrotic syndrome with peritonitis/Steroid dependent or resistent/Un
MEDICAL ONCOLOGY
MO00001057
Oral Metronomic
MO000010570000753
chemotherapy forEtoposide/
CA Ovary/Cyclophosphamide
breast 50 mg/m2 OD D1-D21 every 28 days
MEDICAL ONCOLOGY
MO00001072
Paediatric-GCT/JEB
MO000010720000754 Paediatric-GCT/JEB/PEB Maximum 6 cycles
MEDICAL ONCOLOGY
MO00001076
Palliative and
MO000010760000755
supportive care for malignant
Palliative disease
care endatstage
advanced
disease
or end stage
MEDICAL ONCOLOGY
MO00001081
Palliative Care
MO000010810000756
Approach to managing Hematuria
Haematuria Palliative
in advanced
Interventions
cancer patients- Endoscopic/ Surgical/ Radio
MEDICAL ONCOLOGY
MO00001092
Palliative Radiological
MO000010920000757
and endoscopical
Palliative
Interventions
Radiological Interventions. Like-PTBD/ERCP/PCN//Pericardiost
MEDICAL ONCOLOGY
MO00001095
Palliative surgical
MO000010950000758
interventions like-Colostomy,
Palliative surgical
Tracheostomy,
interventions
Feeding Jejunostomy/Gastrostomy, Bowel b
MEDICAL ONCOLOGY
MO00001116
PEDIATRIC NONMO000011160000759
HODGKINS LYMPHOMA PEDIATRIC
(LMB NON
89-96)HODGKINS
INDUCTION-COPADAM
LYMPHOMA (LMB (8 WEEKS,
89-96)2INDUCTION-COPAD
CYCLES)-LMB 89 -
MEDICAL ONCOLOGY
MO00001117
(LMB NON
89-96)HODGKINS
MAINTAINENCE
LYMPHOMA
(12 WEEKS)-LMB
(LMB 89-96)89MAINTAINENCE
- 96 - Maintenan
(1
MEDICAL ONCOLOGY
MO00001118
(MCP-842)
NON HODGKINS
8 cycles-MCP LYMPHOMA
- 842-Cycle(MCP-842) 8 cycles-MCP - 842-C
MEDICAL ONCOLOGY
MO00001159
PET scan MO000011590000762 PET scan
MEDICAL ONCOLOGY
MO00001165
Plasmapheresis
MO000011650000763 Plasmapheresis - Add on
MEDICAL ONCOLOGY
MO00001168
Platelet pheresis
MO000011680000764 Platelet pheresis - Add on
MEDICAL ONCOLOGY
MO00001325
SEVERE ANEMIAMO000013250000765 Iron deficiency anemia / Thalessmia / Other anemias
MEDICAL ONCOLOGY
MO00001334
Sickle cell Anemia
MO000013340000766 Sickle cell Anemia - Govt Reserve
MEDICAL ONCOLOGY
MO0000139Blood transfusion
MO00001390000545 Whole Blood transfusion/Blood component including platelet transfusio
MEDICAL ONCOLOGY
MO0000139Blood transfusion
MO00001390000546 Whole Blood transfusion/Blood component SDP ( IF platelet
MEDICAL ONCOLOGY
MO00001480
Tumor LysisMO000014800000767
Syndrome RasburicaseFebuxostatAllopurinolSevelamer
MEDICAL ONCOLOGY
MO0000149Bone marrow MO00001490000547
MEDICAL ONCOLOGY
MO00001541
Vertebroplasty/Kyphoplasty
MO000015410000768 Vertebroplasty/Kyphoplasty - Govt reserved
MEDICAL ONCOLOGY
MO0000201Central linesMO00002010000548
in cancer patients for drug
Longtherapy
term indwelling
-Silicon catheters
venous catheter
in advanced cancer patients- Long term c
MEDICAL ONCOLOGY
MO0000320CT (Induction)for
MO00003200000549
Paediatric Acute Lymphoblastic
India collaboraLeukemia/Lymphoblastic
ve childhood leukaemialymphoma
group
MEDICAL ONCOLOGY
MO0000321CT Consolidation
MO00003210000551
for Acute Lymphoblastic
Berlin- Leukemia
Frankfurt -Munster-90Berlin- Frankfurt -Munster-95
MEDICAL ONCOLOGY
MO0000322CT Consolidation
MO00003220000550
for Paediatric NonFAB
Hodgkins
LMB 89/96
Lymphoma
(Max 4 cycles)
MEDICAL ONCOLOGY
MO0000323CT for AcuteMO00003230000552
Lymphoblastic Leukemia Berlin-
/Lymphoblastic
Frankfurt -Munster-90,
lymphoma Berlin- Frankfurt -Munster-95, Berlin- Fra
MEDICAL ONCOLOGY
MO0000324CT for AcuteMO00003240000553
Lymphoblastic Leukemia/ 6 Mercaptopurine
Lymphoblastic Lymphoma
50 mg / M2 dailyMethotrexate 25 mg / M2 Weekly / I
MEDICAL ONCOLOGY
MO0000325CT for AcuteMO00003250000554
Myeloid Leukemia Cytarabine 100 mg / M2 7 daysDaunomycin 60 mg / M2 3 days ( this incl
MEDICAL ONCOLOGY
MO0000326CT for AcuteMO00003260000555
Myeloid Leukemia Consolidation
High dose Cytarabine for 3 cycles Including antibiotics and blood produc
MEDICAL ONCOLOGY
MO0000327CT for AcuteMO00003270000556
Promyelocy c Leukemia Arsenic trioxideATRADaunomycin or Idarubcin
MEDICAL ONCOLOGY
MO0000328CT for AcuteMO00003280000557
Promyelocy c Leukemia Arsenic trioxideATRADaunomycin or Idarubcin
MEDICAL ONCOLOGY
MO0000329CT for AcuteMO00003290000558
Promyelocy c Leukemia 6 MP 50 mg / day dailyMethotrexate 15 mg Weekly
MEDICAL ONCOLOGY
MO0000330CT for AcuteMO00003300000559
Promyelocy c Leukemia ATO: Arsenic trioxide 0.15 mg / kg day 1-45 or 60
MEDICAL ONCOLOGY
MO0000331CT for AcuteMO00003310000560
Promyelocy c Leukemia ATO: Arsenic trioxide 0.15 mg / kg day 1-Day 5, day 8-12, day 15-19, day
MEDICAL ONCOLOGY
MO0000332CT for Anal MO00003320000561
Cancer 5 Fluorouracil (FU)+ Mitomycin C5 Fluorouracil(FU) 1000mg/m2 D1-D4 D
MEDICAL ONCOLOGY
MO0000332CT for Anal MO00003320000562
Cancer Capecitabine + Mitomycin CCapecitabine 825mg/m2 PO twice daily ll c
MEDICAL ONCOLOGY
MO0000333CT for Anal MO00003330000563
Cancer-Carboplatin + Paclitaxel-Cycle
CT for Anal Cancer-Carboplatin + Paclitaxel-Cycle
MEDICAL ONCOLOGY
MO0000334CT for Anal MO00003340000564
Cancer-Cisplatin + Paclitaxel-Cycle
CT for Anal Cancer-Cisplatin + Paclitaxel-Cycle
MEDICAL ONCOLOGY
MO0000335CT for B - Cell
MO00003350000565
NHL - High Grade Cyclophosphamide + Etoposide + Prednsiolone
MEDICAL ONCOLOGY
MO00003360000566
NHL - High Grade CT for B - Cell NHL - High Grade(Except Burki 's & PCNSL)-R - CEOP
MEDICAL ONCOLOGY
MO00003370000567
NHL - High Grade CT for B - Cell NHL - High Grade(Except Burki 's & PCNSL)-R - CHOP
MEDICAL ONCOLOGY
MO00003380000568
NHL Cyclophosphamide + Doxorubicin + Prednsiolone
MEDICAL ONCOLOGY
MO0000339CT for BrainMO00003390000569
Tumor/ CA Brain TemozolamideTemozolomide 150 - 200 mg/m2 D1-D5 every 28 days
MEDICAL ONCOLOGY
MO0000340CT for Burkitt's
MO00003400000570
NHL Codox - M - IVAC- cyclophosphamide, vincris ne, doxorubicin, high-dose
MEDICAL ONCOLOGY
MO0000341CT for CA Brain
MO00003410000571 TemozolamideTemozolomide 75mg/m2 once daily
MEDICAL ONCOLOGY
MO0000342CT for CA Breast
MO00003420000572 Cyclophosphamide + Doxorubicin every 21 days
MEDICAL ONCOLOGY
MO00003420000573 Docetaxel + CyclophosphamideDocetaxel 75mg/m2 D1
MEDICAL ONCOLOGY
MO00003420000574 FulvestrantFulvestrant 500 mg D1 D15 D28 then every 28 days
MEDICAL ONCOLOGY
MO00003420000575 TamoxifenTamoxifem 20 mg orally daily
MEDICAL ONCOLOGY
MO00003420000576 TrastuzumabTrastuzumab 8 mg/Kg in Cycle 1 D1
MEDICAL ONCOLOGY
MO00003430000577
/ Esophagus/ StomachWeekly Paclitaxel for Paclitaxel 80mg/m2 every week ( Max 12 weeks )
MEDICAL ONCOLOGY
MO0000344CT for CA Breast/
MO00003440000578
Head & Neck/ Colorectal/
CapecitabineCapecitabine
Esophagus/ Stoamch/- 1000mg/m2
Gall bladder/
orally
pancreas/
twice daily
cholangiocarcino
D1-D14 every
MEDICAL ONCOLOGY
MO0000345CT for CA Breast/
MO00003450000579
Lung/Ovary/ HeadPaclitaxelPaclitaxel
& Neck/ Esophagus/Stomach
175 mg/m2 D1 every 21 days Maximum 6 cycles
MEDICAL ONCOLOGY
MO0000346CT for CA Breast/Head
MO00003460000580
& Neck/ Ovary/
Cispla
Endometrium/
n/ CarboplaCervix/
n + Paclitaxel
Vulvar//Paclitaxel
Urinary Bladder/
+ Carbopla
Anal nCancer
every 21 days
MEDICAL ONCOLOGY
MO0000347CT for CA Breast-Letrozole-Duration
MO00003470000581 CT + Cycle
for CA Breast-Letrozole-Duration + Cycle
MEDICAL ONCOLOGY
MO0000348CT for CA Head
MO00003480000582
& Neck Carbopla n + GemcitabineGemcitabine 1000 mg/m2 D1 D8
MEDICAL ONCOLOGY
MO00003480000583
& Neck Docetaxel + Cispla n + 5 FUDocetaxel 75 mg/m2 D1
MEDICAL ONCOLOGY
MO00003490000584
& Neck/ Cervix/ Esophagus/
CarboplaVulva
n/ Cispla n every week
MEDICAL ONCOLOGY
MO00003500000585
& Neck-Docetaxel-Duration
CT for CA+ Head
Cycle & Neck-Docetaxel-Duration + Cycle
MEDICAL ONCOLOGY
MO0000351CT for CA Lung
MO00003510000586 Docetaxel/ PaclitaxelDocetaxel 75 mg/m2 D1 every 21 days
MEDICAL ONCOLOGY
MO00003510000587 GefitnibGefi nib 250 mg once daily
MEDICAL ONCOLOGY
MO00003510000588 Gemcitabine + Carbopla nGemcitabine 1000 mg/m2 D1 D8
MEDICAL ONCOLOGY
MO00003510000589 Pemetrexed + Carbopla nPemetrexed 500mg/m2 D1
MEDICAL ONCOLOGY
MO00003510000590 PemetrexedPemetrexed 500mg/m2 D1 every 21 days
MEDICAL ONCOLOGY
MO0000352CT for CA Lung/
MO00003520000591
metastatic Neuroendocrien
Etoposidecarcinoma
+ Carbopla(prostate/
n/ CisplaLung/
nEtoposide
GIT) 100mg/m2 D1 - D3
MEDICAL ONCOLOGY
MO0000353CT for CA Lung-Paclitaxel
MO00003530000592
+ Carboplatin-Duration
CT for CA Lung-Paclitaxel
+ Cycle + Carboplatin-Duration + Cycle
MEDICAL ONCOLOGY
MO0000353CT for CA Lung-Paclitaxel
MO00003530000593
CT for CA Lung-Paclitaxel
+ Cycle + Carboplatin-Duration + Cycle
MEDICAL ONCOLOGY
MO0000354CT for CA Ovary
MO00003540000594 Carbopla n/ GemcitabineGemcitabine - 1000mg/m2 D1 D8
MEDICAL ONCOLOGY
MO00003540000595 Lipodox + Carbopla nLipopdox 30 mg/m2 D1
MEDICAL ONCOLOGY
MO00003540000596 LipodoxLipodox 40 mg/m2 IV every 28 days Maximum 6 cycles
MEDICAL ONCOLOGY
MO0000355CT for CA Ovary-Carboplatin
MO00003550000597 + Paclitaxel-Cycle
CT for CA Ovary-Carboplatin + Paclitaxel-Cycle
MEDICAL ONCOLOGY
MO0000356CT for CA Ovary-Cisplatin
MO00003560000598
+ Irinotecan-Cycle
CT for CA Ovary-Cisplatin + Irinotecan-Cycle
MEDICAL ONCOLOGY
MO0000357CT for CA Ovary-Etoposide-Duration
MO00003570000599 CT + Cycle
for CA Ovary-Etoposide-Duration + Cycle
MEDICAL ONCOLOGY
MO0000358CT for CA Ovary-Irinotecan-Cycle
MO00003580000600 CT for CA Ovary-Irinotecan-Cycle
MEDICAL ONCOLOGY
MO0000359CT for CA Penis
MO00003590000601 CapecitabineCapecitabine 1000-1250 mg/m2 PO twice daily D1 -D14 eve
MEDICAL ONCOLOGY
MO0000360CT for CA Penis-Cisplatin
MO00003600000602
+ Paclitaxel-Cycle
CT for CA Penis-Cisplatin + Paclitaxel-Cycle
MEDICAL ONCOLOGY
MO0000361CT for CA Penis-Paclitaxel
MO00003610000603+ Carboplatin-Cycle
CT for CA Penis-Paclitaxel + Carboplatin-Cycle
MEDICAL ONCOLOGY
MO0000362CT for CA Penis-Paclitaxel-Duration
MO00003620000604 CT + Cycle
for CA Penis-Paclitaxel-Duration + Cycle
MEDICAL ONCOLOGY
MO0000363CT for CA Prostate
MO00003630000607 Etoposide + Carbopla nEtoposide 100mg/m2 D1 - D3
MEDICAL ONCOLOGY
MO00003630000606 DocetaxelDocetaxel 75 mg/m2 D1 every 21 days
MEDICAL ONCOLOGY
MO00003630000605 Abiraterone 1000 mg + Prednisolone 10mg daily
MEDICAL ONCOLOGY
MO00003630000608 LHRH AgonistLeuprolide 22.5 ug every 3 months
MEDICAL ONCOLOGY
MO0000364CT for CD 20MO00003640000609
Lymphoma B Cell NHLRituximabRituximab
/ ITP / AIHA 375mg/m2 Maximum 6 cycles as per protocol
MEDICAL ONCOLOGY
MO0000365CT for Cervical
MO00003650000610
/Vulvar Cancer Cispla n/ Carbopla nCispla n 40 mg/m2 every week maximum 6 cycles
MEDICAL ONCOLOGY
MO0000366CT for Chronic
MO00003660000611
Lymphocytic Leukemia Fludarabine + CyclophosphamideFludarabine 25mg/m2 D1-3
MEDICAL ONCOLOGY
MO00003670000612
Lymphocytic Leukemia-Lenalidomide-Duration
CT for Chronic Lymphocytic+ Leukemia-Lenalidomide-Duration
Cycle + Cycle
MEDICAL ONCOLOGY
MO00003680000613
Lymphocytic Leukemia-Rituxmab
CT for Chronic+ Lymphocytic
Chlorambucil-Cycle
Leukemia-Rituxmab + Chlorambucil-Cycle
MEDICAL ONCOLOGY
MO00003690000614
Myeloid Leukemia/ Ph Ima+venibIma
ALL nib 400 mg, 600 mg, 800 mg(per month X 5 years)
MEDICAL ONCOLOGY
MO00003700000615
Myeloid Leukemia/ Ph+Ve
Dasatinib
ALL/ AML (Both adult and Paediatric)
MEDICAL ONCOLOGY
MO0000371CT for Colorectal
MO00003710000616
Cancer 5 FU + Leucovorin + Oxalipla n5 FU 1200mg/m2 D1 D2
MEDICAL ONCOLOGY
MO00003710000617
Cancer 5FU + Leucovorin + Irinotecan5 FU 1200mg/m2 D1 D2
MEDICAL ONCOLOGY
MO00003710000618
Cancer 5FU + Leucovorin + Oxalipla n + Irinotecan5 FU 1200mg/m2 D1 D2
MEDICAL ONCOLOGY
MO00003710000619
Cancer Capecitabine + IrinotecanCapecitabine 1000mg/m2 D1-D14
MEDICAL ONCOLOGY
MO00003710000620
Cancer Capecitabine along with RTCapecitabine 825 mg/m2 twice daily
MEDICAL ONCOLOGY
MO00003720000621
Cancer/ Esophagus/ Capecitabine
Gastric/ Gall+ Oxalipla
Bladder/ nCapecitabine
Pancreas/ Cholangiocarcinoma
1000mg/m2 D1-D14
MEDICAL ONCOLOGY
MO00003730000622
Cancer-5 FU + Leucovorin-Cycle
CT for Colorectal Cancer-5 FU + Leucovorin-Cycle
MEDICAL ONCOLOGY
MO00003740000623
Cancer-CapecitabineCT for Colorectal Cancer-Capecitabine
MEDICAL ONCOLOGY
MO00003750000624
Cancer-Folfirinox-Cycle
CT for Colorectal Cancer-Folfirinox-Cycle
MEDICAL ONCOLOGY
MO0000376CT for Endometrial
MO00003760000625
Cancer Carbopla n + GemcitabineGemcitabine - 1000mg/m2 D1 D8
MEDICAL ONCOLOGY
MO00003760000626
Cancer Cispla n + DoxorubicinDoxorubicin 60 mg/m2 D1
MEDICAL ONCOLOGY
MO00003760000627
Cancer Lipodox + Carbopla nLipopdox 30 mg/m2 D1
MEDICAL ONCOLOGY
MO00003770000628
Cancer-Carboplatin
CT for
+ Paclitaxel-Cycle
Endometrial Cancer-Carboplatin + Paclitaxel-Cycle
MEDICAL ONCOLOGY
MO0000378CT for Esophageal
MO00003780000629
/ Stomach CancerCispla n + DocetaxelDocetaxel 40mg/m2 D1Cispla n 40 mg/m2 D1
MEDICAL ONCOLOGY
MO00003780000630
/ Stomach CancerDocetaxel + Oxalipla n + 5 FUDocetaxel 50mg/m2 D1
MEDICAL ONCOLOGY
MO00003780000631
/ Stomach CancerDocetaxel + Oxalipla n + CapecitabineDocetaxel 50mg/m2 D1
MEDICAL ONCOLOGY
MO00003790000632
/ Stomach Cancer-Capecitabine-Cycle
CT for Esophageal / Stomach Cancer-Capecitabine-Cycle
MEDICAL ONCOLOGY
MO00003800000633
/ Stomach Cancer-CAPOX-Cycle
CT for Esophageal / Stomach Cancer-CAPOX-Cycle
MEDICAL ONCOLOGY
MO00003810000634
/ Stomach Cancer-Cisplatin
CT for Esophageal
+ Docetaxel-Duration
/ Stomach Cancer-Cisplatin
+ Cycle + Docetaxel-Duration + Cy
MEDICAL ONCOLOGY
MO00003820000635
/ Stomach Cancer-Folfox-Cycle
CT for Esophageal / Stomach Cancer-Folfox-Cycle
MEDICAL ONCOLOGY
MO00003830000636
Cancer Cispla n + 5 FUCispla n 75mg/m2 D1 D295FU 1000mg/m2 D1-D4 D29 D
MEDICAL ONCOLOGY
MO00003840000637
Cancer-CarboplatinCT +for
Paclitaxel-Duration
Esophageal Cancer-Carboplatin
+ Cycle + Paclitaxel-Duration + Cycle
MEDICAL ONCOLOGY
MO00003850000638
Cancer-Paclitaxel CT
+ Carbopla
for Esophageal
n for defini
Cancer-Paclitaxel
ve Non - metasta
+ Carbopla
c n for defini ve Non - me
MEDICAL ONCOLOGY
MO0000386CT for EwingMO00003860000639
Sarcoma Vincris ne + Adriamycin + Cyclophosphamide
MEDICAL ONCOLOGY
MO0000386CT for EwingMO00003860000640
Sarcoma Vincris ne + Topotecan + Cyclophosphamide + Irinotecan + Temozolamid
MEDICAL ONCOLOGY
MO0000387CT for EwingMO00003870000641
Sarcoma-EFT 2001 CT for Ewing Sarcoma-EFT 2001
MEDICAL ONCOLOGY
MO0000388CT for Gall Bladder
MO00003880000642
Cancer / Cholangiocarcinoma
Cispla n + GemcitabineGemcitabine 1000 mg/m2 D1 D8
MEDICAL ONCOLOGY
MO00003880000643
GemcitabineGemcitabine 1000mg /m2 D1 D8 every 21 days
MEDICAL ONCOLOGY
MO00003880000644
Oxalipla n + GemcitabineGemcitabine 1000 mg/m2 D1
MEDICAL ONCOLOGY
MO00003890000645
Cancer / Cholangiocarcinoma-Gemcitabine-Duration
CT for Gall Bladder Cancer / Cholangiocarcinoma-Gemcitabine-Duration
+ Cycle
MEDICAL ONCOLOGY
MO0000390CT for Gastointestinal
MO00003900000646
stromal tumor Suni nibSuni nb 37.5 mg once daily
MEDICAL ONCOLOGY
MO0000391CT for GermMO00003910000647
Cell Tumor Etoposide + Cispla nCispla n 20 mg/m2 IV D1-D5
MEDICAL ONCOLOGY
MO0000391CT for GermMO00003910000648
Cell Tumor Paclitaxel + Ifosfamide + Cispla nPaclitaxel 240 mg/m2 D1
MEDICAL ONCOLOGY
MO0000391CT for GermMO00003910000649
Cell Tumor Vinblas n + Ifosfamide + Cispla nVinblas ne 0.11 mg/kg IV D1-D2
MEDICAL ONCOLOGY
MO0000392CT for GermMO00003920000650
Cell Tumor (Ovary/ testis/
Bleomycin
Mediastinal)
+ Etoposide + Cispla nBleomycin 30 units D1 D8 D15
MEDICAL ONCOLOGY
MO0000393CT for GermMO00003930000651
Cell Tumor-CarboplatinCT (AUC
for Germ
7)-Cycle
Cell Tumor-Carboplatin (AUC 7)-Cycle
MEDICAL ONCOLOGY
MO0000394CT for Gestational
MO00003940000652
Trophoblastic Neoplasia
Etoposide + Methotrexate + Dac nomycin + Cispla n
MEDICAL ONCOLOGY
MO00003940000653
Etoposide + Methotrexate + Dac nomycin- Cyclophosphamide + Vincris
MEDICAL ONCOLOGY
MO00003940000654
MethotrexateMethotrexate 1/mg/kg IM every other day x 4 days D1 3 D
MEDICAL ONCOLOGY
MO00003950000655
Trophoblastic Neoplasia-EMA
CT for Gestational
- EP-Cycle
Trophoblastic Neoplasia-EMA - EP-Cycle
MEDICAL ONCOLOGY
MO00003960000656
Trophoblastic Neoplasia-Methotrexate-Duration
CT for Gestational Trophoblastic+Neoplasia-Methotrexate-Duration
Cycle + Cyc
MEDICAL ONCOLOGY
MO0000397CT for Hepatocellular
MO00003970000657
Carcinoma Lenvatinib 4- 12 mg daily
MEDICAL ONCOLOGY
MO0000397CT for Hepatocellular
MO00003970000658
Carcinoma SorafenibSorafenib 400mg PO twice daily
MEDICAL ONCOLOGY
MO0000398CT for High MO00003980000659
- Grade NHL - B Cell DHAP Dexamethasone + High Dose Cytarabine + Cispla n
MEDICAL ONCOLOGY
MO0000399CT for High MO00003990000660
- Grade NHL - B Cell-Rituxmab
CT for High
+ Dexamethasone
- Grade NHL - +B Cell-Rituxmab + Dexamethasone +
MEDICAL ONCOLOGY
MO0000400CT for Hodgkin's
MO00004000000662
Lymphoma AEVDAdriamycin 25mg/m2Vinblas ne 6mg/m2
MEDICAL ONCOLOGY
MO00004000000661
Lymphoma ABVD Adriamycin 25mg/m2Bleomycin 10unit/m2
MEDICAL ONCOLOGY
MO00004000000663
Lymphoma COPPCyclophosphamide 650mg/m2 D1, 8Vincris ne 1.4mg/m2 D1, 8
MEDICAL ONCOLOGY
MO0000401CT for Langerhans
MO00004010000664
Cell Histiocytosis Langerhans
(Maintenance Cell His ocytosis(His ocytosis Protocol - Maintenance) each
MEDICAL ONCOLOGY
MO0000402CT for Langerhans
MO00004020000665
Cell Histiocytosis Langerhans
Induction Cell His ocytosis(His ocytosis Protocol - Induc on) Maximu
MEDICAL ONCOLOGY
MO0000403CT for Low Grade
MO00004030000666
B - Cell NHL Bendamus ne + RituximabBendamus ne 90mg/m2 on day 1, 2
MEDICAL ONCOLOGY
MO00004040000667
B - Cell NHL-Lenalidomide
CT for Low+ Rituximab-Cycle
Grade B - Cell NHL-Lenalidomide + Rituximab-Cycle
MEDICAL ONCOLOGY
MO00004050000668
Glioma Vincris ne + Carbopla nVincris ne 1.5mg/m2 (day 1, 8 and 15 for first 4
MEDICAL ONCOLOGY
MO00004060000669
NHL Rituximab-Cycle CT for Low Grade NHL / ITP / AIHA -Rituximab-Cycle
MEDICAL ONCOLOGY
MO0000407CT for Low grade
MO00004070000670
NHL/ Chronic Lymphocytic
ChlorambucilChlorambucil
Leukemia Prednisolone Repeat every 28 days for 12 cyc
MEDICAL ONCOLOGY
MO0000408CT for Lymphoblastic
MO00004080000671
Lymphoma Berlin- Frankfurt -Munster-90Berlin- Frankfurt -Munster- 95
MEDICAL ONCOLOGY
MO0000409CT for Medulloblastoma
MO00004090000672 / Brain PNET-PACKER-Cycle
CT for Medulloblastoma / Brain PNET-PACKER-Cycle
MEDICAL ONCOLOGY
MO0000410CT for Medulloblastoma
MO00004100000673/ CNS PNETCispla n + Cyclophosphamide + Vincris ne + etoposide
MEDICAL ONCOLOGY
MO0000411CT for Mesothelioma
MO00004110000674 Pemetrexed + Cispla n/ Carbopla nPemetrexed 500mg/m2 D1
MEDICAL ONCOLOGY
MO0000412CT for Metastatic
MO00004120000675
bone malignancy Zoledronic
and multiple AcidZoledronic
myeloma acid 4 mg IV Monthly
MEDICAL ONCOLOGY
MO00004130000676
Melanoma Dacarbazine + Cispla nDacarbazine 250mg/m2 D1-D5
MEDICAL ONCOLOGY
MO00004130000677
Melanoma Tab Imatinib 400/600/800 mg daily
MEDICAL ONCOLOGY
MO0000414CT for MM MO00004140000679
/ Amyloidosis Bortezomib + Lenalidomide + Dexamethasone
MEDICAL ONCOLOGY
MO0000414CT for MM MO00004140000678
/ Amyloidosis Bortezomib + Cyclophosphamide + Dexamethasone
MEDICAL ONCOLOGY
MO0000414CT for MM MO00004140000680
/ Amyloidosis Bortezomib + Thalidomide + Dexamethasone
MEDICAL ONCOLOGY
MO0000414CT for MM MO00004140000682
/ Amyloidosis Melphalan + Thalidomide + PrednisoloneMelphalan 9mg/m2 D1-D4
MEDICAL ONCOLOGY
MO0000414CT for MM MO00004140000681
/ Amyloidosis Cyclophosphamide + Thalidomide + Dexamethasone
MEDICAL ONCOLOGY
MO0000415CT for MM MO00004150000683
/ Amyloidosis / POEMS Lenalidomide + DexamethasoneLenalidomide 25 mg daily Day1-21
MEDICAL ONCOLOGY
MO0000415CT for MM MO00004150000684
/ Amyloidosis / POEMS Pomalidomide + DexamethasonePomalidomide 4 mg daily Day 1-21
MEDICAL ONCOLOGY
MO0000416CT for MM MO00004160000685
/ Amyloidosis-VMP-Duration CT for+ MM
Cycle/ Amyloidosis-VMP-Duration + Cycle
MEDICAL ONCOLOGY
MO0000417CT for Myeloproliferative
MO00004170000686 NeoplasmHydroxureaHydroxurea daily(Dose will be based on blood counts)
MEDICAL ONCOLOGY
MO0000418CT for Neuroblastoma
MO00004180000687 13-cis re noic acid 160mg/m2 per day for 2 weeks
MEDICAL ONCOLOGY
MO00004180000688 Cabropla n + Etoposide + Cyclophosphamide + Doxorubicin
MEDICAL ONCOLOGY
MO00004190000689 (Low / Intermediate
Carboplatin Risk)
or Cisplatin + Cyclophosphamide + Vincristine + Etoposide +
MEDICAL ONCOLOGY
MO0000420CT for NHL MO00004200000690 Cyclophosphamide + Vincris ne + Prednisolone
MEDICAL ONCOLOGY
MO0000421CT for NK - MO00004210000691
T Cell Lymphoma GELOXGemcitabine 1000mg/m2 D1 and D8Oxalipla n 130mg/m2 D1
MEDICAL ONCOLOGY
MO0000422CT for Osteogenic
MO00004220000692
Sarcoma Doxorubicin + Cispla nCispla n 100mg/m2Doxorubicin 75mg/m2 given
MEDICAL ONCOLOGY
MO00004220000693
Sarcoma High dose Methotrexate Osteogenic Sarcoma
MEDICAL ONCOLOGY
MO00004220000694
Sarcoma OGS - 12Ifosfamide 1800 mg/m2 D1-D5Mesna 600mg/m2 0h 3h 6h 9h D
MEDICAL ONCOLOGY
MO00004230000695
Sarcoma-MethotrexateCT for Osteogenic
+ DoxorubicinSarcoma-Methotrexate
+ Cisplatin for Relapsed
+ Doxorubicin
Osteogenic +Sarcoma-Durat
Cisplatin for R
MEDICAL ONCOLOGY
MO00004240000696
Sarcoma-OGS - 12-Cycle
CT for Osteogenic Sarcoma-OGS - 12-Cycle
MEDICAL ONCOLOGY
MO0000425CT for Paediatric
MO00004250000697
Acute Lymphoblastic 6 - Leukemia
Mercaptopurine 75mg/m2 dailyMethotrexate 20mg/m2 weekly
MEDICAL ONCOLOGY
MO00004250000698
Acute Lymphoblastic Consolida
Leukemia on (Phase II, CNS Therapy Reinduc on) Maximum 6 months
MEDICAL ONCOLOGY
MO00004260000699
Acute Myeloid Leukemia
Cytrabine
(Consolidation)
3 gram/m2 twice a dayDays 1, 3 and 5 (Maximum 4 cycles )
MEDICAL ONCOLOGY
MO00004270000700
Acute Myeloid Leukemia
Cytrabine
(Induction)
200mg/m2/day days 1-10 and Daunorubicin 50mg/m2 days 1,
MEDICAL ONCOLOGY
MO00004280000701
Acute Promyelocytic Arsenic
Leukemia
trioxideATRADaunomycin or Idarubcin
MEDICAL ONCOLOGY
MO00004280000702
Acute Promyelocytic Induc
Leukemia
on Arsenic trioxide ATRADaunomycin or Idarubcin- mul agent - v
MEDICAL ONCOLOGY
MO00004290000703
Hepatoblastoma Carboplatin + Cisplatin + Doxorubicin Max 8 cycles
MEDICAL ONCOLOGY
MO00004290000704
Hepatoblastoma Cisplatin max 4 cycles
MEDICAL ONCOLOGY
MO00004300000705
Hodgkins Lymphoma Oncovin,Etoposide,Prednisone,doxorubicin hydrochloride (Maximum 8 c
MEDICAL ONCOLOGY
MO00004310000706
Hodgkins Lymphoma ifosfamide,
Relapse carboplatin, etoposide (Maximum 4 cycles)
MEDICAL ONCOLOGY
MO00004310000707
Hodgkins Lymphoma IGEV:
Relapse
Ifosfamide, Gemcitabine, Etoposide) Other salvage regimens can b
MEDICAL ONCOLOGY
MO00004320000708
Non Hodgkins Lymphoma
FAB LMB 89/96 Maintenance
MEDICAL ONCOLOGY
MO00004320000709
Non Hodgkins Lymphoma
Mitroxantrone,Chlorambucil,Prednisolone: 842
MEDICAL ONCOLOGY
MO0000433CT for Panceratic
MO00004330000710
Cancer Gemcitabine + NanopaclitaxelGemcitabine 1000mg/m2 D1 D8 D15
MEDICAL ONCOLOGY
MO00004330000711
Cancer GemcitabineGemcitabine 1000mg /m2 D1 D8 every 21 days maximum 6
MEDICAL ONCOLOGY
MO00004340000712
Cancer-Capecitabine-Cycle
CT for Panceratic Cancer-Capecitabine-Cycle
MEDICAL ONCOLOGY
MO00004350000713
Cancer-Folfirinox-Cycle
CT for Panceratic Cancer-Folfirinox-Cycle
MEDICAL ONCOLOGY
MO0000436CT for Pediatric
MO00004360000714
Hodgkins Lymphoma CTRelapse-DECA-Cycle
for Pediatric Hodgkins Lymphoma Relapse-DECA-Cycle
MEDICAL ONCOLOGY
MO0000437CT for Pediatric
MO00004370000715
Hodgkins Lymphoma-COPDAC-Cycle
CT for Pediatric Hodgkins Lymphoma-COPDAC-Cycle
MEDICAL ONCOLOGY
MO0000438CT for Peripheral
MO00004380000716
T - Cell LymphomaCHOEPCyclophosphamide 750mg/m2 D1Vincris ne 1.4mg/m2 D1
MEDICAL ONCOLOGY
MO00004390000717
T - Cell Lymphoma-CHOP-Cycle
CT for Peripheral T - Cell Lymphoma-CHOP-Cycle
MEDICAL ONCOLOGY
MO00004400000718
T - Cell Lymphoma-SMILE-Cycle
CT for Peripheral T - Cell Lymphoma-SMILE-Cycle
MEDICAL ONCOLOGY
MO0000441CT for PMBCLMO00004410000719
/ Burki 's LymphomaEtoposide
/ Seroposi+ vePrednsiolone + Vincris ne + Cyclophosphamide + Doxorubic
MEDICAL ONCOLOGY
MO0000442CT for PMBCLMO00004420000720
/ Burki 's LymphomaCT / Seroposi
for PMBCL ve/ Burki 's Lymphoma / Seroposi ve
MEDICAL ONCOLOGY
MO0000443CT for primary
MO00004430000721
CNS lymphoma De-Angelis/Methotrexate
MEDICAL ONCOLOGY
MO0000444CT for relapse
MO00004440000722
Neuroblastoma Topotecan + Cyclophosphamide
MEDICAL ONCOLOGY
MO0000445CT for Relapsed
MO00004450000723
B - Cell NHL - High Grade
ICE - RRituximab 375mg/m2Ifosfamide 1.66g/m2 on day 1 - 3
MEDICAL ONCOLOGY
MO00004460000724
Hodgkin Lymphoma-MINE-Cycle
CT for Relapsed Hodgkin Lymphoma-MINE-Cycle
MEDICAL ONCOLOGY
MO00004470000725
Hodgkin Lymphoma-PTCLCT for Relapsed
- GDP-CycleHodgkin Lymphoma-PTCL - GDP-Cycle
MEDICAL ONCOLOGY
MO00004480000726
Hodgkins/ Non HogkinsICEIfosfamide
lymphoma1.66g/m2 on day 1 - 3Mesna 1.66g/m2 day 1 - 3
MEDICAL ONCOLOGY
MO00004490000727
NHL & HL-DHAP-Cycle CT for Relapsed NHL & HL-DHAP-Cycle
MEDICAL ONCOLOGY
MO0000450CT for RenalMO00004500000728
Cell Cancer Cabozan nib 60 mg od x 1 monthevery 4 weeks
MEDICAL ONCOLOGY
MO0000450CT for RenalMO00004500000729
Cell Cancer Suni nib50 mg once daily 4 weeks on 2 weeks off
MEDICAL ONCOLOGY
MO0000451CT for Retinoblastoma
MO00004510000730 Vincris ne + Carbopla n + EtoposideCarbopla n 600mg/m2 day 1
MEDICAL ONCOLOGY
MO0000452CT for Rhabdomyosarcoma
MO00004520000731 Vincris ne + Cyclophosphamide + Dac nomycin
MEDICAL ONCOLOGY
MO0000452CT for Rhabdomyosarcoma
MO00004520000732 Vincris ne + Ifosfamide + EtoposideVincris ne 1.5mg/m2 (days 1, 8 and
MEDICAL ONCOLOGY
MO0000453CT for Soft Tissue
MO00004530000733
Sarcoma ifosfamide + AdriamycinDoxorubicin 30mg/m2 D1 D2
MEDICAL ONCOLOGY
MO0000454CT for Soft Tissue
MO00004540000734
Sarcoma/ Ewing Sracoma
Gemcitabine + DocetaxelGemcitabine 900 mg/m2 D1 D8
MEDICAL ONCOLOGY
MO0000455CT for Thymic
MO00004550000735
Carcinoma Cispla n + Adriamycin + CyclophosphamideCispla n 50 mg/m2 D1
MEDICAL ONCOLOGY
MO0000455CT for Thymic
MO00004550000736
Carcinoma Cispla n + EtoposideEtoposide 100mg/m2 D1 - D3
MEDICAL ONCOLOGY
MO0000456CT for Ureter
MO00004560000737
/ Bladder / Urethra Carbopla n/ Cispla n + GemcitabineGemcitabine 1000 mg/m2 D1 D8
MEDICAL ONCOLOGY
MO00004570000738
/ Bladder / Urethra-Methotrexate
CT for Ureter+/Vinblastin
Bladder / +Urethra-Methotrexate
Doxorubicin + Cisplatin-Cycle
+ Vinblastin + Doxorubic
MEDICAL ONCOLOGY
MO00004580000739
/ Bladder / Urethra-Paclitaxel
CT for Ureter
/ Bladder / Urethra-Paclitaxel
+ Cycle + Carboplatin-Duration + Cyc
MEDICAL ONCOLOGY
MO0000459CT for WilmsMO00004590000740
Tumor Cyclophosphamide + Doxorubicin + Etoposide + Vincris ne + Carbopla n
MEDICAL ONCOLOGY
MO0000459CT for WilmsMO00004590000741
Tumor Vincristine + Actinomycin D
MEDICAL ONCOLOGY
MO0000459CT for WilmsMO00004590000742
Tumor Vincris ne + Ac nomycin D + DoxorubicinVincris ne 1.5 mg/m2 weekly
MEDICAL ONCOLOGY
MO0000460CT InductionMO00004600000743
for Paediatric Non Hodgkins
FAB LMB Lymphoma
89/96 protcol (2 cycles) Each cycle Duration- 4 weeks
MEDICAL ONCOLOGY
MO000050Advanced /MO0000500000542
high end investigations Advanced
in oncology / high end investigations in oncology
MEDICAL ONCOLOGY
MO0000653Febrile Neutopenia
MO00006530000744 Cefoperazone + SulbactumPiperalicillin + Tazobactum
MEDICAL ONCOLOGY
MO0000654Febrile Neutopenia
MO00006540000745
High Risk MeropenemImipenemColis nTigecyclinLinezolid
MEDICAL ONCOLOGY
MO0000703GCT Testis /MO00007030000746
Ovary SA Carboplatin every 3 weeks
MEDICAL ONCOLOGY
MO0000704GEP NET Neuroendocrine
MO00007040000747 carcinomaTemozolamide 150mg/m2 D9-14 + Capecitabine 1gm/me D1-14 every 2
MEDICAL ONCOLOGY
MO0000716GranulocyteMO00007160000748
Colony Stimulating Factor5 microgram
Use / kg / day(max 300 microgram per day) for 7 days or
MEDICAL ONCOLOGY
MO0000717GranulocyteMO00007170000749
Colony Stimulating FactorGranulocyte
Use-CycleColony Stimulating Factor Use-Cycle
MEDICAL ONCOLOGY
MO000083APML- HIGHMO0000830000543
RISK -CONSOLIDATIONAPML- X8 CYCLES-High
HIGH RISKRisk
-CONSOLIDATION
Consolidation X8 CYCLES-High Risk Consolidation
MEDICAL ONCOLOGY
MO0000838IntravesicalMO00008380000750
BCG / Mitomycin Intravesical BCG / Mitomycin - Induction cycles (PC) for max. 06 Doses
MEDICAL ONCOLOGY
MO0000850Irradiation MO00008500000751
of blood products (RDP,PRC,SDP)
Irradiation of blood products (RDP,PRC,SDP) - Add on
MEDICAL ONCOLOGY
MO000089Aromatase MO0000890000544
inhibitor LetrozoleLetrozole 2.5 mg orally daily
MEDICAL ONCOLOGY
MO0000902Malignant Pleural
MO00009020000752
Effusion for Pleural
Pleural
tap with
effusion
Pig tail
& Pleurodesis
catheter/chest tube insertion with Pleurodesis in adv
PALLIATIVEMP00001079
MEDICINE Palliative and
MP0000107900001347
Palliative disease
care endatstageadvanced
disease
or end stage
PALLIATIVEMP0000202
MEDICINE Central linesMP000020200001346
in cancer patients for drugLongtherapy
term indwelling
-Silicon catheters
venous catheter
in advanced cancer patients- Long term c
NEO - NATAL
NC0000118Basic
CARE neonatal
NC00001180000787
care and screening A. package
Neonates 1800-2500g requiring closer monitoring or short-term care
NEO - NATAL
NC0000123BERA
CARE NC00001230000788 Brainstem Evoked Response Audiometry(BERA)
NEO - NATAL
NC00001299
CARE ROP screening NC000012990000796 ROP screening
NEO - NATAL
NC00001354
CARE Special Neonatal
NC000013540000797
Care Package Neonates with birthweight 1500 g to 1800 g or any weight with mild illn
NEO - NATAL
NC00001539
CARE Ventriculoperitoneal
NC000015390000798
Shunt Surgery Ventriculoperitoneal
(VP) or Omaya Reservoir ShuntorSurgery
External(VP)
Drainage
or Omaya
for Hydrocephalus
Reservoir or External
NEO - NATAL
NC0000226Chronic
CARE Care
NC00002260000789
Package: If the baby requires
Neonates stay
in beyond
Special Neonatal
the upperCare,
limit Special
of usualNeonatal
stay in Package
Care-Plus,
no MN004A
Intensive
NEO - NATAL
NC0000311Cranial
CARE USGNC00003110000790
- Add on Cranial USG - Add on only allow with pkgs of Advanced Neonatal Care Pa
NEO - NATAL
NC0000314Critical
CARE CareNC00003140000791
Neonatal Package Neonates <750 g or any weight with at least one of the following condi
NEO - NATAL
NC000049
CARE Advance screening
NC0000490000784
package - One type
Advance
only screening
and Govt Reserve
package ( Can be book only After neonatal screening
NEO - NATAL
NC0000526Echo
CARE - AddNC00005260000792
on Echo - Add on only allow with pkgs of Advanced Neonatal Care Package
NEO - NATAL
NC000057
CARE Advanced Neonatal
NC0000570000785
Care Package Neonates between 750 g to 1000 gm or any weight and at least one of t
NEO - NATAL
NC000058
CARE Advanced Surgery
NC0000580000786
for Retinopathy of Advanced
Prematurity
Surgery for Re nopathyof Prematurity
NEO - NATAL
NC0000820Intensive
CARE Neonatal
NC00008200000793
Care Package Babies of 1000-1499 g birthweight or any weight with at least one of the
NEO - NATAL
NC0000869Laser
CARE Therapy
NC00008690000794
for Retinopathy of Prematurity
Laser Therapy(Irrespective
for Re nopathy
of no. of
of eyes
Prematurity
affected)-Neo
- per- natal
session
NEO - NATAL
NC0000979neonatal
CARE screening
NC00009790000795
- Add on and dayNeonates
care > 2.5 kg nursed with mother : Includes clinical monitoring, bre
NEPHROLOGYNE00001077
Palliative and
NE000010770000805
Palliative disease
care endatstageadvanced
disease
or end stage
NEPHROLOGYNE00001155
Peritoneal Dialysis
NE000011550000806 Peritoneal Dialysis
NEPHROLOGYNE0000198Central LineNE00001980000801
( Double Lumen / TripleCentralLumenLine
NEPHROLOGYNE000027 Acute glomerulonephritis
NE0000270000799 Acute glomerulonephritis
NEPHROLOGYNE0000294ContinuousNE00002940000802
NEPHROLOGYNE000060 AKI / Renal NE0000600000800
NEPHROLOGYNE0000725HaemodialysisNE00007250000803
NEPHROLOGYNE0000999NEPHROTICNE00009990000804
NEUROSURGERY
NS00001001
Nerve Biopsy NS000010010000875
excluding Hensens Nerve Biopsy excluding Hansen's
NEUROSURGERY
NS00001003
Nerve root NS000010030000876
NEUROSURGERY
NS00001006
Nerve Transposition
NS000010060000877
/ Release / Neurolysis
Nerve Transposition/ Nerve Release/ Nerve Neurolysis/Nerve repair sur
NEUROSURGERY
NS00001090
Palliative nerurosurgical
NS000010900000878 interventions
Palliative
for secondary
neurological
vertebral
interventions
and brain metastasis
NEUROSURGERY
NS0000111AVM EMBOLISATION
NS00001110000835 AVM EMBOLISATION/ THROMBECTOMY
NEUROSURGERY
NS00001151
Peripheral Nerve
NS000011510000879
Surgery Peripheral nerve excision and repair
NEUROSURGERY
NS00001153
Peripheral Neurectomy
NS000011530000880 Peripheral Neurectomy - Govt Reserve
NEUROSURGERY
NS00001175
Plexus injuryNS000011750000881
along with Vascular injury Plexus
repair
injury
/ graft
along with Vascular injury graft
NEUROSURGERY
NS00001196
Posterior Cervical
NS000011960000882
laminoforaminotomyPosterior
and discectomy
cervical laminoforaminotomy
without implant and discectomy- Govt Reserve
NEUROSURGERY
NS00001197
Posterior Cervical
NS000011970000883
Fusion with implantPosterior cervical fusion using lateral mass or pedicle screws and rods
NEUROSURGERY
NS00001198
Posterior cranial
NS000011980000884
fossa encephalocele Posterior
/ meningocele
cranial fossa
- repair
encephalocele/meningocele repair
NEUROSURGERY
NS00001223
R. F. Lesioning
NS000012230000885
for Trigeminal NeuralgiaR. F. Lesioning for Trigeminal Neuralgia
NEUROSURGERY
NS00001253
ReexplorationNS000012530000886
for Cranial / Spinal surgeries
Re exploration for Cranial / Spinal surgeries
NEUROSURGERY
NS00001332
Shunt SurgeryNS000013320000887 Ventriculo-Peritoneal Shunt (Low/Medium/High Pressure) / Ventriculo -
NEUROSURGERY
NS00001356
Spine - Extradural
NS000013560000888
Haematoma Extradural hematoma evacuation
NEUROSURGERY
NS00001357
Spine - Extradural
NS000013570000889
Tumour Excision of extradural spinal tumor
NEUROSURGERY
NS00001357
Spine - Extradural
NS000013570000890
Tumour Excision of extradural spinal tumor with fusion and fixation (Cost of imp
NEUROSURGERY
NS00001358
Spine - Intradural
NS000013580000891
Tumour Excision of Intradural extramedullary tumor
NEUROSURGERY
NS00001358
Spine - Intradural
NS000013580000892
Tumour Excision of Intradural extramedullary tumor with fusion and fixation (Co
NEUROSURGERY
NS00001359
Spine - Intramedullar
NS000013590000893
Tumour Excision of Intramedullary tumor of spine + Neuro monitoring Device 15
NEUROSURGERY
NS00001359
Spine - Intramedullar
NS000013590000894
Tumour Excision of Intramedullary tumor with fusion and ficxation (Cost of impla
NEUROSURGERY
NS00001377
StereotacticNS000013770000895
Lesioning Stereotactic Lesioning for movement disoders
NEUROSURGERY
NS00001388
Superficial Temporal
NS000013880000896
Artery (STA): middle
Superficial
cerebral
Temporal
arteryArtery
(MCA)(STA):
or (other
middle
EC -cerebral
IC) Bypass
artery
procedure
(MCA) or (othe
NEUROSURGERY
NS00001398
Surgery for NS000013980000897
Haematoma - Intracranial Evacuation of Post-trauamtic EDH/SDH- Intraparenchymal Hematoma,
NEUROSURGERY
NS00001398
Haematoma - Intracranial Spontaneous Intraparenchymal hematoma evacuation/Evacuation of Po
NEUROSURGERY
NS00001404
tumour meninges Surgery for supratentorial Extra-axial Tumours (Meningioma etc)/Surger
NEUROSURGERY
NS00001467
Trans oral Surgery
NS000014670000900 Trans oral Surgery
NEUROSURGERY
NS00001468
Trans Sphenoidal
NS000014680000901
Surgery Endoscpic/Microscopic Trans Sphenoidal Surgery
NEUROSURGERY
NS00001471
Transoral surgery
NS000014710000902
(Anterior) and CVTrans
Junction
oral(Posterior
anterior decompression
stabilisation) and Posterior stabilisation or C V junc
NEUROSURGERY
NS00001488
Twist Drill Craniostomy
NS000014880000903 Twist Drill Craniostomy
NEUROSURGERY
NS00001537
Ventricular NS000015370000904
tap Ventricular tapping with Omayya reservoir/external ventricular drain
NEUROSURGERY
NS00001538
Ventricular NS000015380000905
Tap / Puncture Ventricular Tap / Puncture
NEUROSURGERY
NS0000158Brachial Plexus
NS00001580000836
– Repair Brachial Plexus repair
NEUROSURGERY
NS0000162Brain AbscessNS00001620000837
Tapping Burr hole and Tapping of Brain Abscess
NEUROSURGERY
NS0000163Brain BiopsyNS00001630000838 Brain Biopsy- Open/Stereotactic guided
NEUROSURGERY
NS0000172Burr hole surgery
NS00001720000839 Burr hole surgery for evacuation of hematoma/ biopsy/ pus drainage/Pl
NEUROSURGERY
NS0000172Burr hole surgery
NS00001720000840 Burr hole surgery with chronic Sub Dural Haematoma - U/ L or B/L
NEUROSURGERY
NS0000190Carpal TunnelNS00001900000841
Release Carpal tunnel release
NEUROSURGERY
NS0000205Cervical DiscNS00002050000842
Multiple level without Anterior
Fusion cervical discectomy without fusion - Govt Reserve
NEUROSURGERY
NS0000206Cervical/Thoracic
NS00002060000843
/ Lumbar Corpectomy
Cervical/Thoracic/
with fusion Lumbar corpectomy with fusion for Tumor/Infection/
NEUROSURGERY
NS0000274Conservative NS00002740000844
NEUROSURGERY
NS0000283Conservative NS00002830000845
NEUROSURGERY
NS0000292Conservatively
NS00002920000846
managed Severe spinalConservatively
injury / Severe
managed
Head injury
Severe spinal injury / Severe Head injury
NEUROSURGERY
NS0000310Cranial NerveNS00003100000847
Anastomosis Cranial nerve anastomosis/Repair - Govt Reserve
NEUROSURGERY
NS0000312CranioPlastyNS00003120000848 Cranioplasty with autologus bone graft/Cranioplasty with exogenous Gra
NEUROSURGERY
NS0000313Craniostenosis
NS00003130000849 Cranial vault remodeling/ surgery for "Craniosynostosis"
NEUROSURGERY
NS0000476DecompressiveNS00004760000850
Craniectomy Craniectomy/ DECRA for head injury/acute stroke/cerebral venous throm
NEUROSURGERY
NS0000487Depressed Skull
NS00004870000851
Fracture Surgery for Depressed Skull fracture
NEUROSURGERY
NS0000496Diagnostic Cerebral
NS00004960000852
/ Spinal Angiography/
Diagnostic
peripheral
Cerebral
(DSA
/ Spinal
- Digital
Angiography/
Substraction
peripheral
Angiography)
(DSA - Digital Subs
NEUROSURGERY
NS0000501DiscectomyNS00005010000853
- Dorsal Discectomy - Dorsal Govt reserve
NEUROSURGERY
NS0000520Duroplasty NS00005200000854 Duroplasty with Exogenous graft- (May be perfomed as an add-on proce
NEUROSURGERY
NS0000559EndoscopicNS00005590000855
Third Ventriculostomy Endoscopic Third ventriculostomy
NEUROSURGERY
NS0000571Epilepsy Surgery
NS00005710000856 Epilepsy Surgery
NEUROSURGERY
NS0000597Excision of Brain
NS00005970000857
Abscess Excision of Brain abscess
NEUROSURGERY
NS00005980000858
Tumor Supratentorial
Supratentorial & other Tumours
NEUROSURGERY
NS00005990000859
Tumor Supratentorial/Infratentorial
Parasagital Tumours/Skull Base Tumours/Surgerey for Supratentorial/ In
NEUROSURGERY
NS0000601Excision of Cervical
NS00006010000860
Ribs Excision of Cervical Ribs
NEUROSURGERY
NS0000605Excision of Orbital
NS00006050000861
Tumour Excision of Orbital Tumour
NEUROSURGERY
NS0000631Extended LOS NS00006310000862
NEUROSURGERY
NS0000640External Ventricular
NS00006400000863
Drainage (EVD)External Ventricular Drainage (EVD)
NEUROSURGERY
NS0000642Extra Coils NS00006420000864 Extra Coils add on
NEUROSURGERY
NS000065 Aneurysm Clipping
NS0000650000830
including angiogram
Aneurysm Clipping including DSA or CTA
NEUROSURGERY
NS0000675Foramen Magnum
NS00006750000865
Decompression Foramen magnum decompression for Chiari malormation with or witho
NEUROSURGERY
NS0000697Gamma Knife NS00006970000866
radiosurgery (GKRS) /Linear
SRS foraccelerator
tumours / Radiosurgeryor
Arteriovenous malformation
Linear accelerator
(AVM)Radiosurgery for tu
NEUROSURGERY
NS000075 Anterior skull
NS0000750000831
base surgery Anterior skull base surgery-Open
NEUROSURGERY
NS000075 Anterior skull
NS0000750000832
base surgery CSF Rhinorrhea Repair-Endoscopic
NEUROSURGERY
NS0000859Laminectomy NS00008590000867
with fusion and fixation
Laminectomy with fusion and fixation for lumbar/cervical/thoracic cana
NEUROSURGERY
NS0000861Laminectomy NS00008610000868
without fusion Laminectomy without fusion for lumbar or dorsal or cervical canal steno
NEUROSURGERY
NS0000893Lumbar Discectomy
NS00008930000869 Microscopic/Endoscopic Lumbar Discectomy (One level) - Govt Reserve
NEUROSURGERY
NS000090 Arterio venous
NS0000900000833
malformation (AVM)Craniotmy
excision and excision of arteriovenous malformation/Laminectomy/La
NEUROSURGERY
NS000090 Arterio venous
NS0000900000834
malformation (AVM)Excision
excisionof scalp arteriovenous malformation
NEUROSURGERY
NS0000907Malignant Spinal
NS00009070000870
Cord compressionSpinal
with Diagnostics,
cord Decompression
palliative radiotherapy, Brace in advanced cancer pati
NEUROSURGERY
NS0000948Meningocele NS00009480000871 Encephalocele/meningocele repair
NEUROSURGERY
NS0000948Meningocele NS00009480000872 Surgery for spina bifida cystica/occulta
NEUROSURGERY
NS0000957Micro discectomy
NS00009570000873 Anterior Cervical Discectomy with fusion- Govt reserve
NEUROSURGERY
NS0000965Muscle BiopsyNS00009650000874 Muscle Biopsy
NEUROLOGY NU00001013
NeuromuscularNU000010130000825
Paediatric seizure
NU000010700000826
disorders Status epilepticus
Palliative and
NU000010780000827
Palliative disease
care endatstage
advanced
disease
or end stage
NEUROLOGY NU0000109Autoimmune NU00001090000810
encephalitis Autoimmune encephalitis
Venous sinus NU000015360000828
thrombosis Venous sinus thrombosis
Viral Encephalitis
NU000015460000829 Viral Encephalitis
NEUROLOGY NU000021 ACUTE ENCEPHALOPATHY
NU0000210000808 Acute Febrile encephalopathy/Acute Disseminated Encephalomyelitis/h
NEUROLOGY NU000040 Acute transverse
NU0000400000809
myelitis/ Acute demyelinating
Acute transverse
encephalitis
myelitis/ Acute demyelinating encephalitis
NEUROLOGY NU0000463CVA / Stroke NU00004630000807 Acute hemorrhagic stroke/Acute hemorrhagic stroke- (Extra ventricular
NEUROLOGY NU0000569epilepsy NU00005690000811 Drug resistant epilepsy/Evaluation of drug resistant epilepsy
NEUROLOGY NU0000721Guillain Barre
NU00007210000812
syndrome Guillain Barre syndrome
NEUROLOGY NU0000723Guillain Barre
NU00007230000813
syndrome (IVIG) Guillain Barre syndrome (IVIG)
NEUROLOGY NU0000758High end histopathology
NU00007580000814 (Biopsies) and
Highadvanced
end histopathology
NEUROLOGY NU0000765High end radiological
NU00007650000815
NEUROLOGY NU0000816Inflammatory NU00008160000816
Crisis Myopathy/ Myaesthenic Crisis
NEUROLOGY NU0000832INTRACRANIAL NU00008320000817
SPACE OCCUPYING LESIONSIntracranial hemorrhage/Intracranial space occupying lesion tuberculom
NEUROLOGY NU0000939Medical Management
NU00009390000819
Raised ICPpressure
NEUROLOGY NU0000943Medical/ neuro
NU00009430000820
rehablitation Comprehensive medical rehabilitation for spinal injury/ traumatic brain
NEUROLOGY NU0000943Medical/ neuro
NU00009430000821
rehablitation Medical rehabilitation of muscular dystrophy/Medical Rehabilitation int
NEUROLOGY NU0000946Meningitis NU00009460000822 Chronic meningitis/Partially treated pyogenic meningitis/Neuro tubercu
NEUROLOGY NU0000966MyastheniaNU00009660000818
Gravis Myasthenia Gravis requiring admission for work-up or in-patient care
NEUROLOGY NU0000967MyasthenicNU00009670000823
crisis Myasthenic crisis
NEUROLOGY NU0000969MyasthenicNU00009690000824
crisis (Plasmapheresis) Myasthenic crisis (Plasmapheresis)
OBSTETRICSOG00001068
& GYNAECOLOGY
Overian Cystectomy
OG000010680000953 Overian Cystectomy - govt reserve
& GYNAECOLOGY
Post coital /OG000011920000954
Injury Repair Post coital Injury / Perineal injury repair - Govt. Reserve
& GYNAECOLOGY
Pyometra drainage
OG000012220000955 Pyometra drainage
& GYNAECOLOGY
Radical Hysterectomy
OG000012270000956 Class II - V radical hysterectomy + bilateral salpingoophorectomy + BPLN
& GYNAECOLOGY
OG000012270000957 Hysterectomy + bilateral salpingoophorectomy + omentectomy + perito
& GYNAECOLOGY
Radical Retroperitoneal
OG000012340000958lymph nodeRadical
dissection
Retroperitoneal lymph node dissection
& GYNAECOLOGY
Rectovaginal OG000012510000959
fistula repair Rectovaginal fistula repair
OBSTETRICSOG0000127
& GYNAECOLOGY
Biopsy OG00001270000910 D&C (Dilatation&curretage) / Dilation and Evacuation (D&E)
& GYNAECOLOGY
Resection ofOG000012710000960
accessory mullarian horn Resection of accessory mullarian horn (Open/Lap)
OBSTETRICSOG0000129
& GYNAECOLOGY
Biopsy- Cervical,
OG00001290000911
Endometrial EA/ ECC; Biopsy-
Vulvar;
Cervical,
Polypectomy
Endometrial EA/ ECC; Vulvar; Polypectomy,Endometria
OBSTETRICSOG000013
& GYNAECOLOGY
Abdomino Perineal
OG0000130000907
repair for Mullerian
Abdomino
AnomalyPerineal repair for Mullerian Anomaly
& GYNAECOLOGY
Sacrocolpopexy
OG000013060000961
(Abdominal) Sacrocolpopexy (Abdominal)
& GYNAECOLOGY
Salpingoophorectomy
OG000013070000962 Salpingoophorectomy- (B/L or U/L)
& GYNAECOLOGY
Severe anemiaOG000013260000963 Severe anemia HB less 8 gm/dl
& GYNAECOLOGY
Sling Surgeries
OG000013480000964
for Prolapse Surgeries for Prolapse - Sling Surgeries
& GYNAECOLOGY
Staging Laparotomy
OG000013720000965
and proceed for Staging
Ovarian
Laparotomy
Cancers. Omentomy
and proceedwith
for Bilateral
Ovarian Cancers.
Salpingo-oophorectomy
Omentomy with B
& GYNAECOLOGY
SterilisationOG000013780000966 Sterilisation - GOVT . Reserve
& GYNAECOLOGY
Surgery for OG000013970000967
Endometriosis Surgery for Endometriosis (Other than Hysterectomy)
& GYNAECOLOGY
Trans - vaginal
OG000014660000968
tape / Trans-obturator Trans-vaginal
tape tape/Trans - With obturator tape
& GYNAECOLOGY
Uretero-vaginal
OG000015090000969
/ Uterine fistula repair
Uretero - vaginal fistula repair - Open/ Laparoscopic/Uretero - Uterine f
& GYNAECOLOGY
Vaginal Myomectomy
OG000015190000970 Vaginal Myomectomy
& GYNAECOLOGY
Vaginal repair
OG000015210000971
for vesico-vaginal fistula
Vaginal
(Repair
repair
forfor
VVF)
vesico-vaginal fistula (Open)
& GYNAECOLOGY
Vaginal Sacrospinus
OG000015220000972
fixation with repair
Vaginal Sacrospinus fixation with repair
& GYNAECOLOGY
Vaginoplasty OG000015230000973
(McIndoe procedure) Vaginoplasty (McIndoe procedure)
& GYNAECOLOGY
Vulval/ vaginal
OG000015500000974
Hematoma drainageVulval/ vaginal Hematoma drainage
& GYNAECOLOGY
VulvectomyOG000015510000975
+ reconstruction procedures Vulvectomy - simple (Rs 20000) / Redical (Rs 40000) reconstruction proc
& GYNAECOLOGY
Vulvo vaginal
OG000015530000976
/ bartholin cyst/ abscess
Vulvoenucleation
vaginal/ bartholin
/ drainage
cyst/ abscess enucleation /Vulvo vaginal/ barth
OBSTETRICSOG0000170
& GYNAECOLOGY
Burch OG00001700000912 Abdominal / Laparoscopic -Burch
OBSTETRICSOG0000178
& GYNAECOLOGY
Caesarean Delivery
OG00001780000913 Caesarean Delivery - Govt Reserve
OBSTETRICSOG0000179
& GYNAECOLOGY
Caesarean hysterectomy
OG00001790000914 Caesarean hysterectomy - Govt Reserve
OBSTETRICSOG0000237
& GYNAECOLOGY
Closure of Burst
OG00002370000915
Abdomen Closure of Burst Abdomen
OBSTETRICSOG0000248
& GYNAECOLOGY
Colpotomy OG00002480000916 Colpotomy
OBSTETRICSOG0000257
& GYNAECOLOGY
Cone biopsyOG00002570000917 Cone biopsy
OBSTETRICSOG0000275
& GYNAECOLOGY
ConservativeOG00002750000918
OBSTETRICSOG0000296
& GYNAECOLOGY
Cordocentesis
OG00002960000919 Cordocentesis
OBSTETRICSOG0000466
& GYNAECOLOGY
Cystocele - OG00004660000920
Anterior repair Cystocele - Anterior repair
OBSTETRICSOG0000472
& GYNAECOLOGY
D&C (Dilatation&curretage)
OG00004720000921 / Dilation
D&C and(Dilatation&curretage)
Evacuation (D&E) / Dilation and Evacuation (D&E)
OBSTETRICSOG0000493
& GYNAECOLOGY
Diagnostic OG00004930000922
laparoscopy Diagnostic laparoscopy (govt reserve)
OBSTETRICSOG0000497
& GYNAECOLOGY
Diagnostic Hysteroscopy
OG00004970000923with / without
Diagnostic
- govt reserve
Hysteroscopy with / without ± biopsy - govt reserve
OBSTETRICSOG0000529
& GYNAECOLOGY
Electro Cauterisation
OG00005290000924
/ Cryo SurgeryElectro Cauterisation / Cryo Surgery
OBSTETRICSOG0000584
& GYNAECOLOGY
EUA (Examination
OG00005840000925
under Anaesthesia)EUA(Examination under Anaesthesia) only in GA
OBSTETRICSOG00006
& GYNAECOLOGY
Perineal Tear
OG000060000906 III and IV degree of Perineal Tear - govt reserve - add on
OBSTETRICSOG0000619
& GYNAECOLOGY
Excision of Vaginal
OG00006190000926
Septum (vaginal Excision
route) of Vaginal Septum (vaginal route)
OBSTETRICSOG000062
& GYNAECOLOGY
Amniocentesis
OG0000620000908
/ Chorionic villus sampling
Amniocentesis / Chorionic villus sampling
OBSTETRICSOG000071
& GYNAECOLOGY
Anterior & Posterior
OG0000710000909
Colpoperineorrhapy
Anterior & Posterior Colpoperineorrhapy
OBSTETRICSOG0000771
& GYNAECOLOGY
High risk delivery
OG00007710000927 Mothers with severe anaemia (<8 g/dL) , Other maternal and fetal cond
OBSTETRICSOG0000775
& GYNAECOLOGY
Hospitalisation
OG00007750000928
for Antenatal Complications
Hospitalisation for Antenatal Complications
OBSTETRICSOG0000778
& GYNAECOLOGY
Hymenectomy OG00007780000929
for imperforate hymen Hymenectomy for imperforate hymen - Govt Reserve
OBSTETRICSOG0000784
& GYNAECOLOGY
HysterectomyOG00007840000930 Abdominal Hysterectomy ± Salpingo-oophorectomy/ Non descent vagin
OBSTETRICSOG0000785
& GYNAECOLOGY
Hysteroscopic
OG00007850000931
adhesiolysis / Laparoscopic
Hysteroscopic
adhesiolysis
adhesiolysis / Laparoscopic adhesiolysis - Govt Reserve
OBSTETRICSOG0000786
& GYNAECOLOGY
Hysteroscopic
OG00007860000932
cannulation Hysteroscopic cannulation
OBSTETRICSOG0000787
& GYNAECOLOGY
Hysteroscopic
OG00007870000933
IUCD removal Hysteroscopic IUCD removal - Govt Reserve
OBSTETRICSOG0000788
& GYNAECOLOGY
Hysteroscopic
OG00007880000934
Myomectomy Hysteroscopic Myomectomy
OBSTETRICSOG0000789
& GYNAECOLOGY
Hysteroscopic
OG00007890000935
polypectomy Hysteroscopic polypectomy
OBSTETRICSOG0000790
& GYNAECOLOGY
Hysteroscopic
OG00007900000936
Septum resection Hysteroscopic Septum resection
OBSTETRICSOG0000791
& GYNAECOLOGY
Hysterotomy OG00007910000937 Hysterotomy
OBSTETRICSOG0000791
& GYNAECOLOGY
Hysterotomy OG00007910000938 Hysterotomy - Govt Reserve
OBSTETRICSOG0000835
& GYNAECOLOGY
IntrauterineOG00008350000939
transfusions Intrauterine transfusions
OBSTETRICSOG0000841
& GYNAECOLOGY
Inversion ofOG00008410000940
uterus Inversion of uterus - vaginal reposition/Abdominal reposition
OBSTETRICSOG0000863
& GYNAECOLOGY
Lap / vaginal
OG00008630000941
Abdominal Myomectomy Abdominal Myomectomy
OBSTETRICSOG0000864
& GYNAECOLOGY
LaparoscopicOG00008640000942
tubal surgeries Tubal surgeries(for any indica on including ectopic pregnancy)
OBSTETRICSOG0000866
& GYNAECOLOGY
LaparotomyOG00008660000943
for Broad Ligament Hematoma
Laparotomy for Broad Ligament Hematoma (+/-internal iliac ligation)
OBSTETRICSOG0000889
& GYNAECOLOGY
LLETZ (including
OG00008890000944
PAP smear and colposcopy)
LLETZ (including PAP smear and colposcopy)
OBSTETRICSOG0000924
& GYNAECOLOGY
ManchesterOG00009240000945
Repair/Sling Surgery forManchester
Prolapse uterus
Repair/Sling Surgery for Prolapse uterus
OBSTETRICSOG0000926
& GYNAECOLOGY
Manual removal
OG00009260000946
of placenta Manual removal of placenta - Govt reserve
OBSTETRICSOG0000932
& GYNAECOLOGY
McDonald'sOG00009320000947
stitch/Shirodkar stitch McDonald's stitch/Shirodkar stitch
OBSTETRICSOG0000941
& GYNAECOLOGY
Medical management
OG00009410000948
of ectopic pregnancy
Medical management of ectopic pregnancy
OBSTETRICSOG0000942
& GYNAECOLOGY
Medical Termination
OG00009420000949
of Pregnancy MTP > 12 weeks - govt reserve
OBSTETRICSOG0000942
& GYNAECOLOGY
Medical Termination
OG00009420000950
of Pregnancy MTP 8 to 12 weeks - govt reserve
OBSTETRICSOG0000942
& GYNAECOLOGY
Medical Termination
OG00009420000951
of Pregnancy MTP upto 8 weeks - govt reserve
OBSTETRICSOG0000963
& GYNAECOLOGY
Molar followOG00009630000952
up for chemotherapy Molar follow up for chemotherapy
OPHTHALMOLOGY
OL00001054
Optic neuritis
OL0000105400001015 Optic neuritis
OPHTHALMOLOGY
OL00001058
Orbital fracture
OL0000105800001016
repair Orbital fracture repair under GA (with or without implant)
OPHTHALMOLOGY
OL00001059
OrbitotomyOL0000105900001017 Orbitotomy
OPHTHALMOLOGY
OL00001208
Pterygium +OL0000120800001018
Conjunctival Autograft Pterygium + Conjunctival Autograft
OPHTHALMOLOGY
OL00001209
Ptosis Surgery
OL0000120900001019 Ptosis Surgery
OPHTHALMOLOGY
OL00001278
Retinal Cryopexy
OL0000127800001020 Retinal Cryopexy
OPHTHALMOLOGY
OL00001279
Retinal Laser
OL0000127900001021
Photocoagulation For retinal tear repair /Sectrol laser / Barrage laser - Per eye per sitting
OPHTHALMOLOGY
OL00001279
Retinal Laser
OL0000127900001022
Photocoagulation Pan Re nal Photocoagula on (PRP) - Re nal Laser including 3 si ngs / p
OPHTHALMOLOGY
OL00001298
ROP Laser -OL0000129800001023
Per Eye ROP Laser - Per Eye
OPHTHALMOLOGY
OL00001300
ROP screening
OL0000130000001024 ROP screening
OPHTHALMOLOGY
OL00001312
Scleral Buckle
OL0000131200001025
Removal Scleral Buckle Removal
OPHTHALMOLOGY
OL00001313
Scleral buckling
OL0000131300001026
surgery Scleral buckling surgery
OPHTHALMOLOGY
OL00001316
Secondary IOL
OL0000131600001027
/ IOL Exchange / Explant
Secondary IOL / IOL Exchange / Explant
OPHTHALMOLOGY
OL00001330
SFIOL (inclusive
OL0000133000001028
of Vitrectomy) SFIOL (inclusive of Vitrectomy)
OPHTHALMOLOGY
OL00001351
Socket Reconstruction
OL0000135100001029
including Amniotic
Socket Membrane
Reconstruction
Graftincluding Amniotic Membrane Graft
OPHTHALMOLOGY
OL00001352
SOR (SiliconOL0000135200001030
Oil Removal) SOR (Silicon Oil Removal)
OPHTHALMOLOGY
OL00001369
Squint correction
OL0000136900001031 Major - 3 or more muscles (complex surgery involving four muscles or o
OPHTHALMOLOGY
OL00001369
Squint correction
OL0000136900001032 Minor - upto 2 muscles
OPHTHALMOLOGY
OL00001401
Surgery for OL0000140100001033
Paediatric Cataract Paediatric lensectomy/Paediatric lens aspiration with posterior capsulot
OPHTHALMOLOGY
OL00001401
Surgery for OL0000140100001034
Paediatric Cataract Paediatric Membranectomy & anterior vitrectomy
OPHTHALMOLOGY
OL00001548
Vitreoretinal
OL0000154800001035
Surgery (with Silicon OilVitreoretinal
Insertion) Surgery (with Silicon Oil Insertion)
OPHTHALMOLOGY
OL0000182Capsulotomy OL00001820000977
(YAG) Capsulotomy (YAG)/Peripheral Iridotomy(PI)
OPHTHALMOLOGY
OL0000192Cataract surgery
OL00001920000978 Phaco emulsification with foldable hydrophobic acrylic IOL - GOVT Rese
OPHTHALMOLOGY
OL0000192Cataract surgery
OL00001920000979 SICS with non-foldable IOL - GOVT Reserve
OPHTHALMOLOGY
OL0000208Chalazion Removal
OL00002080000980 Chalazion Removal
OPHTHALMOLOGY
OL0000268ConjunctivalOL00002680000981
tumour excision includingConjunctival
Amniotictumour
Membrane
excision
Graftincluding Amniotic Membrane Graft
OPHTHALMOLOGY
OL0000284ConservativeOL00002840000982
OPHTHALMOLOGY
OL0000298Corneal / Scleral
OL00002980000983
Patch Graft Corneal / Scleral Patch Graft
OPHTHALMOLOGY
OL0000299Corneal Collagen
OL00002990000984
Crosslinking Corneal Collagen Crosslinking
OPHTHALMOLOGY
OL0000300Corneal Grafting
OL00003000000985 Corneal Grafting ( Kerotoplasty)
OPHTHALMOLOGY
OL0000300Corneal Grafting
OL00003000000986 Lamellar Keratoplasty
OPHTHALMOLOGY
OL0000301Corneal Ulcer
OL00003010000987
Management Corneal Ulcer Management
OPHTHALMOLOGY
OL0000302Corneo / Scleral
OL00003020000988
/ Corneo scleral tear
Tear
repair
repair-corneal/scleral/corneo scleral/with or without iris prolapse r
OPHTHALMOLOGY
OL0000473Dacryocystorhinostomy
OL00004730000989 Canaliculo Dacryocystorhinostomy with Silicon Tube / Stent
OPHTHALMOLOGY
OL0000473Dacryocystorhinostomy
OL00004730000990 Canaliculo Dacryocystorhinostomy without Silicon Tube / Stent
OPHTHALMOLOGY
OL0000491Diabetic Retinopathy
OL00004910000991
Screening Vision refraction,fundus photo and OCT (day care)
OPHTHALMOLOGY
OL0000552Endophthalmitis
OL00005520000992
(excluding Vitrectomy)
Endophthalmitis (excluding Vitrectomy)
OPHTHALMOLOGY
OL0000564Entropion correction/Ectropion
OL00005640000993 correctionEntropion correction / Ectropion correction - GOVT Reserve
OPHTHALMOLOGY
OL0000565EnucleationOL00005650000994 Enucleation With implant
OPHTHALMOLOGY
OL0000565EnucleationOL00005650000995 Enucleation Without implant
OPHTHALMOLOGY
OL0000585EUA for Confirmation
OL00005850000996
of Paediatric Glaucoma
EUA for Confirmation of Paediatric Glaucoma
OPHTHALMOLOGY
OL0000588EUA separateOL00005880000997
OPHTHALMOLOGY
OL0000591EviscerationOL00005910000998 Evisceration
OPHTHALMOLOGY
OL0000620ExenterationOL00006200000999 Exenteration
OPHTHALMOLOGY
OL0000632Extended LOSOL000063200001000
OPHTHALMOLOGY
OL0000696Fundus Fluorescein
OL000069600001001
Angiography (FFA)
Fundus Fluorescein Angiography (FFA) - GOVT Reserve and Day care
OPHTHALMOLOGY
OL0000710Glaucoma Screening
OL000071000001002 Vision Refraction-IOP & Fundus
OPHTHALMOLOGY
OL0000710Glaucoma Screening
OL000071000001003 Vision Refraction-IOP & Fundus OCT & Visual Fields
OPHTHALMOLOGY
OL0000711Glaucoma Surgery
OL000071100001004 Glaucoma Surgery (Trabeculectomy only) with or without Mitomycin C, i
OPHTHALMOLOGY
OL000071200001005 Cyclocryotherapy / Cyclophotocoagulation
OPHTHALMOLOGY
OL000071200001006 Glaucoma Shunt Surgery
OPHTHALMOLOGY
OL000071200001007 Paediatric Glaucoma Surgery
OPHTHALMOLOGY
OL0000814IndocyanineOL000081400001008
Green Angiography (ICGA) Indocyanine Green Angiography (ICGA) - GOVT Reserve and Day care
OPHTHALMOLOGY
OL0000849Iridectomy OL000084900001009 Iridectomy
OPHTHALMOLOGY
OL0000870Laser Therapy
OL000087000001010
for Retinopathy of Prematurity
Laser Therapy
(Irrespective
for Re nopathy
of no. of
of eyes
Prematurity
affected)
-Neo
- per- natal
session
OPHTHALMOLOGY
OL0000877Lid AbscessOL000087700001011
Drainage Lid Abscess Drainage
OPHTHALMOLOGY
OL0000878Lid Tear Repair
OL000087800001012 Lid Tear Repair
OPHTHALMOLOGY
OL0000879Lid Tumor excision
OL000087900001013
+ Lid Reconstruction
Lid Tumor excision + Lid Reconstruction
OPHTHALMOLOGY
OL0000881Limbal Dermoid
OL000088100001014
Removal Limbal Dermoid Removal - GOVT Reserve
ORTHOPAEDICS
OP00001 Closed reduction
OP0000100001056
of joint dislocationHip / Knee / shoulder / elbow / Any small joint
ORTHOPAEDICS
OP00001004
Nerve root OP0000100400001095
ORTHOPAEDICS
OP00001007
Nerve Transposition
OP0000100700001096
ORTHOPAEDICS
OP00001018
NPWT OP0000101800001097 NPWT
ORTHOPAEDICS
OP00001034
Open Reduction
OP0000103400001098
of CDH Open Reduction of CDH
ORTHOPAEDICS
OP00001035
Open Reduction
OP0000103500001099
of Joint Hip / Knee / shoulder / elbow / Any small joint
ORTHOPAEDICS
OP00001067
OsteotomyOP0000106700001100 Long & small Bone (Govt. reserved)
ORTHOPAEDICS
OP00001122
Pelvic Osteotomy
OP0000112200001101
and fixation Pelvic Osteotomy and fixation
ORTHOPAEDICS
OP00001129
Percutaneous OP0000112900001102
- Fixation of Fracture Percutaneous - Fixation of Fracture
ORTHOPAEDICS
OP00001176
Plexus injuryOP0000117600001103
along with Vascular injury Plexus
repair
injury/ graft
ORTHOPAEDICS
OP00001246
Reconstruction
OP0000124600001104
of Cruciate LigamentACL/PCL(Tear
with implant/and Avulsion)
brace / Shoulder
shoulder tendon repair
injuries/
surgeries
Shoulder
including
Dislocatio
Ba
ORTHOPAEDICS
OP00001322
SequestectomyOP0000132200001105
/ Curettage Sequestectomy / Curettage
ORTHOPAEDICS
OP00001342
Single StageOP0000134200001106
Amputation Below Elbow/Above Elbow/Below Knee/Above Knee/Foot/Hand/Wrist/D
ORTHOPAEDICS
OP00001360
Spine deformity
OP0000136000001107
correction Spine deformity correction/Combined spinal segment - front and back (a
ORTHOPAEDICS
OP00001366
Split thickness
OP0000136600001108
skin grafts small (< 4% TBSA)
ORTHOPAEDICS
OP000014 AC Joint reconstruction
OP00001400001039 / Stabilization
Rockwood Type - I to VI
ORTHOPAEDICS
OP00001426
Tendon Grafting
OP0000142600001109
/ Repair Tendon Grafting / Tendon Repair / Tendon transfer
ORTHOPAEDICS
OP00001428
Tendon Release
OP0000142800001110
/ Tenotomy Tendon Release / Tenotomy / Tenolysis
ORTHOPAEDICS
OP00001430
Tension Band OP0000143000001111
Wiring Tension Band Wiring - Stand alone
ORTHOPAEDICS
OP0000145Bone graftingOP000014500001048
for Non union Bone grafting for Fracture Non union
ORTHOPAEDICS
OP00001455
Total Hip Replacement
OP0000145500001112 Cemented
ORTHOPAEDICS
OP00001455
OP0000145500001113 Cementless
ORTHOPAEDICS
OP00001455
OP0000145500001114 Hybrid
ORTHOPAEDICS
OP00001455
OP0000145500001115 Revision - Total Hip Replacement
ORTHOPAEDICS
OP00001456
Total Knee Replacement
OP0000145600001116 Primary - Total Knee Replacement
ORTHOPAEDICS
OP00001456
Total Knee Replacement
OP0000145600001117 Revision - Total Knee Replacement
ORTHOPAEDICS
OP00001489
Two Stage Amputation
OP0000148900001118 Above Elbow/Below Elbow/Above Knee/Below Knee/Foot/Hand/Wrist/D
ORTHOPAEDICS
OP0000151Bone tumors OP000015100001049
/ soft tissue sarcomas:Bone surgery
tumors / soft tissue sarcomas: surgery
ORTHOPAEDICS
OP0000153Bone Tumour OP000015300001050
(benign) cure age / Excision
Bone Tumour (benign) curettage / Excision and bone grafting
ORTHOPAEDICS
OP0000154Bone Tumour OP000015400001051
Excision (malignant) including
Bone TumourGCT +Excision
Joint replacement
(malignant) including GCT + Joint replacement
ORTHOPAEDICS
OP00001542
OP0000154200001119 Vertebroplasty/Kyphoplasty - Govt reserved
ORTHOPAEDICS
OP0000155Bone Tumour OP000015500001052
Excision + reconstruction Bone Tumour Excision + reconstruction
ORTHOPAEDICS
OP0000191Carpal TunnelOP000019100001053
Release Carpal tunnel release
ORTHOPAEDICS
OP0000207Cervical/Thoracic
OP000020700001054
/ Lumbar Corpectomy Cervical/Thoracic/
with fusion -GovtLumbar
Reserve
corpectomy with fusion for Tumor/Infection/
ORTHOPAEDICS
OP0000233Closed reduction
OP000023300001055
Closedforreduction
fracturefor
of maxilla
fracture/of
mandible
maxilla/mandible/zygoma/Closed
/ zygoma reduc
ORTHOPAEDICS
OP0000262Congenital OP000026200001057
Hand Anomaly (Syndactyle, Per Polydactyle,
stage of Syndactyle/Polydactyle/Macrotodactyle
Macrotodactyle)
ORTHOPAEDICS
OP0000297Core Decompression,
OP000029700001058
Excision Arthoplasty
Core Decompression,
of Femur headExcision Arthoplasty of Femur head - govt reserve
ORTHOPAEDICS
OP0000307Correction ofOP000030700001059
club foot POP cast (daycare) / JESS fixator
ORTHOPAEDICS
OP0000309Corrective Surgery
OP000030900001060
for foot deformities
Vertical Talus / Other foot deformities
ORTHOPAEDICS
OP0000474Debridement OP000047400001061
& Closure of injuries -Anti-biotic
contused lacerated
+ dressingwounds,
- minimum
I&Dofof2abcess
sessions
ORTHOPAEDICS
OP0000502Displaced Clavicle
OP000050200001062
Fracture Open / Closed Reduction with Internal Fixation
ORTHOPAEDICS
OP0000518Duputryen’sOP000051800001063
Contracture release + rehabilitation
Duputryen’s Contracture release + rehabilitation
ORTHOPAEDICS
OP0000527Elastic nailing
OP000052700001064
/ External fixator for fracture
Humerusfixation
/ forearm / Across elbow / Across Knee / femur / shaft tibia / A
ORTHOPAEDICS
OP0000528Elbow / Shoulder
OP000052800001065
replacement Elbow / Shoulder replacement
ORTHOPAEDICS
OP0000600Excision of Bursa
OP000060000001066 Excision of Bursa / cyst / Ganglion
ORTHOPAEDICS
OP0000606Excision of Osteochondroma
OP000060600001067 / Exostosis
Osteochondroma
/ Patellectomy / Exostosis / Patellectomy
ORTHOPAEDICS
OP000063 AmputationOP00006300001040
- Fingers / Toes Finger(s)/Toe(s)
ORTHOPAEDICS
OP0000639External fixation
OP000063900001068
of Fracture Small bone (MC,carpal, tarsal, MT, Calcaneum, Talus, Phalanx)
ORTHOPAEDICS
OP0000649FasciotomyOP000064900001069
/ Debridement & Closure Anti-biotic
of injuries+ -dressing
contused - minimum
laceratedofwounds
5 sessions
ORTHOPAEDICS
OP000066 Ankle Fractures
OP00006600001041 ORIF/ CRIF of medial / lateral malleolus or bimalleolar fracture or Trima
ORTHOPAEDICS
OP0000663Fixation of Diaphyseal
OP000066300001070
Fracture - Long
OpenBone/ Closed Reduction & Internal Fixation of long bones (femur shaft
ORTHOPAEDICS
OP0000665Fixation of fracture
OP000066500001071
of jaw Closed reduction (1 jaw) using wires - under LA/GA
ORTHOPAEDICS
OP0000665Fixation of fracture
OP000066500001072
of jaw Open reduction (1 jaw) and fixing of plates / wire - under LA / GA
ORTHOPAEDICS
OP0000683Fracture - Acetabulum
OP000068300001073 ORIF THROUGH combined Approach PLATING
ORTHOPAEDICS
OP0000683Fracture - Acetabulum
OP000068300001074 ORIF THROUGH Single Approach PLATING
ORTHOPAEDICS
OP0000684Fracture - Both
OP000068400001075
Bones - Forearm - ORIF/CRIF
Fracture -- Both
Plating
Bones
/ Nailing
- Forearm
/ JESS- ORIF/CRIF - Plating / Nailing / JESS
ORTHOPAEDICS
OP0000685Fracture - Long
OP000068500001076
Bones - MetaphysealFracture
- ORIF - Long Bones - Metaphyseal - ORIF (excludes forearm bones)
ORTHOPAEDICS
OP0000686Fracture - Neck/
OP000068600001077
IT Femur Closed Reduction and Percutaneous CC-Screw Fixation / DHS / PFN / Ang
ORTHOPAEDICS
OP0000688Fracture - Single
OP000068800001078
Bone - Forearm - ORIFFracture
/ CRIF-- Single
Plating
Bone
/ Nailing
- Forearm
/ JESS- ORIF - Plating / Nailing / JESS
ORTHOPAEDICS
OP0000689Fracture Condyle
OP000068900001079
- Humerus - ORIF ORIF of Medial / lateral Condyle / ORIF with screw of proximal/distal hu
ORTHOPAEDICS
OP0000690Fracture HeadOP000069000001080
radius/ distal end intra-articular
Excision / Fixation
radius fracture
/ radial head
/ Comminuted
prosthesis Fracture
/ Comminuted
Olecranon
Fracture
of Ulna
Olecr
ORTHOPAEDICS
OP0000691Fracture intercondylar
OP000069100001081
Humerus +/-ORIF
olecranon
Fractureosteotomy
intercondylar Humerus +/- olecranon osteotomy +/- TBW
ORTHOPAEDICS
OP00007 Spine fixationOP0000700001037 (Cervical /Cervical
Dorsal /including
lumbar) odontoid / Dorsal / lumbar spine fixation THROUGH A
ORTHOPAEDICS
OP00007 Spine fixationOP0000700001038 (Cervical /Cervical
Dorsal /including
lumbar) odontoid / Dorsal / lumbar spine fixation THROUGH p
ORTHOPAEDICS
OP0000734Hemiarthroplasty
OP000073400001082 Unipolar/Bipolar (Non - Modular/ Modular) (cemented/non cemented)
ORTHOPAEDICS
OP0000772High Tibial Osteotomy
OP000077200001083 High Tibial Osteotomy
ORTHOPAEDICS
OP0000804Ilizarov Fixation
OP000080400001084 Ilizarov Fixation
ORTHOPAEDICS
OP0000810Implant Removal
OP000081000001085
under LA / RA / GAK - Wire/Screw/External fixator
ORTHOPAEDICS
OP0000812Implant Removal
OP000081200001086
under RA / GA Nail/ Plate / TBW / cc-screw from NOF
ORTHOPAEDICS
OP0000821Internal Fixation
OP000082100001087
of Small Bones CRIF/ORIF Small Bones (Patella / carpal /tarsal /phalanx /metatarsal /me
ORTHOPAEDICS
OP0000860Laminectomy OP000086000001088
with fusion and fixationLaminectomy with fusion and fixation for lumbar/cervical/thoracic cana
ORTHOPAEDICS
OP0000862Laminectomy OP000086200001089
without fusion Laminectomy without fusion for lumbar or dorsal or cervical canal steno
ORTHOPAEDICS
OP000087 ApplicationOP00008700001042
of P.O.P slab / cast / Spikas
P.O.P/ Jackets
slab / cast / Spikas / Jackets - Day care
ORTHOPAEDICS
OP000088 ApplicationOP00008800001043
of Traction skin / Skeletal Tractions with pin / crutchfiled tong cervical spine tractio
ORTHOPAEDICS
OP0000880Limb Lengthening
OP000088000001090
/ Bone TransportLimbby Ilizarov
Lengthening
/ LRS / Bone Transport by Ilizarov / LRS
ORTHOPAEDICS
OP0000916Management OP000091600001091
of Chest injury with fracture
Managementof Longofbone
Chest injury with fixation of 2 or more LIMB
ORTHOPAEDICS
OP0000916Management OP000091600001092
Managementof Longofbone
Chest injury with fixation of Single LIMB
ORTHOPAEDICS
OP000092 ArthrodesisOP00009200001044 Knee / Ankle / foot / Triple arthrodesis / Shoulder / elbow/ Wrist / Hand
ORTHOPAEDICS
OP0000922Management OP000092200001093
of Visceral injury and Surgical
fracture intervention
long bone for Visceral injury and fixation of fracture of 2 or m
ORTHOPAEDICS
OP0000922Management OP000092200001094
long bone for Visceral injury and fixation of fracture of single
ORTHOPAEDICS
OP000093 Arthrolysis OP00009300001045
of joint Elbow/Knee/Ankle - govt reserve
ORTHOPAEDICS
OP000094 Arthroscopic OP00009400001046
Meniscus Repair / Meniscectomy
Arthroscopic Meniscus Repair / Meniscectomy / MPFL Repair
ORTHOPAEDICS
OP000095 ArthroscopyOP00009500001047
/ open - synovectomy Arthroscopy / open - synovectomy - govt reserve
ORTHOPAEDICS
OP000096 ArthrotomyOP00009600001036 Arthorotomy of any joint - govt reserve
ORGAN TRANSPLANT
OTS1500 SURGERY
Heart/LungOTS150010005
Transplant (Lung / Heart- Lung Combo)Lung / Heart- Lung ComboTransplant Surger
ORGAN TRANSPLANT
OTS1500 SURGERY
ORGAN TRANSPLANT
OTS1500 SURGERY
ORGAN TRANSPLANT
OTS1500 SURGERY
ORGAN TRANSPLANT
OTS1500 SURGERY
Transplant (Lung / Heart-Lung Combo)Transplant Surgery pre Operative evaluation
ORGAN TRANSPLANT
OTS1500 SURGERY
Transplant (Lung / Heart- Lung Combo)Donor for Multiorgan
ORGAN TRANSPLANT
OTS1501 SURGERY
ECMO OTS150110008 (Heart Transplant Packages) -ECMO Period - per day
ORGAN TRANSPLANT
OTS1501 SURGERY
ECMO OTS150110007 VA/VV ECMO Initiation
ORGAN TRANSPLANT
OTS1501 SURGERY
ECMO OTS150110001 (Lung / Heart- Lung Combo)Short term. ECMO Bridge totransplant
ORGAN TRANSPLANT
OTS1502 SURGERY
Cochlear Implant
OTS150210012 (Cochlear Implant Packages ) - Post-Operative Audio Verbal(speech) The
ORGAN TRANSPLANT
OTS1502 SURGERY
Cochlear Implant
OTS150210011 (Cochlear Implant Packages ) - Cochlear Implant - ADD ON
ORGAN TRANSPLANT
OTS1502 SURGERY
Cochlear Implant
OTS150210010 (Cochlear Implant Packages ) - Cochlear Implant Surgery
ORGAN TRANSPLANT
OTS1502 SURGERY
Cochlear Implant
OTS150210009 (Cochlear Implant Packages ) - Preoperative evaluation for cochlear Imp
ORGAN TRANSPLANT
OTS1502 SURGERY
Cochlear Implant
OTS150210013 (Cochlear Implant Packages ) - Maintenance for cochlear implant
ORGAN TRANSPLANT
OTS1503 SURGERY
Bone Marrow OTS150310020
Tansplant (Bone Marrow Tansplant Packages) - Allogenic Bone marrow transplant
ORGAN TRANSPLANT
OTS1503 SURGERY
ORGAN TRANSPLANT
OTS1503 SURGERY
ORGAN TRANSPLANT
OTS1503 SURGERY
ORGAN TRANSPLANT
OTS1503 SURGERY
ORGAN TRANSPLANT
OTS1503 SURGERY
Tansplant (Bone Marrow Tansplant Packages) - ASCT (Autologous Bone marrow tra
ORGAN TRANSPLANT
OTS1503 SURGERY
Tansplant (Bone Marrow Tansplant Packages) - ASCT (Autologous Bone marrow tra
ORGAN TRANSPLANT
OTS1503 SURGERY
Tansplant (Bone Marrow Tansplant Packages) - Post Autologous / Allogenic (Haplo
ORGAN TRANSPLANT
OTS1503 SURGERY
Tansplant (Bone Marrow Tansplant Packages) - Post Autologous / Allogenic (Haplo
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
OTS150410023 (Liver Transplant Packages) -Transplant surgery - Investigation of donor
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
OTS150410024 (Liver Transplant Packages) -Transplant surgery - Investigation of Recipie
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
OTS150410025 (Liver Transplant Packages) -Transplant surgery, including donor hepate
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
OTS150410026 (Liver Transplant Packages) -Transplant surgery, including donor hepate
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
OTS150410027 (Liver Transplant Packages) -Post-Transplant Medication – Month 1-3 m
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
ORGAN TRANSPLANT
OTS1504 SURGERY
Liver Transplant
OTS150410030 (Liver Transplant Packages) -Interventions for acute rejection/early graft
ORGAN TRANSPLANT
OTS1505 SURGERY
Renal Transplant
OTS150510031 Renal Transplant-Transplant surgery, including donor nephrectomy
ORGAN TRANSPLANT
OTS1505 SURGERY
Renal Transplant
OTS150510032 Renal Transplant – induction /Intervention for acute rejection
ORGAN TRANSPLANT
OTS1505 SURGERY
Renal Transplant
OTS150510033 Renal Transplant – Intervention for acute graft rejection
ORGAN TRANSPLANT
OTS1505 SURGERY
Renal Transplant
OTS150510034 Renal Transplant-Post-Transplant Medication – Month 1-3
ORGAN TRANSPLANT
OTS1505 SURGERY
Renal Transplant
ORGAN TRANSPLANT
OTS1505 SURGERY
Renal Transplant
PAEDIATRICPM00001000
MEDICAL MANAGEMENT
NEPHROTICPM0000100000001184
MEDICAL MANAGEMENT
NeuromuscularPM0000101400001185
MEDICAL MANAGEMENT
Oesophageal PM0000102400001186
PAEDIATRICPM0000105
MEDICAL MANAGEMENT
Atrial Fibrillation
PM000010500001130 Atrial Fibrillation
MEDICAL MANAGEMENT
Optic neuritis
PM0000105500001187 Optic neuritis
MEDICAL MANAGEMENT
Paediatric seizure
PM0000107100001188
disorders Febrile seizures / Acute non-febrile seizures
MEDICAL MANAGEMENT
Paediatric seizure
PM0000107100001189
disorders Status epilepticus
MEDICAL MANAGEMENT
PancreatitisPM0000110200001190 Acute necrotizing severe pancreatitis / Pancreatitis
MEDICAL MANAGEMENT
Plasmapheresis
PM0000116600001191 Plasmapheresis - Add on
MEDICAL MANAGEMENT
Platelet pheresis
PM0000116900001192 Platelet pheresis - Add on
MEDICAL MANAGEMENT
Pleural Effusion
PM0000117100001193 Pleural Effusion
MEDICAL MANAGEMENT
PneumoniaPM0000118000001194 Pneumonia/Severe pneumonia
MEDICAL MANAGEMENT
Pneumothorax PM0000118300001195 Pneumothorax
MEDICAL MANAGEMENT
Poisoning PM0000118600001196 Acute organophosphorus poisoning/Other poisonings
MEDICAL MANAGEMENT
RespiratoryPM0000127500001197
MEDICAL MANAGEMENT
Rheumatic PM0000128700001198
fever Acute rheuma c fever/ Rheuma c valvular heart disease
MEDICAL MANAGEMENT
Rickets - requiring
PM0000129200001199
admission for Work
Rickets
Up - requiring admission for Work Up and/or in-patient managemen
MEDICAL MANAGEMENT
Scrub Typhus PM0000131500001200 Scrub Typhus
MEDICAL MANAGEMENT
SEVERE ANEMIAPM0000132700001201 Iron deficiency anemia / Thalessmia / Other anemias
MEDICAL MANAGEMENT
SEVERE ANEMIAPM0000132700001202 Severe anemia HB less 8 gm/dl
MEDICAL MANAGEMENT
Severe sepsisPM0000132900001203 Severe sepsis/Septic shock
MEDICAL MANAGEMENT
Short staturePM0000133100001204 Short stature- requiring admission for Work Up
MEDICAL MANAGEMENT
Sickle cell Anemia
PM0000133500001205 Sickle cell Anemia - Govt Reserve
MEDICAL MANAGEMENT
Skin and softPM0000134600001206
MEDICAL MANAGEMENT
Snake bite PM0000135000001207 Snake bite
MEDICAL MANAGEMENT
Staphylococcal
PM0000137600001208
scalded skin syndrome Staphylococcal scalded skin syndrome
PAEDIATRICPM0000140
MEDICAL MANAGEMENT
Blood transfusion
PM000014000001131 Blood component FFP - Add on
PAEDIATRICPM0000140
MEDICAL MANAGEMENT
Blood transfusion
PM000014000001132 Whole Blood transfusion/Blood component including platelet transfusio
PAEDIATRICPM0000140
MEDICAL MANAGEMENT
Blood transfusion
PM000014000001133 Blood transfusion-Blood component SDP (IF platelet
PAEDIATRICPM0000141
MEDICAL MANAGEMENT
Blood transfusion-Blood
PM000014100001134componentBloodplatelet
transfusion-Blood
transfusion (SDP)
component platelet transfusion (SDP)
MEDICAL MANAGEMENT
Systematic PM0000142100001209
lupus erythematosus Systematic lupus erythematosus (SLE)/ Diffuse alveolar hemmorhage as
MEDICAL MANAGEMENT
Tetanus PM0000143200001210 Tetanus
MEDICAL MANAGEMENT
Thyrotoxic crisis
PM0000144700001211 Thyrotoxic crisis
MEDICAL MANAGEMENT
Treatment of PM0000147500001212
systemic fungal infections
Treatment of systemic fungal infections
MEDICAL MANAGEMENT
tuberculosisPM0000147800001213 Pericardial tuberculosis / Pleural tuberculosis
MEDICAL MANAGEMENT
Unexplained PM0000149300001214
hepatosplenomegaly Unexplained hepatosplenomegaly-requiring admission for Work Up and
MEDICAL MANAGEMENT
Vasculitis/ autoimmune
PM0000153300001215
disorder Vasculitis/ autoimmune disorder
MEDICAL MANAGEMENT
Viral Encephalitis
PM0000154700001216 Viral Encephalitis
MEDICAL MANAGEMENT
Wilson’s disease
PM0000155700001217 Wilson’s disease-requiring admission for work-up and/or inpatient care
PAEDIATRICPM000019
MEDICAL MANAGEMENT
Acute ataxiaPM00001900001120 Acute ataxia
PAEDIATRICPM0000194
MEDICAL MANAGEMENT
Celiac disease
PM000019400001135 Celiac disease-requiring admission for Work Up and/or in-patient manag
PAEDIATRICPM0000199
MEDICAL MANAGEMENT
Central LinePM000019900001136
LumenLine
PAEDIATRICPM0000213
MEDICAL MANAGEMENT
CHD /RHD PM000021300001137 CHD /RHD
PAEDIATRICPM0000219
MEDICAL MANAGEMENT
Chikungunya PM000021900001138
fever Chikungunya fever
PAEDIATRICPM000022
MEDICAL MANAGEMENT
ACUTE ENCEPHALOPATHY
PM00002200001121 Acute Febrile encephalopathy/Acute Disseminated Encephalomyelitis/h
PAEDIATRICPM0000220
MEDICAL MANAGEMENT
Children withPM000022000001139
dysmorphic features Children with dysmorphic features- requiring admission for work-up
PAEDIATRICPM000024
MEDICAL MANAGEMENT
Acute gastroenteritis
PM00002400001122
with dehydrationAcute gastroenteritis with moderate dehydration/Acute gastroenteritis
PAEDIATRICPM0000266
MEDICAL MANAGEMENT
Congestive PM000026600001140
PAEDIATRICPM000028
MEDICAL MANAGEMENT
Acute glomerulonephritis
PM00002800001123 Acute glomerulonephritis
PAEDIATRICPM0000295
MEDICAL MANAGEMENT
ContinuousPM000029500001141
PAEDIATRICPM000030
MEDICAL MANAGEMENT
Acute ischemic
PM00003000001124
stroke Acute ischemic stroke
PAEDIATRICPM0000316
MEDICAL MANAGEMENT
Croup syndrome
PM000031600001142 Acute laryngotracheobronchitis/Acute epiglottitis
PAEDIATRICPM000033
MEDICAL MANAGEMENT
Acute severe PM00003300001125
malnutrition Acute severe malnutrition
PAEDIATRICPM000038
MEDICAL MANAGEMENT
Acute transverse
PM00003800001126
myelitis Acute transverse myelitis
PAEDIATRICPM000042
MEDICAL MANAGEMENT
Acute urticaria
PM00004200001127
/ Anaphylaxis Acute urticaria / anaphylaxis / Steven Johnson syndrome
PAEDIATRICPM000045
MEDICAL MANAGEMENT
Addison’s disease
PM00004500001128 Addison’s disease
PAEDIATRICPM0000465
MEDICAL MANAGEMENT
Cyanotic spells
PM000046500001143 Cyanotic spells without CHD/Cyanotic spells with CHD
PAEDIATRICPM0000484
MEDICAL MANAGEMENT
Dengue fever PM000048400001144 Dengue fever/Dengue hemorrhagic fever/Dengue shock syndrome
PAEDIATRICPM0000488
MEDICAL MANAGEMENT
DevelopmentalPM000048800001145
and behavioral disorders
Developmental and behavioral disorders for Work Up / in-patient mana
PAEDIATRICPM0000545
MEDICAL MANAGEMENT
Empyema PM000054500001146 Empyema
PAEDIATRICPM0000551
MEDICAL MANAGEMENT
EndocarditisPM000055100001147 Bacterial Endocarditis/Fungal Endocarditis
PAEDIATRICPM0000563
MEDICAL MANAGEMENT
Enteric feverPM000056300001148 Enteric fever
PAEDIATRICPM0000570
MEDICAL MANAGEMENT
epilepsy PM000057000001149 Drug resistant epilepsy/Evaluation of drug resistant epilepsy
PAEDIATRICPM0000572
MEDICAL MANAGEMENT
Epileptic encephalopathy
PM000057200001150 Epileptic encephalopathy
PAEDIATRICPM000061
MEDICAL MANAGEMENT
AKI / Renal PM00006100001129
PAEDIATRICPM0000652
MEDICAL MANAGEMENT
Febrile illness
PM000065200001151 Acute febrile illness / Pyrexia of unknown origin
PAEDIATRICPM0000671
MEDICAL MANAGEMENT
Floppy infantPM000067100001152
syndrome Floppy infant syndrome requiring admission for work-up
PAEDIATRICPM0000708
MEDICAL MANAGEMENT
GI bleedingPM000070800001153 Lower GI bleeding / Upper GI bleeding
PAEDIATRICPM0000713
MEDICAL MANAGEMENT
Global developmental
PM000071300001154
delay / Intellectual
Global disability
developmental
of unknown
delay/Intellectual
etiology disability-requiring admission f
PAEDIATRICPM0000722
MEDICAL MANAGEMENT
Guillain Barre
PM000072200001155
syndrome Guillain Barre syndrome / AFP
PAEDIATRICPM0000726
MEDICAL MANAGEMENT
HaemodialysisPM000072600001156
PAEDIATRICPM0000728
MEDICAL MANAGEMENT
HaemolyticPM000072800001157
uremic syndrome Haemolytic uremic syndrome
PAEDIATRICPM0000737
MEDICAL MANAGEMENT
HemostaticPM000073700001158
Disorders Hemophilia / Platelet disorders - govt reserve
PAEDIATRICPM0000745
MEDICAL MANAGEMENT
Hepatitis PM000074500001159 Acute liver failure/Fulminant Hepatitis / Acute viral hepatitis /Alcoholic
PAEDIATRICPM0000759
MEDICAL MANAGEMENT
High end histopathology
PM000075900001160(Biopsies) and
Highadvanced
end histopathology
PAEDIATRICPM0000766
MEDICAL MANAGEMENT
High end radiological
PM000076600001161
PAEDIATRICPM0000774
MEDICAL MANAGEMENT
HIV with complications
PM000077400001162 HIV with complications
PAEDIATRICPM0000777
MEDICAL MANAGEMENT
Hydrocephalus
PM000077700001163 Hydrocephalus
PAEDIATRICPM0000795
MEDICAL MANAGEMENT
Idiopathic Thrombocytopenic
PM000079500001164 Purpura
Idiopathic Thrombocytopenic Purpura
PAEDIATRICPM0000798
MEDICAL MANAGEMENT
IHD / CAD /PM000079800001165
Arrhythmia IHD/Arrhythmia/CAD
PAEDIATRICPM0000809
MEDICAL MANAGEMENT
Immune mediated
PM000080900001166
PAEDIATRICPM0000813
MEDICAL MANAGEMENT
Inborn errors
PM000081300001167
of metabolism Inborn errors of metabolism-requiring admission for work-up and/or inp
PAEDIATRICPM0000817
MEDICAL MANAGEMENT
InflammatoryPM000081700001168
Crisis Myopathy / Myaesthenic Crisis
PAEDIATRICPM0000827
MEDICAL MANAGEMENT
Intestinal obstruction
PM000082700001169 Intestinal obstruction- medical managment
PAEDIATRICPM0000833
MEDICAL MANAGEMENT
INTRACRANIALPM000083300001170
SPACE OCCUPYING LESIONS
Intracranial hemorrhage/Intracranial space occupying lesion tuberculom
PAEDIATRICPM0000852
MEDICAL MANAGEMENT
Juvenile Arthritis
PM000085200001171 Juvenile Arthritis
PAEDIATRICPM0000854
MEDICAL MANAGEMENT
Juvenile myasthenia
PM000085400001172 Juvenile myasthenia- requiring admission for work-up or in-patient care
PAEDIATRICPM0000856
MEDICAL MANAGEMENT
Kawasaki Disease
PM000085600001173 Kawasaki Disease
PAEDIATRICPM0000857
MEDICAL MANAGEMENT
Ketogenic diet
PM000085700001174
initiation in refractory
Ketogenic
epilepsydiet initiation in refractory epilepsy
PAEDIATRICPM0000876
MEDICAL MANAGEMENT
Leptospirosis
PM000087600001175 Leptospirosis
PAEDIATRICPM0000895
MEDICAL MANAGEMENT
Lung abscessPM000089500001176 Lung abscess
PAEDIATRICPM0000901
MEDICAL MANAGEMENT
Malaria PM000090100001177 malaria / Complicated malaria
PAEDIATRICPM0000940
MEDICAL MANAGEMENT
Medical Management
PM000094000001178
Raised ICPpressure
PAEDIATRICPM0000947
MEDICAL MANAGEMENT
Meningitis PM000094700001179 Chronic meningitis/Partially treated pyogenic meningitis/Neuro tubercu
PAEDIATRICPM0000968
MEDICAL MANAGEMENT
MyasthenicPM000096800001180
crisis Myasthenic crisis
PAEDIATRICPM0000970
MEDICAL MANAGEMENT
MyasthenicPM000097000001181
crisis (Plasmapheresis) Myasthenic crisis (Plasmapheresis)
PAEDIATRICPM0000974
MEDICAL MANAGEMENT
MyxedemaPM000097400001182
coma Myxedema coma
PAEDIATRICPM0000981
MEDICAL MANAGEMENT
Neonatal/ Infantile
PM000098100001183
cholestasis Neonatal/infantile cholestasis / Choledochal cysts
PULMONOLOGY
PO0000102aspiration/ PO000010200001410
PULMONOLOGY
PO00001080
Palliative and
PO0000108000001418
Palliative disease
care endatstage
advanced
disease
or end stage
PULMONOLOGY
PO00001172
Pleural Effusion
PO0000117200001419 Pleural Effusion
PULMONOLOGY
PO00001181
PneumoniaPO0000118100001420 Pneumonia/Severe pneumonia
PULMONOLOGY
PO00001184
PneumothoraxPO0000118400001421 Pneumothorax
PULMONOLOGY
PO00001213
Pulmonary PO0000121300001422
thromboembolism Pulmonary thromboembolism
PULMONOLOGY
PO00001276
RespiratoryPO0000127600001423
PULMONOLOGY
PO00001296
Rigid laryngoscopy
PO0000129600001424
/ Thoracoscopy /Rigid
bronchoscopy
laryngoscopy / / Thoracoscopy / bronchoscopy /
PULMONOLOGY
PO00001479
tuberculosisPO0000147900001425 Pericardial tuberculosis / Pleural tuberculosis/ Pulmonary tuberculosis
PULMONOLOGY
PO0000546Empyema PO000054600001411 Empyema
PULMONOLOGY
PO0000548Endobronchial
PO000054800001412
Ultrasound (EBUS) Endobronchial Ultrasound guided fine needle biopsy
PULMONOLOGY
PO0000662Fibreoptic bronchoscopy
PO000066200001413 (FOB) Fibreoptic bronchoscopy (FOB)
PULMONOLOGY
PO0000760High end histopathology
PO000076000001414 (Biopsies) and
Highadvanced
end histopathology
PULMONOLOGY
PO0000767High end radiological
PO000076700001415
PULMONOLOGY
PO0000896Lung abscessPO000089600001416 Lung abscess
PULMONOLOGY
PO0000903Malignant Pleural
PO000090300001417
Pleural
tap with
effusion
Pig tail
/ Pleurodesis
PMR PR00001005
Nerve root PR0000100500001398
PMR PR00001202
Pressure sore-Interventions
PR0000120200001399 Palliative Care approach to managing Pressure sore in advanced chronic
PMR PR00001205
PRP Injection
PR0000120500001400
For MSK Disorder - Govt PRPreserve
Injection For MSK Disorder - Govt reserve
PMR PR00001285
RF AblationPR0000128500001401
of Peripheral nerve / spinal
RF Ablation
nerve -of Govt
Peripheral
Reservenerve / spinal nerve - Govt Reserve
PMR PR00001341
Single eventPR0000134100001402
multi level surgery (SEMLS)
Singleforevent
spasticity
multi level
management
surgery (SEMLS)
( more than
for spasticity
4 level) management ( mo
PMR PR00001361
Spine Pain relieving
PR0000136100001403
procedures (Caudal
Spine/Painfacet/relieving
stellateprocedures
ganglion block)
( Caudal / facet/ stellate ganglion block)
PMR PR0000290ConservativePR000029000001392
managment of pressure Conservative
ucler in spinal
managment
cord injury
of pressure
patients ucler
including
(NPUPNPWT
grade
(Vac
>=3)
Therapy
in spinal
) Inc
PMR PR0000291ConservativePR000029100001393
Rehabilitaion PackagesComprehensive
( cardiopulmonary;Neurological;Orthopaedic
medical rehabilitation for spinal Rehabilitaion
injury/ traumatic
) Including
brain
PMR PR0000730HALO cervical
PR000073000001394
traction in upper cervical
HALOspinecervical
injury
traction in upper cervical spine injury
PMR PR0000823Interventional
PR000082300001395
Rehabilation of spasticity
Interventional
in storke/ Rehabilation
TBI / CP / SCIofWith
spasticity
Bot. Toxin
in storke/
- GovtTBI
Reserve
/ CP / SCI With Bo
PMR PR0000829Intra Articular
PR000082900001396
Injections for MSK disorder
Intra Articular
- Govt reserve
Injections for MSK disorder - Govt reserve
PMR PR0000944Medical/ neuro
PR000094400001397
rehablitation Medical rehabilitation of muscular dystrophy/Medical Rehabilitation int
PAEDIATRICPS0000101aspiration/
SURGERY PS000010100001227
PAEDIATRICPS00001010
SURGERY NeurogenicPS0000101000001292
bladder - Package for evaluation
Neurogenic/ investigation
bladder - Package
(catheter
for evaluation
+ ultrasound/ investigation
+ culture + RGU/
(catheter
MCU)+ f
SURGERY Open bladderPS0000102800001293
diverticulectomy withOpen/ without
bladder
ureteric
diverticulectomy
re-implantation
with / without ureteric re-implantation ±
SURGERY Operation for
PS0000104100001294
Duplication of IntestineOperation for Duplication of Intestine
PS0000104300001295
Hydrocele (B/L) / herniotomy-
OperationGovt
for Hydrocele
reserved (B/L) / herniotomy- Govt reserved
PS0000104500001296
Hydrocele (U/L) / herniotomy
Operation- for
Govt
Hydrocele
reserved(U/L) / herniotomy - Govt reserved
SURGERY Operation forAbdominal
PS0000104700001297 /Lung Hydatid
Operation
Cyst (Single
forAbdominal/Lung
Organ) - Change Hydatid
in NameCyst (Single Organ) - Change in N
SURGERY Operation ofPS0000104900001298
Choledochal Cyst Operation of Choledochal Cyst
SURGERY Operations PS0000105100001299
for Replacement of Oesophagus
Operations
by for
Colon
Replacement of Oesophagus by Colon/ileal/jejunal/Stom
PAEDIATRICPS0000106Augmentation
SURGERY PS000010600001228
cystoplasty Augmentation cystoplasty
SURGERY OrchidectomyPS0000106100001300 Orchidectomy BL / UL - Govt reserved
SURGERY OrchiopexyPS0000106300001301 Orchiopexy with laparoscopyto be cross checked with pead surgery - U/
SURGERY OrchiopexyPS0000106300001302 Orchiopexy without laparoscopy - U/L or B/L - Govt Reserve
SURGERY Partial Cystectomy
PS0000110800001303 Partial Cystectomy
SURGERY Perineal Urethrostomy
PS0000113600001304
without closure
Perineal Urethrostomy without closure
SURGERY PORTAL HYPERTENSION
PS0000118800001305 NON-SHUNTS
SURGERY Post. Urethral
PS0000119400001306
Valve fulguration Post. Urethral Valve fulguration
SURGERY POSTERIORPS0000120000001307
URETHERAL VALVES VESICOSTOMY
SURGERY Pyelolithotomy
PS0000121400001308 Pyelolithotomy - Open/Lap. ± DJ Stenting
SURGERY PyeloplastyPS0000121600001309
/ Pyeloureterostomy / Pyelopyelostomy
Pyeloplasty - Laparoscopic/Pyeloureterostomy - Laparoscopic/Pyelopyel
SURGERY PyeloplastyPS0000121600001310
Pyeloplasty - Open/Pyeloureterostomy - Open/Pyelopyelostomy - Open
SURGERY Pyloromyotomy
PS0000121900001311 Pyloromyotomy
SURGERY PyloroplastyPS0000122100001312 Pyloroplasty
SURGERY Rectal Polypectomy,
PS0000124900001313
+/-Sigmoiescopic
Rectal
Under
Polypectomy,
GA +/-Sigmoiescopic Under GA
SURGERY Repair of macrostomia
PS0000126500001314 Repair of macrostomia
SURGERY Repair of tongue
PS0000126800001315
SURGERY Resection Anastomosis
PS0000127000001316 Resection Anastomosis
SURGERY Retro - Peritoneal
PS0000128000001317
Lymphangioma Excision
Retro - Peritoneal Lymphangioma Excision
SURGERY Retroperitoneal
PS0000128200001318
Tumor – Excision Retroperitoneal Tumor – Excision
SURGERY Rib Resection
PS0000129100001319
SURGERY Rigid laryngoscopy
PS0000129500001320
/ bronchoscopy /Rigid laryngoscopy / bronchoscopy /oesophagoscopy - Diagnos c + / - b
PAEDIATRICPS0000133Bladder
SURGERY injury
PS000013300001229
repair Bladder injury repair (with or without urethral injury)
PAEDIATRICPS0000135Bladder
SURGERY injury
PS000013500001230
repair with colostomyBladder injury repair with colostomy (with or without urethral injury)
SURGERY Sphinecterotomy
PS0000135500001321
- for Hirschsprung’s
Sphinecterotomy
Disease - for Hirschsprung’s Disease
SURGERY Splenectomy PS0000136300001322 Splenectomy
SURGERY SPLENORRHAPHY
PS0000136400001323 Splenorapphy
SURGERY Staging Laparotomy
PS0000137300001324
and proceed forStaging
Ovarian
Laparotomy
Cancers. Omentomy
and proceedwith
for Bilateral
Ovarian Cancers.
Omentomy with B
SURGERY SUPERNUMMERYPS0000138900001325
DIGIT EXISION Excision of supernumerary digit
SURGERY SuprapubicPS0000139000001326
Drainage - Closed / Trocar Suprapubic Drainage - Closed / Trocar
SURGERY Surgery for PS0000139400001327
Congenital Lobar Emphysema Surgery for Congenital Lobar Emphysema
Hirschsprung’s Disease Myectomy
Hirschsprung’s Disease Rectal Biopsy - Punch
Hirschsprung’s Disease Rectal Biopsy – Open
Hirschsprung’s Disease Pull Through
Sacrococcygeal Teratoma Surgery for Sacrococcygeal Teratoma
SURGERY Surgical Management
PS0000141300001333
of PseudoCystCystoJejunostomy /Cystogastrostomy
SURGERY Syndactyly repair
PS0000141900001334 Syndactyly repair
SURGERY Thoracoscopic
PS0000143600001335
Segmental ResectionThoracoscopic Segmental Resection
SURGERY TORTICOLLIS PS0000145400001336
- Sternomastoid division TORTICOLLIS - Sternomastoid division
SURGERY Tracheostomy PS0000146400001337
SURGERY Ureteric reimplantation
PS0000149700001338 Ureteric reimplantation
SURGERY Ureterostomy PS0000150500001339 Ureterostomy (Cutaneous) ± DJ Stenting
SURGERY Uretero-ureterostomy
PS0000150700001340 Uretero-ureterostomy- Open / Lap. ± DJ Stenting
SURGERY Urethral Dilatation
PS0000151100001341 Endocopic as an independent procedure - Stand Alone
SURGERY Urethral Dilatation
PS0000151100001342 Non endocopic as an independent procedure - Stand Alone
SURGERY Urethrorectal PS0000151400001343
fistula repair Urethrorectal fistula repair
SURGERY UrethrovaginalPS0000151600001344
fistula repair Urethrovaginal fistula repair
SURGERY Wilms tumors: PS0000155500001345
surgery / Neuroblastoma
Wilms tumors: surgery / Neuroblastoma
PAEDIATRICPS0000224Cholecystectomy
SURGERY PS000022400001231 Cholecystectomy
PAEDIATRICPS0000238Closure
SURGERY of Burst
PS000023800001232
PAEDIATRICPS0000242Closure
SURGERY of stoma
PS000024200001233 Closure of stoma
PAEDIATRICPS0000246Colostomy
SURGERY PS000024600001234 Defunctioning Colostomy - Stand Alone
PAEDIATRICPS0000246Colostomy
SURGERY PS000024600001235 Exploratory laprotomy with colostomy
PAEDIATRICPS0000252Complete
SURGERY Excision
PS000025200001236
Complete only
Excision
(inclusive
of Growth
of Histopathology)
from Tongue only
PAEDIATRICPS0000259Congenital
SURGERY PS000025900001237
Atresia & Stenosis of SmallCongenital
/ large Intestine
Atresia & Stenosis of Small/ large Intestine
PAEDIATRICPS0000260Congenital
SURGERY PS000026000001238
Diaphragmatic Hernia Congenital Diaphragmatic Hernia - Govt Reserve
PAEDIATRICPS0000267CONJOINED
SURGERY PS000026700001239
TWINS Separation of twins
PAEDIATRICPS0000276Conservative
SURGERY PS000027600001240
PAEDIATRICPS0000285Conservative
SURGERY PS000028500001241
PAEDIATRICPS000031
SURGERY Acute management
PS00003100001218
of upper urinaryAcute
tractmanagement
trauma – conservative
of upper urinary tract trauma –
PAEDIATRICPS0000467Cystolithotomy
SURGERY PS000046700001242
- Open, including cystoscopy
Cystolithotomy - Open - including cystoscopy
PAEDIATRICPS0000469Cystolithotripsy
SURGERY PS000046900001243
/ Urethral Stone endoscopic,
Cystolithotripsy
including
including
cystoscopy
cystoscopy
PAEDIATRICPS0000469Cystolithotripsy
SURGERY PS000046900001244
Urethral Stone
including
removal
cystoscopy
endoscopic, including cystoscopy
PAEDIATRICPS000047
SURGERY Adrenalectomy PS00004700001219 Adrenalectomy
PAEDIATRICPS0000478Decortication
SURGERY PS000047800001245
(Pleurectomy) Decortication (Pleurectomy)
PAEDIATRICPS0000481Deep
SURGERY neck abscess
PS000048100001246
Deep neckneckabscess drainage/Post trauma neck exploration
PAEDIATRICPS0000505Distal
SURGERY Pancreatectomy
PS000050500001247
with Distal Pancreatectomy/Pancreatico Jejunostomy with/without spleenlec
PAEDIATRICPS0000510Diverticulectomy
SURGERY PS000051000001248 Excision Meckel's Diverticulum/ Duodenal Diverticulum
PAEDIATRICPS0000512DJ
SURGERY stenting PS000051200001249
including cystoscopy, ureteric
DJ stenting
catheterization,
including cystoscopy,
retrogradeureteric
pyelogram
catheterization, retrograde py
PAEDIATRICPS0000517Duplication
SURGERY PS000051700001250
Cyst Excision Duplication Cyst Excision
PAEDIATRICPS0000536Emergency
SURGERY PS000053600001251
management of Acute retention
Emergency of management
Urine of Acute retention of Urine
SURGERY PS000054000001252
SURGERY PS000054200001253
management of UretericEmergency
stone - Package
management
for evaluation
of Ureteric
/ investigation
stone - Package
(ultrasound
for evaluation
+ culture)
/ inv
fo
PAEDIATRICPS0000568Epididymal
SURGERY PS000056800001254
Cyst / Nodule Excision Epididymal Cyst excision/Epididymal Nodule excision Govt reserved
PAEDIATRICPS0000578ESOPHAGEAL
SURGERY PS000057800001255
ATRESIA / TEF PRIMARY REPAIR / esophagostomy & gastrostomy / gastric pull-up
PAEDIATRICPS0000579ESOPHAGEAL
SURGERY PS000057900001256
DILATATION Esophageal dilatation
PAEDIATRICPS0000596Excision
SURGERY of accessory
PS000059600001257
auricle Excision of accessory auricle
PAEDIATRICPS0000623Exomphalos
SURGERY PS000062300001258
/ Gastroschisis Exomphalos/Gastroschisis
PAEDIATRICPS0000625Exploratory
SURGERY PS000062500001259
Laparotomy Exploratory Laparotomy - Stand alone
PAEDIATRICPS0000626exploratory
SURGERY PS000062600001260
laparotomy / Ileostomyexploratory
/ colostomylaparotomy / Ileostomy / colostomy
PAEDIATRICPS0000633Extended
SURGERY LOS
PS000063300001261
PAEDIATRICPS0000647Extrophy
SURGERY Bladder
PS000064700001262
repair including osteotomy
Extrophy Bladder
if neededrepair
+ epispadias
includingrepair
osteotomy
+ ureteric
if needed
reimplant
+ epispadias rep
PAEDIATRICPS0000655Fecal
SURGERY FistulaPS000065500001263
Closure Fecal Fistula Closure
PAEDIATRICPS0000657Feeding
SURGERY Jejunostomy
PS000065700001264 Feeding Jejunostomy
PAEDIATRICPS0000677Foreign
SURGERY BodyPS000067700001265
Removal ( Airway) Foreign Body Removal ( Airway)
PAEDIATRICPS000068
SURGERY Ankyloglossia PS00006800001220 Ankyloglossia Major
PAEDIATRICPS000068
SURGERY Ankyloglossia PS00006800001221 Ankyloglossia Minor
PAEDIATRICPS0000680Foreign
SURGERY BodyPS000068000001266
PAEDIATRICPS000069
SURGERY Ano Rectal PS00006900001222
Malformation Ano Rectal Malformation Redo - Pullthrough
PAEDIATRICPS000069
Malformation Abd - Perineal PSARP / PSARP
PAEDIATRICPS000069
Malformation Anoplasty
PAEDIATRICPS0000702Gastrostomy
SURGERY PS000070200001267
+ Esophagoscopy + Threading
Gastrostomy + Esophagoscopy + Threading
PAEDIATRICPS0000709GI
SURGERY Tumor Excision
PS000070900001268 GI Tumor Excision
PAEDIATRICPS0000719Groin
SURGERY HerniaPS000071900001269
Repair Groin Hernia Repair Obturator - GOVT RESERVED
PAEDIATRICPS0000739Hepatic
SURGERY Resection
PS000073900001270 Hepatic Resection
PAEDIATRICPS0000746Hepatoblastoma
SURGERY PS000074600001271
Excision Hepatoblastoma Excision
PAEDIATRICPS0000749Hernia
SURGERY PS000074900001272 Umbilical/Paraumbilical/Spigelian/Incisional hernia
PAEDIATRICPS0000751Hernia
SURGERY - Epigastric/
PS000075100001273
Ventral Hernia - Epigastric/ Ventral
PAEDIATRICPS0000753Hiatus
SURGERY Hernia
PS000075300001274
Repair / Fundoplication Hiatus Hernia Repair - Open/Hiatus Hernia Repair - Lap/Fundoplication -
PAEDIATRICPS0000768High
SURGERY inguinal
PS000076800001275
Orchiectomy High inguinal Orchiectomy
PAEDIATRICPS0000781Hypospadias
SURGERY PS000078100001276
repair Single stage Hypospadias repair - govt reserve
SURGERY PS000078100001277
repair Two or more stage (Final Stage) / Fistula repair- govt reserve
SURGERY PS000078100001278
repair Two or more stage (First Stage) Hypospadias repair independently - govt
PAEDIATRICPS0000801Ileostomy
SURGERY PS000080100001279 Ileostomy-Stand alone
PAEDIATRICPS0000828Intestinal
SURGERY obstruction
PS000082800001280 Intestinal obstruction- medical managment
PAEDIATRICPS0000840Intussusception
SURGERY PS000084000001281 Non – Operative Reduction in infants
PAEDIATRICPS0000840Intussusception
SURGERY PS000084000001282 Operative in infants
PAEDIATRICPS000085
SURGERY Appendicectomy
PS00008500001225 Appendicectomy
PAEDIATRICPS000086
SURGERY APPENDICO-VESICOSTOMY/Mitraffanof
PS00008600001226 Appendicovesicostomy or Monti procedure
PAEDIATRICPS0000888LIVER
SURGERY / Spleen
PS000088800001283
TRAUMA NON-OP Non-operative management of LIVER / Spleen trauma
PAEDIATRICPS0000909MALROTATION
SURGERY PS000090900001284 Ladd's procedure
PAEDIATRICPS0000933Meatotomy
SURGERY PS000093300001285
/ Meatoplasty Meatotomy/Meatoplasty
PAEDIATRICPS0000954Mesenteric
SURGERY PS000095400001286
Cyst – Excision Mesenteric Cyst – Excision
PAEDIATRICPS0000982Nephrectomy
SURGERY PS000098200001287 Nephrectomy For Benign pathology /Nephrectomy- Radical (Renal tumo
PAEDIATRICPS0000985Nephrectomy
SURGERY PS000098500001288
- Partial or Hemi Nephrectomy - Partial or Hemi
PAEDIATRICPS0000988Nephro
SURGERY ureterectomy
PS000098800001289
(Benign) Nephro ureterectomy (Benign)
PAEDIATRICPS0000991Nephro
SURGERY ureterectomy
PS000099100001290
with cuff of bladder
Nephro ureterectomy with cuff of bladder
PAEDIATRICPS0000996Nephrostomy
SURGERY PS000099600001291
POLYTRAUMAPT00001177Plexus injury
PT0000117700001409
along with Vascular injury
Plexus
repair
injury
/ graft
along with Vascular injury graft/ Repair
POLYTRAUMAPT0000289Conservative PT000028900001404
management Conservative management of Chest/Abdomen/HNF/Pelvis(Blood transfu
POLYTRAUMAPT0000917Management PT000091700001406
Management
of Longofbone
Chest injury with fixation of Single LIMB
Management
of Longofbone
Chest injury with fixation of 2 or more LIMB
RADIATIONRO000010
ONCOLOGY2D ExternalRO00001000001429
Beam Radiotherapy (Telecobalt
Additional/ Strock
fractions
LA) - 18 Max upto (Every additional fraction at Rs.500 p
RADIATIONRO00001082
ONCOLOGYPalliative Care
RO0000108200001460
HaematuriaPalliative
in advanced
Interventions
RADIATIONRO00001088
ONCOLOGYPalliative Care
RO0000108800001461
Management of Osteoradionecrosis
Osteoradionecrosis -Surgical
-Surgical
intervention
intervention
RADIATIONRO00001091
ONCOLOGYPalliative nerurosurgical
RO0000109100001462
interventions
Palliative
for secondary
neurological
vertebral
interventions
and brain metastasis
RADIATIONRO00001093
ONCOLOGYPalliative Radiological
RO0000109300001463
and endoscopical
Palliative
Interventions
RADIATIONRO00001096
ONCOLOGYPalliative surgical
RO0000109600001464
Palliative surgical
Tracheostomy,
interventions
RADIATIONRO000011
Adjuvant/Neoadjuvant
/ Strock LA)
RADIATIONRO000011
Radical / Strock LA)
RADIATIONRO00001160
ONCOLOGYPET scan RO0000116000001465 PET scan
RADIATIONRO00001277
ONCOLOGYRespiratoryRO0000127700001466
Ga ng along with LinearAddi Accelerator
onal fracplanning
ons - 10(5Max
FracuptoEvery
ons) addi onal frac on at Rs.3500 pe
RADIATIONRO00001277
ONCOLOGYRespiratoryRO0000127700001467
Ga ng along with LinearRespiratory
AcceleratorGating
planning
along
(5 with
Frac Linear
ons) Accelerator planning
RADIATIONRO00001370
ONCOLOGYSRS with IGRTRO0000137000001468
(Stereotaca c radiotherapy)
SRS with IGRT (Stereotacatic radiotherapy)
RADIATIONRO00001371
ONCOLOGYSRT / SBRT RO0000137100001469
with IGRT Addi onal frac ons - 4 Every addi onal frac on at Rs.11000 per Frac on
RADIATIONRO00001371
ONCOLOGYSRT / SBRT RO0000137100001470
with IGRT SRT / SBRT with IGRT (Stereotaca c radiotherapy)
RADIATIONRO00001543
ONCOLOGYVertebroplasty/Kyphoplasty
RO0000154300001471 Vertebroplasty/Kyphoplasty - Govt reserved
RADIATIONRO0000160Brachytherapy
ONCOLOGY RO000016000001433
High Dose Radia onIntracavitory/Intraluminal/Endobiliary/Endobronchial/CVS
(2D/X-ray)
ONCOLOGY RO000016100001434
High Dose Radia on Addi (5 doses)
onal frac ons - 11 Max uptoEvery addi onal frac on at Rs.1600 pe
ONCOLOGY RO000016100001435
High Dose Radia on Interstitial
(5 doses) / Intracavitary complex planning like CT or MR/Surface Mould
RADIATIONRO000051
ONCOLOGYAdvanced /RO00005100001432
RADIATIONRO0000589EUA
ONCOLOGY separateRO000058900001436
RADIATIONRO00008
Beam Radiotherapy - PalliaPalliative
ve (Telecobalt / Strock LA)
RADIATIONRO0000842Iodine
ONCOLOGY treatment
RO000084200001437
100 mCi Iodine treatment 100 mCi
ONCOLOGY treatment
RO000084300001438
ONCOLOGY treatment
RO000084400001439
ONCOLOGY treatment
RO000084500001440
RADIATIONRO0000846iodine
ONCOLOGY treatment
RO000084600001441
3 mCi large Dose scan/ Pre Ablation - calculation of treatment
RADIATIONRO0000847iodine
ONCOLOGY treatment
RO000084700001442
30 mCi Ablation residual disease any risk
ONCOLOGY treatment
RO000084800001443
50 mCi Ablation of residual neck disease low/intermediate
RADIATIONRO0000882Linear
ONCOLOGY Accelerator
RO000088200001444
External Beam Radiotherapy
Addi onal frac IGRT
ons(Image
- 15 MaxGuided
upto(Every
radiotherapy)
addi onal
withfrac
3D CRT
on atorRs.2500
IMRT p
RO000088200001445
Linear Accelerator
IGRT (Image
ExternalGuided
Beam radiotherapy)
Radiotherapy IGRT
with 3D
(Image
CRT or
Guided
IMRTrad
RO000088300001446
Addi onal frac IGRT
ons(Image
- 18 MaxGuided
uptoEvery
radiotherapy)
addi onal
with
frac
3D on
CRTatorRs.2500
IMRT pe
RO000088300001447
Linear Accelerator
IGRT (Image
ExternalGuided
Beam radiotherapy)
Radiotherapy IGRT
with 3D
(Image
CRT or
Guided
IMRTrad
ONCOLOGY Accelerator,
RO000088400001448
Additional fractions
3D CRT -(2510 Frac
Max upto
ons) (Every additional fraction at Rs.1000
RO000088400001449
Linear Accelerator,
3D CRTExternal
(25 FracBeam
ons) Radiotherapy 3D CRT (25 Frac ons)
RO000088500001450
3D CRT -(618Frac
Maxons)
upto (Every additional fraction at Rs.1000
RO000088500001451
Linear Accelerator,
3D CRTExternal
(6 Frac Beam
ons) Radiotherapy 3D CRT (6 Frac ons)
RO000088600001452
IMRT (Intensity
- 15 (EveryModulated
additionalRadiotherapy)
fraction at Rs.2000 per Fractio
RO000088600001453
Linear Accelerator,
IMRT (Intensity
External Beam
Modulated
Radiotherapy
Radiotherapy)
IMRT (Intensity Modula
RO000088700001454
IMRT (Intensity
- 18 MaxModulated
upto (EveryRadiotherapy)
additional fraction at Rs.2000
RO000088700001455
Linear Accelerator,
IMRT (Intensity
External Beam
Modulated
Radiotherapy
Radiotherapy)
IMRT (Intensity Modula
RADIATIONRO00009
2D External
/ Strock
BeamLA) Radiotherapy (Telecobalt / Strock LA)
RADIATIONRO00009
Additional/ Strock
fractions
LA) - 10 Max upto (additional fraction at Rs.500 per Frac
RADIATIONRO0000904Malignant
ONCOLOGY Pleural
RO000090400001456
Pleural
tap with
effusion
Pig tail
& Pleurodesis
RADIATIONRO0000908Malignant
ONCOLOGY Spinal
RO000090800001457
Cord compressionMalignant
with Diagnostics,
Spinal cord
palliative
compression
radiotherapy, Brace in advanced cancer pati
RADIATIONRO0000910Management
ONCOLOGY RO000091000001458
of bleeding in malignantTranshead
arterial
and neck
Embolization
/ inguinal malignancies
RADIATIONRO0000913Management
ONCOLOGY RO000091300001459
of bleeding malignantHaemostatic
head and neck Surgery
/ inguinal
in advance
lesionscancer patient/Haemostatic Radiothera
PLASTIC & RECONSTRUCTIVE
RP00001008
Nerve Transposition
SURGERY
RP0000100800001373
RP00001019
NPWT SURGERY RP0000101900001374 NPWT
RP00001033
Open reduction
SURGERY
RP0000103300001375
and internal fixationOpen
of maxilla
reduction
/ mandible
and internal
/ zygoma
fixation of maxilla/Open reduction and inte
RP00001086
Palliative
SURGERY
Care
RP0000108600001376
approach to managing Pressure
Pressure
sore-Interventions
sore in advanced chronic diseases who are bed ridden-Surgic
RP00001191
Post Burn
SURGERY
Contracture
RP0000119100001377
surgeries forPost
Functional
Burn Contracture
Improvement surgeries for Functional Improvement (Package in
RP00001244
Reconstruction
SURGERY
RP0000124400001378
Flap Tissue Reconstruction Flap / Flap Reconstructive Surgery / Rotation flap
RP00001254
RegionalSURGERY
flap
RP0000125400001379 Myocutaneous flap/Fasciocutaneous flap - add on
RP00001269
Repair SURGERY
of tongue
RP0000126900001380
RP00001284
Revascularization
SURGERY
RP0000128400001381
of limb / digit Revascularization of limb / digit (single digit)
RP00001284
Revascularization
SURGERY
RP0000128400001382
of limb / digit Revascularization of limb / digit(more than one digit)
RP00001309
Scalp avulsion
SURGERY
RP0000130900001383
reconstruction Scalp avulsion reconstruction
RP00001367
Split thickness
SURGERY
RP0000136700001384
skin grafts Large (>4% TBSA)
RP00001367
Split thickness
SURGERY
RP0000136700001385
RP00001427
TendonSURGERY
Grafting
RP0000142700001386
/ Repair Tendon Grafting / Tendon Repair / Tendon transfer
RP00001429
TendonSURGERY
Release
RP0000142900001387
/ Tenotomy Tendon Release / Tenotomy / Tenolysis
RP00001448
Tissue Expander
SURGERY
RP0000144800001388
for disfigurement following
Tissue Expander
burns / for
trauma
disfigurement
/ congenital
following
deformity
burns / trauma / congenital
RP00001450
TM jointSURGERY
ankylosis
RP0000145000001389
of both jaws - under
TM joint
GA ankylosis of both jaws - under GA (Unilateral) / (Bilateral)
RP0000146Bone grafting
SURGERY
RP000014600001348
for Non union Bone grafting for Fracture Non union
RP00001527
VascularSURGERY
reconstruction
RP0000152700001390 Vascular reconstruction with or without vein graft
RP00001530
VascularSURGERY
reconstruction
RP0000153000001391
with graft/patch
RP0000159BrachialSURGERY
Plexus
RP000015900001349
– Repair Brachial Plexus repair
RP0000166Breast SURGERY
Lump RP000016600001350
Excision (Benign) Breast Lump Excision (Benign) under GA/RA
RP0000229Cleft Lip
SURGERY
andRP000022900001351
Palate Surgery (per stage)
Cleft Lip and Palate Surgery (per stage)
RP0000235Closed SURGERY
reduction
RP000023500001352
Closedfor
reduction
fracture/ofintermaxillary
maxilla / mandible
fixation/ for
zygoma/
fracture
Nasal
of maxilla / mandi
RP0000263Congenital
SURGERY
RP000026300001353
Hand Anomaly (Syndactyly, Per Polydactyly,
stage of Syndactyly/Polydactyly/Macrodactyly
Macrodactyly)
RP0000277Conservative
SURGERY
RP000027700001354
RP0000286Conservative
SURGERY
RP000028600001355
RP0000486Dentoalveolar
SURGERY
RP000048600001356
trauma - wiring Dentoalveolar trauma - wiring (dental /trauma wiring- one jaw)
RP0000519Duputryen’s
SURGERY
RP000051900001357
Contracture release + rehabilitation
Duputryen’s Contracture release + rehabilitation
RP0000525Ear Reconstruction
SURGERY
RP000052500001358 Stage-1 & Subsequent stages
RP0000582Estlander
SURGERY
Operation
RP000058200001359
(lip) Estlander Operation (lip)
RP0000634ExtendedSURGERY
LOS
RP000063400001360
RP0000650Fasciotomy
SURGERY
RP000065000001361
/ Debridement & Closure Anti-biotic
of injuries+ -dressing
contused- minimum
laceratedofwounds
5 sessions
RP0000666FixationSURGERY
of fracture
RP000066600001362
of jaw Closed reduction (1 jaw) using wires -under LA/GA
RP0000670Flame /SURGERY
scald
RP000067000001363
% Total Body Surface Area Burns (TBSA) - any % (not requiring admission
scald
RP000067000001364
% Total Body Surface Area Burns (TBSA): < 40 %; Includes % TBSA skin gr
scald
RP000067000001365
% Total Body Surface Area Burns (TBSA): > 40 %; Includes % TBSA skin gr
RP0000693Free Grafts
SURGERY
RP000069300001366
- Wolfe Grafts Free Grafts - Wolfe Grafts
RP0000731Hemangioma
SURGERY
RP000073100001367 Debulking / Excision
RP0000731Hemangioma
SURGERY
RP000073100001368 Sclerotherapy under GA - govt reserve
RP0000782Hypospadias
SURGERY
RP000078200001369
SURGERY
RP000078200001370
SURGERY
RP000078200001371
RP0000960Microvascular
SURGERY
RP000096000001372
reconstruction (free flaps)
Microvascular reconstruction (free flaps)
GENERAL SURGERY
SG00001017
NPWT SG000010170000448 NPWT
GENERAL SURGERY
SG00001025
Oesophagectomy
SG000010250000449 Oesophagectomy Open / lap / VATS / Transthorasic/2F/3F
GENERAL SURGERY
SG00001038
Operation forSG000010380000450
Carcinoma Lip Wedge Excision
GENERAL SURGERY
SG00001038
Carcinoma Lip Wedge Excision and Vermilionectomy/Cheek advancement
GENERAL SURGERY
SG00001040
Duplication of IntestineOperation for Duplication of Intestine
GENERAL SURGERY
SG00001042
Hydrocele (B/L) / herniotomy-
OperationGovt
for Hydrocele
reserved (B/L) / herniotomy- Govt reserved
GENERAL SURGERY
SG00001044
Hydrocele (U/L) / herniotomy
Operation- for
GovtHydrocele
reserved(U/L) / herniotomy - Govt reserved
GENERAL SURGERY
SG00001046
Operation forAbdominal
SG000010460000455 /Lung Hydatid
Operation
Cyst (Single
forAbdominal/Lung
Organ) - ChangeHydatid
in NameCyst (Single Organ) - Change in N
GENERAL SURGERY
SG00001048
Operation of SG000010480000456
Choledochal Cyst Operation of Choledochal Cyst
GENERAL SURGERY
SG00001050
Operations SG000010500000457
for Replacement of Oesophagus
Operationsby for
Colon
Replacement of Oesophagus by Colon/ileal/jejunal
GENERAL SURGERY
SG00001052
Operative Management
SG000010520000459of VolvulusOperative
of Large Bowel
Management of Volvulus of Large Bowel
GENERAL SURGERY
SG00001060
Orchidectomy SG000010600000460 Orchidectomy BL / UL - Govt reserved
GENERAL SURGERY
SG00001085
Palliative Care
SG000010850000461
Pressuresore-Interventions
GENERAL SURGERY
SG00001098
PancreaticoDuodenectomy
SG000010980000462 (Whipple's)
PancreaticoDuodenectomy (Whipple's)
GENERAL SURGERY
SG0000110AV Fistula without
SG00001100000373
prosthesis AV Fistula without prosthesis
GENERAL SURGERY
SG00001106
ParotidectomySG000011060000463 Superficial Parotidectomy
GENERAL SURGERY
SG00001106
ParotidectomySG000011060000464 Total Parotidectomy
GENERAL SURGERY
SG00001135
Perineal Procedure
SG000011350000465
for Rectal Prolapse
Perineal Procedure for Rectal Prolapse
GENERAL SURGERY
SG00001174
Plexus injurySG000011740000466
along with Vascular injury
Plexus
repair
injury
/ graft
GENERAL SURGERY
SG00001189
Porto CavalSG000011890000467
Anastomosis Porto Caval Anastomosis
GENERAL SURGERY
SG000012 Abdominal SG0000120000370
Procedure for Rectal Prolapse
Abdominal Procedure for Rectal Prolapse
GENERAL SURGERY
SG00001203
Procedure forSG000012030000468
Fissure in Ano Procedure for Fissure in Ano/ anal Fistula / hemorrhoid (Govt reserve)
GENERAL SURGERY
SG00001218
PyloromyotomySG000012180000469 Pyloromyotomy
GENERAL SURGERY
SG00001220
PyloroplastySG000012200000470 Pyloroplasty
GENERAL SURGERY
SG00001231
Radical Neck SG000012310000471
GENERAL SURGERY
SG00001243
Reconstruction
SG000012430000472
GENERAL SURGERY
SG00001247
Rectal PolypSG000012470000473
Excision Rectal Polyp Excision
GENERAL SURGERY
SG00001250
RectovaginalSG000012500000474
fistula repair Rectovaginal fistula repair
GENERAL SURGERY
SG00001266
Repair of Renal
SG000012660000475
Artery Stenosis Repair of Renal Artery Stenosis
GENERAL SURGERY
SG00001281
Retroperitoneal
SG000012810000476
GENERAL SURGERY
SG00001290
Rib Resection
SG000012900000477
GENERAL SURGERY
SG0000130Biopsy underSG00001300000374
GA Biopsy under GA
GENERAL SURGERY
SG00001336
Sigmoid Resection
SG000013360000478 Sigmoid Resection
GENERAL SURGERY
SG00001345
Skin and soft
SG000013450000479
GENERAL SURGERY
SG00001362
Splenectomy SG000013620000480 Splenectomy
GENERAL SURGERY
SG00001365
Split thickness
SG000013650000481
GENERAL SURGERY
SG00001365
Split thickness
SG000013650000482
GENERAL SURGERY
SG00001379
Stoma Management
SG000013790000483 Stoma Management follow up of Ileostomy/Stoma Management follow
GENERAL SURGERY
SG00001384
Submandibular
SG000013840000484
swelling Excision Submandibular swelling Excision
GENERAL SURGERY
SG00001386
Subtotal Colectomy
SG000013860000485 Subtotal Colectomy
GENERAL SURGERY
SG00001411
Surgical management
SG000014110000486
of Lower GI bleed
Surgical
(inclusive
management
of sigmoidoscopy
of Lower GI/ bleed
colonoscopy)
(inclusive
- Colonoscopic
of sigmoidoscopy
manage
/ co
GENERAL SURGERY
SG00001412
Surgical Management
SG000014120000487
of PseudoCystCystoJejunostomy /Cystogastrostomy
GENERAL SURGERY
SG00001415
Surgical procedure
SG000014150000488
under LA Cyst / biopsy / FNAC/ I&D- Day care
GENERAL SURGERY
SG00001417
Surgical removal
SG000014170000489
of Branchial Cyst/Sinus/Fistula
Surgical removal of Branchial Cyst/Sinus/Fistula
GENERAL SURGERY
SG00001418
Sympathectomy
SG000014180000490 Sympathectomy-Bilateral (B/L) / Unilateral (U/L)
GENERAL SURGERY
SG00001434
Thoracoplasty
SG000014340000491 Thoracoplasty
GENERAL SURGERY
SG00001435
Thoracoscopic
SG000014350000492
Segmental ResectionThoracoscopic Segmental Resection
GENERAL SURGERY
SG00001440
Thymectomy SG000014400000493 Thymectomy
GENERAL SURGERY
SG00001443
Thyroidectomy
SG000014430000495 Total thyroidectomy
GENERAL SURGERY
SG00001443
Thyroidectomy
SG000014430000494 Hemi thyroidectomy
GENERAL SURGERY
SG00001443
Thyroidectomy
SG000014430000496 Total Thyroidectomy with central neck Dissection
GENERAL SURGERY
SG00001463
TracheostomySG000014630000497
GENERAL SURGERY
SG00001520
Vaginal repair
SG000015200000498
for vesico-vaginal fistula
Vaginal
(Repair
repair
forfor
VVF)
vesico-vaginal fistula (Open)
GENERAL SURGERY
SG00001524
Vagotomy SG000015240000499 Gastro Jejunostomy +/- Vagotomy/Vagotomy +/- Pyloroplasty
GENERAL SURGERY
SG00001534
Vasovasostomy
SG000015340000500 Vasovasostomy Govt reserved
GENERAL SURGERY
SG0000165Breast Lump SG00001650000375
GENERAL SURGERY
SG0000173Bypass - Inoperable
SG00001730000376
Pancreas Bypass - Inoperable Pancreas
GENERAL SURGERY
SG0000177Caecopexy SG00001770000377 Caecopexy
GENERAL SURGERY
SG0000187Carotid BodySG00001870000378
tumour - Excision Carotid Body tumour - Excision
GENERAL SURGERY
SG00002 Gastrectomy SG000020000367 Total Gastrectomy
GENERAL SURGERY
SG0000223Cholecystectomy
SG00002230000379 Cholecystectomy
GENERAL SURGERY
SG0000225Choledochoduodenostomy
SG00002250000380 Or Choledocho
Choledochoduodenostomy
Jejunostomy Or Choledocho Jejunostomy
GENERAL SURGERY
SG0000227CircumcisionSG00002270000381 Circumcision - Phimosis / Paraphimosis or any other clinical condition G
GENERAL SURGERY
SG0000236Closure of Burst
SG00002360000382
GENERAL SURGERY
SG0000241Closure of stoma
SG00002410000383 Closure of stoma
GENERAL SURGERY
SG0000245Colostomy SG00002450000384 Defunctioning Colostomy - Stand Alone
GENERAL SURGERY
SG0000245Colostomy SG00002450000385 Exploratory laprotomy with colostomy
GENERAL SURGERY
SG0000251Complete Excision
SG00002510000386
Complete only
Excision
(inclusive
of Growth
of Histopathology)
from Tongue only
GENERAL SURGERY
SG0000258Congenital SG00002580000387
Atresia & Stenosis of SmallCongenital
/ large Intestine
Atresia & Stenosis of Small/ large Intestine
GENERAL SURGERY
SG0000273ConservativeSG00002730000388
GENERAL SURGERY
SG0000282ConservativeSG00002820000389
GENERAL SURGERY
SG0000475Debridement SG00004750000390
of Ulcer Debridement of Ulcer
GENERAL SURGERY
SG0000477Decortication
SG00004770000391
(Pleurectomy) Decortication (Pleurectomy)
GENERAL SURGERY
SG0000480Deep neck abscess
SG00004800000392
Deep neck
neckabscess drainage/Post trauma neck exploration
GENERAL SURGERY
SG0000492Diagnostic SG00004920000393
GENERAL SURGERY
SG00005 Pancreatic SG000050000368
Necrosectomy Pancreatic Necrosectomy
GENERAL SURGERY
SG0000503Distal Pancreatectomy
SG00005030000394
+ Splenectomy Distal Pancreatectomy + Splenectomy
GENERAL SURGERY
SG0000504Distal Pancreatectomy
SG00005040000395
GENERAL SURGERY
SG0000509Diverticulectomy
SG00005090000396 Excision Meckel's Diverticulum/ Duodenal / Colonic Diverticulum
GENERAL SURGERY
SG0000539EmergencySG00005390000397
GENERAL SURGERY
SG0000567Epididymal SG00005670000398
Cyst / Nodule Excision Epididymal Cyst excision/Epididymal Nodule excision Govt reserved
GENERAL SURGERY
SG0000577ERCP SG00005770000399 ERCP
GENERAL SURGERY
SG0000577ERCP SG00005770000400 ERCP + Stenting/Stone removal
GENERAL SURGERY
SG0000581Estlander Operation
SG00005810000401
GENERAL SURGERY
SG0000587EUA separateSG00005870000402
GENERAL SURGERY
SG0000594Excision Mammary
SG00005940000403
Fistula Excision Mammary Fistula
GENERAL SURGERY
SG0000595Excision of SG00005950000404
any benign swelling Excision of any benign swelling
GENERAL SURGERY
SG0000603Excision of Growth
SG00006030000405
neck node
of Growth
dissection
GENERAL SURGERY
SG0000607Excision of Parathyroid
SG00006070000406
Adenoma / Carcinoma
Excision of Parathyroid Adenoma/Carcinoma
GENERAL SURGERY
SG0000622Exicision ofSG00006220000407
Sinus and Curettage Exicision of Sinus and Curettage
GENERAL SURGERY
SG0000624ExploratorySG00006240000408
Laparotomy Emergency Exploratory Laparotomy -Stand alone
GENERAL SURGERY
SG0000630Extended LOSSG00006300000409
GENERAL SURGERY
SG0000656Feeding Jejunostomy
SG00006560000410 Feeding Jejunostomy
GENERAL SURGERY
SG0000659Femoral Groin
SG00006590000411
Hernia Repair Femoral Groin Hernia Repair
GENERAL SURGERY
SG0000669Flame / scald
SG00006690000412
% Total Body Surface Area Burns (TBSA) - any % (not requiring admission
GENERAL SURGERY
SG0000676Foreign BodySG00006760000413
Removal ( Airway) Foreign Body Removal ( Airway)
GENERAL SURGERY
SG0000679Foreign BodySG00006790000414
GENERAL SURGERY
SG0000692Free GraftsSG00006920000415
- Wolfe Grafts Free Grafts - Wolfe Grafts
GENERAL SURGERY
SG0000698Gastrectomy SG00006980000416 Bleeding Peptic Ulcer - Partial Gastrectomy without Vagotomy/Bleeding
GENERAL SURGERY
SG0000698Gastrectomy SG00006980000417 Partial Gastrectomy for Carcinoma/Subtotal Gastrectomy for Carcinoma
GENERAL SURGERY
SG0000718Groin HerniaSG00007180000418
Repair Groin Hernia Repair Inguinal
GENERAL SURGERY
SG0000718Groin HerniaSG00007180000419
Repair Groin Hernia Repair Obturator - GOVT RESERVED
GENERAL SURGERY
SG000072 Anterior Resection
SG0000720000369
of rectum Anterior Resection of rectum
GENERAL SURGERY
SG0000729Haemorroidectomy
SG00007290000420 Haemorroidectomy-with Stapler (govt reserve)
GENERAL SURGERY
SG0000732Hemi colectomy
SG00007320000421 Hemi colectomy Right /Hemi colectomy Left
GENERAL SURGERY
SG0000738Hepatic Resection
SG00007380000422 Hepatic Resection
GENERAL SURGERY
SG0000742Hepatico Jejunostomy
SG00007420000423
for biliary stricture
Hepatico Jejunostomy for biliary stricture
GENERAL SURGERY
SG0000748Hernia SG00007480000424 Umbilical/Paraumbilical/Spigelian/Incisional hernia
GENERAL SURGERY
SG0000750Hernia - Epigastric/
SG00007500000425
Ventral Hernia - Epigastric/ Ventral
GENERAL SURGERY
SG0000752Hiatus Hernia
SG00007520000426
Repair / Fundoplication Hiatus Hernia Repair - Open/Hiatus Hernia Repair - Lap/Fundoplication -
GENERAL SURGERY
SG0000792I Stage- SubSG00007920000427
Total Colectomy + Ileostomy I Stage-
+ JSub
- Pouch
Total Colectomy + Ileostomy + J - Pouch
GENERAL SURGERY
SG0000793I Stage-SubSG00007930000428
Total Colectomy + Ileostomy I Stage- Total/Sub Total Colectomy + Ileostomy
GENERAL SURGERY
SG0000800Ileostomy SG00008000000429 Ileostomy-Stand alone
GENERAL SURGERY
SG0000818Inguinal Node
SG00008180000430
(dissection) Inguinal Node (dissection) - U/L and B/L
GENERAL SURGERY
SG0000826Intestinal obstruction
SG00008260000431 Intestinal obstruction- medical management (2days)
GENERAL SURGERY
SG000084 Appendicectomy
SG0000840000371 Appendicectomy
GENERAL SURGERY
SG0000890LobectomySG00008900000432 LUNG Lobectomy-Open/Thoracoscopic
GENERAL SURGERY
SG0000899LymphaticsSG00008990000433
Excision of Subcutaneous Lymphatics
Tissues InExcision
Lymphoedema
of Subcutaneous Tissues In Lymphoedema
GENERAL SURGERY
SG0000912Management SG00009120000434
/ inguinal
in advance
GENERAL SURGERY
SG0000915Management SG00009150000436
Management
of Longofbone
Chest injury with fixation of Single LIMB (Min 5 Days LO
GENERAL SURGERY
SG0000915Management SG00009150000435
Management
of Longofbone
Chest injury with fixation of 2 or more LIMB (Min 5 Day
GENERAL SURGERY
SG0000918management SG00009180000458
of GI perforation / Appendicular
Operative management
Abscess of GI perforation / Operative drainage of Appen
GENERAL SURGERY
SG0000919Management SG00009190000437
of Pilonidal Sinus Management of Pilonidal Sinus Under RA/GA (Pre op MRI)
GENERAL SURGERY
SG0000920Management SG00009200000439
of Varicose Veins Minor sclerotherapy
GENERAL SURGERY
SG0000920Management SG00009200000438
of Varicose Veins Management of Varicose Veins-Operative management
GENERAL SURGERY
SG0000921Management SG00009210000441
GENERAL SURGERY
SG0000921Management SG00009210000440
GENERAL SURGERY
SG0000927Mastectomy SG00009270000443 Simple Mastectomy
GENERAL SURGERY
SG0000927Mastectomy SG00009270000442 Radical / Modified Radical Mastectomy
GENERAL SURGERY
SG0000952MesentericSG00009520000444
Caval Anastomosis Mesenteric Caval Anastomosis
GENERAL SURGERY
SG0000953MesentericSG00009530000445
Cyst – Excision Mesenteric Cyst – Excision
GENERAL SURGERY
SG0000976Neck dissection
SG00009760000446 Selec ve Benign neck tumourexcision/Comprehensive Benign neck tumo
GENERAL SURGERY
SG0000978NecrotisingSG00009780000447
fasciitis / Fournier Gangrene
Necrotising fasciitis / Fournier Gangrene
GENERAL SURGERY
SG000099 aspiration/ SG0000990000372
SURGICAL ONCOLOGY
SO00001020
Oesophageal SO0000102000001564
/ Tracheal stenting Oesophageal stenting/Tracheal stenting
SURGICAL ONCOLOGY
SO00001026
Oesophagectomy
SO0000102600001565 Oesophagectomy Open / lap / VATS / Transthorasic/2F/3F
SURGICAL ONCOLOGY
SO00001027
Omentectomy SO0000102700001566 Omentectomy - Govt Reserve
SURGICAL ONCOLOGY
SO00001031
Open laryngeal
SO0000103100001567
framework surgery Open/ Thyroplasty
laryngeal framework surgery / Thyroplasty
SURGICAL ONCOLOGY
SO00001039
Operation forSO0000103900001568
Carcinoma Lip Wedge Excision
SURGICAL ONCOLOGY
SO00001039
Operation forSO0000103900001569
Carcinoma Lip Wedge Excision and Vermilionectomy/Cheek advancement
SURGICAL ONCOLOGY
SO00001062
Orchidectomy SO0000106200001570 Orchidectomy BL / UL - Govt reserved
SURGICAL ONCOLOGY
SO00001075
Palatectomy SO0000107500001571 Soft palate / Hard palate
SURGICAL ONCOLOGY
SO00001083
Palliative Care
SO0000108300001572
in advanced
Interventions
SURGICAL ONCOLOGY
SO00001087
Palliative Care
SO0000108700001573
Pressuresore-Interventions
SURGICAL ONCOLOGY
SO00001089
Palliative Care
SO0000108900001574
Management of Osteoradionecrosis
Osteoradionecrosis -Surgical
-Surgical
intervention
intervention
SURGICAL ONCOLOGY
SO00001094
Palliative Radiological
SO0000109400001575
and endoscopical
Palliative
Interventions
SURGICAL ONCOLOGY
SO00001097
Palliative surgical
SO0000109700001576
Palliative surgical
Tracheostomy,
interventions
SURGICAL ONCOLOGY
SO00001099
PancreaticoDuodenectomy
SO0000109900001577 (Whipple's)
PancreaticoDuodenectomy (Whipple's)
SURGICAL ONCOLOGY
SO00001103
Parapharyngeal
SO0000110300001578
Tumour Excision Parapharyngeal Tumour Excision
SURGICAL ONCOLOGY
SO00001107
ParotidectomySO0000110700001579 Superficial Parotidectomy
SURGICAL ONCOLOGY
SO00001107
ParotidectomySO0000110700001580 Total Parotidectomy
SURGICAL ONCOLOGY
SO00001109
Partial Cystectomy
SO0000110900001581 Partial Cystectomy
SURGICAL ONCOLOGY
SO00001119
Pelvic Exenteration
SO0000111900001582 Pelvic Exenteration Anterior - Open/Pelvic Exenteration Anterior - Lap/P
SURGICAL ONCOLOGY
SO0000112Axillary dissection
SO000011200001480 Axillary dissection
SURGICAL ONCOLOGY
SO00001120
Pelvic lymphadenectomy,
SO0000112000001583after priorPelvic
cancerlymphadenectomy,
surgery after prior cancer surgery- Open/Laparoscopic
SURGICAL ONCOLOGY
SO00001123
PenectomySO0000112300001584 Partial Penectomy
SURGICAL ONCOLOGY
SO00001123
PenectomySO0000112300001585 Total Penectomy + Perineal Urethrostomy
SURGICAL ONCOLOGY
SO00001126
Penile preserving
SO0000112600001586
surgery Penile preserving surgery (WLE, Glansectomy, Laser)
SURGICAL ONCOLOGY
SO0000113Axillary Sampling
SO000011300001481
/ Sentinel Node Biopsy
Axillary Sampling / Sentinel Node Biopsy
SURGICAL ONCOLOGY
SO00001161
PET scan SO0000116100001587 PET scan
SURGICAL ONCOLOGY
SO00001173
Pleurectomy SO0000117300001588
Decortication Pleurectomy Decortication
SURGICAL ONCOLOGY
SO00001178
PneumonectomySO0000117800001589 Pneumonectomy
SURGICAL ONCOLOGY
SO00001199
Posterior Exenteration
SO0000119900001590
(Gynaec) Posterior Exenteration (Gynaec)
SURGICAL ONCOLOGY
SO00001204
Procedure on SO0000120400001591
Fallopian Tube for establishing
ProcedureTubalon Fallopian Tube forestablishing Tubal Patency
SURGICAL ONCOLOGY
SO0000122Benign SoftSO000012200001482
Tissue Tumour - ExcisionBenign Soft Tissue Tumour - Excision - govt reserve
SURGICAL ONCOLOGY
SO00001224
Radical / Revision
SO0000122400001592
Cholecystectomy Radical / Revision Cholecystectomy
SURGICAL ONCOLOGY
SO00001225
Radical cystectomy
SO0000122500001594 Radical cystectomy With continent diversion - Open + BPLND
SURGICAL ONCOLOGY
SO00001225
Radical cystectomy
SO0000122500001593 Radical cystectomy - With ureterosigmoidostomy + BPLND - Open/Lap.
SURGICAL ONCOLOGY
SO00001225
Radical cystectomy
SO0000122500001595 Radical cystectomy With continent diversion + BPLND - Open
SURGICAL ONCOLOGY
SO00001225
Radical cystectomy
SO0000122500001598 Radical cystectomy Without Ileal Conduit + BPLND
SURGICAL ONCOLOGY
SO00001225
Radical cystectomy
SO0000122500001596 Radical cystectomy With Ileal Conduit + BPLND
SURGICAL ONCOLOGY
SO00001225
Radical cystectomy
SO0000122500001597 Radical cystectomy- With neobladder + BPLND
SURGICAL ONCOLOGY
SO00001228
SO0000122800001599 Class II - V radical hysterectomy + bilateral salpingoophorectomy + BPLN
SURGICAL ONCOLOGY
SO00001228
SO0000122800001600 Hysterectomy + bilateral salpingoophorectomy + omentectomy + perito
SURGICAL ONCOLOGY
SO00001232
Radical Neck SO0000123200001601
SURGICAL ONCOLOGY
SO00001235
SO0000123500001602lymph nodeRadical
dissection
Retroperitoneal lymph node dissection
SURGICAL ONCOLOGY
SO00001237
Radical Small
SO0000123700001603
Bowel Resection Radical Small Bowel Resection
SURGICAL ONCOLOGY
SO00001238
Radical Urethrectomy
SO0000123800001604 Radical Urethrectomy
SURGICAL ONCOLOGY
SO0000124Bilateral Orchidectomy
SO000012400001483for hormoneBilateral
ablationOrchidectomy for hormone ablation
SURGICAL ONCOLOGY
SO00001240
Radical vaginectomy
SO0000124000001605 Radical vaginectomy
SURGICAL ONCOLOGY
SO00001241
Radical Vulvectomy
SO0000124100001606
with Inguinal and
Radical
PelvicVulvectomy
lymph nodewith
disection
Inguinal and Pelvic lymph node disection
SURGICAL ONCOLOGY
SO00001245
Reconstruction
SO0000124500001607
SURGICAL ONCOLOGY
SO00001248
Rectal PolypSO0000124800001608
Excision Rectal Polyp Excision
SURGICAL ONCOLOGY
SO00001255
Regional flap
SO0000125500001609 Myocutaneous flap/Fasciocutaneous flap - add on
SURGICAL ONCOLOGY
SO00001259
Removal ofSO0000125900001610
Chest Wall Tumour Chest Wall malignant Tumour Excision
SURGICAL ONCOLOGY
SO0000126Bilateral pelvic
SO000012600001484
lymph Node Dissection Bilateral
(BPLND)pelvic lymph Node Dissection (BPLND) - add on (excluded with
SURGICAL ONCOLOGY
SO00001262
Removal ofSO0000126200001611
Submandibular SalivaryGland Removal / Salivary
of Submandibular
or without Lymph
/ Salivary
NodeRanula- with or with
SURGICAL ONCOLOGY
SO00001273
Resection ofSO0000127300001612
nasopharyngeal tumour Resection of nasopharyngeal tumour
SURGICAL ONCOLOGY
SO0000128Biopsy SO000012800001485 Cervix Cancer screening (PAP + Colposcopy+VIA)
SURGICAL ONCOLOGY
SO00001283
Retroperitoneal
SO0000128300001613
SURGICAL ONCOLOGY
SO00001305
Sacral Tumour
SO0000130500001614
Excision Sacral Tumour Excision
SURGICAL ONCOLOGY
SO00001308
Salpingoophorectomy
SO0000130800001615 Salpingoophorectomy- (B/L or U/L)
SURGICAL ONCOLOGY
SO0000131Biopsy underSO000013100001486
GA Biopsy under GA
SURGICAL ONCOLOGY
SO00001310
Scalp tumourSO0000131000001616
excision with skull bone Scalp
excision
tumour excision with skull bone excision
SURGICAL ONCOLOGY
SO00001317
Secondary suturing
SO0000131700001617
in operated Head Secondary
and Necksuturing
Cancer cases
in operated
- LA / Head
GA and Neck Cancer cases - LA / GA
SURGICAL ONCOLOGY
SO00001318
Segmental resection
SO0000131800001618
of lung Segmental resection of lung-Open /Thoracoscopic
SURGICAL ONCOLOGY
SO00001319
Segmentectomy
SO0000131900001619
- hepatobiliary system
Segmentectomy - hepatobiliary system
SURGICAL ONCOLOGY
SO00001347
Sleeve resection
SO0000134700001620
of lung cancer Sleeve resection of lung cancer
SURGICAL ONCOLOGY
SO00001368
Split thickness
SO0000136800001621
SURGICAL ONCOLOGY
SO00001368
Split thickness
SO0000136800001622
SURGICAL ONCOLOGY
SO00001374
Staging Laparotomy
SO0000137400001623
and proceed forStaging
OvarianLaparotomy
Cancers. Omentomy
and proceedwith
for Bilateral
Ovarian Cancers.
Omentomy with B
SURGICAL ONCOLOGY
SO00001380
Stress incontinence
SO0000138000001624
surgery Stress incontinence surgery - Open
SURGICAL ONCOLOGY
SO00001385
Submandibular
SO0000138500001625
swelling Excision Submandibular swelling Excision
SURGICAL ONCOLOGY
SO00001387
Subtotal Colectomy
SO0000138700001626 Subtotal Colectomy
SURGICAL ONCOLOGY
SO00001392
Surgery for SO0000139200001627
Abdominal wall tumourAbdominal wall tumour resection
SURGICAL ONCOLOGY
SO00001392
Abdominal wall tumourAbdominal wall tumour resection with reconstruction
SURGICAL ONCOLOGY
SO00001396
/ Mandible/ excision of cyst / tumour of jaws under LA
SURGICAL ONCOLOGY
SO00001396
Cyst & tumour of Maxilla Enuclea
/ Mandible
on / excision of cyst / tumour of jaws under GA
SURGICAL ONCOLOGY
SO00001416
Surgical procedure
SO0000141600001631
under LA Cyst / biopsy / FNAC/ I&D/ In growing toe nail - Day care
SURGICAL ONCOLOGY
SO00001437
ThoracostomySO0000143700001632 Thoracostomy
SURGICAL ONCOLOGY
SO00001444
Thyroidectomy
SO0000144400001633 Hemi thyroidectomy
SURGICAL ONCOLOGY
SO00001444
Thyroidectomy
SO0000144400001634 Total thyroidectomy
SURGICAL ONCOLOGY
SO00001444
Thyroidectomy
SO0000144400001635 Total Thyroidectomy with central neck Dissection
SURGICAL ONCOLOGY
SO00001457
Total Pharyngectomy
SO0000145700001636 Total Pharyngectomy
SURGICAL ONCOLOGY
SO00001459
Tracheal / Carinal
SO0000145900001637
resection Tracheal / Carinal resection
SURGICAL ONCOLOGY
SO00001460
Tracheal Stenosis
SO0000146000001638
(End to end Anastamosis)
Tracheal(Throat)
Stenosis (End to end Anastamosis) (Throat)
SURGICAL ONCOLOGY
SO00001483
TURBT - Restage
SO0000148300001639 TURBT - Restage
SURGICAL ONCOLOGY
SO00001485
TURBT (Transurethral
SO0000148500001640
Resec on of the
TURBT
Bladder
(Transurethral
Tumor) Resec on of the Bladder Tumor)
SURGICAL ONCOLOGY
SO00001496
Ureteric endSO0000149600001641
to end anastomosis Ureteric end to end anastomosis
SURGICAL ONCOLOGY
SO0000150Bone marrow SO000015000001487
SURGICAL ONCOLOGY
SO0000152Bone tumors SO000015200001488
/ soft tissue sarcomas:Bonesurgery
tumors / soft tissue sarcomas: surgery
SURGICAL ONCOLOGY
SO00001528
Vascular reconstruction
SO0000152800001642 Vascular reconstruction with or without vein graft
SURGICAL ONCOLOGY
SO00001531
Vascular reconstruction
SO0000153100001643with graft/patch
SURGICAL ONCOLOGY
SO00001540
Vertebral Tumour
SO0000154000001644
Excision and Reconstruction
Vertebral Tumour Excision and Reconstruction
SURGICAL ONCOLOGY
SO00001544
SO0000154400001645 Vertebroplasty/Kyphoplasty - Govt reserved
SURGICAL ONCOLOGY
SO00001552
VulvectomySO0000155200001646
+ reconstruction procedures Vulvectomy - simple (Rs 20000) / Redical (Rs 40000) reconstruction proc
SURGICAL ONCOLOGY
SO00001554
Wedge resection
SO0000155400001647
lung Wedge resection lung- Open/Thoracoscopic
SURGICAL ONCOLOGY
SO00001556
Wilms tumors:
SO0000155600001648
surgery / Neuroblastoma Wilms tumors: surgery / Neuroblastoma
SURGICAL ONCOLOGY
SO0000156Bone Tumour SO000015600001489
Excision + reconstruction Bone Tumour Excision + reconstruction
SURGICAL ONCOLOGY
SO0000164Breast conserving
SO000016400001490
surgery Breast conserving surgery (lumpectomy + axillary surgery)
SURGICAL ONCOLOGY
SO0000167Breast Lump SO000016700001491
SURGICAL ONCOLOGY
SO0000174Bypass - Inoperable
SO000017400001492
Pancreas Bypass - Inoperable Pancreas
SURGICAL ONCOLOGY
SO0000188Carotid BodySO000018800001493
tumour - Excision Carotid Body tumour - Excision
SURGICAL ONCOLOGY
SO0000209Chamberlain SO000020900001494
procedure Chamberlain procedure
SURGICAL ONCOLOGY
SO0000210Channel TURPSO000021000001495 Channel TURP
SURGICAL ONCOLOGY
SO0000215Chemo PortSO000021500001496
Insertion Chemo Port/PICC Insertion
SURGICAL ONCOLOGY
SO0000217Chemoport/implantable
SO000021700001497 lines Chemoport/implantable lines
SURGICAL ONCOLOGY
SO0000239Closure of Burst
SO000023900001498
SURGICAL ONCOLOGY
SO0000243Closure of stoma
SO000024300001499 Closure of stoma
SURGICAL ONCOLOGY
SO0000247Colostomy SO000024700001500 Defunctioning Colostomy - Stand Alone
SURGICAL ONCOLOGY
SO0000247Colostomy SO000024700001501 Exploratory laprotomy with colostomy
SURGICAL ONCOLOGY
SO0000250Complete -Endoprosthesis
SO000025000001502 Revision Complete -Endoprosthesis Revision
SURGICAL ONCOLOGY
SO0000253Complete Excision
SO000025300001503
Complete only
Excision
(inclusive
of Growth
of Histopathology)
from Tongue only
SURGICAL ONCOLOGY
SO0000256Composite SO000025600001504
resection (Oral Cavity) Composite resection (Oral Cavity)
SURGICAL ONCOLOGY
SO0000278ConservativeSO000027800001505
SURGICAL ONCOLOGY
SO0000287ConservativeSO000028700001506
SURGICAL ONCOLOGY
SO00003 Gastrectomy SO0000300001472 Total Gastrectomy
SURGICAL ONCOLOGY
SO00004 Intersphincteric
SO0000400001473
resection/Abdominoperineal
Intersphincteric
resection
resection/Abdominoperineal
. resection .
SURGICAL ONCOLOGY
SO0000461Curopsy / Sclerotherapy
SO000046100001507 Curopsy / Sclerotherapy - govt reserve
SURGICAL ONCOLOGY
SO0000471Cytoreductive
SO000047100001508
surgery for ovarian cancerCytoreductive surgery for ovarian cancer with multi organ resection ( M
SURGICAL ONCOLOGY
SO0000494Diagnostic SO000049400001509
SURGICAL ONCOLOGY
SO0000498Diagnostic thoracoscopy
SO000049800001510 Diagnostic thoracoscopy - govt reserve
SURGICAL ONCOLOGY
SO0000499Diagnostic/Staging
SO000049900001511
MediastinoscopyDiagnostic/Staging Mediastinoscopy - govt reserve
SURGICAL ONCOLOGY
SO0000506Distal Pancreatectomy
SO000050600001512
SURGICAL ONCOLOGY
SO0000507Distal ureterectomy
SO000050700001513
with reimplantation
Distal ureterectomy with reimplantation
SURGICAL ONCOLOGY
SO000052 Advanced /SO00005200001474
SURGICAL ONCOLOGY
SO000054 Advanced anterior
SO00005400001475
skull base surgery Endoscopic Hypophysectomy/Clival tumour excision
SURGICAL ONCOLOGY
SO0000553Endoprosthesis
SO000055300001514
Revision Partial Endoprosthesis Revision
SURGICAL ONCOLOGY
SO000056 Advanced lateral
SO00005600001476
skull base surgery Fisch approach/Translabyrinthine approach/Transcochlear approach/Tem
SURGICAL ONCOLOGY
SO0000566EnucleationSO000056600001515
of pancreatic neoplasmEnucleation of pancreatic neoplasm
SURGICAL ONCOLOGY
SO0000583Estlander Operation
SO000058300001516
SURGICAL ONCOLOGY
SO0000590EUA separateSO000059000001517
SURGICAL ONCOLOGY
SO0000604Excision of Growth
SO000060400001518
neck node
of Growth
dissection
SURGICAL ONCOLOGY
SO0000608Excision of Parathyroid
SO000060800001519
Adenoma / Carcinoma
Excision of Parathyroid Adenoma/Carcinoma
SURGICAL ONCOLOGY
SO0000611Excision of Pinna
SO000061100001520
for Growths / InjuriesGrowth
- Total
- Squamous/
Amputation Basal/
& Excision
Injury of External Auditory Meatus
SURGICAL ONCOLOGY
SO0000616Excision of tumour
SO000061600001522
Excision of
sinus
tumour
/ laryngopharynx
of oral cavity with
/ paranasal
or without
sinusreconstruction
/ laryngopharynx
SURGICAL ONCOLOGY
SO000061600001521
Excision of
sinus
tumour
/ laryngopharynx
of oral cavity with
/ paranasal
or without
sinusreconstruction
SURGICAL ONCOLOGY
SO000061600001523
Excision of
sinus
tumour
/ laryngopharynx
of oral cavity with
/paranasal
or without
sinusreconstruction
/ laryngopharynx with
SURGICAL ONCOLOGY
SO0000617Excision of undescended
SO000061700001524 testicular mass
Excision of undescended testicular mass
SURGICAL ONCOLOGY
SO0000621ExenterationSO000062100001525 Exenteration
SURGICAL ONCOLOGY
SO0000635Extended LOSSO000063500001526
SURGICAL ONCOLOGY
SO0000646ExtrapleuralSO000064600001527
pneumonectomy Extrapleural pneumonectomy
SURGICAL ONCOLOGY
SO0000658Feeding Jejunostomy
SO000065800001528 Feeding Jejunostomy
SURGICAL ONCOLOGY
SO0000699Gastrectomy SO000069900001529 Partial Gastrectomy for Carcinoma/Subtotal Gastrectomy for Carcinoma
SURGICAL ONCOLOGY
SO0000700Gastric pull-up
SO000070000001530
/ Jejunal Graft Gastric pull-up / Jejunal Graft
SURGICAL ONCOLOGY
SO0000701Gastrojejunostomy
SO000070100001531 Gastrojejunostomy
SURGICAL ONCOLOGY
SO0000705Germ Cell Tumour
SO000070500001532
Excision Germ Cell Tumour Excision
SURGICAL ONCOLOGY
SO0000714Glossectomy SO000071400001533 Hemiglossectomy
SURGICAL ONCOLOGY
SO0000714Glossectomy SO000071400001534 Total Glossectomy
SURGICAL ONCOLOGY
SO000073 Anterior Resection
SO00007300001477
of rectum Anterior Resection of rectum
SURGICAL ONCOLOGY
SO0000733Hemi colectomy
SO000073300001535 Hemi colectomy Right /Hemi colectomy Left
SURGICAL ONCOLOGY
SO0000735Hemipelvectomy
SO000073500001536
- Internal Hemipelvectomy - Internal
SURGICAL ONCOLOGY
SO0000740Hepatic Resection
SO000074000001537 Hepatic Resection
SURGICAL ONCOLOGY
SO0000747Hepatoblastoma
SO000074700001538
Excision Hepatoblastoma Excision
SURGICAL ONCOLOGY
SO000076 Anterior skull
SO00007600001478
base surgery CSF Rhinorrhea Repair - open / Endoscopic
SURGICAL ONCOLOGY
SO000076 Anterior skull
SO00007600001479
base surgery Optic nerve decompression/Orbital decompression/Craniofacial resectio
SURGICAL ONCOLOGY
SO0000769High inguinal
SO000076900001539
SURGICAL ONCOLOGY
SO0000802Ilio-InguinalSO000080200001540
lymphadenectomy Ilio-Inguinal lymphadenectomy - U/L OR B/L
SURGICAL ONCOLOGY
SO0000819Inguinal Node
SO000081900001541
(dissection) Inguinal Node (dissection) - U/L and B/L
SURGICAL ONCOLOGY
SO0000865LaparoscopicSO000086500001542
tubal surgeries tubal surgeries(for any indica on including ectopic pregnancy)
SURGICAL ONCOLOGY
SO0000867LaryngectomySO000086700001543 Partial laryngectomy (voice preserving)/Total Laryngectomy
SURGICAL ONCOLOGY
SO0000872Lateral skullSO000087200001544
base procedures Subtotal petrosectomy/Post-trauma c facial nerve decompression/CSF O
SURGICAL ONCOLOGY
SO0000874LeiomyomaSO000087400001545
excision Leiomyoma excision- Open/MIS - Govt reserve
SURGICAL ONCOLOGY
SO0000891LobectomySO000089100001546 LUNG Lobectomy-Open/Thoracoscopic
SURGICAL ONCOLOGY
SO0000897Lung metastectomy
SO000089700001547 Lung metastectomy- Open/VATS
SURGICAL ONCOLOGY
SO0000905Malignant Pleural
SO000090500001548
Effusion for PleuralPleural
tap with
effusion
Pig tail
& Pleurodesis
SURGICAL ONCOLOGY
SO0000906Malignant Soft
SO000090600001549
Tissue Tumour -Excision Malignant Soft Tissue Tumour - Excision
SURGICAL ONCOLOGY
SO0000911Management SO000091100001550
of bleeding in malignant Transhead
arterial
and neck
Embolization
/ inguinal malignancies
SURGICAL ONCOLOGY
SO0000914Management SO000091400001551
/ inguinal
in advance
SURGICAL ONCOLOGY
SO0000928Mastectomy SO000092800001552 Radical / Modified Radical Mastectomy
SURGICAL ONCOLOGY
SO0000928Mastectomy SO000092800001553 Simple Mastectomy
SURGICAL ONCOLOGY
SO0000931MaxillectomySO000093100001554 Partial / Total Maxillectomy
SURGICAL ONCOLOGY
SO0000935MediastinalSO000093500001555
lymphadenectomy Mediastinal lymphadenectomy- Open/Video - assisted
SURGICAL ONCOLOGY
SO0000936MediastinalSO000093600001556
mass excision with lungMediastinal
resection mass excision with lung resection
SURGICAL ONCOLOGY
SO0000959Microlaryngoscopic
SO000095900001557
Surgery Microlaryngoscopic Surgery
SURGICAL ONCOLOGY
SO0000961Microvascular
SO000096100001558
reconstruction (free flaps)
Microvascular reconstruction (free flaps)
SURGICAL ONCOLOGY
SO0000977Neck dissection
SO000097700001559 Selec ve Benign neck tumourexcision/Comprehensive Benign neck tumo
SURGICAL ONCOLOGY
SO0000983Nephrectomy SO000098300001560 Nephrectomy For Benign pathology /Nephrectomy- Radical (Renal tumo
SURGICAL ONCOLOGY
SO0000986Nephrectomy SO000098600001561
SURGICAL ONCOLOGY
SO0000989Nephro ureterectomy
SO000098900001562(Benign) Nephro ureterectomy (Benign)
SURGICAL ONCOLOGY
SO0000992Nephro ureterectomy
SO000099200001563with cuff of bladder
UROLOGY UL00001011NeurogenicUL0000101100001697
bladder - Package for evaluation
Neurogenic / investigation
bladder - Package(catheter
for evaluation
+ ultrasound
/ investigation
+ culture + RGU/
(catheter
MCU)+ f
UROLOGY UL00001029Open bladderUL0000102900001698
diverticulectomy withOpen / without
bladderureteric
diverticulectomy
re-implantationwith / without ureteric re-implantation ±
UROLOGY UL00001036Open simple UL0000103600001699
prostatetctomy for BPH Open simple prostatetctomy for BPH
UROLOGY UL00001064OrchiopexyUL0000106400001700 Orchiopexy with laparoscopyto be cross checked with pead surgery - U/
UROLOGY UL00001064OrchiopexyUL0000106400001701 Orchiopexy without laparoscopy - U/L or B/L
UROLOGY UL0000107Augmentation UL000010700001651
cystoplasty Augmentation cystoplasty
UROLOGY UL00001084Palliative Care
UL0000108400001702
in advanced
Interventions
UROLOGY UL00001110Partial Cystectomy
UL0000111000001703 Partial Cystectomy
UROLOGY UL00001112PCNL (Percutaneous
UL0000111200001704
Nephrolithotomy)PCNL (Percutaneous Nephrolithotomy) ± DJ Stenting
UROLOGY UL00001121Pelvic lymphadenectomy,
UL0000112100001705 after priorPelvic
cancer
lymphadenectomy,
surgery after prior cancer surgery- Open/Laparoscopic
UROLOGY UL00001124PenectomyUL0000112400001706 Partial Penectomy
UROLOGY UL00001124PenectomyUL0000112400001707 Total Penectomy + Perineal Urethrostomy
UROLOGY UL00001125Penile Fracture
UL0000112500001708 Penile Fracture - Govt Reserve
UROLOGY UL00001127Penile preserving
UL0000112700001709
surgery Penile preserving surgery (WLE, Glansectomy, Laser)
UROLOGY UL00001128
Penile prosthesis
UL0000112800001710
insertion Penile prosthesis insertion - Govt Reserve
UROLOGY UL00001137
Perineal Urethrostomy
UL0000113700001711
without closure
Perineal Urethrostomy without closure
UROLOGY UL00001138
PerinephricUL0000113800001712
Abscess drainage Percutaneous abscess drainage Endoscopic
UROLOGY UL00001138
PerinephricUL0000113800001713
Abscess drainage Perinephric Abscess drainage -Open
UROLOGY UL00001157
PermanentUL0000115700001714
tunnelled catheter placement
Permanent as substitute
tunnelled forcatheter
AV fistula
placement
in long term
as substitute
dialysis for AV fistula in l
UROLOGY UL00001193
Post TURBTUL0000119300001715
- Check Cystoscopy (PerPost sitting)
TURBT with- Check
cold-cupCystoscopy
biopsy (Per sitting) with / without cold-cup biop
UROLOGY UL00001195
Post. Urethral
UL0000119500001716
Valve fulguration Post. Urethral Valve fulguration
UROLOGY UL00001215
Pyelolithotomy
UL0000121500001717 Pyelolithotomy - Open/Lap. ± DJ Stenting
UROLOGY UL00001217
PyeloplastyUL0000121700001718
Pyeloplasty - Laparoscopic/Pyeloureterostomy - Laparoscopic/Pyelopyel
UROLOGY UL00001217
PyeloplastyUL0000121700001719
Pyeloplasty - Open/Pyeloureterostomy - Open/Pyelopyelostomy - Open
UROLOGY UL00001226
Radical cystectomy
UL0000122600001720 Radical cystectomy - With ureterosigmoidostomy + BPLND - Open/Lap.
UROLOGY UL00001226
Radical cystectomy
UL0000122600001721 Radical cystectomy With continent diversion - Open + BPLND
UROLOGY UL00001226
Radical cystectomy
UL0000122600001722 Radical cystectomy With continent diversion + BPLND - Open
UROLOGY UL00001226
Radical cystectomy
UL0000122600001723 Radical cystectomy With Ileal Conduit + BPLND
UROLOGY UL00001226
Radical cystectomy
UL0000122600001724 Radical cystectomy- With neobladder + BPLND
UROLOGY UL00001226
Radical cystectomy
UL0000122600001725 Radical cystectomy Without Ileal Conduit + BPLND
UROLOGY UL00001233
Radical prostatectomy
UL0000123300001726 Radical prostatectomy
UROLOGY UL00001236
UL0000123600001727
lymph nodeRadical
dissectionRetroperitoneal lymph node dissection
UROLOGY UL00001239
Radical Urethrectomy
UL0000123900001728 Radical Urethrectomy
UROLOGY UL0000125Bilateral Orchidectomy
UL000012500001652
for hormoneBilateral
ablationOrchidectomy for hormone ablation
UROLOGY UL00001264
Repair for VVF
UL0000126400001729 Repair for VVF -Laparoscopic/open
UROLOGY UL0000134Bladder injury
UL000013400001653
repair Bladder injury repair (with or without urethral injury)
UROLOGY UL0000136Bladder injury
UL000013600001654
repair with colostomyBladder injury repair with colostomy (with or without urethral injury)
UROLOGY UL0000137Bladder NeckUL000013700001655
incision - Endoscopic Bladder Neck incision - Endoscopic - Stand Alone
UROLOGY UL00001381
Stress incontinence
UL0000138100001730
surgery Stress incontinence surgery - Open
UROLOGY UL00001391
SuprapubicUL0000139100001731
Drainage - Closed / Trocar Suprapubic Drainage - Closed / Trocar
UROLOGY UL00001402
Surgery for UL0000140200001732
Priapism Priapism Aspiration
UROLOGY UL00001402
Surgery for UL0000140200001733
Priapism Priapism Shunt
UROLOGY UL00001409
Surgical Correction
UL0000140900001734
of Varicocele Non Micro surgical / Microsurgical
UROLOGY UL0000143Boari flap for
UL000014300001656
ureteric stricture Boari flap for ureteric stricture -Open / Lap. ± DJ Stenting
UROLOGY UL00001453
Torsion of testis
UL0000145300001735 Torsion of testis
UROLOGY UL00001472
Transrectal UL0000147200001736
Ultrasound guided prostate Transrectal
biopsy (minimum
Ultrasound12 guided
core) prostate biopsy (minimum 12 core)
UROLOGY UL00001484
TURBT - Restage
UL0000148400001737 TURBT - Restage
UROLOGY UL00001486
TURBT (Transurethral
UL0000148600001738
Resec on of the
TURBTBladder
(Transurethral
Tumor) Resec on of the Bladder Tumor)
UROLOGY UL00001487
TURP-Transurethral
UL0000148700001739
Resection of theMonopolar/Bipolar/
Prostate, BPH Laser Surgery
UROLOGY UL00001491
Undescended UL0000149100001740
Testis Bilateral /Unilateral - Palpable/ Nonpalpable - Govt Reserve
UROLOGY UL00001495
Urachal CystUL0000149500001741
excision Urachal Cyst excision - Open / Lap.
UROLOGY UL00001498
Ureteric reimplantation
UL0000149800001742 Ureteric reimplantation
UROLOGY UL00001499
Ureteric sampling
UL0000149900001743
Ureteric
ureteric
sampling
catheterization,
retrogradeureteric
pyelogram
catheterization, retrogr
UROLOGY UL00001500
Ureterocalycostomy
UL0000150000001744 Ureterocalycostomy - Laparoscopic ± DJ Stenting
UROLOGY UL00001500
Ureterocalycostomy
UL0000150000001745 Ureterocalycostomy - Open ± DJ Stenting
UROLOGY UL00001501
UreteroceleUL0000150100001746
incision including cystoscopy,
Ureterocele
uretericincision
catheterization,
retrogradeureteric
pyelogramcatheterization, retro
UROLOGY UL00001502
Ureterolithotomy
UL0000150200001747 Ureterolithotomy -Open/Lap. ± DJ Stenting
UROLOGY UL00001503
UreterolysisUL0000150300001748
for retroperitoneal fibrosis
Open(with- Ureterolysis
or withoutfor omental
retroperitoneal
wrapping) fibrosis
UROLOGY UL00001504
UreteroscopyUL0000150400001749
+ Stone removal withLowerlithotripsy
Ureter/Upper Ureter/ RIRS/URSL - stand alone
UROLOGY UL00001506
UreterostomyUL0000150600001750 Ureterostomy (Cutaneous) ± DJ Stenting
UROLOGY UL00001508
Uretero-ureterostomy
UL0000150800001751 Uretero-ureterostomy- Open / Lap. ± DJ Stenting
UROLOGY UL00001510
Uretero-vaginal
UL0000151000001752
/ Uterine fistula repair
Uretero - vaginal fistula repair - Open/Uretero - vaginal fistula repair - La
UROLOGY UL00001512
Urethral Dilatation
UL0000151200001753 Endocopic as an independent procedure - Stand Alone
UROLOGY UL00001512
Urethral Dilatation
UL0000151200001754 Non endocopic as an independent procedure - Stand Alone
UROLOGY UL00001513
Urethroplasty
UL0000151300001755 Stage Urethroplasty Stage I ± Endoscopy
UROLOGY UL00001513
Urethroplasty
UL0000151300001756 Stage Urethroplasty Stage II ± Endoscopy
UROLOGY UL00001513
Urethroplasty
UL0000151300001757 Urethroplasty - End to end ± Endoscopy
UROLOGY UL00001513
Urethroplasty
UL0000151300001758 Urethroplasty - Transpubic ± Endoscopy
UROLOGY UL00001515
Urethrorectal
UL0000151500001759
fistula repair Urethrorectal fistula repair
UROLOGY UL00001517
Urethrovaginal
UL0000151700001760
fistula repair Urethrovaginal fistula repair
UROLOGY UL00001535
Vasovasostomy
UL0000153500001761 Vasovasostomy Govt reserved
UROLOGY UL0000157Botulinum toxin
UL000015700001657
injection for Neuropathic
Botulinumbladder
toxin injection for Neuropathic bladder
UROLOGY UL0000171Burch UL000017100001658 Abdominal / Laparoscopic -Burch
UROLOGY UL0000240Closure of Burst
UL000024000001659
UROLOGY UL0000261Congenital UL000026100001660
Diaphragmatic Hernia Congenital Diaphragmatic Hernia - Govt Reserve
UROLOGY UL0000279ConservativeUL000027900001661
UROLOGY UL0000288ConservativeUL000028800001662
UROLOGY UL000032 Acute management
UL00003200001649
of upper urinaryAcute
tractmanagement
trauma – conservative
of upper urinary tract trauma – conservative
UROLOGY UL0000468Cystolithotomy
UL000046800001663
- Open, including cystoscopy
Cystolithotomy - Open - including cystoscopy
UROLOGY UL0000470Cystolithotripsy
UL000047000001664
Cystolithotripsy
includingincluding
cystoscopy
cystoscopy
UROLOGY UL0000470Cystolithotripsy
UL000047000001665
Urethral Stone
including
removal
cystoscopy
UROLOGY UL000048 Adrenalectomy
UL00004800001650 Adrenalectomy
UROLOGY UL0000482Deflux for VUR
UL000048200001666 Deflux for VUR(only procedure charge)
UROLOGY UL0000508Distal ureterectomy
UL000050800001667
with reimplantation
Distal ureterectomy with reimplantation
UROLOGY UL0000511DJ Stent Removal
UL000051100001668 DJ Stent Removal
UROLOGY UL0000513DJ stenting UL000051300001669
including cystoscopy, ureteric
DJ stenting
catheterization,
retrogradeureteric
pyelogram
catheterization, retrograde py
UROLOGY UL0000537EmergencyUL000053700001670
management of Acute retention
Emergency of management
Urine of Acute retention of Urine
management of UretericEmergencystone - Package
management
for evaluation
of Ureteric
/ investigation
stone - Package
(ultrasound
for evaluation
+ culture)
/ inv
fo
UROLOGY UL0000554Endopyelotomy
UL000055400001673 Retrograde with laser / bugbee/Antegrade with laser / bugbee With End
UROLOGY UL0000573Epispadias Extrophy
UL000057300001674
Complex surgery Epispadias Extrophy Complex surgery three stage surgery - Govt Reserve
UROLOGY UL0000574Epispadias Repair
UL000057400001675 Epispadias Repair - Govt Reserve
UROLOGY UL0000618Excision of Urethral
UL000061800001676
Caruncle Excision of Urethral Caruncle
UROLOGY UL0000636Extended LOSUL000063600001677
UROLOGY UL0000643Extracoporeal
UL000064300001678
shock - wave LithotripsyExtracoporeal
(ESWL) shock - wave Lithotripsy (ESWL) stone, with or without ste
UROLOGY UL0000648Extrophy Bladder
UL000064800001679
repair including osteotomy
Extrophy Bladder
if needed repair
+ Epispadias
includingrepair
osteotomy
+ ureteric
if needed
reimplant
+ Epispadias rep
UROLOGY UL0000674Follow up for
UL000067400001680
urological proceduresFollow up for urological procedures
UROLOGY UL0000770High inguinal
UL000077000001681
UROLOGY UL0000783Hypospadias UL000078300001683
UROLOGY UL0000799Ileal replacement
UL000079900001685
for ureteric stricture
Ileal replacement for ureteric stricture
UROLOGY UL0000803Ilio-InguinalUL000080300001686
lymphadenectomy Ilio-Inguinal lymphadenectomy - U/L OR B/L
UROLOGY UL0000822Internal Ureterotomy
UL000082200001687
including cystoscopy
Internalas Uretherotomy
an independent including
procedure
cystoscopy as an independent procedu
UROLOGY UL0000839IntravesicalUL000083900001688
BCG / Mitomycin Intravesical BCG / Mitomycin - Induction cycles (PC) for max. 06 Doses
UROLOGY UL0000934MeatotomyUL000093400001689
/ Meatoplasty Meatotomy/Meatoplasty
UROLOGY UL0000962MitropfanoffUL000096200001690
procedure For UrinaryMitropfanoff
divertion procedure For Urinary divertion - Govt Reserve
UROLOGY UL0000984Nephrectomy UL000098400001691 Nephrectomy For Benign pathology /Nephrectomy- Radical (Renal tumo
UROLOGY UL0000987Nephrectomy UL000098700001692
UROLOGY UL0000990Nephro ureterectomy
UL000099000001693
(Benign) Nephro ureterectomy (Benign)
UROLOGY UL0000993Nephro ureterectomy
UL000099300001694
with cuff of bladder
UROLOGY UL0000994Nephrolithotomy
UL000099400001695 Nephrolithotomy- Open/Anatrophic
UROLOGY UL0000997Nephrostomy UL000099700001696
rgeries for Functional Improvement (Package including splints, pressure garments, silicone - gel sheet and physiotherapy): Excluding Neck contracture
nt - (Chest/Head/Face/Abdomen) stand alone

or advance surgeries after 6 days (allowed after pre auth, if justifies max 3 days in single go)
a Burns (TBSA) - any % (not requiring admission). Needs at least 5-6 dressing
a Burns (TBSA): Upto 40 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required fo
a Burns (TBSA): 40 % - 60 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required
urface Area Burns (TBSA): 25-40 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are re
a Burns (TBSA): > 60 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for d
graphy (OCT) - GOVT Reserve add on
nal Septal Myocardial Ablation
Subclavian , Mesenteric , Femoral, iliac - Popliteal ETC

monary Artery Stenosis /aortic aneurysm repair - GOVT Reserved
tomy/Balloon Aortic Valvotomy

stic angiogram ( if coronary angiography pkg booked separately then 6000 rs will be deducted from 40000
heuma c valvular heart disease
on/Left Heart Catheterization
(ROTA) Ablation - GOVT Reserve
a aneurysm (RSOV) - GOVT Reserve
Single Chamber - Single chamber VVIR
(for Hemoptysis)
men / Triple Lumen ) with procedure - add on
d) MRI Compatible - GOVT Reserve

d) MRI Compatible - GOVT Reserve
acemaker - add on with CRT / DDD Pacemaker PKG - GOVT Reserve - add on
mic Thrombolysis and anticoagulation ( Including thrombolytic agent r - TPA )
mplantation - Double Chamber
atheter guided Thrombolysis and anticoagulation ( Including r-TPA )
ystemic Thrombolysis and anticoagulation ( Including thrombolytic agent expect r - TPA )
y with/ without Radio Frequency Ablation
tion (AVM) in the Limbs
or advance surgeries after 6 days (allowed after pre auth, if justifies max 3 days in single go)
er 6 month of discharge date

months after discharge date
FFR) - GOVT Reserve - add on
(Biopsies) and advanced serology investigations - Add on
(CT, MRI, nuclear imaging) - Add on
(IVUS) - GOVT Reserve add on
(PDA) Closure via thoracotomy
repair (with Interpostion vain graft)

repair (without bypass/interposition graft)
/Carotid - endearterectomy/Carotid Body Tumor Excision/Thoracic Outlet syndrome Repair/Carotid aneurysm repair/Subclavian aneurysm repair/Axi
/Pulmanary Thromboendarterectomy
Single Chamber - Single chamber VVIR

e / Tricuspid valve - replacement /repair
(SOL) mediastinum
Obstructive Cardiomyopathy (HOCM)

onchopleural Fistula
Septal Defect (ASD) Repair/Glenn procedure/Pulmonary Artery Banding/Systemic - Pulmonary Artery shunt/Vascular Ring division.
malous Venous Drainage Repair/ASD Closure + Mitral procedure/ASD Closure + Tricuspid procedure/ASD Closure + Pulmonary procedure/ASD Closure
ization of MAPCA with intercardiac repair / Arterial switch operation/Senning Operation/Mustard Operation
moly repair/Double switch operation/Rastelli Procedure/Fontan procedure/AP window repair/Arch interruption Repair without VSD closure/Arch inter
Abdominal Approach
us treatment (for one limb) - Govt Reserve

with or without vein graft
Valve Repair/Replacement
all Rupture repair / ventricular Rupture repair / Aneurysm Rupture repair / Mitral Valve Rupture repair
cision / Carotid Endarteractomy
rafting (CABG), Off Pump

rafting (CABG), On Pump
mic Thrombolysis and anticoagulation ( Including thrombolytic agent r - TPA )
Double Chamber

ing re-exploration - ADD On PKG
or advance sugeries after 6 days (allowed after pre auth, if justifies max 3 days in single go)
er 6 month of discharge date

months after discharge date
using Cardiopulmonary bypass (CPB)/Aortic Aneurysm Repair using Left Heart Bypass
without using Cardiopulmonary bypass (CPB)/Aortic Aneurysm Repair without using Left Heart Bypass
using cardiopulmonary bypass/Thoracoabdominal aneurysm Repair using partial cardiopulmonary bypass
Dissection/Aortic Aneurysm ( Root Ascending )/Valve sparing root replacement/AVR + Root enlargement
e / Tricuspid valve - replacement /repair- Add On
(immediate re operation) - Add ON
Aorto femoral bypass - U/L/Aorto Iliac bypass - B/L/Aorto femoral bypass - B/L
age and Management of ICD, Intercostal Block, Antibiotics & Physiotherapy
rome requiring IABP insertion Pre/Intra/post - operatively - ADD On PKG

cation/ Thorcoplasty/Hydatid cyst/Other simple lung procedure excluding lung resection /Bronchial Repair Surgery for Injuries/ FB Removal
ws management by excision and reconstruction under GA inlcuidng Implant

ws management by excision under LA
ed tooth with wiring (1-3 teeth)3-6 :6000

e bands & coronoidectomy with gra ing - under GA
& gra ing under GA/LA
ar SalivaryGland / Salivary Ranula- with or without Lymph Node
r tooth - govt reserve
cyst / tumour of jaws under GA

cyst / tumour of jaws under LA
D/ In growing toe nail - Day care
e Non union Under GA
h jaws - under GA (Unilateral) / (Bilateral)
hood caries under GA

ery (per stage) Under GA
maxillary fixation for fracture of maxilla / mandible / zygoma/ Nasal
wth from Tongue only (inclusive of Histopathology) - Govt Reserve
Fistula- Govt Reserve

wiring (dental /trauma wiring- one jaw)
Tongue with neck node dissection Stand alone
l cavity / paranasal sinus/ Laryngopharynx with reconstruction Under GA only

paranasal sinus / laryngopharynx with free flap reconstruc on
l cavity / paranasal sinus / laryngopharynxwithout reconstruc on
tarded / Patient with systemic diseases / patient with special need - under GA
g of plates / wire - under LA / GA. Cost of implant Titanium:- TBF at pre-auth
astic Tumour Resection and reconstruction (Cancer surgery)
n/Hypertensive emergencies
unstable cardiopulmonary status with resuscitation
caemia/ Hyponatremia/ Hypernatremia/ Hyperkalaemia/ Hypokalaemia
rk surgery / Thyroplasty
rnal fixation of maxilla/Open reduction and internal fixation of mandible/Open reduction and internal fixation of zygoma
le/Multiple Sinuses)
nage/Intraoral calculus removal
esion Excision/ Sclerotheraphy- LA or GA

oesophagoscopy - Diagnos c + / - biopsy
otomy/stapedotomy - Govt. reserve
n/Thyroglossal sinus excision/Thyroglossal fistula excision/Branchial sinus excision/ Branchial cyst excision/Branchial fistula excision
h central neck Dissection
llectomy (unilateral/bilateral)/Tonsillectomy - B/L adenotonsillectomy - Govt. reserve
tratified (GA/LA) and price adjusted accordingly ) - Govt. reserve
ections/Wide bore aspiration/ Turbinate reduction

ture of maxilla/mandible/zygoma/Closed reduction and Intermaxillary fixation
nt - (Chest/Head/Face/Abdomen)stand alone
age/Post trauma neck exploration

omy/ Clival tumour excision
yrinthine approach/ Transcochlear approach/ Temporal Bone resection

l cavity / paranasal sinus/ laryngopharynx with reconstruction
one - Regular PKG / Day care

nus (FESS)stratified as U/L or B/L and cost adjusted - Govt. reserve
ation - Open/Ant. Ethmoidal artery ligation - Endoscopic/ Sphenopalatine artery ligation - Open/Sphenopalatine artery ligation - Endoscopic
on/Orbital decompression/Craniofacial resection/Maxillary swing
ost-trauma c facial nerve decompression/CSF Otorrhoea repair

Mastoidectomy - Govt. reserve
excision/Comprehensive Benign neck tumourexcision/Selec ve Pharyngeal diver culumexcision/Comprehensive Pharyngeal
pancreatitis / Pancreatitis
Lower GI bleed (inclusive of sigmoidoscopy / colonoscopy) - Colonoscopic management only excluding local perineal conditions
h moderate dehydration/Acute gastroenteritis with severe dehydration/ Recurrent vomiting with dehydration/Chronic diarrohea/Persistent diarrohea
d ligation (EVL) including band - ADD ON
nant Hepatitis / Acute viral hepatitis /Alcoholic Liver Disease/Ascites/ Chronic Hepatitis/Liver abscess
uodenal / colonic stenting/balloon dilatation

lasty/Gastrostomy/ vacuum assisted biopsy/thrombin injection- Govt Reserve
Subclavian , Mesenteric , Femoral, iliac - Popliteal ETC
monary Artery Stenosis /aortic aneurysm repair - GOVT Reserved
lation -Trigeminal nerve/Genicular nerve/Celiac plexus/stellate ganglion/Symphathetic nerve /Varicose vein- Govt Reserve
(ROTA) Ablation - GOVT Reserve
aneurysm/ dissection - Govt Reserve
portosystemic shunt creation (TIPSS)/Direct transjugular Intrahepatic Portosystemic shunt(DIPSS) - Govt Reserve
biopsy - Govt Reserve
elling catheter for refractory ascites / pleural effusion

ous catheter - Govt Reserve
(for Haemoptysis)
a (CCF) embolization with coils.( Upto 5 coils, guide catheter, micro-catheter, micro-guidewire,general items] - Govt Reserve
cutting balloon/drug coated balloon/ high pressure balloons/BTK/re-entry device or Stent:venous or SFA stent/two bare metal stents/ covered stent o
peripheral (DSA - Digital Substraction Angiography)
tion (AVM) in the Limbs
eous Metallic Stent/ Balloon /Snare /Balloon occlusion- govt reserved
d guided fine needle biopsy
rysm/AV Malformation or fistula - Govt reserve
ressure measurement (HVPG) - Govt Reserve

ous: drainage placement /biliary drainage/ cholecystostomy/ sclerotherapy
oplasty with stenting - Govt Reserve
/ clot retrieval - Govt Reserve
(IVUS) - GOVT Reserve
eous Image guided / Fluoroscopic Guided

er/Mixed DevelopMental Disorders/Tourette Syndrome / Chronic Tic Disorde/Attention Deficit Hyperactivity Disorder (ADHD/Specific DevelopMental
nd somatoform disorders
al and Developmental and Educational Interventions (Typically Includes Child Counselling / Psychotherapy, Family Counselling / Psychotherapy / Train
Complete Haemogram, Liver Function Test, Renal Function Test, Serum Electrolytes, Electro Cardiogram (ECG), CT / MRI Brain, Electroencephalogram
ed in Management of Child & Adult Psycholoigical DisordersiIncluding Anti-ADHD Medication
order/ Conduct Disorder/Mixed Disorder of Conduct and Emotions/Anxiety and Depressive Disorders/Other Internalizing and Externalizing Disorders o
ssociated with physiological disturbances and physical factors
ts (Includes IQ Testing, Specific Learning Disability Assessments, Assessments For Autism Spectrum Disorder, Developmental Assessments, Projective T
al and delusional disorders
py (ECT) - per session
disorders due to psychoactive substance use

nic, including symptomatic
e nacrotizing severe pancreatitis / Chronic Pancreatitis
poisoning/Other poisonings
/Type 2 respiratory failure/Due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, poisoning, head injury, Acute excaberation of COPD /Ac
heumatic valvular heart disease / Rheumtoid Arthritis /Septic Arthritis
e) Status Epileptics / Drug resistant Epilepsy/Evaluation of drug resistant epilepsy & Ketogenic diet in Refractory Epilepsy / Epileptic encephalopathy
Thalessmia / Other anemias
/Blood component including platelet transfusion RDP And PRC ( IF HB ≤ 8 mg/dl and platelet ≤ 40000 - Add on
≤ 20000 ) - Add on
matosus (SLE)/ Diffuse alveolar hemmorhage associated with SLE
Pleural tuberculosis/ Pulmonary tuberculosis

nomegaly-requiring admission for Work Up and/or in-patient management
Acute worsening in neuro metabolic and neurodegenrative conditions
admission for Work Up and/or in-patient management

pathy/Acute Disseminated Encephalomyelitis/hypertensive/metabolic/febrile/hepatic encephalopathy/Acute meningo encephalitis pyogenic/Aseptic m
h moderate dehydration/Acute gastroenteritis with severe dehydration/ Recurrent vomiting with dehydration/Chronic diarrohea /Dysentery
ment therapy (CRRT) in AKI (including cost for disposable)

nchitis/Acute epiglottitis
/ Acute demyelinating encephalitis

axis / Steven Johnson syndrome
e/Acute hemorrhagic stroke- (Extra ventricular drainage)/Acute hemorrhagic stroke- Hematoma evacuation/ Acute Ischemic Stoke/Acute ischemic str
HD/Cyanotic spells with CHD
morrhagic fever/Dengue shock syndrome
exia of unknown origin
ropoietin - Day care / Add on

orders - govt reserve
/Intracranial space occupying lesion tuberculoma/neurocysticercosis, brain tumours

uiring admission for work-up or in-patient care
surgical procedures/due to trauma/malignancies/ meningo-encephalitis

ally treated pyogenic meningitis/Neuro tuberculosis/Complicated bacterial meningitis/Acute meningitis/Meningitis/ Fungal Meningitis/ACUTE INFECTI
tasis / Choledochal cysts

h peritonitis/Steroid dependent or resistent/Uncomplicated steroid sensitive
mide 50 mg/m2 OD D1-D21 every 28 days
erventions. Like-PTBD/ERCP/PCN//Pericardiostomy, DJ Stenting, etc
NS LYMPHOMA (LMB 89-96) INDUCTION-COPADAM (8 WEEKS, 2 CYCLES)-LMB 89 - 96 - Induction - COPADAM-Duration + Cycle

NS LYMPHOMA (LMB 89-96) MAINTAINENCE (12 WEEKS)-LMB 89 - 96 - Maintenance
NS LYMPHOMA (MCP-842) 8 cycles-MCP - 842-Cycle
/Blood component SDP ( IF platelet ≤ 20000 ) - Add on
ood leukaemia group Berlin- Frankfurt -Munster Kill acute lymphocy c leukemia cells Mitroxantrone,Chlorambucil,Prednisolone: 841 including blood p
Berlin- Frankfurt -Munster-95Berlin- Frankfurt -Munster-2000Hyper (cyclophosphamide, Vincris ne, Adriamycin,Dexamethasone
er-90, Berlin- Frankfurt -Munster-95, Berlin- Frankfurt -Munster-2000Hyper (cyclophosphamide, Vincris ne, Adriamycin,Dexamethasone
Methotrexate 25 mg / M2 Weekly / Inj. Vincris ne monthly for 2 years
Daunomycin 60 mg / M2 3 days ( this include an bio cs, an fungals, blood and platelets transfusion)
3 cycles Including antibiotics and blood product transfusion Maximum 3 cycles
nomycin or IdarubcinCytarabine - mul agent - vary on protocol
nomycin or IdarubcinCytarabine - mul agent - vary in each protocol include an bio cs, an fungals, blood and platelets ; FFP transfusion
ethotrexate 15 mg WeeklyATRA 45 mg / M2 for 14 days Every three months for 18 Months
5 mg / kg day 1-45 or 60ATRA: All trans re noic acid 45 mg / M2 - day 1-45 or 60
5 mg / kg day 1-Day 5, day 8-12, day 15-19, day 22-26 every 56 days for 4 cyclesATRA : All trans re noic acid 45 mg / M2 day 1-Day 14 and Day 29-43 ev
5 Fluorouracil(FU) 1000mg/m2 D1-D4 D29-D32Mitomycin 10mg/m2 D1
Capecitabine 825mg/m2 PO twice daily ll comple on of RTMitomycin 10mg/2 D1
platin + Paclitaxel-Cycle
tin + Paclitaxel-Cycle
poside + PrednsioloneCyclophosphamide 750 mg/m2Vincris ne 1.4 mg/m2, on Day1Etoposide 65mg/m2 Day 1 to 3Prednisolone 100 mg Day 1-5
(Except Burki 's & PCNSL)-R - CEOP
(Except Burki 's & PCNSL)-R - CHOP
orubicin + PrednsioloneCyclophosphamide 750 mg/m2Doxorubicin 50mg/m2Vincris ne 1.4 mg/m2 on Day1Prednisolone 100 mg Day 1-5
mide 150 - 200 mg/m2 D1-D5 every 28 days
hosphamide, vincris ne, doxorubicin, high-dose methotrexate / ifosfamide, etoposide, high-dose cytarabine)GMALL (German mul center acute lymph
mide 75mg/m2 once daily
every 21 days
Docetaxel 75mg/m2 D1Cyclophosphamide 600 mg/m2 D1 every 21 days ( Maximum 6 Cycles )
00 mg D1 D15 D28 then every 28 days
b 8 mg/Kg in Cycle 1 D1Trastuzumab 6 mg/kg D1 from C2 every 21 days ( Max 17 cycles )

litaxel 80mg/m2 every week ( Max 12 weeks )
e - 1000mg/m2 orally twice daily D1-D14 every 21 days
mg/m2 D1 every 21 days Maximum 6 cycles
Paclitaxel + Carbopla n every 21 days
Gemcitabine 1000 mg/m2 D1 D8Carbopla n AUC 5-6 D1 every 21 days

Docetaxel 75 mg/m2 D1Cispla n 75 mg/m2 D15 FU 750 mg/m2 D1- D5 every 21 days
ocetaxel-Duration + Cycle
etaxel 75 mg/m2 D1 every 21 days

Pemetrexed 500mg/m2 D1Carbopla n AUC 5-6 D1 every 21 days
500mg/m2 D1 every 21 days
Etoposide 100mg/m2 D1 - D3Carbopla n AUC 5-6 D1 every 21 days
+ Carboplatin-Duration + Cycle
+ Carboplatin-Duration + Cycle
Gemcitabine - 1000mg/m2 D1 D8Carbopla n AUC 5-6 D1 only Repeat every 21 days
opdox 30 mg/m2 D1Carbopla n AUC 5-6 D1 every 28 days maximum 6 cycles
2 IV every 28 days Maximum 6 cycles
atin + Paclitaxel-Cycle
e 1000-1250 mg/m2 PO twice daily D1 -D14 every 21 days
l + Carboplatin-Cycle
toposide 100mg/m2 D1 - D3Carbopla n AUC 5-6 D1 every 21 days

g/m2 D1 every 21 days
rednisolone 10mg daily Once every month
22.5 ug every 3 months
mg/m2 Maximum 6 cycles as per protocol
pla n 40 mg/m2 every week maximum 6 cycles
Fludarabine 25mg/m2 D1-3Cyclophosphamide 250 mg/m2 D1-3 every 28 days for 6 cycles
tic Leukemia-Lenalidomide-Duration + Cycle
tic Leukemia-Rituxmab + Chlorambucil-Cycle
(per month X 5 years)
5 FU 1200mg/m2 D1 D2Leucovorin 400mg/m2 D1Oxalipla n 85 mg/m2 D1 every 14 days

5 FU 1200mg/m2 D1 D2Leucovorin 400mg/m2 D1Irinotecan 180mg/m2 85 mg/m2 D1 every 14 days
5 FU 1200mg/m2 D1 D2Leucovorin 400mg/m2 D1Oxalipla n 85 mg/m2 D1Irinotecan 180mg/m2 every 14 days
Capecitabine 1000mg/m2 D1-D14Irinotecan 200 mg/m2 D1 every 21 days
Capecitabine 825 mg/m2 twice daily
Capecitabine 1000mg/m2 D1-D14Oxalipla n 130 mg/m2 D1 every 21 days
5 FU + Leucovorin-Cycle
Gemcitabine - 1000mg/m2 D1 D8Carbopla n AUC 2 D1 D8Gemcitabine - 1000mg/m2 D1 D8 Carbopla n AUC 5-6 D1 only every 3 weeks
oxorubicin 60 mg/m2 D1Cispla n 50mg/m2 every 3 weeks
opdox 30 mg/m2 D1Carbopla n AUC 5 D1 every 28 days
er-Carboplatin + Paclitaxel-Cycle
Cispla n 40 mg/m2 D1Leucovorin 400mg/m2 D15FU 1000mg/m2 D1 D2 every 14 days
Docetaxel 50mg/m2 D1Oxalipla n 85 mg/m2 D1Leucovorin 400mg/m2 D15FU 1200mg/m2 D1 D2 every 14 days
Docetaxel 50mg/m2 D1Oxalipla n 85 mg/m2 D1Capecitabine 825 mg/m2 Twice daily every 14 days
ach Cancer-Capecitabine-Cycle
ach Cancer-CAPOX-Cycle
ach Cancer-Cisplatin + Docetaxel-Duration + Cycle
ach Cancer-Folfox-Cycle
5FU 1000mg/m2 D1-D4 D29 D32 every 35 days
r-Carboplatin + Paclitaxel-Duration + Cycle
-Paclitaxel + Carbopla n for defini ve Non - metasta c(With RT)-Cycle
+ CyclophosphamideIfosfamide + EtoposideIfosfamide: 1800mg/m2 (days1-5)Etposide: 100mg/sq.m (days 1-5)Vincris ne 1.5mg/m2 (day 1 and 8)
Cyclophosphamide + Irinotecan + TemozolamideVincris ne 1.5mg/m2( day 1)Topotecan 1.5mg/m2 (day 1-5)Cyclophosphamide 250mg/m2 (days 1-5)
emcitabine 1000 mg/m2 D1 D8Cispla n 25 mg/m2 D1 D8 every 21 days

e 1000mg /m2 D1 D8 every 21 days
Gemcitabine 1000 mg/m2 D1Oxalipla n 100 mg/m2 D1 every 14 days
er / Cholangiocarcinoma-Gemcitabine-Duration + Cycle
la n 20 mg/m2 IV D1-D5Etoposide 100mg/m2 D1-D5 every 21 days

Paclitaxel 240 mg/m2 D1Ifosfamide 1500mg/m2 D2-D5Mesna 300 mg/m2 0h 4h 8h D2-D5Cispla n 25mg/m2 D2-D5 every 21 days
Vinblas ne 0.11 mg/kg IV D1-D2Mesna 240mg/m2 0h 4h 8h D1-D5Ifosfamide 1200mg/m2 D1-D5Cispla n 20 mg/m2 D1-D5 every 21 days for
Bleomycin 30 units D1 D8 D15Cispla n 20 mg/m2 IV D1-D5Etoposide 100mg/m2 D1-D5 every 21 days
Carboplatin (AUC 7)-Cycle
e + Dac nomycin + Cispla nEtoposide 100mg/m2 IV D1 D2 D8Dac nomycin 0.5 mg IV push D1 D2 Methotrexate 300 mg /m2 D1
e + Dac nomycin- Cyclophosphamide + Vincris neEtoposide 100mg/m2 IV D1 D2Dac nomycin 0.5 mg IV push D1 D2Methotrexate 300 mg /m2 D1
ate 1/mg/kg IM every other day x 4 days D1 3 D5 D7Alterna ng every other day withLeucovorin 15 mg PO repeat every 14 days
oblastic Neoplasia-EMA - EP-Cycle
oblastic Neoplasia-Methotrexate-Duration + Cycle
High Dose Cytarabine + Cispla nCytarabine 2g/m2 BD on day 2Dexamethasone 40 mg Day 1 - 4Cispla n 75mg/m2 or Carbopla n AUC-5 on day 1
B Cell-Rituxmab + Dexamethasone + High Dose Cytarabine + Cispla n-Cycle
Vinblas ne 6mg/m2Dacarbazine 375 mg/m2 Day 1,15Etoposide 65mg/m2 Day 1-3, 15-17Every 28 days for 6 cycles
Bleomycin 10unit/m2Vinblas ne 6mg/m2Dacarbazine 375 mg/m2 All drugs Day 1,15Every 28 days for Maximum 6 cycles
Vincris ne 1.4mg/m2 D1, 8Procarbazine 100 mg/m2 D1-14Prednisolone 40mg/m2 D1-14Every 28days. Total 6 - 8 cycles
(His ocytosis Protocol - Maintenance) each cycle 3 months dura onn Maximum 2 years
(His ocytosis Protocol - Induc on) Maximum 8 weeks
Bendamus ne 90mg/m2 on day 1, 2Rituximab 375mg/m2 on day 1Repeat every 28 days, Total 6 cycles
NHL-Lenalidomide + Rituximab-Cycle
Vincris ne 1.5mg/m2 (day 1, 8 and 15 for first 4 cycles and then only day 1 from cycle 5 to 17)Carbopla n 550mg/m2 every 3 weeks (all cycles) Maxim
TP / AIHA -Rituximab-Cycle
Repeat every 28 days for 12 cycles
Berlin- Frankfurt -Munster- 95Berlin- Frankfurt -Munster- 2000Hyper CVAD (cyclophosphamide, Vincris ne, Adriamycin,Dexamethasone
/ Brain PNET-PACKER-Cycle
mide + Vincris ne + etoposide Cyclophosphamide 1000mg/m2 (2 days every cycles)Vincris ne 1.5mg/m2 (days 1 and 8)Cispla n 100mg/m2 (1 day per
Pemetrexed 500mg/m2 D1Cispla n 75 mg/m2 D1 every 21 days
c acid 4 mg IV Monthly
acarbazine 250mg/m2 D1-D5Cispla n 75 mg/m2 Every 21 days
de + DexamethasoneLenalidomide 25 mg daily Day 1 - 21Dexamethasone 40mg Day 1, 8, 15, 22Bortezomib 1.3 mg/m2 Day 1, 8, 15, 22
phamide + DexamethasoneCyclophosphamide - 300 mg/m2 day 1, 8, 15, 22Dexamethasone 40mg Day 1, 8, 15, 22Bortezomib 1.3 mg/m2 Day1, 8, 15, 2
e + DexamethasoneThalidomide 100 mg daily Day 1 - 28 Dexamethasone 40 mg Day 1, 8, 15, 22Bortezomib 1.3 mg/m2 Day 1, 8, 15, 22
Melphalan 9mg/m2 D1-D4Thalidomide 100mg D1-28Prednisolone 100mg Day1-4Every 28days
lidomide + DexamethasoneCyclophosphamide 100mg D1-D14Thalidomide 100-200 mg daily Day 1-28Dexamethasone 40mg Day 1, 8, 15, 22
Lenalidomide 25 mg daily Day1-21Dexamethasone 40mg Day 1, 8, 15, 22Every 28days Maximum 12 cycles
Pomalidomide 4 mg daily Day 1-21Dexamethasone 40mg Day 1, 8, 15, 22Every 28 days Maximum 12 cycles
-VMP-Duration + Cycle
(Dose will be based on blood counts)
g/m2 per day for 2 weeksEach cycle given 4 weekly (Max cycles6)
+ Cyclophosphamide + DoxorubicinCarbopla n 600mg/m2Etoposide 100mg/m2 (days 1-5)CyclophosphamideDoxorubicin
Cyclophosphamide + Vincristine + Etoposide + Doxorubicin (maximum 8 cycles)
cris ne + PrednisoloneCyclophosphamide 750mg/m2Vincris ne 1.4mg/m2 Day 1Prednisolone 100 mg Day 1 - 5Repeat every 21days. Total 6 cycles
Oxalipla n 130mg/m2 D1L- asparginase 6000 U/m2 D1-7Repeat every 21 days
Doxorubicin 75mg/m2 given every 3 weeks Maximum 6 cycles
Osteogenic SarcomaMethotrexate 8-12 gram/m2Weekly Maximum 12 cycles
Mesna 600mg/m2 0h 3h 6h 9h D1-D5Adriamycin 25mg/m2 D1- D3Cispla n 33 mg/m2 D1-D3 every 21 days
ma-Methotrexate + Doxorubicin + Cisplatin for Relapsed Osteogenic Sarcoma-Duration + Cycle
Methotrexate 20mg/m2 weeklyVincris ne 1.5mg/m2 monthlyIntrathecal methotrexate 12 mg 3 monthly Maximum for 2 years
NS Therapy Reinduc on) Maximum 6 months
Days 1, 3 and 5 (Maximum 4 cycles )
Daunorubicin 50mg/m2 days 1, 3 and 5Etposide 100mg/m2 days 1-5 (Etoposide may be omi ed)
nomycin or IdarubcinCytarabine - mul agent - vary on protocol include an bio cs, an fungals, blood and platelets, FFP transfusion
Daunomycin or Idarubcin- mul agent - vary on protocol include an bio cs, an fungals, blood and platelets, FFP transfusion (Dura on 8 weeks m
Doxorubicin Max 8 cycles
isone,doxorubicin hydrochloride (Maximum 8 cycles)

etoposide (Maximum 4 cycles)
abine, Etoposide) Other salvage regimens can be allowed like DHAP, ESHAP, GVD in the same code if possible
ucil,Prednisolone: 842
Gemcitabine 1000mg/m2 D1 D8 D15Albumin bound Paclitaxel 125mg/m2 D1 D8 D15 every 28 days
e 1000mg /m2 D1 D8 every 21 days maximum 6 cycles
Lymphoma Relapse-DECA-Cycle
Lymphoma-COPDAC-Cycle
Vincris ne 1.4mg/m2 D1Adriamycin 50 mg/m2 D1Etoposide 100mg/m2 D1-3Prednisolone 100 mg D1-5Every 21days. Total 6 cycles
Lymphoma-CHOP-Cycle
Lymphoma-SMILE-Cycle
e + Vincris ne + Cyclophosphamide + DoxorubicinRituximab 375mg/m2 Day 1Etoposide 50mg/m2VCR 0.4mg/m2Doxorubicin 10mg/m2 Day1 - 4
Lymphoma / Seroposi ve B - Cell NHLR-EPOCH-Cycle
Ifosfamide 1.66g/m2 on day 1 - 3Mesna 1.66g/m2 day 1 - 3Carbopla n AUC 5 on day 1Etoposide 100mg/m2 on day 1 - 3
Lymphoma-MINE-Cycle
Lymphoma-PTCL - GDP-Cycle
Mesna 1.66g/m2 day 1 - 3Carbopla n AUC 5 on day 1Etoposide 100mg/m2 on day 1 - 3Cycle every 21days for 6 cycles
every 4 weeks
y 4 weeks on 2 weeks off
Carbopla n 600mg/m2 day 1Etoposide 150mg/m2 days 1-3 Vincris ne1.5mg/m2 day 1 (Max cycles= 8)
hamide + Dac nomycinVincris ne 1.5mg/m2 (day 1, 8 and 15)Cyclophosphamie 1200 - 2200 mg/m2 (day 1)Dac nomycin 1.5mg / m2 (day 1)
Vincris ne 1.5mg/m2 (days 1, 8 and 15)Ifosfamide 1.8gm/m2 (days 1-5)Etoposide 100mg/m2 (days 1-5)Each cycle every 3 weeks (maximum
Doxorubicin 30mg/m2 D1 D2Ifosfamide 2000 to 3000mg/m2Mesna 400 to 600 mg/m2 0h 4h 8h D1 - D3Every 21 days Maximum 6 cycles
Gemcitabine 900 mg/m2 D1 D8Docetaxel 100 mg/m2 D8 every 21 days Maximum 6 cycles
Cispla n 50 mg/m2 D1Doxorubicin 50 mg/m2 D1Cyclophosphamide 500 mg/m2 D1 every 21 days
poside 100mg/m2 D1 - D3Cispla n 75-100 mg/m2 D1 every 21 days
Urethra-Methotrexate + Vinblastin + Doxorubicin + Cisplatin-Cycle
Urethra-Paclitaxel + Carboplatin-Duration + Cycle
orubicin + Etoposide + Vincris ne + Carbopla nVincris ne + Dac nomycin +Adriamyicn+Cyclophosphamide +EtoposideWeekly chemotherapy - varyin
Vincris ne 1.5 mg/m2 weekly for 12 weeks and then 3 weeklyAc nomycin D 45 microgram/kg 3 weeklyDoxorubicin 60mg/m2 for 24
2 cycles) Each cycle Duration- 4 weeks
estigations in oncology
Piperalicillin + TazobactumCefoperazonePiperacillinAmikacinGentamicinCefipimeLevofloxacinAmoxycillin and clavulanate
LinezolidVoriconazoleCaspfunginAmphotericin - B
2 D9-14 + Capecitabine 1gm/me D1-14 every 28 days

max 300 microgram per day) for 7 days orPEG - GCSF 6mg one single dose per chemotherapy cycle
ulating Factor Use-Cycle
OLIDATION X8 CYCLES-High Risk Consolidation
ycin - Induction cycles (PC) for max. 06 Doses
ucts (RDP,PRC,SDP) - Add on
requiring closer monitoring or short-term care on mother's bedside for condi ons like, but not limited to: o Birth asphyxia (need for posi ve pressure
nse Audiometry(BERA)
ht 1500 g to 1800 g or any weight with mild illness like and at least one of the following condi ons: : • Mild Respiratory Distress/ tachypnea
nt Surgery (VP) or Omaya Reservoir or External Drainage forHydrocephalus
natal Care, Special Neonatal Care-Plus, Intensive Neonatal Care or Critical Neonatal Care packages (MN002,MN003,MN004, MN005) who have not fully
y allow with pkgs of Advanced Neonatal Care Package / Critical Care Neonatal Package
weight with at least one of the following condi ons: • Severe Respiratory Failure requiring High Frequency Ven la on or inhaled Nitric Oxide (iNO)
ge ( Can be book only After neonatal screening PKG , if any significant finding and indications required for more workup) karyotype, FISH, Urine GCMS
with pkgs of Advanced Neonatal Care Package / Critical Care Neonatal Package
to 1000 gm or any weight and at least one of the following condi ons: • Any condi on requiring invasive ven la on longer than 24 hours
of Prematurity
rthweight or any weight with at least one of the following condi ons: • Need for mechanical ven la on for less than 24 hours or non-invasive respirat
pathy of Prematurity -Neo - natal (Irrespec ve of no. of eyes affected)per session
d with mother : Includes clinical monitoring, breastfeeding support, birth vaccination, thyroid screening, universal hearing screening and pre-discharge

ve Release/ Nerve Neurolysis/Nerve repair surgery
foraminotomy and discectomy- Govt Reserve

using lateral mass or pedicle screws and rods
cephalocele/meningocele repair
unt (Low/Medium/High Pressure) / Ventriculo - pleural Shunt (Low/Medium/High Pressure )/Ventriculo - atrial Shunt (Low/Medium/High Pressure )/T
nal tumor with fusion and fixation (Cost of implants to be extra)
ramedullary tumor with fusion and fixation (Cost of implants to be extra)

y tumor of spine + Neuro monitoring Device 15000
y tumor with fusion and ficxation (Cost of implants to be extra)
r movement disoders
ery (STA): middle cerebral artery (MCA) or (other EC - IC) Bypass procedure
mtic EDH/SDH- Intraparenchymal Hematoma,
hymal hematoma evacuation/Evacuation of Post-trauamtic Intraparenchymal Hematoma in Paediatric Age group
al Extra-axial Tumours (Meningioma etc)/Surgery for infratentorial ExtraaxialTumour(meningioma etc)
rans Sphenoidal Surgery

mpression and Posterior stabilisation or C V junction
Omayya reservoir/external ventricular drain
cuation of hematoma/ biopsy/ pus drainage/Placement of ICP monitoring device

hronic Sub Dural Haematoma - U/ L or B/L
omy without fusion - Govt Reserve

ar corpectomy with fusion for Tumor/Infection/Trauma
Severe spinal injury / Severe Head injury
s/Repair - Govt Reserve
gus bone graft/Cranioplasty with exogenous Graft
/ surgery for "Craniosynostosis"
head injury/acute stroke/cerebral venous thrombosis
nal Angiography/ peripheral (DSA - Digital Substraction Angiography)
us graft- (May be perfomed as an add-on procedure) Cost of graft will be extra
ll Base Tumours/Surgerey for Supratentorial/ Infratentorial intra-axial tumours/Cerebello-pontine angle Angle/ Brainstem
mpression for Chiari malormation with or without duraplasty or tonsillar resection.

urgeryor Linear accelerator Radiosurgery for tumors/AVMs/ Trigeminal Neuralgia
and fixation for lumbar/cervical/thoracic canal stenosis or for tumor / trauma/Bleed(Cost of implants to be extra)
sion for lumbar or dorsal or cervical canal stenosis - Govt reserve
Lumbar Discectomy (One level) - Govt Reserve
f arteriovenous malformation/Laminectomy/Laminotomy and excision of Intraspinal arteriovenous malformation
enous malformation
omy with fusion- Govt reserve

/ Acute demyelinating encephalitis
e/Acute hemorrhagic stroke- (Extra ventricular drainage)/Acute hemorrhagic stroke- Hematoma evacuation/ Acute Ischemic Stoke/Acute ischemic str
valuation of drug resistant epilepsy


rehabilitation for spinal injury/ traumatic brain injury, CVA, Cerebral palsy with or without orthosis - govt reserved
muscular dystrophy/Medical Rehabilitation intellectual disability/Medical Rehabilitation special learning disability/Medical Rehabilitation multiple dis
ing admission for work-up or in-patient care
eal injury repair - Govt. Reserve
ectomy + bilateral salpingoophorectomy + BPLND - Lap./Class I radical hysterectomy + bilateral salpingoophorectomy + BPLND - Open
salpingoophorectomy + omentectomy + peritonectomy and organ resections ( Minimum 2 organs )
ymph node dissection
ge) / Dilation and Evacuation (D&E)

ullarian horn (Open/Lap)
trial EA/ ECC; Vulvar; Polypectomy,Endometrial Aspiration - govt reserve
r for Mullerian Anomaly
proceed for Ovarian Cancers. Omentomy with BilateralSalpingo-oophorectomy (BPLND if req )
(Other than Hysterectomy)

- With obturator tape
epair - Open/ Laparoscopic/Uretero - Uterine fistula repair - Open/ Laparoscopic/Urethrovaginal fistula repair ± DJ Stenting
vaginal fistula (Open)
20000) / Redical (Rs 40000) reconstruction procedures

cyst/ abscess enucleation /Vulvo vaginal/ bartholin cyst/ abscess drainage
ge) / Dilation and Evacuation (D&E)
with / without ± biopsy - govt reserve
Anaesthesia) only in GA
eal Tear - govt reserve - add on
emia (<8 g/dL) , Other maternal and fetal conditions as per guidelines-eg previous caesarean section, diabetes, eclampsia, pre-eclampsia, severe grow
forate hymen - Govt Reserve

y ± Salpingo-oophorectomy/ Non descent vaginal hysterectomy /TLH / LAVH/Vaginal hysterectomy with anterior and posterior colpoperineorrhaphy- G
is / Laparoscopic adhesiolysis - Govt Reserve
nal reposition/Abdominal reposition
dica on including ectopic pregnancy)

gament Hematoma (+/-internal iliac ligation)
Surgery for Prolapse uterus
nder GA (with or without implant)

ectrol laser / Barrage laser - Per eye per sitting
a on (PRP) - Re nal Laser including 3 si ngs / package of re no laser photocoagula on (3 si ngs per eye for both eyes)
cluding Amniotic Membrane Graft
es (complex surgery involving four muscles or oblique muscles)
aediatric lens aspiration with posterior capsulotomy & anterior vitrectomy

my & anterior vitrectomy
th Silicon Oil Insertion)
h foldable hydrophobic acrylic IOL - GOVT Reserve
sion including Amniotic Membrane Graft

al/corneo scleral/with or without iris prolapse repair

inostomy with Silicon Tube / Stent
inostomy without Silicon Tube / Stent
photo and OCT (day care)
tropion correction - GOVT Reserve
Paediatric Glaucoma
ography (FFA) - GOVT Reserve and Day care
Fundus OCT & Visual Fields

culectomy only) with or without Mitomycin C, including postopera ve medica ons for 12 weeks (and wherever surgical or laser procedures required f
graphy (ICGA) - GOVT Reserve and Day care
pathy of Prematurity -Neo - natal (Irrespec ve of no. of eyes affected)per session

bow / Any small joint
bow / Any small joint
/ Shoulder tendon injuries/ Shoulder Dislocation
w/Below Knee/Above Knee/Foot/Hand/Wrist/Disarticulation

on/Combined spinal segment - front and back (anterior/posterior/ combined anterior and posterior)
n Repair / Tendon transfer
w/Above Knee/Below Knee/Foot/Hand/Wrist/Disarticulation
urettage / Excision and bone grafting

alignant) including GCT + Joint replacement (depending upon type of joint and implant)
ar corpectomy with fusion for Tumor/Infection/Trauma -Govt Reserve

ture of maxilla/mandible/zygoma/Closed reduction and Intermaxillary fixation for fracture of mandible
Polydactyle/Macrotodactyle
ision Arthoplasty of Femur head - govt reserve
inimum of 2 sessions
with Internal Fixation
release + rehabilitation
oss elbow / Across Knee / femur / shaft tibia / Across ankle / pelvis
arsal, MT, Calcaneum, Talus, Phalanx)
teral malleolus or bimalleolar fracture or Trimalleolar fracture or talus or calcaneum
& Internal Fixation of long bones (femur shaft / tibia shaft / Fibula / Humerus)
using wires - under LA/GA
nd fixing of plates / wire - under LA / GA
d Approach PLATING
orearm - ORIF/CRIF - Plating / Nailing / JESS

Metaphyseal - ORIF (excludes forearm bones)
rcutaneous CC-Screw Fixation / DHS / PFN / Angle plate
orearm - ORIF - Plating / Nailing / JESS
ondyle / ORIF with screw of proximal/distal humerus
l head prosthesis / Comminuted Fracture Olecranon of Ulna/ distal end intra-articular radius fracture
lar Humerus +/- olecranon osteotomy +/- TBW
oid / Dorsal / lumbar spine fixation THROUGH Anterior approach
oid / Dorsal / lumbar spine fixation THROUGH posterior approach
Modular/ Modular) (cemented/non cemented)
Patella / carpal /tarsal /phalanx /metatarsal /metacarpal /calcaneum /tarsal)

and fixation for lumbar/cervical/thoracic canal stenosis or for tumor / trauma/Bleed
sion for lumbar or dorsal or cervical canal stenosis - Govt reserve
with pin / crutchfiled tong cervical spine traction - Day care

Transport by Ilizarov / LRS
ury with fixation of 2 or more LIMB
ury with fixation of Single LIMB
le arthrodesis / Shoulder / elbow/ Wrist / Hand +/-implant
Visceral injury and fixation of fracture of 2 or more llmb
Visceral injury and fixation of fracture of single limb
epair / Meniscectomy / MPFL Repair

ovectomy - govt reserve
bo)Lung / Heart- Lung ComboTransplant Surgery

o)Transplant Surgery pre Operative evaluation
bo)Donor for Multiorgan
es) -ECMO Period - per day
bo)Short term. ECMO Bridge totransplant

ges ) - Post-Operative Audio Verbal(speech) Therapy
ges ) - Cochlear Implant - ADD ON
ges ) - Cochlear Implant Surgery
ges ) - Preoperative evaluation for cochlear Implant
ges ) - Maintenance for cochlear implant
Packages) - Allogenic Bone marrow transplant - Immunization/Vaccination
Packages) - Allogenic Bone marrow transplant chronic GVHD.
Packages) - Allogenic Bone marrow transplant (Haplo) - Allogenic Bone marrow transplant (Haplo)
Packages) - Allogenic Bone marrow transplant (MSD) - Allogenic Bone marrow transplant (MSD)
Packages) - Allogenic Bone marrow transplant (MSD/Haplo) - Pre-evaluation/Work up
Packages) - ASCT (Autologous Bone marrow transplant)
Packages) - ASCT (Autologous Bone marrow transplant) - Pre-evaluation/Work up
Packages) - Post Autologous / Allogenic (Haplo/MSD) Transplant follow up (upto 6 months) -
Packages) - Post Autologous / Allogenic (Haplo/MSD) Transplant follow up (6-12 months) -
es) -Transplant surgery - Investigation of donor - Pre-evaluation/Work up
es) -Transplant surgery - Investigation of Recipient - Pre-evaluation/Work up
es) -Transplant surgery, including donor hepatectomy - for cadaveric donor
es) -Transplant surgery, including donor hepatectomy - for Live donor
es) -Post-Transplant Medication – Month 1-3 months -
es) -Interventions for acute rejection/early graft dysfunction
ant surgery, including donor nephrectomy
tion /Intervention for acute rejection
ention for acute graft rejection
ansplant Medication – Month 1-3
pancreatitis / Pancreatitis
poisoning/Other poisonings
heuma c valvular heart disease
sion for Work Up and/or in-patient management
admission for Work Up

component SDP (IF platelet ≤ 20000 )- Add on
component platelet transfusion (SDP)
matosus (SLE)/ Diffuse alveolar hemmorhage associated with SLE
Pleural tuberculosis
nomegaly-requiring admission for Work Up and/or in-patient management
g admission for work-up and/or inpatient care
admission for Work Up and/or in-patient management


c features- requiring admission for work-up
h moderate dehydration/Acute gastroenteritis with severe dehydration/ Recurrent vomiting with dehydration/Chronic diarrohea/Persistent diarrohea
nchitis/Acute epiglottitis
axis / Steven Johnson syndrome
HD/Cyanotic spells with CHD

morrhagic fever/Dengue shock syndrome
vioral disorders for Work Up / in-patient management
valuation of drug resistant epilepsy
exia of unknown origin

equiring admission for work-up
lay/Intellectual disability-requiring admission for Work Up and/or in-patient management
orders - govt reserve

ism-requiring admission for work-up and/or inpatient care

/ Myaesthenic Crisis
uiring admission for work-up or in-patient care
n refractory epilepsy

tasis / Choledochal cysts
racoscopy / bronchoscopy /oesophagoscopy - Diagnos c + / - biopsy
Pleural tuberculosis/ Pulmonary tuberculosis
d guided fine needle biopsy

to managing Pressure sore in advanced chronic diseases who are bed ridden-Surgical- Govt Reserve
sorder - Govt reserve
nerve / spinal nerve - Govt Reserve
urgery (SEMLS) for spasticity management ( more than 4 level) (CP)
edures ( Caudal / facet/ stellate ganglion block)
t of pressure ucler (NPUP grade >=3) in spinal cord injury patients including NPWT (Vac Therapy ) In Spinal Cord Injury (Min LOS 15 Days)
rehabilitation for spinal injury/ traumatic brain injury, CVA, Cerebral palsy with or without orthosis - govt reserved
upper cervical spine injury
on of spasticity in storke/ TBI / CP / SCI With Bot. Toxin - Govt Reserve (Spasticity >=3)
for MSK disorder - Govt reserve
muscular dystrophy/Medical Rehabilitation intellectual disability/Medical Rehabilitation special learning disability/Medical Rehabilitation multiple dis
kage for evaluation / investigation (catheter + ultrasound + culture + RGU/ MCU) for 1 month (medicines - antibiotics) including cystoscopy, Uro dyna
ctomy with / without ureteric re-implantation ± DJ Stenting
(B/L) / herniotomy- Govt reserved

(U/L) / herniotomy - Govt reserved
/Lung Hydatid Cyst (Single Organ) - Change in Name
ent of Oesophagus by Colon/ileal/jejunal/Stomach
copyto be cross checked with pead surgery - U/L OR B/L - Govt Reserve
roscopy - U/L or B/L - Govt Reserve
c/Pyeloureterostomy - Laparoscopic/Pyelopyelostomy - Laparoscopic ± DJ Stenting

ureterostomy - Open/Pyelopyelostomy - Open ± DJ Stenting
igmoiescopic Under GA
oesophagoscopy - Diagnos c + / - biopsy

h or without urethral injury)
(with or without urethral injury)
rschsprung’s Disease

Open / Lap. ± DJ Stenting
dent procedure - Stand Alone
ependent procedure - Stand Alone
wth from Tongue only (inclusive of Histopathology)

nosis of Small/ large Intestine
c Hernia - Govt Reserve
pper urinary tract trauma – conserva ve
ncluding cystoscopy

ancreatico Jejunostomy with/without spleenlectomy
culum/ Duodenal Diverticulum
oscopy, ureteric catheterization, retrograde pyelogram - Stand Alone
of Acute retention of Urine
of Ureteric stone - Package for evaluation / investigation (ultrasound + culture) for 3 weeks (medicines).
/Epididymal Nodule excision Govt reserved
agostomy & gastrostomy / gastric pull-up
Ileostomy / colostomy
ncluding osteotomy if needed + epispadias repair + ureteric reimplant
Redo - Pullthrough
urator - GOVT RESERVED
Spigelian/Incisional hernia
pen/Hiatus Hernia Repair - Lap/Fundoplication - Open(+/- Hiatus Hernia repair) /Anti GERD Surgery
repair - govt reserve

Stage) / Fistula repair- govt reserve
Stage) Hypospadias repair independently - govt reserve
ent of LIVER / Spleen trauma
pathology /Nephrectomy- Radical (Renal tumor)

Vascular injury graft/ Repair
nt of Chest/Abdomen/HNF/Pelvis(Blood transfusion and Investigations included)
ury with fixation of Single LIMB
ury with fixation of 2 or more LIMB
Max upto (Every additional fraction at Rs.500 per Fraction)
Every addi onal frac on at Rs.3500 per Frac on

with Linear Accelerator planning
very addi onal frac on at Rs.11000 per Frac on

ereotaca c radiotherapy)
al/Endobiliary/Endobronchial/CVS
complex planning like CT or MR/Surface Mould / Intracavitary complex planning like CT or MR
ation - calculation of treatment
disease low/intermediate
(Every addi onal frac on at Rs.2500 per Frac on)
nal Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT or IMRT (20 Frac ons)(Inclusive of Simula on & Planning Cost)
nal Beam Radiotherapy IGRT (Image Guided radiotherapy) with 3D CRT or IMRT (6 Frac ons)(Inclusive of Simula on & Planning Cost)
nal Beam Radiotherapy 3D CRT (25 Frac ons)(Inclusive of Simula on & Planning Cost)
nal Beam Radiotherapy 3D CRT (6 Frac ons)(Inclusive of Simula on & Planning Cost)
(Every additional fraction at Rs.2000 per Fraction)
nal Beam Radiotherapy IMRT (Intensity Modulated Radiotherapy) (20 Frac ons)(Inclusive of Simula on & Planning Cost)
nal Beam Radiotherapy IMRT (Intensity Modulated Radiotherapy) (6 Frac ons)(Inclusive of Simula on & Planning Cost)
herapy (Telecobalt / Strock LA)(25 Frac ons) (Inclusive of Simula on & Planning Cost)
Max upto (additional fraction at Rs.500 per Fraction upto a max)
dvance cancer patient/Haemostatic Radiotherapy

rnal fixation of maxilla/Open reduction and internal fixation of mandible/Open reduction and internal fixation of zygoma
rgeries for Functional Improvement (Package including splints, pressure garments, silicone - gel sheet and physiotherapy): Contracture release with - S
p / Flap Reconstructive Surgery / Rotation flap
ocutaneous flap - add on
/ digit (single digit)

/ digit(more than one digit)
n Repair / Tendon transfer
gurement following burns / trauma / congenital deformity (including cost of expander / implant)
(Unilateral) / (Bilateral)

maxillary fixation for fracture of maxilla / mandible / zygoma/ Nasal
Polydactyly/Macrodactyly
wiring (dental /trauma wiring- one jaw)
release + rehabilitation
using wires -under LA/GA
a Burns (TBSA): < 40 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for d
a Burns (TBSA): > 40 %; Includes % TBSA skin grafted, flap cover, follow-up dressings etc. as deemed necessary; Surgical procedures are required for d

lap / VATS / Transthorasic/2F/3F
milionectomy/Cheek advancement
(B/L) / herniotomy- Govt reserved

(U/L) / herniotomy - Govt reserved
/Lung Hydatid Cyst (Single Organ) - Change in Name
ent of Oesophagus by Colon/ileal/jejunal

of Volvulus of Large Bowel
Ano/ anal Fistula / hemorrhoid (Govt reserve)

ow up of Ileostomy/Stoma Management follow up of Colostomy
Lower GI bleed (inclusive of sigmoidoscopy / colonoscopy) - Colonoscopic management only excluding local perineal conditions
chial Cyst/Sinus/Fistula
l (B/L) / Unilateral (U/L)
vaginal fistula (Open)

agotomy/Vagotomy +/- Pyloroplasty
my Or Choledocho Jejunostomy
Paraphimosis or any other clinical condition Govt reserve

nosis of Small/ large Intestine

culum/ Duodenal / Colonic Diverticulum
/Epididymal Nodule excision Govt reserved

denoma/Carcinoma
aparotomy -Stand alone

artial Gastrectomy without Vagotomy/Bleeding Ulcer - Partial Gastrectomy with Vagotomy

arcinoma/Subtotal Gastrectomy for Carcinoma
urator - GOVT RESERVED
Stapler (govt reserve)
Spigelian/Incisional hernia
pen/Hiatus Hernia Repair - Lap/Fundoplication - Open(+/- Hiatus Hernia repair) /Anti GERD Surgery
omy + Ileostomy + J - Pouch
olectomy + Ileostomy
edical management (2days)
ubcutaneous Tissues In Lymphoedema

ury with fixation of Single LIMB (Min 5 Days LOS)
ury with fixation of 2 or more LIMB (Min 5 Days LOS)
of GI perforation / Operative drainage of Appendicular Abscess
Sinus Under RA/GA (Pre op MRI)
Veins-Operative management
lap / VATS / Transthorasic/2F/3F
rk surgery / Thyroplasty
milionectomy/Cheek advancement
rior - Open/Pelvic Exenteration Anterior - Lap/Pelvic Exenteration Total - Open/Pelvic Exenteration Total - Lap.
, after prior cancer surgery- Open/Laparoscopic
(WLE, Glansectomy, Laser)
establishing Tubal Patency

ur - Excision - govt reserve
continent diversion - Open + BPLND

h ureterosigmoidostomy + BPLND - Open/Lap.
continent diversion + BPLND - Open
out Ileal Conduit + BPLND
Ileal Conduit + BPLND
h neobladder + BPLND
ectomy + bilateral salpingoophorectomy + BPLND - Lap./Class I radical hysterectomy + bilateral salpingoophorectomy + BPLND - Open
salpingoophorectomy + omentectomy + peritonectomy and organ resections ( Minimum 2 organs )
or hormone ablation
Inguinal and Pelvic lymph node disection

ocutaneous flap - add on
de Dissection (BPLND) - add on (excluded with hysterectomy)

PAP + Colposcopy+VIA)
th skull bone excision

erated Head and Neck Cancer cases - LA / GA
ung-Open /Thoracoscopic
esection with reconstruction

cyst / tumour of jaws under LA
cyst / tumour of jaws under GA
D/ In growing toe nail - Day care
end Anastamosis) (Throat)
ec on of the Bladder Tumor)
n and Reconstruction
20000) / Redical (Rs 40000) reconstruction procedures
(lumpectomy + axillary surgery)
n/Abdominoperineal resection .
r ovarian cancer with multi organ resection ( Minimum 2 organ's)
astinoscopy - govt reserve

omy/Clival tumour excision
yrinthine approach/Transcochlear approach/Temporal Bone resection

denoma/Carcinoma

l cavity / paranasal sinus
arcinoma/Subtotal Gastrectomy for Carcinoma

on/Orbital decompression/Craniofacial resection/Maxillary swing
dica on including ectopic pregnancy)

ce preserving)/Total Laryngectomy
ost-trauma c facial nerve decompression/CSF Otorrhoea repair
en/MIS - Govt reserve
ctomy- Open/Video - assisted

n with lung resection

kage for evaluation / investigation (catheter + ultrasound + culture + RGU/ MCU) for 1 month (medicines - antibiotics) including cystoscopy, Uro dyna
ctomy with / without ureteric re-implantation ± DJ Stenting
copyto be cross checked with pead surgery - U/L OR B/L

roscopy - U/L or B/L
hrolithotomy) ± DJ Stenting
, after prior cancer surgery- Open/Laparoscopic
(WLE, Glansectomy, Laser)

heter placement as substitute for AV fistula in long term dialysis
oscopy (Per sitting) with / without cold-cup biopsy
c/Pyeloureterostomy - Laparoscopic/Pyelopyelostomy - Laparoscopic ± DJ Stenting

ureterostomy - Open/Pyelopyelostomy - Open ± DJ Stenting
h ureterosigmoidostomy + BPLND - Open/Lap.
continent diversion - Open + BPLND
continent diversion + BPLND - Open
Ileal Conduit + BPLND
h neobladder + BPLND
out Ileal Conduit + BPLND
or hormone ablation
h or without urethral injury)

(with or without urethral injury)
ndoscopic - Stand Alone
icture -Open / Lap. ± DJ Stenting
uided prostate biopsy (minimum 12 core)
ec on of the Bladder Tumor)
pable/ Nonpalpable - Govt Reserve
ng cystoscopy, ureteric catheterization, retrograde pyelogram ± URS ± DJ Stenting

paroscopic ± DJ Stenting
uding cystoscopy, ureteric catheterization, retrograde pyelogram ± DJ Stenting
etroperitoneal fibrosis(with or without omental wrapping)/Ureterolysis for retroperitoneal fibrosis (with or without omental wrapping- Lap. ± DJ Sten
ter/ RIRS/URSL - stand alone
Open / Lap. ± DJ Stenting

epair - Open/Uretero - vaginal fistula repair - Laparoscopic/Uretero - Uterine fistula repair - Open/Uretero - Uterine fistula repair - Laparoscopic ± DJ
dent procedure - Stand Alone
ependent procedure - Stand Alone
n for Neuropathic bladder
c Hernia - Govt Reserve
pper urinary tract trauma – conservative
ncluding cystoscopy
oscopy, ureteric catheterization, retrograde pyelogram - Stand Alone

of Acute retention of Urine
of Ureteric stone - Package for evaluation / investigation (ultrasound + culture) for 3 weeks (medicines).
ugbee/Antegrade with laser / bugbee With Endopyelotomy Stent
plex surgery three stage surgery - Govt Reserve
ve Lithotripsy (ESWL) stone, with or without stent (one side) - stand alone
ncluding osteotomy if needed + Epispadias repair + ureteric reimplant

cluding cystoscopy as an independent procedure /Laser internal uretherotomy - Stand ALONE

ycin - Induction cycles (PC) for max. 06 Doses
For Urinary divertion - Govt Reserve


t and physiotherapy): Excluding Neck contracture; Contracture release with - Split thickness Skin Graft (STSG) / Full Thickness Skin Graft (FTSG) / Flap c
ed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone.
med necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone.
as deemed necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone.
necessary; Surgical procedures are required for deep burns that are not amenable to heal with dressings alone.
aneurysm repair/Subclavian aneurysm repair/Axillary aneurysm repair/Brachial artery aneurysm repair/Femoral artery aneurysm repair/Popliteal arte
y shunt/Vascular Ring division.

ASD Closure + Pulmonary procedure/ASD Closure + Infundibular procedure/VSD closure/Infundibular PS repair/Valvular PS / PR repair/Partial AV cana
erruption Repair without VSD closure/Arch interruption Repair with VSD closure/DORV Repair/Supravalvular AS repair/Konno procedure/Norwood pr
Repair Surgery for Injuries/ FB Removal
sion/Branchial fistula excision
nopalatine artery ligation - Endoscopic
/Comprehensive Pharyngealdiver culum excision

g local perineal conditions
hydration/Chronic diarrohea/Persistent diarrohea/Dysentery
se vein- Govt Reserve
al items] - Govt Reserve
SFA stent/two bare metal stents/ covered stent or Embolization: with microcatheter/Drug eluting beads-TACE/Plug assisted or tumor ablation or Mec
activity Disorder (ADHD/Specific DevelopMental Disorderss
rapy, Family Counselling / Psychotherapy / Training Such As Parent Management Training, Behavioral / Cognitive-Behavioral Interventions, Developm
ram (ECG), CT / MRI Brain, Electroencephalogram, Thyroid Function Test, VDRL, HIV Test, Vitamin B12 levels, Folate levels, Lipid Profile, Homocysteine
Other Internalizing and Externalizing Disorders of Childhood and Adolescence
sorder, Developmental Assessments, Projective Tests and Other Tests Of Psychopathology), Other Psychosocial Assessments (Family, Schooling)
ing, head injury, Acute excaberation of COPD /Acute excaberation of Interstitial Lung Disease/ Bronchiectasis / Acute bronchitis/ Acute asthmatic atta
Refractory Epilepsy / Epileptic encephalopathy

y/Acute meningo encephalitis pyogenic/Aseptic meningitis tubercular/ Hypertensive encehalopathy viral/Brain abscess/Intracranial abscess/ Aseptic m
hydration/Chronic diarrohea /Dysentery
uation/ Acute Ischemic Stoke/Acute ischemic stroke- intravenous thrombolysis

tis/Meningitis/ Fungal Meningitis/ACUTE INFECTIOUS MENINGITIS AND MENINGOENCEPHALITIS/Pyogenic Meningitis/Tuberculous meningitis (Hydroc
OPADAM-Duration + Cycle
Chlorambucil,Prednisolone: 841 including blood products and an bio cs

ne, Adriamycin,DexamethasoneUKALL (United kingdom acute lymphoblas c leukaemia)GMALL (German mul center acute lymphoblas c leukemia) -
s ne, Adriamycin,Dexamethasone UKALL (United kingdom acute lymphoblas c leukaemia)GMALL (German mul center acute lymphoblas c leukemia
ood and platelets ; FFP transfusion
c acid 45 mg / M2 day 1-Day 14 and Day 29-43 every 56 days for 4 cycles
Prednisolone 100 mg Day 1-5Total 6 cycles, repeat 21 days
Prednisolone 100 mg Day 1-5Total 6 cycles, repeat 21 days
GMALL (German mul center acute lymphoblas c leukemia)Berlin- Frankfurt -MunsterHyper CVAD (cyclophosphamide, Vincris ne, Adriamycin,
an 180mg/m2 every 14 days
pla n AUC 5-6 D1 only every 3 weeks
Vincris ne 1.5mg/m2 (day 1 and 8)Adriamyicn: 75mg/m2 (day 1)Cyclophosphamide 1200mg/m2 (day 1)Given 2-3 weekly
Cyclophosphamide 250mg/m2 (days 1-5)Given every 3 weeksIrinotecan 10-50 mg/sqM days 1-5 and days 8-12 Temozolamide 100mg/m2 days
pla n 25mg/m2 D2-D5 every 21 days

Cispla n 20 mg/m2 D1-D5 every 21 days for 3 months maximun 6 cycles
ethotrexate 300 mg /m2 D1Leucovorin 15 mg PO every 12 hrs for 4 doses Cispla n 75mg/m2 D8 every 2 weeks
Methotrexate 300 mg /m2 D1Leucovorin 15 mg PO every 12 hrs for 4 dosesCyclophosphamide 600mg/m2 D8
g PO repeat every 14 days
Carbopla n AUC-5 on day 1Cycle to be repeated every 21days maximum cycles-6
for Maximum 6 cycles

Every 28days. Total 6 - 8 cycles
a n 550mg/m2 every 3 weeks (all cycles) Maximum 6 cycles
Vincris ne, Adriamycin,DexamethasoneUKALL (United kingdom acute lymphoblas c leukaemia)GMALL (German mul center acute lymphoblas c leuke
Cispla n 100mg/m2 (1 day per cycle) Etoposide Day 3-4Cycles given every 3 weekly Maximum 8 cyces
zomib 1.3 mg/m2 Day 1, 8, 15, 22Every 28 days

Bortezomib 1.3 mg/m2 Day1, 8, 15, 22Every 28 days Maximum 12 cycles
zomib 1.3 mg/m2 Day 1, 8, 15, 22Every 28 days Maximum 8 cycles
Dexamethasone 40mg Day 1, 8, 15, 22Every 28 days Maximum 12 cycles
Repeat every 21days. Total 6 cycles
D1-D3 every 21 days
mg 3 monthly Maximum for 2 years
and platelets, FFP transfusion

and platelets, FFP transfusion (Dura on 8 weeks maximum)
Every 21days. Total 6 cycles
Doxorubicin 10mg/m2 Day1 - 4Cyclophosphamide 750mg/m2 on day 5 Prednisolone 100 mg day 1-5Every 21 days
00mg/m2 on day 1 - 3Cycle every 21days for 6 cycles
cle every 21days for 6 cycles
Dac nomycin 1.5mg / m2 (day 1)3 weekly cycle (maximum 15 cycles)

Each cycle every 3 weeks (maximum 15 cycles)
Every 21 days Maximum 6 cycles
Weekly chemotherapy - varying hybrid regimen (maximum 3 days admission each cycle) Maximum dura on 34 weeks
Doxorubicin 60mg/m2 for 24 weeks
ycillin and clavulanateTeicoplaninVancomycin

o Birth asphyxia (need for posi ve pressure ven la on at birth; no HIE) o Moderate jaundice requiring phototherapy
• Mild Respiratory Distress/ tachypnea • Mild encephalopathy • Severe jaundice requiring intensive phototherapy • Unwell baby requiring monitorin
N002,MN003,MN004, MN005) who have not fully recovered and continue to require NICU/SNCU care, e.g. for respiratory support, gavage feeding, the
uency Ven la on or inhaled Nitric Oxide (iNO) • Mul system failure requiring mul ple organ support including mechanical ven la on and mul ple ino
d for more workup) karyotype, FISH, Urine GCMS & Blood TMS or any other required Genetic, metabolic, NGS, biochemical screening investigatons
asive ven la on longer than 24 hours • Moderate to Severe Hypoxic Ischemic encephalopathy • Cardiac rhythm disorders needing interven on (the c
on for less than 24 hours or non-invasive respiratory support (CPAP, HFFNC) • Sepsis / pneumonia without complica ons
ng, universal hearing screening and pre-discharge counselling,visible defect screening ,pulse oxy meter screening CCHB
lo - atrial Shunt (Low/Medium/High Pressure )/Theco - peritoneal Shunt (Low/Medium/High Pressure )

gle Angle/ Brainstem
uation/ Acute Ischemic Stoke/Acute ischemic stroke- intravenous thrombolysis
ning disability/Medical Rehabilitation multiple disability- govt reserve

goophorectomy + BPLND - Open
ula repair ± DJ Stenting

diabetes, eclampsia, pre-eclampsia, severe growth retardation, congenital malformation etc that qualify for high risk delivery - Govt Reserve
th anterior and posterior colpoperineorrhaphy- Govt Reserve

wherever surgical or laser procedures required for bleb augmenta on and anterior chamber maintenance)
hydration/Chronic diarrohea/Persistent diarrohea/Dysentery

pinal Cord Injury (Min LOS 15 Days)

ning disability/Medical Rehabilitation multiple disability (Min 7 Days Stay)- govt reserve
ines - antibiotics) including cystoscopy, Uro dynamics

e of Simula on & Planning Cost)
of Simula on & Planning Cost)
t and physiotherapy): Contracture release with - Split thickness Skin Graft (STSG) / Full Thickness Skin Graft (FTSG) / Flap cover is done for each joint w
g local perineal conditions
goophorectomy + BPLND - Open

ines - antibiotics) including cystoscopy, Uro dynamics

th or without omental wrapping- Lap. ± DJ Sten ng
etero - Uterine fistula repair - Laparoscopic ± DJ Stenting

t (STSG) / Full Thickness Skin Graft (FTSG) / Flap cover is done for each joint with post - operative regular dressings for STSG / FTSG / Flap cover.
with dressings alone.

air/Femoral artery aneurysm repair/Popliteal artery aneurysm repair/Femoral - popliteal Bypass/Axillo - Brachial Bypass/Carotio - carotid Bypass/Caro
PS repair/Valvular PS / PR repair/Partial AV canal repair/Intermediate AV canal repair/Atrial septectomy + Glenn/Atrial septectomy + PA Band /Sinus
valvular AS repair/Konno procedure/Norwood procedure/VSD closure + RV - PA conduit/VSD + Aortic procedure/VSD + Mitral procedure/VSD + Tricus
ads-TACE/Plug assisted or tumor ablation or Mechanical thrombectomy device or intraarterial retinoblastome traetment- Govt Reserve
l / Cognitive-Behavioral Interventions, Developmental Interventions Such As Early Intervention, Speech / Language Therapy, Occupational Therapy, Ph
2 levels, Folate levels, Lipid Profile, Homocysteine levels), serum Lithium level - all test should be done
ychosocial Assessments (Family, Schooling)
hiectasis / Acute bronchitis/ Acute asthmatic attack / Status asthmaticus etc.)

iral/Brain abscess/Intracranial abscess/ Aseptic meningitis
genic Meningitis/Tuberculous meningitis (Hydrocephalus – VP SHUNT/ EVD/Omaya)
man mul center acute lymphoblas c leukemia) - Con nua on pahse
erman mul center acute lymphoblas c leukemia) Induc on phase include an bio cs, an fungals, blood and platelets transfusion
VAD (cyclophosphamide, Vincris ne, Adriamycin,DexamethasoneMaximum 6 cycles every 3/4 weekly
Given 2-3 weekly
1-5 and days 8-12 Temozolamide 100mg/m2 days 1-5 of each cycle every 3 weeks
phamide 600mg/m2 D8Vincrs ne 1 mg/m2 D8 every 2 weeks

L (German mul center acute lymphoblas c leukemia) - Induc on phase
Every 21 daysDose adjustment each cycle depending on nadir countsTotal- 6 cycles
ycle) Maximum dura on 34 weeks

quiring phototherapy o Large for dates (>97 percen le) or Small for gesta onal age (less than 3rd cen le) o Rule-out sepsis
• Unwell baby requiring monitoring • Some dehydra on • Hypoglycaemia • Cholestasis requiring inves ga ons and in-hospital manage
, e.g. for respiratory support, gavage feeding, thermal support, etc.,
including mechanical ven la on and mul ple inotropes • Requiring parenteral nutri on • NEC requiring opera ve interven on
olic, NGS, biochemical screening investigatons
diac rhythm disorders needing interven on (the cost of cardiac surgery or implant will be covered under cardiac surgery packages)
thout complica ons • Hyperbilirubinemia requiring exchange transfusion • Seizures requring an -convulsants • Major congenital malforma ons (pre-

alify for high risk delivery - Govt Reserve

Graft (FTSG) / Flap cover is done for each joint with post - operative regular dressings for STSG / FTSG / Flap cover.
ular dressings for STSG / FTSG / Flap cover.
o - Brachial Bypass/Carotio - carotid Bypass/Carotido - subclavian artery bypass/Carotido - axillary bypass/Axillo - femoral bypass - U/L/Axillo - femoral
omy + Glenn/Atrial septectomy + PA Band /Sinus of Valsalva aneurysm repair with aortic valve procedure/Sinus of Valsalva aneurysm repair without a
procedure/VSD + Mitral procedure/VSD + Tricuspid procedure/VSD + Pulmonary artery procedure/VSD + Infundibular procedure/VSD + Coarctation r
blastome traetment- Govt Reserve
ch / Language Therapy, Occupational Therapy, Physiotherapy, Remediation For Specific Learning Disability and Other Rehabilitative / Psychosocial Inte
ood and platelets transfusion
le) o Rule-out sepsiso Inves ga ons warranted because of antenatal scan findings. Includes ac vi es listed under Basic Neonatal care package and Ka
s requiring inves ga ons and in-hospital management The package includes food and stay for the mother in the hospital for breas eeding, Kangaroo M
ing opera ve interven onThe above list is illustra ve but not limited to these condi ons. The package includes mandatory stay and food of the mothe
der cardiac surgery packages) • Sepsis with complica ons such as meningi s or bone and joint infec on, DIC or shock • Renal failure requiring dialysis
• Major congenital malforma ons (pre-surgical stabiliza on) • Cri cal congenital heart disease (excluding surgical costs)
pass/Axillo - femoral bypass - U/L/Axillo - femoral bypass - B/L/Aorto - carotid bypass/Aorto - subclavian bypass/Patch Graft Angioplasty/Small Arterial
dure/Sinus of Valsalva aneurysm repair without aortic valve procedure/Sub-aortic membrane resection
SD + Infundibular procedure/VSD + Coarctation repair/TAPVC Repair/Truncus arteriosus repair/Tetralogy of Fallot Repair/Complete AV canal repair
bility and Other Rehabilitative / Psychosocial Interventions)
s listed under Basic Neonatal care package and Kangaroo Mother Care support B .Mandatory screening to be done as prescribed as below
ther in the hospital for breas eeding, Kangaroo Mother Care (KMC) and Family centered care
e includes mandatory stay and food of the mother in the hospital for breas eeding, Kangaroo Mother Care (KMC) and Family centered care
• Renal failure requiring dialysis • Inborn errors of metabolism•NEC not requiring opera ve interven on
ase (excluding surgical costs) • Conges ve heart failure or shock •Meconium aspira on syndrome needing only brief ven la on of less than 24 hours
an bypass/Patch Graft Angioplasty/Small Arterial Aneurysms – Repair/Medium size arterial aneurysms with synthetic graft/Surgery for Arterial Aneurs
logy of Fallot Repair/Complete AV canal repair

g to be done as prescribed as below • Head to toe examina on ( Visible birth defect screening) • Red reflex of both eyes• Ortolani and barlow
Care (KMC) and Family centered care
pera ve interven on The above list is illustra ve but not limited to these condi ons. The package includes mandatory stay and food of the mother in
eding only brief ven la on of less than 24 hours or requiring CPAP/HFNC The above list is illustra ve but not limited to these condi ons.
s with synthetic graft/Surgery for Arterial Aneursysm –Vertebral/Surgery for Arterial Aneurysm Renal Artery/Operations for Acquired Arteriovenous F
• Ortolani and barlow• Pulse oximeter screening for CCHD • Serum TSH (cord value or day 3) with interpreta on of the report
ludes mandatory stay and food of the mother in the hospital for breas eeding, Kangaroo Mother Care (KMC) and Family centered care
but not limited to these condi ons. The package includes mandatory stay and food of the mother in the hospital for breas eeding, Kangaroo Mother C
Artery/Operations for Acquired Arteriovenous Fistual/Congenital Arterio Venous Fistula
ue or day 3) with interpreta on of the report• OAE examina on for hearing screening Universal hearing screening
e (KMC) and Family centered care
he hospital for breas eeding, Kangaroo Mother Care (KMC) and Family centered care

T3 - Pack Code Details

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Speciality Name

nt - (Chest/Head/Face/Abdomen) stand alone

graphy (OCT) - GOVT Reserve add on

nal Septal Myocardial Ablation

Subclavian , Mesenteric , Femoral, iliac - Popliteal ETC

tomy/Balloon Aortic Valvotomy

Single Chamber - Single chamber VVIR

men / Triple Lumen ) with procedure - add on

d) MRI Compatible - GOVT Reserve

er 6 month of discharge date

(IVUS) - GOVT Reserve add on

(PDA) Closure via thoracotomy

repair (with Interpostion vain graft)

Single Chamber - Single chamber VVIR

Obstructive Cardiomyopathy (HOCM)

us treatment (for one limb) - Govt Reserve

rafting (CABG), Off Pump

atheter guided Thrombolysis and anticoagulation ( Including r-TPA )

er 6 month of discharge date

e / Tricuspid valve - replacement /repair- Add On

(immediate re operation) - Add ON

rome requiring IABP insertion Pre/Intra/post - operatively - ADD On PKG

ws management by excision and reconstruction under GA inlcuidng Implant

ed tooth with wiring (1-3 teeth)3-6 :6000

r tooth - govt reserve

cyst / tumour of jaws under GA

hood caries under GA

wth from Tongue only (inclusive of Histopathology) - Govt Reserve

Fistula- Govt Reserve

Tongue with neck node dissection Stand alone

l cavity / paranasal sinus/ Laryngopharynx with reconstruction Under GA only

g of plates / wire - under LA / GA. Cost of implant Titanium:- TBF at pre-auth

astic Tumour Resection and reconstruction (Cancer surgery)

unstable cardiopulmonary status with resuscitation

caemia/ Hyponatremia/ Hypernatremia/ Hyperkalaemia/ Hypokalaemia

nage/Intraoral calculus removal

esion Excision/ Sclerotheraphy- LA or GA

oesophagoscopy - Diagnos c + / - biopsy

otomy/stapedotomy - Govt. reserve

h central neck Dissection

llectomy (unilateral/bilateral)/Tonsillectomy - B/L adenotonsillectomy - Govt. reserve

tratified (GA/LA) and price adjusted accordingly ) - Govt. reserve

ections/Wide bore aspiration/ Turbinate reduction

age/Post trauma neck exploration

paranasal sinus / laryngopharynx with free ﬂap reconstruc on

one - Regular PKG / Day care

on/Orbital decompression/Craniofacial resection/Maxillary swing

ost-trauma c facial nerve decompression/CSF Otorrhoea repair

excision/Comprehensive Benign neck tumourexcision/Selec ve Pharyngeal diver culumexcision/Comprehensive Pharyngeal

d ligation (EVL) including band - ADD ON

uodenal / colonic stenting/balloon dilatation

monary Artery Stenosis /aortic aneurysm repair - GOVT Reserved

elling catheter for refractory ascites / pleural effusion

ressure measurement (HVPG) - Govt Reserve

eous Image guided / Fluoroscopic Guided

disorders due to psychoactive substance use

e nacrotizing severe pancreatitis / Chronic Pancreatitis

Pleural tuberculosis/ Pulmonary tuberculosis

Acute worsening in neuro metabolic and neurodegenrative conditions