pre- post operativ no of specialty procedure governm ... · supraten torial-basal ct clinical...

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Package No Sub Specialty Procedur e Name Pre- Operativ e Investiga tion Post Operativ e Investiga tion No of Follow up Package Rates Remarks Specialty Code PMJAY Procedure Code PMJAY Governm ent Reserve 6.1 Brain Cranioto my and Evacuatio n of Haemato ma –Subdura l CT Clinical Photogra ph 3 57040 S8 S812001 No 6.2 Brain Cranioto my and Evacuatio n of Haemato ma – Extradura l CT Clinical Photogra ph 3 51520 S8 S812002 No 6.3 Brain Excision of Brain Tumor Supraten torial- Parasagit al CT Clinical Photogra ph 3 51750 S8 S812003 No 6.4 Brain Excision of Brain Tumor Supraten torial- Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical Photogra ph 3 70000 S8 S812005 No 6.6 Brain Excision of Brain Tumor - C P Angle CT Clinical Photogra ph 3 50000 S8 S812006 No 6.7 Brain Excision of Brain Tumor Supraten torial & others CT Clinical Photogra ph 3 34500 S8 S800056 No Cluster - 6 NEUROSURGERY/NEUROLOGY/INTERVENTIONAL NEURORADIOLOGY

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Page 1: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

Package

No

Sub

Specialty

Procedur

e Name

Pre-

Operativ

e

Investiga

tion

Post

Operativ

e

Investiga

tion

No of

Follow

up

Package

Rates Remarks

Specialty

Code

PMJAY

Procedure

Code

PMJAY

Governm

ent

Reserve

6.1 Brain

Cranioto

my and

Evacuatio

n of

Haemato

ma

–Subdura

l

CT

Clinical

Photogra

ph

3 57040 S8 S812001 No

6.2 Brain

Cranioto

my and

Evacuatio

n of

Haemato

ma –

Extradura

l

CT

Clinical

Photogra

ph

3 51520 S8 S812002 No

6.3 Brain

Excision

of Brain

Tumor

Supraten

torial-

Parasagit

al

CT

Clinical

Photogra

ph

3 51750 S8 S812003 No

6.4 Brain

Excision

of Brain

Tumor

Supraten

torial-

Basal

CT

Clinical

Photogra

ph

3 51750 S8 S812004 No

6.5 Brain

Excision

of Brain

Tumor -

Brainste

m

CT

Clinical

Photogra

ph

3 70000 S8 S812005 No

6.6 Brain

Excision

of Brain

Tumor -

C P Angle

CT

Clinical

Photogra

ph

3 50000 S8 S812006 No

6.7 Brain

Excision

of Brain

Tumor

Supraten

torial &

others

CT

Clinical

Photogra

ph

3 34500 S8 S800056 No

Cluster - 6 NEUROSURGERY/NEUROLOGY/INTERVENTIONAL NEURORADIOLOGY

Page 2: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.8 Brain

Excision

of Brain

Tumors –

Infratent

orial

MRI

Clinical

Photogra

ph

3 110000 S8 S812007 No

6.9

Brain /

Spinal

(Endovas

cular)

Intervent

ion with

coiling /

embolisa

tion

procedur

es

DSA DSA 3 85000 S8 S812008 No

6.10 Brain

Ventricul

oatrial

/Ventricu

loperiton

eal/

Ventricul

o-other

Shunt

CT

Clinical

Photogra

ph

3 40000 S8 S812009 No

6.11 Brain

Twist

Drill

Craniosto

my

CT

Clinical

Photogra

ph

3 18630 S8 S800051 No

6.12 BrainSubdural

TappingCT

Clinical

Photogra

ph

3 17020 S8 S812010 No

6.13 Brain

Abscess

Tapping

Single

CT

Clinical

Photogra

ph

3 17250 S8 S800057 No

6.14 Brain

Abscess

Tapping

multiple

CT

Clinical

Photogra

ph

3 23920 S8 S800058 No

6.15 Brain

Meningo

Encephal

ocele

MRI

Clinical

Photogra

ph

3 34270 S8 S812011 No

6.17 Brain

C.S.F.

Rhinorrh

oea

(Transcra

nial /

Transnas

al)

CT

Clinical

Photogra

ph

3 75000 S8 S812012 No

6.18 BrainCraniopla

sty

CT ,

Clinical

Photogra

ph

Clinical

Photogra

ph

3 27830 S8 S812013 No

6.20 Brain

Excision

of Brain

Abcess

CT

Clinical

Photogra

ph

3 28750 S8 S800059 No

Page 3: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.21 Brain

Aneurys

m

Clipping

MRI

Angio /

DSA

Clinical

Photogra

ph , X-

RAY

3 34500 S8 S800060 No

6.22

Brain /

Spinal

(Endovas

cular)

Carotid

angioplas

ty with

stent

ANGIOGR

AM

DOPPLER

, X-RAY3 60000 S8 S812014 No

6.23

Brain /

Spinal

(Endovas

cular)

Carotid

angioplas

ty

without

stent

ANGIOGR

AM

DOPPLER

, X-RAY3 40000 S8 S812015 No

6.24 Brain

External

Ventricul

ar

Drainage

(EVD)

CT

Clinical

Photogra

ph

3 28750 S8 S812016 No

6.25 Spinal

Spinal

Cord

Tumours

(extrame

dullary)

MRI

Biopsy ,

Clinical

Photogra

ph

3 34270 S8 S812017 No

6.26 Spinal

Excision

of

Cervical

Inter-

Vertebral

Discs

MRI

Clinical

Photogra

ph

3 34270 S8 S812018 No

6.27 Spinal

Anterior

Cervical

Spine

Surgery

with

fusion

MRI

Clinical

Photogra

ph

3 34270 S8 S812019 No

6.28 Spinal

Anterio

Lateral

Decompr

ession

MRI

Clinical

Photogra

ph

3 17250 S8 S812020 No

6.29 Spinal

Laminect

omy-

Cervical/

dorsal/lu

mbar

MRI

Clinical

Photogra

ph

3 34270 S8 S812021 No

6.30 Spinal

Discecto

my-

Dorsal

MRI

Clinical

Photogra

ph

3 28520 S8 S812022 No

6.31 Spinal

Discecto

my-

Lumbar

MRI

Clinical

Photogra

ph

3 28520 S8 S812023 No

Page 4: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.32 Spinal

Discecto

my + cost

of

implant

MRI

Clinical

Photogra

ph

3 34270 S8 S812024 No

6.33 Spinal

Spinal

Intra

Medullar

y

Tumours

MRI

Biopsy ,

Clinical

Photogra

ph , X-

RAY

3 68540 S8 S812025 No

6.34 Spinal

Spina

Bifida

Surgery

Major

MRI

Clinical

Photogra

ph , X-

RAY

3 28750 S8 S812026 No

6.35 Spinal

Spina

Bifida

Surgery

Minor

MRI

Clinical

Photogra

ph , X-

RAY

3 20700 S8 S812027 No

6.36Brain /

Spinal

Stereotax

ic

Procedur

es

(Framed

/

Frameles

s)

CT/MRI

Clinical

Photogra

ph

3 50000 S8 S800065 No

6.37

Brain /

Spinal

(Endovas

cular)

Vertebral

artery

Stenting

ANGIOGR

AMDOPPLER 3 60000 S8 S812028 No

6.38AAD

Surgeries

Transoral

surgery

and CV

Junction

(With

Posterior

Fixation)

MRI , X-

Ray

Cerical

Spine

Clinical

Photogra

ph

3 125000 S8 S812029 No

6.39AAD

Surgeries

Trans

oral

Surgery

CT

Biopsy ,

Clinical

Photogra

ph

3 39790 S8 S800071 No

6.40 Brain

Trans

Sphenoid

al

Surgery

CT, MRI

Biopsy ,

Clinical

Photogra

ph

3 34040 S8 S812030 No

6.41 Brain

RF

Lesions

for

Trigminal

Neuralgia

MRI

Clinical

Photogra

ph

3 28750 S8 S800050 No

Page 5: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.44Neuro

muscular

Muscle

Biopsy

with

report

EMG,

NCVBiopsy 3 17250 S8 S800074 No

6.45 Brain MVD MRI

Clinical

Photogra

ph

3 45000 S8 S812031 No

6.46Neuro

Surgery

Nerve

Biopsy

with

report

EMG,

NCVBiopsy 3 8625 S8 S812032 No

6.47Neuro

Surgery

Nerve

Decompr

ession

MRI

Clinical

Photogra

ph

3 17250 S8 S800075 No

6.48Neuro

Surgery

Peripher

al Nerve

Surgery

Major

EMG,

NCV

Clinical

Photogra

ph

3 34500 S8 S800076 No

6.49Neuro

Surgery

Peripher

al Nerve

Surgery

Minor

EMG,

NCV

Clinical

Photogra

ph

3 17250 S8 S800077 No

6.50C.V.JUNC

TION

POSTERI

OR

FIXATION

ALONE

MRI

SPINE

+CT

SPINE-

FLEXION/

EXTENTI

ON/

NEUTRAL

X RAY

SPINE5 65000 S8 S812033 No

6.51 BRAIN

SURGERY

FOR

ORBITAL

TUMORS

/PROPTO

SIS

MRI

CONTRAS

T/ CECT

CECT+BI

OPSY

REPORT

5 90000 S8 S812034 No

6.52BRAIN+S

PINE

INFRATE

NTORIAL

TUMOR

WITH

SPINAL

EXTENSI

ON

MRI

CONTRAS

T/ CECT

CECT+BI

OPSY

REPORT

5 100000 S8 S812035 No

Page 6: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.53 BRAIN

VASCULA

R

MALFOR

MATION

SURGERY

/Procedu

re

(SUPRAT

ENTORIA

L/INFRAT

ENTORIA

L)

CTA/MRA

/DSA

CTA+BIO

PSY5 120000 S8 S812036 No

6.54 BRAIN

EPILEPSY

SURGERY-

GRID

INSERTIO

N +

LOCALISA

TION

+SURGER

Y/Proced

ure

MRI

BRAIN

(1.5/3

TESLA)

+VEEG

+CT SCAN

CT BRAIN 5 110000 S8 S812037 No

6.55 BRAIN

EPILEPSY

SURGERY-

LESIONEC

TOMY

MRI

BRAIN

(1.5/3

TESLA)

+EEG

CT BRAIN 5 60000 S8 S812038 No

6.56 BRAIN

EPILEPSY

SURGERY-

ATL/AH

FOR MTS

MRI

BRAIN

(1.5/3

TESLA)

+EEG

CT BRAIN 5 70000 S8 S812039 No

6.57 SKULL

BONY

TUMOR

OF SKULL

CECT

CT BRAIN

+BIOPSY

REPORT

5 50000 S8 S812040 No

6.58 BRAIN

ENDOSPI

C BRAIN

SURGERI

ES

(DIAGNO

STIC)

MRI

BRAIN/CT

BRAIN

CT BRAIN 5 30000 S8 S812041 No

Page 7: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.59 BRAIN

ENDOSPI

C BRAIN

SURGERI

ES

(THIRD

VENTRIC

ULOSTO

MY)

MRI

BRAIN/CT

BRAIN

CT BRAIN 5 45000 S8 S812042 No

6.60 BRAIN

ENDOSPI

C BRAIN

SURGERY

(AQUEDU

CTOPLAS

TY)

WITHOU

T

IMPLANT

MRI

BRAIN/

CT BRAIN

CT BRAIN 5 50000 S8 S812043 No

6.61 BRAIN

ENDOSPI

C BRAIN

SURGERY

(AQUEDU

CTOPLAS

TY) WITH

IMPLANT

MRI

BRAIN/

CT BRAIN

CT BRAIN 5 60000 S8 S812044 No

6.62 BRAIN

ENDOSPI

C BRAIN

SURGERI

ES (

TUMOUR

/CYST

EXISION)

MRI

BRAIN/CT

BRAIN

CT BRAIN

+BIOPSY5 60000 S8 S812045 No

6.63 NERVE

PAIN

MANAGE

MENT

SURGERY

(SYMPET

HECTOM

Y/RHIZOT

OMY)

RELATED

INVESTIG

ATIONS

RELATED

INVESTIG

ATIONS

3 40000 S8 S812046 No

Page 8: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.64C.V.JUNC

TION

C V

JUNCTIO

N

DECOMP

RESSION

(POSTERI

OR)

(ARNOLD-

CHIARY

MALFOR

MATION

AND

OTHERS)

MRI CV

JUNCTIO

N + CT CV

JUNCTIO

N-

FLEXION/

EXTENTI

ON/NEUT

RAL

X RAY

SPINE3 70000 S8 S812047 No

6.65 SKULL

BONE

FLAP

REMOVA

L

CT BRAIN CT BRAIN 3 35000 S8 S812048 No

6.66 SPINE

CORPECT

OMY

AND

FIXATION

CERVICAL

/DORSAL

/LUMBER

(SINGLE

LEVEL)

MRI

SPINE

X RAY

SPINE5 65000 S8 S812049 No

6.67 SPINE

CORPECT

OMY

AND

FIXATION

CERVICAL

/DORSAL

/LUMBER

(MULTIPL

E LEVEL)

MRI

SPINE

X RAY

SPINE5 80000 S8 S812050 No

6.68 SPINE

CERVICAL

SPINE

STABLISA

TION

ANTERIO

R

MRI

SPINE

X RAY

SPINE5 60000 S8 S812051 No

Page 9: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.69 A SPINE

CERVICAL

SPINE

STABLISA

TION-

POSTERI

OR Level

one

MRI

SPINE

X RAY

SPINE5 50000 S8 S812052 A No

6.69 B SPINE

CERVICAL

SPINE

STABLISA

TION-

POSTERI

OR Level

two

MRI

SPINE

X RAY

SPINE5 60000 S8 S812052 B No

6.70 A SPINE

CERVICAL

SPINE

STABLISA

TION-

GLOBAL

(Anterior

&

Posterior

combine)

MRI

SPINE

X RAY

SPINE5 90000 S8 S812053 A No

6.70 B SPINE

CERVICAL

SPINE

STABLISA

TION-

POSTERI

OR Level

three

MRI

SPINE

X RAY

SPINE5 70000 S8 S812053 B No

6.70 C SPINE

CERVICAL

SPINE

STABLISA

TION-

POSTERI

OR Level

four

MRI

SPINE

X RAY

SPINE5 80000 S8 S812053 C No

6.71 SPINE

DL SPINE

STABLISA

TION-

ANTERTI

OR

MRI

SPINE

X RAY

SPINE5 60000 S8 S812054 No

Page 10: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.72 A SPINE

DL SPINE

STABLISA

TION-

POSTERI

OR Level

one

MRI

SPINE

X RAY

SPINE5 50000 S8 S812055 A No

6.72 B SPINE

DL SPINE

STABLISA

TION-

POSTERI

OR Level

two

MRI

SPINE

X RAY

SPINE5 60000 S8 S812055 B No

6.73 A SPINE

DL SPINE

STABLISA

TION-

GLOBAL

(Anterior

&

Posterior

combine)

MRI

SPINE

X RAY

SPINE5 90000 S8 S812056 A No

6.73 B SPINE

DL SPINE

STABLISA

TION-

POSTERI

OR Level

three

MRI

SPINE

X RAY

SPINE5 70000 S8 S812056 B No

6.73 C SPINE

DL SPINE

STABLISA

TION-

POSTERI

OR Level

four

MRI

SPINE

X RAY

SPINE5 80000 S8 S812056 C No

6.74 SKULL

CRANIOS

YNOSTOS

IS

SURGERY

MRI+3D

CT BRAIN

CT

BRAIN5 100000 S8 S800009 No

Page 11: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.75 SPINE

LAMINOP

LASTY

CERVICAL

/DORSAL

/LUMBER

MRI

SPINE

X RAY

SPINE3 50000 S8 S812057 No

6.76 BRAIN

DIAGNOS

TIC

CEREBRA

L/SPINAL

ANGIOGR

APHY

(DSA-

DIGITAL

SUBSTRA

CTION

ANGIOGR

APHY)

CT

BRAIN/M

RI SPINE

RELATED

INVESTIG

ATIONS

0 12000 S8 S812058 No

6.77 SPINE

ENDOSC

OPIC

SPINE

SURGERY

MRI

SPINE

X RAY

SPINE3 40000 S8 S812059 No

6.78 SPINE

THECO-

PERITON

EAL

SHUNT

MRI

BRAIN/CT

BRAIN

X RAY

SPINE+CS

F REPORT

3 30000 S8 S812060 No

6.79 BRAIN

CRANIO-

FACIAL

RESECTIO

N

MRI

BRAIN/CT

BRAIN

+FACE

CT BRAIN

+FACE5 90000 S8 S812061 No

6.80

BRAIN

REVASCU

LARISATI

ON

ST-MCA

BYPASS/E

C-ICA

BYPASS

CTA/MRA

/DSACTA 5 95000 S8 S812062 No

6.81VASCULA

R

CAROTID

LIGATION

FOR

CCF/GIA

NT

ANEURYS

M

CTA/MRA

/DSACTA 5 30000 S8 S812063 No

6.82 BRAIN

REEXPLO

RATION

FOR

DEBRIDE

MENT/CS

F

LEAK/HA

EMATOM

A

CT BRAIN CT BRAIN 3 25000 S8 S812064 No

Page 12: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.83REANIMA

TION

FACIAL

NERVE

REANIMA

TION

CONCER

NED

INVESTIG

ATIONS

CONCER

NED

INVESTIG

ATIONS

5 40000 S8 S812065 No

6.84 SPINE

TRANSPE

DICULAR

BIOPSY

MRI

SPINE

CONTRAS

T

X RAY

SPINE

+BIOPSY

REPORT

1 25000 S8 S812066 No

6.85 SPINE

VERTEBR

OPLASTY

/KYPHOP

LASTY

MRI

SPINE

X RAY

SPINE

+BIOPSY

REPORT

5 50000 S8 S812067 No

6.86 Brain

Cranioto

my and

Evacuatio

n of

Haemato

ma -

Intracrani

al

Spontane

ous /

Traumati

c

NCCT

BRAIN

NCCT

BRAIN5 90000 S8 S812068 No

6.87 Brain

Decompr

essive

Craniecto

my - For

Infarct /

Lesion

with

mass

effect on

brain

NCCT

BRAIN

NCCT

BRAIN5 70000 S8 S812069 No

6.88 BRAIN

SUPRATE

NTORIAL

TUMOUR

WITH

INFRATE

NTORIAL

TUMOR

EXTENSI

ON

MRI/CT

BRAIN

(WITH

CONTRAS

T)

CECT+BI

OPSY

REPORT

5 100000 S8 S812070 No

Page 13: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.89*

MEDICAL

NEUROL

OGY

CONSERV

ATIVE

MANAGE

MENT

(ISCHEMI

C

STROKE)

CT brain

plain,oth

ers

MRI

brain

with

angiogra

phy

3

60000

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112001 No

6.90*

MEDICAL

NEUROL

OGY

THROMB

OLYSIS

WITH

ACTILYSE

FOR

ISCHEMI

C STROKE

CT brain

plain,oth

ers

Repeat

CT brain

after 24

hours,MR

I brain

with

angiogra

phy

3

120000

(Payment

fraction (

1st week-

55%,2nd

week-

15%,3rd

week-

10%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

55%,2nd

week-

15%,3rd

week-

10%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112002 No

Page 14: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.91*

MEDICAL

NEUROL

OGY

INTRAPA

RENCHY

MAL

/SUBARA

CHNOID

HEMMO

RRHAGE

(CONSER

VATIVE

MANAGE

MENT)

CT brain

plain,oth

ers

Repeat

CT brain

plain , CT

angiogra

phy brain

3

40000

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112003 No

6.92*

MEDICAL

NEUROL

OGY

MENING

OENCEPH

ALITIS,

OR/ AND

EVD/VP

shunt

(CONSER

VATIVE

MANAGE

MENT)

CT brain

plain,CSF

,others

MRI

brain

with

contrast

3

110000

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112004 No

Page 15: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.93*

MEDICAL

NEUROL

OGY

MYASTH

ENIA

CRISIS

MANAGE

MENT BY

PLASMAP

HERESIS

Clinical

diagnosis

by

neurophy

sician OR

previousl

y

diagnose

d case

Anyone

of the

following

:repetitiv

e nerve

stimulati

on,ACH-R

antibody,

Anti-

MUSK

antibody

3

110000

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112005 No

6.94*

MEDICAL

NEUROL

OGY

MYASTH

ENIA

CRISIS

MANAGE

MENT BY

IV

IMMUNO

GLOBINS

Clinical

diagnosis

by

neurophy

sician OR

previousl

y

diagnose

d case

Anyone

of the

following

:repetitiv

e nerve

stimulati

on,ACH-R

antibody,

Anti-

MUSK

antibody

3

200000

(Payment

fraction (

1st week-

55%,2nd

week-

15%,3rd

week-

10%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

55%,2nd

week-

15%,3rd

week-

10%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112006 No

Page 16: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.95*

MEDICAL

NEUROL

OGY

Gullian-

barre

syndrom

e

manage

ment by

plasmaph

eresis

Clinical

diagnosis

by

neurophy

sician

CSF

study,

NCV/EM

G

3

109627

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

40%,2nd

week-

25%,3rd

week-

15%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112007 No

6.96*

MEDICAL

NEUROL

OGY

Gullian-

barre

syndrom

e

manage

ment by

Intraveno

us

immunog

lobulin

Clinical

diagnosis

by

neurophy

sician

CSF

study,

NCV/EM

G

3

200000

(Payment

fraction (

1st week-

55%,2nd

week-

15%,3rd

week-

10%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

(Payment

fraction (

1st week-

55%,2nd

week-

15%,3rd

week-

10%,4th

week-

10%,5th

week-

10%) of

total

package

rate)

S8 M112008 No

6.97Neurolog

y

Anterior

Encephal

ocele

CT Brain/

MRI

Brain

CT Brain 2 50000 S8 S800001 No

6.100Neurolog

y

Carpal

Tunnel

Release

including

pre and

post Op.

MRI

MRI,

EMG/NC

V

- 2 10000 S8 S800004 No

6.101Neurolog

y

Cervical

Ribs –

Bilateral

X-Ray

Cervical

Spine/

Chest X-

Ray, CT

Scan

X-Ray

Cervical

Spine/

Chest X-

Ray, CT

Scan

2 35000 S8 S800005 No

Page 17: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.102Neurolog

y

Cervical

Ribs –

Unilatera

l

X-Ray

Cervical

Spine/

Chest X-

Ray, CT

Scan

X-Ray

Cervical

Spine/

Chest X-

Ray, CT

Scan

2 20000 S8 S800006 No

6.103Neurolog

y

Duroplas

ty -

Endogen

ous

CT Brain CT Brain 2 12500 S8 S800010 No

6.104Neurolog

y

Duroplas

ty -

Exogeno

us(Impla

nt cost is

not

iclluded

in

package

rate)

CT Brain

PlainCT Brain 2 12500

Implant

cost will

added

seperatly

in this

package

S8 S800011 No

6.105Neurolog

y

Haemato

ma (Child

subdural)

inclusive

of

General

anaesthe

sia, pre

and post

Op. CT

CT Brain CT Brain 2 50000 S8 S800014 No

6.106Neurolog

y

Laminect

omy with

Fusion

and

fixation

MRI

Spine

X-Ray

Spine.2 50000 S8 S800015 No

6.107Neurolog

y

Laminect

omy with

Fusion

MRI

Spine

X-Ray

Spine.2 40000 S8 S800016 No

6.108Neurolog

y

Local

Neurecto

my

CT/MRI

Clinical

Photogra

ph

2 16000 S8 S800017 No

6.109Neurolog

y

Meningo

cele –

Anterior

Brain ,

Spinal

Cord MRI

X Ray/

Post OP

Operativ

e Site

2 36000 S8 S800019 No

6.110Neurolog

y

Meningo

cele –

Lumbar

Brain ,

Spinal

Cord MRI

X Ray/

Post OP

Operativ

e Site

2 36000 S8 S800020 No

Page 18: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.111Neurolog

y

Meningo

coccal –

Occipital

Clinical

Photo/M

RI/CT

X Ray/

Post OP

Operativ

e Site

2 50000 S8 S800021 No

6.113Neurolog

y

Spine -

Canal

Stenosis

CT/MRI CT 2 40000 S8 S800027 No

6.114Neurolog

y

Spine -

Extradura

l

Haemato

ma

MRI

Spine

X-Ray

Spine.2 30000 S8 S800032 No

6.115Neurolog

y

Spine -

Extradura

l

Haemato

ma with

fixation

MRI

Spine

X-Ray

Spine.2 40000 S8 S800033 No

6.116Neurolog

y

Spine -

Intradura

l

Haemato

ma

MRIX-Ray

Spine.2 40000 S8 S800036 No

6.117Neurolog

y

Spine -

Intradura

l

Haemato

ma with

fixation

MRI

Spine

X-Ray

Spine.2 50000 S8 S800037 No

6.118Neurolog

y

Spine -

Intramed

ullar

Tumour

CT/MRI HPEE 2 50000 S8 S800038 No

6.119Neurolog

y

Spine -

Intramed

ullar

Tumour -

fixation

MRI

Spine

Biopsy , X-

Ray Spin2 60000 S8 S800039 No

6.120Neurolog

y

Brain

Biopsy

MRI

Brain/ CT

Brain

Biopsy 2 15000 S8 S800045 No

6.121Neurolog

y

Cranial

Nerve

Anastom

osis

concecrn

ed

Investigat

ion

concecrn

ed

Investigat

ion

2 32000 S8 S800046 No

6.122Neurolog

y

Depresse

d

Fracture

CT Brain CT Brain 2 40000 S8 S800047 No

Page 19: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.123Neurolog

y

Peripher

al

Neurecto

my

(Trigemin

al)

MRI Biopsy 2 16500 S8 S800049 No

6.124Neurolog

y

Additonal

clip for

Aneurys

m

Clipping

MRI

ANGIO/D

SA

X Ray +

Clinical

Photo of

Operativ

e Site

2 15000 S8 S800061 No

6.125Neurolog

y

Cervical

Disc

Multiple

level

without

Fusion

MRI

Spine

X Ray +

Clinical

Photo of

Operativ

e Site

2 40000 S8 S800068 No

6.126Neurolog

y

Foramen

Magnum

Decompr

ession

CT/MRI X-Ray 2 45000 S8 S800072 No

6.127Neurolog

y

Arterio

venous

malforma

tion

(AVM)

excision

(whateve

r size and

location)

MRA/DS

A Report

X-Ray ,

Clinical

Photo of

Operativ

e Site

2 50000 S8 S800079 No

6.128Neurolog

y

Scalp

Arterio

venous

malforma

tion

(AVM)

CT/MRI

ANGIO

HistoPath

o Repot +

Clinical

Photo of

Operativ

e Site

2 25000 S8 S800080 No

6.129Neurolog

y

Gamma

Knife

radiosurg

ery

(GKRS)/

SRS for

tumours/

Arteriove

nous

malforma

tion

(AVM)

CT/MRIClinical

Photo 2 75000 S8 S800083 No

Page 20: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.130

Intervent

ional

Neurorad

iology

Coil

emboliza

tion for

aneurys

ms

(includes

cost of

first 3

coils +

balloon

and/ or

stent if

used) 1

to 20

coils may

be

required

as per

need.

DSA/CT/

MRI

ANGIO

CT/MR

ANGIO2 1,00,000 S9 S900001 No

6.131

Intervent

ional

Neurorad

iology

Additiona

l coil for

coil

emboliza

tion for

aneurys

ms

DSA/CT/

MRI

ANGIO

CT/MR

ANGIO2 24000 S9 S900002 No

6.132

Intervent

ional

Neurorad

iology

Dural

AVMs/AV

Fs (per

sitting)

with glue

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 70000 S9 S900003 No

6.133

Intervent

ional

Neurorad

iology

Dural

AVMs/AV

Fs (per

sitting)

with onyx

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 1,50,000 S9 S900004 No

Page 21: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.134

Intervent

ional

Neurorad

iology

Carotico-

cavernou

s Fistula

(CCF)

emboliza

tion with

coils.

[includes

5 coils,

guide

catheter,

micro-

catheter,

micro-

guidewir

e,

general

items]

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 1,50,000 S9 S900005 No

6.135

Intervent

ional

Neurorad

iology

Carotid-

cavernou

s Fistula

(CCF)

emboliza

tion with

balloon

(includes

one

balloon,

guide

catheter,

micro-

catheter,

micro-

guidewir

e,

general

items)

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 75000 S9 S900006 No

6.136

Intervent

ional

Neurorad

iology

Cerebral

& Spinal

AVM

emboliza

tion (per

sitting).

Using

Histoacry

l

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 1,00,000 S9 S900007 No

Page 22: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.137

Intervent

ional

Neurorad

iology

Parent

vessel

occlusion

- Basic

CT/MR

ANGIO

CT/MR

ANGIO2 30000 S9 S900008 No

6.138

Intervent

ional

Neurorad

iology

Additonal

coil for

Parent

Vessel

Occlusion

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 24000 S9 S900009 No

6.139

Intervent

ional

Neurorad

iology

Additonal

balloon

for

Parent

Vessel

Occlusion

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 11000 S9 S900010 No

6.140

Intervent

ional

Neurorad

iology

Balloon

test

occlusion

CT/MR

ANGIO

CT/MR

ANGIO2 70000 S9 S900011 No

6.141

Intervent

ional

Neurorad

iology

Intracrani

al

balloon

angioplas

ty with

stenting

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 1,60,000 S9 S900012 No

6.142

Intervent

ional

Neurorad

iology

Intracrani

al

thrombol

ysis / clot

retrieval

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 1,60,000 S9 S900013 No

6.143

Intervent

ional

Neurorad

iology

Pre-

operative

tumour

emboliza

tion (per

session)

DSA/CT/

MR

ANGIO

CT/MR

ANGIO2 40000 S9 S900014 No

8.76NEUROS

URGERY

SKULL

TRACTIO

N

CLINICAL

PHOTOG

RAPH, X-

RAY, CT

SCAN

BRAIN

CLINICAL

PHOTOG

RAPH, X-

RAY

3 12880 S8 S612027 No

Page 23: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

8.77NEUROS

URGERY

BURR

HOLE

CLINICAL

PHOTOG

RAPH, X-

RAY, CT

SCAN

BRAIN

CLINICAL

PHOTOG

RAPH, X-

RAY

3 28750 S8 S612028 No

8.78NEUROS

URGERY

TEMPOR

AL BONE

RESECTIO

N

CLINICAL

PHOTOG

RAPH, X-

RAY, CT

SCAN

BRAIN

CLINICAL

PHOTOG

RAPH, X-

RAY

3 57500 S8 S612029 No

8.79NEUROS

URGERY

SKULL

BASE

SURGERY

CLINICAL

PHOTOG

RAPH, X-

RAY, CT

SCAN

BRAIN

CLINICAL

PHOTOG

RAPH, X-

RAY

3 69000 S8 S612030 No

8.88NEUROS

URGERY

DEFORMI

TY

SURGERY

FOR

SPINE

(KYPHO/S

COLIOSIS

)

Clinical

Photogra

ph, Xray

Clinical

Photogra

ph, Xray

3 150000 S8 S612036 No

8.89NEUROS

URGERY

Plexus

injury

along

with

Vascular

injury

repair/

graft

Pre-op.

Doppler

study,Ne

rve

Conducti

on

study,CT

Post-op.

Doppler

study,Cli

nical

photo

showing

scar

2 60000 S8 S600002 No

8.91NEUROS

URGERY

Head

injury

requiring

Facio-

Maxillary

Injury

repairs &

fixations

(includin

g

implants)

X-RAY/CT

Clinical

photogra

ph

showing

scar,Post-

op. X-ray

2 35000 S8 S600004 No

Page 24: Pre- Post Operativ No of Specialty Procedure Governm ... · Supraten torial-Basal CT Clinical Photogra ph 3 51750 S8 S812004 No 6.5 Brain Excision of Brain Tumor - Brainste m CT Clinical

6.144NEUROS

URGERY

Unspecifi

ed

Surgical

Package

(Amount

Capped

@

1,00,000r

s per

anum per

family,Pa

ckage

amount

is

Negotiabl

e)

Concern

Investigat

ion

Concern

Investigat

ion

1 1,00,000 S8 U100 No