Gui ListedTherapies PDF

ANNEXURE- I
Listed Therapies
ICD ICD POST_

DIAGNOS PROCED SPECIAL PACKAGE THERAPEUTI
S.NO AS_CODE SYSTEM/THERAPY
TIC URE INVESTIGATIONS PRICE C
CODE CODE EVIDENCE
S1 GENERAL SURGERY
S1.1 HEAD & NECK
S1.1.1 NECK
Biopsy , Clinical
744.42 29.2 1 S1.1.1.1 Branchial Cyst Excision Clinical Photograph 20000
Photograph
Biopsy , Clinical
744.42 29.52 2 S1.1.1.2 Branchial Sinus Excision Clinical Photograph 20000
Photograph
Carotid Body-Tumours Clinical Photograph , Biopsy , Clinical
337 39.8 3 S1.1.1.3 30000
Excision U S Neck Photograph
40.2 Cystic Hygroma Biopsy , Clinical
228.1 4 S1.1.1.4 Clinical Photograph 20000
40.29 Excision-Extensive Photograph

40.29 Excision-Major Photograph

40.2 Excision-Minor Photograph
Excision Of Lingual Clinical Photograph , Biopsy , Clinical

759.2 6.6 7 S1.1.1.7 25000
Thyroid Isotope Scan Photograph
Biopsy , Clinical
252.1 6.8 8 S1.1.1.8 Parathyroidectomy USG 30000
Photograph
106
ICD ICD POST_
CODE CODE EVIDENCE
Excision Of Thyroglossal Clinical Photograph , Biopsy , Clinical

759.2 6.7 9 S1.1.1.9 20000
Cyst Fistula Radionucleide Scan Photograph
Color Doppler , X- Color Doppler ,

756.2 77.91 10 S1.1.1.10 Cervical Rib Excision 15000
RAY X-RAY
527.3 Removal Of
Clinical Photograph , Biopsy , Clinical
527.5 26.3 11 S1.1.1.11 Submandibular Salivary 10000
FNAC Photograph
527.9 Gland
527.3
26.4 12 S1.1.1.12 Parotid Duct Repair Silography 20000 Silography
527.5
S1.1.2 MANDIBLE
526 76.31 13 S1.1.2.1 Hemimandibulectomy X-RAY 25000 X-RAY
Segmental Mandible
526 76.31 14 S1.1.2.2 X-RAY 25000 X-RAY
Excision
S1.1.3 TOUNGE
Biopsy , Clinical
529 25.2 15 S1.1.3.1 Partial Glossectomy Clinical Photograph 15000
Photograph
S1.1.4 LIP
27.5 Clinical
V50.1 16 S1.1.4.1 Abbe Operation Clinical Photograph 15000
70.6 Photograph
Clinical
528 27.9 17 S1.1.4.2 Vermilionectomy Clinical Photograph 15000
Photograph
107
ICD ICD POST_
CODE CODE EVIDENCE
27.4 Wedge Excision& Biopsy , Clinical

528 18 S1.1.4.3 Clinical Photograph 20000
27.9 Vermilionectomy Photograph
Biopsy , Clinical
528 27.4 19 S1.1.4.4 Wedge Excision Clinical Photograph 15000
Photograph
S1.1.5 THYROID (NO-MALIGNANT)
Biopsy , Clinical
240-246 6.2 20 S1.1.5.1 Hemithyroidectomy FNAC , T F T , USG 20000
Photograph
6.39 Biopsy , Clinical

245 21 S1.1.5.2 Isthmectomy FNAC , T F T , USG 20000
6.91 Photograph
Biopsy , Clinical
6.3 22 S1.1.5.3 Partial Thyroidectomy FNAC , T F T , USG 20000
Photograph
Biopsy , Clinical
6.2 23 S1.1.5.4 Resection Enucleation FNAC , T F T , USG 20000
Photograph
Biopsy , Clinical
6.3 24 S1.1.5.5 Subtotal Thyroidectomy FNAC , T F T , USG 20000
Photograph
242
Biopsy , Clinical
245 6.4 25 S1.1.5.6 Total Thyroidectomy FNAC , T F T , USG 20000
Photograph
246
108
ICD ICD POST_
CODE CODE EVIDENCE
S1.2 BREAST
217
233 Biopsy , Clinical
85.41 26 S1.2.1 Simple Mastectomy(Nm) Mammography 25000
174 Photograph
175
S1.3 ABDOMEN
551.29
53.5 Epigastric Hernia Without Clinical
53.59 Mesh Photograph
553.29
551.29
56.6 Epigastric Hernia With Clinical
53.69 Mesh Photograph
553.29
551 53.2
Clinical
552 53.3 29 S1.3.1.3 Femoral Hernia Clinical Photograph 20000
Photograph
553
551.3
Hiatus Hernia Repair U S Abdomen , UGI Endoscopy
552.3 44.66 30 S1.3.1.4 40000
Abdominal Endoscopy picture
553.3
109
ICD ICD POST_
CODE CODE EVIDENCE
Rare Hernias
Clinical Photograph , Clinical
553.8 53.9 31 S1.3.1.5 (Spigalion,Obuturator,Sci 20000
USG Photograph
atic)
551.1
Umbilical Hernia Without Clinical
552.1 53.4 32 S1.3.1.6 Clinical Photograph 20000
Mesh Photograph
553.1
551.1
Umbilical Hernia With Clinical
Mesh Photograph
553.1
551.2
Ventral And Scar Hernia Clinical Photograph , Clinical
552.2 53.5 34 S1.3.1.8 20000
Without Mesh USG Photograph
553.2
551.2
Ventral And Scar Hernia Clinical Photograph , Clinical
552.2 53.6 35 S1.3.1.9 30000
With Mesh USG Photograph
553.2
S1.3.2 APPENDIX
540
Biopsy , Clinical
541 47.0 36 S1.3.2.1 Lap. Appendicectomy USG 18000
Photograph
542
110
ICD ICD POST_
CODE CODE EVIDENCE
540 Biopsy , Clinical

47/47.09 37 S1.3.2.2 Appendicular Perforation USG 20000
543.9 Photograph
S1.3.3 STOMACH, DUODENUM AND JEJUNUM
Highly Selective Clinical
531 42.02 38 S1.3.3.1 Endoscopy 25000
Vagotomy Photograph
44.03 Selective Vagotomy Clinical

531 39 S1.3.3.2 Endoscopy 40000
44.3 Drainage Photograph
44.0 Clinical
531 40 S1.3.3.3 Vagotomy Pyloroplasty Endoscopy 40000
44.2 Photograph
534
44.0 Gastrojejunostomy & Endoscopy-Video Clinical
564.2 41 S1.3.3.4 40000
44.3 Vagotomy Photo Photograph
278.01
533.0 Operation For Bleeding Clinical

44.4 42 S1.3.3.5 Endoscopy 40000
533.4 Peptic Ulcer Photograph
43.5
553.8 Partial/Subtotal Clinical
43.6 43 S1.3.3.6 Endoscopy 40000
278.01 Gastrectomy For Ulcer Photograph
43.7
Clinical
750.5 43.3 44 S1.3.3.7 Pyloromyotomy Endoscopy 20000
Photograph
111
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , CT , Clinical
536.4 43.1 45 S1.3.3.8 Gastrostomy 20000
Endoscopy , USG Photograph
44.6 Clinical
536.4 46 S1.3.3.9 Gastrostomy Closure Clinical Photograph 20000
44.62 Photograph
532.1 surgical management of CT-Abdomen , USG , Clinical

46.99 47 S1.3.3.10 40000
532.5 duodenal perforation X-RAY Photograph
S1.3.4 SMALL INTESTINE
96.29 Surgical Management Of Endoscopy , USG , Biopsy , Clinical
560 48 S1.3.4.1 40000
46.80 Intususception X-Ray ABD Photograph
560
Operation For Acute Biopsy , Endoscopy , Biopsy , Clinical
553 46.99 49 S1.3.4.2 40000
Intestinal Obstrucion USG , X-Ray ABD Photograph
560.9
Biopsy , CXR ,
Operation For Acute Biopsy , Clinical
569.83 46.99 50 S1.3.4.3 Endoscopy , USG , 40000
Intestinal Perforation Photograph
X-Ray ABD
578
Operation For
562.02 44.49 CT With Contrast , Biopsy , Clinical
51 S1.3.4.4 Haemorrhage Of The 40000
562.03 39.98 Endoscopy Photograph
Small Intestine
562.12
112
ICD ICD POST_
CODE CODE EVIDENCE
Operations For Recurrent

Biopsy , Clinical
560 46.99 52 S1.3.4.5 Intestinal Obstruction CT-Contrast 40000
Photograph
(Noble Plication Other)
43.5 Resection & Anastomosis Biopsy , Clinical

560 53 S1.3.4.6 CT , X-Ray ABD 35000
45.9 Of Small Intestine Photograph
Biopsy , Endoscopy , Clinical

560.1 46.2 54 S1.3.4.7 Ileostomy 20000
USG Photograph
Clinical
560.1 46.51 55 S1.3.4.8 Ileostomy Closure Clinical Photograph 20000
Photograph
S1.3.5 LARGE INTESTINE
Operation for Mal- Clinical

560.2 46.8 56 S1.3.5.1 Rotation & Volvulus Of CT , X-Ray ABD 40000 Photograph , X-
The Midgut RAY
Clinical
Operation For Volvulus CT-Contrast , X-Ray
560.2 46.8 57 S1.3.5.2 40000 Photograph , X-
Of Large Bowel Abdomen
Ray Abdomen
Operation Of The
Clinical
751.5 46.99 58 S1.3.5.3 Duplication Of The CT-Contrast 40000
Photograph
Intestines
113
ICD ICD POST_
CODE CODE EVIDENCE
152
45.7 Barium , CT , Biopsy , Clinical
153 59 S1.3.5.4 Left Hemi Colectomy 30000
45.75 Endoscopy , USG Photograph
154
152
45.7 Barium , CT , Biopsy , Clinical
153 60 S1.3.5.5 Right Hemi Colectomy 30000
154
152
153
Barium , CT , Biopsy , Clinical
154 45.8 61 S1.3.5.6 Total Colectomy 40000
556
v64.4
Barium , CT , Clinical
569.6 46.1 62 S1.3.5.7 Colostomy 20000
Clinical
154 46.52 63 S1.3.5.8 Colostomy Closure Clinical Photograph 20000
Photograph
S1.3.6 RECTUM AND ANUS
Pull Through Abdominal Clinical

154 48.49 64 S1.3.6.1 Clinical Photograph 30000
Resection Photograph
Biopsy , Clinical
154 65 S1.3.6.2 Anterior Resection Photograph , 50000
48.63 Photograph
Colonoscopy
114
ICD ICD POST_
CODE CODE EVIDENCE
S1.4 LIVER
50.2 Operation For Hydatid
122 66 S1.4.1 CT , USG 30000 USG
50.21 Cyst Of Liver
MRI , UGI Endoscopy ,
156 39.1 67 S1.4.2 Portocaval Anastomosis 80000
Endoscopy , USG USG
S1.5 GALLBLADDER
574 Clinical
51.2
575 68 S1.5.1 Cholecystectomy CT , LFT , USG 20000 Photograph ,
51.22
576 USG
574 Clinical
51.2
575 69 S1.5.2 Lap.Cholecystectomy CT , LFT , USG 30000 Photograph ,
51.23
576 USG
574, 51.2 Clinical
Cholecystectomy &
575, 51.22 70 S1.5.3 CT , LFT , USG 35000 Photograph ,
Exploration Cbd
576 51.41 USG
574.0
574.3
Clinical
574.6
51.0 71 S1.5.4 Cholecystostomy CT , LFT , USG 25000 Photograph ,
574.8
USG
575.0
575.12
Clinical
596.89 52.4 72 S1.5.5 Cystojejunostomy CT , LFT , USG 40000 Photograph ,
USG
115
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
577.2
52.4 73 S1.5.6 Cystogastrostomy CT , LFT , USG 40000 Photograph ,
157
USG
576.8
Clinical
576.2 51.7 74 S1.5.7 Repair Of Cbd CT , LFT , USG 40000
Photograph ,
576.4
USG
S1.6 ADRENALS
Operation Of Adernal Biochemical

198.7
7.3 75 S1.6.1 Glands, Bilateral For Investigations , CT , 40000 USG
194
Tumor USG
227
Operation On Adrenal Biochemical

198.7
7.22 76 S1.6.2 Glands Unilateral For Investigations , CT , 25000 USG
194
Tumour USG
227
S1.7 SPLEEN
282.0
Splenectomy For CT , Peripheral
289.4 41.5 77 S1.7.1 35000 USG
Hypersplenism Smear , USG
289.50

401.9 39.1 78 S1.7.2 Splenorenal Anastomosis 60000
Endoscopy , USG USG
116
ICD ICD POST_
CODE CODE EVIDENCE

39.1 79 S1.7.3 Warren Shunt 60000
Endoscopy , USG USG
S2 ENT SURGERY
S2.1 EAR
Clinical
20.79 80 S2.1.1 Labyrinthectomy CT-Scan PTI , IA 20000
Photograph
351.9 Facial Nerve Clinical
4.42 81 S2.1.2 CT-Scan 20000
767.5 Decompression Photograph
348.81
808.8
Clinical
730.18 2.07 82 S2.1.3 Temporal Bone Excision CT-Scan MRI Scan 50000
Photograph
801.0
829.0
S2.2 THROAT
Clinical
478 31.98 83 S2.2.1 Microlaryngeal Surgery Nasal Endoscopy 12000
Photograph
117
ICD ICD POST_
CODE CODE EVIDENCE
478.33
478.30
Phono Surgery For Vocal Clinical
478.31 31.98 84 S2.2.2 CT-Scan MRI Scan 25000
Cord Paralysis Photograph
478.32
478.34
Clinical
464.01 30.29 85 S2.2.3 Laryngo Fissurectomy CT-Scan 20000
Photograph
146
147
148
Exision Of Tumors In Biopsy , Clinical
210.6 29.39 86 S2.2.4 FNAC 20000
Pharynx Photograph
210.7
210.8
210.9
231.0
Parapharyngeal Tumour CT-Scan MRI Scan , Biopsy , Clinical
232.2 29.3 87 S2.2.5 20000
Excision FNAC Photograph
787.23
Impedance
Adenoidectomy - Gromet Clinical
474.12 28.3 88 S2.2.6 Audiometry , X-Ray 10000
Insertion Photograph
Nasopharynx
Uvulo-Palato- Clinical
327.23 27.7 89 S2.2.7 Polysomnography 25000
Pharyngoplasty. Photograph
118
ICD ICD POST_
CODE CODE EVIDENCE
S2.3 NOSE
461
461.0
461.1
461.2
461.3
461.8
461.9 CT PNS , DNE Photo Endoscopy
22.19 90 S2.3.1 Endoscopic Sinus Surgery 15000
473 graph Photo
473.0
473.1
473.2
473.3
473.8
473.9
383.00
CT Temporal Bone ,
383.1 20.4 91 S2.3.2 Mastoidectomy 15000 X-Ray Mastoids
PTA
383.3
384.2 PTA , X-Ray PTA , Per OP

19.4 92 S2.3.3 Tympanoplasty 15000
385.23 Mastoids Photo
119
ICD ICD POST_
CODE CODE EVIDENCE
19.0
19.1
19.11 CT Temporal Bone , Clinical Photo
212 19.19 93 S2.3.4 Stapedectomy - Veingraft Impedance 15000 With Piston +
19.2 Audiometry , PTA Vein Graft
19.21
19.29
Excision Of Benign Clinical

212 21.3 94 S2.3.5 CT PNS , DNE 15000
Tumour Nose Photograph
Surgical correction of Clinical

210.7 21.31 95 S2.3.6 CT PNS , DNE 40000
Angiofibroma Nose Photograph
375.30
9.19 Endoscopic Surgery for Endoscopic
375.32 96 S2.3.7 Clinical Photograph 20000
21.29 Dacrocystitis Photo
375.42
FOREIGN BODY
REMOVAL
S2.4
(BRONCHUS-
OESOPHAGUS)
Bronchoscopy Foreign Clinical

934 33.78 97 S2.4.1 Relevant X-Ray 20000
Body Removal Photograph
120
ICD ICD POST_
CODE CODE EVIDENCE
S3 OPHTHALMOLOGY SURGERY
S3.2 CORNEA AND SCLERA
11.63 Therapeutic Penetrating Clinical

371 98 S3.2.1 BSCAN 15000
11.64 Keratoplasty Photograph
11.61 Clinical
371 99 S3.2.2 Lamellar Keratoplasty BSCAN 3000
11.62 Photograph
Clinical
371 11.6 100 S3.2.3 Corneal Patch Graft Clinical Photograph 4000
Photograph
Clinical
12.87 101 S3.2.4 Scleral Patch Graft Clinical Photograph 6000
Photograph
Clinical
371 11.64 102 S3.2.5 Penetrating Keratoplasty Clinical Photograph 15000
Photograph
Clinical
371 103 S3.2.6 Double Z-Plasty Clinical Photograph 4000
Photograph
Amniotic Membrane Clinical

371 104 S3.2.7 Clinical Photograph 7000
Graft Photograph
121
ICD ICD POST_
CODE CODE EVIDENCE
S3.3 VITREO-RETINA
S3.3.1 VITREO
360.4 Clinical
14.7 105 S3.3.1.1 Vitrectomy - 6000
365 Photograph
Vitrectomy - Membrane
Peeling - Endolaser - B.Scan , Fundus Fundus
362 14.7 106 S3.3.1.2 30000
Silicon oil or Gas - with Photograph Photograph
or without belt buckling
Vitrectomy - Membrane B.Scan , Fundus Fundus

362 14.7 107 S3.3.1.3 25000
Peeling- Endolaser Photograph Photograph
Vitrectomy Plus Silicon

362 14.7 108 S3.3.1.4 - 20000 -
Oil Or Gas
BSCAN ,
Removal Of Silicon Oil BSCAN , FUNDUS
362 14.7 109 S3.3.1.5 6000 FUNDUS
Or Gas PHOTOGRAPH
PHOTOGRAPH
Monthly Intravitreal Anti-

Vegf For Macular B.Scan , Fundus Fundus
362 110 S3.3.1.6 7000
Degeneration - Per Photograph Photograph
Injection (Maximum - 6)
122
ICD ICD POST_
CODE CODE EVIDENCE
S3.3.2 RETINA
Scleral buckle procedure B.Scan , Fundus Fundus

361 14.4 111 S3.3.2.1 15000
for retinal detachment Photograph Photograph
14.2
Photocoagulation for B.Scan , Fundus Fundus
362 14.23 112 S3.3.2.2 1500
Retinopathy Photograph Photograph
14.24
S3.4 ORBIT
360 Clinical
16.64 113 S3.4.1 Socket Reconstruction Clinical Photograph 7000
376 Photograph
Clinical
86.69 114 S3.4.2 Dermis Fat Graft Clinical Photograph 9000
Photograph
360 Clinical
16.0 115 S3.4.3 Orbitotomy - 10000
376 Photograph
360 16.3 Enucleation/Evisceration CT Skull , Clinical Clinical

116 S3.4.4 20000
376 16.4 with Orbital implant Photograph , Orbit Photograph
Decompression/Excision
377 4.42 117 S3.4.5 MRI 65000 Photograph
of optic nerve lesions
Surgical management for Clinical

376.3 118 S3.4.6 CT , MRI 60000
Proptosis Photograph
123
ICD ICD POST_
CODE CODE EVIDENCE
SQUINT
S3.5 CORRECTION
SURGERY
Rectus Muscle Clinical
378 15.1 119 S3.5.1 Clinical Photograph 6000
Surgery(Single) Photograph
15.1
15.3
Rectus Muscle Clinical
Surgery(Two/Three) Photograph
15.5
15.6
15.1
15.3
Clinical
378 15.4 121 S3.5.3 Oblique muscle surgery Clinical Photograph 6000
Photograph
15.5
15.6
S3.6 LID SURGERY

Lid Reconstruction Clinical
Surgery- Photograph
Clinical Photograph ,
Surgical correction of Clinical
374 8.3 123 S3.6.2 ICE pack test with 25000
Ptosis Photograph
Chin Elevation
124
ICD ICD POST_
CODE CODE EVIDENCE
S3.7 PEDIATRIC OPHTHALMIC SURGERY
Fundus
Fluorescein
Fundus Fluorescein
Angiography ,
Photocoagulation For Angiography ,
Fundus
362 14.2 124 S3.3.6 Retinopathy Of Fundus Photograph , 7500
Photograph ,
Prematurity Optical Coherence
Optical
Tomography
Coherence
Tomography
Paediatric Cataract
B.Scan , Fundus Fundus
366 13.4 125 S3.3.7 Surgery(Phacoemulsificat 15000
Photograph Photograph
ion-Iol)
Glaucoma Filtering Fundus Fluorescein

Fundus
365 12.79 126 S3.3.8 Surgery For Paediatric Angiography , 15000
Photograph
Glaucoma Fundus Photograph
125
ICD ICD POST_
CODE CODE EVIDENCE
S4 GYNAECOLOGY AND OBSTETRICS SURGERY

S4.1 OBSTETRICS
665
665.1
68.9 Caesarean Hysterectomy Photograph ,
665.5 127 S4.1.1 USG 30000
75.61 With Bladder Repair Post-op USG
666.04
666.14
75.5
665 Rupture Uterus With
75.52 128 S4.1.2 USG 25000 USG
665.1 Tubectomy
66.32
ABG , APTT , CUE ,

Surgical management of Biochemical
Heamatocrit , LFT ,
Eclampsia With Investigations ,
642.5 93.9 129 S4.1.3 PT , Platelet Count , 20000
Complications Requiring Clinical
RFT , S.Fibrinogen
Ventilatory Support Photograph
Level
APTT , Heamatocrit , Clinical

Surgical management of
PT , Platelet Count , Photograph of
641.3 130 S4.1.4 Abruptio-Placenta With 20000
S.Fibrinogen Level , Retroplacental
Coagulation Defects(Dic)
USG clots , USG
126
ICD ICD POST_
CODE CODE EVIDENCE
S4.2 GYNAECOLOGY
626.2
68.51 131 S4.2.1 Lavh USG 20000 Post-op USG
621.33
620.5 Biopsy , Post-op

65.23 132 S4.2.2 Laparoscopic Cystectomy USG 20000
617.1 USG
Laparoscopic Ectopic Biopsy , Post-op

633.1 66.62 133 S4.2.3 USG 20000
Resection USG
Laparoscopic Biopsy , Post-op

218 68.29 134 S4.2.5 USG 25000
Myomectomy USG
Laparoscopic Biopsy , Post-op

628.2 66.73 135 S4.2.6 USG 20000
Recanalisation USG
69.2 Laparoscopic Sling Biopsy , Post-op

618.9 136 S4.2.7 USG 25000
69.22 Operations USG
Biopsy , Post-op
614.6 54.51 137 S4.2.8 Laparoscopic Adhesolysis USG 25000
USG
618.1 Biopsy , Post-op

68.5 138 S4.2.9 Vaginal Hysterectomy Scan 20000
621.33 USG
127
ICD ICD POST_
CODE CODE EVIDENCE
618.3
Vaginal Hysterectomy Biopsy , Post-op
618.01 68.5 139 S4.2.10 Scan 30000
With Pelvic Floor Repair USG
618.04
Cystocele ,Rectocele & Biopsy , Post-op

618 70.5 140 S4.2.12 USG 20000
Perineorraphy USG
Mc Indo-S Repair For Clinical Photograph , Biopsy , Post-op

752.4 70.62 141 S4.2.14 30000
Vaginal Atresia Scan USG
70.77 Vault Prolapse Clinical Photograph ,

618.5 142 S4.2.16 30000 USG
70.92 Abdominal Repair USG
Vault Prolapse
70.77 Clinical Photograph ,
618.5 143 S4.2.17 Abdominal Repair With 40000 USG
70.92 USG
Mesh
S5 ORTHOPEDIC SURGERY AND PROCEDURES

FRACTURE
CORRECTION
79 S5.1
SURGERIES/PROCED
URES
Bone Grafting As
78 144 S5.1.1 X-RAY 20000 Post opX-RAY
Exclusive Procedure
128
ICD ICD POST_
CODE CODE EVIDENCE
Excision Or Other
814.1 80.03 145 S5.1.2 Operations For Scaphoid X-RAY 15000 Post opX-RAY
Fractures
79.3 Open Reduction &

79.84 146 S5.1.3 Internal Fixation Of X-RAY 15000 Post opX-RAY
79.88 Fingers & Toes
78.1
79 Reduction Of Compound
93.51- 147 S5.1.4 Fractures & External X-RAY 15000 Post opX-RAY
93.56 Fixation
93.59.
Clinical
Ilizarov Ring Fixator
84.72 148 S5.1.5 X-RAY 40000 Photograph , X-
Application
RAY
Clinical
Ctev Neglected . Jess
149 S5.1.6 Clinical Photograph 30000 Photograph , X-
Fixator
RAY
79 S5.2 DISLOCATIONS
Open Reduction Of
79.8 150 S5.2.1 X-RAY 30000 Post opX-RAY
Dislocations - Deep
129
ICD ICD POST_
CODE CODE EVIDENCE
AMPUTATIONS
84 S5.3
(NON-TRAUMATIC)
Clinical
Amputations -
84.09 151 S5.3.1 X-RAY 30000 Photograph , X-
Forequarter
RAY
Amputations - Hind Clinical
84.19 152 S5.3.2 Quarter And X-RAY 40000 Photograph , X-
Hemipelvectomy RAY
BONE AND JOINT
S5.4
SURGERY/PROCEDURES
Arthrodesis Of - Major Fluid Analysis , X-
81.2 153 S5.4.1 30000 Post opX-RAY
Joints RAY
Arthroscopy
80.2 154 S5.4.2 Arthroscopy - Diagnostic MRI 20000
Picture
Arthroscopy . Operative Arthroscopy

80.6 155 S5.4.3 MRI 25000
Meniscectomy Picture
Arthroscopy
844.2 81.45 156 S5.4.4 Arthroscopy - Acl Repair MRI 30000
Picture
130
ICD ICD POST_
CODE CODE EVIDENCE
Avascular Necrosis Of
733.42 157 S5.4.5 Femoral Head (Core MRI , X-RAY 15000 Post opX-RAY
Decompression)
Soft Tissue
Clinical
Reconstruction
77.3 158 S5.4.6 Clinical Photograph 30000 Photograph , X-
Procedures For
RAY
Joints/Osteotomy
S5.5 SPINE SURGERY

Anterolateral Clearance
159 S5.5.1 MRI 50000 Post opX-RAY
For Tuberculosis
722 3.99 160 S5.5.2 Costo Transversectomy MRI 30000 Post opX-RAY
3.9 Spinal Ostectomy And
161 S5.5.3 MRI 40000 Post opX-RAY
86.94 Internal Fixations
SOFT TISSUE
S5.6
SURGERY
04.3 Nerve Repair With Clinical

162 S5.6.1 Clinical Photograph 30000
04.5 Grafting Photograph
4.49 Clinical
163 S5.6.2 Neurolysis/Nerve Suture Clinical Photograph 25000
04.3 Photograph
131
ICD ICD POST_
CODE CODE EVIDENCE
353 Clinical
Operations For Brachial
723.4 3.9 164 S5.6.3 MRI 30000 Photograph , X-
Plexus & Cervical Rib
953.4 RAY
S5.7 TUMOR SURGERY
Excision Of Bone
Clinical
77.6 Tumours . Deep With Re-
170 165 S5.7.1 MRI 40000 Photograph , X-
78.4 Construction With
RAY
Conventional Prosthesis
S6 SURGICAL GASTRO ENTEROLOGY
S6.1 EMERGENCY
531
531.2
531.4
532
532.2
532.4 Surgery For Bleeding Endoscopy
44.4 166 S6.1.1 Endoscopy 40000
533 Ulcers Picture
533.2
533.4
534
534.2
534.4
132
ICD ICD POST_
CODE CODE EVIDENCE
Surgery For Obscure Gi Endoscopy

167 S6.1.2 Endoscopy 60000
Bleed Picture
S6.2 OESOPHAGUS
Biopsy , CT-Scan , Biopsy , Clinical
168 S6.2.1 Colonic Pull Up 30000
Endoscopy Photograph
Biopsy ,
Biopsy , CT-Scan ,
42.4 169 S6.2.2 Oesophagectomy 60000 Endoscopy
Endoscopy
Picture
Biopsy ,
Biopsy , CT-Scan ,
42.99 170 S6.2.3 Oesophago-Gastrectomy 75000 Endoscopy
Endoscopy
Picture
Biopsy ,
Biopsy , CT-Scan ,
42.7 171 S6.2.4 Lap Heller.S Myotomy 30000 Endoscopy
Endoscopy
Picture
Biopsy ,
Biopsy , CT-Scan ,
44.67 172 S6.2.5 Lap Fundoplications 45000 Endoscopy
Endoscopy
Picture
S6.3 STOMACH
43.5
Biopsy , Clinical
43.6 173 S6.3.1 Partial Gastrectomy Biopsy , EUS , USG 40000
Photograph
43.7
Biopsy , CT-Scan , Biopsy , Clinical

43.9 174 S6.3.2 Total Gastrectomy 40000
133
ICD ICD POST_
CODE CODE EVIDENCE
44.0 Truncal Vagotomy + Biopsy , CT-Scan , Biopsy , Clinical

175 S6.3.3 40000
44.3 Gastro Jejunostomy Endoscopy , USG Photograph
Distal Gastrectomy For

43.6 Biopsy , CT-Scan , Biopsy , Clinical
176 S6.3.4 Gastric Outlet 40000
Obstruction
Surgery For Corrosive Biopsy , CT-Scan , Biopsy , Clinical

44.99 177 S6.3.5 50000
Injury Stomach Endoscopy , USG Photograph
S6.4 SMALL INTESTINE
46.8 CT-Scan , X-Ray Biopsy , Clinical
178 S6.4.1 Volvulus 40000
46.80 ABD Photograph
CT-Scan , X-Ray Biopsy , Clinical
46.8/46.80 179 S6.4.2 Malrotation 40000
ABD Photograph
CT-Scan , X-Ray Biopsy , Clinical
54.51 180 S6.4.3 Lap Adhesiolysis 40000
ABD Photograph
S6.5 LARGE INTESTINE
Biopsy , CT-Scan ,
181 S6.5.1 Right Hemicolectomy Colonoscopy , 30000
45.73 Photograph
Endoscopy
Biopsy , CT-Scan ,
182 S6.5.2 Left Hemicolectomy Colonoscopy , 30000
45.75 Photograph
Endoscopy
134
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , CT-Scan ,
Extended Right Biopsy , Clinical
45.73 183 S6.5.3 Colonoscopy , 35000
Hemicolectomy Photograph
Endoscopy
Biopsy , CT-Scan ,
184 S6.5.4 Anterior Resection Colonoscopy , 40000
48.62 Photograph
Endoscopy
Biopsy , CT-Scan ,
48.6 Anterior Resection With Biopsy , Clinical
185 S6.5.5 Colonoscopy , 50000
46.2 Ileostomy Photograph
Endoscopy
Abdomino Perineal Biopsy , CT-Scan ,
Biopsy , Clinical
48.5 186 S6.5.6 Resection(Non- Colonoscopy , 50000
Photograph
Malignant) Endoscopy
Biopsy , CT-Scan ,
Hartman.S Procedure Biopsy , Clinical
48.62 187 S6.5.7 Colonoscopy , 45000
With Colostomy Photograph
Endoscopy
ULCERATIVE
S6.5.8
COLITIS
III STAGE
S6.5.8.1
PROCEDURE
CT-Scan with
I Stage-Sub Total Contrast , Biopsy , Clinical
45.8/46.2 188 S6.5.8.1.1 50000
Colectomy + Ileostomy Colonoscopy , Photograph
Endoscopy
45.95 189 S6.5.8.1.2 II Stage-J - Pouch Colonoscopy 30000 Biopsy , Clinical
135
ICD ICD POST_
CODE CODE EVIDENCE
Photograph
III Stage-Ileostomy Biopsy , Clinical

46.5 190 S6.5.8.1.3 Endoscopy 20000
Closure Photograph
II STAGE
S6.5.8.2
PROCEDURE
CT-Scan with
45.8 I Stage- Sub Total
Contrast , Biopsy , Clinical
46.2 191 S6.5.8.2.1 Colectomy + Ileostomy + 80000
Colonoscopy , Photograph
45.95 J - Pouch
Endoscopy
CT-Scan with
Ii Stage- Ileostomy Contrast , Biopsy , Clinical
46.5 192 S6.5.8.2.2 20000
Closure Colonoscopy , Photograph
Endoscopy
S6.6 LIVER
Hepato Cellular Biopsy , CT-Scan ,

Clinical
Carcinoma(Advanced) EUSDiagnostic
155 193 S6.6.1 60000 Photograph ,
Radio Frequency Laparoscopy , Intra
USG
Ablation operative Ultrasound
Haemangioma Sol Liver Biopsy , Clinical

50.2 CT-Scan , Endoscopy
194 S6.6.2 Hepatectomy + Wedge 75000 Photograph ,
50.3 , USG
Resection USG
136
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
50.2 Hydatid Cyst- Biopsy , CT-Scan ,
195 S6.6.3 30000 Photograph ,
50.21 Marsupilisation USG
USG
S6.7 GALL BLADDER
51.6 Cyst Excision + Hepatic Biopsy , Clinical
196 S6.7.1 CT , USG 45000
51.37 Jejunostomy Photograph

197 S6.7.2 Cholecystectomy CT , USG 15000
51.22 Photograph
51.2
Gb+ Calculi Cbd Stones CBD , ERClinical Biopsy , Clinical
51.22 198 S6.7.3 25000
Or Dilated Cbd Photograph , USG Photograph
51.4
Biopsy , Clinical
51.23 199 S6.7.4 Lap.Cholecystectomy CT , USG 30000
Photograph
Biopsy , Clinical
51.37 200 S6.7.5 Hepatico Jejunostomy Biopsy , CT-Scan 45000
Photograph
Choledochoduodenostom
Biopsy , Clinical
51.39 201 S6.7.6 y Or Choledocho CT , USG 35000
Photograph
Jejunostomy
S6.8 SPLEEN
Clinical
41.5 202 S6.8.1 Splenectomy CT , USG 35000 Photograph ,
USG
137
ICD ICD POST_
CODE CODE EVIDENCE
Splenectomy +
203 S6.8.2 Devascularisation + CT , USG 60000
39.1 Photograph
Spleno Renal Shunt
Clinical
Spleenectomy For Space
41.5 204 S6.8.3 CT , USG 35000 Photograph ,
Occupying Lesion
USG
S6.9 PANCREAS
CT-Scan , ERCP ,
Lap- Pancreatic ERClinical Biopsy , Clinical
577 52.9 205 S6.9.1 100000
Necrosectomy Photograph , Photograph
Endoscopy
CT-Scan , ERCP ,
Lateral
ERClinical Biopsy , Clinical
52.96 206 S6.9.2 Pancreaticojejunostomy( 100000
Photograph , Photograph
Non- Malignant)
Endoscopy
CT-Scan , ERCP ,
Pancreatic Necrosectomy ERClinical Biopsy , Clinical
52.9 207 S6.9.3 100000
(Open) Photograph , Photograph
Endoscopy
CT-Scan , ERCP ,
52.52 Distal Pancreatectomy + ERClinical Biopsy , Clinical
208 S6.9.4 100000
41.5 Splenectomy Photograph , Photograph
Endoscopy
138
ICD ICD POST_
CODE CODE EVIDENCE
CT-Scan , ERCP ,
52.5 ERClinical Biopsy , Clinical
209 S6.9.5 Central Pancreatectomy 100000
52.59 Photograph , Photograph
Endoscopy
Biopsy , Clinical
52.4 210 S6.9.7 Cysto Jejunostomy CT , USG 40000
Photograph
Biopsy , Clinical
52.4 211 S6.9.8 Cysto Gastrostomy CT , USG 40000
Photograph
53 S6.10 HERNIA
551.3
53.7 Diaphragmatic Hernia Ba.Study , CXR , Biopsy , Clinical
552.3 212 S6.10.1 40000
53.8 (Gortex Mesh Repair) Endoscopy , USG Photograph
553.3
S6.11 LIVER SURGERIES
155
155.0
CT , ERClinical Clinical
155.1 50.3 213 S6.11.1 Rt.Hepatectomy 75000
Photograph , USG Photograph
197.7
230.8
139
ICD ICD POST_
CODE CODE EVIDENCE
155
155.0
155.1 50.3 214 S6.11.2 Lt.Hepatectomy 75000
197.7
230.8
211.5 50.3 215 S6.11.3 Segmentectomy 50000
PANCREATIC
S6.12
SURGERIES
52.5 Clinical
211.6 216 S6.12.1 Distal Pancreatectomy CT , ERCP 100000
52.52 Photograph
Clinical
577 52.22 217 S6.12.2 Enucleation Of Cyst CT 75000
Photograph
Clinical
577 52.7 218 S6.12.3 Whipples Any Type CT , ERCP 75000
Photograph
Clinical
577 219 S6.12.4 Triple Bypass CT 25000
Photograph
Clinical
577 220 S6.12.5 Other Bypasses CT 25000
Photograph
140
ICD ICD POST_
CODE CODE EVIDENCE
S7 CARDIAC AND CARDIOTHORACIC SURGERY

CARDIAC INTERVENTIONS /
S7.1
PROCEDURES
Coronary Balloon
36.09 221 S7.1.1.1 2 CAD 60000 X-RAY
Angioplasty
36.09
00.45 222 S7.1.1.2 Ptca Additional Stent CAG 20000 X-RAY
00.48
S7.1.2 ASD AND VSD

2D ECHO , X-
35.51 223 S7.1.2.1 Asd Device Closure 2D ECHO 80000
RAY
2D ECHO , X-
35.53 224 S7.1.2.2 Vsd Device Closure 2D ECHO 80000
RAY
PATENT DUCTUS
S7.1.3
ARTERIOUSUS
225 S7.1.3.1 Pda Stenting 2D ECHO 65000 2D ECHO
226 S7.1.3.2 Device Closure 2D ECHO 60000 2D ECHO
S7.1.3.3 COIL CLOSURE
227 S7.1.3.3.1 Single Coil - 20000 -
228 S7.1.3.3.2 Multiple Coils - 30000 -
141
ICD ICD POST_
CODE CODE EVIDENCE
BALLOON
S7.1.4
PROCEDURES
35.0 229 S7.1.4.1 Balloon Valvotomy 2D ECHO 20000 2D ECHO
Balloon Atrial
35.41 230 S7.1.4.2 2D ECHO 30000 2D ECHO
Septostomy
PACEMAKER
S7.1.5
IMPLANTION
37.8 Permanent Pacemaker

231 S7.1.5.1 CAG , ECG 75000 ECHO , X-RAY
37.80 Implantation
Temporary Pacemaker
37.8 232 S7.1.5.2 CAG , ECG 10000 ECHO , X-RAY
Implantation
S7.1.6 COARACTATION OF AORTA REPAIR/AORTOPLASTY
233 S7.1.6.1 With Stent 2D ECHO , CAG 80000 DOPPLER
234 S7.1.6.2 Without Stent Aortogram 30000 DOPPLER
S7.1.7 ANGIOPLASTY
DOPPLER , X-
39.50 235 S7.1.7.1 Renal Angioplasty ANGIOGRAM 60000
RAY
2D ECHO ,
39.50 236 S7.1.7.2 Peripheral Angioplasty 60000 DOPPLER
ANGIOGRAM
0.61 237 S7.1.7.3 Vertebral Angioplasty ANGIOGRAM 75000 DOPPLER
142
ICD ICD POST_
CODE CODE EVIDENCE
DOPPLER , X-
238 S7.1.7.4 Additional Stent ANGIOGRAM 40000
RAY
S7.2 CARDIOTHORACIC AND VASCULAR SURGERIES
S7.2.1 SURGERY FOR CAD
Clinical
410 36.1 239 S7.2.1.1 Coronary Bypass Surgery CAG 95000
Photograph
Coronary Bypass Clinical

410 36.1 240 S7.2.1.2 POST PTCA-CAG 105000
Surgery-Post Angioplasty Photograph
36.1 Clinical
410 241 S7.2.1.3 Cabg With Iabp Pump 2D ECHO , CAG 125000
37.61 Photograph
Cabg With Aneurismal Clinical

414.11 242 S7.2.1.4 CAG 110000
Repair Photograph
INTRACARDIAC
S7.2.2.1
TUMORS
Clinical
Surgery For Intracardiac
243 S7.2.2.1 2D ECHO , CAG 75000 Photograph ,
Tumors
ECHO , HPE
143
ICD ICD POST_
CODE CODE EVIDENCE
S7.2.3 SINUS OF VALSALVA
Clinical
Ruptured Sinus Of
244 S7.2.3.1 CAG 95000 Photograph ,
Valsulva Correction
ECHO
S7.2.4 TAPVC
Clinical
35.82 245 S7.2.4.1 Tapvc Correction 2D ECHO 95000 Photograph ,
ECHO
S7.2.5 TOF
Systemic Pulmonary
246 S7.2.5.1.1 2D ECHO 20000 2D ECHO
Shunts With Graft
Systemic Pulmonary
247 S7.2.5.1.2 2D ECHO 20000 2D ECHO
Shunts Without Graft
Clinical
Total Correction Of
745.2 35.81 248 S7.2.5.2 2D ECHO 95000 Photograph ,
Tetralogy Of Fallot
ECHO
S7.2.6 ASD AND VSD
35.5
Intra Cardiac Repair Of
745.5 35.6 249 S7.2.6.1 2D ECHO 75000 2D ECHO
Asd
35.7
144
ICD ICD POST_
CODE CODE EVIDENCE
35.5
Intracardiac Repair Of
745.4 35.6 250 S7.2.6.2 2D ECHO 75000 2D ECHO
Vsd
35.7
PATENT DUCTUS
S7.2.7
ARTERIOUSUS
747.83 251 S7.2.7.1 Surgery-Pda 2D ECHO 20000 2D ECHO
ROSS PROCEDURE INTRACARDIAC REPAIR OF COMPLEX
S7.2.8
CONGENITAL HEART DISEASES
35.92
35.93 252 S7.2.8.1 With Special Conduits 2D ECHO 125000 2D ECHO
35.94
253 S7.2.8.2 Without Special Conduits 2D ECHO 95000 2D ECHO
S7.2.9 VALVE REPAIRS

254 S7.2.9.1 With Prosthetic Ring 2D ECHO 100000 ECHO
255 S7.2.9.2 Without Prosthetic Ring 2D ECHO 85000 ECHO , X-RAY
Open Pulmonary
746.83 35.1 256 S7.2.9.3 2D ECHO 75000 2D ECHO
Valvotomy
746 35.02 257 S7.2.9.4 Closed Mitral Valvotomy 2D ECHO 20000 2D ECHO
145
ICD ICD POST_
CODE CODE EVIDENCE
746 35.1 258 S7.2.9.5 Mitral Valvotomy (Open) 2D ECHO 80000 2D ECHO
VALVE
S7.2.10
REPLACEMNT
35.2 Mitral Valve

2D ECHO , X-
394 35.23 259 S7.2.10.1 Replacement (With 2D ECHO 120000
RAY
35.24 Valve)
35.2 Aortic Valve

3D ECHO , X-
RAY
35.22 Valve)
35.2
Tricuspid Valve 4D ECHO , X-
397 32.27 261 S7.2.10.3 2D ECHO 120000
Replacement RAY
35.28
Double Valve
5D ECHO , X-
RAY
Valve)
S7.2.11 PERICARDIUM
37.12 263 S7.2.11.1 Pericardiostomy 2D ECHO 10000 2D ECHO
37.31 264 S7.2.11.2 Pericardiectomy 2D ECHO 30000 2D ECHO
146
ICD ICD POST_
CODE CODE EVIDENCE
37.0 265 S7.2.11.3 Pericardiocentesis 2D ECHO 2000 2D ECHO
COARCTATION-
S7.2.12
AORTA REPAIR
39.31 Coarctation-Arota Repair

266 S7.2.12.1 2D ECHO , CAG 32000 DOPPLER
39.5 With Graft
39.31
Coarctation-Arota Repair
39.56 - 267 S7.2.12.2 2D ECHO , CAG 25000 DOPPLER
Without Graft
39.58
S7.2.13 AORTA REPAIR
Aneurysm Resection &
414 38.4 268 S7.2.13.1 2D ECHO , CAG 125000 DOPPLER
Grafting
Intrathoracic Aneurysm -
414 269 S7.2.13.2 Aneurysm Not Requiring CT-Angio , Cath 65000 DOPPLER
Bypass (With Graft)
Intrathoracic Aneurysm -
414 270 S7.2.13.3 Requiring Bypass (With CT-Angio , Cath 125000 DOPPLER
Graft)
414.12 39.54 271 S7.2.13.4 Dissecting Aneurysms CT-Angio , Cath 75000 DOPPLER
147
ICD ICD POST_
CODE CODE EVIDENCE
Annulus Aortic Ectasia DOPPLER ,

272 S7.2.13.5 angio 150000
With Valved Conduits ECHO
AORTA-AORTO
S7.2.14
BYPASS
Aorto-Aorto Bypass With

273 S7.2.14.1 angio 60000 DOPPLER
Graft
Aorto-Aorto Bypass
274 S7.2.14.2 angio 45000 DOPPLER
Without Graft
FEMORO-POPLITIAL
S7.2.15
BYPASS
Femoro- Poplitial Bypass

39.29 275 S7.2.15.1 angio 45000 DOPPLER
With Graft
Femoro- Poplitial Bypass

276 S7.2.15.2 angio 30000 DOPPLER
Without Graft
FEMORO-ILEAL
S7.2.16
BYPASS
277 S7.2.16.1 With Graft angio 45000 DOPPLER
278 S7.2.16.2 Without Graft angio 25000 DOPPLER
148
ICD ICD POST_
CODE CODE EVIDENCE
FEMORO-FEMORAL
S7.2.17
BYPASS
Femoro-Femoral Bypass
39.29 279 S7.2.17.1 angio 45000 DOPPLER
With Graft
Femoro-Femoral Bypass
280 S7.2.17.2 angio 25000 DOPPLER
Without Graft
S7.2.18 TGA
281 S7.2.18.1 Arterial Switch 2D ECHO , angio 150000 2D ECHO
35.91 282 S7.2.18.2 Sennings Procedure 2D ECHO , angio 120000 2D ECHO
S7.2.19.1 TGA
DOPPLER , X-
38.0 283 S7.2.19.1 Carotid Embolectomy ANGIOGRAM 50000
RAY
S7.3 LUNGS
Clinical
32.5 284 S7.3.1 Pneumonectomy CT-Chest , X-RAY 50000 Photograph , X-
RAY
Clinical
32.4 285 S7.3.2 Lobectomy CT-Chest , X-RAY 50000 Photograph , X-
RAY
Clinical
35.41 286 S7.3.3 Decortication CT-Chest , X-RAY 50000 Photograph , X-
RAY
149
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
32.2 287 S7.3.4 CT-Chest , X-RAY 50000
Photograph , X-
lung cyst
RAY
Clinical
34.3 288 S7.3.5 CT-Chest , X-RAY 50000 Photograph , X-
Sol Mediastinum
RAY
S7.3.6 SURGICAL CORRECTION OF BRONCHOPLEURAL FISTULA.
Clinical
33.54 289 S7.3.6.1 Thorocoplasty CT-Chest , X-RAY 50000 Photograph , X-
RAY
Clinical
83.87 290 S7.3.6.2 Myoplasty CT-Chest , X-RAY 50000 Photograph , X-
RAY
Clinical
34.73 291 S7.3.6.3 Transpleural Bpf Closure CT-Chest , X-RAY 50000 Photograph , X-
RAY
S7.4 CHEST SURGERY
Surgical Management of
53.7 BARIUM STUDIES
292 S7.4.1 Diaphragmatic 40000 USG
53.8 , CT-Scan
Eventeration
53.7 Surgical Management of

293 S7.4.2 CT-Scan , USG 40000 USG
53.8 Diaphragmatic Hernia
150
ICD ICD POST_
CODE CODE EVIDENCE
BARIUM STUDIES
42.7 294 S7.4.3 Oesophageal Diverticula 40000 USG
, CT-Scan
/Achalasia Cardia
S7.5 SURGICAL MANAGEMENT OF DIAPHRAGMATIC INJURIES
Surgical Management of Clinical
34.8 295 S7.5.1 Thoracotomy, Thoraco CT-Scan 40000 photograph with
Abdominal Approach operative scars
S7.6 SURGICAL MANAGEMENT OF BRONCHIAL INJURIES/FB
Bronchoscopy , CT- Endoscopy
33.78 296 S7.6.1 Foreign Body Removal 20000
Scan picture
With Scope
Surgical Management Bronchoscopy , CT- Endoscopy
297 S7.6.2 40000
For Injuries Due To Fb Scan picture
S7.8 SURGICAL MANAGEMENT OF OESOPHAGEAL INJURY/FB
Gastro Study Followed
By Thoracotomy & Endoscopy
298 S7.8.1 Gastroscopy 50000
Repairs For Oesophageal picture
Injury For Corrosive
Injuries/Fb
151
ICD ICD POST_
CODE CODE EVIDENCE
S7.9 SURGICAL MANAGEMENT OF VASCULAR INJURY
Clinical
Surgery Without Graft ANGIOGRAM ,
39.3 299 S7.9.1 10000 photograph with
For Arterial Injuries DOPPLER
operative scars
Venous Injuries
Vascular Injury In Upper
Limbs - ANGIOGRAM ,
39.3 300 S7.9.1.1 - 40000
Axillary,Branchial,Radial Color Doppler
And Ulnar -With Vein
Graft
ANGIOGRAM ,
39.3 301 S7.9.1.2 Major Vascular Injury -In - 60000
Color Doppler
Lower Limbs
ANGIOGRAM ,
39.3 302 S7.9.1.3 Minor Vascular Injury - - 20000
Color Doppler
Tibial Vessels In Leg
ANGIOGRAM ,
39.3 303 S7.9.1.4 Minor Vascular Injury - - 20000
Color Doppler
Vessels In Foot
152
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
Surgical Management of ANGIOGRAM ,
39.58 304 S7.9.2 15000 photograph with
Surgery With Vein Graft DOPPLER
operative scars
Clinical
Surgical Management of ANGIOGRAM ,
305 S7.9.3 40000 photograph with
With Prosthetic Graft DOPPLER
operative scars
ANGIOGRAM ,
306 S7.9.4 Neck Vascular Injury - 100000 -
Color Doppler
Carotid Vessels
Abdominal Vascular ANGIOGRAM ,
307 S7.9.6 100000 Color Doppler
Injuries - Aorta, Illac Color Doppler
Arteries, Ivc, Iliac Veins
ANGIOGRAM ,
308 S7.9.7 Thoracic Vascular 150000 Color Doppler
Color Doppler
Injuries
S7.10 CARDIAC INJURES
309 S7.10.1 Surgery Without Cpb 2D ECHO 40000 2D ECHO
310 S7.10.2 Surgery With Cpb 2D ECHO 75000 2D ECHO
153
ICD ICD POST_
CODE CODE EVIDENCE
S7.11 VASCULAR SURGERIES
Peripheral Embolectomy ANGIOGRAM ,

444 38.0 311 S7.11.1 25000 Color Doppler
Without Graft Spiral CT Angiogram
Aorto Billiac - Bifemoral

ANGIOGRAM ,
440 39.25 312 S7.11.2 Bypass With Synthetic 125000 Color Doppler
Spiral CT Angiogram
Graft
Axillo Bifemoral Bypass ANGIOGRAM ,

440 39.29 313 S7.11.3 100000 Color Doppler
With Synthetic Graft Spiral CT Angiogram
Femoro Distal Bypass ANGIOGRAM ,

440 314 S7.11.4 60000 Color Doppler
With Vein Graft Spiral CT Angiogram
Femoro Distal Bypass ANGIOGRAM ,

445 315 S7.11.5 80000 Color Doppler
Axillo Brachial Bypass

ANGIOGRAM ,
445 39.29 316 S7.11.6 Using With Synthetic 65000 Color Doppler
Spiral CT Angiogram
Graft
Brachio - Radial Bypass ANGIOGRAM ,

445 39.29 317 S7.11.7 50000 Color Doppler
154
ICD ICD POST_
CODE CODE EVIDENCE
Excicion Of Carotid Body

ANGIOGRAM ,
39.8 318 S7.11.8 Tumor With Vascular 60000 Color Doppler
Spiral CT Angiogram
Repair
Carotid Artery Bypass ANGIOGRAM ,

433.1 39.9 319 S7.11.9 100000 Color Doppler
Excision Of Arterio
MRI Angiogram ,
747.6 747.6 320 S7.11.10 Venous Malformation - 75000 Color Doppler
Spiral CT Angiogram
Large
Excision Of Arterio
MRI Angiogram ,
747.6 38.6 321 S7.11.11 Venous Malformation - 40000 Color Doppler
Spiral CT Angiogram
Small
ANGIOGRAM , ANGIOGRAM ,
444 38.0 322 S7.11.12 Arterial Embolectomy 20000
Color Doppler PVR , SBP
447 39.27 323 S7.11.13 A V Fistula At Wrist Color Doppler 10000 Color Doppler
447 39.27 324 S7.11.14 A. V Fistula At Elbow Color Doppler 20000 Color Doppler
Plain X-Ray
453 38.7 325 S7.11.15 D V T - Ivc Filter Color Doppler 100000
Abdomen
448 ANGIOGRAM ,
326 S7.11.16 Vascular Tumors 40000 Color Doppler
228 Spiral CT Angiogram
155
ICD ICD POST_
CODE CODE EVIDENCE
39.51 Small Arterial Aneurysms ANGIOGRAM ,

442 327 S7.11.17 15000 Color Doppler
39.52 - Repair Spiral CT Angiogram
39.51 Medium Size Arterial ANGIOGRAM ,

442 328 S7.11.18 50000 Color Doppler
39.52 Aneurysms - Repair Spiral CT Angiogram
Medium Size Arterial

ANGIOGRAM ,
442 38.4 329 S7.11.19 Aneurysms With 75000 Color Doppler
Spiral CT Angiogram
Synthetic Graft
S8 PEDIATRIC SURGERIES
S8.1 PAEDIATRIC CONGENITAL MALFORMATIONS
S8.1.1 GI TRACT
31.73 330 S8.1.1 - 60000 -
750.3 Oesophageal Atresia
750.4 53.7 Surgical Management of

331 S8.1.2 - 60000 -
750.3 53.8 Diaphragmatic Hernia
750.5 45.3 Surgical Management of

751.1 45.9 332 S8.1.3 Intestinal Atresias & - 50000 -
751.2 Obstructions
156
ICD ICD POST_
CODE CODE EVIDENCE
51.6
751.61 333 S8.1.4 Biliary Atresia & - 55000 -
51.37
Choledochal Cyst
751.2 334 S8.1.5 Anorectal Malformations - 45000 -
Stage 1
335 S8.1.6 Anorectal Malformations - 60000 -
Stage 2
751.3 48.65 336 S8.1.7 Hirschprungs Disease - 45000 -
Stage1
751.3 48.65 337 S8.1.8 Hirschprungs Disease - 60000 -
Stage 2
S8.2 UROGENITAL
753.21 338 S8.2.1 Congenital - 50000 -
Hydronephrosis
157
ICD ICD POST_
CODE CODE EVIDENCE
56.5
753.4 339 S8.2.2 - 65000 -
56.7 Ureteric Reimplantations
56.71
753.5 57.86 340 S8.2.3.1 - 65000 -
Extrophy Bladder Stage 1
57.86 341 S8.2.3.2 - 60000 -
Extrophy Bladder Stage 2
753.8 58.39 342 S8.2.4 - 30000 -
Posterior Urethral Valves
753.6 58.45 343 S8.2.5 - 40000 -
Hypospadias Single Stage

Hypospadias Stage1 Photograph
158
ICD ICD POST_
CODE CODE EVIDENCE
753.6 58.45 345 S8.2.6.2 - 35000 -
Hypospadias Stage 2
S8.3 PEDIATRIC TUMOURS
204-208
191
192
194
189 346 S8.3.1 Biopsy , CT 50000
Paediatric Tumors Photograph
202
171
190.5
170.9
S8.4 PLASTIC REPAIR

27.54 347 S8.4.1 - 10000 -
Cleft Lip
27.62 348 S8.4.2 - 15000 -
Cleft Palate
159
ICD ICD POST_
CODE CODE EVIDENCE
528.9 349 S8.4.3 Velo-Pharyngeal - 15000 -
Incompetence
755.1 86.85 350 S8.4.4 Syndactyly Of Hand For - 15000 -
Each Hand
18.7 351 S8.4.5 - 30000 -
Microtia/Anotia

352 S8.4.6 - 40000 -
718.5 Tm Joint Ankylosis
S8.5 CONGENITAL MALFORMATIONS
Surgical Management of IVP , Renogram , Clinical

747.9 353 S8.5.1 20000
Hamartoma Excision USG Photograph , IVP
Surgical Management of Clinical Photograph , Clinical

228 354 S8.5.2 25000
Hemangioma Excision USG Photograph , IVP
40.29 355 S8.5.3 - 40000 -
Lymphangioma Excision
160
ICD ICD POST_
CODE CODE EVIDENCE
S8.6 HEAD AND NECK

Clinical
194 356 S8.6.1 CT/USG/FNAC 25000 Photograph/Biop
Neuroblastoma
sy

357 S8.6.2 - 30000 -
473.9 Congenital Dermal Sinus
759.2
744.42
358 S8.6.3 Cystic Lesions Of The - 20000 -
709.8
Neck
228.00
2.1 359 S8.6.4 - 20000 -
Encephalocele
759.2
744.42
360 S8.6.5 Sinuses & Fistula Of The - 20000 -
709.8
Neck
228.00
S8.7 CHEST
Bronchoscopy for Foreign Clinical
Body Removal Photograph
161
ICD ICD POST_
CODE CODE EVIDENCE
Surgical Correction of -
Clinical
362 S8.7.2 Paediatric Esophageal Clinical Photograph 30000
Photograph
Obstructions
Clinical
363 S8.7.3 Paediatric Esophageal Endoscopy 60000
Photograph
Substitutions
Excision of Clinical
Thoracoscopic Cysts Photograph
Thoracoscopic Clinical
Decortication Photograph
Surgical Correction of - Clinical Photograph , Clinical

366 S8.7.6 40000
Thoracic Duplications X-RAY Photograph
34.4 367 S8.7.7 - 50000 -
Thoracic Wall Defects
S8.8 ABDOMEN
CT , Clinical Clinical
43.3 368 S8.8.1 Gastric Outlet 30000
Obstructions
162
ICD ICD POST_
CODE CODE EVIDENCE
44.66 Surgical Correction of Clinical

369 S8.8.2 CT , Neuro USG 30000
44.67 Gastro Esophageal Reflux Photograph
Surgical Correction of
Clinical
122.9 370 S8.8.3 Hydatid Cysts In CT , Neuro USG 40000
Photograph
Paediatric Patient
45.4 371 S8.8.4 - 50000 -
Intestinal Polyposis
46.8 372 S8.8.5 - 40000 -
Intususception
46.99 373 S8.8.6 Paediatric Acute - 40000 -
Intestinal Obstruction
Laparoscopic
47.01 374 S8.8.7 - 25000 -
Appendicectomy
Laparoscopic
51.23 375 S8.8.8 - 40000 -
Choleycystectomy
Laparoscopic Pull
751.5 376 S8.8.9 Through For Ano Rectal - 60000 -
Anomalies
163
ICD ICD POST_
CODE CODE EVIDENCE
Laparoscopic Pull
377 S8.8.10 - 60000 -
Through Surgeries For Hd
Paediatric Splenectomy
41.5 378 S8.8.11 - 35000 -
(Non Traumatic)
7.0
Surgeries On Adrenal
7.2 379 S8.8.12 - 25000 -
Gland In Children
7.3
S8.9 GENITO URINARY SYSTEM

Biopsy , Clinical
55.5 380 S8.9.1 Nephrectomy CT , FNAC , USG 40000
Photograph
Surgical Correction of Biopsy , Clinical
58.45 381 S8.9.2 CT , Neuro USG 40000
Epispadiasis Photograph
CT- Clinical
752.81 61.49 382 S8.9.3 Photograph , MRI , 20000
Scrotal Transposition Photograph
USG
62.5 383 S8.9.4 CT , Neuro USG 25000
Undescended Testis Photograph
Surgical Correction of CT , Clinical Biopsy , Clinical

63.52 384 S8.9.5 25000
Torsion Testis Photograph Photograph
164
ICD ICD POST_
CODE CODE EVIDENCE
Laparoscopic
62.5 385 S8.9.6 - 25000 -
Orchidopexy
Laparoscopic Varicocele
63.1 386 S8.9.7 - 25000 -
Ligation
S9 GENITO URINARY SURGERIES
S9.1 RENAL TRANSPLANTATION
A.V. Fistula(Pre- RenalFunction Test , Clinical
39.27 387 S9.1.1 10000
Transplant Procedure S.Electrolytes Photograph
Only)
Renal Transplantation Clinical

55.6 388 S9.1.2 RFT , USG 140000
Surgery Photograph
Post Transplant
Immunosuppressive
v58.65 389 S9.1.3 Treatment From 1st To RFT , USG 50000 Bills Copy
6th Month After
Transplantation
165
ICD ICD POST_
CODE CODE EVIDENCE
S9.2 SURGERY FOR RENAL CALCULI

Clinical
53.1
592 390 S9.2.1 Open Pyelolithotomy IVP , KUB , USG 10000 Photograph ,
55.11
USG , X-RAY
Clinical
55.1
592 391 S9.2.2 Open Nephrolithotomy IVP , KUB , USG 10000 Photograph ,
55.01
USG , X-RAY
Clinical
592 57.19 392 S9.2.3 Open Cystolithotomy IVP , KUB , USG 10000 Photograph ,
USG , X-RAY
Clinical
55.1 Laparoscopic
592 393 S9.2.4 USG 30000 Photograph , X-
55.11 Pyelolithotomy
RAY
Anatrophic Clinical
55.1
394 S9.2.5 Peylolithotomy For IVP , KUB , USG 50000 Photograph ,
55.11
Staghorn Caliculus USG , X-Ray
S9.3 LITHOTRIPSY PROCEDURES

Clinical
592 57 395 S9.3.1 Cystolithotripsy IVP , KUB , USG 10000 Photograph ,
USG , X-RAY
Clinical
592 55.04 396 S9.3.2 Pcnl IVP , KUB , USG 30000 Photograph , X-
RAY
166
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
592 98.5 397 S9.3.3 Eswl IVP , KUB , USG 20000 Photograph , IVP
, X-RAY
Clinical
594 56 398 S9.3.4 Ursl IVP , KUB , USG 25000 Photograph , X-
RAY
Clinical
997.5 55.02 399 S9.3.5 Nephrostomy IVP , USG 2000
Photograph
59.8 400 S9.3.6 Dj Stent (One Side) IVP , USG 5000 X-RAY
S9.4 OTHER CORRECTIVE SURGERIES/PROCEDURES

Clinical
401 S9.4.1.1 Single Stage RUG 50000
Photograph
S9.4.1.2 DOUBLE STAGE
Clinical
402 S9.4.1.2.1 Stage-1 RUG 30000
Photograph
Clinical
403 S9.4.1.2.2 Stage-2 RUG 30000
Photograph
404 S9.4.2 Reconstruction Procedure Photo 50000 Photo
S9.4.3 HYPOSPADIASIS (ADULT)

Clinical
405 S9.4.3.1 Single Stage Clinical Photograph 40000
Photograph
167
ICD ICD POST_
CODE CODE EVIDENCE
S9.4.3.2 DOUBLE STAGE

Clinical
406 S9.4.3.2.1 Stage-1 Clinical Photograph 35000
Photograph
Clinical
407 S9.4.3.2.2 Stage-2 Clinical Photograph 35000
Photograph
Clinical
57.4 408 S9.4.4 Turbt CT 30000
Photograph
585.5
55.6 S9.5 RENAL TRANSPLANTATION
585.6
Post Transplant
Immunosuppressive
v58.65 409 S9.5.1 Treatment From 7th To RFT , USG 50000 Bills Copy
12 Th Month After
Transplantation
S9.6 RENAL
55.02 410 S9.6.1 Nephrostomy IVP , USG 10000 USG
Nephrectomy
55.5 411 S9.6.2 IVP , USG 40000 USG
Pyonephrosis/Xgp
55.5 412 S9.6.3 Simple Nephrectomy IVP , USG 40000 USG
55.5 413 S9.6.4 Lap. Nephrectomy Simple IVP , USG 30000 USG
168
ICD ICD POST_
CODE CODE EVIDENCE
55.5
07.21
07.3 Lap. Nephrectomy
414 S9.6.5 IVP , USG 40000 USG
40.3 Radical
40.52
40.59
54.5 415 S9.6.6 Lap. Partial Nephrectomy IVP , USG 35000 USG
Bilateral
55.51 416 S9.6.7 IVP , USG 25000 USG
Nephroureterectomy
55.91 417 S9.6.8 Renal Cyst Excision IVP , USG 15000 USG
S9.7 RENAL STONE SURGERY/THERAPIES
Endoscope Removal Of IVP , Scopy , USG , Endoscopy
57.0 418 S9.7.1 10000
Stone In Bladder X-Ray KUB Picture
S9.8 CORRECTIVE SURGERIES

Anderson Hynes Clinical
55.87 419 S9.8.1 IVP , USG , X-RAY 40000
Pyeloplasty Photograph
169
ICD ICD POST_
CODE CODE EVIDENCE

51.84 420 S9.8.2 IVP , Scopy , rgp 40000
Vasico Vaginal Fistula Photograph
Clinical
58.45 421 S9.8.3 Epispadiasis - Correction Clinical Photograph 40000
Photograph
Closure Of Urethral Clinical

58.43 422 S9.8.4 RGU 25000
Fistula Photograph
Endoscopy
58.5 423 S9.8.5 Optical Urethrotomy RGU , X-RAY 20000
Picture
Endoscopy
58 424 S9.8.6 Perineal Urethrostomy RGU , X-RAY 20000
Picture
56.5
56.6 425 S9.8.7 Ureteric Reimplantation IVP , USG , X-RAY 25000 USG
56.7
Clinical
56.5 426 S9.8.8 Ileal Conduit Formation IVP , USG , X-RAY 20000
Photograph
56.4 Clinical
427 S9.8.9 Ureterocele RGU , X-RAY 15000
56.41 Photograph
S9.9 BLADDER AND PROSTATE
60.2 Transurethral Resection
428 S9.9.1 U.scopy , USG 30000 USG
60.29 Of Prostate (Turp)
170
ICD ICD POST_
CODE CODE EVIDENCE
60.2
60.29 429 S9.9.2 Turp Cyst Lithotripsy USG , X-RAY 30000 USG
57.0
60.3 Clinical
430 S9.9.3 Open Prostatectomy USG , X-RAY 30000
60.4 Photograph
57.87 431 S9.9.4 Caecocystoplasty U.scopy , USG 30000 USG
57.7 432 S9.9.5 Total Cystectomy U.scopy , USG 35000 USG
57.59
433 S9.9.6 Diverticulectomy U.scopy , USG 10000 USG
57.49
Incontinence Urine
788.3 434 S9.9.7 U.scopy , USG 20000 USG
(Female)
Incontinence Urine
788.3 435 S9.9.8 U.scopy , USG 20000 USG
(Male)
S9.10 TESTIS AND PENIS
Clinical
62.1 436 S9.10.1 Orchidopexy Bilateral USG 15000
Photograph
Clinical
63.52 437 S9.10.2 Torsion Testis USG 12000
Photograph
Clinical
64.4 438 S9.10.3 Chordee Correction USG 15000
Photograph
171
ICD ICD POST_
CODE CODE EVIDENCE
Partial Amputation Of Biopsy , Clinical

Penis(Non-Malignant) Photograph
Total Amputation Of Biopsy , Clinical

Penis(Non-Malignant) Photograph
S10 NEUROSURGERY
S10.1 BRAIN
Craniotomy And
1.59 Clinical
432.1 441 S10.1.1 Evacuation Of CT 60000
1.24 Photograph
Haematoma Subdural
Craniotomy And
1.2 Clinical
432 442 S10.1.2 Evacuation Of CT 60000
1.24 Photograph
Haematoma Extradural
Evacuation Of Brain Clinical

1.31 443 S10.1.3 CT 25000
Abscess-Burr Hole Photograph
Excision Of Lobe
Biopsy , Clinical
1.53 444 S10.1.4 (Frontal,Temporal,Cerebe CT 40000
Photograph
llum Etc.)
S10.1.5 EXCISION OF BRAIN TUMOUR

Biopsy , Clinical
445 S10.1.5.1 Parasagital CT 50000
Photograph
172
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
446 S10.1.5.2 Basal CT 60000
Photograph
Biopsy , Clinical
447 S10.1.5.3 Brain Stem CT 70000
Photograph
Biopsy , Clinical
4.01 448 S10.1.5.4 C P Angle CT 70000
Photograph
Biopsy , Clinical
449 S10.1.5.5 Others CT 40000
Photograph
Excision Of Brain Biopsy , Clinical
225 1.6 450 S10.1.11 CT 45000
Tumors Subtentorial Photograph
02.3 Ventriculoatrial /
Clinical
02.32 451 S10.1.12 Ventriculoperitoneal CT 20000
Photograph
02.34 Shunt
Clinical
432 452 S10.1.13 Twist Drill Craniostomy CT 15000
Photograph
Clinical
1.09 453 S10.1.14 Subdural Tapping CT 15000
Photograph
Clinical
454 S10.1.15 Ventricular Tapping CT 15000
Photograph
Clinical
455 S10.1.16 Abscess Tapping CT 20000
Photograph
Clinical
747.9 456 S10.1.17 Vascular Malformations MRI Angio 40000
Photograph
Clinical
2.24 457 S10.1.18 Peritoneal Shunt CT 20000
Photograph
173
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
2.32 458 S10.1.19 Atrial Shunt CT 20000
Photograph
02.1 Clinical
742 459 S10.1.20 Meningo Encephalocele MRI 25000
02.12 Photograph
Clinical
741.9 460 S10.1.21 Meningomyelocele MRI 25000
Photograph
Clinical
349.81 461 S10.1.22 C.S.F. Rhinorrhoea CT 20000
Photograph
CT , Clinical Clinical
0.2 462 S10.1.23 Cranioplasty 30000
Clinical
1.51 463 S10.1.24 Meningocele Excision MRI 25000
Photograph
02.3 Clinical
464 S10.1.25 Ventriculo-Atrial Shunt CT 20000
02.32 Photograph
Clinical
1.59 465 S10.1.26 Excision Of Brain Abcess CT 60000
Photograph
Clinical
39.51 466 S10.1.27 Aneurysm Clipping MRI Angio 100000 Photograph , X-
RAY
External Ventricular Clinical
2.3 467 S10.1.28 CT 40000
Drainage (Evd) Photograph
S10.2 SPINAL SURGERIES

174
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
3.4 468 S10.2.1 Surgery Of Cord Tumours MRI 25000
Photograph
80.5 Excision Of Cervical Clinical

469 S10.2.2 MRI 25000
80.51 Inter-Vertebral Discs Photograph
80.5 Posterior Cervical Clinical

470 S10.2.3 MRI 15000
80.51 Discectomy Photograph
80.5 Anterior Cervical Clinical

471 S10.2.4 MRI 15000
80.51 Discectomy Photograph
80.5
Anterior Cervical Spine MRI , X-Ray Cerical
80.51 472 S10.2.5 45000 X-RAY
Surgery With Fusion Spine
81.0
Clinical
Anterior Lateral
473 S10.2.6 MRI 30000 Photograph , X-
Decompression
RAY
Clinical
3.09 474 S10.2.7 Laminectomy MRI 25000 Photograph , X-
RAY
Clinical
80.51 475 S10.2.8 Discectomy MRI 25000 Photograph , X-
RAY
Clinical
81 476 S10.2.9 Spinal Fusion Procedure MRI 50000 Photograph , X-
RAY
175
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
Spinal Intra Medullary
3.4 477 S10.2.10 MRI 50000 Photograph , X-
Tumours
RAY
Clinical
Spina Bifida Surgery
Major
RAY
Clinical
Spina Bifida Surgery
Minor
RAY
S10.3 OTHER SURGERIES/PROCEDURES
Clinical
480 S10.3.1 Stereotactic Procedures - 20000
Photograph
227.3
194.3
7.14
7.62 481 S10.3.2 Trans Sphenoidal Surgery CT 20000
239.7 Photograph
7.65
253
255
Biopsy , Clinical
482 S10.3.3 Trans Oral Surgery CT 25000
Photograph
Combined Trans-Oral
MRI , X-Ray Cerical Clinical
483 S10.3.4 Surgery & Cv Junction 30000
Spine Photograph
Fusion
176
ICD ICD POST_
CODE CODE EVIDENCE
MRI , X-Ray Cerical Clinical

484 S10.3.5 C.V. Junction Fusion 20000
Spine Photograph
S10.4 BRAIN
Clinical
485 S10.4.1 Endoscopy Procedures MRI 65000
Photograph
De-Compressive
Clinical
1.2 486 S10.4.1.1 Craniectomy(Non - 50000
Photograph
Traumatic)
Intra-Cerebral Hematoma Clinical

1.39 487 S10.4.2 MRI 60000
Evacuation Photograph
Endoscopic Third Clinical

2.2 488 S10.4.3 - 30000
Ventriculostomy Photograph
S10.5 SPINE
Anterior Discectomy &
489 S10.5.1 MRI 40000 X-RAY
Bone Grafting
Discectomy With
84.6 490 S10.5.2 MRI 65000 X-RAY
Implants
Corpectomy For Spinal

491 S10.5.3 MRI 70000 X-RAY
Fixation
177
ICD ICD POST_
CODE CODE EVIDENCE
Spinal Fixation Rods And

492 S10.5.4 MRI 85000 X-RAY
Plates, Artificial Discs
Clinical
336 493 S10.5.5 Syringomyelia MRI 65000
Photograph
SOFT TISSUE AND VASCULAR
S10.6
SURGERIES
Repair Of Brachial Plexus Clinical
494 S10.6.1 MRI 60000
Injury Photograph
5.2 EMG , MRI , Nerve Clinical

495 S10.6.2 Cervical Sympathectomy 50000
5.22 conduction study Photograph
5.2 EMG , MRI , Nerve Clinical

496 S10.6.3 Lumbar Sympathectomy 50000
5.23 conduction study Photograph
4.4 Decompression/Excision Clinical

497 S10.6.4 MRI 65000
4.42 Of Optic Nerve Lesions Photograph
04.3 Peripheral Nerve Injury EMG , Nerve Clinical

498 S10.6.5 50000
04.5 Repair conduction study Photograph
Clinical
376.3 499 S10.6.6 Proptosis MRI 60000
Photograph
178
ICD ICD POST_
CODE CODE EVIDENCE
S10.7 EPILEPSY SURGERY

MRI-Video EEG
Clinical
1.53 500 S10.7.1 Temporal Lobectomy Psychologic 90000
Photograph
assesment
MRI-Video EEG
Clinical
1.59 501 S10.7.2 Lesionectomy Type 1 Psychologic 150000
Photograph
assesment
MRI-Video EEG
Clinical
1.59 502 S10.7.3 Lesionectomy Type 2 Psychologic 160000
Photograph
assesment
MRI-Video EEG Clinical
Temporal Lobectomy
1.53 503 S10.7.4 Psychologic 140000 Photograph , X-
Plus Depth Electrodes
assesment RAY
S10.8 MANAGEMENT OF TRIGEMINAL NEURALGIA
Radiofrequency Ablation EMG , Nerve Clinical

4.2 504 S10.8.1 30000
For Trigeminal Neuralgia Conduction Photograph
Microvascular
EMG , Nerve Clinical
4.41 505 S10.8.2 Decompression For 60000
Conduction Photograph
Trigeminal Neuralgia
S10.9 MANAGEMENT OF ANURYISMS
179
ICD ICD POST_
CODE CODE EVIDENCE
Embolization Of ANGIOGRAM , Clinical

39.53 506 S10.9.1 50000
Aneurysm MRI Angio Photograph
ANGIOGRAM , Clinical
507 S10.9.2 Cost Of Each Coil 30000
MRI Angio Photograph
S11 SURGICAL ONCOLOGY
S11.1 HEAD & NECK
Biopsy , Clinical
Composite Resection & Biopsy , Clinical
508 S11.1.1 Photograph , USG , 60000
Reconstruction Photograph
X-RAY
Biopsy , Clinical
Neck Dissection Any Biopsy , Clinical
40.4 509 S11.1.2 Photograph , USG , 25000
Type Photograph
X-RAY
Biopsy , Clinical
Biopsy , Clinical
25.2 510 S11.1.3 Hemiglossectomy Photograph , USG , 15000
Photograph
X-RAY
Biopsy , Clinical
145 511 S11.1.4 Maxillectomy Any Type Photograph , USG , 25000
76.39 Photograph
X-RAY
180
ICD ICD POST_
CODE CODE EVIDENCE

Biopsy , Clinical
06.4 512 S11.1.5 Thyroidectomy Any Type Photograph , USG , 20000
Photograph
06.5 X-RAY
Biopsy , Clinical
142 513 S11.1.6 Parotidectomy Any Type Photograph , USG , 20000
26.32 Photograph
X-RAY
30.1
Biopsy , Clinical
161 514 S11.1.7 Laryngectomy Any Type Photograph , USG , 40000
30.3 Photograph
X-RAY
30.4
Biopsy , Clinical
30.3 Laryngopharyngo Biopsy , Clinical
150 515 S11.1.8 Photograph , USG , 75000
42.4 Oesophagectomy Photograph
X-RAY
Biopsy , Clinical
Biopsy , Clinical
145 76.31 516 S11.1.9 Hemimandibulectomy Photograph , USG , 25000
Photograph
X-RAY
Biopsy , Clinical
Biopsy , Clinical
517 S11.1.10 Wide Excision Photograph , USG , 25000
Photograph
X-RAY
181
ICD ICD POST_
CODE CODE EVIDENCE
S11.2 GASTROINTESTINAL TRACT

Biopsy , Clinical
Oesophagectomy Any Biopsy , CT ,
42.4 518 S11.2.1 60000 Photograph ,
Type Endoscopy , USG
USG
43.5
Biopsy , CT ,
43.7 519 S11.2.2 Gastrectomy Any Type 40000 Photograph ,
Endoscopy , USG
43.8 USG
43.9
Biopsy , Clinical
Biopsy , CT ,
45.7 520 S11.2.3 Colectomy Any Type 40000 Photograph ,
Endoscopy , USG
USG
Biopsy , Clinical
Biopsy , CT ,
48.62 521 S11.2.4 Anterior Resection 50000 Photograph ,
Endoscopy , USG
USG
Biopsy , Clinical
Abdominoperinial Biopsy , CT ,
48.5 522 S11.2.5 40000 Photograph ,
Resection Endoscopy , USG
USG
Biopsy , Clinical
Biopsy , CT ,
52.7 523 S11.2.6 Whipples Any Type 75000 Photograph ,
Endoscopy , USG
USG
Biopsy , Clinical
Biopsy , CT ,
52.7 524 S11.2.7 Triple Bypass 25000 Photograph ,
Endoscopy , USG
USG
182
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
Biopsy , CT ,
52.9 525 S11.2.8 Other Bypasses-Pancreas 25000 Photograph ,
Endoscopy , USG
USG
S11.3 GENITO URINARY SYSTEM

Biopsy , CT , IVP ,
7.21-0.73 526 S11.3.1 Radical Nephrectomy 40000 Photograph ,
KUB , USG
40.3 USG
Biopsy , Clinical
Biopsy , CT , IVP ,
57.71 527 S11.3.2 Radical Cystectomy 60000 Photograph ,
KUB , USG
USG
Biopsy , Clinical
Biopsy , CT , IVP ,
57.6 528 S11.3.3 Other Cystectomies 40000 Photograph ,
KUB , USG
USG
Biopsy , Clinical
64.3 529 S11.3.4 Total Penectomy Clinical Photograph 25000 Photograph ,
USG
Biopsy , Clinical
64.3 530 S11.3.5 Partial Penectomy Clinical Photograph 15000 Photograph ,
USG
Biopsy , Clinical
Inguinal Block Dissection Biopsy , Clinical
40.54 531 S11.3.6 15000 Photograph ,
One Side Photograph
USG
Biopsy , Clinical
60.5 532 S11.3.7 Radical Prostatectomy CT , KUB , USG 60000 Photograph ,
USG
183
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
62.3
533 S11.3.8 High Orchidectomy Biopsy , USG 15000 Photograph ,
62.24
USG
Biopsy , Clinical
62.4 534 S11.3.9 Bilateral Orchidectomy Biopsy , USG 10000 Photograph ,
USG
Biopsy , Clinical
64.3
535 S11.3.10 Emasculation Biopsy , USG 30000 Photograph ,
62.1
USG
S11.4 GYNAECOLOGICAL ONCOLOGY
179
Biopsy , Clinical
180 71.5
536 S11.4.1 Hysterectomy Biopsy , CT , USG 25000 Photograph ,
182.0 71.6
USG
182.1
Biopsy , Clinical
180.0
68.6 537 S11.4.2 Radical Hysterectomy Biopsy , CT , USG 30000 Photograph ,
180.1
USG
Biopsy , Clinical
Surgery For Ca Ovary
183 65 538 S11.4.3 Biopsy , CT , USG 25000 Photograph ,
Early Stage
USG
Biopsy , Clinical
Surgery For Ca Ovary
183 65.0-65.6 539 S11.4.4 Biopsy , CT , USG 40000 Photograph ,
Advance Stage
USG
184
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
184.4 540 S11.4.5 Vulvectomy 15000 Photograph ,
71.6 Photograph
USG
Biopsy , Clinical
65.4
220 541 S11.4.6 Salpingo Oophorectomy Biopsy , CT , USG 25000 Photograph ,
65.6
USG
174 S11.5 TUMORS OF THE FEMALE BREAST
Biopsy , Clinical
Biopsy , Clinical
174 85.4 542 S11.5.1 Mastectomy Any Type Photograph , 25000
Photograph
Mammography
Biopsy , Clinical Biopsy , Clinical

174 40.51 543 S11.5.2 Axillary Dissection 15000
85.2 Biopsy , Clinical Biopsy , Clinical

217 544 S11.5.3 Wide Excision 5000
85.22 Photograph Photograph
85.2 Biopsy , Clinical Biopsy , Clinical

217 545 S11.5.4 Lumpectomy 3000
85.21 Photograph Photograph

174 85.7 546 S11.5.5 Breast Reconstruction 25000
185
ICD ICD POST_
CODE CODE EVIDENCE

34 547 S11.5.6 Chest Wall Resection 20000
S11.6 SKIN TUMORS
176
Skin Tumors Wide Biopsy , Clinical Biopsy , Clinical
172 86.4 548 S11.6.1 10000
Excision Photograph Photograph
216
176 86.4 Skin Tumorswide

172 86.6 549 S11.6.2 Excision + 20000
216 86.7 Reconstruction

86.9 550 S11.6.3 Skin Tumors amputation 20000
170-175 S11.7 SOFT TISSUE AND BONE TUMORS
213
214 77.6 Soft Tissue And Bone Biopsy , Clinical Biopsy , Clinical
551 S11.7.1 15000
215 83.49 Tumors Wide Excision Photograph Photograph
216
186
ICD ICD POST_
CODE CODE EVIDENCE
213 77.6
Soft Tissue And Bone
214 83.49 Biopsy , Clinical Biopsy , Clinical
552 S11.7.2 Tumors Wide Excision + 25000
215 76.44 Photograph Photograph
Reconstruction
216 77.7
77.9
215 Soft Tissue And Bone Biopsy , Clinical Biopsy , Clinical
76.45 553 S11.7.3 20000
213 Tumors Amputation Photograph Photograph
83.49
S11.8 LUNG CANCER

Biopsy , Clinical
162 Lung Cancer
32.5 554 S11.8.1 Biopsy , CT , X-RAY 50000
Photograph , X-
212.3 Pneumonectomy
RAY
Biopsy , Clinical
162
32.4 555 S11.8.2 Lung Cancer Lobectomy Biopsy , CT , X-RAY 50000 Photograph , X-
212.3
RAY
Biopsy , Clinical
511.9 34.51 556 S11.8.3 Decortication Biopsy , CT , X-RAY 50000 Photograph , X-
RAY
S11.8.4 SURGICAL CORRECTION OF BRONCHOPLEURAL FISTULA
Surgical Correction Of Biopsy , Clinical

34.73
510 557 S11.8.4.1 Bronchopleural Fistula. Biopsy , CT , X-RAY 50000 Photograph , X-
33.34
Thoracoplasty RAY
187
ICD ICD POST_
CODE CODE EVIDENCE

510 34.73 558 S11.8.4.2 Bronchopleural Fistula. Biopsy , CT , X-RAY 50000 Photograph , X-
Myoplasty RAY

510 559 S11.8.4.3 Bronchopleural Fistula. Biopsy , CT , X-RAY 50000 Photograph , X-
Transpleural Bpf Closure RAY
140-149 S11.9 CA.ORAL CAVITY

Marginal Clinical
76.4 560 S11.9.1 Orthopantomogram 25000
Mandibulectomy Photograph
Segmental CT , Clinical
76.4 561 S11.9.2 25000
Mandibulectomy Orthopantomogram Photograph
Total Glossectomy + Clinical

141 25.3 562 S11.9.3 CT 40000
Full Thickness Buccal

Clinical
27.49 563 S11.9.4 Mucosal Resection & Biopsy 50000
Photograph
Reconstruction
188
ICD ICD POST_
CODE CODE EVIDENCE
190
145
S11.10 SURGICAL MANAGEMENT OF CA.EYE/ MAXILLA /PARA NASAL SINUS
160
respectively
16.59 564 S11.10.1 CT 25000
Orbital Exenteration Photograph
Maxillectomy + Orbital Clinical

16.52 565 S11.10.2 CT 35000
Exenteration Photograph
Maxillectomy +
Clinical
16.51 566 S11.10.3 Infratemporal Fossa CT 40000
Photograph
Clearance
Clinical
567 S11.10.4 Cranio Facial Resection CT , MRI 70000
Photograph
147 S11.11 CA. NASOPHARYNX
Resection Of Biopsy , Clinical

29.3 568 S11.11.1 CT , MRI 50000
Nasopharyngeal Tumor Photograph
145 S11.12 CA.SOFT PALATE
Clinical
27.32 569 S11.12.1 Palatectomy Any Type CT 30000
Photograph
160 S11.13 CA. EAR
189
ICD ICD POST_
CODE CODE EVIDENCE
43.89
Clinical
32.1 570 S11.13.1 Sleeve Resection CT 25000
Photograph
18.79
Lateral Temporal Bone Clinical

76.39 571 S11.13.2 CT , MRI 30000
Subtotal Temporal Bone Clinical

76.39 572 S11.13.3 CT , MRI 50000
Total Temporal Bone Clinical

76.45 573 S11.13.4 CT , MRI 60000
142 S11.14 CA. SALIVARY GLAND
26.3 Submandibular Gland Biopsy , Clinical
26.32 Excision Photograph
193 S11.15 CA. THYROID
Biopsy , Clinical
31.5 575 S11.15.1 Tracheal Resection Bronchoscopy , CT 52000
Photograph
162 S11.16 CA. TRACHEA
Sternotomy + Superior Clinical
34.3 576 S11.16.1 CT 45000
Mediastinal Dissection Photograph
Biopsy , Clinical
31.5 577 S11.16.2 Tracheal Resection Bronchoscopy , CT 40000
Photograph
190
ICD ICD POST_
CODE CODE EVIDENCE
194 S11.17 CA. PARATHYROID
CT , Nuclear scan , Biopsy , Clinical
6.8 578 S11.17.1 Parathyroidectomy 30000
S.PTH Photograph
150 - 153 S11.18 CA. GASTRO INTESTINAL TRACT
Barium Meal Follow Biopsy , Clinical
45.3 579 S11.18.1 Small Bowel Resection 40000
Through , CT Photograph
Clinical
46.51 580 S11.18.2 Closure Of Ileostomy Colonoscopy 20000
Photograph
Clinical
46.52 581 S11.18.3 Closure Of Colostomy Colonoscopy 20000
Photograph
154 S11.19 CA.RECTUM
Abdomino Perineal
Biopsy , Clinical
48.5 582 S11.19.1 Resection (Apr) + BMFT , CT 50000
Photograph
Sacrectomy
Biopsy , Clinical
68.8 583 S11.19.2 Posterior Exenteration BMFT , CT 50000
Photograph
Biopsy , Clinical
68.8 584 S11.19.3 Total Exenteration BMFT , CT 75000
Photograph
156 S11.20 CA. GALL BLADDER
Biopsy , Clinical
51.2 585 S11.20.1 Radical Cholecystectomy CT 60000
Photograph
S11.21 SPLEEN
191
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
41.5 586 S11.21.1 Splenectomy CT 35000
Photograph
158 S11.22 SURGICAL MANAGEMENT OF RETROPERITONEAL TUMOR
Resection Of Biopsy , Clinical

54.4 587 S11.22.1 CT 45000
Retroperitoneal Tumors Photograph
171.5 S11.23 SURGICAL MANAGEMENT OF ABDOMINAL WALL TUMOR
Abdominal Wall Tumor Biopsy , Clinical

54.3 588 S11.23.1 CT 35000
Resection With Biopsy , Clinical

589 S11.23.2 CT 45000
S11.24 GYNAEC CANCERS
40.3 Bilateral Pelvic Lymph Biopsy , Clinical

590 S11.24.1 CT 25000
40.5 Node Dissection(Bplnd) Photograph
Biopsy , Clinical
67.4 591 S11.24.2 Radical Trachelectomy CT 40000
Photograph
192
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
70.4 592 S11.24.3 Radical Vaginectomy CT 40000
Photograph
593 S11.24.4 Radical Vaginectomy + CT 45000
70.6 Photograph
Reconstruction
180 S11.25 CA. CERVIX
Radical Hysterectomy
68.6
+Bilateral Pelvic Lymph
40.3
Node Dissection (Bplnd) Biopsy , Clinical
40.5 594 S11.25.1 CT 45000
+ Bilateral Salpingo Photograph
65.61
Ophorectomy (Bso) /
65.41
Ovarian Transposition
Biopsy , Clinical
68.8 595 S11.25.2 Anterior Exenteration CT 60000
Photograph
Biopsy , Clinical
68.8 596 S11.25.3 Posterior Exenteration CT 50000
Photograph
Biopsy , Clinical
68.8 597 S11.25.4 Total Pelvic Exenteration CT 75000
Photograph
Supra Levator Biopsy , Clinical
68.8 598 S11.25.5 CT 70000
Exenteration Photograph
193
ICD ICD POST_
CODE CODE EVIDENCE
S11.26 CA. ENDOMETRIUM
Total Abdominal
Hysterectomy(Tah) +
68.4
Bilateral Salpingo
599 S11.26.1 Ophorectomy (Bso) + CT 35000
40.3 Photograph
Bilateral Pelvic Lymph
40.5
Node Dissection (Bplnd)
+ Omentectomy
170-175 S11.27 SOFT TISSUE /BONE TUMORS . CHEST WALL
Surgical Resection of
Bone Scan , CT- Clinical
34.4 600 S11.27.1 Soft tissue /Bone tumors 20000
Chest Photograph
of Chest wall
Surgical Resection and

34.4 Reconstruction of Soft Bone Scan , CT- Clinical
601 S11.27.2 30000
34.7 tissue /Bone tumors of Chest Photograph
Chest wall
77.6
170-175 S11.28 SURGICAL MAQNAGEMENT OF BONE / SOFT TISSUE TUMORS
83.49
194
ICD ICD POST_
CODE CODE EVIDENCE
Surgical Maqnagement of Bone Scan , CT-

Clinical
602 S11.28.1.1 Bone / Soft tissue tumors- Chest , CT-Local Part 40000
Photograph
Without Prosthesis , MRI
Surgical Maqnagement of
Bone Scan , CT-
Bone / Soft tissue tumors- Clinical
84.09 603 S11.28.1.2 Chest , CT-Local Part 50000
With Custom Made Photograph
, MRI
Prosthesis
Surgical Maqnagement of Bone Scan , CT-

Clinical
84.19 604 S11.28.1.3 Bone / Soft tissue tumors- Chest , CT-Local Part 75000
Photograph
With Modular Prosthesis , MRI
Clinical
84.19 605 S11.28.2 Forequarter Amputation CT-Chest 40000 Photograph , X-
RAY
Clinical
CT , CT-Chest ,
606 S11.28.3 Hemipelvectomy 55000 Photograph , X-
MRI-Pelvis
RAY
Clinical
CT , CT-Chest ,
607 S11.28.4 Internal Hemipelvectomy 65000 Photograph , X-
MRI-Pelvis
RAY
Curettage & Bone Clinical
608 S11.28.5 CT , MRI 30000
Cement Photograph , X-
195
ICD ICD POST_
CODE CODE EVIDENCE
RAY
Clinical
77 609 S11.28.6 Bone Resection CT , MRI 30000 Photograph , X-
RAY
Clinical
Shoulder Girdle Bone Scan , CT ,
77.81 610 S11.28.7 40000 Photograph , X-
Resection MRI
RAY
Clinical
611 S11.28.8 Sacral Resection CT , MRI 60000 Photograph , X-
RAY
S11.29 GENITO URINARY CANCER
CT , Isotope Biopsy , Clinical
55.4 612 S11.29.1 Partial Nephrectomy 55000
renogram Photograph
Nephroureterectomy For
Transitional Cell Biopsy , Clinical
55.51 613 S11.29.2 CT 50000
Carcinima Of Renal Photograph
Pelvis
186 S11.30 TESTES CANCER
Retro Peritoneal Lymph CT-Abdomen +

Biopsy , Clinical
40.5 614 S11.30.1 Node Dissection(Rplnd) Pelvis , CT-Chest , 60000
Photograph
(For Residual Disease) Tumor Markers
196
ICD ICD POST_
CODE CODE EVIDENCE
07.22 CT , MRI , Biopsy , Clinical

615 S11.30.2 Adrenalectomy 45000
07.3 UrinaryHormones Photograph
56.5
Biopsy , Clinical
56.6 616 S11.30.3 Urinary Diversion - 40000
Photograph
56.7
Retro Peritoneal Lymph

Biopsy , Clinical
40.5 617 S11.30.4 Node Dissection Rplnd CT 20000
Photograph
As Part Of Staging
188 S11.31 CA. URINARY BLADDER

57.71
40.3
Biopsy , Clinical
40.5 618 S11.31.1 Anterior Exenteration CT 60000
Photograph
56.51-
56.79
57.71
40.3
Biopsy , Clinical
40.5 619 S11.31.2 Total Exenteration CT 75000
Photograph
56.51-
56.79
Bilateral Pelvic Lymph Biopsy , Clinical
40.53 620 S11.31.3 CT 20000
Node Dissection(Bplnd) Photograph
197
ICD ICD POST_
CODE CODE EVIDENCE
THORACIC AND
S11.32
MEDIASTINUM
Resection of mediastinal Biopsy , Clinical

34.3 621 S11.32.1 CT 50000
tumors Photograph
162 S11.33 LUNG
Lung Metastatectomy .
622 S11.33.1 CT 50000 Biopsy , X-RAY
Solitary
32.3
32.4 Lung Metastatectomy .
623 S11.33.2 CT 60000 Biopsy , X-RAY
32.5 Multiple
32.9
Sleeve Resection Of Lung

32.1 624 S11.33.3 Bronchoscopy , CT 90000 Biopsy , X-RAY
Cancer.
150 S11.34 ESOPHAGUS
Oesophagectomy With
Biopsy , Clinical
42.4 625 S11.34.1 Two Field CT 90000
Photograph
Lymphadenectomy
Oesophagectomy With
Biopsy , Clinical
42.4 626 S11.34.2 Three Field - 100000
Photograph
Lymphadenectomy
198
ICD ICD POST_
CODE CODE EVIDENCE
PALLIATIVE
S11.35
SURGERIES
31.1 Clinical
627 S11.35.1 Tracheostomy Clinical Photograph 5000
31.2 Photograph
Biopsy , Clinical
628 S11.35.10 Substernal Bypass Clinical Photograph 35000
Photograph
Clinical
43.1 629 S11.35.2 Gastrostomy Clinical Photograph 20000
Photograph
46.3 Clinical
630 S11.35.3 Jejunostomy Clinical Photograph 20000
46.39 Photograph
Clinical
46.2 631 S11.35.4 Ileostomy Clinical Photograph 20000
Photograph
Clinical
46.1 632 S11.35.5 Colostomy Clinical Photograph 20000
Photograph
57.17 Clinical
633 S11.35.6 Suprapubic Cystostomy Clinical Photograph 10000
57.18 Photograph
Clinical
34.04 634 S11.35.7 Intercostal Drainage(Icd) Clinical Photograph 3000
Photograph
Biopsy , Clinical
44.3 635 S11.35.8 Gastro Jejunostomy Clinical Photograph 35000
Photograph
636 S11.35.9 Ileotransverse Colostomy Clinical Photograph 50000
45.93 Photograph
199
ICD ICD POST_
CODE CODE EVIDENCE
S11.36 RECONSTRUCTION
Myocutaneous / Clinical
Cutaneous Flap Photograph
85.5 Micro Vascular Clinical

85.7 Reconstruction Photograph
S12 MEDICAL ONCOLOGY
S12 MEDICAL ONCOLOGY
174
S12.1 CANCER - CHEMOTHERAPHY* BREAST CANCER
175
Chemotherapy for Ca
Biopsy , Clinical
Breast with Clinical
V58.6 639 S12.1.1 Photograph , 3000
Adriamycin/Cyclophosph Photograph
Mammography
amide (Ac)
Chemotherapy for Ca Biopsy , Clinical
Clinical
V58.6 640 S12.1.2 Breast with 5- Photograph , 3100
Photograph
Fluorouracil A-C (Fac) Mammography
Biopsy , Clinical
chemotherapy for Ca Clinical
V58.6 641 S12.1.3 Photograph , 3000
Breast Ac (Ac Then T) Photograph
Mammography
200
ICD ICD POST_
CODE CODE EVIDENCE
Biopsy , Clinical
V58.6 642 S12.1.4 Photograph , 9500
Breast Paclitaxel Photograph
Mammography
chemotherapy for Ca
Breast Biopsy , Clinical
Clinical
V58.6 643 S12.1.5 Cyclophosphamide/ Photograph , 1500
Photograph
Methotrexate / Mammography
5fluorouracil (Cmf)
Biopsy , Clinical
V58.6 644 S12.1.6 Photograph , 85
Breast Tamoxifen Tabs Photograph
Mammography
chemotherapy for Ca Biopsy , Clinical

Clinical
645 S12.1.7 Breast Aromatase Photograph , 835
Photograph
Inhibitors Mammography
180 S12.2 CERVICAL CANCER
Chemotherapy for
Clinical
646 S12.2.1 Cervical Cancer with Biopsy , USG 2000
Photograph
Weekly Cisplatin
184.1-184.3 S12.3 VULVAL CANCER
201
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for Vulval

Biopsy , Clinical Clinical
647 S12.3.1 Cancer with Cisplatin/5- 5000
Fu
184 S12.4 VAGINAL CANCER
Chemotherapy for
Biopsy , Clinical Clinical
648 S12.4.1 Vaginal Cancer with 5000
Cisplatin/5-Fu
183 S12.5 OVARIAN CANCER
Chemotherapy for
Clinical
649 S12.5.1 Ovarian cancer with Biopsy , CT , USG 10500
Photograph
Carboplatin/Paclitaxel
OVARY- GERM CELL

S12.6
TUMOR
Chemotherapy for Ovary-

Germ Cell Tumor Clinical
V58.6 650 S12.6.1 Biopsy , CT , USG 8000
Bleomycin-Etoposide- Photograph
Cisplatin (Bep)
202
ICD ICD POST_
CODE CODE EVIDENCE
GESTATIONAL
S12.7
TROPHOBLAST DS.
S12.7.1 CHEMOTHERAPY FOR LOW RISK GESTATIONAL TROPHOBLAST DS
Chemotherapy with Clinical
651 S12.7.1.1 Biopsy , CT , USG 600
Weekly Methotrexate Photograph
Chemotherapy with Clinical

652 S12.7.1.2 Biopsy , CT , USG 3000
Actinomycin Photograph
S12.7.2 CHEMOTHERAPY FOR HIGH RISK GESTATIONAL TROPHOBLAST DS.
Chemotherapy with
Etoposide-Methotrexate-
Clinical
V58.6 653 S12.7.2.1 Actinomycin / Biopsy , CT , USG 6000
Photograph
Cyclophosphamide
Âvincristine (Ema-Co)
TESTICULAR
186 S12.8
CANCER
203
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for
Testicular Cancer with Clinical
654 S12.8.1 Biopsy , USG 8000
Bleomycin-Etoposide- Photograph
Cisplatin (Bep)
185 S12.9 PROSTATE CANCER
Clinical
V07.4 655 S12.9.1 Hormonal Therapy Biopsy , USG 3000
Photograph
188 S12.10 BLADDER CANER
Chemotherapy for Ca
Clinical
V58.6 656 S12.10.1 Bladder with Weekly Biopsy , USG 2000
Photograph
Cisplatin.
Chemotherapy for Ca
Bladder with
Methotrexate Vinblastine Clinical
V58.6 657 S12.10.2 Biopsy , CT , USG 5000
Adriamycin Photograph
Cyclophosphamide
(Mvac)
162 S12.11 LUNG CANCER NON-SMAL CELL LUNG CANCER
204
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for Lung

Biopsy , CT-Scan , Clinical
V58.6 658 S12.11.1 Cancer 7000
X-RAY Photograph
Cisplatin/Etoposide (Iiib)
OESOPHAGEAL
150 S12.12
CANCER
Chemotherapy for
V58.6 659 S12.12.1 oesophageal Cancer with 5000
Cisplatin- 5fu
151 S12.13 GASTRIC CANCER
Chemotherapy for Gastric

Cancer with 5-Fu Biopsy , CT-Scan , Clinical
V58.6 660 S12.13.1 5000
Leucovorin (Mcdonald Endoscopy Photograph
Regimen)
153 COLORECTAL
S12.14
154 CANCER
Chemotherapy for
V58.6 661 S12.14.1 colorectal Cancer with 4000
Monthly 5-Fu
205
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for
colorectal Cancer with 5-
V58.6 662 S12.14.2 Fluorouracil-Oxaliplatin 10000
Leucovorin (Folfox)
(Stage Iii Only
170.9 S12.15 OESTEOSARCOMA/ BONE TUMORS
Chemotherapy for Bone

V58.6 663 S12.15.1 Tumors with 20000
X-RAY Photograph
Cisplatin/Adriamycin
CHEMOTHERAPY FOR BONE TUMORS WITH LYMPHOMA I) HODGKIN

201 S12.16.1
DISEASE
Chemotherapy for Bone

Tumors with Adriamycin Clinical
V58.6 664 S12.16.1.1 Biopsy 4000
Bleomycin Vinblastine Photograph
Dacarbazine (Abvd)
202 S12.16.2 CHEMOTHERAPY FOR NON HODJKINS WITH LYMPHOMA
206
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for NHL

Cyclophosphamide Clinical
V58.6 665 S12.16.2.1 Biopsy 3500
Adriamycin Vincristine Photograph
Prednisone (Chop)
MULTIPLE
203 S12.17
MYELOMA
Chemotherapy for
Multiple Myeloma
Clinical
V58.6 666 S12.17.1 Vincristine, Heamatology 4000
Photograph
Adriamycin,Dexamethaso
ne(Vad)
Chemotherapy for
Multiple Myeloma with Clinical
V58.6 667 S12.17.2 Heamatology 3000
Thalidomide+Dexametha Photograph
sone(Oral)
Chemotherapy for
Multiple Myeloma with Clinical
V58.6 668 S12.17.3 Heamatology 1500
Melphalan Prednisone Photograph
(Oral)
207
ICD ICD POST_
CODE CODE EVIDENCE
189 S12.18 WILMS TUMOR
Chemotherapy for Wilms

Clinical
669 S12.18.1 Tumor with Siop/Nwts Biopsy , CT , USG 7000
Photograph
Regimen(Stages I Iii)
HEPATOBLASTOMA-
S12.19
OPERABLE
Chemotherapy for
HEPATOBLASTOMA- Clinical
V58.6 670 S12.19.1 Biopsy , CT , USG 15000
OPERABLE WITH Photograph
Cisplatin -Adriamycin
CHILDHOOD B CELL
S12.20
LYMPHOMAS
Chemotherapy for
Childhood B cell Clinical
671 S12.20.1 Heamatology 12000
Lymphoma with variable Photograph
regimen
208
ICD ICD POST_
CODE CODE EVIDENCE
NEUROBLASTOMA (
194 S12.21
STAGES I-III )
Chemotherapy for
Neuroblastoma Stages I- Clinical
672 S12.21.1 Biopsy , CT 10000
Iii ) with Variable Photograph
Regimen
190.5 S12.22 RETINOBLASTOMA
Chemotherapy for
Retinoblastoma with Clinical
673 S12.22.1 Biopsy 4000
Carbo/Etoposide/Vincristi Photograph
ne
S12.23 HISTIOCYTOSIS
Chemotherapy for
Histiocytosis with Biopsy , Clinical
674 S12.23.1 8000
Histiocytosis with Heamatology Photograph
Variable Regimen
RHABDOMYOSARCO
171 S12.24
MA
209
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for
Rhabdomyosarcoma with
Clinical
V58.6 675 S12.24.1 Vincristine-Actinomycin- Biopsy 9000
Photograph
Cyclophosphamide(Vactc
) Based Chemo
170.9 S12.25 EWINGS SARCOMA
Chemotherapy for Ewings

676 S12.25.1 Sarcoma with Variable 9000
X-RAY Photograph
Regimen
ACUTE MYELOID
205 S12.26
LEUKEMIA
Chemotherapy for Acute

Clinical
677 S12.26.1 Myeloid Leukemia Heamatology 60000
Photograph
Induction Phase
Chemotherapy for Clinical

678 S12.26.2 - 40000
Consolidation Phase Photograph
210
ICD ICD POST_
CODE CODE EVIDENCE

679 S12.26.3 - 3000
Maintenance phase Photograph
204 S12.27 ACUTE LYMPHOBLASTICLEUKEMIA
Chemotherapy for
Clinical
680 S12.27.1.1 Induction 1st And 2nd Heamatology 50000
Photograph
Months

681 S12.27.1.2 Heamatology 20000
Induction 3rd, 4th, 5th Photograph
Clinical
682 S12.27.1.3 Induction Maintenance Heamatology 3000
Photograph
S12.28 FOR UNLISTED REGIMEN
Clinical
V58.11 683 S12.28.1 Palliative Chemotherapy Biopsy , CT , USG 5000
Photograph
S12.29 FOR TERMINALLY ILL CANCER PATIENT
211
ICD ICD POST_
CODE CODE EVIDENCE
Palliative And Supportive Clinical

684 S12.29.1 Biopsy , CT , USG 3000
Therapy Photograph
S12.30 COLO RECTAL CANCER STAGE 2 AND 3
Chemotherapy for Acute

Biochemical
Myeloid Leukemia with CT-Abdomen +
V58.6 Investigations ,
685 S12.30.1 Xelox Along With Pelvis , Photograph , 4000
V58.11 Biopsy , CT ,
Adjuvant Chemotherapy Tissue Biospy
USG
Of As-I
203 S12.31 MULTIPLE MYELOMA

2D ECHO , Biopsy ,
Chemotherapy for Bone marrow
Biochemical
Multiple myeloma with aspiration ,
V58.6 Investigations ,
686 S12.31.1 S.Electrolytes , SIEP
Zoledronic Acid Along 3000
V58.11 Biopsy , CT ,
With Adjuvant , Skeltal survey ,
USG
Chemotherapy Of As-I Urine for Bence
Jones protein
S12.32 FEBRILE NEUTROPENIA
212
ICD ICD POST_
CODE CODE EVIDENCE
Chemotherapy for Febrile

Neutropenia with 1st Line
Biochemical
Iv Antibiotics And Other
Blood CandS , Tissue Investigations ,
V58.62 687 S12.32.1 Supportive Therapy ( 9000
Biospy , X-Ray Chest Biopsy , CT ,
Third Generation
USG
Cephalosporin,
Aminoglycoside Etc.,)
Chemotherapy for Febrile

Neutropenia with 2nd
Line Iv Antibiotics And
Biochemical
Other Supportive
Blood CandS , Tissue Investigations ,
V58.62 688 S12.32.2 Therapy(Carbapenems, 30000
Biospy , X-Ray Chest Biopsy , CT ,
Fourth Generation
USG
Cephalosporins,
Piperacillin, Anti-Fungal .
Azoles Etc.,)
S13 RADIATION
ONCOLOGY
213
ICD ICD POST_
CODE CODE EVIDENCE
V58 S13.1 COBALT 60 EXTERNAL BEAM RADIOTHERAPY
RT Treatment
Biopsy , CT , USG ,
689 S13.1.1 Radical Treatment 20000
Charts , Clinical
X-RAY
Photograph
RT Treatment
Biopsy , CT , USG ,
V58.0 690 S13.1.2 Palliative Treatment 10000 Charts , Clinical
X-RAY
Photograph
RT Treatment
Biopsy , CT , USG ,
691 S13.1.3 Adjuvant Treatment 15000 Charts , Clinical
X-RAY
Photograph
S13.2 EXTERNAL BEAM RADIOTHERAPY (ON LINEAR ACCELERATOR)
RT Treatment
Radical Treatment With Biopsy , CT , USG ,
92.24 692 S13.2.1 50000 Charts , Clinical
Photons X-RAY
Photograph
RT Treatment
Palliative Treatment With Biopsy , CT , USG ,
92.24 693 S13.2.2 20000 Charts , Clinical
Photons X-RAY
Photograph
RT Treatment
92.24 Adjuvant Treatment With Biopsy , CT , USG ,
694 S13.2.3 35000 Charts , Clinical
92.41 Photons/Electrons X-RAY
Photograph
S13.3.1 BRACHYTHERAPY A) INTRACAVITARY
92.27 RT Treatment
A) Intracavitary I. Ldr Per Biopsy , CT , USG ,
92.28 695 S13.3.1.1 4500 Charts , Clinical
Application X-RAY
92.29 Photograph
214
ICD ICD POST_
CODE CODE EVIDENCE
RT Treatment
A) Intracavitary Ii. Hdr Biopsy , CT , USG ,
696 S13.3.1.2 2500 Charts , Clinical
Per Application X-RAY
Photograph
60.28 S13.3.2 BRACHYTHERAPY B) INTERSTITIAL
RT Treatment
B) Interstitial I. Ldr Per Biopsy , CT , USG ,
697 S13.3.2.1 15000 Charts , Clinical
Application X-RAY
Photograph
B) Interstitial Ii. Hdr One RT Treatment
Biopsy , CT , USG ,
698 S13.3.2.2 Application And Multiple 25000 Charts , Clinical
X-RAY
Dose Fractions Photograph
SPECIALIZED RADIATION THERAPY - IMRT (Intensity modulated
S13.4.1
radiotherapy)
RT Treatment
Upto 40 Fractions In 8 Biopsy , CT-Scan Charts , CT ,
699 S13.4.1.1 100000
Weeks with Contrast Tumor Markers ,
USG
SPECIALIZED RADIATION THERAPY - 3DCRT(3-D conformational
S13.4.2
radiotherapy)
Upto 30 Fractions In 6 Biopsy , CT-Scan
700 S13.4.2.1 75000 CT , USG
Weeks with Contrast
S13.4.3 SPECIALIZED RADIATION THERAPY - SRS/SRT
RT Treatment
Upto 30 Fractions In 6 Biopsy , CT-Scan
701 S13.4.3.1 75000 Charts , Tumor
Weeks with Contrast
Markers
215
ICD ICD POST_
CODE CODE EVIDENCE
S14 PLASTIC
SURGERY
S14.1 PLASTIC REPAIR
Clinical
749.1 27.54 702 S14.1.1 Repair of cleft lip Clinical Photograph 10000
Photograph
Clinical
749.2 27.62 703 S14.1.2 Correction of cleft palate Clinical Photograph 15000
Photograph
Clinical
704 S14.1.3 Velo-Pharyngial Endoscopy 15000
Photograph
Incompetence
Correction of Syndactyly Clinical

755.1 86.85 705 S14.1.4 Clinical Photograph 15000
of Each Hand Photograph
Reconstruction or
Clinical
744.23 18.71 706 S14.1.5 prosthetic appliance for Clinical Photograph 30000
Photograph
absent ear
Surgery for Tm Joint Clinical Photograph , Clinical

524.6 707 S14.1.6 40000
Ankylosis X-RAY Photograph
940-949 S14.2 BURNS
216
ICD ICD POST_
CODE CODE EVIDENCE
Conservative
Clinical
948.3 708 S14.2.1.1 management of 40% Clinical Photograph 35000
Photograph
burns

40% mixed burns Photograph
Conservative
Clinical
Photograph
burns

Conservative
Clinical
Photograph
burns

948.6 - Surgical Management of Clinical

714 S14.2.2.3 Clinical Photograph 120000
948.9 above 60% mixed burns Photograph
217
ICD ICD POST_
CODE CODE EVIDENCE
POST BURN CONTRACTURE SURGERIES FOR FUNCTIONAL

S14.3 IMPROVEMENT(PACKAGE INCLUDING SPLINTS, PRESSURE
GARMENTS AND PHYSIOTHERAPY)
Clinical
715 S14.3.1 Mild Clinical Photograph 20000
Photograph
Clinical
716 S14.3.2 Moderate Clinical Photograph 30000
Photograph
Clinical
717 S14.3.3 Severe Clinical Photograph 40000
Photograph
S14.4 PLASTIC SURGERY
755.1
Surgical correction for
755.57 Clinical
82.8 718 S14.4 Congenital Deformity Of CT-Scan , X-RAY 15000
755.58 Photograph
86.85 Hand (Per Hand)
755.9
Surgical correction for Clinical

756 2.01 719 S14.5 3D CT , MRI 50000
Craniosynostosis Photograph
18.5 Correction of anamolies Clinical

744.29 720 S14.6 Clinical Photograph 20000
18.7 of Ear(cup & bat ears) Photograph
218
ICD ICD POST_
CODE CODE EVIDENCE
Management of electrical
Clinical
86.7 721 S14.7 burns with vitals exposed Clinical Photograph 50000
Photograph
with flap cover
125.9 Reduction Surgery For Clinical

722 S14.8 Clinical Photograph 20000
457.1 Filarial Lymphoedema Photograph
Correction of Hemifacial Clinical

754 723 S14.9 3D CT , MRI 30000
Atrophy Photograph
524.04 Correction of hemifacial Clinical

724 S14.10 3D CT , MRI 50000
524.06 microsomia Photograph
Correction of Leprosy Nerve conduction Clinical

V74.2 725 S14.11 20000
Reconstructive Surgery study Photograph
04.3 Correction of Nerve And

CT-Scan , Nerve Clinical
82.4 726 S14.12 Tendon Repair + Vascular 30000
conduction study Photograph
39.3 Repair
Clinical Photograph ,
Correction of lid Clinical
743.61 8.38 727 S14.13 ICE pack test with 25000
retraction Photograph
Chin Elevation
219
ICD ICD POST_
CODE CODE EVIDENCE
170.1 Correction of lid

Biopsy , CT , HPE , Clinical
213.0 76.41 728 S14.14 retraction with Tumour 40000
MRI Photograph
213.1 Of Mandible And Maxilla
Vaginal reconstruction Ultra sound of Clinical

752.4 70.62 729 S14.15 25000
for vaginal atresia abdomin Photograph
747.6
Surgical correction for Clinical
747.81 730 S14.16 ANGIOGRAM 25000
Vascular malformations Photograph
743.58
S15 POLY TRAUMA

POLY TRAUMA & ACCIDENT SURGERIES
S15.1
ORTHOPEDIC TRAUMA
812
813
Surgical Correction Of
820 731 S15.1.1 X-RAY 22000 X-RAY
Longbone Fracture
821
823
220
ICD ICD POST_
CODE CODE EVIDENCE
84.0 Clinical
732 S15.1.2 Amputation Surgery X-RAY 5000
84.1 Photograph
Management of Soft Clinical

Tissue Injury Photograph
S15.2 NEURO-SURGICAL TRAUMA
Medical Management in Clinical

734 S15.2.1.1 CT , X-RAY 6000
General Ward @ Rs.500/- Photograph
Medical Management in
Clinical
735 S15.2.1.2 Stay In Neuro CT , X-RAY 48000
Photograph
Icu@Rs.4000/Day
Surgical Treatment (Up Clinical

736 S15.2.2 CT , X-RAY 150000
To) Photograph
S15.3 CHEST INJURIES
Conservative
management for Chest Clinical
737 S15.3.1.1 CT , X-RAY 3000
injuries in General Ward, Photograph
@ Rs. 500/-
221
ICD ICD POST_
CODE CODE EVIDENCE
intesive care management

Clinical
738 S15.3.1.2 in RICU Rs. 4000/- per CT , X-RAY 20000
Photograph
day
739 S15.3.2 Surgical Treatment CT , X-RAY 50000 X-RAY

S15.4 ABDOMINAL INJURIES
Conservative
management for
740 S15.4.1.1 Abdominal Injuries In CT , USG , X-RAY 3000 USG
General
Ward@Rs.500/Day
intesive care management

741 S15.4.1.2 In Surgical CT , USG , X-RAY 7000 USG
ICU@Rs.1000/Day
Conservative Surgical Clinical

742 S15.4.2 Management for CT , USG , X-RAY 75000 Photograph ,
Abdominal Injuries USG
S15.5 EMERGENCY ROOM PROCEDURES

31.1 Clinical
743 S15.5.1 Tracheostomy Clinical Photograph 3000
31.2 Photograph
222
ICD ICD POST_
CODE CODE EVIDENCE
34.04
Clinical
34.09 744 S15.5.2 Thoracostomy Clinical Photograph 3000
Photograph
33.32
S15.6 WOUND MANAGEMENT FOR COMPOUND FRACTURES

745 S15.6.1 10000
Grade I&II X-Ray Photograph

746 S15.6.2 20000
Grade III X-Ray Photograph
Clinical Photograph , Clinical
747 S15.6.3 wound In Compound 20000
X-Ray Photograph
Fracture with Flap cover
SURGICAL MANAGEMENT WITH K-WIRING FOR SMALL BONE

S15.7 FRACTURES (TO BE COVERED ALONG WITH OTHER INJURIES ONLY
AND NOT AS EXCLUSIVE PROCEDURE)
Patella Fracture (To Be
Covered Along With
748 S15.7.1 X-Ray 5000 X-Ray
Other Injuries Only And
Not As Exclusive
Procedure)
223
ICD ICD POST_
CODE CODE EVIDENCE
Surgical management
with K-WIRING for
SMALL BONE
FRACTURES (TO BE
749 S15.7.2 COVERED ALONG X-Ray 5000 X-Ray
WITH OTHER
INJURIES ONLY AND
NOT AS EXCLUSIVE
PROCEDURE)
SURGICAL MANAGEMENT WITH FACIAL
S15.8
INJURIES
Surgical Management
Clinical
with Facial Bone Clinical Photograph ,
750 S15.8.1 15000 Photograph , X-
Fractures (Facio- X-Ray
Ray
Maxillary Injuries)
PELVIC BONE
S15.9
FRACTURE
Surgical Correction Of
751 S15.9.1 X-Ray 20000 X-Ray
Pelvic Bone Fractures.
S16 COCHLEAR IMPLANT SURGERY
S16.1 COCHLEAR IMPLANT SURGERY FOR CHILDREN BELOW 2 YEARS
224
ICD ICD POST_
CODE CODE EVIDENCE
20.96
752 S16.1 Cochlear Implant Surgery - 520000 -
20.98
S16.2 AUDITORY-VERBAL THERAPY
Initial Mapping/Switch Progress Reports , Progress Reports
753 S16.2.1 50000
On Mapping Charts , Mapping Charts
Post Switch On
Mapping/Initiation Of
Progress Reports , Progress Reports
754 S16.2.2 AVT And Training Of 20000
Mapping Charts , Mapping Charts
Child And Mother - First
Installment
Post Switch On
Child And Mother -
Second Installment
Post Switch On
Child And Mother - Third
Installment
225
ICD ICD POST_
CODE CODE EVIDENCE
Post Switch On
Child And Mother -
Fourth Installment
S16.3 HEARING IMPAIRED
Behind Ear Analogue Clinical

V53.2 20.95 758 S16.3.1 Audiometry 10000
Hearing Aid Photograph
S17 PROSTHESES
S17.1.1 SYMES PROSTHESES
Clinical
759 S17.1.1.1 Hdp/Pp Clinical Photograph 1000
Photograph
Clinical
760 S17.1.1.2 Fibre Clinical Photograph 1200
Photograph
Clinical
761 S17.1.1.3 Modular Clinical Photograph 1500
Photograph
S17.1.2 BELOW KNEE(BK/PTB) PROSTHESES
Clinical
Photograph
226
ICD ICD POST_
CODE CODE EVIDENCE
Clinical
Photograph
Clinical
Photograph
S17.1.3 THROUGH KNEE PROSTHESES
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
S17.1.4 ABOVE KNEE(AK) PROSTHESES
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
Clinical
774 S17.1.5.4 Partial Foot Prostheses Clinical Photograph 500
Photograph
227
ICD ICD POST_
CODE CODE EVIDENCE
S17.2 UPPERLIMB
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
S17.2.2 ABOVE ELBOW PROSTHESES
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
S17.2.3 WHOLE UPPERLIMB PROSHESES
Clinical
Photograph
Clinical
Photograph
Clinical
Photograph
228
ICD ICD POST
SPECIAL PACKAG
DIAGNOS PROCEDU AS_ SYSTEM/ TREATMENT THERAP-
S.NO INVESTI- E
TIC RE CODE THERAPY PROTOCOL EUTIC
GATIONS PRICE
CODE CODE EVIDENCE
M1 CRITICAL CARE
Medical
ABG , Serum IgE
Management of
, Spirometry , ABG , other
Acute Severe Asthma Guide lines - GINA
493 784 M1.1 clinical photo 45000 lab
Asthma With /India, Ventilatory Care
intubated with investigation
Acute Respiratory
ventilator
Failure
Medical
Management of Blood gases ,
According to International ABG , other
496 Copd with HRCT Chest ,
785 M1.2 Guide lines, Ventilatory 70000 lab
518.81 Respiratory ventilator when
Care investigation
Failure (Infective necessary
Exacerbation)
Medical
Clinical
Management of
photoHRCT Scan ABG , other
Acute Bronchitis IP 10 days, Inhalers, LABA,
466 786 M1.3 , FOB , 50000 lab
And Pneumonia Ventilatory Care
SputumC/S , investigation
With Respiratory
Ventilator
Failure
Clinical
Medical photoHRCT Scan ABG , other
Antimicrobials, MICU, O2,
518.5 787 M1.4 Management of , FOB , 80000 lab
Ventilatory Care
Ards SputumC/S , investigation
Ventilator
229
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
ABGS , Clinical
Medical
photoHRCT Scan ABG , other
Management of Antimicrobials, MICU, O2,
518.81 788 M1.5 , FOB , 100000 lab
Ards With Multi Ventilatory Care
SputumC/S, , investigation
Organ Failure
Ventilator
Medical ABGS , Clinical
Management of photoHRCT Scan ABG , other
518 Cryo precipitate, FFP,
789 M1.6 Ards Plus Dic , FOB , 120000 lab
785 Ventilatory Care
(Blood & Blood SputumC/S , investigation
Products) Ventilator
Clinical photo
Medical
Renal chemistry
Management of
Drug/Poison level ABG , other
Poisioning MICU, O2, Ventilatory
977 790 M1.7 in blood,Blood 30000 lab
Requiring Care, atropine
gases , Intubation investigation
Ventilatory
, Ventilatory
Assistance
assistance
Blood Culture ,
Blood gases ,
Clinical phot ABG and
Intensive care Antimicrobials, MICU, O2,
785.52 Renal Chemistry , other Lab
791 M1.8 management of Ventilatory Care and other 50000
998.02 Intubation , USG , Investigation
Septic Shock supportive measures
Urine Culture , s
Ventilatory
assistance
230
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M2 GENERAL MEDICINE
Aspiration /
BiopsyReport ,
Medical Bone Marrow ,
Management of Leptospira , PT Factor -VIII, IV fluids, PRP, Lab
287.3 792 M2.1 Thrombocytopeni APTT , Parasite F SDPIV - IgIV 20000 Investigation
a With Bleeding / V , Platelet antimicrobials s
Diathesis count , Report and
video clip
"online"
Factor VIII / IX ,
286.0 Medical Lab
PT APTT , Report
286.1 793 M2.2.1 Management of Factor -VIII, IV-FPP 50000 Investigation
and video clip
286.2 Hemophilia s
"online"
Medical
Lab
Management of Von willi brands Factor - VIII -
286.9 794 M2.2.2 50000 Investigation
Other Coagulation factor Cryoprecipitate, IV FFP
s
Disorders
282.40
Ferritin ,
282.43 Chelation
Heamatocrit , Lab
282.44 Therapy For
795 M2.3 Heamogram , Chelation Theraphy 20000 Investigation
282.45 Thalassemia
Peripheral Smear , s
282.46, and Major
S.Iron , Serum
282.47.
231
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Blood and Platelet

Transfusion, IV antibiotics,
Clinical and
Medical CSF Analysis , IV fluids, Mefloquine, Oral
Lab
84.9 796 M2.4 Management of Parasite F Test Chloroquine or IV quinine 20000
Investigation
Cerebral Malaria and QBC or IV artesunate,
s
Paracetamol, Ventilatiory
Support
Anticonvulsants
(Midazolam or Lorazepam,
Phenobarbitone or
Phenytoin), Antitubercular
ABG , CT Scan theraphy, IV Mannitol, IV Lab
13 797 M2.5 Tb Meningitis Brain CSF ADA antibiotics, IV 30000 Investigation
Analysis dexamethasone and oral s
steroids, IV fluids,
Mechanical Ventilatory
support, Naso gastric feeds,
Paracetamol
232
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Anticonvulsants
(Inj.Lorazepam,
Inj.Phenobarbitone,
Medical Inj.Phenytoin), Antisnake
ABG 8 hrly (3-
Management of Venom, IV fluids,
day X 7-days) , Lab
Snake Bite Inj.Meropenem,
989.5 798 M2.6 Blood Sugar 4 50000 Investigation
Requiring Inj.Midazolam infusion,
hrly , CT Scan s
Ventilator Inj.Vancomycin,
Brain , EEG
Support Inotropes(Dobutamine,
Dopamine, Adrenaline,
Noradrenaline), Mechanical
Ventilation, Oxygen
Antiscorption Venom, IV
ABG 8 hrly (3-
Medical fluids, Inj.Meropenem,
day X 7-days) ,
Management of Inj.Midazolam infusion,
Arterial Blood Lab
Scorpion Sting Inj.Vancomycin,
E905.2 799 M2.7 Pressure , Blood 25000 Investigation
Requiring Inotropes(Dobutamine,
Sugar 8 hrly , s
Ventilator Dopamine, Adrenaline,
CVP monitoring ,
Support Noradrenaline), Mechanical
ECG , Echo
Ventilation, Oxygen
233
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
ABG , Arterial Adrenaline, Antiscorption

Medical Blood Pressure , Venom, Dobutamine,
250.3
Management of Blood Sugar , Dopamine, IV antibiotics,
780.01 Lab
Metabolic Coma Blood Urea , CVP IV fluids, Inj.Midazolam
780.02 800 M2.8 30000 Investigation
Requiring monitoring , ECG infusion, Mechanical
780.03 s
Ventilatory , Echo , Ventilation, Noradrenaline,
780.09
Support S.Creatininine , Oxygen, Sodium
Thyroid Profile Nitroprusside
M3 INFECTIOUS DISEASES
ABG Ventilator ,
Management of Clinical Photo MEDICAL, Tracheostomy, Clinical
37 801 M3.1 20000
severe Tetanus intubation , Swab ventilator Photograph
for c/s
ECG-5 times ,
Management of Lab
Throat swab for MEDICAL, Tracheostomy,
32 802 M3.2 Complicated 25000 Investigation
c/s-3 times , Urine ventilator
Diphtheria s
for ketone bodies
Medical Cryptococcal
Lab
Management of antigen , Lumbar Amphoterecin B,
321 803 M3.3 20000 Investigation
Cryptococcal Puncture CSF Fluconazole
s
Meningitis analysis
234
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M4 PEDIATRICS
M4.1 NEONATAL INTENSIVE CARE
Medical
management of 25 % dextrose, Calcium
term Baby With gluconate, Fluconazole, IV Evidence for
Septicemia antibiotics -Meropenem - Clinical
Lumbar Puncture
Culture 500mg, Maintenance IV Improvemen
771.81 804 M4.1.1 CSF analysis , 25000
Positive,Hyperbili Fluids - Isolyte P, t with lab
Neurosonogram
rubinemia Not Nasogastric tube feeds, investigation
requiring Phototherapy, Tobramycin - s
Ventilatory 80mg
support.
235
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
25 % dextrose, Aminoven,
Calcium gluconate,
Medical Dobutamine, Dopamine,
management of FFP, Frusemide, Heparin,
pre-term Baby of IV antibiotics (Meropenem -
30 To 32 Weeks 500mg , Tobramycin - Evidence for
Septi cemia 2D ECHO - 80mgFluconazole), Clinical
769
M4.1.1 Culture TWICE , Maintenance IV Fluids - Improvemen
771.81 93.9 805 90000
0 Positive,Hyperbili Neurosonogram Isolyte P, Mechanical t with lab
774.2
rubinemia Patent on day 2 and 5 ventilation, Midazolam, investigation
Ductus Arteriosus Nasogastric tube feeds, s
-requiring PRBC, PRP, Phototherapy-
Mechanical Umbilical venous and
Ventilation. arterial lines, Supplemental
Oxygen, Surfactant therapy
- Neosurf, Vecuronium
236
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Calcium gluconate,
Medical
Dobutamine, Dopamine,
management of
FFP, Frusemide, Heparin,
pre-term Baby of
IV antibiotics (Meropenem -
<30 Weeks
500mg , Tobramycin -
Severe Hyaline Evidence for
80mgFluconazole),
Membrane 2D ECHO - Clinical
769 Maintenance IV Fluids -
M4.1.1 Disease Septi TWICE , Improvemen
771.81 93.9 806 Isolyte P, Mechanical 90000
1 cemia Culture Neurosonogram t with lab
774.2 ventilation, Midazolam,
Positive,Hyperbili on day 2 and 5 investigation
Nasogastric tube feeds,
rubinemia Patent s
Normal saline, PRBC, PRP,
Ductus Arteriosus
Phototherapy-Umbilical
-requiring
venous and arterial lines,
Mechanical
Supplemental Oxygen,
Ventilation.
Surfactant therapy -
Neosurf, Vecuronium
237
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Calcium gluconate,
Medical
IV antibiotics (Meropenem -
Management of
500mg , Tobramycin -
Term Baby With
80mgFluconazole), Evidence for
Persistent
Maintenance IV Fluids - Clinical
747.83 Pulmonary
M4.1.1 2D ECHO - 4 , Isolyte P, Mechanical Improvemen
771.81 93.9 807 Hypertension 80000
2 Neurosonogram 2 ventilation, Midazolam, t with lab
774.2 Ventilation-Hfo
Nasogastric tube feeds, investigation
Hyperbilirubinem
Normal saline, PRBC, PRP, s
ia Clinically
evident
septicemia.
Sodium bicarbonate,
Neosurf, Vecuronium
238
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
25 % dextrose, Calcium
Medical
gluconate, IV
Management of
Phenobarbitone, IV
Term Baby With
Phenytoin, IV antibiotics Evidence for
Severe Perinatal
BERA CSF (Piperacillin Tazobactum, Clinical
768.5 Asphyxia
M4.1.1 analysis(LP) , CT- Tobramycin - 80 mg ), Improvemen
771.81 808 Clinically evident 25000
3 Scan , Maintenance IV Fluids - t with lab
774.2 septicemia,
Neurosonogram 2 Isolyte P, Midazolam, investigation
Hyperbilirubinem
Nasogastric tube feeds, s
ia - Not requiring
Normal saline,
Ventilatory
Phisiotherapy, Supplemental
support.
Oxygen
239
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Calcium gluconate,
FFP, Heparin, IV
Medical
Phenobarbitone, IV
Management of
Phenytoin, IV antibiotics
Term Baby With
(Meropenem - 500mg , Evidence for
Severe Perinatal
BERA CSF Tobramycin - Clinical
768.5 Asphyxia
93.90 M4.1.1 analysis(LP) , CT- 80mgFluconazole), Improvemen
771.81 809 Clinically evident 40000
96.04 4 Scan , Maintenance IV Fluids - t with lab
774.2 septicemia,
Neurosonogram 3 Isolyte P, Midazolam, investigation
Hyperbilirubinem
ia - requiring
Ventilatory
Phisiotherapy,
support.
Vecuronium
240
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Whole blood, 25 %
dextrose, Calcium
Medical
gluconate, Double surface
Management of Evidence for
Phototherapy, Double
Term Baby Clinical
volume exchange
M4.1.1 Severe Improvemen
774 810 Neurosonogram transfusion, IV antibiotics 25000
5 Hyperbilirubinem t with lab
(Piperacillin Tazobactum,
ia Clinically investigation
Tobramycin - 80 mg ),
evident s
Maintenance IV Fluids -
Septicemia.
Isolyte P, Nasogastric tube
feeds
241
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Calcium gluconate,
FFP, Heparin, IV
Blood ammonia ,
Phenobarbitone, IV
CT-Scan ,
Phenytoin, IV antibiotics
Medical Lumbar Puncture Evidence for
(Meropenem - 500mg ,
management of CSF analysis , Clinical
Tobramycin -
M4.1.1 Seizures in term Metabolilc Improvemen
779 93.9 811 80mgFluconazole), 25000
6 baby requiring screening-blood t with lab
ventilatory and urine ABG , investigation
Isolyte P, Mechanical
support. Neurosonogram , s
ventilation, Midazolam,
Ultra sound of
abdomin , lactate
PRBC, PRP, Phisiotherapy,
Supplemental Oxygen
242
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Metronidazole, 25 %
dextrose, Albumin,
Medical
Aminoven, Calcium
Management of
gluconate, Central line,
Necrotising Abdomen Evidence for
Heparin, IV antibiotics
Enterocolitis, radiograph, , LFT Clinical
777.5 (Meropenem - 500mg ,
M4.1.1 Clinically evident , Neurosonogram Improvemen
771.81 812 Tobramycin - 25000
7 Septicemia, , Stool for occult t with lab
774.2 80mgFluconazole),
Hyperbilirubinem blood , Ultra investigation
ia not requiring sound of abdomin s
Isolyte P, Nasogastric tube
ventilatory
feeds, Normal saline,
support.
Phototherapy, Total
parenteral nutrition
243
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
25 % dextrose, Adrenaline,
Albumin, Aminoven,
Calcium gluconate,
Medical
Management of
2D ECHO , IV antibiotics (Meropenem -
Term Baby,
Abdomen 500mg , Tobramycin -
Fulminant
radiograph, , 80mgFluconazole), Evidence for
septicemia
BERA CSF Maintenance IV Fluids - Clinical
Culture Positive
M4.1.1 analysis(LP) , Isolyte P, Midazolam, Improvemen
813 with Septic 40000
8 LFT , Nasogastric tube feeds, t with lab
Shock,
Neurosonogram , Nonadrenaline, Normal investigation
Hyperbilirubinem
Stool for occult saline, PRBC, PRP, s
ia Renal Failure
blood , Ultra Peritoneal dialysis,
requiring
sound of abdomin Phototherapy-Umbilical
ventilatory
support.
Sodium bicarbonate,
Total parenteral nutrition,
Vecuronium
244
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
Management of
Preterm Baby 33
Calcium gluconate, Heparin,
To 34 Weeks with Evidence for
IV antibiotics (Piperacillin
Severe Hyaline Clinical
Tazobactum-1, Tobramycin
Membrane 2D ECHO , Improvemen
814 M4.1.2 - 80 mg), Midazolam, 40000
Disease Clinically Neurosonogram t with lab
evident investigation
septicemia s
Hyperbilirubinem
Supplemental Oxygen
ia requiring
Bubble Cpap.
245
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
Management of 25 % dextrose, Aminoven,
pre term baby of Calcium gluconate, FFP,
33 To 34 Weeks Heparin, IV antibiotics
with Preterm (Piperacillin Tazobactum-1,
Evidence for
Baby Severe Tobramycin - 80 mg),
Clinical
Hyaline Maintenance IV Fluids -
2D ECHO , Improvemen
815 M4.1.3 Membrane Isolyte P, Mechanical 60000
Neurosonogram t with lab
Disease Clinically ventilation, Midazolam,
investigation
evident Nasogastric tube feeds,
s
septicemia PRBC, PRP, Phototherapy-
Hyperbilirubinem Umbilical venous and
ia requiring arterial lines, Supplemental
ventilatory Oxygen
support.
246
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
management of
Preterm baby of
25 % dextrose, Calcium
35 To 36 Weeks
gluconate, Fluconazole, IV Evidence for
with Mild Hyaline
2D ECHO , antibiotics -Meropenem - Clinical
Membrane
Lumbar Puncture 500mg, Maintenance IV Improvemen
816 M4.1.4 Disease 35000
CSF analysis , Fluids - Isolyte P, t with lab
septicemia
Neurosonogram 3 Nasogastric tube feeds, investigation
Culture Positive
Phototherapy, Supplemental s
Hyperbilirubinem
Oxygen, Tobramycin -80mg
ia not requiring
ventilatory
support.
Medical
management of
Preterm baby of 25 % dextrose, Calcium
33 To 34 Weeks gluconate, FFP,
Evidence for
with Mild Hyaline Fluconazole, IV antibiotics -
2D ECHO , Clinical
Membrane Meropenem - 500mg,
Lumbar Puncture Improvemen
817 M4.1.5 Disease Maintenance IV Fluids - 45000
CSF analysis , t with lab
septicemia Isolyte P, Nasogastric tube
Neurosonogram 3 investigation
Culture Positive feeds, PRBC, PRP,
s
Hyperbilirubinem Phototherapy, Supplemental
ia not requiring Oxygen, Tobramycin -80mg
ventilatory
support.
247
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
management of
Calcium gluconate,
Preterm baby of
33 To 34 Weeks
FFP, Fluconazole, Heparin,
with severe
IV antibiotics -Meropenem - Evidence for
Hyaline
2D ECHO , 500mg, Maintenance IV Clinical
Membrane
Lumbar Puncture Fluids - Isolyte P, Improvemen
818 M4.1.6 Disease 60000
CSF analysis , Mechanical ventilation, t with lab
septicemia
Neurosonogram 4 Nasogastric tube feeds, investigation
Culture Positive
Normal saline, PRBC, PRP, s
Hyperbilirubinem
Phototherapy, Supplemental
ia requiring
ventilatory
- Neosurf, Tobramycin -
support/ bubble
80mg, Vecuronium
Cpap.
248
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
Calcium gluconate,
management of
Preterm baby of
FFP, Heparin, IV antibiotics
30 To 32 Weeks
with severe
Tobramycin - Evidence for
Hyaline
2D ECHO , 80mgFluconazole), Clinical
Membrane
Lumbar Puncture Maintenance IV Fluids - Improvemen
819 M4.1.7 Disease 90000
CSF analysis , Isolyte P, Mechanical t with lab
septicemia
Neurosonogram 3 ventilation, Midazolam, investigation
Culture Positive
Hyperbilirubinem
PRBC, PRP, Phototherapy-
ia requiring
Umbilical venous and
Mechanical
arterial lines, Supplemental
ventilatory
support.
- Neosurf, Vecuronium
249
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Calcium gluconate,
Medical
management of
FFP, Heparin, IV antibiotics
Preterm baby of
<30 Weeks with
Tobramycin -
severe Hyaline Evidence for
80mgFluconazole),
Membrane 2D ECHO , Clinical
Disease Lumbar Puncture Improvemen
820 M4.1.8 Isolyte P, Mechanical 90000
septicemia CSF analysis , t with lab
ventilation, Midazolam,
Culture Positive Neurosonogram 4 investigation
Hyperbilirubinem s
ia requiring
Mechanical
ventilatory
support.
Neosurf, Vecuronium
250
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical 25 % dextrose, Aminoven,

management of Calcium gluconate,
Preterm baby of Dobutamine, Dopamine,
33 To 34 Weeks FFP, Frusemide, Heparin,
with severe IV antibiotics (Meropenem -
Hyaline 500mg , Tobramycin -
Evidence for
Membrane 80mgFluconazole),
Clinical
Disease 2D ECHO - Maintenance IV Fluids -
Improvemen
821 M4.1.9 septicemia TWICE , Isolyte P, Mechanical 70000
t with lab
Culture Positive Neurosonogram 4 ventilation, Midazolam,
investigation
Hyperbilirubinem Nasogastric tube feeds,
s
ia Patent Ductus Normal saline, PRBC, PRP,
Arteriosus- Phototherapy-Umbilical
requiring venous and arterial lines,
Mechanical Supplemental Oxygen,
ventilatory Surfactant therapy -
support. Neosurf, Vecuronium
251
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M4.2 PEDIATRIC INTENSIVE CARE

M4.2.1 RESPIRATORY
Medical
Budesonide, IV fluids, Inj.
management of ABG , X-
M4.2.1. ABG OD (ABG - Ceftriaxone, Inj.
466 822 Severe 15000 RAY , pulse
1 5) , CP Hydrocortisone, Oxygen,
Bronchiolitis oxymetry
Salbutamol
(Non Ventilated)

Medical Amikacin, Inj. Methyl
Management of ABG 8th hrly prednisolone, Inj. ABG , X-
M4.2.1.
466 823 Severe (3/day X 7 days) , Midazolam Infusion ., Inj. 20000 RAY , pulse
2
Bronchiolitis ( CP Pipracillin Tazobactum, oxymetry
Ventilated) Oxygen, Salbutamol,
nebulisations
Medical
Management of
ABG , X-
M4.2.1. Severe ABG OD (ABG -
485 824 Oxygen 15000 RAY , pulse
3 Bronchopneumon 5) , CP
oxymetry
ia (Non
Ventilated)
252
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE

Medical
Amikacin, Inj. Midazolam
Management of ABG , X-
M4.2.1. ABG 8th hrly Infusion ., Inj. Pipracillin
485 825 Severe 30000 RAY , pulse
4 (3/day X 7 days) Tazobactum, Mechanical
Bronchopneumon oxymetry
ventilation, Oxygen,
ia ( Ventilated)
Salbutamol, nebulisations

Medical
Amikacin, Inj. Midazolam
Management of ABG , X-
M4.2.1. ABG 8th hrly Infusion ., Inj. Pipracillin
493 826 Acute Severe 35000 RAY , pulse
5 (3/day X 7 days) Tazobactum, Mechanical
Asthma oxymetry
ventilation, Oxygen,
(Ventilated)
Salbutamol, nebulisations
507 Medical
IV fluids, Inj. Amikacin, Inj.
770.12 Management of ABG , X-
M4.2.1. ABG OD (ABG - Pipracillin Tazobactum,
770.14 827 Severe Aspiration 20000 RAY , pulse
6 3) Oxygen, Salbutamol,
770.16 Pneumonia (Non oxymetry
nebulisations
770.18 Ventilated)
253
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
IV fluids, Inj. Amikacin, Inj.

507 Medical
Midazolam Infusion ., Inj.
770.12 Management of ABG , X-
M4.2.1. ABG 8th hrly Pipracillin Tazobactum,
770.14 828 Severe Aspiration 25000 RAY , pulse
7 (3/day X 7 days) Mechanical ventilation,
770.16 Pneumonia ( oxymetry
Oxygen, Salbutamol,
770.18 Ventilated)
nebulisations
ABGS , Clinical
Medical ABG and
Photo , FOB ,
M4.2.1. Management of Antimicrobials, MICU, O2, other Lab
518 829 HRCT Scan , 100000
8 Ards With Multi- Ventilatiory Care Investigation
Sputum C-S ,
Organ Failure s
Ventilator
Medical ABGS , Clinical
ABG and
Management of Photo , FOB ,
M4.2.1. Cryp Precipitate, FFP, other Lab
518 830 Ards Plus Dic HRCT Scan , 120000
9 Ventilatiory Care Investigation
(Blood & Blood Sputum C-S ,
s
Products) Ventilator
254
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
IV fluids, Inj. Adrenaline,

032.82 Inj. Amikacin, Inj. Lasix,
036.43 Inj. Midazolam Infusion .,
Medical arterial blood
074.23 Inj. Pipracillin Tazobactum, ABG , X-
M4.2.2. Management of pressure , ABG
130.3 831 Mechanical ventilation, 40000 RAY , pulse
1 Severe 12 hrly , ECG ,
391.2 Oxygen, Syp. Digoxin, T. oxymetry
Myocarditis ECHO
422 Captopril, T.lasilactone, inj.
422.90 Milrinone, inj.Dobutamine,
inj.Dopamine, inotropes
Medical
Management of IV fluids, Inj. Ceftriaxone,
ABG , X-
M4.2.2. Congenital Heart ECHO , pulse Oxygen, inj.Dobutamine,
832 30000 RAY , pulse
2 Disease With oxymetry inj.Dopamine,
oxymetry
Infection (Non inj.Tobramycin
Ventilated)
255
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical Adrenaline, Dobutamine,

Management of Dopamine, IV fluids, Inj.
Congenital Heart Midazolam, Inj.
ABG , X-
M4.2.2. Disease With ABG 8th hrly Vancomycin, Mechanical
833 50000 RAY , pulse
3 Infection And (3/day X 7 days) ventilation X,
oxymetry
Cardiogenic Nonadrenaline, Oxygen, inj.
Shock Meropenem, inotropes,
(Ventilated) milirinone
Adrenaline, Dobutamine,
Medical
Dopamine, IV fluids, ABG , X-
785.51 M4.2.2. Management of ABG 8th hrly
834 Nonadrenaline, Oxygen, inj. 50000 RAY , pulse
998.01 4 Cardiogenic (3/day X 7 days)
Meropenem, inotropes, oxymetry
Shock
milirinone
Adrenaline, Dobutamine,
Dopamine, IV fluids, Inj.
Medical Midazolam, Low molecular
ABG , X-
M4.2.2. Management of ABG 8th hrly weight Heparin, Mechanical
421 835 50000 RAY , pulse
5 Infective (3/day X 7 days) ventilation, Nonadrenaline,
oxymetry
Endocarditis Oxygen, inj. Meropenem,
inj.Heparin, inotropes,
milirinone
256
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Anticonvulsants, IV fluids,
Evidence for
Medical Inj. Midazolam Infusion .,
Clinical
Management of Inj. Vancomycin, Oxygen,
M4.2.3. CSF analysis , Improvemen
323 836 Meningo- inj.Acyclovir, 40000
1 CT-Scan , EEG t with lab
Encephalitis (Non inj.Lorazapem,
investigation
Ventilated) inj.Phenibarbitone,
s
inj.Phenytoin, inj.cefepime
ABG 8th hrly Evidence for
Medical Inj. Midazolam Infusion .,
(3/day X 7 days) , Clinical
Management of Inj. Vancomycin, Oxygen,
M4.2.3. CSF analysis , Improvemen
323 837 Meningo- inj.Acyclovir, 60000
2 CT-Scan , EEG , t with lab
Encephalitis ( inj.Lorazapem,
arterial investigation
Ventilated) inj.Phenibarbitone,
monitoring s
Inj. Midazolam Infusion ., Evidence for
ABG 8th hrly Inj. Vancomycin, Clinical
Medical
M4.2.3. (3/day X 7 days) , Mechanical ventilation, Improvemen
345.3 838 Management of 50000
3 CSF analysis , Oxygen, inj.Acyclovir, t with lab
Status Epilepticus
EEG inj.Lorazapem, investigation
inj.Phenibarbitone, s
257
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical Evidence for
Inj. Amikacin, Inj.
Management of ABG 8th hrly Clinical
Midazolam Infusion .,
M4.2.3. Febrile Seizures (3/day X 7 days) , Improvemen
780.31 839 Mechanical ventilation, 25000
4 (Atypical- CSF analysis , t with lab
Oxygen, inj.Lorazapem,
Mechanical EEG investigation
inj.Phenibarbitone,
Ventilated) s
Adrenaline,
Inj. Midazolam Infusion .,
Mechanical ventilation,
Evidence for
ABG 8th hrly Nonadrenaline, Oxygen, inj.
Medical Clinical
(3/day X 7 days) , Meropenem, inj.Calcium,
432.9 M4.2.3. Management of Improvemen
840 Blood sugar 4 inj.Dobutamine, 40000
853 5 Intra Cranial t with lab
hrly , CT Brain , inj.Dopamine,
Bleed investigation
carotied doppler inj.Lorazapem,
s
inj.Phenibarbitone,
inj.Phenytoin,
inj.Tobramycin, inotropes,
milirinone
258
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Antibiotics (Inj. Ceftriaxone

578 , Inj. Ofloxacin, Inj. Evidence for
578.1 Medical Amikacin), Dobutamine, Clinical
ABG OD/Upper
545.01 M4.2.4. Management of Dopamine, IV fluids, Inj. Improvemen
841 GI Endoscopy , 30000
562.12 1 Acute Gastro Midazolam Infusion ., t with lab
USG abdomen
569.3 Intestinal Bleed Mechanical ventilation, investigation
578.9 Oxygen, endoscopic s
sclerotherapy, inotropes
Adrenaline, Antibiotics (
Inj. Meropenem , Inj.
Evidence for
Vancomycin), Dobutamine,
Clinical
Medical Dopamine, IV fluids, Inj.
M4.2.4. CT-Scan , USG Improvemen
577 842 Management of Midazolam Infusion ., 50000
2 abdomen t with lab
Acute Pancreatitis Insulin, Mechanical
investigation
ventilation, Nonadrenaline,
s
Oxygen, TPN, inj.Calcium,
inotropes, milirinone
259
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Inj. N- Acetyl Cystein,

Adrenaline,
Antibiotic(inj.Meropenem),
ABG 8th hrly Anticonvulsants, IV fluids,
(3/day X 7 days) , Inj. L-ornathine, Inj.
Evidence for
Medical Blood sugar 4 Midazolam Infusion ., L-
Clinical
70.2 Management of hrly , CT-Scan , Carnitine, Mechanical
M4.2.4. Improvemen
572.2 843 Acute Hepatitis Hepatic viral ventilation, Nonadrenaline, 50000
3 t with lab
348.3 With Hepatic studies ( Hepatitis Oxygen, inj.Calcium,
investigation
Encephalopathy B, Hepatitis C, inj.Dobutamine,
s
Hepatitis A) , inj.Dopamine,
USG abdomen inj.Lorazapem,
inj.Phenibarbitone,
inj.Phenytoin, inotropes,
milirinone
ABG 8th hrly Antibiotics(inj.Meropenem,i Evidence for

Medical (3/day X 7 days) , nj.ofloxacin), Dobutamine, Clinical
M4.2.5. Management of Blood Urea cum Dopamine, IV fluids, Inj. Improvemen
584 844 40000
1 Acute Renal Serum Creatinine Midazolam Infusion ., t with lab
Failure 4 hrly , USG Mechanical ventilation, investigation
abdomen Oxygen, Peritoneal dialysis, s
260
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
inj.Calcium, inotropes
ABG 8 hrly Calcium, Dobutamine, Evidence for

Medical (3/day X 5 days), Dopamine, IV antibiotics Clinical
M4.2.6. Management of , Blood sugar 4 (Piperacillin Tazobactum, Improvemen
250.1 845 30000
1 Diabetic hrly , Serum Tobramycin - 80 mg ), IV t with
Ketoacidosis Electrolytes CVP fluids, Oxygen, inotropes, biochemical
monitoring insulin infusion parameters
Adrenaline,
Anticonvulsants,
Dobutamine, Dopamine, IV
fluids, Inj. Midazolam Evidence for
Infusion ., Inj. Vancomycin, Clinical
Medical
785.52 M4.2.7. ECHO , EEG , Mechanical ventilation, Improvemen
846 Management of 50000
998.02 1 USG abdomen Nonadrenaline, Oxygen, t with lab
Septic Shock
TPN, inj. Meropenem, investigation
inj.Lorazapem, s
inj.Phenibarbitone,
inj.Phenytoin, inotropes,
milirinone
261
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Adrenaline,
Anticonvulsants,
Dobutamine, Dopamine, IV
Medical ABG 4 hrly Evidence for
fluids, Inj. Midazolam
Management of (3/day X 4 days) , Clinical
Infusion ., Inj. Vancomycin,
M4.2.8. Snake Bite ABG 8 hrly Improvemen
989.5 847 Mechanical ventilation, 50000
1 Requiring (3/day X 4 days) , t with
Nonadrenaline, Oxygen,
Ventilatory CT Brain , ECHO biochemical
antisnake Venom, inj.
Assistance , EEG parameters
Meropenem,
inj.Phenibarbitone,
inj.Phenytoin, inotropes
Adrenaline, Antiscorpion
Medical
arterial blood Venom, Dobutamine,
Management of Evidence for
pressure , ABG 8 Dopamine, IV fluids, Inj.
Scorpion Sting Clinical
422.9 hrly (3/day X 4 Midazolam Infusion ., Inj.
M4.2.8. With Myocarditis Improvemen
995.62 848 days) , Blood Vancomycin, Mechanical 25000
2 And Cardiogenic t with lab
E905.2 sugar 8 hrly , ventilation, Nonadrenaline,
Shock Requiring investigation
CVP monitoring , Oxygen, Sodium
Ventilatory s
ECG , ECHO nitroprusside, inj.
Assistance
Meropenem, inotropes
262
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical Blood sugar 8

Evidence for
Management of hrly , CVP Dobutamine, Dopamine, IV
Clinical
Poison Ingestion/ monitoring , ABG fluids, Inj. Midazolam
M4.2.8. Improvemen
977 849 Aspiration 8 hrly (3/day X 4 Infusion ., Mechanical 40000
3 t with
Requiring days) , ECG , ventilation, Oxygen,
biochemical
Ventilatory ECHO , arterial Specific antidote, inotropes
parameters
Assistance blood pressure
M4.3 MEDICAL MANAGEMENT OF GENERAL PEDIATRICS
IV Antibiotics (Amoxycillin
clavulanate or ceftriaxone ,
Medical
Amikacin ,vancomycin),
Management of
485 Mechanical ventilation if
Acute Broncho/ Pus culture , X-
510.9 850 M4.3.1 required and oral antibiotics, 20000 X-Ray Chest
Lobarpneumonia RAY
511.9 Anti tubercular drugs after
With Empyema/
discharge, IV fluids,
Pleural Effusion
Oxygen, chest
physiotherapy
Medical Mechanical ventilation if

Management of required and oral antibiotics,
485 Acute Anti tubercular drugs after
Pus culture , X-
512 851 M4.3.2 Broncho/Lobarpn discharge, ICD chest drain, 20000 X-Ray Chest
RAY
11.7 eumonia With IV antibiotics, IV fluids,
Pyo Oxygen, chest
Pneumothorax physiotherapy, nebulisations
263
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
MCUG (
Medical Amikacin and ofloxacin
Micturating cysto
Management of paracetamol, Dialysis, IV
urethrogram),
Urinary Tract Antibiotics (Amoxycillin
Urine for Culture
M4.3.3. Infection With clavulanate or ceftriaxone ,
599 852 and Sensitivity, 15000 urine culture
2 Complications Amikacin ,vancomycin), IV
Ultrasound ,
Like fluids, oral antibiotics
Ultrasound ,
Pyelonephritis (Amoxycillin clavulanate or
Urine for Culture
And Renal Failure Cefixime)
and Sensitivity
Medical Digoxin, IV Antibiotics

Management of (Ceftriaxone , Amikacin or
402.11 2D ECHO ,
Congenital Heart 2D ECHO , ECG ofloxacin), IV fluids,
428 853 M4.4.1 15000 ECG , X-
Disease With , Pus culture Mechanical ventilation,
746.9 Ray Chest
Congestive Oxygen, diuretics,
Cardiac Failure nebulisations
Medical Ace inihibitors, Digoxin, IV

Management of Antibiotics (Ceftriaxone ,
2D ECHO ,
414.9 Acquired Heart 2D ECHO , ECG Amikacin or ofloxacin), IV
854 M4.4.2 15000 ECG , X-
429.4 Disease With , Pus culture fluids, Mechanical
Ray Chest
Congestive ventilation, Oxygen,
Cardiac Failure diuretics, nebulisations
422.9 855 M4.4.3 Medical 2D ECHO , ECG IV Antibiotics (Ceftriaxone 15000 2D ECHO ,
264
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
429 Management of , Pus culture , Amikacin or ofloxacin), IV ECG , X-

Viral Myocarditis fluids, Oxygen, diuretics, Ray Chest
inotropes, steroids
Medical
Antihypertensives, IV
Management of
Antibiotics (Ceftriaxone ,
Steroid Resistant
Amikacin or ofloxacin),
581 856 M4.5.1 Nephrotic Renal biopsy 25000 RFT
Immunosuppressives .,
Syndrome
ascitic tap, diuretics, pleural
Complicated Or
tap
Resistant
collagen vascular
profile , Antibiotics,
Medical
Complement Antihypertensives, Haemo
Management of
584 857 M4.5.3 levels, , RFT , dialysis, Peritoneal dialysis, 10000 RFT
Acute Renal
Serum Supportive management,
Failure
Electrolytes , c1 , diuretics
c3
Complement
Medical Antibiotics,
levels, , RFT ,
Management of Antihypertensives, Haemo
Serum
584 39.95 858 M4.5.4 Acute Renal dialysis, Peritoneal dialysis, 20000 RFT
Electrolytes , c1 ,
Failure With Supportive management,
c3 , collagen
Dialysis diuretics
vascular profile
265
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
Hb Clinical and
Management of
electrophoresis , Haematologi
Thalassemia Blood transfusion.,
282 859 M4.6.1 Osmotic fragility 20000 cal
Major Requiring Chelating Agents, IV fluids
test , Serum Improvemen
Chelation
Ferritin ts
Therapy
Medical Clinical and
Management of Coagulation Haematologi
Blood and Blood products,
286 860 M4.6.2 Haemophillia studies and Factor 20000 cal
Factor concentrate
Including Von analysis Improvemen
Willibrands ts
Clinical and
Medical
Haematologi
Management of Hb Bloods transfusion,
285 861 M4.6.3 10000 cal
Anemia Of electrophoresis Hemantinics etc, IV fluids
Improvemen
Unknown Cause
ts
266
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
IV dexamethasone for
below 5 yr old children,
Anticonvulsants
(midazolam or lorazepam,
Medical
CT-Scan , Phenobarbitone or
Management of
320 862 M4.7.1 Lumbar Puncture Phenytoin), IV antibiotics 35000 Repeat CSF
Pyogenic
CSF analysis (Amoxycillin clavulanate
Meningitis
,ceftriaxone , Amikacin or
ofloxacin,vancomycin), IV
fluids, Paracetamol,
Ventilatory Support
IVMannitol,
Anticonvulsants
Medical Phenobarbitone or
Brain CSF ADA clinical and
Management of Phenytoin), IV antibiotics,
16.4 863 M4.7.2 analysis , CT- 10000 lab
Neuro IV dexamethasone and oral
Scan investigation
Tuberculosis steroids, IV fluids,
Paracetamol, anti tubercular
therapy, ventilatory support
267
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
IVMannitol,
Anticonvulsants
Medical Phenobarbitone or
Management of ABG , Brain CSF Phenytoin), IV antibiotics, clinical and
16.04 864 M4.7.3 Neuro ADA analysis , IV dexamethasone and oral 20000 lab
Tuberculosis With CT-Scan steroids, IV fluids, investigation
Ventilation Nasogastric tube feeds,
Paracetamol, anti tubercular
therapy, mechanical
ventilation SUPPORT
Paracetamol, followed by
Medical
oral antibiotics ( Cefixime, clinical and
Management of ABD , Blood
2 865 M4.7.4 Ofloxacin), IV antibiotics 10000 lab
Enteric Fever culture , USG
ceftriaxone, Amikacin , investigation
Complicated
ofloxacin, IV fluids
268
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
IV antibiotics ceftriaxone,
Amikacin , ofloxacin, IV
Medical Lumbar Puncture artesunate, IV artesunate, IV
clinical and
Management of CSF analysis , fluids, IV quinine,
84.9 866 M4.7.5 10000 lab
Cerebral Malaria Parasite F Test Mechanical ventilation, Oral
investigation
(Falciparum) and QBC chloroquine, blood and
platelet transfusion,
mefloquine
Medical
Management of clinical and
345.3 867 M4.8.1 Convulsive CT , EEG 10000 lab
Oxygen, ventilator
Disorders/Status investigation
Epilepticus (Fits)
Medical 2D ECHO , Anti Epieptics, IV fluids, clinical and
435.9
868 M4.8.2 Management of ANGIOGRAM , Low molecular weight 20000 lab
436
Stroke Syndrome CT , EEG Heparin, Oxygen investigation
Medical
CT , Lumbar clinical and
Management of Anticonvulsants, IV fluids,
348.3 869 M4.8.3 Puncture CSF 15000 lab
Encephalitis / Mannitol, inj.Acyclovir
analysis investigation
Encephalopathy
269
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
ABG , ENMG ,
Medical
Lumbar Puncture IV fluids, immunoglobin, clinical and
Management of
357 870 M4.8.4 CSF analysis , physiotherapy, ventilary and 60000 lab
Guillian-Barre
Nerve Conduction supportive care investigation
Syndrome
studies
M5 CARDIOLOGY
Medical
Management of
2DEcho ,
Acute Mi 2DEcho ,
ECG , Lab
410 871 M5.1.1 (Conservative CPKMB , ECG , Medical 20000
Investigation
Management Troponin
s
Without
Angiogram)
Medical
2DEcho ,
Management of 2DEcho ,
CPKMB ,
Acute Mi ECG , Lab
410 872 M5.1.2 Coronary Medical 30000
(Conservative Investigation
Angiodraphy ,
Management s
ECG , Troponin
With Angiogram)
Medical 2DEcho ,
2DEcho ,
Management of CPKMB ,
ECG , Lab
785.51 873 M5.1.3 Acute Mi With Coronary Medical 30000
Investigation
Cardiogenic Angiodraphy ,
s
Shock ECG , Troponin
270
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical 2DEcho ,
2DEcho ,
Management of CPKMB ,
ECG , Lab
410 874 M5.1.4 Acute Mi Coronary Medical 50000
Investigation
Requiring Iabp Angiodraphy ,
s
Pump ECG , Troponin
2DEcho ,
Medical 2DEcho ,
CPKMB ,
Management of ECG , Lab
428 875 M5.1.5 Coronary Medical 30000
Refractory Investigation
Angiodraphy ,
Cardiac Failure s
ECG , Troponin
Medical 2D ECHO ,
Management of 2D ECHO , Blood ECG , Lab
421 876 M5.2 Medical 25000
Infective c/s , ECG Investigation
Endocarditis s
Medical DOPPLER ,
Management of Lab
415 877 M5.3 MRI doppler Medical 30000
Pulmonary, Investigation
Embolism s
Medical 2D ECHO ,
Management of ECG , Lab
878 M5.4 ECG doppler Cartoguided 95000
Complex Investigation
Arrhythmias s
2D ECHO ,
427.2 Ablation Therapy
Color Doppler , ECG , Lab
427.8 879 M5.5 for Simple Focus Ablation 70000
ECG Investigation
427.9 Arrythmias
s
271
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
Management of 2D ECHO ,
Pericardial ECG , Lab
423.3 880 M5.6 DOPPLER Aspiration 25000
Effusion, Investigation
Tamponade s
with Aspiration
M6 NEPHROLOGY
2D ECHO ,
Calicum , ECG ,
Medical Electolytes ,
Management of HBSAG , HCD , Dialysis and supportive
584 39.95 881 M6.1 20000
Acute Renal HIV , Phosphate , therapy
Failure-(Arf) RFT , S.Protein ,
USG , Urine
protein , uric acid
Medical
RFT , other
Management of HIV , RFT ,
581 882 M6.2 Immunosuppressive RX 15000 lab
Nephrotic S.Protein
investigation
Syndrome
Medical
Management of RFT , other
Medicines, Steroids
583 883 M6.3 Rapidly RFT 35000 lab
parenteral
Progressive Renal investigation
Failure (Rprf)
272
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
24 hrs urine ,
HCV ,
Alb/Globulin ratio
, HB Sag , RFT ,
Medical S.Calcium ,
RFT , other
Management of S.Protein , S.Uric Dialysis and supportive
585 39.95 884 M6.4 15000 lab
Chronic Renal acid , therapy, Initial treatment
investigation
Failure 1 (Crf ) S.electrolytes ,
Spot
Urine/Creatinine
ratio , X-Ray
Chest
24 hrs urine , Spot

Urine/Creatinine
ratio , 2D ECHO ,
Alb/Globulin ratio
Maintenance Dialysis and supportive RFT , other
, HB Sag , HCV ,
585 39.95 885 M6.5 Hemodialysis For therapy (Minimum of 8 10000 lab
RFT , S.Calcium ,
Crf dialysis) investigation
S.Po4 , S.Protein ,
S.Uric acid ,
S.electrolytes , X-
Ray Chest
273
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M7 NEUROLOGY
antacids, Dialysis and
supportive therapy
Evoked Potentials
Medical (Minimum of 8 dialysis),
, CSF Monoclonal
Management of Inj. Methylprednisolone, clinical and
Bands, , CSF
340 886 M7.1 Adem Or Relapse Oral steroids for 4 weeks, 20000 lab
analysis , HIV
In Multiple Ventilatory Support, investigation
profile , MRI
Sclerosis physiotherapy, supportive
Brain
care, vitamin
supplementaion
Carotid and
vertebral Doppler
etc. special tests
for Evaluation of
cause ,
Medical
Echocardiography
Management of
, Nerve Biopsy . ,
Chronic Ajathioprine, Oral steroids, clinical and
CSF analysis , CT
357 887 M7.2 Inflammatory physiotherapy, vitamin 8000 lab
Brain , ECG ,
Demyelinating supplementaion investigation
EMG , Lipid
Polyneuropathy(C
profile , MRI
IDP)
Brain , MRV
/MRA , NCS ,
Serum Protein
electropheresis ,
repeated blood
274
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
tests for
electrolytes and
glucose
4-Vessel Cerebral
Angio if
necessary (DSA) ,
CT BRAIN ,
Carotid and
Medical Vertebral Doppler Antidiabetics, IVMannitol,
clinical and
Management of etc. , ECG , Surgery if necessary,
434.9 888 M7.3 25000 lab
Hemorrhagic Enchocardiograph antacids, Antihypertensives,
investigation
Stroke/Strokes y , Lipid profile , IV fluids
MRA , MRI
BRAIN , MRV ,
Special tests for
Evaluation of
Cause
275
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Carotid and
vertebral Doppler
etc. special tests
for Evaluation of
cause , Antidiabetics, IVMannitol,
Medical Echocardiography antacids, Antihypertensives, clinical and
411
889 M7.4 Management of , CT Brain , ECG Heparanoids for 5 days, IV 20000 lab
434.91
Ischemic Strokes , Lipid profile , fluids, surgery in some investigation
MRI Brain , MRV cases
/MRA , repeated
blood tests for
electrolytes and
glucose
Serum calcium ,
Muscle Biopsy ,
NCS, /EMG , Azathiaprine, Calcium
Medical
Phosphate and supplementation, clinical and
359 Management of
890 M7.5 alkaline Prednisolone, endocrine 15000 lab
728.9 Myopathies -
phophatase , therapy, vitamin investigation
Acquired
Serum CPK , supplementation
endocrine
evaluation
276
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
CSF serology for

tuberculous
Medical antigens , ADA ,
IVMannitol, antacids, clinical and
Management of CSF analysis , CT
321 891 M7.6 Antifungal drugs, IV fluids, 40000 lab
Neuroinfections - Brain , Cell count
steroids investigation
Fungal Meningitis , Fungal studies ,
MRI Brain scan ,
culture
Medical
ADA , CSF
Management of IVMannitol, Surgery if
analysis , CT clinical and
Neuroinfections - necessary, Higher
320 892 M7.7 Brain , Cell count 25000 lab
Pyogenic antibiotics, IV fluids,
, MRI Brain scan , investigation
Meningitis(Bacter antacids, steroids
culture
ial)
Medical
ADA , CSF
Management of
analysis , CSF
Neuroinfections -
antibodies for IVMannitol, Methyl clinical and
Viral
323 893 M7.8 HSV , CT Brain , prednisolone, antacids, IV 25000 lab
Meningoencephal
Cell count , MRI fluids, acyclovir investigation
itis ( Including
Brain scan ,
Herpes
culture
Encephalitis)
277
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical CT-Abdomen ,
Azathiaprine, Calcium
Management of CT-Chest , clinical and
supplementation,
358 894 M7.9 Neuromuscular Neostgmine test , 15000 lab
Prednisolone, Ventilatory
(Myasthenia RNS , Thyroid investigation
Care, neostignime
Gravis) profile
antacids, Inj. Methyl

Medical Nerve Biopsy
prednisolone, Ventilatory clinical and
356 Management of (2000), , CSF
895 M7.10 Care, physiotherapy, 35000 lab
357 Neuropathies analysis , NCS /
supportive care, vitamin investigation
(Gbs) EMG(1000)
supplementation
Lumbar Puncture
antacids, Inj. Methyl
Medical CSF analysis , clinical and
prednisolone, oral steroids
341 896 M7.11 Management of MRI Brain and 10000 lab
for 2 weeks, vitamin
Optic Neuritis Optic nerves , investigation
supplementation
VEPs
Management with Investigations clinical and

897 M7.12 Immunoglobulin indicative of - 100000 lab
Therapy - Iv diseases investigation
278
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M8 PULMONOLOGY
Medical FOB , HRCT
Management of Chest ,
clinical and
Bronchiectasis Spirometry , According to International
494 898 M8.1 20000 lab
With Repeated Sputum culture , Guide lines
investigation
Hospitalisation>6 drug
per Year susceptability
Medical
clinical and
Management of CT-Chest , FOB ,
513 899 M8.2 Antibiotics, Bronchial toilet 15000 lab
Lung Abscess PUS c/s
investigation
,Non Resolving
Medical
Antimicrobials, MICU, clinical and
Management of HRCT Chest ,
512 900 M8.3 Oxygen, Pleuredesis, 35000 lab
Pneumothorax VATS
Thoracostomy investigation
(Large/Recurrent)
516
2D ECHO ,
516.3 Medical
Bronchoscopy , clinical and
516.4 Management of Antimicrobials, MICU,
901 M8.4 HRCT Chest , 30000 lab
516.5 Interstitial Lung steroids
Spirometry , investigation
516.6 Diseases
collagen profile
516.8
279
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
2D ECHO ,
Medical Bronchoscopy , clinical and
MICU, Medical
500-505 902 M8.5 Management of HRCT Chest , 25000 lab
management
Pneumoconiosis Spirometry , investigation
collagen profile
2D ECHO , ABG
, Bronchial
Medical washing ,
Management of Bronchoscopy , Antimicrobials, Oxygen, clinical and
518.81 903 M8.6 Acute Respiratory ECG , ET suction Supportive therapy in 25000 lab
Failure ( Without for analysis , MICU investigation
Ventilator) Serum
Electrolytes ,
sputum
2D ECHO , ABG
, Bronchial
Medical washing ,
Management of Bronchoscopy , clinical and
Antimicrobials, Oxygen,
518.81 904 M8.7 Acute Respiratory ECG , ET suction 50000 lab
Supportive therapy in RICU
Failure ( With for analysis , investigation
Ventilator) Serum
Electrolytes ,
sputum
280
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M9 DERMATOLOGY
Medical DIF , Skin biopsy clinical and

IV antibiotics, IV fluids, IV
694 905 M9.1 management of - HPE , Tzanck 25000 lab
steroids, Pulse therapy
Pemphigus Smear investigation
Blood culture ,
Echo-Cardiogram
Medical
, LFT , Skin clinical and
management of IV antibiotics, IV fluids, IV
695.15 906 M9.2 biopsy - HPE, , 30000 lab
Toxic Epidermal steroids
Skin swab, , USG investigation
Necrolysis
abdomen , urine
culture
Blood culture ,
Echo-Cardiogram
Medical
, LFT , Skin clinical and
management of IV antibiotics, IV fluids, IV
695.13 907 M9.3 biopsy - HPE , 20000 lab
Stevens- Johnson steroids
Skin swab, , USG investigation
Syndrome
abdomen , urine
culture
281
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M10 RHEUMATOLOGY
24 Hrs
URINARY
Medical PROTEIN , ACL
management of ANTIBODIES , clinical and
M10.1. As per American College of
710 908 Sle (Systemic ANA PROFILE , 15000 lab
1 Rheumatology Guidelines.
Lupus EN ANTIGEN , investigation
Erythematosis) HR CT ,
KIDNEYBIOPSY
, dSDNA
Medical
management of
M10.1. Sle (Systemic
909 - - 50000 -
2 Lupus
Erythematosis)
with sepsis
2D ECHO , ANA
PROFILE ,
Medical RENAL clinical and
As per American College of
701 910 M10.2 management of DOPPLER , 15000 lab
Rheumatology Guidelines.
Scleroderma SKIN BIOPSY investigation
WITH HPE
REPORT
282
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
24 Hrs
URINARY
Medical
PROTEIN , CPK ,
management of clinical and
ENMG , As per American College of
710.9 911 M10.3 Mctd Mixed 15000 lab
KIDNEYBIOPSY Rheumatology Guidelines.
Connective Tissue investigation
, LDH , MRI OF
Disorder
HANDS , MRI
OF MUSCLES
24 Hrs
URINARY
PROTEIN , ANA
PROFILE ,
Medical
CANCA , CPK , clinical and
management of As per American College of
710.2 912 M10.4 ENMG , 15000 lab
Primary Sjogren'S Rheumatology Guidelines.
KIDNEYBIOPSY investigation
Syndrome
, LDH , MRI OF
HANDS , MRI
OF MUSCLES ,
pANCA
Medical clinical and

As per American College of
709 913 M10.5 management of - 10000 lab
Rheumatology Guidelines.
Vasculitis investigation
283
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
M11 ENDOCRINOLOGY
MEDICAL
MANAGEMEN
T OF
UNCONTROLL
ED DIABETES
250 M11.1
MELLITUS
WITH
INFECTIOUS
EMERGENCIE
S
Medical Antibiotics, IV fluids, other clinical and
M11.1. USG , Urine C
590 914 management of therapy with treatment of 20000 lab
1 and S
Pyelonephritis Diabetics investigation
466 Medical
Antibiotics, IV fluids, other clinical and
480 M11.1. management of CXR , Sputum
915 therapy with treatment of 20000 lab
490.6 2 Lower Respiratoy C/S
Diabetics investigation
490 Tract Infection
Anti-fingal agents,
Medical clinical and
117.9 M11.1. Antibiotics, IV fluids, other
916 management of CT PNS 40000 lab
461.9 3 therapy with treatment of
Fungal Sinusitis investigation
Diabetics
284
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical Antibiotics, IV fluids, other clinical and

M11.1. CT-Abdomen ,
575 917 management of therapy with treatment of 25000 lab
4 USG
Cholecystitis Diabetics investigation
Medical
Antibiotics, IV fluids, other clinical and
M11.1. management of
325 918 MRI , Venogram therapy with treatment of 40000 lab
5 Cavernous Sinus
Diabetics investigation
Thrombosis
Medical Anti-fingal agents,

clinical and
M11.1. management of Antibiotics, IV fluids, other
117 919 CT-Scan 40000 lab
6 Rhinocerebral therapy with treatment of
investigation
Mucormycosis Diabetics
OTHER ENDOCRINAL
M11.2
DISORDERS
FSH , LH ,
Hormonal therapy clinical and
M11.2. estradiol , t3 Hormone Therapy for three
253 99 920 for 100000 lab
1 t4TSH , months
Hypopitutarism investigation
testosterone
285
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
t3 t4TSH , 2D
ECHO , Basal
cortisal cost
ACTH , FSH , LH
, MRI
colonoscopy if
Hormonal therapy clinical and
M11.2. needed, , Post Hormone Therapy for three
253 99 921 for Pituitary - 15000 lab
2 glucose on assay , months
Acromegaly investigation
Visual field ,
estradiol ,
prolactin ,
testosterone ,
water deprivation
test(if needed),
ACTH assay , CT
Chest , Cortisol
Medical Diabetis mellitus drugs,
assay after clinical and
M11.2. Management of Hypertension, Osteoporesis,
255 922 dexame-thasone , 30000 lab
3 Cushings infection with antibiotics,
DHEAS , Dexa of investigation
Syndrome surgery
Hip spine , MRI
pituitary CT ABD
286
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
testosterone , 2D
ECHO , FSH , LH
Hormonal therapy
, MRI brain
forDelayed
DEXA , T4 TSH clinical and
M11.2. Puberty Inj Testosterone250mg/ 3
259 99 923 X-ray bone age , 12000 lab
4 Hypogonadism(E wks, oc pills
USG pelvis investigation
x.Turners Synd,
karyotyping , X-
Kleinfelter Synd)
ray skull ,
estradiol
M12 GASTROENTEROLOGY
Medical
management of Endoscopic
MICU stay, Medical Barium
868.1 924 M12.1 Corrosive dilatation- 20000
treatment swallow
Oesophageal video/photo
Injury
Radiological
medical
M12.17 ERCP , EUS , and
925 management of Biliary stent, MEDICAL 50000
.1 MRCP , PTBD endoscopic
Post op stent
image
Radiological
Medical
M12.17 ERCP , EUS , and
926 management of Biliary stent, MEDICAL 75000
.2 MRCP , PTBD endoscopic
Post op leaks
image
287
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical Radiological
M12.17 management of ERCP , EUS , and
576.1 927 Biliary stent, MEDICAL 75000
.3 Sclerosing MRCP , PTBD endoscopic
Cholangitis image
Conservative
Foreign body
management of Endoscopic
935.1 928 M12.2 removal - photo Conservative 5000
Oesophageal photograph
of the procedure
Foreign Body
Conservative
CT scan
management of
530.4 929 M12.3 thorax,and Conservative, MICU stay 25000 -
Oesophageal
abdomen,
Perforation
Medical
Botulinum, Dilatation, Endoscopic
530 930 M12.4 management of UGI Endoscopy 7000
Taxim inj. photograph
Achalasia Cardia
Medical
Management
Endoscopic variceal Endoscopic
530 931 M12.5 ofOesophageal UGI Endoscopy 10000
banding photograph
Varices using
Variceal Banding
Medical
Management of
Endoscopic sclerotherapy Endoscopic
45.13 932 M12.6 Oesophageal UGI Endoscopy 5000
injection photograph
Varices with
Sclerotherapy
288
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Medical
CT Thorax Photograph
management of Covered esophageal stent -
530.8 933 M12.7 Gastrograffin 30000 of stent in
Oesophageal MICU
contrast picture position
Fistula
Medical Argon laser
Endoscopic
537.8 934 M12.8 management coagulation , UGI Argon laser, MEDICAL 20000
photograph
ofGave Endoscopyphoto
Medical Endoscopic Glue
Endoscopic
456 935 M12.9 management injection , UGI MICU 15000
photograph
ofGastric Varices Endoscopy
Medical
CT-Abdomen + Lab
management of
577 936 M12.10 Pelvis , EUS , MICU 75000 Investigation
Acute Pancreatitis
MRCP s , USG
(Mild)
Medical
Lab
management o CT-Abdomen +
577 937 M12.11 MICU 150000 Investigation
Acute Pancreatitis Pelvis
s , USG
(Severe)
Conservative
management CT-Abdomen +
Endoscopy drainage, MICU, Lab
ofAcute Pelvis , EUS ,
577.2 938 M12.12 Percutaneous drainage, 30000 Investigation
Pancreatitis With Post procedure
surgical drainage s , USG
Pseudocyst USG
(Infected)
289
ICD ICD POST
SPECIAL PACKAG
S.NO INVESTI- E
GATIONS PRICE
CODE CODE EVIDENCE
Conservative
Celiac ganglion block,
management of Lab
CT-Abdomen + Conservative, ERCP,
577.1 939 M12.13 Chronic 20000 Investigation
Pelvis , EUS ERCP+Stenting, EUS
Pancreatitis With s
guided, MICU
Severe Pain
BMFT , Capsule
Conservative
Endoscopy , Endoscopic
578 940 M12.14 management of Argon Laser Rx 50000
Enteroscopy photograph
Obscure Gi Bleed
biopsy
Conservative
management Ascitic fluid Lab
348.3 941 M12.15 ofCirrhosis With analysis , UGI EVL-EST, MICU 10 days 30000 Investigation
Hepatic Endoscopy s
Encephalopathy
Medical
management Lab
Reports of Serum EVL-EST, MEDICAL,
572.4 942 M12.16 ofCirrhosis With 40000 Investigation
Chemistry MICU 10 days
Hepato Renal s
Syndrome
290
291
292
293
ANNEXURE-II
Followup Packages
FOLLOW UP PACKAGES SURGICAL
FIRST SUBSEQUENT 3
S.NO CODE SYSTEM PACKAGE
INSTALLMENT INSTALLMENTS
1 SF1.1.5.6 Total Thyroidectomy 3000 1200 600

2 SF1.4.2 Portocaval Anastomosis 10000 4000 2000
Operation of Adernal
3 SF1.6.1 4000 1600 800
glands bilateral
Splenorenal
4 SF1.7.2 10000 4000 2000
Anastomosis
5 SF1.7.3 Warren shunt 10000 4000 2000
Spleenectomy +
6 SF6.8.2 Devascularisation + 10000 4000 2000
Spleno Renal Shunt
Lap- Pancreatic
7 SF6.9.1 8000 3500 1500
Necrosectomy
Pancreatic
8 SF6.9.3 8000 3500 1500
Necrosectomy (open)
Coronary Balloon
9 SF7.1.1.1 10000 4000 2000
Angioplasty
10 SF7.1.7.1 Renal Angioplasty 10000 4000 2000
11 SF7.1.7.2 Peripheral Angioplasty 10000 4000 2000
12 SF7.1.7.3 Vertebral Angioplasty 10000 4000 2000
Coronary Bypass
13 SF7.2.1.1 10000 4000 2000
Surgery
Coronary Bypass
14 SF7.2.1.2 Surgery-post 10000 4000 2000
Angioplasty
CABG with IABP
15 SF7.2.1.3 10000 4000 2000
pump
CABG with aneurismal
16 SF7.2.1.4 10000 4000 2000
repair
17 SF7.2.9.1 With Prosthetic Ring 10000 4000 2000
18 SF7.2.9.2 Without Prosthetic Ring 10000 4000 2000
Open Pulmonary
19 SF7.2.9.3 10000 4000 2000
Valvotomy
Closed mitral
20 SF7.2.9.4 10000 4000 2000
valvotomy
Mitral Valvotomy
21 SF7.2.9.5 10000 4000 2000
(Open)
292
FIRST SUBSEQUENT 3
Mitral Valve
22 SF7.2.10.1 Replacement (With 10000 4000 2000
Valve)
Aortic Valve
Valve)
Tricuspid Valve
24 SF7.2.10.3 10000 4000 2000
Replacement
Double Valve
Valve)
26 SF7.2.19.1 Carotid Embolectomy 10000 4000 2000
27 SF8.6.4 Encephalocele 4000 1600 800
Surgeries on adrenal
28 SF8.8.12 4000 1600 800
gland in Children
29 SF9.2.1 Open Pyelolithotomy 2000 800 400
30 SF9.2.2 Open Nephrolithotomy 2000 800 400
31 SF9.2.3 Open Cystolithotomy 2000 800 400
Laparoscopic
32 SF9.2.4 2000 800 400
Pyelolithotomy
33 SF9.3.1 Cystolithotripsy 2000 800 400
34 SF9.3.2 PCNL 2000 800 400
35 SF9.3.3 ESWL 2000 800 400
36 SF9.3.4 URSL 2000 800 400
Endoscope Removal of
37 SF9.7.1 2000 800 400
stone in Bladder
Transurethral resection
38 SF9.9.1 2000 800 400
of prostate (TURP)
39 SF9.9.2 TURP Cyst lithotripsy 2000 800 400
40 SF9.9.3 Open prostatectomy 2000 800 400
Craniotomy and
41 SF10.1.1 Evacuation of 8000 3200 1600
Haematoma �Subdural
Craniotomy and
Evacuation of
42 SF10.1.2 Haematoma 8000 3200 1600
�Extradural
Evacuation of Brain
43 SF10.1.3 8000 3200 1600
Abscess-burr hole
293
FIRST SUBSEQUENT 3
Excision of Lobe
44 SF10.1.4 (Frontal,Temporal,Cere 8000 3200 1600
bellum etc.)
Excision of Brain
45 SF10.1.5 8000 3200 1600
Tumor Supratentorial
46 SF10.1.6 Parasagital 8000 3200 1600
47 SF10.1.7 Basal 8000 3200 1600
48 SF10.1.8 Brain Stem 8000 3200 1600
49 SF10.1.9 C P Angle Tumor 8000 3200 1600
50 SF10.1.10 Other tumors 8000 3200 1600
Excision of Brain
51 SF10.1.11 8000 3200 1600
Tumors �Subtentorial
Ventriculoatrial
52 SF10.1.12 /Ventriculoperitoneal 8000 3200 1600
Shunt
53 SF10.1.14 Subdural Tapping 8000 3200 1600
54 SF10.1.15 Ventricular Tapping 8000 3200 1600
55 SF10.1.16 Abscess Tapping 8000 3200 1600
56 SF10.1.17 Vascular Malformations 8000 3200 1600
57 SF10.1.18 Peritoneal Shunt 8000 3200 1600
58 SF10.1.19 Atrial Shunt 8000 3200 1600
59 SF10.1.20 Meningo Encephalocele 8000 3200 1600
60 SF10.1.21 Meningomyelocele 8000 3200 1600
61 SF10.1.25 Ventriculo-Atrial Shunt 8000 3200 1600
Excision of Brain
62 SF10.1.26 8000 3200 1600
Abcess
63 SF10.1.27 Aneurysm Clipping 8000 3200 1600
External Ventricular
64 SF10.1.28 8000 3200 1600
Drainage (EVD)
Trans Sphenoidal
65 SF10.3.2 8000 3200 1600
Surgery
66 SF10.3.3 Trans Oral Surgery 8000 3200 1600
67 SF10.4.1 Endoscopy procedures 8000 3200 1600
Intra-Cerebral
68 SF10.4.2 8000 3200 1600
Hematoma evacuation
69 SF10.7.1 Temporal Lobectomy 8000 3200 1600
294
FIRST SUBSEQUENT 3
70 SF10.7.2 Lesionectomy type 1 8000 3200 1600

71 SF10.7.3 Lesionectomy type 2 8000 3200 1600
Temporal lobectomy
72 SF10.7.4 8000 3200 1600
plus Depth Electrodes
Stay in General
73 SF15.2.1.1 8000 3200 1600
Ward@Rs.500/day
Stay in Neuro
74 SF15.2.1.2 8000 3200 1600
ICU@Rs.4000/day
Surgical Treatment (Up
75 SF15.2.2 8000 3200 1600
to)
FOLLOW UP PACKAGES MEDICAL
FIRST
SUBSEQUENT 3
S.NO CODE SYSTEM DISEASE INSTALLMEN
INSTALLMENTS
T
Acute severe asthma
1 MF1.1 with Acute respiratory 10000 4000 2000
failure
COPD Respiratory
2 MF1.2 Failure (infective 10000 4000 2000
exacerbation)
Term baby with
persistent pulmonary
hypertension
3 MF4.1.12 6000 3000 1000
Ventilation-HFO
Hyperbilirubinemia
Clinical sepsis
Term baby with
4 MF4.1.16 5000 2000 1000
seizures ventilated
Acute Severe Asthma
5 MF4.2.1.5 4000 1600 800
(Ventilated)
6 MF4.2.2.5 Infective Endocarditis 10000 4000 2000
Meningo- encephalitis
7 MF4.2.3.1 6500 2000 1500
(Non Ventilated)
Meningo- encephalitis (
8 MF4.2.3.2 6500 2000 1500
Ventilated)
9 MF4.2.3.3 Status Epilepticus 6500 2000 1500
10 MF4.2.3.5 Intra cranial bleed 6500 2000 1500
295
FIRST
SUBSEQUENT 3
INSTALLMENTS
T
Congenital heart
11 MF4.3.2.1 disease with congestive 5000 2000 1000
cardiac failure
Acquired heart disease
12 MF4.3.2.2 with congestive cardiac 5000 2000 1000
failure
Steroid Resistant
Nephrotic syndrome
13 MF4.3.3.1 5000 2000 1000
Complicated or
Resistant
Anemia of unknown
14 MF4.3.4.3 5000 2000 1000
cause
15 MF4.3.5.1 Pyogenic meningitis 5000 2000 1000
16 MF4.3.5.2 Neuro tuberculosis 5000 2000 1000
Neuro tuberculosis with
17 MF4.3.5.3 5000 2000 1000
ventilation
Convulsive
18 MF4.3.6.1 Disorders/Status 5000 2000 1000
Epilepticus (Fits)
Encephalitis /
19 MF4.3.6.3 5000 2000 1000
Encephalopathy
Acute Myocardial
Infarction
20 MF5.1.1 (Conservative 10000 4000 2000
management without
Angiogram)
Acute Myocardial
Infarction
21 MF5.1.2 (Conservative 10000 4000 2000
management with
Angiogram)
Acute Myocardial
22 MF5.1.3 Infarction with 10000 4000 2000
Cardiogenic shock
Acute Myocardial
23 MF5.1.4 Infarction requiring 10000 4000 2000
IABP Pump
Refractory Cardiac
24 MF5.1.5 10000 4000 2000
Failure
25 MF5.2 Infective Endocarditis 10000 4000 2000
26 MF5.4 Complex Arrhythmias 10000 4000 2000
27 MF6.2 Nephrotic Syndrome 5000 2000 1000
296
FIRST
SUBSEQUENT 3
INSTALLMENTS
T
ADEM or Relapse in
28 MF7.1 5000 2000 1000
Multiple sclerosis
29 MF7.2 CIDP 5000 2000 1000
Hemorrhagic
30 MF7.3 5000 2000 1000
Stroke/Strokes
31 MF7.4 Ischemic Strokes 5000 2000 1000
NEUROINFECTIONS
32 MF7.6 5000 2000 1000
-Fungal Meningitis
NEUROINFECTIONS
33 MF7.7 5000 2000 1000
-Pyogenic Meningitis
NEUROINFECTIONS
-Viral
34 MF7.8 Meningoencephalitis ( 5000 2000 1000
Including Herpes
encephalitis)
Neuromuscular
35 MF7.9 4000 1600 800
(myasthenia gravis)
Interstitial Lung
36 MF8.4 10000 4000 2000
diseases
37 MF8.5 Pneumoconiosis 10000 4000 2000
Pemphigus /
38 MF9.1 3500 1400 700
Pemphigoid
SLE (SYSTEMIC
39 MF10.1 LUPUS 6000 2400 1200
ERYTHEMATOSIS)
40 MF10.2 SCLERODERMA 6000 2400 1200
MCTD MIXED
41 MF10.3 CONNECTIVE 6000 2400 1200
TISSUE DISORDER
MCTD MIXED
42 MF10.4 CONNECTIVE 6000 2400 1200
TISSUE DISORDER
43 MF10.5 VASCULITIS 6000 2400 1200
44 MF11.2.1 Hypopitutarism 8000 3500 1500
45 MF11.2.2 Pituitary - Acromegaly 6500 2000 1500
Delayed Puberty
Hypogonadism
46 MF11.2.4 7000 2500 1500
(ex.Turners synd,
Kleinfelter synd)
47 MF12.9 Gastric varices 7000 2500 1500
Chronic pancreatitis
48 MF12.13 7000 2500 1500
with severe pain
297
FIRST
SUBSEQUENT 3
INSTALLMENTS
T
Cirrhosis with Hepatic
49 MF12.15 7000 2500 1500
Encephalopathy
Cirrhosis with hepato
50 MF12.16 7000 2500 1500
renal syndrome
298
299
ANNEXURE – III
List of Hospitals
S. Date of Surgeries/
Name of Hospital District Location Hospital Type Status
No Empanelment Therapies
ADILABAD
1 Area Hospital - Mancherial Adilabad Adilabad Government 17-07-2008 146 Active
2 GK Hospitals Nirmal Adilabad Adilabad Corporate 18-05-2011 146 Active
3 Rims Hospital Adilabad Adilabad Government 17-07-2008 909 Active
Thirumala Nursing Home Nirmal-
4 Adilabad Adilabad Corporate 29-09-2008 147 Delisted
Adilabad
ANANTAPUR
5 Aasha Hospital Anantapur Anantapur Corporate 01-04-2007 2805 Active
6 Area Hospital - Kadiri Anantapur Anantapur Government 17-07-2008 327 Active
7 Dr. YSR Memorial Hospitals Anantapur City14 Corporate 10-02-2012 138 Active
8 Govt General Hospital Anantapur Anantapur Anantapur Government 01-04-2007 1108 Active
9 Jeevana Jyothi Anantapur Anantapur Corporate 29-09-2007 77 Delisted
10 Mytri Hospital- Anantapur Anantapur Anantapur Corporate 23-03-2009 424 Delisted
11 Pavani Multi Speciality Hospital Anantapur Anantapur Corporate 01-04-2007 3439 Active
12 Preethi Nursing Home Anantapur Anantapur Corporate 31-07-2010 750 Delisted
13 Sainath Hospital Anantapur Kadiri Corporate 18-05-2011 767 Active
De-
14 Snehalatha Nursing Home Anantapur Anantapur Corporate 30-08-2011 3522
empanelment
15 Vaatsalya Hospital Anantapur Anantapur Corporate 17-11-2011 472 Active
300
CHITTOOR
Apollo Hospitals Enterprises Ltd-
16 Chittoor Chittoor Corporate 01-04-2007 581 Active
A
17 Area Hospital - Kuppam Chittoor Kuppam Government 17-07-2008 41 Active
18 Area Hospital - Madanapalli Chittoor Chittoor Government 17-07-2008 891 Active
19 Area Hospital - Palamaneru Chittoor Chittoor Government 17-07-2008 104 Active
20 Chandra Mohans Nursing Home Chittoor Madanapalli Corporate 05-08-2008 2331 Active
Dbr And Sk Super Specialty
21 Chittoor Chittoor Corporate 18-02-2011 643 Delisted
Hospital
22 District Hospital - Chittoor Chittoor Chittoor Government 17-07-2008 382 Active
Government Maternity Hospital
23 Chittoor Tirupathi Government 17-07-2008 373 Active
Tirupathi
24 Om Hospital Chittoor Tirupathi Corporate 17-07-2008 829 Active
Pes Institute Of Medical Sciences
25 Chittoor Kuppam Corporate 04-03-2009 2375 Active
And Research Hospital
26 Russh Hospitals Pvt Ltd Chittoor Tirupathi Corporate 17-07-2008 5017 Active
27 S.V.R.R.Hospital Chittoor Tirupathi Government 17-07-2008 6707 Active
28 Sneha Hospital Chittoor Tirupathi Corporate 09-05-2008 1019 Active
Sree Ramadevi Multy Speciality
29 Chittoor Tirupathi Corporate 17-07-2008 2958 Active
Hospital
30 Sri Priya Nursing Home Chittoor Kuppam Corporate 30-03-2009 1799 Active
Sri Ramadevi Multi Speciality
31 Chittoor Tirupathi Corporate 17-07-2008 12 Active
Hospital
32 Sri Sai Sudha Hospital Chittoor Tirupathi Corporate 11-04-2008 4208 Active
301
Sri Venkateswara Institute Of
33 Chittoor Tirupathi Government 01-06-2007 29450 Active
Medical Sciences
EAST GODAVARI
34 7 Star Super Speciality Hospital East Godavari Kakinada Corporate 17-11-2011 50 Active
35 Abhaya Emergency Centre East Godavari Rajahmundry Corporate 13-01-2011 919 Delisted
36 Adarsh Hospital East Godavari Rajahmundry Corporate 17-07-2008 856 Active
Aravindam Orthopdeics And
37 East Godavari Rajahmundry Corporate 17-07-2008 645 Active
Physiotherapy Centre
Area Hospital - Ramachandrapur
38 East Godavari Government 17-07-2008 33 Active
Ramachandrapuram am
39 Bollineni Heart Centre East Godavari Rajahmundry Corporate 17-02-2010 3206 Delisted
Bollineni Hospitals (A Unit Of
Bollineni Heart Centre Pvt Ltd)
41 Chakradhar Hospitals East Godavari Rajahmundry Corporate 18-05-2011 321 Active
42 District Hospital - Rajahmundry East Godavari Rajahmundry Government 17-07-2008 886 Active
Ramachandrapur
43 Dr.KVR HOSPITAL East Godavari Corporate 17-10-2011 146 Active
am
44 Goutami Eye Institute East Godavari Rajahmundry Corporate 17-07-2008 3971 Active
Government General
45 East Godavari Kakinada Government 01-04-2007 29702 Active
Hospital,Kakinada
Gsl Medical College And Gsl
General Hospital
302
Gsl Trust Cancer Hospital And

Research Centre
48 Haritha Hospitals East Godavari Kakinada Corporate 11-04-2008 2169 Active
Konaseema Institute Of Medical
49 East Godavari Amalapuram Corporate 05-12-2007 3322 Active
Science
Life Line Emergency Neuro &
50 East Godavari Kakinada Corporate 18-05-2011 268 Active
Trauma Hospital
51 Raghava 24 Hours Hospital East Godavari Kakinada Corporate 17-05-2011 1681 Delisted
Raju Neuro And Multispeciality
Hospitals (P) Ltd
53 Royal Hospital East Godavari Rajahmundry Corporate 30-03-2009 2459 Active
54 S.A.I. Hospitals East Godavari Rajahmundry Corporate 17-07-2008 6416 Active
55 Safe Emergency Hospital East Godavari Kakinada Corporate 23-02-2010 1025 Active
56 Sai Sudha Hospital East Godavari Kakinada Corporate 11-04-2008 3037 Active
Samudra Healthcare Enterprises
Ltd (Apollo Hospital Kakinada)
58 Siddhartha Hospital East Godavari Kakinada Corporate 18-05-2011 413 Active
Sidharatha Orthopedic Hospital
59 East Godavari Rajahmundry Corporate 29-04-2009 708 Delisted
And Poly Clinic
60 Sri Bikkina Nursing Home East Godavari mandapeta Corporate 21-02-2009 2150 Active
Sri Kiran Institute Of
Ophthalmology
303
Sri Lalitha Hospitals Insitute Of
62 Laparoscopic Surgery And East Godavari Kakinada Corporate 30-03-2009 1015 Active
Training
Sri Sai Raghavendra Super De-
63 East Godavari Kakinada Corporate 30-08-2011 1263
Specialty empanelment
64 Srujana Multi Speciality Hospital East Godavari Kakinada Corporate 30-03-2009 764 Active
Sudha Urology And Andrology
Hospital
66 Swatantra Hospitals(M.S) Pvt Ltd East Godavari Rajahmundry Corporate 15-12-2007 2374 Active
Trust Hospital (A Unit Of
Sarvottam Health Care)
GUNTUR
Amaravathi Institute Of Medical
68 Guntur Guntur Corporate 19-04-2008 1644 Active
Sciences Pvt Ltd
69 Anji Reddy Hospitals Guntur Guntur Corporate 29-11-2009 1198 Delisted
70 Area Hospital - Bapatla Guntur Guntur Government 17-07-2008 63 Active
71 Area Hospital - Narsaraopet Guntur Guntur Government 17-07-2008 19 Active
72 Aswini Hospital Guntur Guntur Corporate 05-05-2008 3478 Active
73 Balaji Cancer Care Centre Guntur Guntur Corporate 05-12-2007 3875 Active
74 BMR Hospital Guntur Guntur Corporate 21-04-2008 2681 Active
75 District Hospital - Tenali Guntur Guntur Government 17-07-2008 927 Active
76 Ent Nursing Home Guntur Guntur Corporate 05-12-2007 3446 Active
304
Government General Hospital,
77 Guntur Guntur Government 05-12-2007 28466 Active
Guntur
Guntur Cancer Care Centre
Limited
79 Health Hospitals Guntur tenali Corporate 05-05-2009 2250 Active
Hitech Trauma And Critical Care
80 Guntur Guntur Corporate 02-09-2010 519 Delisted
Hospitals Ltd
81 Hyma Hospital Guntur Guntur Corporate 17-07-2008 1667 Active
82 Karumuri Hospital Guntur Guntur Corporate 05-12-2007 1040 Active
Katuri Medical College And
83 Hospital A unit of Vignan Guntur Guntur Corporate 17-07-2008 3412 Active
Educational Foundation
Lalitha Super Speciality Hospital
(P) Ltd
85 Life Hospital Guntur Guntur Guntur Corporate 26-02-2011 598 Delisted
86 M N Hospital Guntur Guntur Corporate 24-01-2009 548 Active
Manipal Health Enterprises PVT
LTD
88 Nandana Hospital Guntur Guntur Corporate 17-07-2008 2343 Active
89 Nri Academyof Sciences Guntur Guntur Corporate 05-12-2007 19208 Active
Peoples Trauma And Emergency
Hospital
Sanjivi Orthopedic And
91 Guntur Guntur Corporate 09-05-2011 682 Delisted
92 Sankar Eye Hospital Guntur Guntur Corporate 05-05-2009 1844 Active
305
93 Sravani Hospital Guntur Guntur Corporate 02-05-2009 1059 Delisted
Sri Lakshmi Maternity And
Surgical Nursing Home
Sri Ramachandra Childrens And

Dental Hospital
96 Sri Sai Hospitals Guntur Guntur Corporate 05-04-2008 2531 Active
97 Srinivasa Nursing Home Guntur Guntur Corporate 06-07-2010 438 Delisted
98 St. Joseph Guntur Guntur Corporate 21-02-2009 2771 Active
99 Veena Hospital Guntur Guntur Corporate 18-03-2008 15 Delisted
100 Yerras Super Speciality Hospital Guntur Guntur Corporate 12-04-2008 1588 Active
HYDERABAD
101 Aditya Hospital Hyderabad Hyderabad Corporate 05-12-2007 3961 Active
102 Alpha Super Speciality Hospital Hyderabad Hyderabad Corporate 17-07-2008 219 Active
103 Apollo Hospitals Secunderabad Hyderabad Secunderabad Corporate 26-02-2011 532 Active
Apollo Hospitals Enterprises Ltd
104 Hyderabad Hyderabad Corporate 17-04-2008 7977 Active
(Jubilee Hills)
Apollo Hospitals Enterprises Ltd De-
105 Hyderabad Hyderabad Corporate 10-10-2011 1770
(Vikrampuri) empanelment
106 Area Hospital - Golconda Hyderabad Hyderabad Government 17-07-2008 23 Active
107 Area Hospital - Nampally Hyderabad Hyderabad Government 17-07-2008 170 Active
108 Area Hospital - Vanasthalipuram Hyderabad Hyderabad Government 17-07-2008 10 Active
306
Asian Institute Of Gastro
Enterology
Axon Hospitals, Neuro Trauma
110 Hyderabad Hyderabad Corporate 30-05-2009 264 Delisted
And Stoke Institute
111 Azam Hospital Hyderabad Hyderabad Corporate 20-08-2010 100 Delisted
BASAVATARAKAM INDO
AMERICAN CANCER
HOSPITAL & RESEARCH
INSTITUTE, Hyderabad
113 Bbc Hospital Hyderabad Hyderabad Corporate 05-04-2008 264 Active
114 District Hospital - Kingkoti Hyderabad Hyderabad Government 17-07-2008 1118 Active
115 Dolphin Childrens Hospital Hyderabad Hyderabad Corporate 20-08-2010 228 Delisted
Durga Bhai Deshmukh Hospital
116 and Research Centre A unit of Hyderabad Hyderabad Corporate 01-04-2007 3738 Active
Andhra Mahila Shaba
117 Gandhi Hospitals Hyderabad Hyderabad Government 01-04-2007 26268 Active
Goodwill Kidney And Surgical
Centre
119 Govt Ent Hospital - Koti Hyderabad Hyderabad Government 17-07-2008 5522 Active
120 Govt Meternity Hospital,Koti Hyderabad Hyderabad Government 17-07-2008 488 Active
121 Govt. Genl. And Chest Hospital Hyderabad Hyderabad Government 01-04-2007 693 Active
122 GSR HOSPITALS Hyderabad Hyderabad Corporate 31-07-2010 681 Delisted
123 Gurunanak Care Hospital Hyderabad Hyderabad Corporate 01-04-2007 1271 Active
124 Healing Touch Hospital Hyderabad Hyderabad Corporate 25-03-2010 103 Delisted
307
Himabindu Multi Speciality
Hospital
126 Hyderabad Nursing Home Hyderabad Hyderabad Corporate 21-02-2009 1559 Active
127 Image Hospital- Ameerpet Hyderabad Hyderabad Corporate 01-04-2007 5415 Active
128 Image Hospitals- Madhapur Hyderabad Hyderabad Corporate 11-03-2011 13 Delisted
Innova Childrens Heart Hospital
Pvt
130 Jagadamba Hospitals Hyderabad Hyderabad Corporate 31-02-2012 298 Delisted
131 Kamineni Hospital King Koti Hyderabad Hyderabad Corporate 17-04-2010 1224 Active
132 Kamineni Hospitals - Iii (Genesis Hyderabad Hyderabad Corporate 07-08-2008 426 Delisted
133 Kamineni Hospitals Pvt Ltd Hyderabad Hyderabad Corporate 01-04-2007 4730 De-list
Kamineni Wockhardt Hospitals -
Kingkoti
135 Krishna Childrens Hospitals Hyderabad Hyderabad Corporate 30-05-2009 28 Delisted
Krishna Institute Of Medical
Sciences Ltd
Lazarus Hospital limited
Hyderabad
138 Life Hospital Hyderabad Hyderabad Corporate 15-04-2008 3418 Active
139 Life Hospital Hyderabad Hyderabad Corporate 15-04-2008 3 Active
140 Lotus Childrens Hospital Hyderabad Hyderabad Corporate 01-04-2007 2153 Active
141 M.N.J.Hospitals Hyderabad Hyderabad Government 01-04-2007 43744 Active
308
Maa Hospitals Pvt. Ltd. (Unit Of

Vasavi Ent Institute)
Madhava Nursing Home,
Secunderabad
Mahavir Hospital And Research
Centre
Mahesh Hospital And Research
Foundation
146 Medicare Hospitals Hyderabad Hyderabad Corporate 11-11-2008 153 Delisted
147 Mediciti Hospitals Hyderabad Hyderabad Corporate 01-04-2007 6796 Active
148 Medwin Hospitals Hyderabad Hyderabad Corporate 01-04-2007 7701 Active
Mn Area Hospital Hospital
149 Hyderabad Hyderabad Government 17-07-2008 81 Active
(Apvvp)
150 New Life Hospital Hyderabad Hyderabad Corporate 05-04-2008 5066 Active
151 Nice Institute For The Newborn Hyderabad Hyderabad Corporate 21-02-2009 641 Active
152 Nikhil Hospital Hyderabad Hyderabad Corporate 17-07-2008 517 Active
153 Niloufer Hospital Hyderabad Hyderabad Government 01-04-2007 12600 Active
154 Nims Hospitals Hyderabad Hyderabad Government 01-04-2007 27408 Active
155 Osmania General Hospital Hyderabad Hyderabad Government 01-04-2007 28273 Active
156 Paramitha Children Hospital Hyderabad Hyderabad Corporate 23-10-2009 411 Delisted
157 Pargna Hospital Hyderabad Hyderabad Corporate 30-05-2009 1 Delisted
158 Prime Hospitals Hyderabad Hyderabad Corporate 05-04-2008 5494 Active
159 Princess Esra Hospital (Dcms) Hyderabad Hyderabad Corporate 17-07-2008 2253 Active
309
160 Pushpagiri Eye Hospital Hyderabad Secunderabad Corporate 21-08-2008 4019 Active
Quality Care India Ltd (Care
Hospitals Banjarahills)

Hospitals- Nampally )
Rainbow Childrens Hospital And

Perinatal Centre- Banjara Hills
Rainbow Childrens Hospital-
Vikrampuri
Ravindranath Ge Medical
165 Associates Pvt Ltd. (Global Hyderabad Hyderabad Corporate 01-04-2007 3648 Active
Hospital Lakdikapool)
166 Remedy Hospitals Hyderabad Hyderabad Corporate 25-04-2011 620 Delisted
167 S V Pooja Hospital Hyderabad Hyderabad Corporate 12-11-2010 67 Delisted
168 S.V.R. Super Speciality Hospital Hyderabad Hyderabad Corporate 01-04-2007 1204 Active
Sagarlal Memorial Hospital &
Matadin Goel Research Centre
170 Sai Krishna Neuro Hospitals Hyderabad Hyderabad Corporate 30-04-2009 6 Delisted
Sai Krishna Super Specialty
171 Hyderabad Hyderabad Corporate 01-04-2007 245 De-list
Neuro And Poly Trauma Hospital
172 Sai Vani Hospitals Ltd Hyderabad Hyderabad Corporate 11-03-2011 310 Delisted
173 Sarojini Devi Eye Hospital Hyderabad Hyderabad Government 15-12-2008 2235 Active
310
Satya Kidney Centre And Super

Speciality Hospital
175 Seha Hospital Hyderabad Hyderabad Corporate 09-05-2008 320 Active
De-
176 Shravana Hospitals Hyderabad Hyderabad Corporate 25-04-2011 2384
empanelment
177 Sigma Hospitals (Secunderabad) Hyderabad Hyderabad Corporate 01-04-2007 3740 Active
178 Smt.Bhagawan Devi Hospital Hyderabad Hyderabad Corporate 15-10-2008 39 Delisted
179 Soumya Multispeciality Hospital Hyderabad Hyderabad Corporate 11-03-2011 622 Delisted
180 Sowmya Hospital Ramnagar Hyderabad Hyderabad Corporate 17-07-2008 1036 Active
Sri Narmada
Hospital,Gandhinagar
182 Sri Sai Kamala Hospital Hyderabad Hyderabad Corporate 15-06-2010 76 Active
183 Sri Sai Kidney Center Hyderabad Hyderabad Corporate 06-01-2009 2975 Active
Sri Sai Srinivasa Speciality
Hospital
185 Sunshine Hospital Hyderabad Secunderabad Corporate 18-05-2011 963 Active
Superintendent- Govt. Maternity
186 Hyderabad Hyderabad Government 17-07-2008 1000 Active
Hospital- Nayapul
SURAKSHA CHILDRENS
187 HOSPITAL a unit of rochismathi Hyderabad Hyderabad Corporate 23-08-2011 373 Active
health care pvt.ltd.
Surakshaka Multi Speciality
Hospital
311
189 Times Hospital Hyderabad Hyderabad Corporate 22-10-2009 1227 Active
Unimed Healthcare Pvt- Ltd (Star
Hospitals)
191 Usha Mohan Hospitals Hyderabad Hyderabad Corporate 31-01-2012 275 Delisted
192 Vasavi Hospital Hyderabad Hyderabad Corporate 17-07-2008 5936 Active
193 Vijaya Health Care Hyderabad Hyderabad Corporate 19-05-2008 15 Delisted
Wockhardt Heart Center -
194 Hyderabad Hyderabad Corporate 01-04-2007 1532 De-list
L.B.Nagar
195 Woodlands Hospital Hyderabad Hyderabad Corporate 05-12-2007 2216 Active
Yashoda Cancer
De-
196 Hospital,Unit:Datta Chandra Hyderabad Hyderabad Corporate 29-09-2011 5465
empanelment
Hospitals Pvt. Ltd.
197 Yashoda Hospitals Hyderabad Secunderabad Corporate 01-04-2007 17188 Active
198 Yashoda Hospitals - Somajiguda Hyderabad Hyderabad Corporate 01-04-2007 8525 Active
KARIMNAGAR
199 Amrutha Nursing Home Karimnagar Karimnagar Corporate 14-04-2008 3686 Active
200 Apollo Reach Hospital Karimnagar Karimnagar Corporate 29-10-2008 8955 Active
201 Area Hospital - Jagityal Karimnagar Karimnagar Government 05-08-2008 261 Active
Chalmeda Anand Rao Institute Of
202 Karimnagar Karimnagar Corporate 14-04-2008 6408 Active
Medical Sciences
203 District Hospital - Karimnagar Karimnagar Karimnagar Government 17-07-2008 205 Active
Dr Laxman Institute Of
Orthopedics
312
205 Dr.Bhoom Reddys Hospital Karimnagar Karimnagar Corporate 14-04-2008 2819 Active
206 Govt Area Hospital Karimnagar Godavarikhani Government 22-10-2009 83 Active
207 Medwin General Hospital Karimnagar Karimnagar Corporate 27-12-2008 129 Delisted
Prathima Insitute Of Medical
Scienc
209 Renee Hospital Karimnagar Karimnagar Corporate 08-10-2010 658 Delisted
210 Sai Praja Hospital Pvt .Ltd Karimnagar Karimnagar Corporate 12-11-2010 7 Delisted
211 Sai Ram Multi Specialty Hospital Karimnagar Karimnagar Corporate 26-02-2011 1198 Delisted
212 Sarojini Hospital Karimnagar Karimnagar Corporate 24-06-2008 2258 Active
213 Siva Rama Hospital Karimnagar Karimnagar Corporate 16-10-2010 638 Delisted
Sri Rama Multi Speciality
Hospital
215 Surya Hospitals Karimnagar Karimnagar Corporate 07-01-2010 307 Delisted
216 Surya Nursing Home Karimnagar Karimnagar Corporate 16-09-2009 589 Delisted
217 Sushrutha Cancer Hospital Karimnagar Karimnagar Corporate 17-07-2008 9363 Active
218 Venkateshwara Kidney Center Karimnagar Karimnagar Corporate 16-04-2008 4470 Active
KHAMMAM
219 Area Hospital - Badrachalam Khammam Khammam Government 17-07-2008 55 Active
220 Area Hospital - Kothagudem Khammam Khammam Government 17-07-2008 108 Active
221 Cure Emergency Hospital Khammam Khammam Corporate 22-02-2010 51 Delisted
222 District Hospital-Khammam- Khammam Khammam Government 17-07-2008 293 Active
223 Hope Super Speciality Hospital Khammam Khammam Corporate 11-11-2008 4 Delisted
313
Mamatha General And Super
224 Speciality Hospital A unit of Khammam Khammam Corporate 23-08-2008 6737 Active
Mamatha Educational Society
New Life Emergency And Multi
225 Khammam Khammam Corporate 28-02-2009 243 Delisted
Speciality Hospital
226 Shyamala Hospital Khammam Khammam Corporate 23-12-2011 683 Delisted
Sri Ram Kidney Infertility And
227 Khammam Khammam Corporate 17-07-2008 4650 Active
Laparoscopic Centre
Srujan Ortho And Accident Care
228 Khammam Khammam Corporate 11-11-2008 502 Delisted
Hospital
KRISHNA
Andhra Health Diagnostic
229 Services Limited(Global Krishna Vijayawada Corporate 05-04-2008 2667 Active
Vijayawada)
230 Andhra Hospitals Krishna Vijayawada Corporate 17-07-2008 10518 Active
Annapurna Multi Speciality
231 Krishna Vijayawada Corporate 21-02-2009 859 Active
Hospital
232 Area Hospital - Gudivada Krishna Vijayawada Government 17-07-2008 7 Active
233 Charithasri Hospital Ltd Krishna Vijayawada Corporate 05-12-2007 11034 Active
234 Citi orthopaedic center Krishna Vijayawada Corporate 17-11-2011 227 Active
235 City Cancer Centre Krishna Vijayawada Corporate 03-08-2007 16405 Active
236 District Hospital - Machilipatnam Krishna Machilipatnam Government 17-07-2008 2342 Active
314
Dr.Ramesh Cardiac And

Multispeciality Hospital Ltd
Govt. General Hospital-
238 Krishna Vijayawada Government 05-12-2007 5633 Active
Vijayawada
Hcg Curie City Cancer Centre A
239 unit of Health care Global Vijay Krishna Vijayawada Corporate 22-10-2009 10318 Active
Oncology Private Limited
240 Heart Care Centre Krishna Vijayawada Corporate 15-04-2008 1290 Active
241 Help Hospitals Pvt Ltd Krishna Vijayawada Corporate 05-12-2007 3233 Active
Krishna Institute of Medical
Sciences LTD
243 M V S Accident Hospital Krishna Vijayawada Corporate 25-02-2009 2352 Active
Manipal Super Speciality De-
244 Krishna Vijayawada Corporate 18-05-2011 11160
Hospital empanelment
245 Metro Superspeciality Hospitals Krishna Vijayawada Corporate 17-10-2011 193 Active
246 Nagarjuna Hospital Krishna Vijayawada Corporate 05-12-2007 4052 Active
Pinnamaneni Institue Of Medical
Sciences
248 Prasanth Hospital Krishna Vijayawada Corporate 05-01-2009 3060 Active
249 Praveen Cardiac Center Krishna Vijayawada Corporate 05-01-2009 2142 Active
250 Purna Heart Insititute Krishna Vijayawada Corporate 17-05-2011 536 Delisted
251 Krishna Vijayawada Corporate 25-03-2010 2594 Delisted
Hospital Vijayawada)
315
Rainbow Childrens Medicare Pvt
252 Ltd(Rainbow Childrens Hospital) Krishna Vijayawada Corporate 05-04-2008 489 Active
Vijayawada
253 Suraksha Neuro Centre Krishna Vijayawada Corporate 24-11-2010 1660 Delisted
254 Svr Neuro Hospitals Krishna Vijayawada Corporate 31-12-2008 474 Active
255 Time Hospitals Private Limited Krishna Vijayawada Corporate 21-08-2010 475 Active
256 Trust Hospital Krishna Vijayawada Corporate 05-04-2008 3679 Active
257 Usha Cardiac Centre Limited Krishna Vijayawada Corporate 05-12-2007 9242 Active
258 Usha Multi Specialty Hospital Krishna Vijayawada Corporate 24-11-2010 2322 Delisted
V R L S Memorial Neuro
Hospital
260 Vijetha Hospitals Krishna Vijayawada Corporate 05-08-2007 6713 Active
KURNOOL
261 Aayushman Hospital Kurnool Kurnool Corporate 17-07-2008 3527 Active
262 Area Hospital - Adoni Kurnool Kurnool Government 17-07-2008 4 Active
263 District Hospital - Nandyal Kurnool Kurnool Government 17-07-2008 223 Active
264 G V R Children Hospital Kurnool Kurnool Corporate 21-02-2009 638 Active
265 Govt General Hospital Kurnool Kurnool Kurnool Government 05-12-2007 16526 Active
266 Gowri Gopal Hospital Kurnool Kurnool Corporate 05-12-2007 3838 Active
267 Kurnool Heart And Brain Centre Kurnool Kurnool Corporate 17-05-2011 1188 Delisted
268 Medicare Hospitals Kurnool nandyala Corporate 22-10-2009 1987 Active
Padma Chandra Super Speciality
269 Kurnool Kurnool Corporate 15-04-2008 4372 Active
Hospital
316
Padma Chandra Super Speciality
Hospital
271 R.R Hospital Kurnool Kurnool Corporate 16-04-2011 1530 suspended
Rainbow Institute Of Child
Health And Maternity Hospital
Shantiram Medical College
General Hospital
Suseela Netralaya And Maternity
274 Kurnool Kurnool Corporate 28-02-2009 109 Delisted
Hospital
275 Vijaya Hospital - Kurnool Kurnool Kurnool Corporate 05-12-2007 3636 Active
276 Viswabharathi Cancer Hospital Kurnool Kurnool Corporate 10-11-2009 10323 Active
Viswabharathi Super Speciality
277 Kurnool Kurnool Corporate 17-05-2010 1099 Delisted
Hospital
MAHABUBNAGAR
278 Area Hospital - Gadwal Mahabubnagar Mahbubnagar Government 17-07-2008 9 Active
Govt General Hospital-

279 Mahabubnagar Mahbubnagar Government 17-07-2008 758 Active
Mahaboobnagar
280 S.V.S Hospital Mahabubnagar Mahbubnagar Corporate 05-12-2007 5122 Active
281 Shadnagar-Chc Mahabubnagar Mahbubnagar Government 17-07-2008 3 Active
282 Sudha Nursing Home Mahabubnagar Mahbubnagar Corporate 17-11-2011 150 Active
283 Susrutha Peoples Hospital Mahabubnagar Mahbubnagar Corporate 08-09-2010 1976 Active
284 Svs Hospital Mahabubnagar Mahbubnagar Corporate 05-12-2007 24 Active
317
MEDAK
285 Area Hospital - Siddipet Medak Siddipet Government 17-07-2008 146 Active
286 Area Hospital Medak Medak Medak Government 17-07-2008 26 Active
287 Dist Hospital Sanga Reddy Medak Sangareddy Government 17-07-2008 171 Active
288 G.G.H Sanga Reddy Medak Sangareddy Government 17-07-2008 1 Active
Maternity And Child Health
289 Medak Siddipet Government 17-07-2008 8 Active
Hospital - Siddipet
Mnr Medical College And
290 Medak Sangareddy Corporate 18-04-2008 1533 Active
Hospital
NALGONDA
291 Area Hospital - Miriyalaguda Nalgonda Nalgonda Government 17-07-2008 52 Active
292 Area Hospital - Suryapet Nalgonda Nalgonda Government 17-07-2008 139 Active
293 Area hospital Huzurnagar Nalgonda Nalgonda Government 10-01-2012 1 Active
294 Govt General Hosptial, Nalgonda Nalgonda Nalgonda Government 17-07-2008 1659 Active
295 Kims, Nalgonda Nalgonda Nalgonda Corporate 05-12-2007 3588 Active
NELLORE
Anasuya Institute Of Medical
296 Nellore Nellore Corporate 23-07-2008 1375 Active
Sciences
297 Aravind Kidney Center Nellore Nellore Corporate 17-07-2008 5535 Active
Bollineni Ramanaiah Memorial
Hospital
299 D S R District Hospital - Nellore Nellore Nellore Government 16-04-2008 717 Active
318
Ircs Cancer Hospital (Indian Red

Cross Society Cancer Hospital)
301 Jayabharat Hospital Nellore Nellore Corporate 11-04-2008 2237 Active
302 Kandukuri Hospital Nellore Nellore Corporate 17-07-2008 2626 Active
Modern Eye Hospital & Research
Centre
Narayana Medical College
Hospital
Ravi Institute Of Child Health Pvt
Ltd (Rich Hospitals) Nellore
Sai Suresh Children Surgical
306 Nellore Nellore Corporate 13-02-2009 56 Delisted
Hospitals
Sri Durga Hospital And Brain
307 Nellore Nellore Corporate 13-02-2009 193 Delisted
Centre
308 St.Josephs General Hospital Nellore Nellore Corporate 17-07-2008 2422 Active
Vijaya Krishna Hospitals
(P)Ltd.(Vijaya Hospital)
NIZAMABAD
310 Aparna Hospital Nizamabad Armoor Corporate 17-11-2011 119 Active
311 Area Hospital - Banswada Nizamabad Nizamabad Government 17-07-2008 280 Active
312 Area Hospital - Bodhan Nizamabad Nizamabad Government 17-07-2008 57 Active
313 Area Hospital - Kamareddy Nizamabad Nizamabad Government 17-07-2008 146 Active
314 District Hospital - Nizamabad Nizamabad Nizamabad Government 17-07-2008 943 Active
319
315 Pragathi Hospital Nizamabad Nizamabad Corporate 17-07-2008 5518 Active
316 Shashank Hospital Nizamabad Nizamabad Corporate 05-05-2009 2019 Active
PRAKASAM
317 Area Hospital - Cheerala Prakasam Cheerala Government 17-07-2008 243 Active
318 Chaitanya Hospital Prakasam Ongole Corporate 15-07-2009 61 Delisted
319 Chandamama Childrens Hospital Prakasam Ongole Corporate 27-06-2009 367 Delisted
320 Dr Bethune Nursing Home Prakasam Ongole Corporate 27-06-2009 222 Delisted
321 Dr.Kota Reddy Prakasam Ongole Corporate 17-07-2008 1553 Active
Dr.Rajamma Mytri
322 Prakasam Ongole Corporate 27-06-2009 685 Delisted
Multispeciality Hospital
323 Kamala Nursing Home Prakasam Ongole Corporate 27-06-2009 371 Delisted
Kiran Neuro And Orthopedic
324 Prakasam Ongole Corporate 27-06-2009 252 Delisted
Hospital
325 MCH Ongole Prakasam Ongole Government 10-02-2012 1 Active
326 Nalluri Nursing Home Prakasam Ongole Corporate 12-01-2012 3211 Delisted
Rajiv Gandhi Institute of Medical
327 Prakasam Ongole Government 17-07-2008 1039 Active
Sciences RIMS Ongole
328 Sai Nursing Home Prakasam Ongole Corporate 27-06-2009 230 Delisted
Sri Sai Neuro And Trauma De-
329 Prakasam Ongole Corporate 25-04-2011 1082
Superspeciality Hospital empanelment
330 Srinivasa Hospitals Prakasam Ongole Corporate 27-06-2009 64 Delisted
331 Vaatsalya Hospital Prakasam Ongole Corporate 17-11-2011 193 Active
320
332 Venkataramana Nursing Home Prakasam Ongole Corporate 14-04-2008 2588 Active
RANGAREDDY
Apollo Hospitals Enterprise Ltd
333 Rangareddy Hyderabad Corporate 01-04-2007 5321 Active
(Drdo)
334 Area Hospital - Kondapur Rangareddy Hyderabad Government 17-07-2008 5 Active
335 Aware Global Hospitals Rangareddy Hyderabad Corporate 25-09-2009 5061 Active
336 Balaji Hospital Rangareddy Hyderabad Corporate 05-12-2007 1448 Active
Bibi Cancer And General
Hospital
Hyderabad Kidney And
Laproscopic Center
(A unit of JVC Super Speciality
Hospitals PVT LTD)
339 Induss Hospitals Rangareddy Hyderabad Corporate 18-05-2011 609 Active
340 Kamala Hospital Rangareddy Hyderabad Corporate 12-04-2008 1622 Active
Kamineni Oncology Private
Limited
342 L.K.Hospitals (P) Ltd Rangareddy Hyderabad Corporate 17-07-2008 2499 Active
343 Mamatha Hospital Rangareddy Hyderabad Corporate 05-04-2008 910 Active
344 Mythri Hospital (Chanda Nagar) Rangareddy Hyderabad Corporate 02-08-2008 1833 Active
345 Narayana Hrudayalaya Hospitals Rangareddy Hyderabad Corporate 17-04-2010 5564 Active
346 Nightingale Hospital Rangareddy Hyderabad Corporate 17-07-2008 1632 Active
Owaisi Hospital And Research
Center
321
348 Poulomi Hospital Rangareddy Hyderabad Corporate 01-04-2007 4149 Active
349 Ram Hospital, Shapurnagar Rangareddy Hyderabad Corporate 05-08-2008 899 Active
Sai Bhavani Super Speciality
Hospital
351 Shadan Medical College Rangareddy Hyderabad Corporate 24-06-2008 558 Active
Share Medical Care (Mediciti
352 Institute Of Medical Sciences- Rangareddy Hyderabad Corporate 05-12-2007 2238 Active
Medchal)
353 Shree Hrishikeshaya Hospitals Rangareddy Hyderabad Corporate 11-04-2008 5710 Active
354 Sigma Hospitals (Dilsuknagar) Rangareddy Hyderabad Corporate 01-04-2007 2144 Active
355 Sigma Hospitals (Jeedimetla) Rangareddy Hyderabad Corporate 17-07-2008 2787 Active
356 Sreshta Orange Hospitals Rangareddy Hyderabad Corporate 26-02-2011 783 Active
Sri Laxmi Multispeciality
357 Hospital Laparoscopic And Rangareddy Rangareddy Corporate 11-11-2008 86 Delisted
Reseach Centre
358 Sri Raghavendra Hospital Rangareddy Hyderabad Corporate 17-07-2008 2273 Active
359 Sridhar Multi Speciality Hospital Rangareddy Hyderabad Corporate 17-07-2008 1248 Active
360 Vijaya Hospital Rangareddy Hyderabad Corporate 13-10-2010 359 Active
361 Yashoda Hospital (Malakpet) Rangareddy Hyderabad Corporate 01-04-2007 9895 Active
SRIKAKULAM
362 Area Hospitalc - Palakonda Srikakulam Srikakulam Government 17-07-2008 28 Active
363 Bharath Speciality Hospital Srikakulam Srikakulam Corporate 18-05-2009 1334 Delisted
364 Kamala Hospital-Srikakulam Srikakulam Srikakulam Corporate 18-05-2009 851 Delisted
322
M S Baggu Sarojini Devi
365 Srikakulam Srikakulam Corporate 21-02-2009 3462 Active
Hospital
Rims Govt. General Hospital,
366 Srikakulam Srikakulam Government 05-08-2008 3229 Active
Srikakulam
367 Sindhura Hospitals Srikakulam Srikakulam Corporate 18-02-2011 1159 Delisted
VISHAKHAPATNAM
368 Abhaya Critical Care Vishakhapatnam Vishakhapatnam Corporate 24-12-2008 432 Delisted
369 Abhi Multi Speciality Hospital Vishakhapatnam Vishakhapatnam Corporate 12-11-2010 54 Delisted
370 Aditya Multi Care Hospital Vishakhapatnam Vishakhapatnam Corporate 19-08-2008 56 Delisted
371 Annapoorna Hopsital Vishakhapatnam Vishakhapatnam Corporate 04-03-2009 2192 Active
Apollo Hospitals Enterprises Ltd -
372 Vishakhapatnam Vishakhapatnam Corporate 01-04-2007 4950 Active
Vizag
373 Area hosital Anakapalli Vishakhapatnam Anakapalli Government 03-12-2011 9 Active
374 Area Hospital - Narsipatnam Vishakhapatnam Vishakhapatnam Government 05-08-2008 95 Active
375 Care Hospital Vishakhapatnam Vishakhapatnam Corporate 01-04-2007 9073 Active
376 Care Hospital (Trauma Centre) Vishakhapatnam Vishakhapatnam Corporate 30-03-2009 2036 De-list
Community Health Centre
377 Vishakhapatnam Vishakhapatnam Government 10-02-2012 1 Active
Agnampudi
378 Government Ent Hospital Vishakhapatnam Vishakhapatnam Government 17-09-2009 1626 Active
Govt Hospital For Chest And
379 Vishakhapatnam Vishakhapatnam Government 04-08-2008 1003 Active
Communicable Diseases
380 Kala Hospitals (P) Ltd Vishakhapatnam Vishakhapatnam Corporate 01-04-2007 3332 Active
381 Kalasimha Hospitals Pvt Ltd Vishakhapatnam Vishakhapatnam Corporate 13-01-2011 2342 Delisted
323
382 King George Hospital Vishakhapatnam Vishakhapatnam Government 01-04-2007 18627 Active
383 Krishi Trust Hospital Vishakhapatnam Vishakhapatnam Corporate 16-04-2011 3227 Delisted
384 Lazarus Hospital Limited Vishakhapatnam Vishakhapatnam Corporate 05-12-2007 5252 Active
Lions District 324 C1 Cancer
Treatment And Research Center
386 Manipal Hospital Vishakhapatnam Vishakhapatnam Corporate 02-08-2008 3992 Active
387 Nikitha Hospital Vishakhapatnam Vishakhapatnam Corporate 23-02-2010 1389 Active
388 Nri General Hospital Vishakhapatnam Vishakhapatnam Corporate 05-04-2008 771 Active
389 Padmaja Hospital Vishakhapatnam Vishakhapatnam Corporate 26-02-2011 333 Active
390 Queens Nri Hospitals Vishakhapatnam Vishakhapatnam Corporate 01-04-2007 8373 Active
391 Raghavendra Hospital Vishakhapatnam Vishakhapatnam Corporate 24-12-2008 185 Delisted
392 Sagara Durga Hospital Vishakhapatnam Vishakhapatnam Corporate 17-09-2009 3628 Active
393 Sai Spoorthy Hospital Vishakhapatnam Vishakhapatnam Corporate 26-02-2011 774 Active
394 Sevenhills Hospitals Ltd Vishakhapatnam Vishakhapatnam Corporate 01-04-2007 6061 Active
Shankar Foundation And Eye
Institute
396 Simhadri Hospital Vishakhapatnam Vishakhapatnam Corporate 13-01-2011 280 Delisted
397 Subham Prema Hospital Vishakhapatnam Vishakhapatnam Corporate 15-12-2008 4 Delisted
398 Surya Sri Hospital Private Ltd. Vishakhapatnam Vishakhapatnam Corporate 01-04-2007 5907 Active
399 Vaishnavi Hospital Vishakhapatnam Vishakhapatnam Corporate 05-04-2008 2009 Active
324
Vasugan Medical Specialities Pvt

Ltd (Indus Hospital-Vizag)
Vizag Hospitals And Cancer
Research
VIZIANAGARAM
402 Area Hospital - Parvathipuram Vizianagaram Vizianagaram Government 17-07-2008 304 Active
403 District Hospital - Vizianagaram Vizianagaram Vizianagaram Government 17-07-2008 1111 Active
404 Kolaparthi Hospital Vizianagaram Vizianagaram Corporate 22-02-2010 220 Delisted
Maharajah Institute Of Medical
405 Vizianagaram Vizianagaram Corporate 05-12-2007 2565 Active
Sciences
Sri Sai Super Speciality Hospital-
406 Vizianagaram Vizianagaram Corporate 05-04-2008 2537 Active
Vizianagaram
407 Tirumala Nursing Home Vizianagaram Vizianagaram Corporate 05-12-2007 6799 Active
408 Vaatsalya Hospital Vizianagaram Vizianagaram Corporate 14-10-2011 493 Active
De-
409 Venkatapadma Hospital Vizianagaram Vizianagaram Corporate 14-11-2011 1963
empanelment
WARANGAL
410 Aarogyamatha Udumala Hospital Warangal Warangal Corporate 06-10-2008 306 Active
411 Adithya Hospital Warangal Warangal Warangal Corporate 25-09-2008 798 Active
Amrutha Childrens Nursing
412 Warangal Warangal Corporate 25-09-2008 1190 Active
Home
413 Area Hospital - Jangoan Warangal Warangal Government 05-08-2008 2 Active
414 Area Hospital - Mahaboobabad Warangal Warangal Government 05-08-2008 6 Active
325
415 Balaji Hospital Warangal Warangal Warangal Corporate 22-12-2010 691 Active
Government Maternity Hospital
416 Warangal Warangal Government 17-07-2008 473 Active
Warangal
Govt Maternity Hospital
Hanmakonda
Guardian Multi Specialty
Hospital
419 Jaya Hospital Warangal Warangal Corporate 05-12-2007 1723 Active
420 Kalyani Hospital Warangal Warangal Corporate 16-04-2011 645 Delisted
421 Laxmi Narasimha Hospital Warangal Warangal Corporate 25-09-2008 3951 Active
422 Life Line Hospital Warangal Warangal Corporate 23-12-2010 2055 Delisted
423 Life Line Hospital Warangal Hanmakonda Corporate 10-01-2012 112 Active
Mahatma Gandhi Memorial
Hospital
425 Medicare Hospital Warangal Warangal Corporate 04-12-2010 597 Active
426 Rohini Medicare Pvt. Ltd. Warangal Warangal Corporate 11-04-2008 7244 Active
427 Sai Care Hospital Warangal Warangal Corporate 31-12-2009 1443 Delisted
428 Satya Hospital Warangal Warangal Corporate 17-07-2008 3073 Active
Sri Sharanya Nursing Home And
Critical Care
Sri Srinivasa Kidney And
Maternity Center
431 St.Anns Hospital Warangal Warangal Corporate 05-12-2007 6006 Active
326
Warangal Hosiptal Diagnostic

And Research Center Pvt Ltd
Warangal Kidney Center And

Childrens Hospital
WEST GODAVARI
Alluri Sitarama Raju Academy Of
434 Medical Sciences (Asram West Godavari Eluru Corporate 05-12-2007 14493 Active
Hospital)
435 Area Hospital - Bhimavaram West Godavari Bhimavaram Government 10-05-2012 20 Active
436 Area Hospital - Kovvuru West Godavari Kovvuru Government 05-08-2008 133 Active
437 Area Hospital - Narsapuram West Godavari West Godavari Government 05-08-2008 1 Active
438 Area Hospital - Palakollu West Godavari Palakollu Government 05-08-2008 85 Active
439 Area Hospital - Tadepalligudem West Godavari Tadepalli gudem Government 05-08-2008 160 Active
440 Area Hospital - Tanuku West Godavari West Godavari Government 17-07-2008 195 Active
441 Bhimavaram Hospitals West Godavari Bhimavaram Corporate 10-04-2008 4411 Active
Bishop John And Dr.Y.V.Rao
442 West Godavari Eluru Corporate 24-11-2010 938 Delisted
Multi Specialty Hospitals
443 District Hospital - Eluru West Godavari Eluru Government 05-08-2008 1319 Active
Good Samaritan Cancer &
444 West Godavari Eluru Corporate 21-02-2009 5085 Active
General Hospital
445 Krishna Hospital West Godavari Bhimavaram Corporate 07-01-2010 180 Delisted
Madhu Chalapathi Urological
446 West Godavari Bhimavaram Corporate 12-01-2010 1416 Active
Hospita
327
447 Mother Vannini Hospital West Godavari Tadepalli gudem Corporate 17-04-2010 1526 Active
448 Siri Hospital West Godavari Eluru Corporate 30-08-2010 218 Delisted
449 Sri Lakshmi Hospitals West Godavari Bhimavaram Corporate 26-02-2011 383 Active
450 Sri Sai Hospital-Tanuku West Godavari Tanuku Corporate 07-01-2010 883 Delisted
451 Sri Surya Nursing Home West Godavari Tanuku Corporate 07-01-2010 721 Delisted
452 Srisaihospital West Godavari Tanuku Corporate 17-04-2010 1244 Active
453 Sudha Hospital Tanuku West Godavari Tanuku Corporate 05-08-2008 4336 Active
Varma Heart And Super De-
454 West Godavari Bhimavaram Corporate 17-03-2011 1986
Speciality Hospital- Bhimavaram empanelment
455 Varma Hospitals West Godavari Bhimavaram Corporate 18-05-2011 641 Active
YSR
456 Bharathi Hospital YSR Cuddapa Corporate 18-05-2011 415 Active
Himalaya Multi Speciality
457 YSR Cuddapa Corporate 25-09-2009 4027 Active
Hospital
458 Rims General Hospital YSR Cuddapa Government 15-04-2008 2542 Active
328
329
ANNEXURE-IV
Empanelment Profile
SPECIALITY EMPANELMENT OPTIONS
Surgical AS_ Additional Mandatory AS_ Additional Mandatory
Basic Specialities Super Specialities
Specialities Code Empanelment Code Empanelment
M2-General Medicine or M12-Medical
SB1 S1-General Surgery SS1 S6-Surgical Gastroenterology
S5-Orthopaedics Gastroenterology
SB2 S2-ENT NIL SS2 S7-Cardio Thorasic Surgery M5-Cardiology
SB3 S3-Ophthalmology NIL SS3 S8-Paediatric Surgery M4-Paediatrics
M4-Paediatrics or
SB4 S4-Obstetric & Gyneacology SS4 S9-Genitourinary Surgery M6-Nephrology
S1-General Surgery
SB5 S5-Orthopaedics S15-Polytrauma SS5 S10-Neuro Surgery S5-Orthopaedics
SB6 S18-Dental Surgery NIL SS6 S11-Surgical Oncology S13-Radiation Oncology
SS7 S14-Plastic Surgery NIL
Medical AS_ Additional Mandatory AS_ Additional Mandatory
Basic Specialities Super Specialities
Specialities Code Empanelment Code Empanelment
MB1 M2- General Medicine NIL MS1 M5-Cardiology NIL
MB2 M4-Paediatrics S8-Paediatric Surgery MS2 M6-Nephrology NIL
M8-Chest diseases and
MB3 respiratory medicine M2-General Medicine MS3 M7-Neurology NIL
(Pulmonology)
MB4 M9-Skin (Dermatology) M2-General Medicine MS5 M11-Endocrinology M2-General Medicine
M12-Medical
MB5 M10-Rheumatology M2-General Medicine MS4 NIL
Gastroenterology
MB6 M13-Psychiatry NIL MS6 S12-Medical Oncology S13-Radiation Oncology
S12-Medical Oncology or
MB7 S13-Radiation Oncology
S11-Surgical Oncology
Additional
AB1 M1-Critical Care M2-General Medicine
Categories
AB2 M3-Infectious diseases M2-General Medicine
AB3 S16-Cochlear Implant Surgery S2-ENT
M4-Paediatrics and S8-
AB4 M 4.3-Neonatology
Paediatric Surgery
AB5 S15-Polytrauma S5-Orthopaedics
330
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
ADILABAD
Area Hospital -
1 Govt. √ √ √ √ √ √ √
Bhinsa
Area Hospital -
2 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Mancherial
3 Area hospital Nirmal Govt. √ √ √ √ √ √ √
4 Rims Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
5 GK Hospitals Nirmal Corporate √ √
ANANTAPUR
Area Hospital -
6 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Guntakal
Area Hospital -
7 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kadiri
Area Hospital -
8 Govt. √ √ √ √ √ √ √
Penukonda
Govt General
9 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital Anantapur
10 Aasha Hospital Corporate √ √ √ √ √ √
Dr. YSR Memorial
11 Corporate √ √ √ √ √ √ √ √
Hospitals
Pavani Multi
12 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Speciality Hospital
13 Sainath Hospital Corporate √ √ √ √ √
VAATSALYA
14 Corporate √ √ √ √ √ √
HOSPITAL
CHITTOOR
Area Hospital -
15 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kuppam
Area Hospital -
16 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Madanapalli
331
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Area Hospital -
17 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Palamaneru
Area Hospital - Sri
18 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kalahasthi
19 CHC-Punganur Govt. √ √ √ √ √ √ √
District Hospital -
20 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Chittoor
Government
21 Maternity Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Tirupathi
22 S.V.R.R.Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Sri Venkateswara
23 Institute Of Medical Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Sciences
Apollo Hospitals
24 Corporate √ √ √ √ √ √ √ √ √ √ √
Enterprises Ltd- A
Chandra Mohans
25 Corporate √ √ √ √ √ √
Nursing Home
26 Om Hospital Corporate √ √ √ √
Pes Institute Of
Medical Sciences
27 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
And Research
Hospital
Russh Hospitals Pvt
28 Corporate √ √ √ √ √ √
Ltd
29 Sneha Hospital Corporate √ √ √
Sree Ramadevi Multy
30 Corporate √ √ √ √ √ √
Speciality Hospital
Sri Priya Nursing
31 Corporate √ √ √ √ √ √
Home
Sri Sai Sudha
32 Corporate √ √ √ √ √
Hospital
332
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
EAST GODAVARI
Area hospital -
33 Govt. √ √ √ √ √ √ √
Amalapuram
Area hospital -
34 Govt. √ √ √ √ √ √ √
Kothapeta
Area Hospital -
35 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ramachandrapuram
Area hospital -
36 Govt. √ √ √ √ √ √ √
Razole
37 Area hosptial - Tuni Govt. √ √ √ √ √ √ √
District Hospital -
38 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Rajahmundry
Government General
39 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital,Kakinada
7 STAR SUPER
40 SPECIALITY Corporate √ √
HOSPITAL
41 Adarsh Hospital Corporate √ √ √ √ √
Aravindam
42 Orthopdeics And Corporate √ √ √
Bollineni Hospitals
43 (A Unit Of Bollineni Corporate √ √ √ √ √ √
Heart Centre Pvt Ltd)
44 Chakradhar Hospitals Corporate √ √ √

45 Dr.KVR HOSPITAL Corporate √ √ √ √
46 Goutami Eye Institute Corporate √ √
Gsl Medical College
47 And Gsl General Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
333
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Gsl Trust Cancer
48 Hospital And Corporate √ √ √
Research Centre
49 Haritha Hospitals Corporate √ √ √ √ √ √ √ √
Konaseema Institute
50 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Of Medical Science
Life Line Emergency
51 Neuro & Trauma Corporate √ √ √ √
Hospital
Raju Neuro And
52 Multispeciality Corporate √ √ √ √ √ √ √ √ √
Hospitals (P) Ltd
53 Royal Hospital Corporate √ √ √ √
54 S.A.I. Hospitals Corporate √ √ √ √ √ √ √ √ √
Safe Emergency
55 Corporate √ √ √ √ √ √ √
Hospital
56 Sai Sudha Hospital Corporate √ √ √ √ √ √ √ √
Samudra Healthcare
Enterprises Ltd
57 Corporate √ √ √ √ √ √ √ √ √ √ √ √
(Apollo Hospital
Kakinada)
58 Siddhartha Hospital Corporate √ √ √ √ √
Sri Bikkina Nursing
Home
Sri Kiran Institute Of
60 Corporate √
Ophthalmology
Sri Lalitha Hospitals
Insitute Of
61 Corporate √ √
Laparoscopic Surgery
And Training
Srujana Multi
62 Corporate √ √ √
Speciality Hospital
334
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Sudha Urology And
63 Corporate √ √ √ √
Andrology Hospital
SURYA GLOBAL
MULTI SPECIALITY
64 HOSPITALS AND Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
CANCER RESEARCH
CENTRE
Swatantra
65 Hospitals(M.S) Pvt Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ltd
TRUST HOSPITAL
(A UNIT OF
66 Corporate √ √ √ √ √ √ √ √ √
SARVOTTAM
HEALTH CARE)
GUNTUR
Area Hospital -
67 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Bapatla
Area Hospital -
68 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Narsaraopet
District Hospital -
69 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Tandur
District Hospital -
70 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Tenali
Government General
71 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital, Guntur
72 Govt Fever Hospital Govt. √ √ √
Amaravathi Institute
73 Of Medical Sciences Corporate √ √ √ √ √ √ √ √
Pvt Ltd
74 Aswini Hospital Corporate √ √ √ √ √ √
Balaji Cancer Care
Centre
76 Bmr Hospital Corporate √ √ √ √ √
335
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
77 Ent Nursing Home Corporate √ √ √ √
Guntur Cancer Care
Centre Limited
79 Health Hospitals Corporate √ √ √ √ √ √ √ √ √ √
80 Hyma Hospital Corporate √ √ √ √ √ √ √ √ √
81 Karumuri Hospital Corporate √ √
Katuri Medical
College And
82 Hospital A unit of Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Vignan Educational
Foundation
Lalitha Super
83 Speciality Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
(P) Ltd
84 M N Hospital Corporate √ √ √ √ √
Manipal Health
85 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Enterprises PVT LTD
86 Nandana Hospital Corporate √ √
Nri Academyof
87 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Sciences
Peoples Trauma And
88 Corporate √ √ √ √ √ √ √ √ √ √ √
Emergency Hospital
89 Sankar Eye Hospital Corporate √
Sri Lakshmi
Maternity And
Surgical Nursing
Home
Sri Ramachandra
91 Childrens And Dental Corporate √ √ √
Hospital
92 Sri Sai Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
336
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
93 St. Joseph Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Yerras Super
94 Corporate √ √ √ √ √ √ √ √ √
Speciality Hospital
HYDERABAD
Area Hospital -
95 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Golconda
Area Hospital -
96 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nampally
Area Hospital -
97 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Vanasthalipuram
District Hospital -
98 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kingkoti
99 Gandhi Hospitals Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Govt Ent Hospital -
100 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Koti
Govt Meternity
101 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital,Koti
Govt. Genl. And
102 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Chest Hospital
103 M.N.J.Hospitals Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
104 Niloufer Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
105 Nims Hospitals Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Osmania General
106 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
S R R I T C D Govt
107 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Fever Hospital
Sarojini Devi Eye
108 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Superintendent- Govt.
109 Maternity Hospital- Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nayapul
337
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Surajbhan bhagavati
110 bai maternity and Govt. √ √ √ √ √ √ √
children hospital
111 Aditya Hospital Corporate √ √ √ √ √ √ √ √
Alpha Super
112 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Speciality Hospital
Apollo Hospitals
113 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Secunderabad
Apollo Hospitals
114 Enterprises Ltd Corporate √ √ √ √ √
(Jubilee Hills)
Asian Institute Of
Gastro Enterology
Axon Hospitals,
116 Neuro Trauma And Corporate √ √ √ √ √ √ √ √
Stoke Institute
BASAVATARAKA
M INDO
AMERICAN
CANCER
HOSPITAL &
RESEARCH
INSTITUTE,
Hyderabad
118 Bbc Hospital Corporate √ √ √
BHASKAR
119 GENERAL Corporate √ √ √ √ √ √ √ √
HOSPITAL
Durga Bhai
Deshmukh Hospital
120 and Research Centre Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
A unit of Andhra
Mahila Shaba
Goodwill Kidney And
121 Corporate √ √ √ √ √ √ √ √ √
Surgical Centre
338
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Gurunanak Care
122 Corporate √ √ √ √ √ √ √ √ √ √
Hospital
Hyderabad Nursing
123 Corporate √ √ √ √ √ √ √ √ √ √
Home
Image Hospital-
124 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ameerpet
Innova Childrens
125 Corporate √ √ √ √ √ √ √ √ √ √ √
Heart Hospital Pvt
Kamineni Hospital
126 Corporate √ √ √ √ √ √ √ √ √
King Koti
Kamineni Oncology
Private Limited
Krishna Institute Of
128 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Medical Sciences Ltd
Lazarus Hospital
129 Corporate √ √ √ √ √ √ √ √ √ √ √
limited Hyderabad
130 Life Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Lotus Childrens
131 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Maa Hospitals Pvt.
132 Ltd. (Unit Of Vasavi Corporate √ √ √
Ent Institute)
Madhava Nursing
133 Corporate √ √ √ √ √ √ √ √ √ √ √
Home, Secunderabad
Mahavir Hospital
134 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
And Research Centre
Mahesh Hospital And
135 Corporate √ √ √ √ √
Research Foundation
136 Mamatha Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
137 Mediciti Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √
138 Medwin Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
339
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
139 New Life Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nice Institute For The
Newborn
141 Nikhil Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √
142 OLIVE HOSPITAL Corporate √ √ √ √ √ √ √ √ √
143 Poulomi Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
144 Prime Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Princess Esra
145 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital (Dcms)
Pushpagiri Eye
Hospital
Quality Care India
147 Ltd (Care Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Banjarahills)
Quality Care India
148 Ltd (Care Hospitals- Corporate √ √ √ √ √ √ √
Nampally )
Rainbow Childrens
Hospital And
149 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Perinatal Centre-
Banjara Hills
Ravindranath Ge
Medical Associates
150 Pvt Ltd. (Global Corporate √ √ √ √ √
Hospital
Lakdikapool)
S.V.R. Super
151 Corporate √ √ √ √ √ √ √ √
Speciality Hospital
Sagarlal Memorial
152 Hospital & Matadin Corporate √ √ √ √ √ √
Goel Research Centre
Satya Kidney Centre
153 And Super Speciality Corporate √ √
Hospital
340
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
154 Seha Hospital Corporate √ √ √ √ √ √
Share Medical Care
(Mediciti Institute Of
155 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Medical Sciences-
Medchal)
Sigma Hospitals
156 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
(Secunderabad)
Sowmya Hospital
157 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ramnagar
Sri Narmada
158 Corporate √ √ √ √ √ √
Hospital,Gandhinagar
159 Sri Sai Kidney Center Corporate √ √
160 Sunshine Hospital Corporate √ √ √ √ √ √ √ √ √ √ √
SURAKSHA
CHILDRENS
161 HOSPITAL a unit of Corporate √ √
rochismathi health
care pvt.ltd.
162 Times Hospital Corporate √ √ √ √ √ √ √ √ √ √
Unimed Healthcare
163 Pvt- Ltd (Star Corporate √ √ √ √ √ √
Hospitals)
164 Vasavi Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
165 Woodlands Hospital Corporate √ √ √ √ √ √ √ √ √ √ √
166 Yashoda Hospitals Corporate √ √ √ √ √
Yashoda Hospitals -
167 Corporate √ √ √ √ √ √ √
Somajiguda
KARIMNAGAR
Area Hospital -
168 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Jagityal
Area hospital -
169 Govt. √ √ √ √ √ √ √
Siricilla
341
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
170 CHC - Mantani Govt. √ √ √ √ √ √ √
171 CHC - Peddapally Govt. √ √ √ √ √ √ √
District Hospital -
172 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Karimnagar
173 Govt Area Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Amrutha Nursing
174 Corporate √ √ √ √ √
Home
Apollo Reach
175 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Chalmeda Anand Rao
176 Institute Of Medical Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Sciences
Dr Laxman Institute
Of Orthopedics
Dr.Bhoom Reddys
178 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Prathima Insitute Of
179 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Medical Scienc
180 Sarojini Hospital Corporate √ √ √ √
Sri Rama Multi
181 Corporate √ √ √ √ √ √
Speciality Hospital
Sushrutha Cancer
Hospital
Venkateshwara
183 Corporate √ √ √ √ √ √ √ √ √ √ √
Kidney Center
KHAMMAM
Area Hospital -
184 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Badrachalam
Area Hospital -
185 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kothagudem
Area hospital -
186 Govt. √ √ √ √ √ √ √
Penuballi
342
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Area Hospital -
187 Govt. √ √ √ √ √ √ √
Sathupally
Area Hospital
188 Govt. √ √ √ √ √ √ √
Paloncha
District Hospital-
189 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Khammam-
Mamatha General
And Super Speciality
190 Hospital A unit of Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Mamatha Educational
Society
Sri Ram Kidney
191 Infertility And Corporate √ √ √
Laparoscopic Centre
Srujan Ortho And
192 Accident Care Corporate √ √
Hospital
KRISHNA
Area hospital -
193 Govt. √ √ √ √ √ √ √
Avanigadda
Area Hospital -
194 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Gudivada
Area hospital -
195 Govt. √ √ √ √ √ √ √
Nandigama
Area Hospital -
196 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nuzividu
District Hospital -
197 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Machilipatnam
Govt. General
198 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital- Vijayawada
Andhra Health
Diagnostic Services
199 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Limited(Global
Vijayawada)
200 Andhra Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
343
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Annapurna Multi
Speciality Hospital
Charithasri Hospital
202 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ltd
Citi orthopaedic
center
204 City Cancer Centre Corporate √ √ √ √
Dr.Ramesh Cardiac
205 And Multispeciality Corporate √ √
Hospital Ltd
Hcg Curie City
Cancer Centre A unit
206 of Health care Global Corporate √ √ √
Vijay Oncology
Private Limited
207 Heart Care Centre Corporate √ √
Help Hospitals Pvt
208 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ltd
Krishna Institute of
209 Medical Sciences Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
LTD
M V S Accident
Hospital
METRO
211 SUPERSPECIALITY Corporate √ √ √ √ √ √ √ √ √ √ √
HOSPITALS
212 Nagarjuna Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Pinnamaneni Institue
213 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Of Medical Sciences
214 Prasanth Hospital Corporate √ √ √ √ √ √ √
Praveen Cardiac
Center
344
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Rainbow Childrens
Medicare Pvt
216 Ltd(Rainbow Corporate √ √ √
Childrens Hospital)
Vijayawada
217 Svr Neuro Hospitals Corporate √ √ √ √
Time Hospitals
218 Corporate √ √ √ √ √ √
Private Limited
219 Trust Hospital Corporate √ √ √ √ √ √ √ √
Usha Cardiac Centre
Limited
V R L S Memorial
Neuro Hospital
222 Vijetha Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
KURNOOL
223 Area Hospital - Adoni Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
224 CHC - Banaganapalli Govt. √ √ √ √ √ √ √
District Hospital -
225 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nandyal
Govt General
226 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital Kurnool
MCH HOSPITAL
227 Govt. √ √ √ √ √ √ √ √ √
ADONI
228 Aayushman Hospital Corporate √ √ √ √ √ √ √ √ √
G V R Children
Hospital
230 Gowri Gopal Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √
231 Medicare Hospitals Corporate √ √ √ √ √ √ √ √ √
Padma Chandra Super
232 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Speciality Hosp
345
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Rainbow Institute Of
233 Child Health And Corporate √ √
Maternity Hospital
Shantiram Medical
234 College General Corporate √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Vijaya Hospital -
235 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kurnool
Viswabharathi Cancer
Hospital
MAHABUBNAGAR
Area Hospital -
237 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Gadwal
Area hospital -
238 Govt. √ √ √ √ √ √ √
Nagarkurnool
Area Hospital -
239 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Wanaparthy
240 CHC - Kalwakurthy Govt. √ √ √ √ √ √ √
Govt General
241 Hospital- Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Mahaboobnaga
242 Shadnagar-Chc Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
243 S.V.S Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √
SUDHA NURSING
HOME
Susrutha Peoples
245 Corporate √ √ √ √ √
Hospital
MEDAK
Area Hospital -
246 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Siddipet
247 Area Hospital Medak Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Area Hospital
248 Govt. √ √ √ √ √ √ √
Patancheru
346
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Area hospital
249 Govt. √ √ √ √ √ √ √
Zahirabad
Community Health
250 Govt. √ √ √ √ √ √ √
Centre Gajwel
Community Health
251 Govt. √ √ √ √ √ √ √
Centre Jogipet
Dist Hospital Sanga
252 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Reddy
Maternity And Child
253 Health Hospital - Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Siddipet
Mnr Medical College
254 Corporate √ √ √ √ √ √ √
And Hospital
NALGONDA
Area Hospital -
255 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Bongir
Area Hospital -
256 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Miriyalaguda
Area Hospital -
257 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Suryapet
Area hospital
258 Govt. √ √ √ √ √ √ √
Devarakonda
Area hospital
259 Govt. √ √ √ √ √ √ √
Huzurnagar
Area Hospital
260 Govt. √ √ √ √ √ √ √
Ramannapet
Govt General
261 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hosptial, Nalgonda
262 KN Area Hospital Govt. √ √ √ √ √ √ √
263 Kims, Nalgonda Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
NELLORE
Area Hospital -
264 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Gudur
265 Area Hospital - Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
347
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Kavali
Area Hospital -
266 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Narayanpet
D S R District
267 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital - Nellore
Mother & Child
268 Govt. √ √ √ √ √ √ √
Hospital
Anasuya Institute Of
269 Corporate √ √ √ √ √ √ √ √ √ √ √
Medical Sciences
Aravind Kidney
270 Corporate √ √ √ √ √
Center
Bollineni Ramanaiah
271 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Memorial Hospital
Ircs Cancer Hospital
(Indian Red Cross
Society Cancer
Hospital)
273 Jayabharat Hospital Corporate √ √ √ √ √
274 Kandukuri Hospital Corporate √ √ √ √ √ √ √ √ √ √ √
Modern Eye Hospital
& Research Centre
Narayana Medical
276 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
College Hospital
Ravi Institute Of
Child Health Pvt Ltd
(Rich Hospitals)
Nellore
St.Josephs General
278 Corporate √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Vijaya Krishna
Hospitals
279 Corporate √ √ √ √ √ √ √ √
(P)Ltd.(Vijaya
Hospital)
348
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
NIZAMABAD
Area Hospital -
280 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Banswada
Area Hospital -
281 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Bodhan
Area Hospital -
282 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kamareddy
District Hospital -
283 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nizamabad
APARNA
HOSPITAL
285 Pragathi Hospital Corporate √ √ √ √ √ √
286 Shashank Hospital Corporate √ √
PRAKASAM
Area Hospital -
287 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Cheerala
Area Hospital -
288 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Markapur
Area Hospital
289 Govt. √ √ √ √ √ √ √
Giddalur
Area Hospital
290 Govt. √ √ √ √ √ √ √
kandukur
Area Hospital
291 Govt. √ √ √ √ √ √ √
Kanigiri
Area hospital
292 Govt. √ √ √ √ √ √ √
Markapur
293 MCH ongole Govt. √ √ √ √ √ √ √
Rajiv Gandhi Institute
294 of Medical Sciences Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
RIMS Ongole
295 Dr.Kota Reddy Corporate √ √ √ √ √
296 Vaatsalya Hospital Corporate √ √ √ √ √
349
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Venkataramana
297 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Nursing Home
RANGA REDDY
Area Hospital -
298 Govt. √ √ √ √ √ √ √
Chevella
Area hospital -
299 Govt. √ √ √ √ √ √ √
Ghatkesar
Area Hospital -
300 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kondapur
Mn Area Hospital
301 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital (Apvvp)
Apollo Hospitals
302 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Enterprise Ltd (Drdo)
Aware Global
303 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospitals
304 Balaji Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Bibi Cancer And
General Hospital
Hyderabad Kidney
And Laproscopic
306 Center A unit of JVC Corporate √ √ √ √ √ √
Super Speciality
Hospitals PVT LTD
307 Induss Hospitals Corporate √ √ √ √ √ √
308 Kamala Hospital Corporate √ √ √ √ √ √ √ √
309 L.K.Hospitals (P) Ltd Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Mythri Hospital
310 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
(Chanda Nagar)
Narayana
311 Hrudayalaya Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospitals
312 Nightingale Hospital Corporate √ √ √ √ √ √ √ √ √ √
350
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Owaisi Hospital And
313 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Research Center
Ram Hospital,
314 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Shapurnagar
Sai Bhavani Super
315 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Speciality Hospital
Shadan Medical
316 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
College
Shree Hrishikeshaya
317 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospitals
Sigma Hospitals
318 Corporate √ √ √ √ √ √ √ √
(Dilsuknagar)
Sigma Hospitals
319 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
(Jeedimetla)
Sreshta Orange
320 Corporate √ √ √ √ √
Hospitals
Sri Raghavendra
321 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Sridhar Multi
322 Corporate √ √ √ √ √ √ √
Speciality Hospital
323 Vijaya Hospital Corporate √ √ √ √ √ √ √ √ √
Yashoda Hospital
324 Corporate √ √ √ √ √ √ √ √ √
(Malakpet)
SRIKAKULAM
Area hospital -
325 Govt. √ √ √ √ √ √ √
Narasannapet
Area hospital -
326 Govt. √ √ √ √ √ √ √
Tekkali
Area Hospitalc -
327 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Palakonda
328 CHC - Palasa Govt. √ √ √ √ √ √ √
329 CHC - Patapatnam Govt. √ √ √ √ √ √ √
330 CHC - Rajam Govt. √ √ √ √ √ √ √
351
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Rims Govt. General
331 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital, Srikakulam
KIMS SAI SESHDRI
332 Corporate √ √ √ √ √ √ √ √ √ √ √
HOSPITAL
M S Baggu Sarojini
333 Corporate √ √ √ √ √ √ √ √ √ √ √
Devi Hospital
VISHAKHAPATNAM
Area hosital
334 Govt. √ √ √ √ √ √ √
anakapalli
Area Hospital -
335 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Narsipatnam
Community Health
336 Govt. √ √ √ √ √ √ √
Centre Agnampudi
Dr.R.S.P.R.Govt.Regi
337 Govt. √ √
onal Eye Hospital
Government Ent
338 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
Govt Hospital For
Chest And
339 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Communicable
Diseases
340 King George Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
341 Annapoorna Hopsital Corporate √ √ √ √ √
Apollo Hospitals
342 Enterprises Ltd - Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Vizag
343 Care Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kala Hospitals (P)
344 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ltd
Lazarus Hospital
345 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Limited
352
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Lions District 324 C1
346 Cancer Treatment Corporate √ √ √
And Research Center
347 Manipal Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
348 Nikitha Hospital Corporate √ √ √ √ √
349 Nri General Hospital Corporate √ √ √ √ √
350 Padmaja Hospital Corporate √ √ √
351 Queens Nri Hospitals Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Sagara Durga
352 Corporate √ √ √ √ √ √ √ √ √ √ √
Hospital
353 Sai Spoorthy Hospital Corporate √ √ √ √
Sevenhills Hospitals
354 Corporate √ √ √ √ √ √ √ √ √ √ √ √
Ltd
Shankar Foundation
355 Corporate √
And Eye Institute
Surya Sri Hospital
356 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Private Ltd.
357 Vaishnavi Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Vasugan Medical
Specialities Pvt Ltd
358 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
(Indus Hospital-
Vizag)
Vizag Hospitals And
359 Corporate √ √ √ √ √ √ √
Cancer Research
VIZIANAGARAM
Area Hospital -
360 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Parvathipuram
361 Area hospital - S.kota Govt. √ √ √ √ √ √ √
District Hospital -
362 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Vizianagaram
353
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
363 MCH - Vizianagaram Govt. √ √ √ √ √ √ √
Maharajah Institute
364 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Of Medical Sciences
Sri Sai Super
365 Speciality Hospital- Corporate √ √
Vizianagaram
Tirumala Nursing
366 Corporate √ √ √ √ √ √ √ √ √ √ √ √
Home
VAATSALYA
HOSPITAL
WARANGAL
Area Hospital -
368 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Jangoan
Area Hospital -
369 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Mahaboobabad
Area hospital -
370 Govt. √ √ √ √ √ √ √
Narsampet
Government
371 Maternity Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Warangal
Govt Maternity
372 Hospital Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hanmakonda
Govt.CD & TB
373 Govt. √ √ √ √ √ √ √
hospital
Govt.Regional Eye
374 Govt. √ √ √ √ √ √ √
Hospital
Mahatma Gandhi
375 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Memorial Hospital
Aarogyamatha
Udumala Hospital
Adithya Hospital
Warangal
Amrutha Childrens
Nursing Home
354
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Balaji Hospital
Warangal
Guardian Multi
Specialty Hospital
381 Jaya Hospital Corporate √ √ √ √ √ √ √ √ √ √ √ √
Laxmi Narasimha
Hospital
LIFE LINE
383 Corporate √ √ √ √ √
HOSPITAL
384 Medicare Hospital Corporate √ √
Rohini Medicare Pvt.
385 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Ltd.
386 Satya Hospital Corporate √ √ √ √ √
Sri Sharanya Nursing
387 Home And Critical Corporate √ √ √ √ √ √ √
Care
Sri Srinivasa Kidney
And Maternity Center
389 St.Anns Hospital Corporate √ √ √ √ √ √
Warangal Hosiptal
Diagnostic And
390 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √
Research Center Pvt
Ltd
Warangal Kidney
391 Center And Childrens Corporate √
Hospital
WEST GODAVARI
Area Hospital -
392 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Bhimavaram
Area Hospital -
393 Govt. √ √ √ √ √ √ √
Jangareddy gudem
Area Hospital -
394 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Kovvuru
355
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Area Hospital -
395 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Narsapuram
Area Hospital -
396 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Palakollu
Area Hospital -
397 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Tadepalligudem
Area Hospital -
398 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Tanuku
District Hospital -
399 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Eluru
Alluri Sitarama Raju
Academy Of Medical
400 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Sciences (Asram
Hospital)
Bhimavaram
401 Corporate √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospitals
Good Samaritan
402 Cancer & General Corporate √ √ √ √
Hospital
Madhu Chalapathi
403 Corporate √ √ √ √ √
Urological Hospita
Mother Vannini
404 Corporate √ √ √ √ √ √ √ √
Hospital
405 Sri Lakshmi Hospitals Corporate √ √ √
406 Srisaihospital Corporate √ √ √ √ √ √ √
Sudha Hospital
407 Corporate √ √ √ √ √ √ √ √ √ √
Tanuku
408 Varma Hospitals Corporate √ √ √ √ √
YSR
Area Hospital -
409 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Pulivendula
District Hospital -
410 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Proddutur
356
M10
M11
M12
HOSPITAL
S10
S11
S12
S13
S14
S15
S16
S17
M1
M2
M3
M4
M5
M6
M7
M8
M9
S1
S2
S3
S4
S5
S6
S7
S8
S9
S.NO HOSPITAL
TYPE
Rims General
411 Govt. √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ √
Hospital
412 Bharathi Hospital Corporate √ √ √ √
Himalaya Multi
413 Corporate √ √ √ √ √
Speciality Hospital
357
358
ANNEXURE -V
CASE SELECTION GUIDELINES
1. ORTHOPEDIC AND NEURO-SURGERY PROCEDURES

Neurosurgery Procedures
I. Laminectomy & Discectomy:
1) Laminectomy shall be done only in cases of clear evidence of canal

stenosis in MRI with Neurological claudication.
2) Evidence of having tried conservative treatment for a period of at least
6 months prior to the surgery. The Relevant documents to be uploaded.
See Clause 4.
3) Discectomy being a procedure done for either an acute or sub-acute
condition, clear cut clinical evidence should be submitted. Proof of at
least 3 months conservative management in cases of sub-acute
indication is preferable. See Clause 4.
4) The evidence for the conservative management has to be submitted as
follows.
a. For an Aarogyasri Network Hospital: The OP details
captured in the Aarogyasri workflow along with case
documents for respective periods of 6 months and 3
months for cases of Laminectomy and Discectomy prior
to sending pre-authorization for procedure.
b. For Hospitals outside Aarogyasri network: Case sheet or
other case documents to prove the patient has received
conservative treatment prior to sending the pre-
authorization will be verified.
5) Hospitals shall prefer telephonic approval in case of acute indication.

6) All the cases of laminectomy and discectomy shall submit evidence of
well informed counseling session through video recording. Video
recording of pre-operative counseling of the patient with treating
doctor, RAMCO and patients relative is mandatory for giving pre-
authorization. The attachment shall be made in the counseling
359
documents slot in the online workflow at the time of sending the case
for pre-authorization. The consent form shall be in local language
(patient’s mother tongue).
7) Implants shall be of titanium make and shall submit invoice with
implant details during claim submission.
8) Claim for all the procedures of Laminectomy and Discectomy shall be
submitted at the end of 3 weeks only and submit patient satisfaction
evidence in this regard in prescribed proforma annexed.
9) Second opinion may be obtained before pre-authorizations for above
procedures being done for subjective reasons in cases of less than 25
years of age from any hospital.
10) Declaration by the treating doctor to be submitted in the form of a letter
stating that other causes of low back ache have been ruled out in cases
of subjective symptom of pain being the reason for surgery.
Spinal Fusion Procedures:
The Spinal Fusion Procedure to be carried out wherever the evidence of

spinal instability is established. The hospital shall submit evidence of
spinal instability in the form of dynamic views of x-ray viz., Lateral view
in flexion and extension and oblique view and or 3D CT in cases of
doubtful indications.
Orthopaedic Procedures
I. Surgical Correction of Long bone fracture (ORIF):
The package under ORIF is for coverage of surgical correction using

Nails, Plates, Screws etc., of standard make. However if any of the
surgical correction is done using K-Wire or Screws / Square nail / Rush
nail, the package amount shall be reduced to Rs.5000/10000 respectively
except in case of following conditions as all these procedures are
technically demanding and require C-arm assistance.
1) Cannulated Cancellous Screws (CCS) for Intra Capsular Fracture
neck of femur
2) Femoral Condylar Fracture
3) Tibial Condylar Fracture
4) Proximal Humerus Fracture
360
5) Distal Humerus Fracture
6) Distal Radius Fracture
7) Medial Malleolus Fracture correction with screw fixation / Tension
band wiring
8) Isolated Lateral Malleolus Fracture with subluxation / dislocation of
ankle
9) Fracture Olecranon correction with Screw fixation / Tension Band
wiring.
In all the above cases the pre-authorization will be given for full package
amount of Rs. 22,000/- . However, the claim will be settled based on the
procedure done and the type of implant used.
II. The following procedures to be approved under ORIF with a package

amount of Rs.15,000 /-.
1) Girdlestone excision Arthoplasty
2) Radial head excision
III. Combined procedures
1) ORIF + Bone grafting: These two combined procedures to be
approved in following conditions.
a. All long bone fractures with significant comminution.
b. Non union of long bone fractures.
2) Combined Internal and External fixation (Hybrid fixation) to be
approved for
a. Grossly comminuted long bone fractures.
b. Minimum gap of 3 weeks shall be observed between both
the procedures.
3) Open reduction of dislocations with fractures: All these cases
the approval will be for two procedures of open reduction of
dislocation @ Rs.30,000/- + Rs.10,000/- for associated fracture.
2. HYSTERECTOMY OPERATIONS
Women Below 30 Years

Hysterectomies will not be approved unless the woman is suffering from :
1. Multiple fibroids (Symptomatic). Total Hysterectomy may be
required for technical reasons, even while doing conservative
surgery.
361
2. Carcinoma in situ.
3. Carcinoma Cervix Stage I, II.
4. Ovarian Carcinoma including chorio carcinoma
5. Placental site trophoblastic tumour.
(All the Gestational Trophoblastic Neoplasia respond well to Chemo
Therapy, except placental site trophoblastic tumour).
Woman in the age group of 30 – 45 Years

Hysterectomies will not be approved unless the woman is suffering from:
1. Cervical Intraepithelial Neoplasia
2. Carcinoma in situ of Cervix.
3. Invasive cervical cancer.
4. Atypical endometrial hyperplasia / Complex endometrial hyperplasia.
5. Endometrial cancer.
6. Ovarian cancer.
7. Gestational Trophoblastic Neoplasia.
8. Adenomyosis.
9. Symptomatic fibroid uterus.
10. Abnormal uterine bleeding not responding to conservative management
(Medical / Surgical).
11. Uterovaginal Prolapse III & IV degree with or without Cystocele /
Rectocele.
12. Genital Tuberculosis, persisting or increasing Tubo Ovarian mass after
a course of Anti TB treatment.
Woman in the age group of 30 – 45 Years

1. DUB
2. Endometriosis with chocolate cysts.
3. Chronic Pelvic Inflamatory Disease with Tubo Ovarian mass.
4. Prolapse II degree with symptoms (with or without Cystocele).
Woman more than 45 years of age

1. Prolapse of any degree with symptoms.
2. Abnormal uterine bleeding.
3. Post menopansal bleeding with endometrial hyperplasia.
4. Cancer Ovary.
362
5. Endometrial Carcinoma
6. Endometrial Sarcoma.
7. Carcinoma Cervix Stage I & II.
8. Pyometra (non malignant due to recurrent Endometritis and Cervical
Stenosis).
3. CARDIOLOGY AND CARDIO THORACIC PROCEDURES
Triple Vessel Disease (TVD) (CABG or Angioplasty)
Whenever a treating doctor decides to perform angioplasty for Triple Vessel

Disease instead of CABG, either due to associated conditions or due to
patient’s choice of selection after being counselled about the advantages and
disadvantages of both the procedures, the following evidence shall be
uploaded for approval.
(i) The detailed explanation letter by the treating doctor for opting
for angioplasty procedure.
(ii) A consent letter from the patient stating that the procedure was of
his choice and decision was taken after due counseling by the
treating cardiologist and cardio thorasic surgeon.
(iii) The consent letter must be duly signed by the treating cardiologist
and cardio thorasic surgeon.
Additional objective assessment required in case of moderate

stenosis(<70%)
In cases of moderate stenosis(<70%) where the role of angioplasty is
doubtful as perceived by the pre-authorization specialist, the hospital shall
submit the following additional objective assessment of Ischaemia.
(i) Treadmil Test and/or

(ii) Thallium study
The Trust may obtain second opinion from senior cardiologist which are
required either alone or in combination as case requires.
363
4. GUIDELINES ON SPECIALIZED RADIATION THERAPY
SPECIAL POST OPERATIVE/

PACKAG
S.NO. SYSTEM INVESTI PROCEDURE
ES
GATIONS INVESTIGATION
IMRT (Intensity
S13.4.
modulated
1
radiotherapy)
1 Brain Tumors
Unifocal Maligant
a
gliomas (Primary)
Biopsy &
Low grade USG/CT/umor Marker/RT
CT/MRI 1,00,000
b astrocytoma (PO) Treatmetn Charts
(Pre-Auth)
with residual lesion
c Optic nerve glioma
Head and neck
2 cancers(Early T1,T2
Lesions N0,M0)
a Ca. Tonsil
b Ca. Soft Palate Biopsy &
Clinical USG/CT/umor Marker/RT
c Ca. UVULA 1,00,000
photo (for Treatmetn Charts
d Ca. Base of tongue Pre-Auth)
e Ca. Vallecula
USG/CT/umor Marker/RT
3 Ca. Nasopharynx 1,00,000
Treatmetn Charts
Ca. Para Nasal USG/CT/umor Marker/RT
4 Biopsy, CT 1,00,000
Sinuses Treatmetn Charts
scan (MRI
Ca. Prostate – Non
for Pre- USG/CT/umor Marker/RT
5 metastasis & Low 1,00,000
Auth) Treatmetn Charts
risk
Isotope
Superior sulcus Bone scan USG/CT/umor Marker/RT
6 syndrome (CT scan for surgery 1,00,000
Treatmetn Charts
+ Biopsy) is required
Orbital Rhabdo Myo USG/CT/umor Marker/RT
7 1,00,000
Sarcoma Treatmetn Charts
S13.4.
3DCRT (3-D conformational radiotherapy)
2
364
1 Brain Tumors
Low grade glioma
a (Post-operative)
residual lesion Biopsy,
CT/MRI USG/CT/Tumor Marker/RT
Medulloblastoma 75,000
b for (Pre- Treatment Charts
(Post-operative)
Auth)
Evendymorna (Post-
c
operative)
Biopsy,
CT/MRI
Ca. Prostate – Non USG/CT/Tumor Marker/RT
2 Bone scan 75,000
metastatic & low risk Treatment Charts
for (Pre-
Auth)
Head&Neck
3 Cancer(T1,T2 lesions
Only)
a Ca. Tonsil
b Ca. Soft Palate Biopsy,
CT/MRI USG/CT/Tumor Marker/RT
c Ca. UVULA 75,000
for (Pre- Treatment Charts
d Ca. Base of Tongue Auth)
e Ca. Vallecula
Superior sulcus Biopsy,
syndrome, CT CT/MRI USG/CT/Tumor Marker/RT
4 75,000
scan/MRI and Biopsy for (Pre- Treatment Charts
is required. Auth)
Orbital Rhabdo myo USG/CT/Tumor Marker/RT
5 75,000
sarcoma Treatment Charts
Retino Blastoma-
USG/CT/Tumor Marker/RT
6 Non-metastatic, 75,000
Treatment Charts
unilateral/bilateral
Pediatric abdominal
USG/CT/Tumor Marker/RT
7 neuroblastoma (non- 75,000
Treatment Charts
metastatic)
S13.4.
SRS/SRT
3
Stereotactic
1
Radiosurgery:SRS
365
MR
Clinical photo with patient
Angiogram
AVM (Arterio- on treatment couch with
for
(i) Venous 75000 SRS/SRT frame should be
diagnosis
Malformation) provided for all of the above
required for
for claim.
(Pre-Auth)
Stereotactic
Radiotherapy: SRT
Pituitary adenoma USG/CT/Tumor Marker/RT
I
(Post Operative) Treatment Charts
Low grade glioma
II CT&MRI
(Post Operative)
& (Pre- 75,000
Auth) Clinical photo with patient
on treatment couch with
Meningioma (Post
III SRS/SRT frame should be
Operative)
provided for all of the above
for claim.
366

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ANNEXURE- I

ICD ICD POST_

40.2 Cystic Hygroma Biopsy , Clinical

40.29 Cystic Hygroma Biopsy , Clinical

Excision Of Lingual Clinical Photograph , Biopsy , Clinical

Excision Of Thyroglossal Clinical Photograph , Biopsy , Clinical

Color Doppler , X- Color Doppler ,

27.4 Wedge Excision& Biopsy , Clinical

S1.1.5 THYROID (NO-MALIGNANT)

6.39 Biopsy , Clinical

540 Biopsy , Clinical

44.03 Selective Vagotomy Clinical

533.0 Operation For Bleeding Clinical

532.1 surgical management of CT-Abdomen , USG , Clinical

Operations For Recurrent

43.5 Resection & Anastomosis Biopsy , Clinical

Biopsy , Endoscopy , Clinical

Operation for Mal- Clinical

S1.3.6 RECTUM AND ANUS

Pull Through Abdominal Clinical

Operation Of Adernal Biochemical

Operation On Adrenal Biochemical

MRI , UGI Endoscopy ,

MRI , UGI Endoscopy ,

384.2 PTA , X-Ray PTA , Per OP

Excision Of Benign Clinical

Surgical correction of Clinical

Bronchoscopy Foreign Clinical

S3.2 CORNEA AND SCLERA

11.63 Therapeutic Penetrating Clinical

Amniotic Membrane Clinical

Vitrectomy - Membrane B.Scan , Fundus Fundus

Vitrectomy Plus Silicon

Monthly Intravitreal Anti-

Scleral buckle procedure B.Scan , Fundus Fundus

360 16.3 Enucleation/Evisceration CT Skull , Clinical Clinical

Surgical management for Clinical

S3.6 LID SURGERY

S3.7 PEDIATRIC OPHTHALMIC SURGERY

Glaucoma Filtering Fundus Fluorescein

S4 GYNAECOLOGY AND OBSTETRICS SURGERY

ABG , APTT , CUE ,

APTT , Heamatocrit , Clinical

620.5 Biopsy , Post-op

Laparoscopic Ectopic Biopsy , Post-op

Laparoscopic Biopsy , Post-op

Laparoscopic Biopsy , Post-op

69.2 Laparoscopic Sling Biopsy , Post-op

618.1 Biopsy , Post-op

Cystocele ,Rectocele & Biopsy , Post-op

Mc Indo-S Repair For Clinical Photograph , Biopsy , Post-op

70.77 Vault Prolapse Clinical Photograph ,

S5 ORTHOPEDIC SURGERY AND PROCEDURES

79.3 Open Reduction &

Arthroscopy . Operative Arthroscopy

S5.5 SPINE SURGERY

04.3 Nerve Repair With Clinical

Surgery For Obscure Gi Endoscopy

Biopsy , CT-Scan , Biopsy , Clinical

44.0 Truncal Vagotomy + Biopsy , CT-Scan , Biopsy , Clinical

Distal Gastrectomy For

Surgery For Corrosive Biopsy , CT-Scan , Biopsy , Clinical

III Stage-Ileostomy Biopsy , Clinical