| Specialty code |
Package Code |
Package name |
Package Amount |
Preauth Required or Not (Y/N) |
Mandatory investigations for pre-auth |
Post-Op investigations for claims submission |
Average length of Stay (Including Days in intensive care units) |
Govt Reserved Procedure (Y/N) |
Medical (M) or Surgical (S) |
| S13 |
0001 |
Coronary artery bypass grafting (CABG) |
90,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0002 |
Coronary artery bypass grafting (CABG) with Intra-aortic balloon pump (IABP) |
110,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0003 |
Coronary artery bypass grafting (CABG) + one mechanical Valve Replacement + Intra-aortic balloon pump (IABP) |
150,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0004 |
Coronary artery bypass grafting (CABG) with LV Aneurysmal repair |
100,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0005 |
Coronary artery bypass grafting (CABG) with Mitral Valve repair without ring |
100,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0006 |
Coronary artery bypass grafting (CABG) with Mitral Valve repair with ring |
125,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0007 |
Coronary artery bypass grafting (CABG) with post MI Ventricular Septal Defect (Ventricular Septal Defect) repair |
100,000 |
Y |
2D ECHO |
ECHO |
5 to 7 |
N |
S |
| CAG report |
Post op X Ray |
| |
scar photo |
| S13 |
0008 |
Open Mitral Valvotomy |
75,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0009 |
Closed Mitral Valvotomy |
30,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0010 |
Open Pulmonary Valvotomy |
75,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0011 |
Mitral Valve Repair |
80,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0012 |
Tricuspid Valve Repair |
80,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0013 |
Aortic Valve Repair |
80,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0014 |
Ring for any Valve Repair |
30,000 |
Y |
2D ECHO |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0015 |
Mitral Valve Replacement (mechanical valve) |
120,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0016 |
Mitral Valve Replacement (biological valve) |
125,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0017 |
Aortic Valve Replacement (mechanical valve) |
120,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0018 |
Aortic Valve Replacement (biological valve) |
125,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0019 |
Tricuspid Valve Replacement (mechanical valve) |
120,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0020 |
Tricuspid Valve Replacement (biological valve) |
125,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0021 |
Double Valve Replacement (mechanical valve) |
150,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0022 |
Double Valve Replacement (biological valve) |
155,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0023 |
Ross Procedure |
105,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0024 |
Atrial Septal Defect (ASD) |
75,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0025 |
Ventricular Septal Defect (VSD) |
75,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0026 |
Atrioventricular septal defect/ Atrioventricular (AV) Canal Defect |
100,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0027 |
Intracardiac repair (ICR) for Tetralogy of Fallot (TOF) |
100,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0028 |
Pulmonary Valvotomy + Right Ventricular Outflow Tract (RVOT) Resection |
90,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0029 |
Aortopulmonary Window (AP Window) |
90,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0030 |
Surgery for Hypertrophic Obstructive Cardiomyopathy (HOCM) |
90,000 |
Y |
2D ECHO/TEE |
ECHO |
10 |
N |
S |
| Chest Xray AP view |
Post op X Ray |
| Cardiac MRI |
scar photo |
| S13 |
0031 |
Ebsteins |
90,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0032 |
Fontan |
90,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0033 |
Total Anomalous Pulmonary Venous Connection (TAPVC) |
105,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0034 |
Any RV to PA conduit (Valved) |
115,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0035 |
Arterial Switch Operation |
120,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0036 |
Double Switch Operation |
120,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0037 |
Sennings |
105,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0038 |
Mustards |
105,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0039 |
Truncus Arteriosus Surgery |
115,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0040 |
Root Replacement (Aortic Aneurysm/ Aortic Dissection) / Bental Procedure |
145,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0041 |
Aortic Arch Replacement |
160,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0042 |
Aortic Aneurysm Repair using Cardiopulmonary bypass (CPB) |
150,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0043 |
Aortic Aneurysm Repair without using Cardiopulmonary bypass (CPB) |
75,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0044 |
Pulmonary Embolectomy |
90,000 |
Y |
2D ECHO |
ECHO |
5 |
N |
S |
| ABG report |
Post op X Ray |
| CT Chest report |
scar photo |
| S13 |
0045 |
Surgery for Cardiac Tumour/ Left Atrial (LA) Myxoma/ Right Atrial (RA) Myxoma |
95,000 |
Y |
2D ECHO |
ECHO |
|
N |
S |
| CT Chest report |
Post op X Ray |
| |
scar photo |
| S13 |
0046 |
Patent Ductus Arteriosus (PDA) Closure |
30,000 |
Y |
2D ECHO |
ECHO |
|
N |
S |
| Post op X Ray |
| scar photo |
| S13 |
0047 |
Coarctation Repair |
30,000 |
Y |
2D ECHO |
Doppler report with stills |
|
N |
S |
| CAG report |
|
| S13 |
0048 |
Coarctation Repair with interpostion graft |
38,000 |
Y |
2D ECHO |
Doppler report with stills |
|
N |
S |
| CAG report |
|
| S13 |
0049 |
Blalock–Thomas–Taussig (BT) Shunt (inclusives of grafts) |
30,000 |
Y |
2D ECHO |
ECHO |
|
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0050 |
Glenn Shunt (without cardiopulmonary bypass) |
35,000 |
Y |
2D ECHO |
ECHO |
|
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0051 |
Central Shunt |
50,000 |
Y |
2D ECHO |
ECHO |
|
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0052 |
Pericardiectomy |
30,000 |
Y |
2D ECHO |
ECHO |
|
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0053 |
Pulmonary AV Fistula surgery |
45,000 |
Y |
CT Chest |
ECHO |
|
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0054 |
Lung Cyst |
45,000 |
Y |
CT Chest |
ECHO |
7 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0055 |
Space-Occupying Lesion (SOL) mediastinum |
45,000 |
Y |
CT Chest |
ECHO |
|
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0056 |
Surgical Correction of Bronchopleural Fistula |
50,000 |
Y |
CT Chest |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0057 |
Diaphragmatic Eventeration |
40,000 |
Y |
CT Chest |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0058 |
Oesophageal Diverticula /Achalasia Cardia |
35,000 |
Y |
Barium Study |
ECHO |
10 |
N |
S |
| CT Chest |
Post op X Ray |
| |
scar photo |
| S13 |
0059 |
Diaphragmatic Injuries/Repair |
35,000 |
Y |
CT Chest |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0060 |
Thoracotomy, Thoraco Abdominal Approach |
30,000 |
Y |
CT Chest |
Post op X Ray |
10 |
N |
S |
| |
scar photo |
| S13 |
0061 |
Foreign Body Removal with scope |
20,000 |
Y |
CT Chest |
Endoscopy Picture |
2 |
N |
S |
| Bronchoscopy report |
|
| S13 |
0062 |
Bronchial Repair Surgery for Injuries due to FB |
35,000 |
Y |
CT Chest |
Endoscopy Picture |
7 |
N |
S |
| Bronchoscopy report |
|
| S13 |
0063 |
Lung Injury repair |
35,000 |
Y |
CT Chest |
Post op X Ray |
7 |
N |
S |
| |
scar photo |
| S13 |
0064 |
Thyomectomy |
35,000 |
Y |
CT Chest |
Post op X Ray |
|
N |
S |
| |
scar photo |
| S13 |
0065 |
Pulmonary Valve Replacement |
120,000 |
Y |
2D ECHO |
ECHO |
10 |
N |
S |
| |
Post op X Ray |
| |
scar photo |
| S13 |
0066 |
Intercostal Drainage and Management of ICD, Intercostal Block, Antibiotics & Physiotherapy |
10,000 |
Y |
Pre-Op X-ray / CT Scan |
Post Op X-ray / CT Scan |
7 |
N |
S |
| S13 |
0067 |
Encysted Empyema/Pleural Effusion - Tubercular |
10,000 |
Y |
Pre-Op X-ray / CT Scan |
Post Op X-ray / CT Scan |
|
N |
S |
| S13 |
0068 |
First rib Excision by transaxillary approach, Excision of cervical rib / fibrous band / muscle by cervical approach |
30,000 |
Y |
Pre-Op X-ray / CT Scan |
Post Op X-ray / CT Scan |
7 |
N |
S |
| |
scar photo |
| S13 |
0069 |
Congenital Cystic Lesions |
30,000 |
Y |
Pre-Op X-ray / CT Scan |
Post Op X-ray / CT Scan |
7 |
N |
S |
| |
scar photo |
| S13 |
0070 |
Pulmonary Sequestration Resection |
40,000 |
Y |
Pre-Op X-ray / CT Scan |
Post Op X-ray / CT Scan |
7 |
N |
S |
| |
scar photo |
| S13 |
0071 |
Pulmonary artero venous malformation |
40,000 |
Y |
Pre-Op X-ray / CT Scan |
Post Op X-ray / CT Scan |
7 |
N |
S |
| |
scar photo |
| S13 |
0072 |
Thromboembolectomy (pre-auth not required, usually done as emergency) |
20,000 |
N |
Duplex ultrasound |
Scar photo |
3 |
N |
S |
| Angio report |
Post op CT angio |
| S13 |
0073 |
Surgery for Arterial Aneursysm -Upper/Distal Abdominal Aorta |
90,000 |
Y |
CT Angio Report |
Scar photo |
10 |
N |
S |
| |
Post op CT angio |
| S13 |
0074 |
Intrathoracic Aneurysm-Aneurysm not Requiring Bypass Techniques |
90,000 |
Y |
CT Angio Report |
Scar photo |
10 |
N |
S |
| |
Post op CT angio |
| S13 |
0075 |
Intrathoracic Aneurysm-Requiring Bypass Techniques |
125,000 |
Y |
CT Angio Report |
Scar photo |
10 |
N |
S |
| |
Post op CT angio |
| S13 |
0076 |
Surgery for Arterial Aneurysm Renal Artery |
40,000 |
Y |
Renal arterial Doppler |
Doppler Report |
|
N |
S |
| Angiogram |
scar photo |
| S13 |
0077 |
Operations for Congenital Arteriovenous Fistula |
15,000 |
Y |
Regional Angiogram & Stills |
Scar photo |
|
N |
S |
| S13 |
0078 |
Operations for Stenosis of Renal Arteries |
40,000 |
Y |
Renal arterial Doppler |
Doppler Report |
|
N |
S |
| angiogram & Stills |
scar photo |
| S13 |
0079 |
Aorto Bi-lliac / Bi femoral /Axillo bi femoral bypass with Synthetic Graft |
90,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
scar photo |
| S13 |
0080 |
Femoro Distal / Femoral - Femoral / Femoral infra popliteal Bypass with Vein Graft |
50,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| Duplex ultrasound |
| scar photo |
| S13 |
0081 |
Femoro Distal / Femoral - Femoral / Femoral infra popliteal Bypass with Synthetic Graft |
70,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
Duplex ultrasound |
| |
scar photo |
| S13 |
0082 |
Axillo Brachial Bypass using with Synthetic Graft |
65,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
Duplex ultrasound |
| |
scar photo |
| S13 |
0083 |
Brachio - Radial Bypass with Synthetic Graft |
30,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
5 |
N |
S |
| |
Duplex ultrasound |
| |
scar photo |
| S13 |
0084 |
Excision of body Tumor with vascular repair |
35,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
Duplex ultrasound |
| |
scar photo |
| S13 |
0085 |
Carotid artery bypass with Synthetic Graft |
60,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
Duplex ultrasound |
| |
scar photo |
| S13 |
0086 |
Excision of Arterio Venous malformation - Large |
50,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
scar photo |
| S13 |
0087 |
Excision of Arterio Venous malformation - Small |
30,000 |
Y |
Angiogram/spiral CT Angiogram reports |
Stills showing the procedure with graft |
7 |
N |
S |
| |
scar photo |
| S13 |
0088 |
Deep Vein Thrombosis (DVT) - Inferior Vena Cava (IVC) filter |
80,000 |
Y |
Color doppler |
X-ray abdomen showing the filter |
7 |
N |
S |
| scar photo |
| S13 |
0089 |
Carotid endarterectomy |
32,000 |
Y |
Angiogram |
Stills showing the procedure with graft |
7 |
N |
S |
| |
scar photo |
| S13 |
0090 |
Aortic Angioplasty with two stents / Iliac angioplasty with stent Bilateral |
90,000 |
Y |
ECG |
Angioplasty stills showing Balloon & post flow |
7 |
N |
S |
| 2D ECHO |
scar photo |
| CAG stills showing blocks |
|
| S13 |
0091 |
Bilateral thrombo embolectomy |
30,000 |
Y |
Duplex ultrasound/Angiogram - pre or intra operative |
Duplex ultrasound |
7 |
N |
S |
| |
scar photo |
| S13 |
0092 |
Aorto-uni-iliac/uni-femoral bypass with synthetic graft |
70,000 |
Y |
Angiogram/ Computed Tomography Angiography (3D-CTA)/Magnetic Resonance Angiography |
Duplex ultrasound |
7 |
N |
S |
| |
scar photo |