HimCare Scheme Opthalmology Package

Specialty codePackage CodePackage namePackage AmountPreauth Required or Not (Y/N)Mandatory investigations for pre-authPost-Op investigations for claims submissionAverage length of Stay (Including Days in intensive care units)Govt Reserved Procedure (Y/N)Medical (M) or Surgical (S)
S30001Buckle Removal5,000YClinical Record DNS
S30002Canaliculo Dacryocysto Rhinostomy7,000YClinical Record 1NS
S30003Capsulotomy (YAG)1,500YClinical Record DNS
S30004Corneal Grafting15,000YClinical Record 3NS
S30005Prophylactic Cryoretinopexy- Closed2,500YClinical Record 1NS
S30006Cyclocryotherapy/Cyclophotocoagulation3,000YClinical Record DNS
S30007Pterygium + ConjunctivalAutograft9,000YClinical Record DNS
S30008Dacryocystectomy with implants10,000YClinical Record DNS
SS0009Enucleation6,000YClinical Record 1NS
S30010Enucleation with Implant11,000YClinical Record 1NS
S30011Exenteration15,000YClinical Record DNS
S30012Glaucoma Surgery (Trabeculectomy only) with or without Mitomycin C, including postoperative medications for 12 weeks (and wherever surgical or laser procedures required for bleb augmentation and anterior chamber maintenance)13,000YIOP DNS
S30013Intraocular Foreign Body Removal from Anterior Segment4,000N  DNS
S30014Intraocular Foreign Body Removal from Posterior Segment20,000N  DNS
S30015Lensectomy /pediatric lens aspiration9,000YClinical Record DNS
S30016Limbal Dermoid Removal4,000YClinical Record DNS
S30017Surgical Membranectomy8,000YClinical Record DNS
S30018Perforating Corneo – Scleral Injury10,000N  2NS
S30019Ptosis Surgery10,000YClinical Record DNS
S30020IRIS Prolapse – Repair4,000YClinical Record DNS
S30021Retinal Detachment Surgery15,000YClinical Record 2NS
S30022Small Tumour of Lid – Excision + Lid Reconstruction8,000YClinical Record DNS
S30023Socket Reconstruction with amniotic membrane8,000YClinical Record 1NS
S30024Iridectomy – Laser2,000YClinical Record DNS
S30025Iridectomy – Surgical3,000YClinical Record DNS
S30026Iris cyst removal 2,500YClinical Record DNS
SS0027Vitrectomy7,500YClinical Record 1NS
S30028Vitrectomy + Retinal Detachment surgery (pre-auth required)17,500YClinical Record 1NS
S30029Cataract with foldable hydrophobic acrylic IOL by Phaco emulsification tech7,500YClinical Record DNS
S30030Cataract with non-foldable IOL using SICS technique5,000YClinical Record DNS
S30031Cataract with foldable hydrophobic acrylic IOL by Phaco emulsification tech + Glaucoma10,500YClinical Record  NS
S30032Cataract with non-foldable IOL using SICS technique + Glaucoma6,500YClinical Record  NS
S30033Conjunctival tumour excision + AMG5,000YClinical Record DNS
S30034Entropion correction4,000YClinical Record DNS
S30035Ectropion correction 5,000YClinical Record DNS
SS0036Evisceration3,500YClinical Record DNS
S30037Laser for retinopathy (per sitting)1,500YClinical Record DNS
S30038Lid tear5,000YClinical Record DNS
SS0039Orbitotomy10,000YClinical Record DNS
S30040Squint correction (per muscle)4,000YClinical Record DNS
S30041Anterior Chamber Reconstruction +Perforating corneo – Scleral Injury + IOL11,500N  2NS
S30043Abscess Drainage of lid550N   NS
S30044Cryoretinopexy-Open5500YClinical Record  NS
S30045Endoscopic Optic nerve Decompression5500YClinical Record  NS
S30046Endoscopic Optic orbital Decompression8800YClinical Record  NS
S30047Keratoplasty3300YClinical Record  NS
S30049Tumours of IRIS2000YClinical Record  NS
S30050Acid and alkali burns500YClinical Record  NS
S30051Cauterisation of ulcer/subconjuctival injection-both eye300YClinical Record  NS
S30052Cauterisation of ulcer/subconjuctival injection-one eye200YClinical Record  NS
S30053Chalazion-both eye600YClinical Record  NS
S30054Chalazion-one eye400YClinical Record  NS
S30055Conjuntival Melanoma1100YClinical Record  NS
S30058Epicantuhus correction2200YClinical Record  NS
S30060ERG800YClinical Record  NS
S30061Laser inter ferometry1650YClinical Record  NS
S30063Abscess Drainage of lid +Cryoretinopexy -closed5250YClinical Record  NS
S30066Syringing of lacrimal sac for both eyes350Y   NS
S30067Syringing of lacrimal sac for one eyes250Y   NS
See also  Himcare Scheme General Surgery Package

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