HimCare Scheme Orthopaedics 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)
S50001AC joint reconstruction/ Stabilization/ Acromionplasty (Nonoperative management is recommended for Rockwood type I and II injuries, whereas surgical reconstruction is recommended for type IV and VI separations. The management for type III and V injuries is more controversial and is determined on a case-by-case basis)25,000YX rays of affected limbX rays of affected limb4NS
MRI of shoulder
S50002Accessory bone – Excision (limbs) – congenital, Accessory digits sometime can be removed3,000YX rays of affected limbX rays of affected limbSNS
 
S50003Amputation – Below Elbow10,000N  5NS
S50004Amputation – Above Elbow10,000N  5NS
S50005Amputation – one or more fingers3,000N  1NS
S50006Amputation – Wrist10,000N  4NS
S50007Amputation – one or more toes/ digits3,000N  1NS
S50008Amputation – Below Knee15,000N  5NS
S50009Amputation – Above Knee18,000N  5NS
S50010Foot & Hand Amputation (whole/ partial)10,000N  5NS
S50011Disarticulation (hind & for quarter)25,000N Clinical report10-15 days of hospital stayNS
 radiological investigations
S50012Anterior Spine Fixation35,000N Clinical report6NS
 radiological investigations
S50013Posterior Spine Fixation25,000N Clinical report5NS
 radiological investigations
S50014Osteochondroma excision/ Excision of Exostosis10,000YClinical reportClinical report4NS
radiological investigationsradiological investigations
S50015Excision Arthoplasty15,000YClinical reportClinical report4NS
radiological investigationsradiological investigations
S50016Arthorotomy of any joint10,000N Clinical report, Radiological Investigations7-10 days hospital stay for iv antibioticsNS
S50017Arthrodesis Ankle Triple15,000YClinical reportradiological investigations6NS
radiological investigationsradiological investigations
S50019Bimalleolar Fracture Fixation15,000N  6NS
S50020Bone Tumour Excision + reconstruction using implant (malignant/ benign)70,000YClinical reportClinical report4NS
radiological investigationsradiological investigations
S50021Bone Tumour (malignant/ benign) curettage and bone grafting20,000YClinical reportClinical report NS
radiological investigationsradiological investigations
S50022Bone Tumour Excision (malignant/ benign) + Joint replacement (depending upon type of joint and implant)1,50,000YClinical reportClinical report NS
radiological investigationsradiological investigations
S50023Clavicle fracture management – conservative (daycare)1,000N  DNS
S50024Closed reduction – Hand Bones3,000N  3NS
S50025Close reduction – Foot Bones3,000N  2NS
S50026Close Reduction – Small Joints3,000N  1NS
S50027Interlock Nailing + Bone Grafting – femur/tibia19,000N  5NS
S50028Closed Interlocking Intermedullary- tibia/femur17,500N  5NS
S50030Closed Reduction and Internal Fixation with K wire6,000N  5NS
S50031Closed Reduction and Percutaneous Screw Fixation (neck femur)15,000N  5NS
S50034Closed Reduction of the Hip (including hip Spika)7,000N  2NS
S50035Debridement & Closure of Major injuries – contused lacerated wounds (anti-biotic + dressing) – minimum of 3 sessions7,000N  2NS
S50036Debridement & Closure of Minor injuries1,000N  2NS
S50037Closed reduction of dislocation (Knee)4,000N  DNS
S50038Closed reduction of dislocation (Shoulder/ Elbow)3,000N  DNS
S50039Duputryen’s Contracture release + rehabilitation10,000N  5NS
S50040Ulnar nerve Repair10,000N  4NS
S50041External fixation – Long bone15,000N  4NS
S50042External fixation – Small bone10,000N  2NS
S50043External fixation – Pelvis15,000N  5NS
S50044Fasciotomy7,000N  2NS
S50045Fixator with Joint Arthrolysis20,000N  7NS
S50046Fracture – Acetabulum Open Reduction Internal Fixation30,000N  7NS
S50047Fracture – Fibula Internal Fixation8,000N  4NS
S50048Fracture – Hip Internal Fixation (Intertrochanteric Fracture with implant) + rehabilitation17,000N  7NS
S50049Fracture – Humerus Internal Fixation17,000N  7NS
S50050Fracture – Olecranon of Ulna8,000N  2NS
S50051Fracture – Radius Internal Fixation with plate10,000N  2NS
S50052Fracture – TIBIA Internal Fixation with plating17,000N  4NS
S50053Fracture – Ulna Internal Fixation8,000N  4NS
S50054Head Radius – Excision8,000N  3NS
S50055High Tibial Osteotomy17,000N  5NS
S50057Internal Fixation Lateral Epicondyle10,000N  4NS
S50058Internal Fixation of other Small Bones (metatarsals)10,000N  3NS
S50059Limb Lengthening25,000N  10NS
S50060Llizarov Fixation15,000N  6NS
S50061Multiple Tendon Repair20,000YClinical reportClinical Photographs Showing scar5NS
electro-diagnostic studies 
S50062Nerve Repair Surgery15,000YClinicalClinical Photographs Showing scar6NS
electro-diagnostic studieselectro-diagnostic studies
S50063Nerve Transposition/Release/ Neurolysis8,000Yelectro-diagnostic studies 6NS
S50064Open Reduction Internal Fixation (Fracture both bone forearm)10,000N  3NS
S50065Open Reduction Internal Fixation (Large Bone)20,000N  6NS
S50066Open Reduction of CDH30,000N  7NS
S50067Open Reduction of Small Joint15,000N  1NS
S50068Open Reduction with bone grafting of nonunion20,000N  3NS
S50069Osteotomy -Small Bone10,000N  5NS
S50070Osteotomy -Long Bone17,000N  7NS
S50071Patellectomy8,000N  7NS
S50072Pelvic Osteotomy with fixation with plaster30,000N  10NS
S50074Excision of Bursa2,000N  2NS
S50075Reconstruction of ACL/PCL with implant and brace30,000YClinical reportClinical report3NS
radiological investigationsradiological investigations
S50076Sequestrectomy of Long Bones + anti-biotics + dressing15,000N  7NS
S50077Tendo Achilles Tenotomy2,000N  2NS
S50078Tendon Grafting15,000N  2NS
S50079Tendon Release/ Tenotomy2,000N  2NS
S50080Tenolysis3,000N  2NS
S50081Tension Band Wiring Patella10,000N  3NS
S50082Application of P.O.P. casts for Upper & Lower Limbs3,000N  DNS
S50083Application of P.O.P. Spikas& Jackets3,500N  DNS
S50084Application of Skeletal Tractions with pin3,000N  DNS
S50085Application of Skin Traction1,000N  DNS
S50086Head radius – Excision + Fracture – Ulna Internal Fixation15,000N  3NS
S50087External fixation – both bones of forearms15,000N  5NS
S50088Fracture intercondylarHumerus + olecranon osteotomy25,000N  5NS
S50089Correction of club foot per cast3,000N  DNS
S50090Arthroscopic Meniscus Repair/ Meniscectomy20,000YClinical reportClinical3NS
radiological investigationsradiological investigations
S50091Total Hip Replacement (cemented)75,000YClinical reportClinical7NS
radiological investigationsradiological investigations
S50092Total Hip Replacement (cementless)90,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50093Total Hip Replacement (hybrid)75,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50094Bipolar Hemiarthroplasty (hip & shoulder)40,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50095Unipolar Hemiarthroplasty30,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50097Elbow replacement40,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50098Arthrodesis of shoulder40,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50099Arthrodesis of Knee (with implant)40,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50100Arthrodesis of Wrist (with implant)30,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50101Arthrodesis of Ankle (with implant)30,000YClinical reportClinical report7NS
radiological investigationsradiological investigations
S50102Arthrotomy+ synevectomy15000    NS
S50103Calcaneal Supr- Excision2000    NS
S50104Clavicle surgery15000    NS
S50108Decompresion of carpal Tunnel syndrome4500    NS
S50111Drainage of absces cold1250    NS
S50112Epiphyseal stimulation10000    NS
S50115Fractured fragment excision7500    NS
S50119Laminectomy/Discectomy18000    NS
S50122Sinus over sacrum excision7500    NS
S50126Synovial cyst -excision7500    NS
S50128Trigger thumb2500    NS
S50129Application of functional cast brace1200    NS
S50131Aspiration & intra articular injections1000    NS
S50132Bandage &Stapping for fractures600    NS
S50133internal wire fixation of mandible &Maxilla9500    NS
S50134Reducation of compound fractures4000    NS
S50135Rducation of facial fractures of maxilla8500    NS
S50136Reducation of fractures of mandible & maxilla -cast netal splints5500    NS
S50137Reducation of fractures of mandible & maxilla -eye let splinting5500    NS
S50138Reducation of fractures of mandible & maxilla -gumming splints5500    NS
S50139Fistulectomy +Sequestrectomy14500    NS
S50142Above elbow post -slab for sogt tisue injury550    NS
S50143Below knee post -slab for sogt tisue injury750    NS
S50144Colles fracture ant.pr post,slab750    NS
S50145Colles fracture Below elbow950    NS
S50146Colles fracture full plaster1700    NS
S50147Fingers (post, slab)250    NS
S50148Fingers full plaster300    NS
S50149Minerva Jacket1500    NS
S50150Plaster jacket1500    NS
S50152Strapping Ankle300    NS
S50153Strapping Ball Bandage450    NS
S50154Strapping Chest450    NS
S50155Strapping colar anf cuff sling300    NS
S50156strapping elbow300    NS
S50157straping figure of 8 bandage450    NS
S50158strapping finger200    NS
S50159strapping knee350    NS
S50160Strapping nasal bone fracture400    NS
S50161strapping shoulder250    NS
S50162strapping toes150    NS
S50163strapping wrist300    NS
S50164Tube plaster(or plster cylinder)1050    NS
          
          

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