Chief Minister's Comprehensive Health Insurance Scheme

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Follow Up Procedure Guidelines - NEUROSURGERY

SERIAL NUMBER Procedure 1st Qtr Per Qtr (for next 3 Qtrs) Requirements while submitting for follow-up Preauth Requirements while submitting for follow-up Claims
43 FP0043 : Evacuation of Brain Abscess-burr hole 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, CT or MRI-Mandatory)
44 FP0044 : Excision of Lobe (Frontal,Temporal, Cerebellum etc 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, CT or MRI-Mandatory)
45 FP0045 : Excision of Brain Tumour Supratentorial 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
46 FP0046 : Parasagittal 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
47 FP0047 : Basal 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
48 FP0048 : Brain Stem 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
49 FP0049 : C P Angle Tumour 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI, EEG-Mandatory)
50 FP0050 : Excision of Brain Tumour Subtentorial 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
51 FP0051 : Ventriculoatrial/Ventriculoperitoneal Shunt 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI, CSF-Mandatory)
52 FP0052 : Subdural Tapping 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI, CSF-Mandatory)
53 FP0053 : Abscess Tapping 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, CSF-Mandatory)
54 FP0054 : Vascular Malformations 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory), CSF
55 FP0055 : Meningo Encephalocele 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory), CSF
56 FP0056 : Meningo myelocele 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory), CSF
57 FP0057 : Ventriculo-Atrial Shunt 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory), CSF
58 FP0058 : Excision of Brain Abscess 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory), CSF
59 FP0059 : Aneurysm Clipping 3,200 1,600 Previous Discharge Summary [Clinical Evaluation, Ct Scan or MRI (1st and 3rd quarter)-I-Mandatory]
60 FP0060 : External Ventricular Drainage (EVD) 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, CSF Analysis, CT or MRI-Mandatory)
61 FP0061 : Trans Sphenoidal Surgery 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
62 FP0062 : Trans Oral Surgery 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
63 FP0063 : Endoscopy Procedures 3,200 1,600 Previous Discharge Summary (Clinical Evaluation/CT or MRI-Mandatory), Endoscopy if required
64 FP0064 : Intra-cerebral Hematoma Evacuation 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI-Mandatory)
65 FP0065 : Temporal Lobectomy 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI, EEG-Mandatory)
66 FP0066 : Lesionectomy Type - 1 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan or MRI, EEG-Mandatory)
67 FP0067 : Lesionectomy Type - 2 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan/ EEG-Mandatory)
68 FP0068 : Temporal Lobectomy Plus Depth Electrodes 3,200 1,600 Previous Discharge Summary (Clinical Evaluation, Ct Scan/ EEG-Mandatory)