A 3 Table of Surgical Procedures TOSP With Minor Surgical Procedures MSPs 1

Annex A-3
Ministry of Health
TABLE OF SURGICAL
PROCEDURES
(Updated as of 12 January 2016)
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CONFIDENTIAL
Annex A-3
TABLE OF CONTENTS
SA - Integumentary ........................................................................... 3
SB - Musculoskeletal ....................................................................... 11
SC - Respiratory .............................................................................. 32
SD - Cardiovascular ........................................................................ 35
SE - Hemic & Lymphatic ................................................................. 42
SF - Digestive .................................................................................. 44
SG - Urinary .................................................................................... 58
SH - Male Genital ............................................................................ 63
SI - Female Genital ......................................................................... 66
SJ - Endocrine ................................................................................. 74
SK - Nervous ................................................................................... 75
SL - Eye........................................................................................... 83
SM - ENT......................................................................................... 90
The Table of Surgical Procedures (TOSP) is an exhaustive list of procedures

with table ranking 1A to 7C, for which Medisdave / MediShield Life can be
claimed. Any procedures not listed or without a table ranking 1A to 7C
are not claimable.
Specifically, Minor Surgical Procedures (procedures with table ranking “MSP”)

are procedures which the TOSP review committee decided to be non-
claimable. The list of MSPs is non-exhaustive, i.e. procedures not in the
TOSP and not a MSP are still not claimable.
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CONFIDENTIAL
SA - INTEGUMENTARY
S/N New Description Table Classification Current
Code code
1 SA700B Botulinum toxin therapy for movement disorders MSP Existing SA700B
2 SA800B Breast (nipple), Various lesions, Graft and/or flap 4B Uptabled / SA800B
reconstruction (bilateral) Description
Change
3 SA801B Breast (nipple), Various lesions, Graft and/or flap 4A Uptabled / SA801B
reconstruction (unilateral) Description
Change
4 SA803B Breast, Diffuse hypertrophy, Reduction >250g 4B Existing SA803B
(unilateral)
5 SA802B Breast, Diffuse Hypertrophy, Reduction 6A Uptabled SA802B
Mammoplasty >500g (bilateral)
6 SA805B Breast, drooping, mastopexy/reduction 4A Existing SA805B
(unilateral)
7 SA804B Breast, Drooping, mastopexy/reduction (bilateral) 5B Uptabled SA804B
8 SA701B Breast, Ductal Lesions, Microdochectomy 3A Existing SA701B
(bilateral)
9 SA702B Breast, Ductal Lesions, Microdochectomy 2C Existing SA702B
(unilateral)
10 SA806B Breast, Gynecomastia, Reduction (bilateral) 4A Existing SA806B
11 SA807B Breast, Gynecomastia, Reduction (unilateral) 3A Existing SA807B
12 SA808B Breast, Hypoplasia, Augmentation Mammoplasty 4A Existing SA808B
(prosthetic and bilateral)
13 SA809B Breast, Hypoplasia, Augmentation Mammoplasty 3A Existing SA809B
(prosthetic and unilateral)
14 SA811B Breast, Inverted Nipple, Surgical Eversion 2C Existing SA811B
(unilateral)
15 SA810B Breast, Inverted Nipples, Surgical Eversion 3A Existing SA810B
(bilateral)
16 SA812B Breast, Lump (single), Excision biopsy 2C Existing SA812B
17 SA705B Breast, Lump, more than 4 cm (removal) with 4A Existing SA705B
parenchymal flap closure (unilateral/bilateral)
18 SA703B Breast, Lump, Percutaneous Biopsy under MRI 2C Existing SA703B
19 SA813B Breast, Lumps (multiple/bilateral), Excision 3A Existing SA813B
biopsy
20 SA706B Breast, Lumps, Imaging Guided Vacuum 2C Existing SA706B
assisted Biopsy / Mammotome, > 1 lesions
21 SA704B Breast, Lumps, Imaging Guided Vacuum 2B Existing SA704B
assisted Biopsy / Mammotome, Single lesion
22 SA814B Breast, Post mastectomy, implant/expander 5A Existing SA814B
reconstruction (bilateral)
23 SA815B Breast, Post mastectomy, implant/expander 4A Existing SA815B
reconstruction (unilateral)
24 SA816B Breast, Post Mastectomy, latissmus dorsi 6C Existing SA816B
pedicled flap with or without implant
reconstruction (bilateral)
25 SA817B Breast, Post Mastectomy, latissmus dorsi 5C Existing SA817B
pedicled flap with or without implant
reconstruction (unilateral)
26 SA818B Breast, Post Mastectomy, Reconstruction using 7A Existing SA818B
pedicled Transverse Rectus Abdominis
Musculocutaneous Flap (bilateral)
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CONFIDENTIAL
SA - INTEGUMENTARY
Code code
27 SA713B Breast, Post mastectomy, reconstruction using 6A Existing SA713B
pedicled transverse rectus abdominis
musculocutaneous flap (unilateral)
28 SA819B Breast, Post mastectomy, reconstruction using 7C Existing SA819B
transverse rectus abdominis free
musculocutaneous flap (unilateral)
29 SA820B Breast, Post Prosthetic Contraction, 3A Existing SA820B
Capsulotomy (bilateral)
30 SA821B Breast, Post Prosthetic Contraction, 2C Existing SA821B
Capsulotomy (unilateral)
31 SA825B Breast, Tumor (malignant), Radical mastectomy 5C Existing SA825B
with/without Axiliary Clearance
32 SA826B Breast, Tumor (malignant), Simple Mastectomy 4A Existing SA826B
33 SA824B Breast, Tumor (malignant), Simple Mastectomy 5A Existing SA824B
with Axiliary Clearance, with/without Sentinel
Node Biopsy
34 SA827B Breast, Tumor (malignant), Simple Mastectomy 4C Existing SA827B
with Sentinel Node Biopsy/ Axiliary Node
Sampling
35 SA822B Breast, Tumor (malignant), Wide Excision/ 3B Existing SA822B
Lumpectomy/Segmental Mastectomy/ Partial
Mastectomy
36 SA823B Breast, Tumor (malignant), Wide Excision/ 4B Existing SA823B
Mastectomy, with Axiliary Clearance,
with/without Sentinel Node Biopsy
37 SA707B Breast, Tumor (malignant), Wide Excision/ 3C Existing SA707B
Mastectomy, with Sentinel Node Biopsy/ Axiliary
Node Sampling
38 SA708B Breast, Various Lesions, Percutaneous MSP Existing SA708B
Aspiration under Ultrasound
39 SA828B Breast, Various lesions, Subcutaneous 4A Existing SA828B
mastectomy bilateral, excluding gynaecomastia
40 SA830B Breast, Various lesions, subcutaneous 3C Existing SA830B
mastectomy unilateral, excluding gynaecomastia
41 SA829B Breast, Various Lesions, Trucut Biopsy 1A Existing SA829B
42 SA709B Breast, Various Lesions, Trucut Biopsy, 1C Existing SA709B
ultrasound guided or stereotactic (multiple)
43 SA710B Breast, Various Lesions, Trucut Biopsy, 1B Existing SA710B
ultrasound guided or stereotactic (single)
44 SA711B Breast, Various Lesions, wire localisation, 3B Existing SA711B
excision (multiple)
45 SA712B Breast, Various Lesions, wire localisation, 3A Existing SA712B
excision (single)
46 SA800F Fascia (deep), Rupture with Herniated Muscle, 1B Existing SA800F
Repair
47 SA800H Hand, Burns (major), Excision and Split Skin 4A Existing SA800H
Graft
48 SA800M Mucous membrane (ear/nose/eyelid) 3A Existing SA800M
avulsion/complex laceration, full thickness repair
49 SA801M Mucous Membrane, Deep Laceration/Multiple 3A Existing SA801M
Lacerations, Repair
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CONFIDENTIAL
SA - INTEGUMENTARY
Code code
50 SA802M Mucous Membrane, Superficial Laceration 1B Existing SA802M
equal/less than 7cm, Repair
51 SA803M Mucous Membrane, Superficial Laceration(s) 2B Existing SA803M
more than 7 cm, Repair
52 SA804M Mucous Membrane, Tumor/Cyst/Ulcer/Scar, 2B Existing SA804M
Excision
53 SA805M Muscle and Deep Tissue, Foreign Body, 2C Existing SA805M
Removal
54 SA700R Radiotherapy, Endoluminal Brachytherapy: 2B Existing SA700R
Oesophagus, Nasopharyngeal carcinoma (NPC),
Hepatobiliary, Cardiac, Lung, Others
55 SA701R Radiotherapy, Interstitial brachytherapy 4B Existing SA701R
(with/without open surgery)
56 SA702R Radiotherapy, Interstitial brachytherapy (without 5A Existing SA702R
open surgery): Prostate
57 SA703R Radiotherapy, Intracavitary Brachytherapy 2C Existing SA703R
(Multi-channel): Cervix, Others
58 SA704R Radiotherapy, Intracavitary Brachytherapy 2A Existing SA704R
(Single channel): Endometrium, others
59 SA705R Radiotherapy, Intra-operative Radiotherapy 3A Existing SA705R
(electrons or kilovoltage): Breast, Sarcoma,
Upper GI, Lower GI, Other sites
60 SA849S Skin & Subcutaneous, Pre-septal/PeriOrbital 2A Existing SA849S
Dermoid/Lesion, Excision
61 SA804S Skin & subcutaneous, Scar revision - face & 1C Existing SA804S
neck (< 3cm)
62 SA700S Skin (Upper Limb), Open Wound, Major 2A Existing SA700S
Desloughing
63 SA803S Skin and Subcutaneous 3B Existing SA803S
tissue(ear/nose/eyelid/face) complex lacerations,
repair
64 SA842S Skin and Subcutaneous tissue, Lacerations 3B Existing SA842S
(deep >3cm/multiple) lacerations, repair/toilet &
suture, with/without debridement
65 SA800S Skin and Mucous Membrane, Various Lesions, 1B Existing SA800S
Excision Biopsy
66 SA805S Skin and Subcutaneous Tissue (face and neck), 2B Existing SA805S
Scar of more than 3cm, Revision
67 SA806S Skin and Subcutaneous Tissue, Burns, 2A Existing SA806S
Escharotomy (extensive)
68 SA807S Skin and Subcutaneous Tissue, Burns, 1A Existing SA807S
Escharotomy (limited)
69 SA808S Skin and Subcutaneous Tissue, Burns, Excision 5A Existing SA808S
and Major Flap Repair
and Major Full Thickness Graft
and Small Full Thickness Graft
72 SA811S Skin and Subcutaneous Tissue, 2C Existing SA811S
Deep>3cm/Extensive Contaminated Wound,
Debridement
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CONFIDENTIAL
SA - INTEGUMENTARY
Code code
73 SA812S Skin and Subcutaneous Tissue, Defect (deep), 3A Existing SA812S
Dermofat/Fascia Graft (including
transplant/muscle flap)
Direct Flap (cross arm/radial fore
arm/abdominal/similar)
75 SA814S Skin and Subcutaneous Tissue, Defect (deep), 5C Existing SA814S
Direct Flap Repair (cross leg)
76 SA815S Skin and Subcutaneous Tissue, Defect (deep), 7C Existing SA815S
Free Flaps
77 SA816S Skin and Subcutaneous Tissue, Defect (deep), 3B Existing SA816S
Free Graft (Split Skin Graft - Extensive/Inlay
Graft using a mould)
Staged Distant Flap (division)
79 SA818S Skin and Subcutaneous Tissue, Defect (multiple 3B Existing SA818S
digits), Free Full Thickness Graft
80 SA819S Skin and Subcutaneous Tissue, Defect (multiple 2A Existing SA819S
digits), Staged Local Flap (division)
81 SA820S Skin and Subcutaneous Tissue, Defect (single 2C Existing SA820S
digit), Free Full Thickness Graft
82 SA821S Skin and Subcutaneous Tissue, Defect, Direct 4A Existing SA821S
Flap (cross finger/similar flaps)
83 SA822S Skin and Subcutaneous Tissue, Defect, Free 1B Existing SA822S
Graft (Split Skin Graft/Pinch Grafts under 1/2%)
Grafts (Split Skin Graft 1/2 to less than 2%)
85 SA824S Skin and Subcutaneous Tissue, Defect, Free 3A Existing SA824S
Grafts (Split Skin Graft 2 to less than 5%)
86 SA825S Skin and Subcutaneous Tissue, Defect, Free 4A Existing SA825S
Grafts (Split Skin Graft 5 to 10%)
Grafts (Split Skin Graft more than 10%)
88 SA827S Skin and Subcutaneous Tissue, Defect, Local 5A Existing SA827S
Flap to Multiple Digits (cross
finger/thenar/flag/rotation flap)
89 SA828S Skin and Subcutaneous Tissue, Defect, Single 5B Existing SA828S
Stage Local Flap (complicated/large)
90 SA829S Skin and Subcutaneous Tissue, Defect, Single 3A Existing SA829S
Stage Local Flap (simple/small)
91 SA830S Skin and Subcutaneous Tissue, Defect, Staged 1B Existing SA830S
Local Flap(division)
92 SA831S Skin and Subcutaneous Tissue, Foreign Body 1C Existing SA831S
(subcutaneous), Removal
93 SA832S Skin And Subcutaneous Tissue, Foreign Body MSP Existing SA832S
(Superficial), Removal
94 SA835S Skin and Subcutaneous Tissue, 7B Existing SA835S
Hemangioma/Lymphangioma (extensive and
complex), Excision
Hemangioma/Lymphangioma (large and deep-
seated), Excision
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CONFIDENTIAL
SA - INTEGUMENTARY
Code code
96 SA837S Skin and Subcutaneous Tissue, 4A Existing SA837S
Hemangioma/Lymphangioma (large), Excision
Hemangioma/Lymphangioma (moderate),
Excision
Hemangioma/Lymphangioma (small), Excision
99 SA833S Skin and subcutaneous tissue, Hematoma MSP Existing SA833S
(small)/furuncle/abscess/similar lesion, Incision
with drainage
100 SA841S Skin and Subcutaneous Tissue, Hematoma 1B Existing SA841S
/Carbuncle Cellulitis/Similar Lesion>3cm,
Saucerisation/Incision with Drainage
101 SA840S Skin and Subcutaneous Tissue, Hematoma, 1A Existing SA840S
Abscess/Cellulitis/Similar lesion<3cm,
Saucerisation/Incision & Drainage
102 SA834S Skin and subcutaneous tissue, Hematoma, MSP Existing SA834S
Aspiration
103 SA843S Skin and Subcutaneous Tissue, Laceration 1B Existing SA843S
(superficial) of less than 7cm, Repair
104 SA844S Skin and Subcutaneous Tissue, Laceration 2C Existing SA844S
(superficial) of more than 7cm, Repair
Neurofibromatosis of Face and Neck, Excision
(small<3cm)
(large >3cm and complicated/multiple)
(large)
(moderate)
109 SA850S Skin and Subcutaneous Tissue, Sinus 2B Existing SA850S
(deep>3cm), Excision with/without biopsy
110 SA851S Skin and Subcutaneous Tissue, Sinus, Excision 1B Existing SA851S
with/without biopsy
Tumor/Cyst/Ulcer/Scar, Excision biopsy,
removal of 2 or more or recurrent or complicated
(adherent), excision
112 SA702S Skin and Subcutaneous Tissue, 1B Existing SA702S
Tumor/Cyst/Ulcer/Scar, Excision biopsy, Lesion
size more than 15mm in diameter
Tumor/Cyst/Ulcer/Scar, Excision biopsy, Lesion
size up to and including 15mm in diameter
114 SA801S Skin and Subcutaneous tissue, Tumour 3A Existing SA801S
(malignant), wide excision and Reconstruction
and local flap/skin graft
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CONFIDENTIAL
SA - INTEGUMENTARY
Code code
115 SA802S Skin and subcutaneous tissue, Tumour 5A Existing SA802S
(malignant), wide excision with immediate block
dissection
116 SA854S Skin and Subcutaneous Tissue, Wound 1A Existing SA854S
(large>3cm), Secondary Suture
117 SA855S Skin And Subcutaneous Tissue, Wound MSP Existing SA855S
(Small<3cm), Secondary Suture
118 SA853S Skin and Subcutaneous Tissue, Wound, 1A Existing SA853S
Debridement <3cm
119 SA703S Skin cancer, Mohs (chemo surgery) micrographic 2C Existing SA703S
surgery with reconstruction/graft/flap
120 SA704S Skin cancer, Mohs (chemo surgery) micrographic 2B Existing SA704S
surgery without reconstruction
121 SA856S Skin, Angioma, Cauterisation/Injection 1A Existing SA856S
122 SA857S Skin, Burns (2% to 5%), Excision 2B Existing SA857S
123 SA858S Skin, Burns (less than 10%), Dressing MSP Existing SA858S
124 SA859S Skin, Burns (less than 2%), Excision 1B Existing SA859S
125 SA860S Skin, Burns (more than 10%), Dressing 1B Existing SA860S
126 SA861S Skin, Burns (more than 10%), Excision 3B Existing SA861S
127 SA862S Skin, Burns (more than 5% to 10%) Excision 2C Existing SA862S
128 SA705S Skin, Defect, Distant Skin Flaps 4B Existing SA705S
129 SA706S Skin, Defect, Neurovascular Island Flap 5A Existing SA706S
130 SA863S Skin, Keratoses/Warts/Tags/Similar Lesions, 2B Existing SA863S
Excision (6 - 10 lesions)
131 SA864S Skin, Keratoses/Warts/Tags/Similar Lesions, 2C Existing SA864S
Excision (more than10 lesions)
132 SA865S Skin, Keratoses/Warts/Tags/Similar Lesions, 1B Existing SA865S
Excision (not more than 5 lesions)
133 SA707S Skin, Neuromas/Hemangiomas, 1C Existing SA707S
Excision/Vaporisation by Laser
134 SA866S Skin, Plantar Wart, Excision or Vaporisation by 1A Existing SA866S
Laser
135 SA867S Skin, Plantar Warts (multiple), Excision 1B Existing SA867S
136 SA868S Skin, Scar (extensive), Revision 3B Existing SA868S
137 SA870S Skin, Scar, Revision with Z-plasty 2C Existing SA870S
138 SA869S Skin, Scar/various lesion (single), removal of 3A Existing SA869S
tissue expander/prosthesis and revision of scar
139 SA871S Skin, scars/lesions(multiple), removal of tissue 3C Existing SA871S
expander/prosthesis and revision/excision of
scars
140 SA872S Skin, Superficial Nasal Dermoid, Excision 3A Existing SA872S
141 SA708S Skin, surgical treatment for vitiligo (involving non- 3C Existing SA708S
cultured cellular grafting) (<20 sq cm)
142 SA709S Skin, surgical treatment for vitiligo (involving non- 4B Existing SA709S
cultured cellular grafting) (>40 sq cm)
143 SA710S Skin, surgical treatment for vitiligo (involving non- 4A Existing SA710S
cultured cellular grafting) (20-40 sq cm)
144 SA873S Skin, Tattoo (1% to 2%), Laser Excision 2B Existing SA873S
145 SA874S Skin, Tattoo (less than 1%), Laser Excision 1C Existing SA874S
146 SA875S Skin, Tattoo (multiple/more than 2%), Laser 3A Existing SA875S
Excision
A-3-8
CONFIDENTIAL
SA - INTEGUMENTARY
Code code
147 SA876S Skin, Tattoo, Repeat Laser Excision 1A Existing SA876S
148 SA877S Skin, Various Lesions of Face (2 to 3), Excision 1B Existing SA877S
Biopsy
149 SA885S Skin, Various Lesions of Face (4 and above), 2B Existing SA885S
Excision Biopsy
150 SA884S Skin, Various Lesions of Face (single), Excision 1A Existing SA884S
Biopsy
151 SA878S Skin, Various Lesions, Abrasive Therapy 3A Existing SA878S
(extensive)
152 SA879S Skin, Various Lesions, Abrasive Therapy 2A Existing SA879S
(limited)
153 SA880S Skin, Various Lesions, Insertion of Tissue 3A Existing SA880S
Expander (multiple)
154 SA881S Skin, Various Lesions, Insertion of Tissue 2B Existing SA881S
Expander (single)
155 SA882S Skin, Various Lesions, Trial Dermabrasion 1A Existing SA882S
156 SA883S Skin, Various Lesions, Wound MSP Existing SA883S
Inspection/Dressing/Removal Of Sutures
157 SA886S Skin, Wrinkles, Partial Rhytidectomy 5C Existing SA886S
158 SA887S Skin, Wrinkles, Total Rhytidectomy 6B Existing SA887S
159 SA711S Soft Tissue (Lower Limb), Contracture, Major 4A Existing SA711S
Release
160 SA712S Soft Tissue (Lower Limb), Contracture, Minor 2C Existing SA712S
Release
161 SA713S Soft Tissue (Lower Limb), Open 2A Existing SA713S
Wound/Infection, Major Desloughing
162 SA714S Soft Tissue (Lower Limb), Small Tumors 1B Existing SA714S
(benign), Excision Biopsy under General
Anesthesia
163 SA715S Soft Tissue (Lower Limb), Tumor/Tumor-like 2C Existing SA715S
Lesions, Marginal Excision
164 SA716S Soft Tissue (Lower Limb), Tumors (benign), 4A Existing SA716S
Wide Excision Biopsy
165 SA717S Soft Tissue (Lower Limb), Tumors (malignant), 5C Existing SA717S
Radical Excision Biopsy
166 SA718S Soft Tissue (Lower Limb), Various Lesions, 4B Existing SA718S
Major Release
167 SA719S Soft Tissue (Lower Limb), Various Lesions, 3A Existing SA719S
Minor Release
168 SA720S Soft Tissue (Palmar Space), Abscess, Drainage 2B Existing SA720S
169 SA721S Soft Tissue (Upper Limb), Tumors (benign), 4A Existing SA721S
Major Excision Biopsy
170 SA722S Soft Tissue (Upper Limb), Tumors (malignant), 6B Existing SA722S
Radical Excision Biopsy
171 SA723S Soft Tissue (Upper Limb), Tumors (malignant), 5A Existing SA723S
Wide Excision Biopsy
172 SA724S Soft Tissue, Tumor (malignant), Major Resection 7C Existing SA724S
and Reconstruction (microsurgical)
173 SA889S Soft Tissue, Tumor (malignant), Radical Excision 5C Existing SA889S
Biopsy >7cm other than upper/lower limbs
174 SA888S Soft Tissue, Tumor (malignant), Wide Excision 3C Existing SA888S
Biopsy <7cm other than upper/lower limbs
A-3-9
CONFIDENTIAL
SA - INTEGUMENTARY
Code code
175 SA890S Subcutaneous Tissue (abdomen), Obesity, 3B Existing SA890S
Liposuction
176 SA891S Subcutaneous Tissue (buttocks), Obesity, 3B Existing SA891S
Liposuction
177 SA892S Subcutaneous Tissue (face), Obesity, 2C Existing SA892S
Liposuction
178 SA893S Subcutaneous Tissue (thigh), Obesity, 3C Existing SA893S
Liposuction
179 SA894S Subcutaneous Tissue (upper limbs), Obesity, 3A Existing SA894S
Liposuction
180 SA896S Subcutaneous Tissue, Obesity, Lipectomy 5C Existing SA896S
(excision with undermining of skin edges and
strengthening of abdominal wall)
181 SA895S Subcutaneous Tissue, Obesity, Lipectomy 4A Existing SA895S
(transverse wedge excision of abdominal
apron/lipectomy with excision of skin)
182 SA897S Subcutaneous Tissue, Obesity, Radical 5C Existing SA897S
Abdominoplasty with Repair of Abdominal Wall
and Transposition of Umbilicus
183 SA725S Sweat Gland, Axillary Hyperhidrosis, Wedge 3A Existing SA725S
Excision (bilateral)
184 SA898S Sweat Gland, Axillary Hyperhidrosis, Wedge 2C Existing SA898S
Excision (unilateral)
185 SA700T Tendon Sheath and Subcutaneous Tissue, 2A Existing SA700T
Ganglion/large Bursa, (>3cm) Excision Biopsy
186 SA800T Tendon Sheath and Subcutaneous Tissue, 1B Existing SA800T
Ganglion/Small Bursa, (<3cm) Excision Biopsy
A-3-10
CONFIDENTIAL
SB – MUSCULOSKELETAL
code code
1 SB700A Ankle, ankle fracture, Bimalleolar, ORIF 4A Existing SB700A
2 SB801A Ankle, ankle fracture, unimalleolar, ORIF 3C Existing SB801A
3 SB701A Ankle, comminuted Plafond fracture ORIF 5A Existing SB701A
4 SB800A Ankle, Dislocation, Open Reduction 3B Existing SB800A
5 SB702A Ankle, ligamentous instability, reconstruction of 5A Existing SB702A
ligaments (eg. Bostrom, Chrisman-Snook)
6 SB705A Ankle, Therapeutic arthroscopy 4A Existing SB705A
7 SB802A Ankle, Various Lesions, Arthrodesis (surgical 5A Existing SB802A
fusion)
8 SB803A Ankle, Various Lesions, Excision/Interposition 4C Existing SB803A
Arthroplasty
9 SB703A Ankle, Various Lesions, Primary Total Joint 6B Existing SB703A
Replacement with augmentation, requiring extra
implants or bone grafts, open/MIS/navigated
10 SB806A Ankle, Various Lesions, Primary Total Joint 6A Existing SB806A
Replacement, open/MIS/navigated
11 SB804A Ankle, Various Lesions, Repair of Ligaments 3A Existing SB804A
12 SB704A Ankle, Various Lesions, Revision Total Joint 6C Existing SB704A
Replacement,open/MIS/navigated
13 SB805A Ankle, Various Lesions, Synovectomies 3B Existing SB805A
14 SB806B Bone (Lower Limb), Osteomyelitis, Drainage with 4A Existing SB806B
Curettage and Irrigation
15 SB803B Bone (Lower Limb), Defect/Non Union, 3B Existing SB803B
Implantation of Bone Stimulator
16 SB801B Bone (Lower Limb), Deformities, Corrective 5C Existing SB801B
Surgery with Internal Fixation with or w/o
Fluoroscopy
17 SB802B Bone (Lower Limb), Deformities, Corrective 4A Existing SB802B
Surgery with Osteotomy alone
18 SB804B Bone (Lower Limb), Fracture/Dislocation, 3B Existing SB804B
Manipulation and Kirschner Wire Fixation
19 SB805B Bone (Lower limb), Grade 1 and 2 Open 2B Existing SB805B
Fractures/Open dislocation or open fracture-
dislocation Wound Debridement
20 SB807B Bone (Lower Limb), Osteomyelitis, Simple 2B Existing SB807B
Drainage
21 SB808B Bone (Lower Limb), Plates and Screws/Nails, 2B Existing SB808B
Removal
22 SB809B Bone (Lower Limb), Simple Implants, Removal 1C Existing SB809B
(e.g screw/wire/pins)
23 SB810B Bone (Lower Limb), Tumor (benign), <3 cm with 4A Existing SB810B
bone grafting +/- reconstruction/internal fixation
24 SB700B Bone (Lower Limb), Tumor (benign), >3 cm with 5A Existing SB700B
bone grafting +/- reconstruction/internal fixation
25 SB811B Bone (Lower Limb), Tumor (malignant), Radical 5C Existing SB811B
Excision (<6cm) with reconstruction and bone
grafting
26 SB701B Bone (Lower Limb), Tumor (malignant), Radical 6A Existing SB701B
Excision >6cm with reconstruction and bone graft
27 SB812B Bone (Lower Limb), Various Lesions, 5C Existing SB812B
Epiphysiolysis with/without Microsurgery
28 SB702B Bone (Skull), Tumor (Large>3cm) Excision and 7B Existing SB702B
Extensive Reconstruction (dura, skull, skin)
A-3-11
CONFIDENTIAL
code code
29 SB814B Bone (Skull), Tumor (Large>3cm) Excision with 6B Existing SB814B
Cranioplasty
30 SB815B Bone (Skull), Tumor (malignant), Wide Excision 5C Existing SB815B
31 SB813B Bone (Skull), Tumor (Small<3cm) Excision with 5B Existing SB813B
Cranioplasty
32 SB818B Bone (Upper Limb), Deformities, Corrective 4B Existing SB818B
Surgery
33 SB819B Bone (Upper Limb), Deformities, Osteotomies with 5C Existing SB819B
Plate Fixation and with or w/o Fluoroscopy and
with or without bone graft
34 SB821B Bone (Upper Limb), Fracture/Dislocation/Sprain, MSP Existing SB821B
Full Cast
35 SB822B Bone (Upper Limb), Grade 1 and 2 Open 2B Existing SB822B
Fractures/Open dislocation or open fracture-
dislocation Wound Debridement
36 SB824B Bone (Upper Limb), Osteomyelitis Simple 2B Existing SB824B
Drainage
37 SB823B Bone (Upper Limb), Osteomyelitis, Extensive 4A Existing SB823B
Curettage/Debridement and Irrigation
38 SB825B Bone (Upper Limb), Plates and Screws, Removal 2B Existing SB825B
39 SB826B Bone (Upper Limb), Simple Implants, Removal 1C Existing SB826B
(eg: K-wires, wires, pins, screws only)
40 SB827B Bone (Upper Limb), Tumor (benign), Major 4A Existing SB827B
Excision <3 cm with bone grafting +/-
reconstruction/internal fixation
41 SB704B Bone (Upper Limb), Tumor (benign), Major 5A Existing SB704B
Excision >3 cm with bone grafting +/-
reconstruction/internal fixation
42 SB828B Bone (Upper Limb), Tumor (malignant), Radical 6B Existing SB828B
Excision with reconstruction/internal fixation
43 SB829B Bone (Upper Limb), Tumour (malignant), Wide 5A Uptabled SB829B
Excision with reconstruction/internal fixation
44 SB833B Bone (Upper Limb/lower limb), Various Lesions, 7C Existing SB833B
Vascularised Bone Transfer
45 SB817B Bone (Upper/Lower Limb), bone loss/nonunion, 3C Description SB817B
bone grafting Change
46 SB703B Bone (Upper/lower Limb), Exostosis, Excision 3A Existing SB703B
Biopsy (more than1/ bilateral)
47 SB820B Bone (Upper/lower Limb), Exostosis, Excision 2C Existing SB820B
Biopsy (Single)
48 SB830B Bone (Upper/Lower Limb), Various Lesions, Bone 6A Description SB830B
Loss, Bone Transfer Change
49 SB800B Bone, Cyst/Tumour Benign/Benign Aggressive, 4A Existing SB800B
Currettage/Burring/Bone Grafting/Cementing
50 SB707B Bone, Tumor (malignant), around joints with limb 7A Existing SB707B
reconstruction and joint replacement
51 SB831B Bone, Tumor (malignant), Wide/Major Resection 6B Existing SB831B
and Reconstruction (non vascularised bone graft)
52 SB708B Bone, Tumour (malignant), Wide/Major Resection 7B Uptabled SB708B
and Reconstruction (vascularised bone graft)
53 SB705B Bone, Tumour, Imaging Guided Percutaneous 4A Existing SB705B
Local Ablation (Radiofrequency, Cryotherapy,
microwave, laser, alcohol,etc) , > 1 lesions
A-3-12
CONFIDENTIAL
code code
54 SB706B Bone, Tumour, Imaging Guided Percutaneous 3C Existing SB706B
microwave, laser, alcohol,etc) , Single lesion
55 SB832B Bone, Various Lesions, Biopsy 1B Existing SB832B
56 SB709B Bone, Various Lesions, Open Biopsy, 1B Existing SB709B
Cementing/Plate Fixation
57 SB711B Bone/ Soft tissue, Various lesions, Imaging 2B Existing SB711B
Guided Percutaneous Biopsy
58 SB812J Bone/Joints (Lower Limb), Major Crush Injuries, 3B Existing SB812J
Wound Debridement
59 SB710B Bone/Soft Tissue, Various Lesions, Trucut Biopsy 1B Existing SB710B
60 SB712B Bursa, Bursitis, Excision Biopsy (more than 2C Existing SB712B
1/bilateral)
61 SB834B Bursa, Bursitis, Excision Biopsy (single) 2A Existing SB834B
62 SB700C Calcaneum Fracture extra-articular open 3C Existing SB700C
reduction internal fixation
63 SB800C Carpus, Delayed/Non Union, Reconstruction 5C Existing SB800C
64 SB801C Carpus, Fracture/Dislocation, Open Reduction 4B Existing SB801C
and Internal Fixation
65 SB802C Cervical Spine, Various Lesions, Anterior 6B Existing SB802C
Decompression and Fusion (multiple levels)
66 SB803C Cervical Spine, Various Lesions, Anterior 6A Existing SB803C
Decompression and Fusion (single level)
67 SB804C Cervical Spine, Various Lesions, Application Of MSP Existing SB804C
Calipers
68 SB805C Clavicle, Clavicle Fracture, Simple 3B Existing SB805C
69 SB701C Clavicle, Clavicle Fracture, Comminuted Plating 4A Existing SB701C
With or without Bone Grafting
70 SB702C Clavicle, Clavicle Fracture, Delayed 4B Existing SB702C
Union/Revision and ORIF with/without bone
grafting
71 SB806C Coccyx, Various Lesions, Excision 2C Existing SB806C
72 SB800N Digit(s), Nail Bed, Deformity/Defect, 4B Existing SB800N
Reconstruction
73 SB700D Digit(s), Nailbed Laceration, Nailbed grafting 4A Existing SB700D
74 SB701D Digit(s), Soft Tissue Defect, Complex Small Skin 5A Existing SB701D
Flaps, multiple flaps
75 SB702D Digit(s), Soft Tissue Defect, Large complex 5C Existing SB702D
pedicled flaps
76 SB703D Digit(s), Soft Tissue Defect, Simple skin flap 3A Existing SB703D
77 SB800E Elbow (Medial Epicondyle), Fracture, Excision 2B Existing SB800E
Bony Fragment
78 SB701E Elbow, Condyle/Radial Head Fracture, Radial 4B Existing SB701E
Head Excision/condyle/arthroplasty
79 SB702E Elbow, Coronoid Fracture, ORIF 4B Existing SB702E
80 SB703E Elbow, Dislocation , Ligament Repair (Complex, 4A Existing SB703E
with/without Implant)
81 SB704E Elbow, Dislocation , Ligament Repair (Single) 3A Existing SB704E
82 SB801E Elbow, Fracture/ Dislocation, Repair Of 4B Existing SB801E
Ligaments/ ORIF
83 SB705E Elbow, Fracture/Dislocation, Open Reduction and 3C Existing SB705E
Internal Fixation (ORIF)
A-3-13
CONFIDENTIAL
code code
84 SB706E Elbow, Supracondylar fracture, M&R, 3C Existing SB706E
percutaneous pinning
85 SB802E Elbow, Tennis Elbow, Release 2B Existing SB802E
86 SB707E Elbow, Various Lesions, Primary Total Joint 6B Existing SB707E
Arthroplasty with augmentation, requiring extra
87 SB708E Elbow, Various Lesions, Primary Total Joint 6A Existing SB708E
Arthroplasty, open/MIS/navigated
88 SB709E Elbow, Various Lesions, Revision Total Joint 6C Existing SB709E
89 SB803E Elbow, Various Lesions, Synovectomy with 5A Existing SB803E
Reconstruction
90 SB700E Elbow,Therapeutic arthroscopy 4A Existing SB700E
91 SB800F Face, Contour Defect, Reconstruction / Insertion 4A Existing SB800F
of Implant (s)
92 SB801F Face, Defect / Deformity, Reconstruction / 5C Existing SB801F
Insertion of Implant
93 SB700F Face, Fracture, Endoscopic Reduction and 5C Existing SB700F
Fixation
94 SB802F Face, Fractures (more than 2), Open Reduction 6B Existing SB802F
and Internal Fixation
95 SB701F Face, Fractures (Panfacial), Open Reduction and 7C Existing SB701F
Internal Fixation
96 SB803F Face, Infection / Osteomyelitis, Major 3B Existing SB803F
Drainage/Sequestrectomy
97 SB804F Face, Infection / Osteomyelitis, Simple Drainage 2C Existing SB804F
/Sequestrectomy
98 SB805F Face, Intraosseous Tumor (large), Excision 5C Existing SB805F
99 SB806F Face, Intraosseous Tumor (small), Excision 3A Existing SB806F
100 SB807F Fascia Palmar, Dupuytren's Contracture, 5C Existing SB807F
Fasciectomy (multiple)
101 SB808F Fascia Palmar, Dupuytren's Contracture, 4A Existing SB808F
Fasciectomy (single)
102 SB809F Femur, Delayed/Non Union, w/ Bone grating 4A Existing SB809F
103 SB702F Femur, Delayed/Non Union, w/ re-internal fixation 5A Existing SB702F
and bone grafting
104 SB703F Femur, Fracture (complex intra-articular), Open 5C Description SB703F
Reduction and Internal Fixation (ORIF) with Plate Change
and Screws
105 SB810F Femur, Fracture (femur shaft), Intramedullary 5A Uptabled / SB810F
Nailing/Rod (with or without locking) Description
Change
106 SB706F Femur, Fracture (intercondylar), Open Reduction 5A Description SB706F
and Internal Fixation (ORIF) Change
107 SB705F Femur, Fracture (multifragmentary), 5A Description SB705F
Intramedullary nailing (with or without locking) Change
108 SB708F Femur, Fracture (paediatric shaft), Intramedullary 4A Description SB708F
flexible nailing Change
109 SB709F Femur, Fracture (single condylar), Open 4B Description SB709F
Reduction and Internal Fixation (ORIF) Change
110 SB811F Femur, Fracture, Open Reduction and Internal 5A Existing SB811F
Fixation with Plate and Screws
A-3-14
CONFIDENTIAL
code code
111 SB707F Femur, Neck of femur fracture (paediatric), Pin 4B Existing SB707F
fixation
112 SB710F Femur, Slipped Capital Femoral Epiphysis 4B Existing SB710F
(SCFE), Screw fixation
113 SB711F Finger, Defect/Contracture (multiple), 4C Existing SB711F
Reconstruction
114 SB812F Finger, Defect/Contracture (single), 3C Existing SB812F
Reconstruction
115 SB813F Finger, Deformities, Correction 4A Existing SB813F
116 SB814F Finger, Injury, Debridement 1B Existing SB814F
117 SB838F Finger, Macrodactyly, surgical reduction of 4A New -
enlarged elements - multiple digits
118 SB837F Finger, Macrodactyly, surgical reduction of 3A New -
enlarged elements - single digit
119 SB817F Finger, Ring Constriction (multiple), Correction 5C Existing SB817F
120 SB816F Finger, Ring Constriction (single), Correction 3B Existing SB816F
121 SB818F Finger, Swan Neck/Boutonniere Deformity 4A Existing SB818F
(single), Correction
122 SB819F Finger, Syndactyly (multiple), Separation 5C Existing SB819F
123 SB820F Finger, Syndactyly (single), Correction 4A Existing SB820F
124 SB821F Finger, Trauma, Replantation (multiple) 7B Existing SB821F
125 SB822F Finger, Trauma, Replantation/Transplantation 6B Existing SB822F
(single)
126 SB823F Finger, Trauma, Terminalisation (multiple) 3B Existing SB823F
127 SB824F Finger, Trauma, Terminalisation (single) 2C Existing SB824F
128 SB825F Finger, Various Lesions, Amputation (multiple) 2C Existing SB825F
129 SB826F Finger, Various Lesions, Amputation (single) 2A Existing SB826F
130 SB712F Finger, Various Lesions, Ray Amputation 3C Existing SB712F
(multiple)
131 SB828F Finger, Various Lesions, Ray Amputation (single) 3A Existing SB828F
132 SB829F Finger, Various Lesions, Synovectomy with Soft 5C Existing SB829F
Tissue Reconstruction
133 SB715F Foot, Achilles tendon reconstruction 4A Existing SB715F
134 SB716F Foot, Congenital Talipes Equinovarus (CTEV), 6A Existing SB716F
bilateral release
Medial Release
136 SB718F Foot, Congenital Talipes Equinovarus (CTEV), 4C Existing SB718F
Post Medial release
Post release
138 SB720F Foot, Congenital Talipes Equinovarus (CTEV), 5C Existing SB720F
Posterior medial release with revision
139 SB830F Foot, Crush Injuries (complex), Wound 3B Existing SB830F
Debridement
140 SB831F Foot, Crush Injuries (simple), Wound Debridement 1B Existing SB831F
141 SB721F Foot, Fractures, Complex, multiple, including talus 5A Existing SB721F
and calcaneum, Open Reduction and Internal
Fixation
142 SB722F Foot, Fractures, Simple, single 3B Existing SB722F
143 SB724F Foot, Haglund's deformity - osteotomy 3C Existing SB724F
A-3-15
CONFIDENTIAL
code code
144 SB732F Foot, Hallux Valgus/Hammer Toe, Proximal 3C New -
Osteotomy, with or without soft tissue
reconstruction
145 SB832F Foot, Hallux Valgus/Hammer Toe, Soft Tissue 3B Description SB832F
Reconstruction Change
146 SB727F Foot, Multiple foot osteotomies 5C Existing SB727F
147 SB725F Foot, One bone osteotomy with soft tissue 5A Existing SB725F
release, Cuboid
148 SB726F Foot, One bone osteotomy with soft tissue 5A Existing SB726F
release, Dwyer’s (calcaneal)
149 SB833F Foot, Polydactyly, Excision 1A Existing SB833F
150 SB834F Foot, Polydactyly, Excision with Reconstruction 4A Existing SB834F
151 SB728F Foot, Posterior Tibial Tendon Dysfunction (PTTD) 4A Existing SB728F
- posterior tibialis reconstruction
152 SB729F Foot, Tendon transfers, split tibialis anterior 4A Existing SB729F
tendon transfer (SPLATT)
153 SB730F Foot, Tendon transfers, split tibialis posterior 4A Existing SB730F
tendon transfer (SPLOTT)
154 SB731F Foot, Tendon transfers, Tibia Anterior Transfer 4A Existing SB731F
155 SB835F Foot, Various Lesions, Floating Osteotomy 3A Existing SB835F
156 SB836F Foot, Various Lesions, Triple Arthrodesis 5C Existing SB836F
157 SB713F Forearm, Radial head fracture, Open reduction of 4A Existing SB713F
radial head for missed Monteggia
158 SB714F Forearm, Radius/ulna shaft fracture, 4B Existing SB714F
Intramedullary rod
159 SB701H Hand and Wrist - Rheumatoid hand reconstruction 6C Existing SB701H
including multiple joint synovectomy, bone/joint
procedures with arthroplasty (multiple) and soft
tissue procedures
160 SB702H Hand and Wrist - Rheumatoid hand reconstruction 5C Existing SB702H
including synovectomy, bone/joint procedures
with/without replacement arthroplasty, and soft
tissue procedures
161 SB800H Hand, Amputated Digit(s), Toe to Hand Transfer 7B Existing SB800H
162 SB703H Hand, Closed fracture, ORIF complex (multiple) 5A Existing SB703H
163 SB713H Hand, Closed fracture, ORIF complex (multiple), 5C Existing SB713H
joint
164 SB704H Hand, Closed fracture, ORIF complex/ plate and 3C Existing SB704H
screws (single)
165 SB705H Hand, Closed fracture, ORIF with K-wire/cerclage 2C Existing SB705H
wire fixation
166 SB801H Hand, Closed Fracture/Dislocation, Open 2C Existing SB801H
Reduction and Fixation (single)
167 SB802H Hand, Complex Injuries, Debridement with 5A Existing SB802H
Repair/Reconstruction (1-2 tendons involved or 1-
2 fractures)
168 SB706H Hand, Complex Injuries, Debridement with 5C Existing SB706H
Repair/Reconstruction (more than 2 tendons
involved or more than 2 fractures)
169 SB707H Hand, Complex Injuries, Microsurgical 6B Existing SB707H
Repair/Reconstruction, >1 digit
170 SB803H Hand, Complex Injuries, Microsurgical 5C Existing SB803H
Repair/Reconstruction, single digit
A-3-16
CONFIDENTIAL
code code
171 SB804H Hand, Crush Injuries (complex), Wound 3C Existing SB804H
Debridement
172 SB805H Hand, Crush Injuries (simple), Wound 1C Existing SB805H
Debridement
173 SB806H Hand, Deep Infection, Drainage 2C Existing SB806H
174 SB807H Hand, Deformities, Major Reconstructive 5C Existing SB807H
Procedures
175 SB808H Hand, Deformities, Osteotomy 3B Existing SB808H
176 SB809H Hand, Deformity, Intrinsic Muscle 5C Existing SB809H
Release/Transfer/Extensor Relocation
177 SB810H Hand, Extra Digit, Amputation/Stump Revision 1C Existing SB810H
178 SB811H Hand, Flexor Tendon Injuries, Insertion of Silastic 5C Existing SB811H
Rod(s)
179 SB733H Hand, Flexor Tendon, Pulley Reconstruction 4B Existing SB733H
180 SB708H Hand, Flexor Tendon, Trigger Finger (multiple), 3A Existing SB708H
Release
181 SB709H Hand, Flexor Tendon, Trigger Finger (single), 2A Existing SB709H
Release
182 SB812H Hand, Foreign Body (deep), Removal with 3A Existing SB812H
Mobilisation of Neurovascular Bundle
183 SB813H Hand, Foreign Body (superficial), Removal with 2A Existing SB813H
Mobilisation of Neurovascular Bundle
184 SB710H Hand, Fracture of fingers/metacarpals, External 3B Existing SB710H
fixation
185 SB711H Hand, Fracture of fingers/metacarpals, Non-union, 4C Existing SB711H
bone-grafting and fixation (multiple)
186 SB712H Hand, Fracture of fingers/metacarpals, Non-union, 3C Existing SB712H
bone-grafting and fixation (single)
187 SB814H Hand, Fractures/Dislocation, Open Reduction and 5C Existing SB814H
Internal Fixation (multiple)
188 SB827F Hand, Free toe pulp transfer 7C Existing SB827F
189 SB714H Hand, Open fracture, Debridement and ORIF 6A Existing SB714H
(multiple), joint
190 SB715H Hand, Open fracture, Debridement and ORIF 5B Existing SB715H
(multiple), non-joint
191 SB716H Hand, Open fracture, Debridement and ORIF 4A Existing SB716H
(single), joint
192 SB717H Hand, Open fracture, Debridement and ORIF 3B Existing SB717H
(single), non-joint
193 SB815H Hand, Polydactyly, Amputation with 4A Existing SB815H
Reconstruction
194 SB816H Hand, Scar, Revision 2C Existing SB816H
195 SB817H Hand, Soft Tissue Tumor, Excision <1.5cm 2A Existing SB817H
196 SB718H Hand, Soft Tissue Tumor, Excision >1.5cm size 2C Existing SB718H
197 SB818H Hand, Superficial Infection, Drainage 1A Existing SB818H
198 SB819H Hand, Tumors, Excision with Dissection of 4B Existing SB819H
Neurovascular Bundle
199 SB820H Hand, Wart/Corn/Naevus, Excision 1B Existing SB820H
200 SB821H Head, Various Lesions, Craniofacial Resection 7C Existing SB821H
and Reconstruction
201 SB822H Head-Face, Soft Tissue Tumors (small), Excision 3A Existing SB822H
A-3-17
CONFIDENTIAL
code code
202 SB823H Head-Face, Trauma, Craniofacial Approach 5C Existing SB823H
Reduction and Fixation
203 SB824H Head-Face, Trauma, Craniofacial Approach 6C Existing SB824H
Reduction and Fixation with Bone Graft
204 SB825H Head-Face, Various Lesions, Major Corrective 7C Existing SB825H
Surgery
205 SB719H Hip, Acetabulum, Fracture, double column fixation 6B Existing SB719H
206 SB720H Hip, Acetabulum, Fracture, single column fixation 5C Existing SB720H
207 SB826H Hip, Avascular Necrosis, Core Decompression 4A Existing SB826H
208 SB827H Hip, Avascular Necrosis, Core Decompression 6B Existing SB827H
with Grafting
209 SB828H Hip, Congenital Dislocation, Open Reduction 5C Existing SB828H
210 SB829H Hip, Congenital Dislocation, Open Reduction 6B Existing SB829H
including Reconstruction
211 SB830H Hip, Dislocation, Manipulation and Reduction 1B Existing SB830H
212 SB831H Hip, Dislocation, Open Reduction 5C Existing SB831H
213 SB721H Hip, Open reduction with Acetabular or Femoral 5B Existing SB721H
Osteotomies
214 SB832H Hip, Snapping Syndrome, Release 1B Existing SB832H
215 SB722H Hip, Soft tissue release and open reduction only 4C Existing SB722H
216 SB833H Hip, Various Lesions, Application of Hip Spicas 1B Existing SB833H
217 SB834H Hip, Various Lesions, Arthrodesis 6B Existing SB834H
218 SB835H Hip, Various Lesions, Arthrotomy 3B Existing SB835H
219 SB836H Hip, Various Lesions, Arthrotomy and 4A Existing SB836H
Synovectomy
220 SB837H Hip, Various Lesions, Excision/Interposition 5A Existing SB837H
Arthroplasty
221 SB838H Hip, Various Lesions, Hemi-Arthroplasty 5C Existing SB838H
222 SB723H Hip, Various Lesions, Primary Total Joint 6B Existing SB723H
223 SB839H Hip, Various Lesions, Primary Total Joint 6A Existing SB839H
224 SB724H Hip, Various Lesions, Revision Total Joint 6C Existing SB724H
225 SB700H Hip/Knee, Hip/Knee Therapeutic Arthroscopy 4A Existing SB700H
226 SB725H Hip/knee, Removal of prostheses with or without 5A Existing SB725H
spacer
227 SB842H Humerus supracondylar AND intercondylar 5A Existing SB842H
fracture
228 SB726H Humerus, cubitus varus, Corrective osteotomy 4B Existing SB726H
with cast or pinning
229 SB727H Humerus, cubitus varus, Corrective osteotomy 5A Existing SB727H
with plating
230 SB728H Humerus, Delayed/Non-Union, Reconstruction w/ 4B Existing SB728H
bone grafting without internal fixation
231 SB840H Humerus, Delayed/Non-Union, Reconstruction w/ 5B Existing SB840H
internal fixation and bone grafting
232 SB729H Humerus, Humerus shaft fracture, Closed 4A Existing SB729H
interlocking intramedullary nail
233 SB730H Humerus, Humerus shaft fracture, Complex multi- 4C Existing SB730H
fragmentary intramedullary nail
A-3-18
CONFIDENTIAL
code code
234 SB841H Humerus, Proximal humerus or supracondylar 4A Existing SB841H
fracture, ORIF
235 SB800J Joints (Finger), Contracture, 4A Existing SB800J
Capsulectomy/Capsulotomy
236 SB801J Joints (Finger), Various Lesions, Arthrodesis 3C Existing SB801J
237 SB802J Joints (Finger), Various Lesions, Excision 3C Existing SB802J
Arthroplasty
238 SB803J Joints (Finger), Various Lesions, Replacement 4C Existing SB803J
Arthroplasty
239 SB804J Joints (Foot excluding Ankle), Synovitis, 2C Existing SB804J
Synovectomy
240 SB805J Joints (Hand excluding Wrist), Synovitis, 2C Existing SB805J
Synovectomy
241 SB806J Joints (Lower Limb) - small, Various Lesions, 3C Existing SB806J
Arthroplasty
242 SB807J Joints (Lower Limb), Deformities, Corrective 4A Existing SB807J
Surgery with Osteotomy alone
243 SB808J Joints (Lower Limb), Deformities, Corrective 5C Existing SB808J
Surgery with Plate Fixation and Fluoroscopy
244 SB809J Joints (Lower Limb), Dislocations, Manipulation 3B Existing SB809J
and Kirschner Wire Fixation
245 SB810J Joints (Lower Limb), Dislocations, Wound 2B Existing SB810J
Debridement
246 SB811J Joints (Lower Limb), Loose Bodies, Removal 3B Existing SB811J
247 SB815J Joints (Lower Limb), Simple Implants, Removal 1C Existing SB815J
(eg. K-wires, pins, screw only)
248 SB816J Joints (Lower Limb), Various Lesions, 5C Existing SB816J
Epiphysiolysis with/without Microsurgery
249 SB813J Joints (Lower Limb, except Hip), Septic Arthritis, 3C Existing SB813J
drainage with curettage and debridement
250 SB814J Joints (Lower Limb, except Hip), Septic Arthritis, 2B Existing SB814J
simple drainage
251 SB703J Joints (Lower Limb, Hip), Septic Arthritis, 4A Existing SB703J
Curettage/Debridement and Irrigation
252 SB704J Joints (Lower Limb, Hip), Septic Arthritis, simple 3A Existing SB704J
drainage
253 SB817J Joints (Other than Finger), Various Lesions, Total 6A Existing SB817J
Joint Replacement
254 SB818J Joints (Other than Hand and Wrist), Various 5C Existing SB818J
Lesions, Arthrodesis
255 SB819J Joints (Other than Hand excluding Wrist), Various 4A Existing SB819J
Lesions, Synovectomy
256 SB707J Joints (Shoulder), Various Lesions, Impingement 5A Existing SB707J
Syndrome
257 SB821J Joints (Temporo-mandibular), Dislocation, 1C Existing SB821J
Reduction under general anaesthesia
258 SB820J Joints (Temporo-Mandibular), Dislocation, MSP Existing SB820J
Reduction without general anaesthesia
259 SB708J Joints (Temporomandibular), Various Lesions, 3A Existing SB708J
Arthrocentesis (bilateral)
260 SB709J Joints (Temporomandibular), Various Lesions, 2B Existing SB709J
Arthrocentesis (unilateral)
A-3-19
CONFIDENTIAL
code code
261 SB701J Joints (Temporomandibular), Various Lesions, 3B Existing SB701J
Arthroscopy (bilateral)
262 SB700J Joints (Temporomandibular), Various Lesions, 2C Existing SB700J
Arthroscopy (unilateral)
263 SB712J Joints (Temporo-mandibular), Various Lesions, 7A Existing SB712J
Condylectomy with Reconstruction (Bilateral)
264 SB822J Joints (Temporo-mandibular), Various lesions, 6B Existing SB822J
Condylectomy with Reconstruction (Unilateral)
265 SB710J Joints (Temporo-mandibular), Various Lesions, 4B Existing SB710J
Condylectomy/Coronoidectomy/Menisectomy
Condylotomy
Plication of Disc
268 SB713J Joints (Temporo-mandibular), Various lesions, 7A Existing SB713J
Reconstruction (Bilateral)
269 SB823J Joints (Temporo-mandibular), Various Lesions, 6B Existing SB823J
Reconstruction (Unilateral)
270 SB825J Joints (Upper Limb), Contracture, 5C Existing SB825J
Capsulectomy/Capsulotomy (multiple)
271 SB826J Joints (Upper Limb), Deformities/Contracture, 4B Existing SB826J
Corrective Surgery
272 SB827J Joints (Upper Limb), Deformities/Contracture, 5C Existing SB827J
Osteotomies and Fixation
273 SB828J Joints (Upper Limb), Fractures/Dislocation/Sprain, MSP Existing SB828J
Full Cast
274 SB829J Joints (Upper Limb), Plates and Screws, Removal 2B Existing SB829J
275 SB830J Joints (Upper Limb), Rush Rods/Wires/Screws, 1C Existing SB830J
Removal
276 SB833J Joints (Upper Limb), Various Lesions, 1A Existing SB833J
Examination and Manipulation under General
Anesthesia
277 SB834J Joints (Upper Limb), Various Lesions, 7C Existing SB834J
Vascularised Joint Transfer
278 SB716J Joints (Upper Limb), Vascular Injury, Major 5A Existing SB716J
vascular reconstruction/anastomosis/graft
279 SB831J Joints (Upper Limb, except Shoulder), Septic 3C Uptabled SB831J
Arthritis, drainage with curretage and debridement
280 SB832J Joints (Upper Limb, except Shoulder), Septic 2B Existing SB832J
Arthritis, simple drainage
281 SB714J Joints (Upper Limb, Shoulder), Septic 4A Existing SB714J
Arthritis/Effusion, Curettage/Debridement and
Irrigation
282 SB715J Joints (Upper Limb, Shoulder), Septic 3C Existing SB715J
Arthritis/Effusion, simple drainage
283 SB835J Joints (Wrist), Various Lesions, Arthrodesis 4B Existing SB835J
284 SB702J Joints, Arthroscopy, diagnostic 2C Existing SB702J
285 SB717J Joints, Major intra-articular fracture with 5C Existing SB717J
discontinuity or bone loss, Reconstruction (for
lower limb)
286 SB718J Joints, Major intra-articular fracture with 5A Existing SB718J
discontinuity or bone loss, Reconstruction (for
upper limb)
A-3-20
CONFIDENTIAL
code code
287 SB705J Joints, Various Lesions, Primary Total Joint 6B Existing SB705J
288 SB706J Joints, Various Lesions, Revision Total Joint 6C Existing SB706J
289 SB800K Knee Ligaments, Disruption, Reconstruction and 5C Existing SB800K
Repair
290 SB700K Knee, Arthroscopy, knee ligament reconstruction 5C Existing SB700K
(1 or more)
291 SB801K Knee, Dislocation, Open Reduction with Repair of 5C Existing SB801K
Ligaments
292 SB802K Knee, Hemarthrosis, Aspiration under General 1A Existing SB802K
Anesthesia
293 SB702K Knee, Hemarthrosis, Aspiration Under Local MSP Existing SB702K
Anesthesia
294 SB701K Knee, Ligaments/Meniscus/Cartilage/Bone 5C Existing SB701K
combined, Arthroscopic ACL or PCL
reconstruction
combined, Arthroscopic ligament reconstruction
with meniscal repair
with meniscectomy
with microfracture
298 SB706K Knee, Ligaments/Meniscus/Cartilage/Bone 6A Existing SB706K
combined, Arthroscopic primary double bundle
ACL or PCL reconstruction
combined, Arthroscopic revision ACL
reconstruction
combined, Arthroscopic revision PCL
reconstruction
combined, Autologous chondrocyte implantation
with osteotomy
combined, Mosaicplasty or Osteoarticular
Transfer System (OATS) with osteotomy
combined, Multi-Ligamented Knee Reconstruction
(3 or more ligaments)
304 SB712K Knee, Meniscus/Cartilage ( small defects ), 5C Existing SB712K
Open/Arthroscopic Mosaicplasty or OATS
305 SB713K Knee, Meniscus/Cartilage, Arthroscopic assisted 5C Existing SB713K
allograft meniscal transplantation
306 SB714K Knee, Meniscus/Cartilage, Arthroscopic cartilage 4A Existing SB714K
harvesting
307 SB715K Knee, Meniscus/Cartilage, Arthroscopic meniscal 5A Existing SB715K
repair
308 SB803K Knee, Various Lesions, Arthrodesis 5A Existing SB803K
A-3-21
CONFIDENTIAL
code code
309 SB804K Knee, Various Lesions, Arthrotomy 3B Existing SB804K
310 SB805K Knee, Various Lesions, Arthrotomy and 4A Existing SB805K
Synovectomy
311 SB806K Knee, Various Lesions, Excision/Interposition 4A Existing SB806K
Arthroplasty
312 SB807K Knee, Various Lesions, Manipulation and 1A Existing SB807K
Examination under Anesthesia
313 SB808K Knee, Various Lesions, Meniscectomy 4A Existing SB808K
with/without Arthroscopy
314 SB716K Knee, Various Lesions, Primary Total Joint 6B Existing SB716K
Replacement (Unilateral) with augmentation,
requiring extra implants or bone grafts,
open/MIS/navigated
315 SB810K Knee, Various Lesions, Primary Total Joint 6A Existing SB810K
Replacement (Unilateral), open/MIS/navigated
316 SB717K Knee, Various Lesions, Revision Total Joint 6C Existing SB717K
317 SB809K Knee, Various Lesions, Total Joint Replacement 7B Existing SB809K
(Bilateral)
318 SB800L Lower Limb, Crush Injuries (extensive), 6B Existing SB800L
Debridement with Repair of Bone and Soft
Tissues
319 SB801L Lower Limb, Crush Injuries (limited), Debridement 5A Existing SB801L
with Repair of Bone and Soft Tissues
320 SB802L Lower Limb, Deformities, Epiphysiodesis 4A Existing SB802L
321 SB803L Lower Limb, Fractures, Open Reduction and 6B Existing SB803L
Fixation with Repair of Arterial Injuries
322 SB804L Lower Limb, Fractures/Dislocation, Manipulation 1B Existing SB804L
and Reduction with/without Application of Cast
323 SB805L Lower Limb, Length Discrepancies, Lengthening 4B Existing SB805L
Procedures
324 SB806L Lower Limb, Length Discrepancies, Shortening 6B Existing SB806L
Procedures
325 SB701L Lower Limb, Open tendon releases and cast 3A Existing SB701L
application, Hamstring releases
326 SB700L Lower Limb, Open tendon releases and cast 4B Existing SB700L
application, tibialis anterior lengthening (TAL)
327 SB702L Lower Limb, Percutaneous Tenotomy and cast 3A Existing SB702L
application, Adductor tenotomy
328 SB703L Lower Limb, Percutaneous Tenotomy and cast 3A Existing SB703L
application, TA tenotomy
329 SB808L Lower Limb, Traumatic Amputation, Major 7C Existing SB808L
Replantation
330 SB809L Lower Limb, Various Lesions, Amputation 4A Existing SB809L
331 SB810L Lower Limb, Various Lesions, Application of cast MSP Existing SB810L
332 SB811L Lower Limb, Various Lesions, Hindquarter 6B Existing SB811L
Amputation
333 SB812L Lower Limb, Various Lesions, Hip Disarticulation 6B Existing SB812L
334 SB800M Mandible (excluding alveolar margins), Various 6B Existing SB800M
Lesions, Complex Osteotomy/Ostectomy
335 SB817M Mandible and / or Maxilla, Various Lesions, 5A Existing SB817M
Insertion of Transmandibular Implant/
Subperiosteal Implant/ Zygomaticus Implant
A-3-22
CONFIDENTIAL
code code
336 SB710M Mandible AND Maxilla, Old Fractures / 3B Existing SB710M
Osteotomy, Removal of Plates or Wires
337 SB700M Mandible and Maxilla, Various Lesions, 7C Existing SB700M
Osteotomy and Insertion of Device for Distraction
Osteogenesis
338 SB801M Mandible and Maxilla, Various Lesions, 7C Existing SB801M
Osteotomy including Segmental Osteotomy
with/without Grafting
339 SB802M Mandible or Maxilla, Alveolar Defect/Deformity, 3A Existing SB802M
Complex Alveoloplasty/Unilateral (lateral window)
sinus lift/ ridge augmentation with bone graft from
separate surgical site.
340 SB803M Mandible or Maxilla, Alveolar Defect/Deformity, 2C Existing SB803M
Simple Alveoloplasty / Bone Regenerative
Procedure
341 SB701M Mandible or Maxilla, Bony protuberance, Excision 1B Existing SB701M
342 SB702M Mandible or Maxilla, Dental Implant(s), 1C Existing SB702M
Osseointegrated, Trephine Removal (x number of
implants removed)
343 SB809M Mandible or Maxilla, Odontogenic Cyst (10mm or 2C Existing SB809M
smaller), Enucleation
344 SB807M Mandible or Maxilla, Odontogenic Cyst (11- 3A Existing SB807M
20mm), Enucleation
345 SB808M Mandible or Maxilla, Odontogenic Cyst (20mm or 4A Existing SB808M
larger or multiple cysts), Enucleation
346 SB810M Mandible or Maxilla, Odontogenic Cyst, 2B Existing SB810M
Marsupialization
347 SB811M Mandible OR Maxilla, Old Fractures / Osteotomy, 2B Existing SB811M
Removal of Plates or Wires
348 SB812M Mandible or Maxilla, Tumor, Marginal Resection 5C Existing SB812M
349 SB703M Mandible or Maxilla, Tumor, Marginal Resection 6B Existing SB703M
with Bone Graft
350 SB814M Mandible or Maxilla, Various Lesions, 4A Existing SB814M
Alveoloplasty with Epithelial Graft, OR Bilateral
Sinus-lift procedure OR Ridge augmentation
(multiple quadrants) with bone graft harvested
from separate site
351 SB816M Mandible or Maxilla, Various Lesions, Insertion of 2C Existing SB816M
Endosseous Dental Implant (single)(For multiple
placement of implants, number of claims =
number of implants placed )
352 SB704M Mandible or Maxilla, Various Lesions, Segmental 5B Existing SB704M
Osteotomy and Insertion of Device for Distraction
Osteogenesis and Bone Transport
353 SB705M Mandible or Maxilla, Various Lesions, 3C Existing SB705M
Vestibuloplasty, Complex.
354 SB706M Mandible or Maxilla, Various Lesions, 2B Existing SB706M
Vestibuloplasty, Simple.
355 SB707M Mandible or Maxilla, Various 5A Existing SB707M
Lesions,Dentoalveolar Osteotomy and Insertion of
Device for Distraction Osteogenesis
356 SB708M Mandible, Atrophy, Lateralisation of Inferior Dental 5A Existing SB708M
Nerve with Implant Fixtures Placement, Bilateral.
A-3-23
CONFIDENTIAL
code code
357 SB709M Mandible, Atrophy, Lateralisation of Inferior Dental 4B Existing SB709M
Nerve with Implant Fixtures Placement, Unilateral
358 SB804M Mandible, Fracture (comminuted), Open 5C Existing SB804M
Reduction and Fixation
359 SB805M Mandible, Fracture, Closed Reduction and 3B Existing SB805M
Fixation
360 SB806M Mandible, Fracture, Open Reduction and Fixation 5A Existing SB806M
361 SB813M Mandible, Various Lesions, Alveolectomy (per 2C Existing SB813M
quadrant)
362 SB711M Mandible, Various Lesions, Body or Ramus 5C Existing SB711M
Osteotomy with Insertion of Distraction
Osteogenesis Device
363 SB815M Mandible, Various Lesions, Genioplasty (Complex 5C Existing SB815M
- not as a combined procedure)
364 SB823M Mandible, Various Lesions, Genioplasty (Simple - 5A Existing SB823M
not as a combined procedure)
365 SB818M Mandible, Various Lesions, Mandibular 6B Existing SB818M
Ramus/Body Ostectomy/ Osteotomy with
Segmental Osteotomy
366 SB819M Mandible, Various Lesions, Mandibular 5C Existing SB819M
Ramus/Body Ostectomy/ Osteotomy without
Segmental Osteotomy
367 SB820M Mandible, Various Lesions, Reconstruction with 5C Existing SB820M
Bone
368 SB821M Mandible, Various Lesions, Segmental 5A Existing SB821M
Ostectomy/Osteotomy (one segment only)
369 SB822M Mandible, Various Lesions, Segmental Resection 6B Existing SB822M
with Bone Graft
370 SB824M Maxilla (excluding alveolar margins) and/or 6B Existing SB824M
Zygoma, Various Lesions, Complex
Ostectomy/Osteotomy
371 SB833M Maxilla Deformity, Le Fort II Osteotomy and 6B Existing SB833M
Insertion of Distraction Osteogenesis Device
372 SB835M Maxilla Deformity, Le Fort III Osteotomy and 7B Existing SB835M
373 SB825M Maxilla, Alveolar Cleft (Bilateral Complete), Bone 6B Existing SB825M
Graft and Closure of Naso Buccal Fistula
374 SB838M Maxilla, Alveolar Cleft (Unilateral Complete), Bone 5B Existing SB838M
Graft and Closure of Naso Buccal Fistula
375 SB839M Maxilla, Alveolar Cleft (Unilateral Incomplete), 4B Existing SB839M
Bone Graft
376 SB826M Maxilla, Bilateral Incomplete Alveolar Cleft, Bone 6A Existing SB826M
Graft
377 SB827M Maxilla, Deformity - Lefort I, Osteotomy 5C Existing SB827M
378 SB828M Maxilla, Deformity - Lefort II, Osteotomy 6B Existing SB828M
379 SB829M Maxilla, Deformity - Lefort III, Osteotomy 7C Existing SB829M
380 SB713M Maxilla, Deformity, Le Fort I Osteotomy and 5C Existing SB713M
381 SB831M Maxilla, Fracture - Lefort I, Open Reduction and 5C Existing SB831M
fixation
382 SB830M Maxilla, Fracture - Lefort I, Closed Reduction and 4A Existing SB830M
Fixation
A-3-24
CONFIDENTIAL
code code
383 SB834M Maxilla, Fracture - Lefort II (complex), Open 6B Existing SB834M
Reduction and Fixation.
384 SB832M Maxilla, Fracture - Lefort II / III, Closed Reduction 5A Existing SB832M
and Fixation.
385 SB836M Maxilla, Fracture - Lefort III, Open Reduction and 6B Existing SB836M
Fixation
386 SB837M Maxilla, Fracture - Lefort III, Open Reduction and 7C Existing SB837M
Fixation using Craniofacial approach
387 SB840M Maxilla, Various Lesions, Ostectomy/Osteotomy 6B Existing SB840M
(more than 1 segment)
388 SB842M Maxilla, Various Lesions, Ostectomy/Osteotomy 5A Existing SB842M
(one segment only)
389 SB712M Maxilla, Various Lesions, Resection with 6B Existing SB712M
Reconstruction
390 SB841M Maxilla, Various Lesions, 5C Existing SB841M
Resection/Hemimaxillectomy (open or endoscopic
method)
391 SB843M Muscle (Lower Limb), Deep Abscess, Drainage 2A Existing SB843M
392 SB844M Muscle (Lower Limb), Rupture, Repair 2C Existing SB844M
393 SB845M Muscle (Lower Limb), Various Lesions, Marginal 2A Existing SB845M
Excision
394 SB846M Muscle (Lower Limb), Various Lesions, Wide 3A Existing SB846M
Excision
395 SB847M Muscle (Quadriceps)/Tendon (Lower Limb), 3A Existing SB847M
Disruption, Repair
396 SB848M Muscle (Upper Limb), Deep Abscess,incision and 2A Existing SB848M
drainage
397 SB849M Muscle (Upper Limb), Rupture, Repair 2C Existing SB849M
398 SB850M Muscle (Upper Limb), Various Lesions, Marginal 2C Existing SB850M
Excision
399 SB851M Muscle (Upper Limb), Various Lesions, Wide 3C Existing SB851M
Excision
400 SB852M Musculoskeletal System, Various Lesions, Free 7B Existing SB852M
Composite Tissue Graft
401 SB853M Musculoskeletal System, Various Lesions, MSP Existing SB853M
Steinman Pins Insertion
402 SB801N Nail Bed, Laceration, Repair (multiple) 2C Existing SB801N
403 SB802N Nail Bed, Laceration, Repair (single) 1C Existing SB802N
404 SB803N Nail, Infection/Injury, Avulsion 1A Existing SB803N
405 SB804N Neck, Torticollis, Correction 3B Existing SB804N
406 SB700O Others, Autologous chondrocyte implantation 5A Existing SB700O
407 SB800P Patella, Fracture, Open Reduction and Internal 3B Existing SB800P
Fixation
408 SB700P Patella, Habitual dislocation- lateral release, 4B Existing SB700P
Medial plication
409 SB801P Patella, Recurrent Dislocation/Chondromalacia, 4B Existing SB801P
Reconstruction
410 SB802P Patella, Various Lesions, Patellectomy 3A Existing SB802P
411 SB803P Pelvis, Fracture (double columns), Open 6B Existing SB803P
Reduction and Internal Fixation
412 SB701P Pelvis, Fracture, Fixation of anterior and posterior 5C Existing SB701P
ring
A-3-25
CONFIDENTIAL
code code
413 SB804P Pelvis, Fracture, Open Reduction and Internal 5C Existing SB804P
Fixation
414 SB702P Pelvis, Fracture, Plate/ screw fixation 5C Existing SB702P
415 SB800R Radius (head), Various Lesions, Excision 3B Existing SB800R
416 SB700R Radius and Ulna, Fracture/Dislocation, non 5A Uptabled SB700R
union/delayed union bone grafting and re-fixation
417 SB701R Radius and Ulna, Fracture/Dislocation, non 3C Existing SB701R
union/delayed union bone grafting only
418 SB801R Radius and Ulna, Fracture/Dislocation, Open 4B Existing SB801R
Reduction and internal fixation with or without
bone grafting
419 SB703S Sacrum, Fracture, Open Reduction and Internal 5C Existing SB703S
Fixation
420 SB704S Sacrum, Fracture, Reconstruction 6A Existing SB704S
421 SB742S Scapula, Complex Scapular fracture (with/without 5B Expanded SB705S
glenohumeral joint involvement), Open Reduction (New) /
and Internal Fixation (ORIF) Description
Change
422 SB705S Scapula, Scapular fracture, Open Reduction and 5A Expanded / SB705S
Internal Fixation (ORIF) with plating Description
Change
423 SB701S Shoulder Fracture/Dislocation, Open Reduction 4A Existing SB701S
and Internal Fixation (2 part fracture)
424 SB702S Shoulder Fracture/Dislocation, Open Reduction 5A Existing SB702S
and Internal Fixation (3 or more part fracture)
425 SB801S Shoulder, Acromioclavicular joint 5B Uptabled SB801S
stabilisation/reconstruction
426 SB706S Shoulder, Deformities, Deformities, Osteotomies 5C Existing SB706S
with Plate Fixation and with or w/o Fluoroscopy
and with or without bone graft
427 SB800S Shoulder, Deformities, Corrective Surgery, 5C Existing SB800S
Osteotomy
428 SB707S Shoulder, Shoulder soft tissue injury, 5A Existing SB707S
Arthroscopic/Open Bankart or Superior Labrum
from anterior to posterior (SLAP) repair
429 SB708S Shoulder, Shoulder soft tissue injury, 5B Existing SB708S
Arthroscopic/Open Bankart repair with Superior
Labrum from anterior to posterior (SLAP)
repair/rotator cuff repair
Arthroscopic/Open decompression alone
431 SB710S Shoulder, Shoulder soft tissue injury, 5B Existing SB710S
Arthroscopic/Open decompression with cuff repair
432 SB711S Shoulder, Shoulder soft tissue injury, 5C Existing SB711S
Arthroscopic/Open decompression with cuff repair
& excision of distal clavicle
Arthroscopic/Open decompression with excision
of distal clavicle
434 SB713S Shoulder, Shoulder soft tissue injury, Shoulder 5B Existing SB713S
reconstruction (eg, Bristow/Latarjet procedure)
435 SB700S Shoulder, Therapeutic arthroscopy 4A Existing SB700S
A-3-26
CONFIDENTIAL
code code
436 SB714S Shoulder, Various Lesions, Primary Total Joint 6B Existing SB714S
437 SB802S Shoulder, Various Lesions, Hemiarthroplasty 5C Existing SB802S
438 SB715S Shoulder, Various Lesions, Primary Total Joint 6A Existing SB715S
439 SB716S Shoulder, Various Lesions, Revision Total Joint 6C Existing SB716S
440 SB803S Soft Tissue (Lower Limb), Small Tumors (Benign), MSP Existing SB803S
Excision Under Local Anesthesia
441 SB804S Spinal Nerves, Various Lesions, Neurolytic Nerve MSP Existing SB804S
Block
442 SB717S Spinal/Epidural, Epidural Adhesiolysis, multiple 4C Existing SB717S
catheter, Cervical, Imaging Guided
443 SB805S Spine (cervical), Various Lesions, Laminoplasty 6B Existing SB805S
444 SB806S Spine, Cervical Rib, Excision 4C Existing SB806S
445 SB807S Spine, Chronic Pain/Stiffness, Manipulation 2A Existing SB807S
446 SB808S Spine, Deformities, Corrective Osteotomy – With / 7C Description SB808S
Without Computer Navigation Change
447 SB718S Spine, Dorsal Root Entry Zone (DREZ) operation 6A Existing SB718S
448 SB809S Spine, Fracture-Dislocation, Open Reduction and 6B Existing SB809S
Stabilisation
449 SB719S Spine, Image guided spinal injections with 2A Existing SB719S
medications (1-3)
450 SB720S Spine, Image guided spinal injections with 2B Existing SB720S
medications (4 or more)
451 SB810S Spine, Infection, Anterior Drainage and Fusion 6B Existing SB810S
452 SB721S Spine, Nerve pain, Image guided spinal 2B Existing SB721S
radiofrequency/laser/cryotherapy
453 SB722S Spine, Prolapsed Disc, Discectomy, Multiple 6A Existing SB722S
Levels
454 SB723S Spine, Prolapsed Disc, Discectomy, Single Level 5C Existing SB723S
455 SB812S Spine, Prolapsed Disc, Laminectomy/Fenestration 5C Description SB812S
with Discectomy (open or MIS), Single Level Change
456 SB811S Spine, Prolapsed Disc, nuclear manipulations 3C Existing SB811S
457 SB724S Spine, Removal of spine implants 5A Existing SB724S
458 SB725S Spine, Removal, revision of port e.g. Port-a-cath MSP Existing SB725S
459 SB813S Spine, Scoliosis/Congenital Deformities, 7C Description SB813S
Correction – With / Without Computer Navigation Change
460 SB814S Spine, Syringomyelia, Laminectomy and Posterior 6B Existing SB814S
Fossa Decompression and Drainage
461 SB815S Spine, Various Lesions And Pain, Caudal/Epidural MSP Existing SB815S
Injection
462 SB726S Spine, Various Lesions --Revision spinal surgery - 6A Existing SB726S
decompression,laminectomy &/or Discectomy
463 SB728S Spine, Various Lesions, Anterior Decompression, 6B Description SB728S
Corpectomy, Debridement, Biopsy Stabilisation Change
without instrumentation
464 SB730S Spine, Various Lesions, Anterior Lumbar 7A Description SB730S
Interbody Fusion, Multiple Levels Change
465 SB731S Spine, Various Lesions, Anterior Lumbar 6A Description SB731S
Interbody Fusion, Single Level Change
A-3-27
CONFIDENTIAL
code code
466 SB733S Spine, Various Lesions, Artificial disc replacement 7A Description SB733S
of the cervical/lumbar spine, Multiple Levels Change
467 SB734S Spine, Various Lesions, Artificial disc replacement 6A Description SB734S
of the cervical/lumbar spine, Single Level Change
468 SB727S Spine, Various Lesions, Decompression 6B Existing SB727S
Laminectomy, Multiple Levels (open or MIS)
469 SB816S Spine, Various Lesions, Decompression 6A Existing SB816S
Laminectomy, single level (1 or 2 roots)
470 SB729S Spine, Various Lesions, Decompression, Spinal 7B Description SB729S
Instrumentation, Multiple Levels Change
471 SB735S Spine, Various lesions, Discogram, > 2 levels 3A Existing SB735S
472 SB736S Spine, Various lesions, Discogram, 1 to 2 levels 2B Existing SB736S
473 SB737S Spine, Various lesions, Imaging Guided 4C Existing SB737S
Percutaneous Disc ablation, 2 levels (eg IDET -
Intradiscal Electrothermal Annuloplasty)
474 SB738S Spine, Various lesions, Imaging Guided 4A Existing SB738S
Percutaneous Disc ablation, single level (eg IDET
- Intradiscal Electrothermal Annuloplasty)
475 SB817S Spine, Various Lesions, Injection of Oradexon 1A Existing SB817S
476 SB743S Spine, Various Lesions, Revision spinal 7A Expanded SB732S
instrumentation, Multiple Levels (New)
477 SB744S Spine, Various Lesions, Revision spinal 6C Expanded SB732S
instrumentation, Single Level (New)
478 SB818S Spine, Various Lesions, Spinal Rhizolysis 6B Existing SB818S
involving Exposure of Spinal Nerve Roots
479 SB739S Spine, Various lesions, Vertebroplasty or 4C Existing SB739S
kyphoplasty, 2 levels or more
480 SB740S Spine, Various lesions, Vertebroplasty or 4A Existing SB740S
kyphoplasty, Single level
481 SB741S Spine, Various Lesions--Decompression, 7A Existing SB741S
Interbody Fusion (circumferential fusion with
instrumentation and cages) - Open or MIS or with
Computer Navigation
482 SB800T Tendon (Peroneal), Subluxation, Reconstruction 4A Existing SB800T
483 SB801T Tendon (Upper Limb), Bowstringing/Entrapment, 3B Existing SB801T
Pulley Reconstruction
484 SB802T Tendon (Upper Limb), Contracture, Tenotomy 2C Existing SB802T
485 SB700T Tendon (Upper Limb), Various Lesions, Tendon 5C Existing SB700T
Transfer (multiple)
486 SB803T Tendon (Upper Limb), Various Lesions, Tendon 4A Existing SB803T
Transfer (single)
487 SB804T Tendon Sheath (Upper Limb), De Quervain's 3C Existing SB804T
(bilateral), Release
488 SB805T Tendon Sheath (Upper Limb), De Quervain's 3A Existing SB805T
(unilateral), Release
489 SB806T Tendon Sheath (Upper Limb), Ganglion/Villo- 2B Existing SB806T
Nodular Synovitis, Excision
490 SB807T Tendon Sheath (Upper Limb), Tenosynovitis 3B Existing SB807T
(multiple), Drainage
491 SB808T Tendon Sheath (Upper Limb), Tenosynovitis 2B Existing SB808T
(single), Drainage
492 SB809T Tendon-Achilles (Lower Limb), Disruption, Repair 3A Existing SB809T
A-3-28
CONFIDENTIAL
code code
493 SB810T Tendon-Extensor (Upper Limb), Adhesion, 5A Existing SB810T
Tenolysis (multiple)
494 SB811T Tendon-Extensor (Upper Limb), Adhesion, 4A Existing SB811T
Tenolysis (single)
495 SB812T Tendon-Extensor (Upper Limb), Injury, Repair 3A Existing SB812T
(multiple)
496 SB813T Tendon-Extensor (Upper Limb), Injury, Repair 2C Existing SB813T
(single)
497 SB814T Tendon-Flexor (Lower Limb), Disruption, Repair 2C Existing SB814T
(single)
498 SB815T Tendon-Flexor (Upper Limb), Adhesion, Tenolysis 5C Existing SB815T
(multiple)
499 SB816T Tendon-Flexor (Upper Limb), Adhesion, Tenolysis 4A Existing SB816T
(single)
500 SB817T Tendon-Flexor (Upper Limb), Defect, Grafting 6B Existing SB817T
(multiple)
501 SB818T Tendon-Flexor (Upper Limb), Defect, Grafting 5C Existing SB818T
(single)
502 SB819T Tendon-Flexor (Upper Limb), Injury, Repair 4B Existing SB819T
(multiple)
503 SB820T Tendon-Flexor (Upper Limb), Injury, Repair 3B Existing SB820T
(single)
504 SB821T Tendon-Flexor (Upper Limb), Injury, Tendon Graft 4C Existing SB821T
505 SB822T Tendons-Flexor (Lower Limb), Disruption, Repair 3B Existing SB822T
(multiple)
506 SB823T Thumb, Deformities, Correction 4A Existing SB823T
507 SB824T Thumb, Paralysis, Opponens Plasty 4B Existing SB824T
508 SB825T Thumb, Various Lesions, Pollicisation or 6B Existing SB825T
Microsurgical reconstruction
509 SB826T Tibia, Delayed/Non-Union, Reconstruction 5C Existing SB826T
510 SB827T Tibia, Fracture(s), Open Reduction and Internal 4B Existing SB827T
Fixation with Intramedullary Rod
511 SB701T Tibia, Fracture, Open Reduction and Internal 5C Existing SB701T
Fixation with Plates and Screws, comminuted
512 SB828T Tibia, Fracture, Open Reduction and Internal 5A Existing SB828T
Fixation with Plates and Screws, simple
513 SB702T Tibia, Tibial plateau, comminuted bicondylar , 5B Existing SB702T
ORIF
514 SB703T Tibia, Tibial plateau, unicondylar comminuted/ 5A Existing SB703T
simple bicondylar , ORIF
515 SB704T Tibia, Tibial plateau, unicondylar, ORIF 4B Existing SB704T
516 SB705T Tibia, Tibial Shaft Fracture, Intramedullary nailing 4B Combined / SB705T
(locked/unlocked) Description
Change
517 SB709T Toes, Toe deformity 1C Existing SB709T
518 SB710T Toes, Toe deformityMultiple/complex 3B Existing SB710T
519 SB829T Toes, Various Lesions, Amputation (multiple) 2C Existing SB829T
520 SB830T Toes, Various Lesions, Amputation (single) 1C Existing SB830T
521 SB831T Toes, Various Lesions, Arthrodesis 2C Existing SB831T
522 SB707T Toes, Various Lesions, Ray Amputation (multiple) 2C Existing SB707T
523 SB708T Toes, Various Lesions, Ray Amputation (single) 1C Existing SB708T
A-3-29
CONFIDENTIAL
code code
524 SB800U Upper Limb, Congenital Deformity, Major 6B Existing SB800U
Reconstruction
525 SB801U Upper Limb, Deformity, Bony and Soft Tissue 5C Existing SB801U
Reconstruction
526 SB802U Upper Limb, Fracture/Dislocation, Manipulation 1B Existing SB802U
and Reduction
527 SB803U Upper Limb, Ischemia, Fasciotomy 2B Existing SB803U
528 SB804U Upper Limb, Trauma, Major Replantation 7B Existing SB804U
529 SB805U Upper Limb, Various Lesions, Amputation 5C Existing SB805U
530 SB806U Upper Limb, Various Lesions, Forequarter 6B Existing SB806U
Amputation
531 SB807U Upper Limb, Various Lesions, Vascularised Free 7A Existing SB807U
Muscle Transfer
532 SB700U Upper Limb/Lower Limb, Fracture, External 5A Existing SB700U
fixation, multiple planes
533 SB701U Upper Limb/Lower Limb, Major soft tissue defects, 7C Existing SB701U
Free flap
534 SB702U Upper Limb/Lower Limb, Major soft tissue defects, 5C Existing SB702U
Pedicled flap
535 SB703U Upper Limb/Lower Limb, Malignant tumour, soft 5C Existing SB703U
tissue, Radical excision
536 SB807L Upper Limb/Lower Limb, Open fractures with 4B Existing SB807L
debridement and External fixation
537 SB704U Upper Limb/Lower Limb, Upper limb fractures, 4B Existing SB704U
Minimally invasive fixation
538 SB701W Wrist, Avascular necrosis, radial recession/ulnar 4C Existing SB701W
lengthening,
539 SB702W Wrist, Distal or radial ulnar joint (DRUJ) instability, 4B Existing SB702W
complex ligament reconstruction
540 SB703W Wrist, Distal or radial ulnar joint (DRUJ) instability, 3A Existing SB703W
Darrach or similar procedure
541 SB704W Wrist, Distal radius fracture, M&R, percutaneous 3B Existing SB704W
pinning
542 SB706W Wrist, Distal radius fracture, Open Reduction and 4C Description SB706W
Internal Fixation (ORIF) (complex, with autologous Change
bone graft)
Internal Fixation (ORIF) (simple open reduction Change
and pinning)
Internal Fixation (ORIF) (with ulnar head/styloid Change
fixation/TFCC repair)
545 SB708W Wrist, Joint, various lesions, proximal row 5C Existing SB708W
carpectomy or 4 corner fusion
546 SB709W Wrist, Lunate dislocation / Perilunate dislocation / 6B Existing SB709W
complex ligament injury, Reconstruction
547 SB710W Wrist, Scaphoid fracture, Open Reduction and 4B Uptabled / SB710W
Internal Fixation (ORIF) with bone grafting Description
Change
548 SB711W Wrist, Scaphoid or carpus, Vascularised bone 4C Existing SB711W
graft
549 SB700W Wrist, Therapeutic arthroscopy 4A Existing SB700W
A-3-30
CONFIDENTIAL
code code
550 SB712W Wrist, Ulnar head/styloid fracture, Percutaneous 2B Downtabled SB712W
Pinning/Fixation
551 SB713W Wrist, Various Lesions, Primary Total Joint 6B Existing SB713W
Arthroplasty with augmentation, requiring extra
552 SB714W Wrist, Various Lesions, Primary Total Joint 6A Existing SB714W
553 SB715W Wrist, Various Lesions, Revision Total Joint 6C Existing SB715W
554 SB800Z Zygoma, Down Fracture, Ostectomy/Articular 5C Existing SB800Z
Eminectomy/Augmentation
555 SB801Z Zygoma, Fracture, Elevation 5A Existing SB801Z
A-3-31
CONFIDENTIAL
SC – RESPIRATORY
code code
1 SC700A Autofluorescence/ Narrow Band Imaging (NBI) 3A Existing SC700A
bronchoscopy
2 SC700B Lung, Bronchoscopy, insertion of prosthesis 3B Description SC700B
Change
3 SC800B Bronchus, Foreign Body, Removal via 4A Existing SC800B
Bronchotomy
4 SC801B Bronchus, Various Lesions, Bronchoplastic 5C Existing SC801B
Procedure
5 SC704B Bronchus/Lung, Bronchoscopy with biopsy, 2A Description SC704B
bronchoalveolar lavage Change
6 SC703B Bronchus/Lung, Bronchoscopy with/without 1B Downtabled / SC703B
biopsy Description
Change
7 SC705B Bronchus/Lung, Bronchoscopy, blind 2A Description SC705B
transbronchial lung biopsy for diffuse disease Change
8 SC706B Bronchus/Lung, Bronchoscopy, targeted 2C Description SC706B
transbronchial lung biopsy for focal lesions Change
(imaging-guided)
9 SC707B Bronchus/Lung, Bronchoscopy, with dilatation of 3A Description SC707B
Tracheal and Bronchial stricture Change
10 SC702B Bronchus/Lung, Endobronchial ultrasound 3A Existing SC702B
(EBUS) biopsy
11 SC802B Bronchus/trachea, Various Lesions, Laser 4A Existing SC802B
Application
12 SC800D Diaphragm, Tumor, Excision 5A Existing SC800D
13 SC801D Diaphragm, Tumor, Excision with Wedge 6B Existing SC801D
Resection of Lung
14 SC700L Larynx, Laryngeal mask airway MSP Existing SC700L
15 SC702L Lung, Massive hemoptysis, Bronchial Artery 4B Existing SC702L
Embolisation
16 SC703L Lung, Tumour, Imaging Guided Percutaneous 3C Existing SC703L
microwave, laser, alcohol, etc)
17 SC800L Lung, Various Lesions, 5A Existing SC800L
Pneumonectomy/Lobectomy/Segmental
Resection, open
18 SC801L Lung, Various Lesions, Repeat/Multiple/Complex 5A Existing SC801L
Resections
19 SC802L Lung, Various Lesions, Wedge Resection 3C Existing SC802L
20 SC701L Lung, Various 5B Existing SC701L
lesions,Pneumonectomy/Lobectomy,Thoracosco
pic
21 SC800M Mouth, Various Lesions, Laser Application 2B Existing SC800M
22 SC700T Thorax, Catheter blockage, Imaging Guided 1A Existing SC700T
Catheter Change / Catheter Adjustment / Check
tube
23 SC701T Thorax, Coastal Cartilage, Harvest and Creation 5A Existing SC701T
of Ear Cartilage Framework
24 SC803T Thorax, Effusion / Fluid / Abscess collection, 1A Existing SC803T
Imaging Guided Percutaneous Aspiration /
Diagnostic Tap
A-3-32
CONFIDENTIAL
SC – RESPIRATORY
code code
25 SC715T Thorax, Effusion / Fluid / Abscess collection, 1C Existing SC715T
Imaging Guided Percutaneous Drainage
Catheter Insertion
26 SC800T Thorax, Empyema, Resection of Rib and Open 2C Existing SC800T
Drainage
27 SC702T Thorax, Evacuation of retained haemothorax 4A Existing SC702T
(open and thorascopic)
28 SC801T Thorax, Mediastinal Lesions, Cervical 1A Existing SC801T
Exploration with/without Biopsy
29 SC703T Thorax, Mediastinum, mediastinoscopy 3B Existing SC703T
with/without Biopsy
30 SC802T Thorax, Pectus Excavatum/Pectus Carinatum, 4B Existing SC802T
Radical Correction
31 SC716T Thorax, Pleural Effusion, Aspiration 1A Existing SC716T
32 SC704T Thorax, Pleural effusion, biopsy 1C Existing SC704T
33 SC705T Thorax, Resuscitative Trauma Thoracotomy 5A Existing SC705T
(haemostasis, damage control, organ repair)
34 SC706T Thorax, Ribs, Open fixation of rib fractures (>3 5A Existing SC706T
ribs)
35 SC707T Thorax, Ribs, Open fixation of rib fractures (1 - 3 4A Existing SC707T
ribs)
36 SC708T Thorax, Subxyphoid pericardial window 3C Existing SC708T
37 SC709T Thorax, Thoracoscopic decortication 4B Existing SC709T
38 SC710T Thorax, Thoracoscopic pleurodesis bilateral 4B Existing SC710T
39 SC711T Thorax, Thoracoscopic thymectomy 6B Existing SC711T
40 SC712T Thorax, Thoracoscopy for pleurodesis 3C Existing SC712T
41 SC714T Thorax, Thoracoscopy, with/without division of 1C Existing SC714T
pleural adhesions
42 SC713T Thorax, Trauma Relook Thoracotomy (includes 4A Existing SC713T
haemostasis, removal of packs)
43 SC717T Thorax, Tumour (mediastinal), Complex 5C Existing SC717T
resection
44 SC804T Thorax, Tumour (mediastinal), Resection 4B Existing SC804T
45 SC805T Thorax, Various Lesions, Chest Wall Resection 5B Existing SC805T
and Major Reconstruction
46 SC806T Thorax, Various Lesions, Chest Wall Resection 4A Existing SC806T
and Minor Reconstruction
47 SC718T Thorax, Various Lesions, Imaging guided 2A Existing SC718T
Percutaneous Biopsy
48 SC807T Thorax, Various Lesions, Intercostal Drain 1C Existing SC807T
(insertion without resection of rib)
49 SC808T Thorax, Various Lesions, Intrathoracic Operation 4A Existing SC808T
on Lungs/Bronchial Tree/Mediastinum
50 SC809T Thorax, Various Lesions, Thoracoplasty 4A Existing SC809T
(complete)
51 SC810T Thorax, Various Lesions, Thoracoplasty (in 4A Existing SC810T
stages) - each stage
52 SC811T Thorax, Various Lesions, Thoracotomy 3B Existing SC811T
(exploration) with/without Biopsy
53 SC812T Thorax, Various Lesions, Thoracotomy for 3C Existing SC812T
Pleurectomy/Pleurodesis/ Enucleation Hydatid
Cysts
A-3-33
CONFIDENTIAL
SC – RESPIRATORY
code code
54 SC813T Thorax, Various lesions, Thoracotomy with 5A Existing SC813T
Pulmonary Decortication
55 SC719T Trachea, Endotracheal intubation MSP Existing SC719T
56 SC720T Trachea, Endotracheal intubation rapid MSP Existing SC720T
sequence induction
57 SC814T Trachea, Foreign Body, Removal 1C Existing SC814T
58 SC815T Trachea, Tracheo-esophageal Fistula, Ligation 5C Existing SC815T
and Division
59 SC721T Trachea, Tracheostomy, Replacement MSP Existing SC721T
60 SC722T Trachea, Tracheostomy, Revision and 3C Existing SC722T
Reinsertion
61 SC816T Trachea, Various Lesions, Trachea 5C Existing SC816T
Reconstruction
62 SC817T Trachea, Various Lesions, Tracheostomy 2C Existing SC817T
63 SC723T Trachea/Bronchus, Stricture, Imaging Guided 2C Existing SC723T
Balloon Dilatation
64 SC724T Trachea/Bronchus, Stricture, Imaging Guided 3A Existing SC724T
Stent Placement
65 SC725T Transbronchial needle aspiration of mediastinal 3A Existing SC725T
lymph nodes
A-3-34
CONFIDENTIAL
SD – CARDIOVASCULAR
code code
1 SD800A Aorta, Abdominal Aortic Aneurysm, Excision and 6B Existing SD800A
Insertion of Graft
2 SD700A Aorta, Aneurysm, Juxtarenal Type 6B Existing SD700A
3 SD801A Aorta, Descending Aortic Aneurysm, Excision and 7A Existing SD801A
Insertion of Graft
4 SD701A Aorta, Ruptured Aortic Aneurysm (thoracic or 6C Existing SD701A
abdominal), Endo-Vascular Aortic Repair (EVAR)
5 SD802A Aorta, Ruptured Abdominal Aortic Aneurysm, 6B Existing SD802A
Excision and Insertion of Graft
6 SD803A Aorta, Thoraco-abdominal Aneurysm, Excision 7C Existing SD803A
and Insertion of Graft
7 SD804A Aorta, Various Lesions, Insertion/Removal of Intra 3A Existing SD804A
aortic Balloon
8 SD702A Aortic dissection, Endovascular fenestration 3B Existing SD702A
9 SD703A Aortic dissection, Endovascular stent graft repair 5C Existing SD703A
10 SD704A Arrhythmia Surgery MAZE (Includes the Mini- 6B Existing SD704A
maze procedure with radiofrequency clam)
11 SD705A Arteriovenous fistula graft, thrombectomy 3A Existing SD705A
12 SD706A Arteriovenous fistula, angiogram 2A Existing SD706A
13 SD707A Arteriovenous fistula, angioplasty with/without 3A Existing SD707A
stenting
14 SD708A Arteriovenous fistula, ligation of side branch 2A Existing SD708A
15 SD709A Arteriovenous fistula, synthetic graft 5A Existing SD709A
16 SD710A Artery - large, Injury, Repair with Grafting 5A Existing SD710A
17 SD711A Artery - small, Injury, Repair (multiple) 5C Existing SD711A
18 SD712A Artery - small, Injury, Repair (single) 4A Existing SD712A
19 SD805A Artery (distal extremity/digit), Various Lesions, 6B Existing SD805A
Microvascular Repair
20 SD806A Artery (extremity), Thrombosis, Endarterectomy 4C Existing SD806A
21 SD807A Artery (femoral/iliac), Thrombosis, 4C Existing SD807A
Endarterectomy
22 SD808A Artery (large), Various Lesions, Ligation 3A Existing SD808A
23 SD809A Artery (major), Aneurysm, Excision and Insertion 5C Existing SD809A
of Graft
24 SD810A Artery (major), Trauma, Repair 5C Existing SD810A
25 SD811A Artery (neck and extremities), Embolism, 3A Existing SD811A
Embolectomy
26 SD812A Artery (others), Thrombosis, Endarterectomy 4C Existing SD812A
27 SD813A Artery (temporal), Various Lesions, Biopsy 2A Existing SD813A
28 SD814A Artery (trunk), Embolism, Embolectomy 4A Existing SD814A
29 SD815A Artery, Arterio-venous Fistula (large), Excision 6B Existing SD815A
30 SD816A Artery, Arterio-venous Fistula (small), Excision 4A Existing SD816A
31 SD817A Artery, Arterio-venous Fistula, Dissection and 5A Existing SD817A
Repair with Restoration of Continuity
32 SD713A Artery, Bypass, Above/below-knee with Vein 5C Existing SD713A
33 SD714A Artery, Bypass, Distal leg/pedal with vein 6B Existing SD714A
34 SD715A Artery, Bypass, Visceral, multiple 7A Existing SD715A
35 SD716A Artery, Bypass, Visceral, single 6B Existing SD716A
36 SD818A Artery, Defect, Arterial Patch Graft 4A Existing SD818A
37 SD717A Artery, Femoral Artery Angioplasty 3A Existing SD717A
38 SD718A Artery, Placement arterial (PA) line insertion MSP Existing SD718A
A-3-35
CONFIDENTIAL
code code
39 SD719A Artery, Stenosis / Occlusion, Percutaneous 3B Existing SD719A
Atherectomy (mechanical or laser)
40 SD720A Artery, Stenosis / Occlusion, Percutaneous 4A Existing SD720A
Transluminal Angioplasty (PTA), Difficult (eg
subintimal PTA, below knee PTA)
41 SD721A Artery, Stenosis / Occlusion, Percutaneous 3A Existing SD721A
Transluminal Angioplasty (PTA), Simple
42 SD722A Artery, Thrombosis, Percutaneous Catheter 4A Existing SD722A
Directed Thrombolysis, with or without angioplasty
/ stenting
43 SD819A Artery, Trauma/Resection, Arterial Anastomosis 5A Existing SD819A
44 SD820A Artery, Trauma/Resection, Micro-vascular Graft 6B Existing SD820A
45 SD723A Artery, Tumour, Trans-Arterial Chemo- 4A Existing SD723A
Embolization (TACE)
46 SD724A Artery, Tumour, Trans-Arterial Radio Nuclide 4B Existing SD724A
infusion
47 SD821A Artery, Various Lesions, Arterio-venuous Fistula 3C Existing SD821A
Creation
48 SD822A Artery, Various Lesions, Axillary- 5C Existing SD822A
femoral/Subclavian-femoral By-pass
49 SD823A Artery, Various Lesions, By-pass/Graft 5C Existing SD823A
50 SD725A Artery, Various lesions, Diagnostic Angiogram of 3A Existing SD725A
multiple vessels
51 SD726A Artery, Various lesions, Diagnostic Angiogram 3B Existing SD726A
using Microcatheter
52 SD727A Artery, Various lesions, Endovascular Stent Graft 3B Existing SD727A
/ Covered Stent Placement
53 SD728A Artery, Various lesions, Endovascular Stent 3B Existing SD728A
Placement
54 SD729A Artery, Various lesions, Flush Aortogram or single 2C Existing SD729A
vessel Diagnostic Angiogram
55 SD824A Artery, Various Lesions, Intra-arterial Infusion 3A Existing SD824A
56 SD825A Artery, Various lesions, Invasive Blood Pressure MSP Existing SD825A
Measurement
57 SD826A Artery, Various Lesions, Ligation (include repair of 2A Existing SD826A
artificial arterio-venous fistula)
58 SD730A Artery, Various lesions, Percutaneous 4A Existing SD730A
Transcatheter Embolisation of 1 to 2 vessels
59 SD731A Artery, Various lesions, Percutaneous 4B Existing SD731A
Transcatheter Embolisation of more than 2
vessels
60 SD827A Artery, Various Lesions, Transluminal 3A Existing SD827A
Arterioplasty
61 SD828A Artery-Carotid, Thrombosis, Endarterectomy 5C Existing SD828A
62 SD829A Artery-Profunda Femoris, Stenosis, 4A Existing SD829A
Profundoplasty
63 SD732A Artery-pseudoaneurysm, Excision and ligation 4A Existing SD732A
64 SD733A Artery-pseudoaneurysm, Excision and patch 5A Existing SD733A
repair
65 SD734A Artery-pseudoaneurysm, Thrombin injection 2A Existing SD734A
66 SD830A Artery-Pulmonary, Pulmonary Embolism, 6C Existing SD830A
Pulmonary Embolectomy using Cardiopulmonary
Bypass
A-3-36
CONFIDENTIAL
code code
67 SD735A Artery-visceral, Stenosis, Angioplasty of visceral 3A Existing SD735A
artery
68 SD736A Artery-visceral, Stenosis, Stenting 3B Existing SD736A
69 SD701B Blood vessels (large), Disruption/Obstruction, 5C Existing SD701B
Repair with Autogenous Vein Grafting
70 SD700B Blood Vessels, Defect, Major Grafts (multiple) 6B Existing SD700B
71 SD703B Blood Vessels, Hickman line insertion 2A Existing SD703B
72 SD704B Blood Vessels, Iliac Angioplasty 3A Existing SD704B
73 SD705B Blood Vessels, Lower Limb Intervention, 3A Existing SD705B
Superficial Femoral Angioplasty
74 SD706B Blood Vessels, Portacath, Insertion 3A Existing SD706B
75 SD707B Blood Vessels, Portacath, removal 2A Existing SD707B
76 SD708B Blood Vessels, Pulmonary Embolectomy 6B Existing SD708B
77 SD800B Blood Vessels, Reactionary/Secondary MSP Existing SD800B
Hemorrhage after minor operation, Hemostasis
78 SD709B Blood Vessels, Renal Angiography 2C Existing SD709B
79 SD710B Blood Vessels, Renal Angioplasty 3A Existing SD710B
80 SD711B Blood Vessels, Saphenous Vein, Harvest, 4A Existing SD711B
Minimally Invasive Endoscopic
81 SD712B Blood vessels, Vascular System, Various Lesions, 2A Existing SD712B
Insertion of Tenckhoff Catheter
82 SD702B Blood vessels-Umbilical, Various Lesions, MSP Existing SD702B
Catheterisation/Cannulation
83 SD800H Heart (great vessels), Various Lesions, 4A Existing SD800H
Intrathoracic Operation
84 SD801H Heart, Aortic/Mitral Valve Lesions, Balloon 5A Existing SD801H
Valvuloplasty
85 SD802H Heart, Arrhythmia, Catheter Ablation, with/without 4A Existing SD802H
Electroanatomical Mapping
86 SD803H Heart, Arrhythmia, Implantable Cardioverter 4C Uptabled SD803H
Defibrillator (ICD) Implantation
87 SD702H Heart, Automatic Implantable Cardioverter 4A Existing SD702H
Defibrillator (AICD)/Pacemaker Lead Extraction
88 SD703H Heart, Automatic Implantable Cardioverter 4C Existing SD703H
Defribrillator dual chamber (inclusive of
defibrillation threshold testing (DFT))
89 SD705H Heart, Automatic Implantable Cardioverter 4B Existing SD705H
Defribrillator single chamber (inclusive of DFT)
90 SD706H Heart, Bivent Automatic Implantable Cardioverter 5A Existing SD706H
Defribrillator (Inclusive of DFT)
91 SD804H Heart, Biventricular Pacing 3C Existing SD804H
92 SD734H Heart, Cardiac Catheterisation (left & right) - 3B Existing SD734H
involving pressure or saturation measurement
(with Left and/or Right Ventriculography)
93 SD707H Heart, Cardiac Catheterisation (left) and 3C Existing SD707H
Intracoronary Pressure Wire without
Percutaneous Transluminal Coronary Angioplasty
(PTCA)
94 SD708H Heart, Cardiac Catheterisation (left) and 3C Existing SD708H
Intravascular Ultrasound (IVUS) without
Percutaneous Transluminal Coronary Angioplasty
(PTCA)
A-3-37
CONFIDENTIAL
code code
95 SD709H Heart, Carotid angioplasty and stenting (with 5A Existing SD709H
embolic protection)
96 SD805H Heart, Congenital Heart Disease (complex), Open 7A Existing SD805H
Heart Surgery
97 SD807H Heart, Congenital Heart Disease, Blalock - 4A Existing SD807H
Taussig Operation
98 SD806H Heart, Congenital Heart Disease, Open Heart 6C Existing SD806H
Surgery
99 SD811H Heart, Coronary angiography (Selective) 3A Existing SD811H
100 SD715H Heart, Coronary angiography (with Left 3A Existing SD715H
Ventriculography)
101 SD813H Heart, Coronary Artery Bypass Graft and Valve 7C Existing SD813H
Surgery
102 SD809H Heart, Coronary Artery Disease, Cardiac 4A Existing SD809H
Catherisation and Coronary Angiogram
103 SD810H Heart, Coronary Disease, Coronary Angioplasty 4A Existing SD810H
(transluminal), with/without angiocardiography
104 SD812H Heart, Coronary Disease, Coronary Artery Bypass 6C Existing SD812H
Graft
105 SD710H Heart, Defibrillation MSP Existing SD710H
106 SD711H Heart, External Cardiac pacing MSP Existing SD711H
107 SD814H Heart, Heart Block, Replacement of Transvenous 2C Existing SD814H
Electrode
108 SD716H Heart, Heart Block/Arrhythmia, Insertion of Dual 3C Existing SD716H
chamber Pacemaker (permanent)
109 SD815H Heart, Heart Block/Arrhythmia, Insertion of Single 3B Existing SD815H
chamber Pacemaker (permanent)
110 SD718H Heart, Implant of Epicardial Leads for Permanent 4A Existing SD718H
Pacemakers
111 SD719H Heart, Implantation of Mechanical Heart Device 7C Existing SD719H
(left ventricular Assist Device Implant)
112 SD720H Heart, Insertable loop recorder 1B Existing SD720H
113 SD816H Heart, Left Ventricular Aneurysm, Resection 6C Existing SD816H
without Coronary Artery Bypass
114 SD721H Heart, Lung, Extra Corporeal Membrane 6B Existing SD721H
Oxygenation
115 SD722H Heart, Off Pump Coronary Artery Bypass Graft 6C Existing SD722H
116 SD817H Heart, Patent Ductus Arteriosus, Ligation 4A Existing SD817H
117 SD723H Heart, Percutaneous Closure of congenital heart 4A Existing SD723H
defect
118 SD724H Heart, Percutaneous Transluminal Coronary 5A Existing SD724H
Angioplasty (PTCA) + arterectomy (e.g
rotablation)
119 SD712H Heart, Percutaneous Transluminal Coronary 4A Existing SD712H
Angioplasty (PTCA) + stenting (1 vessel) -
Complex (defined as > 1 hr)
120 SD713H Heart, Percutaneous Transluminal Coronary 4B Existing SD713H
Angioplasty (PTCA) + stenting (more than 1
vessel) - Intravascular Ultrasound (IVUS),
Fractional Flow Reserve (FFR)
121 SD818H Heart, Pericardial Disease, Pericardiectomy 4B Existing SD818H
122 SD819H Heart, Pericardial Effusion, Paracentesis 1A Existing SD819H
A-3-38
CONFIDENTIAL
code code
123 SD820H Heart, Pericardial Effusion, Transthoracic 3B Existing SD820H
Drainage
124 SD725H Heart, Placement of epicardial pacing wires (open 5A Existing SD725H
and video-assisted thoracic surgery (VATS))
125 SD714H Heart, Primary Percutaneous Transluminal 4B Existing SD714H
Coronary Angioplasty for ST-elevation Myocardial
Infarction
126 SD821H Heart, Proximal Aortic Aneurysm, Aortic Root 7C Existing SD821H
Replacement with Coronary Artery Reimplantation
127 SD822H Heart, Pulmonary Incompetence, Pulmonary 4A Existing SD822H
Artery Banding
128 SD823H Heart, Pulmonary Valve Lesions, Balloon 4A Existing SD823H
Valvuloplasty
129 SD717H Heart, Replacement of Pacemaker 2B Existing SD717H
130 SD726H Heart, Robotic Surgery – for CABG, Mitral Valve 7B Existing SD726H
Repair, Thymectomy and Atrial Septal Defect
(ASD)
131 SD808H Heart, Simple Congenital Open-heart Surgery 6B Existing SD808H
(Atrial Septal Defect & Ventricular Septal Defect)
132 SD727H Heart, Synchronised cardioversion 1A Existing SD727H
133 SD733H Heart, Trans-cathetar Percutaneous Atrial Septal 5A Existing SD733H
Defects (Atrial Septal Defect)/ Patent Foramen
Ovale (PFO) Device Closure
134 SD728H Heart, Trans-cathetar Percutaneous Patent 5A Existing SD728H
Ductus Arteriosus (PDA) Occlusion
135 SD729H Heart, Trans-myocardial Revascularisation (TMR) 6B Existing SD729H
as a sole procedure
136 SD730H Heart, Trans-myocardial Revascularisation (TMR) 2C Existing SD730H
as an adjunct procedure
137 SD731H Heart, Valve (Repair / Replacement) - 1 Valve 6C Existing SD731H
138 SD732H Heart, Valve (Repair / Replacement) - more than 7B Existing SD732H
1 Valve
139 SD824H Heart, Valvular Disease, Open Heart Surgery 6C Existing SD824H
140 SD825H Heart, Valvular Disease, Open Heart Surgery on 7B Existing SD825H
more than one valve/involving more than one
chamber
141 SD826H Heart, Various Lesions, Aneurysmectomy and/or 7B Existing SD826H
Combined Valve Replacement and/or Repair and
Coronary Bypass Grafting
142 SD827H Heart, Various Lesions, Balloon Atrial Septostomy 4A Existing SD827H
143 SD828H Heart, Various Lesions, Cardiac Biopsy 2B Existing SD828H
144 SD829H Heart, Various Lesions, Heart Transplantation 7C Existing SD829H
145 SD830H Heart, Various Lesions, Left Heart Catheterisation 2C Existing SD830H
(direct)
146 SD831H Heart, Various Lesions, Right Heart 2C Existing SD831H
Catheterisation (direct)
147 SD832H Heart, Various Lesions, Right Heart 3A Existing SD832H
Catheterisation with Left Heart Catheterisation
(indirect)
148 SD833H Heart/Lung, Various Lesions, Cardiopulmonary 3B Existing SD833H
Perfusion
149 SD834H Heart/Lung, Various Lesions, Heart and Lung 7C Existing SD834H
Transplantation
A-3-39
CONFIDENTIAL
code code
150 SD835H Heart-Atrium, Arrhythmia, Arrhythmia Surgery 6B Existing SD835H
151 SD836H Heart-Ventricle, Arrhythmia, Arrhythmia Surgery 7B Existing SD836H
152 SD800Z Organ Procurement Costs: Heart 4B Existing SD800Z
153 SD801Z Organ Procurement Costs: Lung 4B Existing SD801Z
154 SD700S Surface Lesions: Angiosarcoma, With Biopsy 1B Existing SD700S
155 SD704V Vein - Central veins (Superior Vena Cava, 2A Existing SD704V
brachiocephalic veins, Inferior Vena Cava, iliac
veins) Various Lesions, Diagnostic Venography
156 SD705V Vein - Hepatic, Portal Hypertension, Diagnostic 2B Existing SD705V
Hepatic Venography with or without Pressure
Measurements
157 SD706V Vein - Peripheral veins (upper / lower limbs / 2A Existing SD706V
dialysis Arteriovenus Fistula/Arteriovenus graft
Fistula), Various Lesions, Diagnostic Venography
158 SD800V Vein (distal extremity/digit), Various Lesions, 5C Existing SD800V
Microvascular Repair
159 SD801V Vein (large), Various Lesions, Ligation 3A Existing SD801V
160 SD802V Vein (major), Trauma, Repair 5C Existing SD802V
161 SD700V Vein (small), Injury, Repair (single) 4A Existing SD700V
162 SD707V Vein, (Spider veins), Injection <3 hand-size area 2C Existing SD707V
163 SD803V Vein, Arterio-venous Fistula, Dissection and 2A Existing SD803V
Ligation
164 SD708V Vein, Catheter blockage, Fibrinsheath stripping 2A Existing SD708V
165 SD709V Vein, Catheter blockage, Imaging Guided 1A Existing SD709V
Catheter Change / Catheter Adjustment
166 SD701V Vein, Pseudoaneurysm, thrombin injection MSP Existing SD701V
167 SD710V Vein, Stenosis / Occlusion, Percutaneous 4A Existing SD710V
Transluminal Angioplasty (PTA), Difficult
168 SD711V Vein, Stenosis / Occlusion, Percutaneous 3A Existing SD711V
Transluminal Angioplasty (PTA), Simple
169 SD712V Vein, Thrombosis, Percutaneous Catheter 4A Existing SD712V
Directed Thrombolysis, with or without angioplasty
/ stenting
170 SD713V Vein, Varicose Veins, Imaging Guided 3B Existing SD713V
Endovenous Laser Treatment, 1 leg
171 SD714V Vein, Varicose Veins, Imaging Guided 4A Existing SD714V
Endovenous Laser Treatment, 2 legs
172 SD715V Vein, Varicosities (recurrent) surgery 4A Existing SD715V
173 SD716V Vein, Varicosities, Endovascular Laser Treatment 3B Existing SD716V
(1 leg)
174 SD717V Vein, Varicosities, Ultrasound guided 3B Existing SD717V
sclerotherapy injection
175 SD804V Vein, Varicosity, Bilateral 4A Existing SD804V
Stripping/Excision/Multiple Ligations
176 SD702V Vein, Varicosity, High Ligation and Complete 4A Existing SD702V
Stripping/Excision of Long/Long & Short
Saphenous Vein (endoscopic)
177 SD805V Vein, Varicosity, High Ligation and Complete 3B Existing SD805V
Stripping/Excision of Long/Long and Short
Saphenous Vein
178 SD806V Vein, Varicosity, High Ligation and Complete 3B Existing SD806V
Stripping/Excision of Short Saphenous Vein
A-3-40
CONFIDENTIAL
code code
179 SD807V Vein, Varicosity, High Ligation of Short 3B Existing SD807V
Saphenous Vein at Sapheno-Popliteal Junction
180 SD808V Vein, Varicosity, Multiple Ligations with/without 3B Existing SD808V
Local Stripping/Excision
181 SD816V Vein, Varicosity, Sub-Fascial Ligation of Multiple 4C Existing SD816V
Perforator (endoscopic)
182 SD809V Vein, Varicosity, Sub-fascial Ligation of Single 1C Existing SD809V
Deep Perforator
183 SD703V Vein, Varicosity, Sub-Fascial Ligation of Single 2B Existing SD703V
Deep Perforator (endoscopic)
184 SD810V Vein, Various Lesions, Bypass/Graft 5C Existing SD810V
185 SD718V Vein, Various lesions, Endovascular Stent Graft / 3B Existing SD718V
Covered Stent Placement
186 SD729V Vein, Various lesions, Endovascular Stent 3B Existing SD729V
Placement
187 SD720V Vein, Various Lesions, Imaging guided Insertion 1C Existing SD720V
of Non Tunnelled Central Venous Catheter
188 SD721V Vein, Various Lesions, Imaging guided Insertion 2A Existing SD721V
of Tunnelled Central Venous Catheter
189 SD722V Vein, Various Lesions, Imaging Guided Peripheral 1C Existing SD722V
Insertion of Central Catheter (PICC)
190 SD723V Vein, Various Lesions, Imaging Guided Venous 2C Existing SD723V
Port Insertion
191 SD811V Vein, Various Lesions, Insertion of Central 1A Existing SD811V
Venous Line
192 SD724V Vein, Various Lesions, Insertion of Inferior Vena 2C Existing SD724V
Caval Filter
193 SD812V Vein, Various Lesions, Intra-arterial Infusion of 3A Existing SD812V
Arteries of Neck/Thorax/Abdomen
194 SD813V Vein, Various Lesions, Ligation (include repair of 2A Existing SD813V
artificial arterio-venous fistula)
195 SD725V Vein, Various lesions, Percutaneous 4B Existing SD725V
Transcatheter Embolisation of more than 2
vessels
196 SD726V Vein, Various lesions, Percutaneous 4A Existing SD726V
Transcatheter Embolization of 1 to 2 vessels
197 SD727V Vein, Various Lesions, Retrieval of Inferior Vena 3A Existing SD727V
Caval Filter
198 SD814V Vein, Various Lesions, Saphenol Femoral/Accelo 5C Existing SD814V
Femoral Bypass Graft
199 SD728V Vein,(Spider veins), Injection 3 or more hand-size 3A Existing SD728V
area
200 SD815V Vein-Portal, Portal Hypertension, Bypass 5C Existing SD815V
201 SD817V Vena Cava Inferior, Various Lesions, 4C Existing SD817V
Plication/Ligation
A-3-41
CONFIDENTIAL
SE – HEMIC & LYMPHATIC
code code
1 SE701L Lymph node (axillary), Various Lesions, Sentinel 3A Existing SE701L
LN Biopsy only
2 SE715L Lymph Node (cervical), Radical with Flap 6B New -
Reconstruction
3 SE707L Lymph Node (pelvic) Dissection, 5A Existing SE707L
Laparoscopic/open
4 SE716L Lymph Node (retropharyngeal), Block Dissection 5A New -
(open/transoral)
5 SE710L Lymph node excision for Mycobacterium Aviare 2C Existing SE710L
Intracellulare Scrophyllorium
6 SE711L Lymph node, Various lesions, Imaging Guided 2A Existing SE711L
Percutaneous Biopsy - Deep (Intra thoracic /
abdominal / pelvic, retroperitoneal)
7 SE712L Lymph node, Various lesions, Imaging Guided 1B Existing SE712L
Percutaneous Biopsy - Superficial
8 SE800L Lymph node (axillary), Various Lesions, Limited 3A Existing SE800L
Excision/Biopsy
9 SE801L Lymph node (axillary), Various Lesions, Radical 4A Existing SE801L
Excision
10 SE700L Lymph node (axillary), Various Lesions, Radical 4A Existing SE700L
Excision /Clearance with or without sentinel LN
biopsy
11 SE702L Lymph Node (cervical) - Deep, Various Lesions, 2C Existing SE702L
Biopsy
12 SE703L Lymph Node (cervical) - Superficial, Various 1B Existing SE703L
Lesions, Biopsy
13 SE704L Lymph node (cervical), Various Lesions, Block 5A Existing SE704L
Dissection bilateral 3 or less levels
Dissection bilateral at least with one side 4 to 5
levels
Dissection unilateral 1-3 levels
16 SE706L Lymph node (cervical), Various Lesions, Block 5C Existing SE706L
Dissection unilateral 4-5 levels
17 SE802L Lymph node (cervical), Various Lesions, Excision 2C Existing SE802L
Biopsy
18 SE804L Lymph node (cervical), Various Lesions, Radical 5C Existing SE804L
Block Dissection
19 SE805L Lymph node (inguinal), Various Lesions, Limited 3B Existing SE805L
Excision
20 SE806L Lymph node (inguinal), Various Lesions, Radical 4B Existing SE806L
Excision
21 SE807L Lymph node (retroperitoneal), Various Lesions, 4B Existing SE807L
Limited Excision
22 SE808L Lymph Node (single), Various Lesions, MSP Existing SE808L
Aspiration/Biopsy
23 SE809L Lymph node (single), Various Lesions, Excision 1A Existing SE809L
Biopsy
24 SE708L Lymph node (single), Various Lesions, Excision 1C Existing SE708L
Biopsy (laparoscopic)
25 SE713L Lymph Node, Various Lesions, Biopsy 1B Existing SE713L
A-3-42
CONFIDENTIAL
SE – HEMIC & LYMPHATIC
code code
26 SE810L Lymphatics (face & neck), Cystic Hygroma, 5C Existing SE810L
Excision (large)
27 SE811L Lymphatics (face & neck), Cystic Hygroma, 4A Existing SE811L
Excision (moderate)
28 SE812L Lymphatics (face & neck), Cystic Hygroma, 3A Existing SE812L
Excision (small)
29 SE709L Lymphatics (Upper Limb), Lymphangioma, 6B Existing SE709L
Excision
30 SE714L Lymphatics and Subcutaneous Tissue, 6B Existing SE714L
Lymphedema, Major Excision and Grafting
31 SE813L Lymphatics, Cystic Hygroma, Excision (extensive) 5C Existing SE813L
with/without Thoracotomy
32 SE814L Lymphatics, Lymphangiectasis, Limited Excision 2C Existing SE814L
33 SE815L Lymphatics, Lymphangiectasis, Radical Excision 4A Existing SE815L
34 SE816L Lymphatics, Lymphedema, Excision (extensive 7C Existing SE816L
and complex)
35 SE817L Lymphatics, Lymphedema, Excision (large & 5C Existing SE817L
deep seated)
36 SE818L Lymphatics, Lymphedema, Excision (large) 4A Existing SE818L
37 SE819L Lymphatics, Lymphedema, Excision (moderate) 3A Existing SE819L
38 SE820L Lymphatics, Lymphedema, Excision (small) 2A Existing SE820L
39 SE821L Lymphatics, lymphedema, lympho- 7C Existing SE821L
venous/lymphatico-venular anastomoses,
unilateral(microsurgery)
40 SE822L Lymphatics, Lymphedema, Major Excision & 6B Existing SE822L
Grafting
41 SE823L Lymphatics, Lymphedema, Thomson's Procedure 5C Existing SE823L
42 SE800M Marrow, for Various Lesions, Harvesting & 5A Existing SE800M
Grafting
43 SE801M Marrow, Various Lesions, Diagnostic Aspiration 1A Existing SE801M
44 SE800S Spleen, Hypersplenism/Massive Enlargement, 5C Existing SE800S
Splenectomy (laparoscopic or open)
45 SE801S Spleen, Trauma, Conservation 4A Existing SE801S
46 SE802S Spleen, Trauma, Splenectomy 4A Existing SE802S
47 SE803S Spleen, Various Non-Traumatic Lesions, 4A Existing SE803S
Splenectomy (laparoscopic or open)
A-3-43
CONFIDENTIAL
SF – DIGESTIVE
code code
1 SF701A Abdomen / Pelvis, Catheter blockage, Imaging 1A Existing SF701A
Guided Catheter Change / Catheter Adjustment /
Check tube
2 SF702A Abdomen / Pelvis, Various Lesions, Imaging 2A Existing SF702A
guided Percutaneous Biopsy
3 SF704A Abdomen, Laparotomy, Trauma Reoperation 5A Existing SF704A
4 SF705A Abdomen, Laparotomy, Trauma, damage 5A Existing SF705A
control, haemostasis, packing
5 SF710A Abdomen, Major / Multiple organ repair (Trauma) 6B Existing SF710A
6 SF706A Abdomen, Peritoneal cavity, Ascites / Fluid / 1B Existing SF706A
Abscess collection, Imaging Guided
Percutaneous Aspiration / Diagnostic
Tap/Catheter
7 SF707A Abdomen, Retroperitoneum, Abscess, Drainage 3A Existing SF707A
with/without Laparotomy
8 SF708A Abdomen, Retroperitoneum, Tumor, Removal 5C Existing SF708A
9 SF800A Abdominal Cavity, Adhesions (Extensive), Lysis 4A Existing SF800A
as primary procedure, extensive with or without
bowel resection (Laparoscopic or Open) where
time taken is more than 2hours
10 SF801A Abdominal Cavity, Adhesions (Limited), Lysis as 3B Existing SF801A
primary procedure (Laparoscopic or Open)
where time taken is less than 2hours
11 SF802A Abdominal Cavity, Lymphoma,for grading 4B Existing SF802A
Lymphoma with Splenectomy/Liver/Lymph Node
Biopsy (laparoscopic or open)
12 SF803A Abdominal Cavity, Multiple Ruptures, Major 6B Existing SF803A
Repair/Removal
13 SF804A Abdominal Cavity, Neonatal Alimentary 5C Existing SF804A
Obstruction, Laparotomy
14 SF709A Abdominal Cavity, Recurrent Abdominal Tumor, 7A Existing SF709A
Resection with Complete Abdominopelvic
Peritonectomy and Hyperthermic intraoperative
Chemotherapy
15 SF806A Abdominal Cavity, Ruptured Viscus, Simple 3B Existing SF806A
Repair
16 SF807A Abdominal Cavity, Subphrenic Abscess, 3B Existing SF807A
Drainage
17 SF808A Abdominal Cavity, Various Lesions, Exploratory 3A Combined SF808A
Laparotomy (open or laparoscopic)
18 SF809A Abdominal Cavity, Various Lesions, including 4A Existing SF809A
Colostomy/Enterostomy/Gastrostomy
(laparoscopic or open)
19 SF810A Abdominal Cavity, Various Lesions, not classified 4A Existing SF810A
elsewhere (laparoscopic or open)
20 SF811A Abdominal Cavity, Various Lesions, Paracentesis MSP Existing SF811A
21 SF812A Abdominal Cavity, Volvulus, Reduction 3B Existing SF812A
22 SF813A Abdominal Wall, Burst Abdomen, Repair 3A Existing SF813A
23 SF814A Abdominal Wall, Epigastric/Umbilical Hernia, 3A Existing SF814A
Repair (laparoscopic or open)
24 SF815A Abdominal Wall, Exomphalos/Gastroschisis, 5B Existing SF815A
Operating by Plastic Flap
A-3-44
CONFIDENTIAL
SF – DIGESTIVE
code code
25 SF816A Abdominal Wall, Exomphalos/Gastroschisis, 4A Existing SF816A
Repair
26 SF817A Abdominal Wall, Inguinal Hernia (infants & 4A Description SF817A
children), Herniotomy (Bilateral) Change
27 SF818A Abdominal Wall, Inguinal Hernia (infants & 3A Description SF818A
children), Herniotomy (Unilateral) Change
28 SF850A Abdominal Wall, Inguinal Hernia (neonates), 4C New But -
Herniotomy (Bilateral) Additional
Description
Change
29 SF851A Abdominal Wall, Inguinal Hernia (neonates), 3C New But -
Herniotomy (Unilateral) Additional
Description
Change
30 SF820A Abdominal Wall, Inguinal/Femoral Hernia, 4C Existing SF820A
Bilateral Herniorrhaphy (laparoscopic or open)
31 SF819A Abdominal Wall, Inguinal/Femoral Hernia, 3B Existing SF819A
Unilateral Herniorrhaphy (laparoscopic or open)
32 SF821A Abdominal Wall, Strangulated/Obstructed 4C Description SF821A
Hernia, Repair with Bowel Resection Change
33 SF822A Abdominal Wall, Strangulated/Obstructed 3C Uptabled SF822A
Hernia, Repair without Bowel Resection
34 SF823A Abdominal Wall, Ventral/Incisional/Recurrent 4A Description SF823A
Hernia, Repair (laparoscopic or open) Change
35 SF805A Abdominal/Retroperitoneal Tumour, Recurrent 6B Existing SF805A
resection with or without vascular involvement
and vascular repair
36 SF711A Anal Incontinence - Artificial Bowel Sphincter 5A Existing SF711A
Insertion
37 SF712A Anal Incontinence Complex Procedures 5C Existing SF712A
including Muscle Transposition
38 SF713A Anal Sphincter Bulking Injection with or without 2C Existing SF713A
Rectal Ultrasound Guidance
39 SF716A Anus, Ano-Rectal Malformation (cloaca / 6C Description SF716A
abdominoperineal) Change
40 SF714A Angioembolisation for Trauma 4B Existing SF714A
41 SF715A Anus, Ano-Rectal Malformation, Anoplasty 2C Combined / SF715A
Description
Change
42 SF719A Anus, Ano-Rectal Malformation, Anorectoplasty 5C Description SF719A
(laparoscopic) Change
43 SF717A Anus, Ano-Rectal Malformation, Limited 4A Description SF717A
Posterior Sagittal Anorectoplasty (PSARP) Change
44 SF718A Anus, Ano-Rectal Malformation, Posterior 5C Uptabled / SF718A
Sagittal Anorectoplasty (PSARP) Combined /
Description
Change
45 SF826A Anus, Ano-Rectal Prolapse, Circumanal Suture 1A Existing SF826A
46 SF827A Anus, Ano-Rectal Prolapse, Injection 1A Existing SF827A
47 SF829A Anus, Ano-Rectal Prolapse, Radical Operation 4A Existing SF829A
with Resection
48 SF828A Anus, Ano-Rectal Prolapse, Radical Operation 5C Existing SF828A
without Resection
A-3-45
CONFIDENTIAL
SF – DIGESTIVE
code code
49 SF830A Anus, Fissure, Examination under Anesthesia 1B Existing SF830A
50 SF831A Anus, Fissure, Excision/Lateral Sphincterotomy 2B Existing SF831A
51 SF832A Anus, Fistula-in-ano (high), Fistulectomy & 3C Existing SF832A
Colostomy, or complex and recurrent
fistulectomy
52 SF833A Anus, Fistula-in-ano, Excision/ Fistulectomy 2B Existing SF833A
53 SF720A Anus, Fistula-in-ano, insertion of seton 1C Existing SF720A
54 SF835A Anus, Hemorrhoids, Cryosurgery 1A Existing SF835A
55 SF836A Anus, Hemorrhoids, Hemorrhoidectomy with or 2C Existing SF836A
without sigmoidoscopy
56 SF834A Anus, Hemorrhoids, Injection/Ligation/Banding MSP Existing SF834A
57 SF838A Anus, Hemorrhoids, Removal of External Anal 1B Existing SF838A
Tags
58 SF721A Anus, Hemorrhoids, transanal haemorrhoidal 2C Existing SF721A
dearterialization (THD)
59 SF837A Anus, Hemorrhoids,Stapled haemorrhoidectomy 3A Existing SF837A
60 SF839A Anus, Incontinence, Operation 4A Existing SF839A
61 SF840A Anus, Ischiorectal Abscess, Saucerisation 1B Existing SF840A
62 SF841A Anus, Perineal Abscess, Saucerisation/Drainage 1B Existing SF841A
63 SF722A Anus, Sphincteroplasty for Anal Incontinence 4B Existing SF722A
64 SF842A Anus, Stricture, Dilatation 1B Existing SF842A
65 SF843A Anus, Stricture, Repair 3B Existing SF843A
66 SF844A Anus, Thrombosed External Hemorrhoid, MSP Existing SF844A
Incision And Drainage
67 SF845A Anus, Tumor, Abdomino-Perineal Resection 6B Existing SF845A
(open or lap)
68 SF846A Anus, Various Lesions, Biopsy of 1B Existing SF846A
Muscle/Mucosa
69 SF847A Appendix, Abscess, Drainage only 2C Existing SF847A
70 SF848A Appendix, Tumor, Right Hemicolectomy 5C Existing SF848A
With/Without Adhesiolysis (open or lap)
71 SF849A Appendix, Various Lesions, Appendicectomy 3B Existing SF849A
Without Drainage, Open/Laparoscopic
72 SF723A Appendix, Various Lesions/Abscess, 4A Existing SF723A
Appendicectomy with Drainage
(Open/Laparoscopic)
73 SF800B Bile Duct, Biliary Atresia, Porto-Enterostomy 6B Existing SF800B
74 SF700B Bile Duct, Choledochal cyst, excision 6A Existing SF700B
75 SF711B Bile Duct, Endoscopic Retrograde 3B Existing SF711B
Cholangiopancreatography (ERCP)
76 SF708B Bile Duct, Endoscopic Retrograde 3C Existing SF708B
Cholangiopancreatography (ERCP) with
sphincerotomy /removal of stone/ insertion of
biliary stent
77 SF801B Bile Duct, Various Lesions, Choledocho- 4A Existing SF801B
Duodenostomy/Choledocho-Gastrostomy
78 SF802B Bile Duct, Various Lesions, Choledocho- 4C Existing SF802B
Jejunostomy
79 SF803B Bile Duct, Various Lesions, Choledochotomy 4C Existing SF803B
(Exploration Common Bile Duct only)
80 SF804B Bile Duct, Various Lesions, Hepatico- 5C Uptabled SF804B
Jejunostomy
A-3-46
CONFIDENTIAL
SF – DIGESTIVE
code code
81 SF805B Bile Duct, Various Lesions, Operative 1B Existing SF805B
Choledochoscopy
82 SF806B Bile Duct, Various Lesions, Revision High Biliary 7C Existing SF806B
Stricture
83 SF807B Bile Duct, Various Lesions, Transduodenal 5C Existing SF807B
Sphincteroplasty/ Sphincterotomy
84 SF707B Bile duct/gall bladder, Endoscopic dilation of 3C Existing SF707B
biliary stricture
85 SF709B Bile duct/gall bladder, Endoscopic Retrograde 3C Existing SF709B
Insertion of Nasobiliary Drain
86 SF712B Bile duct/gall bladder, Endoscopy, Endoscopic 3C Existing SF712B
Sphincterotomy +/- extraction of stone
87 SF701B Bile Ducts, Catheter blockage, Imaging Guided 1A Existing SF701B
Catheter Change / Catheter Adjustment / Check
Cholangiogram
88 SF713B Bile ducts, Stones, Percutaneous Transhepatic 3B Existing SF713B
Biliary Stones Removal
89 SF702B Bile Ducts, Stricture, Percutaneous Transhepatic 3B Existing SF702B
Balloon Dilatation
90 SF703B Bile Ducts, Stricture, Percutaneous Transhepatic 3B Existing SF703B
Biliary Stent Placement
91 SF704B Bile Ducts, Various lesions, Check 1A Existing SF704B
Cholangiogram
92 SF705B Bile Ducts, Various lesions, Percutaneous 2C Existing SF705B
Transhepatic Cholangiography (PTC)
93 SF706B Bile Ducts, Various lesions, Percutaneous 3A Existing SF706B
Transhepatic Cholangiography and Drainage
Catheter insertion (PTC and Drainage)
94 SF714B Bowel (Esophagus, stomach, duodenum, colon, 2C Existing SF714B
rectum), stricture, Imaging Guided Balloon
Dilatation
95 SF715B Bowel (Esophagus, stomach, duodenum, colon, 2C Existing SF715B
rectum), stricture, Imaging Guided Stent
Placement
96 SF716B Bowels, Endoscopic Ultrasound with Coeliac 3A Existing SF716B
Axis Neurolysis
97 SF717B Bowels, Endoscopic Ultrasound with Fine Needle 3A Uptabled SF717B
Aspiration
98 SF719B Bowels, Endoscopic Ultrasound with Pseudocyst 3C Existing SF719B
Drainage
99 SF720B Bowels, Endoscopic Ultrasound with Stent 3C Existing SF720B
Insertion
100 SF718B Bowels, Endoscopic Ultrasound without Fine 2C Description SF718B
Needle Aspiration Change
101 SF700C Capsule Endoscopy 3A Existing SF700C
102 SF701C Colon, Anterior Resection (open or laparoscopic) 6C Existing SF701C
103 SF704C Colon, Colonoscopy (diagnostic), fibreoptic with 3A Existing SF704C
removal of polyp (single or multiple less than
1cm)
104 SF705C Colon, Colonoscopy (diagnostic), fibreoptic with 3B Existing SF705C
removal of polyps (multiple more than 1cm)
A-3-47
CONFIDENTIAL
SF – DIGESTIVE
code code
105 SF702C Colon, Colonoscopy (diagnostic), fibreoptic 2C Description SF702C
with/without biopsy Change
106 SF706C Colon, Colonoscopy (screening), fibreoptic with 3A Existing SF706C
removal of polyp (single or multiple less than
1cm)
107 SF707C Colon, Colonoscopy (screening), fibreoptic with 3B Existing SF707C
removal of polyps (multiple more than 1cm)
108 SF703C Colon, Colonoscopy (screening), fibreoptic 2C Description SF703C
with/without biopsy Change
109 SF708C Colon, Colonoscopy with endoscopic mucosal 3C Description SF708C
resection (EMR) and/or endoscopic submucosal Change
dissection (ESD) of large polyps (>3cm)
110 SF800C Colon, Colostomy, Closure without resection of 4A Combined SF800C
bowel
111 SF709C Colon, Hirschsprung’s disease, Endorectal 5B Description SF709C
pullthrough (MIS) Change
112 SF714C Colon, Hirschsprung's disease, Pullthrough for 6A New -
long segment disease (laparoscopic/open)
113 SF710C Colon, Sigmoid, Sigmoidoscopy (flexible), 1B Existing SF710C
Fibreoptic with/without biopsy
114 SF711C Colon, Sigmoid, Sigmoidoscopy with 1B Existing SF711C
Polypectomy with Biopsy
115 SF712C Colon, Total Colectomy / Subtotal Colectomy 6A Existing SF712C
116 SF713C Colon, Total Proctocolectomy & Ileo-Anal Pouch 6C Existing SF713C
Reconstruction
117 SF802C Colon, Various Lesions, Colostomy 4A Existing SF802C
118 SF803C Colon, Various Lesions, Right/Left 5C Existing SF803C
Hemicolectomy (laparoscopic or open)
119 SF804C Colon, Various Lesions, Total Colectomy with 6A Existing SF804C
Ileorectal Anastomosis/Ileostomy
120 SF805C Colon, Various Lesions, Total Procto-Colectomy 6B Existing SF805C
and Ileostomy
121 SF806C Colon, Various Lesions, Tranverse/Sigmoid 5C Existing SF806C
Colectomy (laparoscopic or open)
122 SF800D Diaphragm, Diaphragmatic/Hiatus Hernia, Repair 4A Existing SF800D
123 SF700D Double Balloon Enteroscopy-Diagnostic 3A Existing SF700D
124 SF701D Double Balloon Enteroscopy-Therapeutic 3C Existing SF701D
125 SF801D Duodenum Various Lesions, 4A Existing SF801D
Gastroenterostomy/Gastroduodenostomy
126 SF802D Duodenum, Trauma, Bypass Operation 5A Existing SF802D
127 SF803D Duodenum, Tumor, Pancreatico-Duodenectomy 7C Existing SF803D
128 SF702D Duodenum, Tumour, Pancreas preserving 7C Existing SF702D
duodenectomy with reconstruction of ampulla
129 SF804D Duodenum, Ulcer, Partial Gastrectomy 5C Existing SF804D
130 SF805D Duodenum, Ulcer, Vagotomy - all types 5C Existing SF805D
131 SF710B Endoscopic Retrograde 3C Existing SF710B
sphincerotomy /removal of stone/ insertion of
biliary stent
132 SF800E Esophagus, Achalasia, Cardiomyotomy 4A Existing SF800E
133 SF701E Esophagus, Achalasia, Cardiomyotomy 4A Existing SF701E
(laparoscopic)
A-3-48
CONFIDENTIAL
SF – DIGESTIVE
code code
134 SF801E Esophagus, Atresia, Repair and Anastomosis 6B Description SF801E
Change
135 SF802E Esophagus, Benign tumour, Resection 5B Existing SF802E
(laparoscopic/Open)
136 SF702E Esophagus, Diverticulum, Excision 5B Existing SF702E
(laparoscopic/Open)
137 SF703E Esophagus, Motility disorder, long myotomy 4B Existing SF703E
(Thoracoscopic/Open)
138 SF803E Esophagus, Stricture, Dilatation (Endoscopic) 2B Existing SF803E
139 SF804E Esophagus, Tumor, Allison/Ivor-Lewis Operation 6B Existing SF804E
140 SF805E Esophagus, Tumor, Bypass with 5C Existing SF805E
Stomach/Intestine (laparoscopic or open)
141 SF806E Esophagus, Tumor, 7C Existing SF806E
Cervical/Laryngopharyngectomy with
Tracheostomy with/without Plastic
Reconstruction
142 SF809E Esophagus, Tumor, Total Esophagectomy 7B Existing SF809E
143 SF810E Esophagus, Varices, Esophageal/Transection 6B Existing SF810E
with Splenectomy
144 SF811E Esophagus, Varices, Gastro Esophageal 6B Existing SF811E
Devascularisation with Esophageal Transection
145 SF812E Esophagus, Various Lesions, Cervical 3A Existing SF812E
Esophagostomy
146 SF807E Esophagus/Intestine/Stomach, Upper GI 3A Existing SF807E
endoscopy with insertion of Prosthesis (e.g.
insertion of Celestin Tube/complicated
Polypectomy)
147 SF700E Esophagus/Stomach, Gastroscopy and 2C Existing SF700E
Dilatation
148 SF808E Esophagus/Stomach, Gastroscopy with Therapy- 3A Existing SF808E
eg APC-Fulgarisation of Tumor
149 SF704E Esophagus/Stomach/Colon, Gastrointestinal 3B Existing SF704E
Endoscopy (GI), Laser Treatment for Tumors
150 SF706G Gallbladder (acute/complicated) open or 4C Existing SF706G
laparascopic cholecyestectomy
151 SF700G Gallbladder, Cholecystitis, Imaging Guided 2C Existing SF700G
Percutaneous Cholecystostomy
152 SF701G Gallbladder, Tumour, Radical cholecystectomy 6C Existing SF701G
with segment 4b and 5 liver resection and radical
lymphadenectomy
153 SF702G Gallbladder, Tumour, Radical cholecystectomy 7A Existing SF702G
with segment 4b and 5 liver resection and radical
lymphadenectomy and choledochectomy with
Hepatico-enteric anastomosis
154 SF707G Gallbladder, Various lesions, cholecystectomy, 5C Existing SF707G
choledochotomy, common bile duct exploration
with choledocho-duodenostomy (open or lap)
155 SF801G Gallbladder, Various Lesions, Cholecystectomy 4A Existing SF801G
(open or lap)
156 SF802G Gallbladder, Various Lesions, Cholecystectomy 5C Existing SF802G
and Choledocho-
Jejunostomy/Duodenostomy/Gastrostomy
A-3-49
CONFIDENTIAL
SF – DIGESTIVE
code code
157 SF703G Gallbladder, Various lesions, cholecystectomy 6A Existing SF703G
and repair of cholecysto-enteric/ cholecysto-
choledochal fistula (open or lap)
158 SF704G Gallbladder, Various lesions, cholecystectomy 4B Existing SF704G
with intraoperative cholangiogram (open or lap)
159 SF803G Gallbladder, Various Lesions, Cholecysto- 4A Existing SF803G
Duodenostomy/Cholecysto-
Gastrectomy/Cholecysto Jejunostomy
160 SF800G Gallbladder, Various Lesions, Cholecystostomy 3B Existing SF800G
(Partial, Open)
161 SF705G Gallbladder, Various lesions, open/laparoscopic 4C Existing SF705G
cholecystectomy and transcystic common bile
duct exploration
162 SF702I Intestine, Bleeding GIT, Mesenteric Artery 4B Existing SF702I
Embolisation
163 SF800I Intestine, Enterostomy, Closure 3B Existing SF800I
164 SF801I Intestine, Intussusception, Reduction (lap or 3B Existing SF801I
open)
165 SF802I Intestine, Intussusception, Reduction by Fluid 2A Existing SF802I
166 SF803I Intestine, Intussusception, Resection 4A Existing SF803I
167 SF805I Intestine, Meckel's Diverticulum, Various 3B Existing SF805I
Lesions, Resection (lap/open)
168 SF703I Intestine, Small Bowel, Ileostomy Stenosis, 3A Existing SF703I
Revision
169 SF704I Intestine, Small Bowel, Various Lesions, 4A Existing SF704I
Enterostomy
170 SF706I Intestine, Small Bowel, Various Lesions, 4C Existing SF706I
Extensive Resection with Anastomoses, With or
Without Stoma (laparoscopic or open)
171 SF705I Intestine, Small Bowel, Various Lesions, 1B Existing SF705I
Intubation with/without Biopsy
172 SF707I Intestine, Small Bowel, Various Lesions, Simple 4A Existing SF707I
Resection with Anastomoses, With or Without
Stoma (laparoscopic or open)
173 SF708I Intestine, Small Bowel, Vitello-Intestinal Fistula, 3A Existing SF708I
Excision
174 SF804I Intestine, Total Aganglionosis, Reconstruction 6B Existing SF804I
175 SF701I Intestine/Stomach, Upper GI endoscopy with / 1B Existing SF701I
without biopsy
176 SF700I Intestine/Stomach, Upper GI endoscopy with 2C Existing SF700I
polypectomy/ removal of foreign body/diathermy
of bleeding lesions / injection of varices /
removal of single polyp
177 SF800L Lip, Mucous Cyst/Mucocele, Removal 1B Existing SF800L
178 SF801L Lip, Various Lesions, Full Thickness Wedge 2C Existing SF801L
Excision with Repair
179 SF802L Lip, Various Lesions, Reconstruction using Full 5C Existing SF802L
Thickness Flap
180 SF803L Lip, Various Lesions, Vermilionectomy 2C Existing SF803L
181 SF700L Liver transplant, donation (Cadaveric donor) 5C Existing SF700L
182 SF701L Liver transplant, donation (Live donor) 6B Existing SF701L
183 SF702L Liver transplant, recipient 7C Existing SF702L
A-3-50
CONFIDENTIAL
SF – DIGESTIVE
code code
184 SF703L Liver, Abscess, Imaging Guided Percutaneous 2A Existing SF703L
Aspiration
185 SF704L Liver, Abscess, Imaging Guided Percutaneous 2C Existing SF704L
Drainage Catheter Insertion
186 SF804L Liver, Abscess, Trans-Abdominal Drainage 3C Existing SF804L
(open or lap)
187 SF805L Liver, Hydatid Cyst, Trans-Abdominal Drainage 3B Existing SF805L
(percutaneous)
188 SF806L Liver, Obstructive Jaundice, Longmire 4C Existing SF806L
Operation/Chlodedocho Jejunostomy
189 SF705L Liver, Portal Hypertension, Transjular 5A Existing SF705L
Intrahepatic Porto-Systemic Shunt creation
(TIPSS)
190 SF807L Liver, Trauma, Major Repair Laceration 6B Existing SF807L
191 SF808L Liver, Trauma, Minor Repair Laceration 4A Existing SF808L
192 SF809L Liver, Trauma/Tumor, Extended Lobectomy (5 7C Existing SF809L
segments/more)
193 SF810L Liver, Trauma/Tumor, Hepatic Artery Ligation 4B Existing SF810L
194 SF811L Liver, Trauma/Tumor, Liver Transplant 7C Existing SF811L
195 SF706L Liver, Tumour, Imaging Guided Percutaneous 3C Existing SF706L
microwave, laser, alcohol,etc)
196 SF707L Liver, Tumour, Trans-Arterial Chemo- 4A Existing SF707L
Embolization (TACE)
197 SF708L Liver, Tumour, Trans-Arterial Radio Nuclide 4B Existing SF708L
infusion
198 SF711L Liver, Various lesions, Imaging Guided 2A Existing SF711L
Percutaneous Biopsy (Focal lesions, targeted)
199 SF814L Liver, Various lesions, Imaging Guided 1C Existing SF814L
Percutaneous Biopsy (Liver parenchyma, non
directed)
200 SF709L Liver, Various lesions, laparoscopic ultrasound 4B Existing SF709L
and local ablation including radio-frequency
ablation
201 SF812L Liver, Various Lesions, Lobectomy (3 - 4 6B Existing SF812L
segments), open or lap
202 SF813L Liver, Various Lesions, Partial 5C Existing SF813L
Lobectomy/Segmental Resection (open or lap)
203 SF710L Liver, Various lesions, Transjugular Liver Biopsy 3B Existing SF710L
204 SF815L Liver, Various Lesions, Wedge/Local Excision 4C Existing SF815L
(open or lap)
205 SF800M Mouth, Abscess (Deep), Drainage (Includes 2B Existing SF800M
submasseteric, submandibular, temporal, and
pterygomandibular spaces)
206 SF801M Mouth, Abscess, (superficial), Drainage 1A Existing SF801M
207 SF802M Mouth, Angular Cleft with Macrostomia (bilateral) 6A Existing SF802M
repair
208 SF803M Mouth, Angular Cleft with Macrostomia 4C Existing SF803M
(unilateral) repair
209 SF804M Mouth, Cleft Lip, Bilateral Primary Repair 6A Existing SF804M
210 SF806M Mouth, Cleft Lip, Secondary Correction 4A Existing SF806M
211 SF805M Mouth, Cleft Lip, Secondary Correction (Abbe 6A Existing SF805M
flap)
A-3-51
CONFIDENTIAL
SF – DIGESTIVE
code code
212 SF807M Mouth, Cleft Lip, Secondary Correction of 4B Existing SF807M
Nostril/Nasal Tip
213 SF808M Mouth, Cleft Lip, Unilateral Primary Repair 4C Existing SF808M
214 SF700M Mouth, Defect, mucous membrane/ connective 2A Existing SF700M
tissue graft
215 SF809M Mouth, Dislocated Teeth/Dento-Alveolar 2C Existing SF809M
Fracture, Reduction and Immobilisation
216 SF810M Mouth, Foreign Body (deep>3cm), Removal 3A Existing SF810M
217 SF811M Mouth, Foreign Body (superficial), Removal 1B Existing SF811M
218 SF701M Mouth, Frenal Attachment, Release 1B Existing SF701M
219 SF702M Mouth, Intra oral tumour radical excision with 7A Existing SF702M
resection of mandible and bilateral neck
dissection
220 SF812M Mouth, Intra oral tumour radical excision with 6C Existing SF812M
resection of mandible and unilateral neck
dissection
221 SF813M Mouth, Leukoplakia, Limited Excision 1B Existing SF813M
222 SF814M Mouth, Leukoplakia, Wide Excision and Skin 3A Existing SF814M
Grafting
223 SF815M Mouth, Macrocheilia and Macroglossia, 3A Existing SF815M
Reconstruction
224 SF816M Mouth, Malignant Tumor, Wide Excision and 6B Existing SF816M
Major Reconstruction
225 SF818M Mouth, Mucous Cyst/Ranula of Floor of Mouth, 2C Existing SF818M
Excision with/without Biopsy
226 SF817M Mouth, Mucous Cyst/Ranula of Floor of Mouth, 1B Existing SF817M
Marsupialization /Biopsy
227 SF819M Mouth, Nasolabial Cyst, Excision Biopsy 2C Existing SF819M
228 SF820M Mouth, Oro-antral Fistula, Removal of 3B Existing SF820M
Tooth/Roots in Antrum and Closure
229 SF703M Mouth, Periodontium (within 1 quadrant), 1A Existing SF703M
Periodontitis, open flap debridement
230 SF704M Mouth, Periodontium (within 1 quadrant), Soft 1B Existing SF704M
tissue defect/deformity, gingivoplasty
231 SF705M Mouth, Periodontium (within 1 quadrant), Soft 2B Existing SF705M
tissue defect/deformity, gingivoplasty with
autogenous soft/hard tissue graft
232 SF706M Mouth, Periodontium (within 2 quadrants), 1C Existing SF706M
Periodontitis, Open flap debridement
233 SF707M Mouth, Periodontium (within 2 quadrants), Soft 2A Existing SF707M
tissue defect/deformity, gingivoplasty
234 SF708M Mouth, Periodontium (within 2 quadrants), Soft 3A Existing SF708M
tissue defect/deformity, gingivoplasty with
autogenous soft/hard tissue graft
235 SF709M Mouth, Periodontium, Bone defect/deformity, 2C Existing SF709M
augmentation (autogenous) /regeneration
236 SF710M Mouth, Periodontium, bone defect/deformity, 2A Existing SF710M
augmentation (non-autogenous) /regeneration
237 SF711M Mouth, Salivary Gland, Various Lesions, MSP Existing SF711M
Dilatation Of Duct
238 SF821M Mouth, Small Soft Tissue Tumor, Excision 1B Existing SF821M
Biopsy < 3cm
A-3-52
CONFIDENTIAL
SF – DIGESTIVE
code code
239 SF713M Mouth, Sublingual Gland, Tumor, Excision 2C Existing SF713M
Biopsy
240 SF714M Mouth, Submandibular Gland, Calculus (deep), 3A Existing SF714M
Removal Biopsy
241 SF715M Mouth, Submandibular Gland, Calculus, 1C Existing SF715M
Removal with Biopsy
242 SF716M Mouth, Submandibular Gland, Various lesions, 3C Existing SF716M
Excision with Biopsy
243 SF712M Mouth, Submucosal Resection, Endoscopic 4A Existing SF712M
Excision with Biopsy
244 SF822M Mouth, Tumor, Radical Excision Biopsy with 7C Existing SF822M
Resection of Mandible and Lymph Nodes and
Reconstruction
245 SF824M Mouth, Various / Pathologic Lesions of Oral 2B Existing SF824M
Mucosa, Cryosurgical/Laser Application with
Biopsy
246 SF823M Mouth, Various Lesions of Oral Mucosa 3B Existing SF823M
(large/multiple), Cryosurgica/Laser Application
with Biopsy
247 SF800N Neck, Branchial Cyst, Removal with Biopsy 3B Existing SF800N
248 SF801N Neck, Branchial Fistula, Removal 3B Existing SF801N
249 SF800P Palate, Cleft (complete), Primary Repair 5C Existing SF800P
250 SF801P Palate, Cleft (partial), Primary Repair 4B Existing SF801P
251 SF802P Palate, Cleft, Secondary Repair (closure of 3B Existing SF802P
fistula)
252 SF804P Palate, Cleft, Uvulopharyngoplasty 5C Existing SF804P
253 SF803P Palate, Secondary Repair (lengthening 5A Existing SF803P
procedure)
254 SF805P Pancreas, Cyst/Pseudocyst, Open or 5A Existing SF805P
Laparoscopic drainage and anastomosis to
Intestine/Stomach
255 SF700P Pancreas, Pseudocyst / abscess, Imaging 2C Existing SF700P
Guided Percutaneous Drainage Catheter
Insertion
256 SF701P Pancreas, Transplant (donation - Cadaveric 5C Existing SF701P
donor)
257 SF702P Pancreas, Transplant (recipient) 7C Existing SF702P
258 SF806P Pancreas, Tumour, Triple Bypass 5C Existing SF806P
259 SF807P Pancreas, Various Lesions, Distal 5C Existing SF807P
Pancreatectomy/Anastomosis of Pancreatic Duct
260 SF703P Pancreas, Various Lesions, duodenum 7A Existing SF703P
preserving pancreatic head resection (Beger's
operation)
261 SF704P Pancreas, Various Lesions, duodenum 7A Existing SF704P
preserving pancreatic head resection with
longitudinal pancreatico-enteric anastomosis
(Frey's Operation)
262 SF705P Pancreas, Various Lesions, enucleation of 4C Existing SF705P
lesions (1 to 2)
263 SF706P Pancreas, Various Lesions, enucleation of 5A Existing SF706P
lesions (3 or more)
264 SF808P Pancreas, Various Lesions, External Drainage 3B Existing SF808P
(Open)
A-3-53
CONFIDENTIAL
SF – DIGESTIVE
code code
265 SF707P Pancreas, Various lesions, Imaging Guided 2A Existing SF707P
Percutaneous Biopsy
266 SF708P Pancreas, Various Lesions, open/laparoscopic 5B Existing SF708P
distal pancreatectomy and splenectomy
267 SF709P Pancreas, Various Lesions, open/laparoscopic 5C Existing SF709P
subtotal pancreatectomy (extending to the neck)
and splenectomy
268 SF710P Pancreas, Various Lesions, Portal Venous 3B Existing SF710P
Sampling
269 SF711P Pancreas, Various Lesions, segmental 6B Existing SF711P
pancreatectomy with pancreatico-enteric
anastomosis
270 SF809P Pancreas, Various Lesions, Whipple 7C Existing SF809P
Operation/Total Pancreatectomy
271 SF712P Pancreas, Various Lesions,open/laparoscopic 5C Existing SF712P
spleen-preserving distal pancreatectomy
272 SF811P Parotid, Calculus (deep), Removal 3A Existing SF811P
273 SF812P Parotid, Calculus (Superficial), Removal 1C Existing SF812P
274 SF813P Parotid, Fistula, Repair 3A Existing SF813P
275 SF713P Parotid, Total parotidectomy with neck dissection 6B Existing SF713P
276 SF714P Parotid, Total Parotidectomy, with/without 6A Existing SF714P
preservation of facial nerve
277 SF814P Parotid, Tumor, Superficial Parotidectomy 5C Existing SF814P
278 SF815P Parotid, Tumor, Total Parotidectomy with 7B Existing SF815P
Parapharyngeal Space Resection and Flap
Reconstruction
279 SF817P Parotid, Tumor, Total Parotidectomy with Radical 6B Existing SF817P
Neck Dissection
280 SF816P Parotid, Tumour, Total Parotidectomy with 6B Existing SF816P
Reconstruction Facial Nerve
281 SF810P Pharynx/Larynx, Parapharyngeal Space Tumor 6A Existing SF810P
Excision
282 SF800R Rectum, Foreign Body, Manual Removal MSP Existing SF800R
283 SF801R Rectum, Hirschsprung's Disease, Anal 2C Existing SF801R
Sphincterotomy
284 SF802R Rectum, Hirschsprung's Disease, Rectal 3B Existing SF802R
Myectomy
285 SF803R Rectum, Hirschsprung's Disease, Recto- 5C Existing SF803R
Sigmoidectomy
286 SF700R Rectum, Perineal Rectosigmoidectomy for Rectal 5C Existing SF700R
Prolapse
287 SF701R Rectum, Resection - Rectopexy for Rectal 5C Existing SF701R
Prolapse (open or laparascopic)
288 SF702R Rectum, STARR - Stapled Hemorroidectomy 3A Existing SF702R
289 SF804R Rectum, Stricture, Laser Treatment 1C Existing SF804R
290 SF805R Rectum, Tumor, Anterior Resection/Abdomino - 6C Existing SF805R
perineal Resection with Salpingo-Oophorectomy
and Total Hysterectomy
291 SF806R Rectum, Tumor, Laser Vaporisation/Endoscopic 2C Existing SF806R
Fulguration
292 SF703R Rectum, Ultra-low Anterior Resection (Total 6C Existing SF703R
Mesorectal Excision) With/Without PLND
A-3-54
CONFIDENTIAL
SF – DIGESTIVE
code code
293 SF807R Rectum, Various Lesions, Abdomino-Perineal 6B Existing SF807R
Pull Through Resection with Colo-Anal
Anastomosis
294 SF808R Rectum, Various Lesions, Hartmann's Procedure 5C Existing SF808R
295 SF809R Rectum, Various Lesions, Transphincteric 4A Existing SF809R
Removal with Biopsy
296 SF700S Sacral Nerve Stimulation 4B Existing SF700S
297 SF800S Sacrum & Coccyx, Pilonidal Sinus/Cyst, Excision 2C Existing SF800S
with Biopsy
298 SF801S Sacrum & Coccyx, Tumor, Excision with Biopsy 6B Existing SF801S
299 SF802S Sacrum & Coccyx, Various Lesions, Excision 2C Existing SF802S
with Biopsy
300 SF701S Stomach, Gastroesophageal Reflux, 5C Existing SF701S
fundoplication, open/laparoscopic with/without
gastrotomy
301 SF713S Stomach, Obesity, Biliopancreatic Diversion 5C New -
with/without Duodenal Switch
302 SF803S Stomach, Obesity, Bypass only 4A Existing SF803S
303 SF702S Stomach, Obesity, Gastric Banding 5C Description SF702S
(laparoscopic) Change
304 SF804S Stomach, Obesity, Reduction & Bypass 5C Existing SF804S
305 SF703S Stomach, Obesity, Sleeve gastrectomy 5B Existing SF703S
(open/laparoscopic)
306 SF705S Stomach, Partial/Subtotal Gastrectomy for 5C Existing SF705S
benign gastric diseases
307 SF805S Stomach, Pyloric Stenosis, Pyloroplasty 3B Existing SF805S
308 SF806S Stomach, Pyloric Tumor (infant), 3A Existing SF806S
Pyloroplasty/Pyloromyotomy
309 SF708S Stomach, Pyloromyotomy, Laparoscopic 3A Existing SF708S
310 SF812S Stomach, Total/Proximal Gastrectomy for benign 6B Existing SF812S
gastric diseases
311 SF807S Stomach, Tumor of Cardia, Endoscopic YAG 3B Existing SF807S
Laser Surgery/Vaporisation
312 SF808S Stomach, Tumor/Ulcer, Gastrojejunostomy 4A Existing SF808S
313 SF709S Stomach, Tumour, Subtotal Gastrectomy and 6B Existing SF709S
radical lymphadenectomy
314 SF710S Stomach, Tumour, Total Gastrectomy and 6B Existing SF710S
radical lymphadenectomy
315 SF809S Stomach, Ulcers, Vagotomy - all types 5C Existing SF809S
316 SF711S Stomach, Various Lesions, Imaging guided 1C Existing SF711S
insertion of Naso-gastric tube / Naso-jejunal tube
317 SF704S Stomach, Various Lesions, Imaging Guided 3A Existing SF704S
Percutaneous Gastrostomy / Gastrojejunostomy
318 SF810S Stomach, Various Lesions, Partial/Subtotal 5C Existing SF810S
Gastrectomy
319 SF706S Stomach, Various Lesions, Total/Proximal 6B Existing SF706S
Gastrectomy with/without Splenectomy
320 SF813S Stomach, Various Lesions, Wedge Resection 4A Existing SF813S
321 SF811S Stomach, Various Lesions/Post-Gastrectomy 5C Existing SF811S
Complications, Revision Gastrectomy
A-3-55
CONFIDENTIAL
SF – DIGESTIVE
code code
322 SF707S Stomach, Wedge Resection/Stomach for benign 4A Existing SF707S
gastric diseases
323 SF712S Stomach/duodenum, perforated ulcer, repair 4B Existing SF712S
324 SF703T Teeth (2 or more) Unerupted/partially 2B Existing SF703T
erupted/impacted, Surgical exposure
325 SF801T Teeth (2 to 3), Impacted, Excision with removal 3B Existing SF801T
of bone (without tooth division)
326 SF800T Teeth (2 to 3), Impacted, Excision with removal 3C Existing SF800T
of bone and tooth division
327 SF704T Teeth (2 to 3), Unerupted/partially 3C Existing SF704T
erupted/impacted, Surgical Exposure and
Bonding for traction and assisted eruption
328 SF705T Teeth (4 or more) Unerupted/ partially erupted/ 4A Existing SF705T
impacted, Surgical Exposure and Bonding for
Traction and assisted eruption
329 SF803T Teeth (4 or more), Impacted, Excision with 4A Existing SF803T
removal of bone (without tooth division)
330 SF802T Teeth (4 or more), Impacted, Excision with 4B Existing SF802T
removal of bone and tooth division
331 SF706T Thoracoscopic repair of esophageal fistula and 6B Existing SF706T
esophageal atresia
332 SF804T Tongue, Tongue Tie, Release 1A Existing SF804T
333 SF805T Tongue, Tongue Tie, Revision 1B Existing SF805T
334 SF806T Tongue, Tumor, Glossectomy with Radical Neck 6B Existing SF806T
Dissection
335 SF807T Tongue, Tumor, Hemi-Glossectomy 4A Existing SF807T
336 SF808T Tongue, Tumor, Total Glossectomy 4A Existing SF808T
337 SF707T Tongue, Various Lesions (Benign Condition) 1B Existing SF707T
Excision Biopsy <3cm
338 SF809T Tongue, Various Lesions, Partial Excision 3A Existing SF809T
339 SF810T Tooth (deep, i.e. completely buried in bone), 3A Existing SF810T
Excision with removal of bone and tooth division
340 SF818T Tooth (Multiple-Rooted or more than 1 tooth), 3A Existing SF818T
Various Lesions, Peri-Radicular Surgery
341 SF708T Tooth (Single-Rooted), Various Lesions, Peri- 2C Existing SF708T
radicular surgery
342 SF811T Tooth (Superficial), Unerupted/Partially MSP Existing SF811T
Erupted/Impacted, Excision with Incision Of
Overlying Soft Tissue And Removal Of Tooth
343 SF812T Tooth (superficial), Unerupted/Partially 1B Existing SF812T
Erupted/Impacted, Excision with removal of bone
(without tooth division)
344 SF813T Tooth (superficial), Unerupted/Partially 2C Existing SF813T
Erupted/Impacted, Excision with removal of bone
and tooth division
345 SF814T Tooth, Dislocation, Reimplantation and 3A Existing SF814T
Transplantation
346 SF815T Tooth, Fracture/dislocation, Removal Of Arch MSP Existing SF815T
Bar/Dental Cap Splint
347 SF816T Tooth, Simple Unerupted/Partially 2C Existing SF816T
erupted/Impacted/Fractured, Removal of Multiple
Roots
A-3-56
CONFIDENTIAL
SF – DIGESTIVE
code code
348 SF817T Tooth, Unerupted/Partially Erupted/Impacted, 4A Existing SF817T
Excision with Release of Neurovascular Bundle
349 SF701T Tooth, Unerupted/Partially Erupted/Impacted, 1C Existing SF701T
Surgical Exposure
350 SF702T Tooth, Unerupted/Partially Erupted/Impacted, 2C Existing SF702T
Surgical Exposure and Bonding for traction and
assisted eruption
A-3-57
CONFIDENTIAL
SG – URINARY
code code
1 SG800B Bladder, Bladder Neck Contracture, 3B Existing SG800B
(Acquired/Congenital), Wedge Excision
2 SG801B Bladder, Broken Cable Connection to Neurogenic 4A Existing SG801B
Bladder, Reconnection of Cable
3 SG802B Bladder, Calculus, 2C Existing SG802B
Vesicolithotomy/Litholapaxy/Ultrasonic Lithotripsy
4 SG803B Bladder, Cutaneous Fistula, Closure 2C Existing SG803B
5 SG700B Bladder, Cystoscopic intradetrusor injection of 2C Existing SG700B
botulinum
6 SG708B Bladder, Cystoscopy, external sphincterotomy for 2C Existing SG708B
neurogenic bladder neck obstruction
7 SG709B Bladder, Cystoscopy, removal of foreign 2C Existing SG709B
body/ureteric stent
8 SG710B Bladder, Cystoscopy, with controlled 1B Existing SG710B
hydrodilatation of the bladder
9 SG711B Bladder, Cystoscopy, with endoscopic 3B Existing SG711B
removal/manipulation of ureteric calculus
10 SG712B Bladder, Cystoscopy, with endoscopic 3B Existing SG712B
resection/incision of bladder neck
11 SG713B Bladder, Cystoscopy, with or without biopsy 1B Existing SG713B
12 SG717B Bladder, Cystoscopy, with ureteric 3B Existing SG717B
meatotomy/with resection of Ureterocele
13 SG702B Bladder, Diverticulum, Laparoscopic Excision 4A Existing SG702B
14 SG804B Bladder, Diverticulum, Open Excision 3B Existing SG804B
15 SG805B Bladder, Ectopia Vesicae/Ectopia Cloacae with 7B Existing SG805B
Congenital Incontinence, Sphincter
Reconstruction
16 SG806B Bladder, Incontinence, Correction, Abdominal 5A Existing SG806B
Approach
17 SG807B Bladder, Mild Stress Incontinence, Cyctoscopic 3B Existing SG807B
Injection of Collagen
18 SG808B Bladder, Retention of Urine, Suprapubic 1B Existing SG808B
Cystostomy
19 SG809B Bladder, Tumor, Anterior Exenteration (Female) 6B Existing SG809B
20 SG704B Bladder, Urachal Fistula, Laparoscopic Excision 4A Existing SG704B
21 SG810B Bladder, Urachal Fistula, Open Excision 3B Existing SG810B
22 SG811B Bladder, Various Lesion, Aspiration MSP Existing SG811B
23 SG705B Bladder, Various Lesions, Catheterisation MSP Existing SG705B
24 SG812B Bladder, Various Lesions, Enlargement 6B Existing SG812B
Cystoplasty with Bowel
25 SG703B Bladder, Various lesions, Image guided 1C Existing SG703B
suprapubic cystostomy
26 SG813B Bladder, Various Lesions, Open Partial Excision 3B Existing SG813B
27 SG814B Bladder, Various Lesions, Total Cystectomy with 6B Existing SG814B
ileal conduit
28 SG707B Bladder, Various Lesions, Total Radical 6C Existing SG707B
Cystectomy, for malignancy + creation of ileal
neobladder
29 SG706B Bladder, Various Lesions,Laparoscopic Partial 4A Existing SG706B
Excision
30 SG815B Bladder, Vesico-Intestinal Fistula, Closure 5C Existing SG815B
31 SG818B Bladder, Vesicostomy 3A New -
A-3-58
CONFIDENTIAL
SG – URINARY
code code
32 SG816B Bladder, Vesico-Ureteric Fistula, Correction 5C Existing SG816B
33 SG817B Bladder, Vesico-Vaginal Fistula, Closure by 5C Existing SG817B
Abdominal Route
34 SG716B Bladder/Ureter, Cystoscopy, with ureteric 1C Existing SG716B
catheterisation
35 SG701B Bladder/Ureter, Lympholysis for chyluria, 4A Existing SG701B
laparoscopic
36 SG718B Bladder/Urethra, Cystoscopy, with urethral 1C Existing SG718B
dilatation
37 SG714B Bladder/Urethra, Transurethral Resection of 4A Existing SG714B
Bladder Tumour (<3cm)
38 SG715B Bladder/Urethra, Transurethral Resection of 4B Existing SG715B
Bladder Tumour (>3cm)
39 SG800K Kidney and Ureter, Various Lesions, 5C Existing SG800K
Nephroureterectomy Open
40 SG700K Kidney and Ureter, Various Lesions, 6A Existing SG700K
Nephroureterectomy, Laparoscopic
41 SG705K Kidney transplant, donation (Cadaveric donor) 5A Existing SG705K
42 SG706K Kidney transplant, donation (Live donor), 5C Existing SG706K
laparoscopic
43 SG707K Kidney transplant, donation (Live donor), open 5B Existing SG707K
44 SG708K Kidney transplant, recipient 6C Existing SG708K
45 SG801K Kidney, Blocked Nephrostomy Tube, Change 1A Existing SG801K
46 SG802K Kidney, Calculus, Extra Corporeal Shockwave 4B Existing SG802K
Lithotripsy (ESWL)
47 SG803K Kidney, Calculus, Nephrolithotomy/Pyelolithotomy 4B Existing SG803K
48 SG709K Kidney, Calculus, Percutaneous Nephrolithotomy 4C Existing SG709K
or Percutaneous Nephrostolithotomy (PCNL)
49 SG804K Kidney, Carcinoma, Radical Nephrectomy open 5C Existing SG804K
50 SG701K Kidney, Catheter blockage, Imaging Guided 1A Existing SG701K
Nephrostomy Catheter Change / Catheter
Adjustment
51 SG805K Kidney, Cyst, Excision 3A Existing SG805K
52 SG702K Kidney, Cyst, Imaging Guided Percutaneous 2B Existing SG702K
Alcohol Ablation
53 SG703K Kidney, Cyst, Imaging Guided Percutaneous 2A Existing SG703K
Aspiration
54 SG704K Kidney, Cyst, Marsupialisation, Laparoscopic 4A Existing SG704K
55 SG711K Kidney, Hydronephrosis, Percutaneous 2B Existing SG711K
Nephrostomy and Drainage Catheter Insertion
(PCN and Drainage)
56 SG806K Kidney, Injury, Repair 5C Uptabled SG806K
57 SG807K Kidney, Nephroptosis, Nephropexy 3B Existing SG807K
58 SG808K Kidney, Pelvi-ureteric Junction Obstruction, Open 5C Existing SG808K
Pyeloplasty/Ureterocalycostomy
59 SG809K Kidney, Perinephric Abscess, Drainage (Open) 3B Existing SG809K
60 SG810K Kidney, Pyonephrosis, Drainage (Open) 3B Existing SG810K
61 SG811K Kidney, Pyonephrosis, Nephrostomy/Pyelostomy 3B Existing SG811K
(Open)
62 SG713K Kidney, Renal abscess / Perinephric Abscess, 2A Existing SG713K
Imaging Guided Percutaneous Aspiration
A-3-59
CONFIDENTIAL
SG – URINARY
code code
63 SG712K Kidney, Renal abscess / Perinephric Abscess, 2C Existing SG712K
Imaging Guided Percutaneous Drainage
64 SG812K Kidney, Staghorn Calculus, Nephrolithotomy or 5C Existing SG812K
percutaneous nephrostolithotomy (PCNL)
65 SG714K Kidney, Stones, Imaging Guided Percutaneous 3B Existing SG714K
Renal Stones Removal
66 SG715K Kidney, Tumour, Laparoscopic Guided 4A Existing SG715K
Percutaneous Local Ablation (Radiofrequency,
Cryotherapyetc)
67 SG813K Kidney, Various Lesions, Biopsy (closed) 1B Existing SG813K
68 SG814K Kidney, Various Lesions, Biopsy (open) 3A Existing SG814K
69 SG716K Kidney, Various Lesions, Check Nephrostogram 1A Existing SG716K
70 SG815K Kidney, Various Lesions, Exploration 3A Existing SG815K
71 SG719K Kidney, Various lesions, Imaging Guided 2A Existing SG719K
Percutaneous Biopsy (Focal lesions, targeted)
72 SG717K Kidney, Various Lesions, Imaging guided 1C Existing SG717K
Percutaneous Biopsy (Renal parenchyma, non
directed)
73 SG720K Kidney, Various Lesions, Partial Nephrectomy, 6A Existing SG720K
laparascopic
74 SG721K Kidney, Various Lesions, Partial Nephrectomy, 5C Existing SG721K
open
75 SG718K Kidney, Various Lesions, Percutaneous 1C Existing SG718K
Antegrade Nephrostography (PCN)
76 SG710K Kidney, Various Lesions, Radical Nephrectomy, 6A Existing SG710K
Laparoscopic
77 SG722K Kidney, Various Lesions, Simple Nephrectomy, 4C Existing SG722K
laproscopic
78 SG816K Kidney, Various Lesions, Simple Nephrectomy, 4B Existing SG816K
open
79 SG723K Kidney/Ureter, Endopyelotomy (percutaneous) 4B Existing SG723K
80 SG724K Kidney/Ureter, Pyeloplasty, Bilateral 6A Existing SG724K
Open/Laparoscopic
81 SG725K Kidney/Ureter, Pyeloplasty, Unilateral 5A Existing SG725K
Open/Laparoscopic
82 SG726K Kidney/Ureter, Retrograde Intrarenal Surgery or 2C Existing SG726K
RIRS using flexible ureteroscopy (diagnostic)
83 SG727K Kidney/Ureter, Retrograde Intrarenal Surgery or 4A Existing SG727K
RIRS using flexible ureteroscopy (therapeutic -
e.g. lithotripsy and/or basket extraction of stones)
84 SG703P Prostate Gland, Laser Transurethral Resection of 5A Existing SG703P
Prostate (TURP), Large gland > 30gm
85 SG701P Prostate Gland, Laser Transurethral Resection of 4A Existing SG701P
Prostate (TURP), Small gland < 30gm
86 SG700P Prostate Gland, Various Lesions, Transurethral 4B Existing SG700P
Resection of Prostate (TURP) (less than 30 gm)
87 SG702P Prostate Gland, Various Lesions, Transurethral 5C Existing SG702P
Resection of Prostate (TURP) (more than 30 gm)
88 SG702U Ureter, Calculus, Ultrasound Lithotripsy 4A Existing SG702U
89 SG801U Ureter, Calculus, Ureterolithotomy 4A Existing SG801U
90 SG832U Ureter, Calculus, Ureterolithotomy 4B New -
(laparoscopic/robotic)
91 SG802U Ureter, Cutaneous Ureterostomy, Closure 2C Existing SG802U
A-3-60
CONFIDENTIAL
SG – URINARY
code code
92 SG700U Ureter, Cystoscopy and insertion of double J stent 2C Existing SG700U
93 SG701U Ureter, Extra Corporeal Shockwave Lithotripsy 4A Existing SG701U
(ESWL) for ureteric stone
94 SG803U Ureter, Previous Diversion, Revision 6A Existing SG803U
95 SG704U Ureter, Stricture, Percutaneous Antegrade 2B Existing SG704U
Balloon Dilatation
96 SG709U Ureter, Ureteroscopy 2C Existing SG709U
97 SG800U Ureter, Ureteroscopy and lithotripsy 4A Existing SG800U
98 SG706U Ureter, Various Lesions, Reimplantation, Bilateral 5A Existing SG706U
99 SG807U Ureter, Various Lesions, Reimplantation, 4A Existing SG807U
Unilateral
100 SG804U Ureter, Various Lesions, Boari Flap 5C Existing SG804U
Reimplantation
101 SG805U Ureter, Various Lesions, Intestinal Conduit 5C Existing SG805U
102 SG707U Ureter, Various lesions, Percutaneous Antegrade 2C Existing SG707U
Insertion of Double J Stent
103 SG806U Ureter, Various Lesions, Reduction Ureteroplasty 5C Existing SG806U
104 SG808U Ureter, Various Lesions, Repair 4A Existing SG808U
105 SG809U Ureter, Various Lesions, Replacement By Bowel 5C Existing SG809U
106 SG810U Ureter, Various Lesions, Ureterocalycostomy 5C Existing SG810U
107 SG811U Ureter, Various Lesions, Ureterostomy 3C Existing SG811U
108 SG812U Ureter, Various Lesions, Ureterotomy/Insertion of 3B Existing SG812U
Double J Stent
109 SG813U Ureter, Various Lesions, Ureteroureterostomy 4B Existing SG813U
110 SG814U Urethra, Excision of urethral diverticulum 3B Existing SG814U
111 SG711U Urethra, Excision of urethral diverticulum, with 4A Existing SG711U
Martius flap
112 SG815U Urethra, Fistula, Closure 2C Existing SG815U
113 SG816U Urethra, Injury, Repair/Urethroplasty of Anterior 4A Existing SG816U
Urethra
114 SG817U Urethra, Meatal Stenosis, Meatotomy 1B Existing SG817U
115 SG703U Urethra, Mid-urethral slings 3A Existing SG703U
116 SG818U Urethra, Prolapse, Excision 1B Existing SG818U
117 SG819U Urethra, Stricture, Dilatation MSP Existing SG819U
118 SG820U Urethra, Stricture, Urethral Wall Stenting 2C Existing SG820U
119 SG821U Urethra, Stricture, Urethrotomy 2C Existing SG821U
120 SG705U Urethra, Substitution urethroplasty - flap or graft 5C Existing SG705U
121 SG822U Urethra, Urethro-rectal Fistula, Closure 4B Existing SG822U
122 SG712U Urethra, Urethroscopy, with related procedures 1B Existing SG712U
123 SG823U Urethra, Valves/Membrane, Resection 3B Existing SG823U
(endoscopic)
124 SG824U Urethra, Valves/Membrane, Resection (open) 4A Existing SG824U
125 SG825U Urethra, Various Lesions, Anterior Urethroplasty 4B Existing SG825U
126 SG826U Urethra, Various Lesions, Excision 3B Existing SG826U
127 SG827U Urethra, Various Lesions, Posterior Urethroplasty 5C Existing SG827U
128 SG828U Urethra, Various Lesions, Staged Urethroplasty 3B Existing SG828U
(each stage)
129 SG829U Urethra, Various Lesions, Transpubic 5A Existing SG829U
Urethroplasty
130 SG830U Urethra, Various Lesions, Urethropexy 3A Existing SG830U
A-3-61
CONFIDENTIAL
SG – URINARY
code code
131 SG831U Urethra, Various Lesions, Urethrotomy 2C Existing SG831U
A-3-62
CONFIDENTIAL
SH – MALE GENITAL
code code
1 SH700G Genital Tract, Various Lesions, MSP Existing SH700G
Hysterosalpingography
2 SH800M Male Genitalia, Transsexualism (Transvestism), 5A Existing SH800M
Sex Reassignment (Male to Female)
3 SH801M Male Genitalia, Transsexualism (Transvestism), 6B Existing SH801M
Sex Reassignment with Mammoplasty (Male to
Female)
4 SH800P Penis, Epispadias, Repair involving Bladder 4C Existing SH800P
Neck Closure
5 SH801P Penis, Epispadias, Repair Not involving 3B Existing SH801P
Sphincter (each stage)
6 SH700P Penis, Glanular hypospadias: meatoplasty and 2A Existing SH700P
circumcision
7 SH802P Penis, Hypospadias, Correction of Chordee 2C Existing SH802P
8 SH803P Penis, Hypospadias, Correction of Chordee with 3B Existing SH803P
Transplantation of Prepuce
9 SH804P Penis, Hypospadias, Meatotomy & 1B Existing SH804P
Hemicircumcision
10 SH805P Penis, Hypospadias, Secondary Correction 2C Existing SH805P
11 SH806P Penis, Hypospadias, Urethral Reconstruction 4A Uptabled SH806P
12 SH807P Penis, Hypospadias, Urethral Reconstruction & 5C Existing SH807P
Correction of Chordee
13 SH701P Penis, Paraphimosis/Phimosis, Reduction MSP Existing SH701P
14 SH808P Penis, Paraphimosis/Phimosis/Reduction 1B Existing SH808P
Prepuce, Circumcision
15 SH809P Penis, Penile Warts, Laser Vaporisation 1B Existing SH809P
16 SH702P Penis, Peyronie's Disease - incision and grafting 3C Existing SH702P
17 SH810P Penis, Peyronie's Disease, Operation 2C Existing SH810P
18 SH811P Penis, Priapism, Decompression (Shunt Op) 3C Existing SH811P
19 SH812P Penis, Priapism, Decompression (Single) 1B Existing SH812P
20 SH703P Penis, Removal of "penile" implant 3B Existing SH703P
21 SH813P Penis, Sex Reassignment (Female to Male), 2B Existing SH813P
Implantation of Penile Prosthesis
22 SH814P Penis, Trauma (Amputation), Microvascular 7C Existing SH814P
Reattachment
23 SH815P Penis, Trauma, Reconstruction (1st Stage) 6B Existing SH815P
24 SH816P Penis, Trauma, Reconstruction (2nd Stage) 5A Existing SH816P
25 SH817P Penis, Trauma, Repair of Avulsion 4A Existing SH817P
26 SH818P Penis, Trauma, Repair of Laceration/Fracture 2C Existing SH818P
Involving Cavernous Tissue
27 SH704P Penis, Tumor, Amputation (Partial) + bilateral 5C Existing SH704P
radical LN dissection
28 SH820P Penis, Tumor, Amputation (Total) 4A Existing SH820P
29 SH821P Penis, Tumor, Amputation (total) with Block 5C Existing SH821P
Dissection
30 SH819P Penis, Tumour, Amputation (Partial) 3A Uptabled SH819P
31 SH822P Penis, Various Lesions, Androscopic MSP Existing SH822P
examination
32 SH823P Penis, Various Lesions, Excision 1B Existing SH823P
33 SH824P Penis, Various Lesions, Injection MSP Existing SH824P
34 SH825P Penis, Various Lesions, Insertion of Penile 5A Existing SH825P
Prosthesis
A-3-63
CONFIDENTIAL
SH – MALE GENITAL
code code
35 SH826P Prostate Gland, Abscess, 2C Existing SH826P
Retropubic/Endoscopic Drainage
36 SH827P Prostate Gland, Hypertrophy, Insertion of 2C Existing SH827P
Prostatic Stent
37 SH705P Prostate Gland, Prostate IMRT (intensity 2C Existing SH705P
modulated radiation therapy) gold seeds
insertion
38 SH832P Prostate Gland, Prostate, Benign Hyperplasia, 3B Existing SH832P
Transurethral microwave thermotherapy (TUMT)
39 SH829P Prostate Gland, Simple Prostatectomy 4B Existing SH829P
(open/laparoscopic/robotic)
40 SH830P Prostate Gland, Various Lesions, Radical 6A Existing SH830P
Prostatectomy (open/laparascopic/robotic)
41 SH835P Prostate Gland, Various Lesions, Saturation 2A New -
Prostate Biopsy
42 SH831P Prostate Gland, Various Lesions, Saturation 1B Description SH831P
Robotic Transrectal/Transperineal Biopsy Change
43 SH833P Prostate Gland, Various Lesions, Trans-Rectal 1A New -
Ultrasound (TRUS)
44 SH834P Prostate Gland, Various Lesions, Trans-Rectal 1B New -
Ultrasound (TRUS) guided biopsy
45 SH804T Scrotum, Exploration, Detorsion of testis and 2A Existing SH804T
bilateral testes fixation
46 SH801S Scrotum, Hydrocele/Varicocele (Bilateral) 3A Existing SH801S
47 SH802S Scrotum, Hydrocele/Varicocele (Unilateral) 2B Existing SH802S
48 SH800S Spermatic Cord, Hydrocele, Tapping MSP Existing SH800S
49 SH803S Spermatic Cord, Spermatocele/Epididymal Cyst, 2A Uptabled SH803S
Excision
50 SH804S Spermatic Cord, Various Lesions, 2A Uptabled SH804S
Epididymectomy
51 SH700T Testis, Torsion testis, orchidectomy done with 2B Existing SH700T
fixation of contralateral testis
52 SH800T Testis, Tumor, Retroperitoneal Lymph Node 5C Existing SH800T
Dissection following Orchidectomy
53 SH801T Testis, Undescended/Ectopic (bilateral), 4A Existing SH801T
Orchidopexy/Transplantation with Hernia Repair
54 SH802T Testis, Undescended/Ectopic (unilateral), 3B Existing SH802T
Orchidopexy/Transplantation with Hernia Repair
55 SH803T Testis, Undescended/Ectopic, Orchidopexy with 5C Existing SH803T
Microvascular Anastomosis
56 SH702T Testis, Variocoele, Spermatic Vein Embolisation 4A Existing SH702T
57 SH805T Testis, Various Lesions, Biopsy 1C Existing SH805T
58 SH806T Testis, Various Lesions, Exploration/Repair 1C Existing SH806T
59 SH807T Testis, Various Lesions, Insertion of Testicular 3A Existing SH807T
Prosthesis
60 SH808T Testis, Various Lesions, Orchidectomy (simple) 2B Existing SH808T
61 SH701T Testis, Various Lesions, Orchidectomy (simple) 3C Existing SH701T
(laparoscopic)
62 SH809T Testis, Various Lesions, Orchidectomy with 3A Existing SH809T
Complete Excision of Spermatic Cord
63 SH810T Testis, Various Lesions, Orchidoplasty 1C Existing SH810T
64 SH700U Urethra, Examination under anaesthesia / 1A Existing SH700U
urethral dilatation
A-3-64
CONFIDENTIAL
SH – MALE GENITAL
code code
65 SH800V Vas Deferens, Various Lesions, Exploration 5C Existing SH800V
(Microsurgical) and Testicular Biopsy
66 SH801V Vas Deferens, Various Lesions, Reanastomosis 4C Existing SH801V
(Microsurgical)
67 SH802V Vas Deferens, Various Lesions, Varicocelectomy 3C Existing SH802V
(Microsurgical)
68 SH803V Vas Deferens, Various Lesions, Vasectomy 1C Existing SH803V
69 SH804V Vas Deferens, Various Lesions, 1B Existing SH804V
Vasoepididymography & Vasovesiculography
70 SH805V Vas Deferens, Various Lesions, 5C Existing SH805V
Vasoepididymostomy (Microsurgical)
A-3-65
CONFIDENTIAL
SI – FEMALE GENITAL
code code
1 SI700C Cervix, Cancer, Radical trachelectomy 5B Existing SI700C
with/without lymphadenectomy
2 SI802C Cervix, Cervical Incompetence, Cerclage 2B Existing SI802C
3 SI701C Cervix, Cervical Incompetence, Removal of 1C Existing SI701C
Suture
4 SI803C Cervix, Cervical Intraepithelial Neoplasia, Cone 3A Existing SI803C
Biopsy with/without laser
5 SI804C Cervix, Ectropion, Amputation/Repair of Cervix 3B Existing SI804C
(Trachelorrhaphy)
6 SI801C Cervix, Polyp, Excision (Outpatient) MSP Existing SI801C
7 SI805C Cervix, Polyp, Excision/Erosion (complicated) 2B Existing SI805C
includes D&C with Biopsy
8 SI806C Cervix, Polyp, Excision/Erosion (simple) with 1B Existing SI806C
Biopsy
9 SI807C Cervix, Polyp/Erosion, Laser Therapy without 1B Existing SI807C
Colposcopy
10 SI808C Cervix, Stenosis, Dilatation 1B Existing SI808C
11 SI809C Cervix, Tear, Repair under Anesthesia 1C Existing SI809C
12 SI800C Cervix, Tear, Simple Repair Without Anesthesia MSP Existing SI800C
13 SI702C Cervix, Transcervical resection (TCR) Myoma 3A Existing SI702C
(<3cm), hysteroscopic
14 SI703C Cervix, Transcervical resection (TCR) Myoma 3B Existing SI703C
(>3cm), hystereoscopic
15 SI704C Cervix, Transcervical resection (TCR) Polyp 2B Existing SI704C
(<2cm), hysteroscopic
16 SI705C Cervix, Transcervical resection (TCR) Polyp 2C Existing SI705C
(>2cm), hysteroscopic
17 SI706C Cervix, Transcervical resection (TCR) Septum, 3A Existing SI706C
hysteroscopic
18 SI811C Cervix, Various Lesions, Colposcopy MSP Existing SI811C
19 SI810C Cervix, Various Lesions, Colposcopy and Biopsy 1C Existing SI810C
20 SI707C Cervix, Various Lesions, Colposcopy, Laser 2A Existing SI707C
Vapourisation/Loop Electrosurgical Excision
Procedure/Laser Excision of Transformation Zone
with Biopsy
21 SI812C Cervix, Various Lesions, Cryosurgery MSP Existing SI812C
22 SI813C Cervix, Various Lesions, Punch Biopsy 1A Existing SI813C
23 SI814C Clitoris, Clitoromegaly, Amputation 2C Existing SI814C
24 SI700F Fallopian Tube, Blocked tube, Fluoroscopic 2C Existing SI700F
Transcervical Fallopian Tubal Recanalisation
(FTR)
25 SI801F Fallopian Tube, Blocked Tubes, Cornual 5C Existing SI801F
Reanastomosis
(microsurgery/laparoscopic/Robotic)
26 SI802F Fallopian Tube, Blocked Tubes, Plastic Repair 5C Existing SI802F
(microsurgery/laparoscopic/Robotic)
27 SI803F Fallopian Tube, Blocked Tubes, Plastic Repair / 4C Existing SI803F
Salpingostomy (macrosurgery)
28 SI701F Fallopian Tube, Blocked Tubes, Tubal 5C Existing SI701F
Reanastomosis, MIS
29 SI800F Fallopian Tube, Blocked Tubes, Tuboplasty, 3B Existing SI800F
Recanalisation, Hysteroscopic
A-3-66
CONFIDENTIAL
code code
30 SI804F Fallopian Tube, Completed Family, 2B Existing SI804F
Division/Ligation
31 SI805F Fallopian Tube, Ectopic Gestation, Laparotomy 3B Existing SI805F
32 SI702F Fallopian Tube, Falloposcopy 2B Existing SI702F
33 SI807F Fallopian Tube, Peritubal Adhesions, 4A Existing SI807F
Salpingolysis (macrosurgery)
34 SI806F Fallopian Tube, Peritubal Adhesions, 5C Existing SI806F
Salpingolysis (microsurgery/Robotic)
35 SI703F Fallopian Tube, Sterilization, Hysteroscopic 2B Existing SI703F
36 SI704F Fallopian Tube, Sterilization, MIS 2B Existing SI704F
37 SI808F Fallopian Tube, Tubal Pathology other than 4A Existing SI808F
Ectopic, Salpingectomy/ Salpingostomy
38 SI705F Fallopian Tube, Tubal Pathology, Salpingectomy, 3C Existing SI705F
MIS/Robotic
39 SI809F Fallopian Tube, Tubo-Ovarian Abscess, 3B Existing SI809F
Drainage(transabdominal)
40 SI706F Fallopian tube/uterus/ovary, Laparoscopy, 3B Existing SI706F
Diagnostic, with Hydrotubation
41 SI707F Fallopian tube/uterus/ovary, Laparoscopy, 4B Existing SI707F
Therapeutic (with laser)
42 SI810F Female Genitalia, Transsexualism (Transvestism), 5A Existing SI810F
Sex Reassignment (Female to Male)
43 SI811F Female Genitalia, Transsexualism (Transvestism), 6B Existing SI811F
Sex Reassignment with Mastectomy (Female to
Male)
44 SI800G Genital Tract, Cancer, Staging under General 1C Existing SI800G
Anesthesia (includes Cystoscopy/Dilatation &
Curettage/Biopsy)
45 SI801G Genital Tract, Pelvic Cyst, Ultrasound Guided 2C Existing SI801G
Procedure-Aspiration
46 SI700L Laparoscopy, Therapeutic, except for Retrieval 3C Existing SI700L
and Placement of Gametes and Placement of
Embryos
47 SI701L Laparotomy Debulking (Advanced Disease - 6A Existing SI701L
Primary/Recurrent)
48 SI703O Ovarian Veins, Pelvic Congestion Syndrome, 3B Existing SI703O
Ovarian Vein Embolisation
49 SI702O Ovary, Malignant Tumor/Cyst, Staging 3C Existing SI702O
Laparotomy, as the only procedure
50 SI800O Ovary, Malignant Tumor/Cyst, Total Hysterectomy 5C Existing SI800O
Bilateral Salpingo-Oophorectomy with
Omentectomy, Surgical Staging with/without
Lymphadenectomy
51 SI801O Ovary, Tumor/Cyst, Aspiration except for Ovum 3B Existing SI801O
Retrieval
52 SI802O Ovary, Tumor/Cyst, Cystectomy (complicated) 4A Existing SI802O
(>5cm)
53 SI803O Ovary, Tumor/Cyst, Cystectomy (simple) (<5cm) 3B Existing SI803O
54 SI804O Ovary, Tumor/Cyst, Hysterectomy with Salpingo- 4A Existing SI804O
Oophorectomy
55 SI806O Ovary, Tumor/Cyst, Oophorectomy/Salpingo- 4A Existing SI806O
Oophorectomy (complicated)
A-3-67
CONFIDENTIAL
code code
56 SI805O Ovary, Tumor/Cyst, Oophorectomy/Salpingo- 3B Existing SI805O
Oophorectomy (simple)
57 SI700O Ovary, Tumor/Cyst, Ovarian Cystectomy, MIS 4B Existing SI700O
/robotic(Complicated) (>5cm)
58 SI701O Ovary, Tumor/Cyst, Ovarian 3C Existing SI701O
Cystectomy,MIS/robotic (Simple) (<5cm) With
Biopsy
59 SI807O Ovary, Various Lesions, Biopsy 3A Existing SI807O
60 SI808O Ovary, Various Lesions, Ovariopexy 3B Existing SI808O
61 SI809O Ovary, Various Lesions, Ovarioplasty, 6B Existing SI809O
Laparotomy/Laparoscopy (using microsurgical
techniques)/robotic
62 SI810O Ovary, Various Lesions, Wedge Resection 3B Existing SI810O
63 SI700P Pelvic Floor Reconstruction, MIS/robotic 4C Existing SI700P
64 SI701P Pelvis, Artery / Vein, Ligation / Occlusion 3C Existing SI701P
65 SI702P Pelvis, Frozen/Dense Pelvic Adhesions, 5A Existing SI702P
Conservative Reconstruction of ovaries, tubes,
uterus, pelvic floor
66 SI703P Pelvis, Malignant, Second Look Laparotomy 4A Existing SI703P
67 SI800P Pelvis, Various Lesions, Examination under 1A Existing SI800P
Anesthesia
68 SI800U Urethra, Caruncle/Polyp, Excision/Laser 1C Existing SI800U
Vaporisation
69 SI801U Urethra, Stenosis, Dilatation 1A Downtabled SI801U
70 SI802U Uterus, Benign Conditions, Sub-Total 4A Existing SI802U
Hysterectomy with/without Salpingo-
Oophorectomy
71 SI702U Uterus, Benign Conditions, Total Abdominal 4C Existing SI702U
Hysterectomy with/without Salpingo-
Oophorectomy and Pelvic Floor Repair (combined
operation)
72 SI803U Uterus, Benign Conditions, Total Hysterectomy 4A Existing SI803U
with/without Salpingo-Oophorectomy
73 SI804U Uterus, Broad Ligament Tumor, Hysterectomy 5C Existing SI804U
74 SI806U Uterus, Congenital Organ Abnormality, Plastic 6A Existing SI806U
Repair including Metroplasty
75 SI807U Uterus, Contraception, Intrauterine Contraceptive MSP Existing SI807U
Device Insertion
76 SI808U Uterus, Delayed Menstruation, Menstrual MSP Existing SI808U
Regulation
77 SI809U Uterus, Displaced Intrauterine Contraceptive 2A Existing SI809U
Device, Removal under General Anesthesia
78 SI810U Uterus, Displaced Intrauterine Contraceptive MSP Existing SI810U
Device, Removal Without General Anaesthesia
79 SI705U Uterus, Elongated Cervix, Cystocoele, 4B Existing SI705U
Rectocoele, Amputation of Cervix + Anterior
Repair + Posterior Repair
80 SI706U Uterus, Endometrial Ablation (balloon) 2B Existing SI706U
81 SI707U Uterus, Endometrial Ablation (hysteroscopic) 2C Existing SI707U
82 SI811U Uterus, Endometrial, Biopsy without General MSP Existing SI811U
Anaesthesia
83 SI812U Uterus, Endometriosis, Hysterectomy with/without 5C Existing SI812U
Salpingo-Oophorectomy
A-3-68
CONFIDENTIAL
code code
84 SI813U Uterus, Fetal Disorder, Ultrasound Guided Fetal 2C Existing SI813U
Blood Sampling/Cordocentesis
85 SI814U Uterus, Fetal Disorder, Ultrasound Guided Fetal 4A Existing SI814U
Therapy
86 SI703U Uterus, Fetal Surgery 3B Existing SI703U
87 SI815U Uterus, Fibroids, Myomectomy (complicated) 5A Existing SI815U
(>5cm)
88 SI816U Uterus, Fibroids, Myomectomy (simple) (<5cm) 3B Existing SI816U
89 SI708U Uterus, Fibroids, Myomectomy, MIS 5A Existing SI708U
(Complicated) (>5cm)
90 SI709U Uterus, Fibroids, Myomectomy, MIS (Simple) 3C Existing SI709U
(<5cm)
91 SI710U Uterus, Fibroids, Uterine Artery Embolization 3C Existing SI710U
92 SI704U Uterus, Foetoscopy 4A Existing SI704U
93 SI817U Uterus, Genetic Abnormality, Ultrasound Guided 1C Existing SI817U
Chorionic Biopsy
94 SI818U Uterus, Genetic Abnormality/Fetal Maturity, 1C Existing SI818U
with/without Ultrasound Guided Amniocentesis
95 SI819U Uterus, Gravid, Evacuation (complicated) 2B Existing SI819U
96 SP819U Uterus, Gravid, Evacuation (complicated) 2B Existing SP819U
97 SI820U Uterus, Gravid, Evacuation (simple/TOP) 2A Existing SI820U
98 SP820U Uterus, Gravid, Evacuation (simple/TOP) 2A Existing SP820U
99 SI821U Uterus, Gravid, Hysterectomy 4A Existing SI821U
100 SI822U Uterus, Gravid, Hysterotomy 4A Existing SI822U
101 SI711U Uterus, Hysterectomy & Pelvic 6A Existing SI711U
Lymphadenectomy, MIS
102 SI805U Uterus, Hysterectomy, Frozen Pelvis 5C Existing SI805U
103 SI712U Uterus, Hysterectomy, MIS (Complicated) (>12 5A Existing SI712U
weeks)
104 SI713U Uterus, Hysterectomy, MIS (Simple) (<12 weeks) 4B Existing SI713U
105 SI714U Uterus, Intrauterine Insemination MSP Existing SI714U
106 SI823U Uterus, Inversion, Repositioning 3C Existing SI823U
107 SI715U Uterus, Laparoscopic ablation of Endometriosis, 3C Existing SI715U
MIS (Simple) (As single procedure, not involving
Rectum, Ureter)
108 SI716U Uterus, Lysis of Asherman's (Complicated), 3A Existing SI716U
hysteroscopic
109 SI717U Uterus, Lysis of Asherman's (Simple), 2C Existing SI717U
hysteroscopic
110 SI824U Uterus, Malignant Condition, Anterior Pelvic 6B Existing SI824U
Exenteration
111 SI825U Uterus, Malignant Condition, Extended 5C Existing SI825U
Hysterectomy with/without lymphadenectomy
112 SI826U Uterus, Malignant Condition, Posterior Pelvic 6B Existing SI826U
Exenteration
113 SI827U Uterus, Malignant condition, Total Hysterectomy 5A Existing SI827U
with/without salpingo-oophorectomy, with lymph
node dissection (without ureteric dissection)
114 SI828U Uterus, Malignant Conditions, Total Hysterectomy 4A Existing SI828U
with/without Salpingo-Oophorectomy
115 SI829U Uterus, Malignant Conditions, Total Pelvic 7C Existing SI829U
Exenteration
A-3-69
CONFIDENTIAL
code code
116 SI830U Uterus, Malignant Conditions, Wertheim's 6B Existing SI830U
Operation including pelvic lymphadenectomy
117 SI831U Uterus, Perforation, Repair 3C Existing SI831U
118 SI832U Uterus, Pregnancy and Multiparity, Lower 4B Existing SI832U
Segment/Classical Caesarean Section and Tubal
Ligation
119 SP832U Uterus, Pregnancy and Multiparity, Lower 4B Existing SP832U
Segment/Classical Caesarean Section and Tubal
Ligation
120 SI833U Uterus, Pregnancy, Assisted Vaginal Delivery ± 3A Existing SI833U
Twins ± Breech
121 SP833U Uterus, Pregnancy, Assisted Vaginal Delivery ± 3A Existing SP833U
Twins ± Breech
122 SI834U Uterus, Pregnancy, Caesarean Section 4A Existing SI834U
(classical/lower segment)
123 SP834U Uterus, Pregnancy, Caesarean Section 4A Existing SP834U
(classical/lower segment)
124 SI835U Uterus, Pregnancy, Caesarean Section with 5C Existing SI835U
Hysterectomy
125 SP835U Uterus, Pregnancy, Caesarean Section with 5C Existing SP835U
Hysterectomy
126 SI836U Uterus, Pregnancy, Vaginal Delivery (with or 2B Existing SI836U
without episiotomy repair)
127 SP836U Uterus, Pregnancy, Vaginal Delivery (with or 2B Existing SP836U
without episiotomy repair)
128 SI719U Uterus, Prolapse, Cystocoele, Rectocoele, 4B Existing SI719U
Amputation of Cervix + Vaginal Sacrospinous
Ligament Hysteropexy + Anteior Repair +
Posterior Repair
Transobturator Mesh + Transsacrospinous
Ligament Mesh
Vaginal Hysterectomy + Anterior Repair +
Bilateral Salpingo-oophorectomy ± Posterior
Repair
Vaginal Sacrospinous Ligament Hysteropexy +
Anterior Repair + Posterior Repair
132 SI837U Uterus, Prolapse, Vaginal Hysterectomy 4A Existing SI837U
133 SI723U Uterus, Prolapse, Vaginal Hysterectomy + 4B Existing SI723U
Bilateral Salpingo-oophorectomy
134 SI838U Uterus, Retained Placenta, Manual Removal in 1B Existing SI838U
OT/GA
135 SI839U Uterus, Retroversion, Ventrosuspension 3A Existing SI839U
136 SI840U Uterus, Ruptured, Repair (complicated) 4A Existing SI840U
137 SI841U Uterus, Ruptured, Repair (simple) 3B Existing SI841U
138 SI842U Uterus, Various Lesions, Curettage with 2C Existing SI842U
Colposcopy/Biopsy/Diathermy/ Cryosurgery/Laser
Therapy of Cervix
139 SI843U Uterus, Various Lesions, Curettage with/without 2A Existing SI843U
Dilatation
140 SI724U Uterus/cervix, Hysteroscopic Cannulation 2B Existing SI724U
A-3-70
CONFIDENTIAL
code code
141 SI701U Uterus/cervix, Hysteroscopy, Diagnostic (without 1A Existing SI701U
Anaesthesia)
142 SI700U Uterus/cervix, Hysteroscopy, diagnostic (with 1C Existing SI700U
General Anesthesia)
143 SI725U Uterus/cervix, Hysteroscopy, Diagnostic, D&C 2B Existing SI725U
144 SI726U Uterus/vagina, Laparoscopic Reconstruction of 5C Existing SI726U
Frozen Pelvis/Lateral Pelvic Wall Dissection;
Extirpation of Rectovaginal Endometriosis
145 SI718U Uterus/vagina, Laparoscopically assisted vaginal 4B Existing SI718U
hysterectomy (LAVH) with/without Pelvic Floor
Repair (PFR)
146 SI800V Vagina, Atresia, Vaginoplasty 4B Existing SI800V
147 SI801V Vagina, Atresia/Stenosis, Dilatation 1B Existing SI801V
148 SI802V Vagina, Cystocoele, Anterior Repair / Kelly's 3B Existing SI802V
Operation
149 SI700V Vagina, Cystocoele, Paravaginal Defect Repair 4A Existing SI700V
(Abdominal) / Burch Colposuspension
150 SI701V Vagina, Cystocoele, Rectocoele, Anterior Repair / 3B Existing SI701V
Kelly's Operation + Posterior Repair
151 SI702V Vagina, Cystocoele, Transobturator Mesh 3B Existing SI702V
152 SI703V Vagina, Enterocoele, Cystocoele, Rectocoele, 5A Existing SI703V
Abdominal Sacrocolpopexy + Paravaginal Defect
Repair/Burch Colposuspension + Posterior Repair
153 SI704V Vagina, Enterocoele, Cystocoele, Rectocoele, 4A Existing SI704V
Vaginal Sacrospinous Ligament / Iliococcygeus
Fixation + Anterior Repair + Posterior Repair
154 SI803V Vagina, Enterocoele, Repair/Vaginal Vault 5A Existing SI803V
Suspension (abdominal)
155 SI804V Vagina, Fistula, Repair (complicated/Multiple) 5A Existing SI804V
156 SI805V Vagina, Fistula, Repair (simple) 4A Existing SI805V
157 SI806V Vagina, Foreign Body, Removal 1A Existing SI806V
158 SI807V Vagina, Incarcerated Pessary, Removal 2B Existing SI807V
159 SI705V Vagina, Intra-Epithelial Neoplasia 4B Existing SI705V
Complete/Upper Vaginectomy
160 SI706V Vagina, Intra-Epithelial Neoplasia Vaginectomy 3C Existing SI706V
(Partial)
161 SI808V Vagina, Lacerations (complex and involving anal 2C Existing SI808V
sphincter) and Debridement/Suture under General
Anaesthesia
162 SI809V Vagina, Lacerations (simple), Debridement/Suture 1C Existing SI809V
(excludes Episiotomy)
163 SI810V Vagina, Malignant Condition, Vaginectomy 4B Existing SI810V
164 SI811V Vagina, Pelvic Abscess, Colpotomy and Drainage 2C Existing SI811V
165 SI812V Vagina, Prolapse, Colporrhaphy 4A Existing SI812V
166 SI813V Vagina, Prolapse, Insertion of Pessary MSP Existing SI813V
167 SI814V Vagina, Prolapse, Obliteration (Colpocleisis) 3B Existing SI814V
168 SI815V Vagina, Rectocoele, Posterior Repair 2C Existing SI815V
169 SI816V Vagina, Simple Tumor/Gartner's Cyst, Removal 2B Existing SI816V
With Biopsy
A-3-71
CONFIDENTIAL
code code
170 SI708V Vagina, Stress Incontience, Combined Prolapse, 4C Existing SI708V
Total Abdominal Hysterectomy ± Bilateral
Salpingo-oophorectomy + Burch
Colposuspension/Paravaginal Defect Repair +
Vault Suspension + Posterior Repair
171 SI818V Vagina, Stress Incontinence, Abdominal 4B Existing SI818V
/combined Abdominovaginal Sling operations ( eg.
Watkins Interposition, Aldridge sling and other
pubovaginal sling operations) +/_ Cystoscopy
172 SI709V Vagina, Stress Incontinence, Combined Prolapse, 4B Existing SI709V
Mid-Urethral Tape/Sling (± Cystoscopy) + Vaginal
Hysterectomy + Anterior Repair + Posterior
Repair
173 SI707V Vagina, Stress Incontinence, Cystocoele, 4B Existing SI707V
Rectocoele, Mid-urethral Tape/Sling (±
Cystoscopy) + Anterior Repair + Posterior Repair
174 SI817V Vagina, Stress Incontinence, Kelly's Operation +/- 3C Existing SI817V
Anterior Repair.
175 SI710V Vagina, Tension Free Vaginal Tape (TVT/TVTO) 4A Uptabled SI710V
176 SI819V Vagina, Various Lesions, Biopsy 1A Existing SI819V
177 SI711V Vagina/rectum, Recto Vaginal Fistula, complex 5B Existing SI711V
Rectal / Transperineal Approach with colostomy
178 SI712V Vagina/rectum, Recto Vaginal Fistula, complex 4C Existing SI712V
Rectal / Transperineal Approach without
colostomy
179 SI713V Vaginal Hysterectomy + Anterior Repair +/- 4A Existing SI713V
Posterior Repair
180 SI714V Vaginal Septum, excision 2A Existing SI714V
181 SI820V Vulva, Abscess, Incision 1B Existing SI820V
182 SI821V Vulva, Atresia/Absence, Detachment of Skin 2B Existing SI821V
Pedicle after Vaginoplasty
183 SI822V Vulva, Bartholin Cyst, Excision with/without use of 2B Existing SI822V
Laser
184 SI823V Vulva, Bartholin Cyst, Incision/Marsupialization 1B Existing SI823V
with or without use of Laser
185 SI824V Vulva, Chronic Dystrophy, Biopsy MSP Existing SI824V
186 SI826V Vulva, Hematoma, Evacuation <5cm (simple) 1A Existing SI826V
187 SI825V Vulva, Hematoma, Evacuation > 5cm 2A Existing SI825V
(complicated/more than 1)
188 SI827V Vulva, Imperforate Hymen, Hymenectomy 1B Existing SI827V
189 SI715V Vulva, Labial Abnormality, Hymenoplasty 1B Existing SI715V
190 SI828V Vulva, Labial Abnormality, Labioplasty 1B Existing SI828V
191 SI830V Vulva, Laceration, Debridement/Suture <5cm MSP Existing SI830V
(Simple)
192 SI829V Vulva, Laceration, Debridement/Suture >5cm 1C Existing SI829V
(complicated/ more than 1)
193 SI716V Vulva, Malignant Condition Wide Local Excision 4B Existing SI716V
with Skin Flap Closure
194 SI717V Vulva, Malignant Condition, Radical Vulvectomy + 6C Existing SI717V
Groin + Pelvic Node Dissection
195 SI831V Vulva, Malignant Condition, Radical Vulvectomy 6B Existing SI831V
with groin dissection and with or without skin flap
closure
A-3-72
CONFIDENTIAL
code code
196 SI718V Vulva, Malignant Condition, Simple Vulvectomy + 5C Existing SI718V
Groin Dissection
197 SI832V Vulva, Malignant Condition, Simple Vulvectomy 5A Existing SI832V
with Skin Flap Closure
198 SI719V Vulva, Malignant Condition, Wide Local Excision 3C Existing SI719V
199 SI833V Vulva, Sebaceous Cyst/Epithelialcyst Etc, MSP Existing SI833V
Exicision
200 SI834V Vulva, Tight Introitus, Fenton's Operation 1C Existing SI834V
201 SI835V Vulva, Warts, Laser Vaporisation 1B Existing SI835V
202 SI720V Vulva/Vagina, Various Lesions, Colposcopy and 1B Existing SI720V
Laser Vaporisation
A-3-73
CONFIDENTIAL
SJ – ENDOCRINE
code code
1 SJ700A Adrenal, Various Lesions, Adrenal Venous 3B Existing SJ700A
Sampling
2 SJ800A Adrenals, Various Lesions, Biopsy/Excision (open 6B Existing SJ800A
or lap)
3 SJ800P Parathyroid, Various Lesions, Excision 5C Existing SJ800P
4 SJ801P Parathyroid, Various Lesions, Re Exploration 6B Existing SJ801P
5 SJ700P Pituitary, Various lesions, Transphenoidal 7B Existing SJ700P
transseptal or endoscopic
6 SJ802P Pituitary, Various Lesions, Transsphenoidal 7C Existing SJ802P
Hypophysectomy with Resection of Nasal Septum
& Grafting
7 SJ701P Pituitary, Various Lesions, Transsphenoidal 6B Existing SJ701P
Hypophysectomy/Excision of Tumor
8 SJ800T Thyroglossal Duct, Cyst Fistula, Excision 3B Existing SJ800T
9 SJ801T Thyroid, Tumor, Excision 3B Existing SJ801T
10 SJ802T Thyroid, Various Lesions, 4A Existing SJ802T
Hemithyroidectomy/Partial Thyroidectomy
11 SJ701T Thyroid, Various Lesions, Imaging Guided 1B Existing SJ701T
Percutaneous Aspiration / Biopsy
12 SJ700T Thyroid, Various Lesions, Needle Biopsy MSP Existing SJ700T
13 SJ702T Thyroid, Various Lesions, Total Thyroidectomy 6A Existing SJ702T
Complex (Recurrence) / with/without Sternal Split
14 SJ803T Thyroid, Various Lesions, Total/Subtotal 5C Existing SJ803T
Thyroidectomy
15 SJ703T Thyroid, Various Lesions, Total/Subtotal 6C Existing SJ703T
Thyroidectomy with Block Dissection (bilateral)
16 SJ804T Thyroid, Various Lesions, Total/Subtotal 6A Existing SJ804T
Thyroidectomy with Block Dissection (unilateral)
A-3-74
CONFIDENTIAL
SK – NERVOUS
code code
1 SK800A Artery, Arterio-Venous Fistula, Ligation 2A Existing SK800A
2 SK700A Artery, Carotico-Cavernous Fistula, Embolisation 6B Existing SK700A
3 SK701A Artery, Extracranial, Various Lesions, Balloon 3B Existing SK701A
Test Occlusion
4 SK702A Artery, Extracranial, Various Lesions, Diagnostic 3A Existing SK702A
Extracranial Angiography
5 SK703A Artery, Extracranial, Various Lesions, Infusion 3C Existing SK703A
6 SK704A Artery, Extracranial, Various Lesions, 4B Existing SK704A
Percutaneous Transcatheter Embolization
7 SK705A Artery, Extracranial, Various Lesions, 4A Existing SK705A
Percutaneous Transluminal Angioplasty
8 SK706A Artery, Extracranial, Various Lesions, Stenting 4B Existing SK706A
9 SK707A Artery, Intracranial, Aneurysm/Arterio-Venous 6B Existing SK707A
Malformation, Embolisation
10 SK708A Artery, Intracranial, Thrombosis, Percutaneous 6B Existing SK708A
Catheter Directed Thrombolysis/Thrombectomy
11 SK709A Artery, Intracranial, Tumour, Percutaneous 4B Existing SK709A
Transcatheter Embolization
12 SK710A Artery, Intracranial, Various Lesions, Diagnostic 3A Existing SK710A
Cerebral Angiography
13 SK711A Artery, Intracranial, Various Lesions, 6A Existing SK711A
Percutaneous Transluminal Angioplasty
14 SK712A Artery, Intracranial, Various Lesions, Stenting 6B Existing SK712A
15 SK713A Artery, Spinal, Aneurysm/Arterio-Venous 6B Existing SK713A
Malformation, Embolisation
16 SK714A Artery, Spinal, Tumour, Percutaneous 4B Existing SK714A
Transcatheter Embolization
17 SK715A Artery, Spinal, Various Lesions, Diagnostic 3B Existing SK715A
Angiography
18 SK716A Artery-Carotid, Aneurysm-repair/grafting 7B Existing SK716A
19 SK717A Artery-Carotid, Arterio-Occlusive Lesions, 7A Existing SK717A
External Carotid Internal Carotid Bypass,
Complex
20 SK801A Artery-Carotid, Arterio-Occlusive Lesions, 6B Existing SK801A
External Carotid Internal Carotid Bypass, Simple
21 SK802A Artery-Carotid, Atherosclerosis, Carotid 6B Existing SK802A
Endarterectomy
22 SK803A Artery-Carotid, Carotid Body Tumor, Excision 6C Existing SK803A
23 SK800B Brain and Spine, Arachnoidal Cyst, Operation 6B Existing SK800B
24 SK700B Brain, Acoustic Tumor/Cerebello-Pontine Angle 7C Existing SK700B
Tumor, Excision, complex
25 SK801B Brain, Acoustic Tumor/Cerebello-Pontine Angle 7A Existing SK801B
Tumor, Excision, simple
26 SK701B Brain, Aneurysm/Arterio-Venous Malformation, 7A Existing SK701B
Clipping/Excision, Complex
27 SK802B Brain, Aneurysm/Arterio-Venous Malformation, 6C Existing SK802B
Clipping/Excision, Simple
28 SK803B Brain, Carotico-Cavernous Fistula, Extracranial 7B Existing SK803B
and Intracranial Trapping
29 SK702B Brain, Cortical Stimulation/Mapping for Functional 7A Existing SK702B
Neurosurgery
30 SK703B Brain, Deep Brain Stimulation, Bilateral 7C Existing SK703B
A-3-75
CONFIDENTIAL
SK – NERVOUS
code code
31 SK704B Brain, Deep Brain Stimulation, Unilateral 7A Existing SK704B
32 SK705B Brain, Epilepsy, Craniotomy, Complex (awake 7A Existing SK705B
craniotomy)
33 SK804B Brain, Epilepsy, Craniotomy, simple 6B Existing SK804B
34 SK805B Brain, Hydrocephalus and Other Lesions, 4A Existing SK805B
Ventriculoatrial/ Ventriculoperitoneal Shunt
35 SK706B Brain, Hydrocephalus and Other Lesions, 4C Existing SK706B
Ventriculoatrial/Ventriculoperitoneal Shunt,
Bilateral
36 SK707B Brain, Hydrocephalus, External Ventricular 4A Existing SK707B
Drainage, Bilateral
37 SK806B Brain, Hydrocephalus, External Ventricular 3B Existing SK806B
Drainage, Unilateral
38 SK807B Brain, Hydrocephalus, Revision/Removal of Shunt 4A Existing SK807B
39 SK808B Brain, Hydrocephalus, Spino-peritoneal Shunt 4A Existing SK808B
40 SK809B Brain, Hydrocephalus, Third Ventriculostomy 6A Existing SK809B
41 SK708B Brain, Intracerebral Tumor, Biopsy and/or 7A Existing SK708B
Decompression/Removal via Craniotomy,
Complex
42 SK810B Brain, Intracerebral Tumor, Biopsy and/or 6B Existing SK810B
Decompression/Removal via Craniotomy, Simple
43 SK811B Brain, Intracranial Abscess, Craniectomy and 6A Existing SK811B
Drainage
44 SK812B Brain, Intracranial Abscess, Drainage via Burr- 4A Existing SK812B
hole
45 SK813B Brain, Intracranial Abscess, Excision 6B Existing SK813B
46 SK709B Brain, Intracranial Extracerebral Tumor, 7A Existing SK709B
Craniotomy & Removal, Complex
47 SK814B Brain, Intracranial Extracerebral Tumor, 6B Existing SK814B
Craniotomy & Removal, Simple
48 SK710B Brain, Intracranial Extracerebral Tumor, 6B Existing SK710B
Craniotomy/ Hemispherectomy
49 SK815B Brain, Intracranial Tumor/Intracranial Cyst, 5C Existing SK815B
Biopsy/Drainage via Burr-hole
50 SK816B Brain, Tumor, Ventricular Puncture through Burr- 4C Existing SK816B
hole
51 SK818B Brain, Various Lesions, Insertion of Ommaya 4A Existing SK818B
Reservoir
52 SK711B Brain, Various Lesions, 6A Existing SK711B
Pallidotomy/Thalamotomy/Other Stereotactic
Procedure - Bilateral
53 SK817B Brain, Various Lesions, 6A Existing SK817B
Pallidotomy/Thalamotomy/Other Stereotactic
Procedure - Unilateral
54 SK712B Brain/Spine Endoscopic CSF (Cerebrospinal Fluid 6B Existing SK712B
Leak) leak repair
55 SK700C Cervical Roots, Brachial plexus block - catheter 1C Existing SK700C
56 SK701C Cervical Roots, Brachial plexus block - injection 1B Existing SK701C
57 SK702C Cervical Roots, Brachial plexus, Brachial plexus 6B Existing SK702C
injury, Exploration and Neurotisation and/or
multiple nerve grafting/crossed nerve transfers
58 SK703C Cervical Roots, Brachial plexus, Brachial plexus 7B Existing SK703C
injury, Exploration, neurolysis
A-3-76
CONFIDENTIAL
SK – NERVOUS
code code
59 SK701F Facial, Trigeminal block, neurolytic 2A Existing SK701F
60 SK700F Facial, Trigeminal ganglion injection, anaesthetic, 3A Existing SK700F
Imaging Guided
61 SK702F Facial, Trigeminal ganglion, radiofrequency, 3C Existing SK702F
neurolytic, Imaging guided
62 SK701L Lumbar, Lumbar plexus, catheter 1C Existing SK701L
63 SK702L Lumbar, Lumbar plexus, single 1B Existing SK702L
64 SK700L Lumbar, Lumbar sympathetic nerve 2B Existing SK700L
block/thoracic/lumbar, anaesthetic, catheter,
Imaging Guided, unilateral
65 SK703L Lumbar, Lumbar sympathetic; anaesthetic 1B Existing SK703L
66 SK704L Lumbar, Lumbar sympathetic; neurolytic 2A Existing SK704L
67 SK800M Meninges, Myelomeningocele, Excision of Sac 6A Existing SK800M
68 SK801M Meninges, Myelomeningocele, Extensive Repair 6B Existing SK801M
with Skin Flaps/Z-plasty
69 SK713N Nerve (Lower Limb), Disruption, Major 6B Existing SK713N
Reconstruction with Repair and/or Neurovascular
Transfer
70 SK714N Nerve (Lower Limb), Disruption, Major Repair 4A Existing SK714N
(single)
71 SK715N Nerve (Lower Limb), Entrapment Syndrome, 3C Existing SK715N
Decompression
72 SK707N Nerve (Orofacial), Defect, Graft (Multiple) Using 6A Existing SK707N
Microsurgical Techniques (include harvesting)
73 SK708N Nerve (Orofacial), Defect, Graft (Single)/Nerve 5A Existing SK708N
Share, Using Microsurgical Techniques (include
harvesting)
74 SK709N Nerve (Orofacial), Injury, Decompression 4A Existing SK709N
(Multiple/Single Intraosseous)
75 SK710N Nerve (Orofacial), Injury, Decompression (Single) 3A Existing SK710N
76 SK711N Nerve (Orofacial), Injury, Microsurgical Repair 5A Existing SK711N
(Multiple/ Single Intraosseous)
77 SK712N Nerve (Orofacial), Injury, Microsurgical Repair 4A Existing SK712N
(Single)
78 SK717N Nerve (Upper Limb), Carpal Tunnel Syndrome, 3A Existing SK717N
Release (unilateral) (with Endoneurolysis)
79 SK716N Nerve (Upper Limb), Carpal Tunnel Syndrome, 4A Existing SK716N
Release, Bilateral, (with Endoneurolysis)
80 SK719N Nerve (Upper Limb), Defect, Graft (single) using 4B Existing SK719N
microsurgical techniques
81 SK720N Nerve (Upper Limb), Defect, 6B Existing SK720N
Grafting/Interfascicular Repair/Neurovascular
Transfer
82 SK721N Nerve (Upper Limb), Entrapment Syndrome 3C Existing SK721N
(others), Decompression (bilateral)
83 SK722N Nerve (Upper Limb), Entrapment Syndrome 3A Existing SK722N
(others), Decompression (unilateral)
84 SK723N Nerve (Upper Limb), Entrapment Syndrome 4A Existing SK723N
(others), Decompression with Nerve
Transposition/Endoneurolysis
85 SK724N Nerve (Upper Limb), Guyon's Tunnel Syndrome, 4A Existing SK724N
Release (bilateral with Endoneurolysis)
A-3-77
CONFIDENTIAL
SK – NERVOUS
code code
86 SK725N Nerve (Upper Limb), Guyon's Tunnel Syndrome, 3A Existing SK725N
Release (unilateral)
87 SK726N Nerve (Upper Limb)-major, Injury, Microsurgical 5C Existing SK726N
Repair (multiple)
88 SK727N Nerve (Upper Limb)-major, Injury, Microsurgical 4B Existing SK727N
Repair (single)
89 SK718N Nerve defect, peripheral graft (microsurgery) 5C Existing SK718N
90 SK700N Nerve Root, Various lesions, Imaging Guided 2B Existing SK700N
Nerve root block (injection of anaesthetic,
therapeutic substance) - Cervical, > 1 level
91 SK701N Nerve Root, Various lesions, Imaging Guided 2A Existing SK701N
therapeutic substance) - Cervical, 1 level
92 SK737N Nerve Root, Various lesions, Imaging Guided 2A Existing SK737N
therapeutic substance) - Lumbar / Thoracic, > 1
level
93 SK738N Nerve Root, Various lesions, Imaging Guided 1C Existing SK738N
therapeutic substance) - Lumbar / Thoracic, 1
level
94 SK728N Nerve Roots, Dorsal root ganglion, anaesthetic, 3A Existing SK728N
cervical, Imaging Guided, one to two
95 SK729N Nerve Roots, Dorsal root ganglion, anaesthetic, 3C Existing SK729N
Imaging Guided more than two
96 SK730N Nerve Roots, Dorsal root ganglion, anaesthetic, 2B Existing SK730N
Imaging Guided, one to two
97 SK731N Nerve Roots, Dorsal root ganglion, 4C Existing SK731N
radiofrequency, neurolytic , Imaging Guided, more
than two
98 SK732N Nerve Roots, Dorsal root ganglion, 4B Existing SK732N
radiofrequency, neurolytic, Imaging Guided, one
to two
99 SK702N Nerve, Cervical plexus, single 1B Existing SK702N
neurolytic/anaesthetic
100 SK703N Nerve, Coeliac Plexus, Various lesions, Imaging 2B Existing SK703N
Guided Injection of Anaesthetic
101 SK705N Nerve, Coeliac Plexus, Various lesions, Imaging 2C Existing SK705N
Guided Injection of Neurolytic
102 SK704N Nerve, Coeliac plexus; anaesthetic 2A Existing SK704N
103 SK706N Nerve, Coeliac plexus; neurolytic 2B Existing SK706N
104 SK733N Nerve, Peripheral nerve block, anaesthetic 1A Existing SK733N
105 SK734N Nerve, Peripheral Nerve block, anaesthetic up to 1A Existing SK734N
2
106 SK735N Nerve, Peripheral Nerve block, anaesthetic,more 1C Existing SK735N
than 2
107 SK736N Nerve, Peripheral nerve block, neurolytic 1B Existing SK736N
108 SK739N Nerve, Peripheral Nerve block, neurolytic, cryo, 1C Existing SK739N
radiofrequency up to 2
109 SK740N Nerve, Peripheral Nerve block, neurolytic, cryo, 2B Existing SK740N
radiofrequency,more than 2
110 SK741N Nerve, Vagus Nerve Stimulator 6A Existing SK741N
111 SK800N Nerve, Various Lesions, Biopsy 1B Existing SK800N
A-3-78
CONFIDENTIAL
SK – NERVOUS
code code
112 SK801N Nerve, various lesions, primary/secondary suture 4A Existing SK801N
113 SK802N Nerve-Cranial, Various Lesions, Microvascular 6B Existing SK802N
Decompression/Neurectomy
114 SK803N Nerve-Cutaneous, Injury, Primary Suture 3B Existing SK803N
115 SK744N Nerve-Digital, Injury, Microsurgical Repair 4B Existing SK744N
(multiple)
116 SK745N Nerve-Digital, Injury, Microsurgical Repair (single) 2C Existing SK745N
117 SK804N Nerve-Digital, Injury, Primary Repair 2C Existing SK804N
118 SK805N Nerve-Facial (Mastoid Portion), Entrapment, 5C Existing SK805N
Decompression
119 SK746N Nerve-facial Paralysis, free fascia and/or nerve 3B Existing SK746N
graft (microsurgical – stage 1)
120 SK748N Nerve-facial paralysis, free fascia sling/graft 3A Existing SK748N
(single/unilateral)
121 SK747N Nerve-facial Paralysis, free muscle flap 7B Existing SK747N
(microsurgical – stage 2)
122 SK749N Nerve-facial paralysis, local muscle transfer 5A Existing SK749N
123 SK806N Nerve-Facial, Various Lesions, Combined Middle 7C Existing SK806N
Fosa and Transmastoid Facial Nerve
Decompression
124 SK807N Nerve-Peripheral (deep), Tumor, Excision 4A Existing SK807N
125 SK808N Nerve-Peripheral (superficial), Tumor, Excision 3A Existing SK808N
126 SK809N Nerve-Sympathetic, Various Lesions, 5A Existing SK809N
Sympathectomy, with/without Video-assistance,
Bilateral
127 SK810N Nerve-Sympathetic, Various Lesions, 4B Existing SK810N
Sympathectomy, with/without Video-assistance,
Unilateral
128 SK811N Nerve-Trigeminal (Ganglion), Neurolagia, 4B Existing SK811N
Injection with alcohol/Radiofrequency
Ganglionotomy, imaging guided
129 SK812N Nerve-Ulnar, Entrapment, Transposition 5A Existing SK812N
130 SK742N Neurostimulator, Insertion of Internal Pulse 4B Existing SK742N
Generator, involves opening of wound, tunneling,
opening of pouch for IPG & testing of system
131 SK743N Neurostimulator, Revision/Replacement of 3B Existing SK743N
Implantable Pulse Generator (does not involve
tunneling)
132 SK800P Plexus-Brachial, Injury, Exploration 6B Existing SK800P
133 SK706S Sacral root block, neurolytic, radiofrequency, 2C Existing SK706S
Imaging Guided, up to 2
134 SK707S Sacral root block, neurolytic, radiofrequency, 4A Existing SK707S
Imaging guided, up to 4
135 SK715S Sacro-iliac Joint, Various lesions, Imaging Guided 4A Existing SK715S
radiofrequency – Bilateral
136 SK716S Sacro-iliac Joint, Various lesions, Imaging Guided 2B Existing SK716S
Sacro-iliac Joint Block (injection of anaesthetic,
therapeutic substance) - Bilateral
137 SK717S Sacro-iliac Joint, Various lesions, Imaging Guided 1B Existing SK717S
Sacro-iliac Joint Block (injection of anaesthetic,
therapeutic substance) - Unilateral
138 SK718S Sacro-iliac Joint, Various lesions, Imaging 3A Existing SK718S
Guided, radiofrequency - Unilateral
A-3-79
CONFIDENTIAL
SK – NERVOUS
code code
139 SK708S Sacrum, Sacral ganglion, radiofrequency, Imaging 4B Existing SK708S
Guided
140 SK709S Sacrum, Sacral ganglion, therapeutic, 3A Existing SK709S
anaesthetic, Imaging Guided
141 SK710S Sciatic nerve block 1A Existing SK710S
142 SK721S Skull, Burr hole, Insertion of intracranial pressure 3B Existing SK721S
(ICP) monitor
143 SK722S Skull, Chiari Malformation/syringomyelia, 7A Existing SK722S
Posterior fossa decompression with duraplasty
144 SK800S Skull, Compound Fracture with Dural Penetration 6B Existing SK800S
and Brain Damage, Operation
145 SK801S Skull, Compound Fracture without Dural 5C Existing SK801S
Penetration, Operation
146 SK802S Skull, Craniostenosis (multiple suture), Operation 6B Existing SK802S
147 SK803S Skull, Craniostenosis (single suture), Operation 6A Existing SK803S
148 SK719S Skull, Craniostenosis, Operation, Craniofacial 7A Existing SK719S
Reconstruction
149 SK804S Skull, Defect, Cranioplasty (large) 5C Existing SK804S
150 SK805S Skull, Defect, Cranioplasty (small) 5A Existing SK805S
151 SK806S Skull, Depressed/Comminuted Fracture, Elevation 5C Existing SK806S
152 SK807S Skull, Fracture with Rhinorrhoea/Otorrhoea, 6B Existing SK807S
Cranioplasty and Repair
153 SK809S Skull, Intracranial Hemorrhage, Burr-hole 4A Existing SK809S
Craniotomy (unilateral)
154 SK808S Skull, Intracranial Hemorrhage, Burr-hole 5A Existing SK808S
Craniotomy, Bilateral
155 SK720S Skull, Intracranial Hemorrhage, Osteoplastic 6A Existing SK720S
Craniotomy/Extensive Craniectomy, Bilateral
156 SK810S Skull, Intracranial Hemorrhage, Osteoplastic 5C Existing SK810S
Craniotomy/Extensive Craniectomy, Unilateral
157 SK811S Skull, Osteomyelitis, Craniectomy 5C Existing SK811S
158 SK723S Sphenopalatine ganglion radiofrequency, Imaging 3C Existing SK723S
Guided
159 SK812S Spinal Cord, Aneurysm/Arterio-Venous 7A Existing SK812S
Malformation Clipping/ Excision
160 SK813S Spinal Cord, Intractable Pain, Injection of 4A Existing SK813S
Alcohol/Phenol
161 SK814S Spinal Cord, Intractable Pain, Percutaneous 5C Existing SK814S
Cordotomy
162 SK724S Spinal Cord, Stimulation/Modulation, 5C Existing SK724S
Closed/Percutaneous
163 SK725S Spinal Cord, Stimulation/Modulation, Open 5C Existing SK725S
164 SK726S Spinal Cord, Tumours, laminectomy and excision 6B Existing SK726S
(extradural)
165 SK727S Spinal Cord, Tumours, laminectomy and excision 6C Existing SK727S
(intradural extramedullary)
166 SK728S Spinal Cord, Tumours, laminectomy and excision 7A Existing SK728S
(intradural intramedullary)
167 SK729S Spinal- implant of electrical pump device 5C Existing SK729S
168 SK815S Spinal Nerve Roots, Various Lesions, Spinal 6C Existing SK815S
Rhizolysis involving Exposure of Spinal Nerve
Roots
A-3-80
CONFIDENTIAL
SK – NERVOUS
code code
169 SK730S Spinal/Epidural removal, revision of implanted 2C Existing SK730S
Reservoir device (e.g. PAR)
170 SK731S Spinal/Epidural, Epidural Adhesiolysis, multiple 3C Existing SK731S
catheter, Thoracic, lumbar, Imaging Guided
171 SK732S Spinal/Epidural, Epidural Adhesiolysis, Single 4B Existing SK732S
catheter, Cervical, Imaging guided
172 SK733S Spinal/Epidural, Epidural Adhesiolysis, single 3B Existing SK733S
catheter, Thoracic / Lumbar Imaging Guided
173 SK700S Spinal/Epidural, Epidural Blood Patch 1B Existing SK700S
174 SK734S Spinal/Epidural, Epiduroscopy 2A Existing SK734S
175 SK703S Spinal/Epidural, Facet Joint, Various lesions, 2C Existing SK703S
Imaging Guided Facet Joint Block (injection of
anaesthetic, therapeutic substance) - Cervical /
Lumbar / Thoracic, More than 3 joints
176 SK702S Spinal/Epidural, Facet Joint, Various lesions, 2B Existing SK702S
Imaging Guided Facet Joint Block (injection of
anaesthetic, therapeutic substance) - Cervical /
Lumbar / Thoracic, Up to 3 joints
177 SK705S Spinal/Epidural, Facet Joint, Various lesions, 4A Existing SK705S
Imaging Guided, Radiofrequency,
Cervical/Lumbar/Thoracic, More than 3 joints
178 SK704S Spinal/Epidural, Facet Joint, Various lesions, 3C Existing SK704S
Imaging Guided, Radiofrequency,
Cervical/Lumbar/Thoracic, Up to 3 joints
179 SK735S Spinal/Epidural, Ganglion Impar Block, neurolytic, 3C Existing SK735S
imaging guided
180 SK750S Spinal/Epidural, Nerve root, Neurolytic 2B Existing SK750S
181 SK751S Spinal/Epidural, Spinal cord, Neurolytic 2B Existing SK751S
182 SK701S Spinal/Epidural/Subarachnoic, Implant of Port eg 2B Existing SK701S
Port-a-cath
183 SK711S Spine, Paravertebral anaesthetic,more than 2 2A Existing SK711S
184 SK712S Spine, Paravertebral, anaesthetic, Imaging 2B Existing SK712S
Guided, more than 2
185 SK713S Spine, Paravertebral, anaesthetic, Imaging 1C Existing SK713S
Guided up to 2 levels
186 SK714S Spine, Paravertebral, anaesthetic, up to 2 1B Existing SK714S
187 SK736S Spine, Percutaneous implant of spinal cord 4B Existing SK736S
stimulator, (permanent) and electrical generator
188 SK737S Spine, Percutaneous implant of spinal cord 3B Existing SK737S
Stimulator, (trial), single lead
189 SK738S Spine, Percutaneous implant of spinal cord 3C Existing SK738S
stimulator,(trial), double leads
190 SK739S Spine, Removal of spinal cord stimulator electrical 3A Existing SK739S
generator
191 SK740S Spine, Replacement of computerized reservoir 3B Existing SK740S
device (e.g. Synchromed)
192 SK741S Spine, Replacement of spinal cord stimulator, 3B Existing SK741S
electrical generator
193 SK742S Spine, Single injection, anaesthetic, blood, 1C Existing SK742S
therapeutic substance, lumbar, caudal, simple
194 SK743S Spine, Various lesions, Imaging Guided Epidural / 2A Existing SK743S
Spinal catheter / drain Insertion
A-3-81
CONFIDENTIAL
SK – NERVOUS
code code
195 SK744S Spine, Various lesions, Imaging Guided Epidural 2A Existing SK744S
Injection (anaesthetic, therapeutic substance) -
Lumbar / Caudal
196 SK745S Spine, Various lesions, Imaging Guided Epidural 2C Existing SK745S
Injection (anaesthetic, therapeutic substance) -
Thoracic / Cervical
197 SK746S Spine, Various lesions, Imaging Guided Lumbar 1C Existing SK746S
Puncture / Myelogram / Intrathecal chemotherapy
198 SK748S Spine, Various lesions, Spinal Catheter, Insertion 1C Existing SK748S
199 SK749S Spine, Various lesions, Spinal injections, single 1B Existing SK749S
200 SK747S Spine, Various Lesions, Syringo- 6A Existing SK747S
arachnoid/pleural/peritoneal shunt
201 SK752S Splanchnic nerves, anaesthetic, Imaging Guided 2B Existing SK752S
202 SK753S Splanchnic nerves, radiofrequency, neurolytic, 2C Existing SK753S
Imaging Guided
203 SK754S Stellate ganglion block, anaesthetic 1B Existing SK754S
204 SK755S Stellate ganglion, Various lesions, Imaging 2A Existing SK755S
Guided Injection of Anaesthetic
205 SK756S Stellate ganglion, Various lesions, Imaging 2B Existing SK756S
Guided Injection of Neurolytic
206 SK757S Superior Hypogastric Plexus, Various lesions, 2B Existing SK757S
Imaging Guided Injection of Anaesthetic
207 SK758S Superior Hypogastric Plexus, Various lesions, 3B Existing SK758S
Imaging Guided Injection of Neurolytic,
radiofrequency
208 SK702T Thorax, Intercostal nerve, Block - Neurolytic 2A Existing SK702T
209 SK700T Thorax, Intercostal nerve, Block, anaesthetic 1C Existing SK700T
more than 3 levels
210 SK701T Thorax, Intercostal nerve, Block, anaesthetic up 1B Existing SK701T
to 3 levels
211 SK705T Thorax, Intercostal nerve, Block, radiofrequency, 2C Existing SK705T
cryo, neurolytic, more than 2
212 SK706T Thorax, Intercostal nerve, Block, radiofrequency, 2A Existing SK706T
cryo, neurolytic, up to 2
213 SK703T Thorax, Interpleural block, catheter 1C Existing SK703T
214 SK704T Thorax, Interpleural block, single 1B Existing SK704T
215 SK701V Vein - Intracranial, Venous sampling 3B Existing SK701V
216 SK702V Vein, Intravenous sympathetic, Bier’s Block 1B Existing SK702V
217 SK700V Vein, Intravenous, anaesthetic 1A Existing SK700V
A-3-82
CONFIDENTIAL
SL – EYE
code code
1 SL800A Anterior Chamber, Glaucoma, Paracentesis 2C Existing SL800A
(diagnostic/therapeutic)
2 SL801A Anterior Chamber, Hyphema, Irrigation 3B Existing SL801A
3 SL802A Anterior Chamber, Various Lesions, Vitreous 3B Existing SL802A
Removal
4 SL700B Brow, Browlift, Endoscopic, Bilateral 5A Existing SL700B
5 SL701B Brow, Browlift, Endoscopic, Bilateral with Mid- 5C Existing SL701B
Face Lift
6 SL702B Brow, Browlift, Endoscopic, Unilateral 4A Existing SL702B
7 SL703B Brow, Direct browplasty, Bilateral 3C Existing SL703B
8 SL704B Brow, Direct browplasty, Unilateral 3A Existing SL704B
9 SL700C Conjunctiva, Excision of Pterygium, bare sclera 1A Existing SL700C
10 SL800C Conjunctiva, Limbic Tumor, Removal 2C Existing SL800C
11 SL801C Conjunctiva, Naevus, Removal 1B Existing SL801C
12 SL802C Conjunctiva, Pinguecula, Removal 1B Existing SL802C
13 SL803C Conjunctiva, Pterygium, Removal with 2C Existing SL803C
conjunctival graft
14 SL701C Conjunctiva, Pterygium, Removal, complex 3B Existing SL701C
(recurrent, double, symblepharon)
15 SL702C Cornea, astigmatic keratotomy (excluding Limbal 3A Existing SL702C
relaxing incisions / graft refractive surgery)
16 SL804C Cornea, Band Keratopathy, Removal with 2A Existing SL804C
ethylene diamine tetra-acetic acid
17 SL805C Cornea, Dendritic Ulcer, Epithelial Debridement MSP Existing SL805C
18 SL703C Cornea, Descemet's Membrane Endothelial 6B Existing SL703C
Keratoplasty (DMEK)
19 SL708C Cornea, Foreign Body, Removal MSP Existing SL708C
20 SL807C Cornea, Laceration, Conjunctival Graft over 2C Existing SL807C
Cornea
21 SL808C Cornea, Laceration, Conjunctival Peritomy/Repair 2C Existing SL808C
by Conjunctival Flap
22 SL809C Cornea, Myopia, Phototherapeutic 3A Existing SL809C
Keratectomy/Laser in-situ Keratomileusis
23 SL704C Cornea, Riboflavin-UVA Induced Collagen 3B Existing SL704C
Crosslinking Treatment for Corneal Ectasia (CXL-
Crosslinking Laser/Post Lasik
Keratectomy/keratitis)
24 SL806C Cornea, Various Lesions, Keratoplasty, complex 6A Existing SL806C
(tectonic, therapeutic, lamellar, Descemet
stripping automated endothelial keratoplasty)
25 SL810C Cornea, Various Lesions, Transplantation 5B Existing SL810C
(superficial/lamellar/full thickness)
26 SL811C Cornea, Various Lesions, Transplantation with 6B Existing SL811C
Cataract Extraction and Intra-ocular Lens
Implantation
27 SL705C Cornea/Conjunctiva, Gunderson flap 3B Existing SL705C
28 SL706C Corneal/Ocular surface, Osteo-odonto- 7C Existing SL706C
keratoprosthesis Stage 1
29 SL707C Corneal/Ocular surface, Osteo-odonto- 5C Existing SL707C
keratoprosthesis Stage 2
30 SL800E Eye, Exophthalmos due to Thyrotoxicosis, 5A Existing SL800E
Retractor Recessions (bilateral)
A-3-83
CONFIDENTIAL
SL – EYE
code code
31 SL801E Eye, Exophthalmos due to Thyrotoxicosis, 4A Existing SL801E
Retractor Recessions (unilateral)
32 SL705E Eye, Glaucoma drainage implants eg. Ahmed 5C Existing SL705E
Valve implant, Molteno implant , Baerveldt Tube
Shunt
33 SL802E Eye, Glaucoma, Cyclodiathermy/Cyclocryotherapy 3B Existing SL802E
34 SL706E Eye, Glaucoma, Cyclophotocoagulation, 3B Existing SL706E
Endoscopic
35 SL803E Eye, Glaucoma, Filtering and Allied Operations 3B Existing SL803E
36 SL700E Eye, Glaucoma, Filtering and Allied Operations 4A Existing SL700E
with anti-metabolites
37 SL707E Eye, Glaucoma, Goniosynechiolysis 3B Existing SL707E
38 SL701E Eye, Glaucoma, Goniotomy/Trabeculotomy 4A Existing SL701E
(Bilateral)
(Bilateral) - paediatric
40 SL804E Eye, Glaucoma, Goniotomy/Trabeculotomy 3B Existing SL804E
(Unilateral)
(Unilateral) - paediatric
42 SL704E Eye, Glaucoma, Selective laser trabeculoplasty 2C Existing SL704E
(Bilateral)
43 SL805E Eye, Glaucoma, Selective laser trabeculoplasty 2A Existing SL805E
(Unilateral)
44 SL806E Eye, Intraocular Foreign Body, Removal from 3A Existing SL806E
Anterior Segment
45 SL807E Eye, Intraocular Foreign Body, Removal from 3B Existing SL807E
Posterior Segment
46 SL712E Eye, Medial canthal reconstruction, Bilateral 3C Existing SL712E
47 SL713E Eye, Medial canthal reconstruction, Unilateral 3A Existing SL713E
48 SL714E Eye, Needling of blebs with anti-metabolites 1A Existing SL714E
49 SL808E Eye, Perforating Wound (not involving intraocular 2C Existing SL808E
structures), Repair
50 SL809E Eye, Perforating Wound (with 3C Existing SL809E
incarceration/prolapse of uveal
tissue/lens/vitreous), Repair
51 SL715E Eye, Socket, Complex Anophthalmic socket 5A Existing SL715E
reconstruction
52 SL708E Eye, Squint, Complex Strabismus Surgery (4 or 5A Existing SL708E
more muscles, transposition, muscle splitting)
53 SL810E Eye, Squint, Complex strabismus surgery (vessel 4C Existing SL810E
sparing Sx, paralytic and restrictive strabismus,
horizontal combined with oblique/vertical
54 SL726E Eye, Squint, Operation (one/both eyes - 2 3B Existing SL726E
muscles)
55 SL811E Eye, Squint, Operation (one/both eyes - 3 4A Existing SL811E
muscles or more)
56 SL812E Eye, Squint, Operation (one/both eyes - 4A Existing SL812E
adjustable sutures)
57 SL813E Eye, Squint, Operation (one/both eyes - 4A Existing SL813E
transposition)
58 SL709E Eye, Thermal photocoagulation of choroidal 3B Existing SL709E
neovascularization and allied conditions
A-3-84
CONFIDENTIAL
SL – EYE
code code
59 SL815E Eye, Various Lesions, Enucleation without Implant 3A Existing SL815E
60 SL816E Eye, Various Lesions, Evisceration 2C Existing SL816E
61 SL817E Eye, Various Lesions, Examination under General 1B Existing SL817E
Anesthesia
62 SL818E Eye, Various Lesions, Resuturing of wound 2A Existing SL818E
following Intraocular Procedures
63 SL819E Eye, Various Lesions, Retrobular Injection MSP Existing SL819E
64 SL719E Eyeball, Enucleation with Acrylic & Scleral Ball 4C Existing SL719E
Implant
65 SL720E Eyelid lowering (gold weight implant), Bilateral 3C Existing SL720E
66 SL721E Eyelid lowering (gold weight implant), Unilateral 3A Existing SL721E
67 SL822E Eyelid retractor repair for involutional entropion 3B Existing SL822E
(unilateral one lid)
68 SL716E Eyelid, ptosis, Conjunctival Mullerectomy 4B Existing SL716E
(bilateral)
69 SL717E Eyelid, ptosis, Conjunctival Mullerectomy 3B Existing SL717E
(unilateral)
70 SL722E Eyelids, Botox injections for blepharospasm & 1C Existing SL722E
hemifacial spasm
71 SL723E Eyelids, Chalazion Cyst, Excision under general 1A Existing SL723E
anaesthesia
72 SL820E Eyelids, Chalazion Cyst/stye, Excision MSP Existing SL820E
73 SL821E Eyelids, Ectropion, Retropunctal Cautery MSP Existing SL821E
74 SL825E Eyelids, Ectropion/Entropion, Correction 4A Existing SL825E
(complicated) (two lids)
75 SL823E Eyelids, Ectropion/Entropion, Correction (simple 2A Existing SL823E
i.e. inverting sutures) (one lid)
76 SL824E Eyelids, Ectropion/Entropion, Correction (simple 2C Existing SL824E
i.e. inverting sutures) (two lids)
77 SL710E Eyelids, Ectropion/Entropion, Correction with 3B Existing SL710E
retractor repair for involutional entropion
(complicated,one lid)
78 SL826E Eyelids, Entropion, Everting Sutures MSP Existing SL826E
79 SL827E Eyelids, Exposure, Tarsorrhaphy (permanent) 1B Existing SL827E
80 SL828E Eyelids, Exposure, Tarsorrhaphy (temporary) 1A Existing SL828E
81 SL829E Eyelids, Full Thickness Laceration, Repair 3A Existing SL829E
82 SL830E Eyelids, Hemangioma, Intra-lesion Injections (full 3A Existing SL830E
course)
83 SL711E Eyelids, non-involutional entropion/ectropion 4A Existing SL711E
(complicated)
84 SL831E Eyelids, Ptosis, Correction Fasanella (bilateral) 4A Existing SL831E
85 SL832E Eyelids, Ptosis, Correction Fasanella (unilateral) 3B Existing SL832E
86 SL833E Eyelids, Ptosis, Correction Levator Palpebrae 5B Existing SL833E
Superioris Resection (bilateral)
87 SL834E Eyelids, Ptosis, Correction Levator Palpebrae 4A Existing SL834E
Superioris Resection (unilateral)
88 SL835E Eyelids, Ptosis, Correction with Fascia Lata Graft 5B Existing SL835E
(bilateral)
89 SL836E Eyelids, Ptosis, Correction with Fascia Lata Graft 4A Existing SL836E
(unilateral)
90 SL837E Eyelids, Ptosis, Tarsorrhaphy (permanent) 1B Existing SL837E
91 SL838E Eyelids, Ptosis, Tarsorrhaphy (temporary) 1A Existing SL838E
A-3-85
CONFIDENTIAL
SL – EYE
code code
92 SL839E Eyelids, Simple Laceration, Repair 1B Existing SL839E
93 SL840E Eyelids, Stye, Incision MSP Existing SL840E
94 SL724E Eyelids, Stye, Incision under general anaesthesia 1A Existing SL724E
95 SL841E Eyelids, Trichiasis, Cryotherapy 1B Existing SL841E
96 SL842E Eyelids, Trichiasis, Electrolysis, Epilation MSP Existing SL842E
97 SL843E Eyelids, Tumor, Excision and Repair with Full 3B Existing SL843E
Thickness Skin Grafting
98 SL844E Eyelids, Tumor, Excision and Repair with Local 4A Existing SL844E
Flap
99 SL845E Eyelids, Tumor, Incisional Biopsy MSP Existing SL845E
100 SL846E Eyelids, Tumor, Shaving Excision 1A Existing SL846E
101 SL718E Eyelids, Various Lesions, Blepharoplasty (2 3C Existing SL718E
eyelids) unilateral/bilateral (lower/upper)
102 SL847E Eyelids, Various lesions, Blepharoplasty (3 to 4 4A Existing SL847E
eyelids) bilateral
103 SL848E Eyelids, Various lesions, Blepharoplasty (single 3A Existing SL848E
eyelid) unilateral (upper/lower)
104 SL849E Eyelids, Various Lesions, Canthoplasty 1C Existing SL849E
(medial/lateral)
105 SL850E Eyelids, Various Lesions, Composite Graft 4A Existing SL850E
(chondro-cutaneous/chondro-mucosal)
106 SL851E Eyelids, Various Lesions, Full Thickness Wedge 3B Existing SL851E
Resection with Repair
107 SL725E Eyelids, Various Lesions, Major reconstruction, 5B Existing SL725E
involving anterior and posterior lamella and more
than 1/3 lid
108 SL852E Eyelids, Various Lesions, Multiple Plastic Lid 5B Existing SL852E
Procedures
109 SL853E Eyelids, Various Lesions, Reconstruction using 5A Existing SL853E
Full Thickness Flap
110 SL854E Eyelids, Various Lesions, Whole Thickness 4A Existing SL854E
Reconstruction (other than direct suture only)
111 SL700I Iris reconstruction / pupilloplasty 3A Existing SL700I
112 SL800I Iris, Tumor, Excision 3C Existing SL800I
113 SL801I Iris, Various Lesions, Laser Iridotomy 2C Existing SL801I
114 SL802I Iris, Various Lesions, Surgical 2C Existing SL802I
Iridectomy/Iridotomy
115 SL800L Lacrimal Gland (Canaliculus), Various Lesions, 2C Existing SL800L
Immediate Repair
116 SL801L Lacrimal Gland (Lacrimal Sac), Various Lesions, 3B Existing SL801L
Excision
117 SL802L Lacrimal Gland (Punctum), Various Lesions, Snip 2C Existing SL802L
Operation
118 SL803L Lacrimal Gland, Obstruction, Probing one/both 1B Existing SL803L
Ducts
119 SL804L Lacrimal Gland, Various Lesions, 5C Existing SL804L
Dacryocystorhinostomy (DCR)
120 SL805L Lacrimal Gland, Various Lesions, 5C Existing SL805L
Dacryocystorhinostomy with Lester Jones Tube
121 SL700L Lacrimal Gland/Duct, Various Lesions, 5C Existing SL700L
Endoscopic Dacryocystorhinostomy (DCR)
122 SL806L Lens, Cataract (juvenile), Removal and Needlings 3B Existing SL806L
A-3-86
CONFIDENTIAL
SL – EYE
code code
123 SL701L Lens, Cataract (Paediatric), Extraction with 4B Existing SL701L
anterior vitrectomy
124 SL702L Lens, Cataract (Paediatric), Extraction with 5A Existing SL702L
anterior vitrectomy - bilateral
125 SL703L Lens, Cataract (Paediatric), Extraction with 4C Existing SL703L
anterior vitrectomy and Intraocular Lens
implantation
126 SL704L Lens, Cataract (Paediatric), Extraction with 5B Existing SL704L
anterior vitrectomy and Intraocular Lens
implantation - bilateral
127 SL807L Lens, Cataract, Extraction with Intra-ocular Lens 5A Existing SL807L
Implant (Bilateral)
Implant (Unilateral Left)
Implant (Unilateral Right)
Implant and Trabeculectomy with/without
antimetabolites
131 SL811L Lens, Cataract, Extraction with Trabeculectomy 4A Existing SL811L
132 SL705L Lens, Combined glaucoma implants with cataract 6A Existing SL705L
extraction (w/wo Intraocular Lens implantation)
133 SL706L Lens, Complicated Cataract extraction with 4C Existing SL706L
Intraocular Lens implant (Capsular Tension
ring/Capsular Tension Segment/)
134 SL707L Lens, Implantation of posterior segment drug 4A Existing SL707L
delivery device
135 SL708L Lens, Secondary Scleral fixated Intraocular Lens 5A Existing SL708L
implantation
136 SL709L Lens, Sectorial laser photocoagulation 2C Existing SL709L
137 SL812L Lens, Various Lesions, Extraction 3B Existing SL812L
138 SL813L Lens, Various Lesions, Removal of Intra-ocular 2B Existing SL813L
Artificial Lens
139 SL814L Lens, Various Lesions, Secondary Insertion of 4A Existing SL814L
Intra-ocular Lens
140 SL815L Lens, Various Lesions, Yag Laser Capsulotomy 2A Existing SL815L
141 SL700O Ocular surface procedure including amniotic 5C Existing SL700O
membrane transplant (complex, cultured
grafts/extensive reconstruction)
142 SL701O Optic Nerve Sheath Fenestration 5A Existing SL701O
143 SL800O Orbit, Contracture, Reconstruction including 4A Existing SL800O
Mucous Membrane Grafting and Stent Mould
144 SL702O Orbit, Reconstruction, Extensive Floor/Medial Wall 5A Existing SL702O
Fracture
145 SL801O Orbit, Tumor, Exenteration/Flap Reconstruction 5C Existing SL801O
146 SL806O Orbit, Tumour, Exenteration with Orbitectomy & 5C Existing SL806O
Primary reconstruction
147 SL703O Orbit, Various Lesions of Mid to Posterior Orbit, 5B Existing SL703O
Excision
148 SL803O Orbit, Various Lesions, Anterior Orbitotomy 3B Existing SL803O
149 SL704O Orbit, Various Lesions, Anterior Orbitotomy 4A Existing SL704O
(Extensive)
150 SL804O Orbit, Various Lesions, Decompression (bilateral) 5A Existing SL804O
A-3-87
CONFIDENTIAL
SL – EYE
code code
151 SL805O Orbit, Various Lesions, Decompression 4B Existing SL805O
(unilateral)
152 SL705O Orbit, Various Lesions, Extended Lateral 6A Existing SL705O
Orbitotomy
153 SL807O Orbit, Various Lesions, Lateral Orbitotomy 4A Existing SL807O
154 SL706O Orbit, Various Lesions, Optic Nerve 6C Existing SL706O
Decompression (Bilateral)
155 SL707O Orbit, Various Lesions, Optic Nerve 5A Existing SL707O
Decompression (Unilateral)
156 SL808O Orbit, Various Lesions, Reconstruction including 7C Existing SL808O
Orbital Shift and Soft Tissue (craniofacial
approach)
157 SL810O Orbit, Various lesions, Reconstruction of 4A Existing SL810O
Floor/Roof with Alloplastic Material
158 SL809O Orbit, Various Lesions, Reconstruction of 4B Existing SL809O
Floor/Roof with Bone Graft
159 SL802O Orbit, Various Lesions/Tumours, 5C Existing SL802O
Exenteration/Removal via Craniotomy
160 SL814E Orbital, Enucleation with Integrated Orbital 4A Existing SL814E
Implant
161 SL708O Orbital/Scleral, Evisceration with Implant & Scleral 4A Existing SL708O
Ball
162 SL800Z Organ Procurement Costs: Cornea 2A Existing SL800Z
163 SL700P Photodynamic therapy 3A Existing SL700P
164 SL701P Photorefractive Keratectomy/Phototherapeutic 3B Existing SL701P
Keratectomy (for diseased eye)
165 SL802R Retina, Detachment (complex), Operation (more 6B Existing SL802R
than one plomb/encirclage)
166 SL800R Retina, Detachment, Removal of Encircling 2C Existing SL800R
Silicone Band
167 SL801R Retina, Detachment, Resection/Buckling 5C Existing SL801R
Operation/Revision Operation with Single Plomb
168 SL700R Retina, Laser retinopexy, complex (subretinal 3B Existing SL700R
fluid, vitreous haemorrhage, multiple tears)
169 SL705R Retina, Pan retinal photocoagulation 3B Existing SL705R
170 SL701R Retina, Pneumatic retinopexy 4A Existing SL701R
171 SL702R Retina, ROP (Retinopathy of Prematurity) laser 3C Existing SL702R
photocoagulation
172 SL804R Retina, Tears, Cryotherapy or Photocoagulation 3C Existing SL804R
(laser) (Bilateral)
173 SL803R Retina, Tears, Diathermy/Cryotherapy (Unilateral) 3A Existing SL803R
174 SL805R Retina, Tears, Photocoagulation (laser) 3B Existing SL805R
(Unilateral)
175 SL703R Retina, Trans pars plana posterior capsulectomy 3B Existing SL703R
176 SL704R Retina/Macula, Grid and focal laser 3A Existing SL704R
photocoagulation
177 SL806R Retinal, Detachment, Removal Of Partially MSP Existing SL806R
Extruded Plomb
178 SL700T Temporal artery biopsy 2B Existing SL700T
179 SL700V Vitreous, Intravitreal Injections 1B Existing SL700V
180 SL701V Vitreous, Various Lesions, Complex Posterior 6B Existing SL701V
Vitrectomy (PVR, GRT, trauma)
A-3-88
CONFIDENTIAL
SL – EYE
code code
181 SL801V Vitreous, Various Lesions, Posterior Vitrectomy 6B Existing SL801V
(pars plana/ sclerotomy/lensectomy/endolaser)
182 SL800V Vitreous, Various Lesions, Simple Vitrectomy 5C Existing SL800V
(pars plana)
183 SL802V Vitreous, Various Lesions, Vitrectomy (pars 4A Existing SL802V
plana/removal of silicone oil)
A-3-89
CONFIDENTIAL
SM – ENT
code code
1 SM700A Adenoids, Various Lesions, Removal 2C Existing SM700A
2 SM800E Ear (Middle), Abscess/Inflammation, Operation 1B Existing SM800E
3 SM701E Ear (middle), Cochlear implant 6A Existing SM701E
4 SM712E Ear (middle), Middle ear implant surgery 5B New -
5 SM801E Ear (Middle), Round Window Perforation, Repair 4A Existing SM801E
6 SM702E Ear (Middle), Various Lesions (Benign 2A Existing SM702E
Condition), Excision Biopsy
7 SM802E Ear (Middle), Various Lesions, Exploration and 3A Existing SM802E
Tympanotomy
8 SM803E Ear (Middle), Various Lesions, Stapedectomy 4B Existing SM803E
9 SM700E Ear, Auditory Meatus (Internal), Tumor, 6B Existing SM700E
Transmastoid Removal with Extended
Mastoidectomy
10 SM703E Ear, Aural toilet by microscopy (complex) eg. MSP Existing SM703E
Impacted ear wax/Foreign Body/Discharge
11 SM706E Ear, Bilateral preauricular sinus excision 3A Existing SM706E
12 SM804E Ear, Cauliflower Ear, Correction 3A Existing SM804E
13 SM805E Ear, Congenital Atresia, Reconstruction of 4B Existing SM805E
External Auditory Canal and Middle Ear
14 SM806E Ear, Deformity, Composite Graft 4A Existing SM806E
15 SM807E Ear, Deformity, Correction (bilateral) 3C Existing SM807E
16 SM808E Ear, Deformity, Correction (unilateral) 3A Existing SM808E
17 SM809E Ear, Deformity, Lobule Reconstruction (bilateral) 2C Existing SM809E
18 SM810E Ear, Deformity, Lobule Reconstruction 1C Existing SM810E
(unilateral)
19 SM836E Ear, Eustachian Tube, Various Lesions, 1A Existing SM836E
Catheterisation/Inflation
20 SM704E Ear, Excision pseudocyst pinna 2A Existing SM704E
21 SM811E Ear, Exostosis Obturans, Excision Biopsy 3A Existing SM811E
22 SM812E Ear, Foreign Body, Removal MSP Existing SM812E
23 SM813E Ear, Foreign Body, Complex Removal/Excision 1B Existing SM813E
(Embedded/Large)
24 SM814E Ear, Hematoma/Seroma, Evacuation/Incision & 1B Existing SM814E
Drainage
25 SM711E Ear, Implantation of bone-anchored hearing aid 4B New -
26 SM815E Ear, Keratosis Obturans moderate/severe, 1C Existing SM815E
Excision Biopsy under GA
27 SM816E Ear, Laceration (full thickness), Repair > 3cm 3A Existing SM816E
28 SM817E Ear, Laceration, Wound Debridement MSP Existing SM817E
29 SM818E Ear, Microtia, Creation of Post-auricular Sulcus 3C Existing SM818E
with Skin Graft
30 SM819E Ear, Microtia, Insertion of Cartilage/Silastic 4A Existing SM819E
Framework
31 SM820E Ear, Microtia, Repositioning of Lobule 2A Existing SM820E
32 SM705E Ear, middle, Ossiculoplasty 4B Existing SM705E
33 SM821E Ear, Partial Amputation, Reconstruction 4A Existing SM821E
34 SM822E Ear, Polyp, Removal 1B Existing SM822E
35 SM824E Ear, Sebaceous Cyst, Excision 1B Existing SM824E
36 SM825E Ear, Total Amputation, Microvascular 7C Existing SM825E
Reconstruction
A-3-90
CONFIDENTIAL
SM – ENT
code code
37 SM826E Ear, Total Amputation, Staged Reconstruction 4A Existing SM826E
(each stage)
38 SM708E Ear, Tympanic Membrane, Bilateral 2B Existing SM708E
myringotomy with tube
39 SM707E Ear, Tympanic Membrane, Bilateral 1C Existing SM707E
myringotomy without tube
40 SM709E Ear, Tympanic Membrane, Perforation, 1B Existing SM709E
Cauterisation/Diathermy
41 SM710E Ear, Tympanic Membrane, Perforation, Round 4A Existing SM710E
Window Repair
42 SM832E Ear, Tympanic Membrane, Unilateral 2A Existing SM832E
myringotomy with tube
43 SM831E Ear, Tympanic Membrane, 1B Existing SM831E
Unilateral,myringotomy without tube
44 SM823E Ear, Unilateral pre auricular sinus excision 2B Existing SM823E
45 SM827E Ear, Various Lesions, Meatoplasty with Split 3B Existing SM827E
Skin Graft
46 SM828E Ear, Various Lesions, Meatotomy MSP Existing SM828E
47 SM837E Ear, Various Lesions, Middle Fossa extra-dural 6B New -
approach to temporal bone with/without
transmastoid approach combined access
48 SM838E Ear, Various Lesions, Myringoplasty (lateral 4B New -
graft/onlay graft technique) with/without
canalplasty
49 SM829E Ear, Various Lesions, Myringoplasty (post- 4A Existing SM829E
aural/endaural approach)
50 SM830E Ear, Various Lesions, Myringoplasty (simple) 3B Existing SM830E
51 SM833E Ear, Various Lesions, Ossicular Chain 4B Existing SM833E
Reconstruction with/without Myringoplasty
52 SM834E Ear, Various Lesions, Various Graft to 4A Existing SM834E
Fenestration Cavity
53 SM835E Endolymphatic Sac, Various Lesions, 5C Existing SM835E
Transmastoid Shunt Procedure
54 SM700I Inferior Turbinate reduction (submucous 1C Existing SM700I
diathermy oblique radiofreqeuncy)
55 SM800L Labyrinth, Various Lesions, 5C Existing SM800L
Destruction/Labyrinthotomy
56 SM702L Larynx and Esophagus, Tumor, Esophagectomy 7C Existing SM702L
(total)/ Laryngopharyngectomy with Restoration
of Alimentary Continuity
57 SM703L Larynx and Pharynx, Various Lesions, Laser 3B Existing SM703L
Application
58 SM704L Larynx and Trachea, Various Lesions, Major 5C Existing SM704L
Microsurgery without Reconstruction
59 SM705L Larynx and Trachea, Various Lesions, Major 5C Existing SM705L
Plastic Operation
60 SM700L Larynx, Elms (Endoscopic Laryngeal 3A Existing SM700L
Microsugery/Phonosurgery)
61 SM706L Larynx, Fractures, Operation 5C Existing SM706L
62 SM709L Larynx, Laryngectomy with bilateral neck 7A Existing SM709L
dissection
63 SM710L Larynx, Laryngectomy with unilateral neck 6B Existing SM710L
dissection
A-3-91
CONFIDENTIAL
SM – ENT
code code
64 SM707L Larynx, Larynogofissure, External Operation 5C Existing SM707L
65 SM711L Larynx, Microlaryngoscopy, with/without 2C Existing SM711L
removal of tumor
66 SM701L Larynx, Transcutaneous injection of larynx 1A Existing SM701L
67 SM708L Larynx, Tumor, Laryngectomy (total) 5C Existing SM708L
68 SM712L Larynx, Tumor, Partial Laryngectomy 5C Existing SM712L
69 SM713L Larynx, Tumor, Partial Laryngectomy with Block 6B Existing SM713L
Neck Dissection
70 SM714L Larynx, Various Disorders, open medialisation 4B Existing SM714L
of vocal cord
71 SM715L Larynx, Various Lesions, Direct Examination 2C Existing SM715L
with Removal of Tumor
72 SM716L Larynx, Various Lesions, Direct Examination 1B Existing SM716L
with/without Biopsy
73 SM717L Larynx, Various Lesions, Hemi/Partial 5C Existing SM717L
Laryngectomy
74 SM718L Larynx, Various Lesions, Hemi/Partial 6B Existing SM718L
Laryngectomy with Radical Neck Dissection
75 SM800M Mastoid, Various Lesions, Mastoidectomy 3C Existing SM800M
(cortical)
(radical/modified radical) with Myringoplasty and
Ossicular Chain Reconstruction
77 SM802M Mastoid, Various Lesions, Mastoidectomy 4B Existing SM802M
(radical/modified)
(radical/modified) with Myringoplasty
79 SM804M Mastoid, Various Lesions, Revision 4B Existing SM804M
Mastoidectomy
80 SM700M Maxilla, Sinuses, Sinoscopy 1B Existing SM700M
81 SM701M Mouth, Cautery of soft palate /tongue base 2B Existing SM701M
82 SM703M Mouth, Various Lesions, Pharyngotomy (lateral) 4A Existing SM703M
with Excision of Tongue
83 SM704M Mouth, Various Lesions, Uvulotomy 1B Existing SM704M
84 SM702M Mouth, Various/Pathologic Lesions of Oral 2B Existing SM702M
Mucosa, Laser Application
85 SM701N Nose, Choanal Atresia, Plastic Repair 4A Existing SM701N
86 SM702N Nose, Choanal Atresia, Repair by Puncture and 2C Existing SM702N
Dilatation
87 SM703N Nose, Foreign Body, Removal MSP Existing SM703N
88 SM704N Nose, Hematoma/Abscess, Evacuation/Incision 1A Existing SM704N
& Drainage
89 SM705N Nose, Hemorrhage, Hemostasis 1B Existing SM705N
(Packing)/Cryotherapy)
90 SM706N Nose, Laceration Full Thickness, Repair >3cm 3A Existing SM706N
91 SM700N Nose, Nasendoscopy 1A Existing SM700N
92 SM707N Nose, Polypi (complex), Excision Biopsy more 2B Existing SM707N
than 2
93 SM708N Nose, Polypi (simple), Excision Biopsy, 1 to 2 1B Existing SM708N
94 SM709N Nose, Post-Nasal Space, Laser Application 4A Existing SM709N
95 SM710N Nose, Rhinophyma, Excision 3B Existing SM710N
96 SM711N Nose, Rhinophyma, Total Construction 6B Existing SM711N
A-3-92
CONFIDENTIAL
SM – ENT
code code
97 SM712N Nose, Simple Fracture, Manipulation 1B Existing SM712N
98 SM713N Nose, Various Lesions (postnasal space), Direct 1B Existing SM713N
Examination with Biopsy and Nasendoscopy
99 SM714N Nose, Various Lesions (turbinates), 2C Existing SM714N
turbinectomy/turbinoplasty/Submucous
Resection (with or without endoscopes)
100 SM715N Nose, Various Lesions, Cauterisation/Diathermy 1A Existing SM715N
101 SM716N Nose, Various Lesions, Composite Graft 4A Existing SM716N
(chondro-cutaneous/chondro-mucosal)
102 SM717N Nose, Various Lesions, Examination MSP Existing SM717N
103 SM718N Nose, Various Lesions, Rhinoplasty 3B Existing SM718N
(augmentation excluding cost of implants)
104 SM719N Nose, Various Lesions, Rhinoplasty (correction 4C Existing SM719N
of bony vault only)
105 SM720N Nose, Various Lesions, Rhinoplasty (correction 4C Existing SM720N
of lateral and/or alar cartilages)
106 SM721N Nose, Various Lesions, Rhinoplasty (restoration 5A Existing SM721N
of the face involving autogenous bone or costal
cartilage graft)
107 SM722N Nose, Various Lesions, Rhinoplasty (secondary 5A Existing SM722N
revision)
108 SM723N Nose, Various Lesions, Rhinoplasty (total) 5C Existing SM723N
including Correction of all Bony and
Cartilaginous Elements
109 SM724N Nose, Various Lesions, Septoplasty/Submucous 3B Existing SM724N
Resection
110 SM700P Pharynx, Adhesions, Division 1B Existing SM700P
111 SM701P Pharynx, Cysts/Vallecular, Removal 2C Existing SM701P
112 SM702P Pharynx, Pouch, Removal 4A Existing SM702P
113 SM703P Pharynx, Tumor, Partial Pharyngectomy and 7B Existing SM703P
Radical Neck Dissection with Flap
114 SM704P Pharynx, Various Lesions, Flap/Pharyngoplasty 4B Existing SM704P
115 SM705P Pharynx, Various Lesions, Partial 4B Existing SM705P
Pharyngectomy with Primary Closure
116 SM706P Pharynx, Various Lesions, Pharyngotomy 7B Existing SM706P
(lateral) with Excision of Tongue and
Reconstruction
117 SM702S Sinal-nasal, Endoscopic hemostasis (complex, 3C Existing SM702S
under general anaesthesia)
118 SM705S Sinuses - Ethmoidal, Various Lesions, External 5C Existing SM705S
Operation
119 SM706S Sinuses - Nasal, Foreign Body/Other Lesions, 2B Existing SM706S
Intranasal Operation/Removal of Foreign Body
120 SM707S Sinuses - Nasal, Hematoma/Abscess, Antral 2B Existing SM707S
Drainage
121 SM708S Sinuses - Nasal, Infection, Functional 3B Existing SM708S
Sinuscopic Drainage of Ethmoidal/ Maxillary
Sinuses
122 SM703S Sinuses - Nasal, Infection, Functional 5A Existing SM703S
Sinuscopic Ethmoidectomy (Bilateral)
123 SM709S Sinuses - Nasal, Infection, Functional 4A Description SM709S
Sinuscopic Ethmoidectomy (Unilateral) Change
124 SM710S Sinuses - Nasal, Oro-antral Fistula, Closure 3A Existing SM710S
A-3-93
CONFIDENTIAL
SM – ENT
code code
125 SM711S Sinuses - Nasal, Various Lesions of Antrum, 1B Existing SM711S
Roof Puncture and/or Lavage
126 SM712S Sinuses - Nasal, Various Lesions, Antrostomy 3A Existing SM712S
(radical)
127 SM713S Sinuses - Nasal, Various Lesions, Fronto- 5C Existing SM713S
Ethmoidectomy (radical) with Osteoplastic Flap
128 SM714S Sinuses - Nasal, Various Lesions, Fronto-nasal 5C Existing SM714S
Ethmoidectomy with/without Sphenoidotomy
129 SM715S Sinuses - Nasal, Various Lesions, Intranasal 3B Existing SM715S
Operation
130 SM716S Sinuses - Sphenoidal, Various Lesions, 5C Existing SM716S
Intranasal Operation
131 SM717S Sinuses Frontal, Various Lesions, 1A Existing SM717S
Catheterisation
132 SM718S Sinuses Frontal, Various Lesions, Radical 5C Existing SM718S
Obliteration
133 SM719S Sinuses Frontal, Various Lesions, Trephine 2B Existing SM719S
134 SM704S Sinuses, Turbinoplasty, submucosal, 2C Existing SM704S
Endoscopic
135 SM720S Sinuses-Nasal, Various Lesions, Lavage MSP Existing SM720S
Through An Oro-Antral Perforation
136 SM721S Skull, Base, Endoscopic resection of skull base 5C Expanded SM701S
soft tissue tumours with no bone involvement (New)
soft tissue tumours with resection of bone and (New)
dura (intradural, including clivus, parasellar area
or cavernous sinus) with skull base
reconstruction
soft tissue tumours with resection of bone and (New)
preservation of dura (extradural)
139 SM700S Skull/Face, Malignant tumour/Trauma, 7C Existing SM700S
Craniofacial resection
140 SM700T Throat, Hyoid suspension 3B Existing SM700T
141 SM701T Throat, Uvulopalatopharyngoplasty (U3P) 4B Existing SM701T
142 SM702T Thyroglossal cyst, Sistrunk operation with hyoid 3B Existing SM702T
bone removal
143 SM706T Tongue suspension 2B Existing SM706T
144 SM703T Tonsils, Abscess, Drainage 1A Existing SM703T
145 SM704T Tonsils, Hemorrhage, Hemostasis 1B Existing SM704T
146 SM705T Tonsils, Various Lesions, Removal with/without 3B Existing SM705T
Adenoidectomy
~END~
A-3-94
CONFIDENTIAL

A 3 Table of Surgical Procedures TOSP With Minor Surgical Procedures MSPs 1

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A 3 Table of Surgical Procedures TOSP With Minor Surgical Procedures MSPs 1

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Annex A-3

The Table of Surgical Procedures (TOSP) is an exhaustive list of procedures

Specifically, Minor Surgical Procedures (procedures with table ranking “MSP”)

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