Speciality Proced Procedure Name Packag Mandatory requirements

Name ure ID e
Amount

Organ and Tissue MG072C Acute Haemodialysis 1500 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings,Clinical notes with planned
line of management,Pathological Examination
(Complete Blood count, Blood urea, Serum
Creatinine, GFR, serum electrolytes). In chronic
renal failure/ chronic dialysis patients
investigations need to be done and submitted only
once. These investigations to be repeated
monthly. Quarterly- Serum Iron, ferritin, TIBC,
TSAT, SGOT, SGPT, viral markers, calcium,
phosphate
Organ and Tissue MG072C Acute Haemodialysis 1800 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings,Clinical notes with planned
line of management,Pathological Examination
(Complete Blood count, Blood urea, Serum
Creatinine, GFR, serum electrolytes). In chronic
renal failure/ chronic dialysis patients
investigations need to be done and submitted only
once. These investigations to be repeated
monthly. Quarterly- Serum Iron, ferritin, TIBC,
TSAT, SGOT, SGPT, viral markers, calcium,
phosphate
Organ and Tissue MG072D Chronic Haemodialysis 1500 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings,Clinical notes with planned
line of management,Pathological Examination
(Complete Blood count, Blood urea, Serum
Creatinine, GFR, serum electrolytes). In chronic
renal failure/ chronic dialysis patients
investigations need to be done and submitted only
once. These investigations to be repeated
monthly. Quarterly- Serum Iron, ferritin, TIBC,
TSAT, SGOT, SGPT, viral markers, calcium,
phosphate
Organ and Tissue MG072D Chronic Haemodialysis 1800 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings,Clinical notes with planned
line of management,Pathological Examination
(Complete Blood count, Blood urea, Serum
Creatinine, GFR, serum electrolytes). In chronic
renal failure/ chronic dialysis patients
investigations need to be done and submitted only
once. These investigations to be repeated
monthly. Quarterly- Serum Iron, ferritin, TIBC,
TSAT, SGOT, SGPT, viral markers, calcium,
phosphate
Organ and Tissue OT001A Pre Procedure workup- 281300 Clinical notes,CT/MRI +/- FNAC/Biopsy,
Transplant Donor or Recipient,
Immunosuppressives,
Transplant and
Induction for recipients
with unrelated
ordeceased donor oror
at high risk for rejection
Organ and Tissue OT001A Pre Procedure workup- 319500 Clinical notes,CT/MRI +/- FNAC/Biopsy,
Transplant Donor or Recipient,
Immunosuppressives,
Transplant and
Induction for recipients
with unrelated
ordeceased donor oror
at high risk for rejection
Organ and Tissue OT001A Pre Procedure workup- 337500 Clinical notes,CT/MRI +/- FNAC/Biopsy,
Transplant Donor or Recipient,
Immunosuppressives,
Transplant and
Induction for recipients
with unrelated
ordeceased donor oror
at high risk for rejection
Organ and Tissue OT001A Transplant surgery, 215595 Clinical notes,CT/MRI +/- FNAC/Biopsy,
Transplant including donor
nephrectomy

Organ and Tissue OT001B Induction 39526 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001C Banff type 1Aor 1B 150000 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001C Banff type 1Aor 1B 213000 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001C Banff type 1Aor 1B 50000 any investigations done,Clinical notes detailing
Transplant history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001C Intervention for acute 107797 any investigations done,Clinical notes detailing
Transplant rejection history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001D Post-Transplant 50000 any investigations done,Clinical notes detailing
Transplant Medication – Month 1-3 history and Admission notes showing vitals and
examination findings
Organ and Tissue OT001D Post-Transplant 56800 any investigations done,Clinical notes detailing
Transplant Medication – Month 1-3 history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001D Post-Transplant 60000 any investigations done,Clinical notes detailing
Transplant Medication – Month 1-3 history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001E Post-Transplant 37500 any investigations done,Clinical notes detailing
Transplant Medication – Month 3-6 history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001E Post-Transplant 42600 any investigations done,Clinical notes detailing
Transplant Medication – Month 3-6 history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001E Post-Transplant 45000 any investigations done,Clinical notes detailing
Transplant Medication – Month 3-6 history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001E Post-Transplant 50000 any investigations done,Clinical notes detailing
Transplant Medication – Month 3-6 history and Admission notes showing vitals and
examination findings

Organ and Tissue OT001F Post-Transplant 37500 any investigations done,Clinical notes detailing
Transplant Medication – Month 6- history and Admission notes showing vitals and
12 examination findings

Organ and Tissue OT001F Post-Transplant 40000 any investigations done,Clinical notes detailing
Transplant Medication – Month 6- history and Admission notes showing vitals and
12 examination findings

Organ and Tissue OT001F Post-Transplant 42600 any investigations done,Clinical notes detailing
Transplant Medication – Month 6- history and Admission notes showing vitals and
12 examination findings

Organ and Tissue OT001F Post-Transplant 45000 any investigations done,Clinical notes detailing
Transplant Medication – Month 6- history and Admission notes showing vitals and
12 examination findings

Organ and Tissue OT002A Pre Transplant 125000

Transplant Evaluation and Stem
Cell Collection and
Cryopreservation
Organ and Tissue OT002A Pre Transplant 142000
Transplant Evaluation and Stem
Cell Collection and
Cryopreservation
Organ and Tissue OT002A Pre Transplant 150000
Transplant Evaluation and Stem
Cell Collection and
Cryopreservation
Organ and Tissue OT002B Transplant(includes 312500
Transplant conditioning)

Organ and Tissue OT002B Transplant(includes 355000

Transplant conditioning)

Organ and Tissue OT002B Transplant(includes 375000

Transplant conditioning)

Organ and Tissue OT002C Post Transplant Care 62500

Transplant for 3 months(includes
supportive care and
investigations)
Organ and Tissue OT002C Post Transplant Care 71000
Transplant for 3 months(includes
supportive care and
investigations)
Organ and Tissue OT002C Post Transplant Care 75000
Transplant for 3 months(includes
supportive care and
investigations)