GIPSA Other Private Insurance Comp

No. of cases No. of cases

done in the Total Amount done in the last
S.NO. PPN CODE GIPSA PROCEDURES last 2 years Paid 2 years
PROCEDURE
CARDIOLOGY
Angiography(Unstable Angina)includes
1 PPN C 01 cost of the dye
2 PPN C 02 Angioplasty
3 PPN C 03 CABG
Valve Replacement(Valve Excluded)
4 PPN C 04
Temporary Pacemaker Implantation
5 PPN C 05
Permanent Pacemaker
6 PPN C 06 Implantation(Implant Excluded)
DVR-Double Valve Replacement
7 PPN C 07 (Cardiac Surgery)
8 PPN C 08 EPS and RFA
ENT
9 PPN E 01 Tonsillectomy
PPN E 02 Adenotonsillectomy
PPN E 03 Tymnoplasty
PPN E 04 Mastoibectomy
PPN E 05 Mastoibectomy & Tymnoplasty
PPN E 06 FESS WITH SEPTOPLASTY &
turbinectomy or polypectomy-
unilateral

PPN E 07
FESS WITH SEPTOPLASTY &
turbinectomy or polypectomy- bilateral
PPN E 08 Cortical Mastoibectomy with
myningoplasty
PPN E 09 peritonsilar abscess drainage ( day
care)
PPN E 10 Myringotomy with grommet insertion

GENERAL SURGERY
PPN G 01 Haemornoidectomy (stapler and
tackers included)
PPN G 02
Haemornoidectomy + fissurectomy
(stapler and tackers included)
PPN G 03 fissurectomy and fissure dilatation
PPN G 04 high end fistulectomy
PPN G 05 low end fistulectomy
PPN G 06 appendectomy (LAP)
PPN G 07 Cholesystectomy (LAP)
PPN G 08 Excigen of pilonoidal sinus with FLAP
COVER
PPN G O8 B Excigen of pilonoidal sinus with
primary closure
PPN G 09 mastectomy(simple)
PPN G 10 mastectomy(radical)
PPN G 11 thyroidectomy (total/sub total )
PPN G 12 inguinal hernioplasty-unilateral ( mesh
and tackers included)
PPN G 13 inguinal hernioplasty-bilateral ( mesh
and tackers included)
PPN G 14 umblicalhernioplasty (mesh and
tackers included
PPN G 15 incisional hernioplasty (mesh and
tackers included).if size of defect is
large mesh to be paid as per actual
defect size with justification

PPN G 16 circumcission ( day care)

PPN G 17 perianal abcess
PPN G 18 breast lumpectomy
PPN G 19 AV fistula ( day care)
PPN G 20 hydrocele
PPN G 21 right or left hemi coloctomy
PPN G 22 resection and anestomosis of small
intestine (single )
PPN G 23 exploratoy laprotomy
PPN G 24 ERCP-EPT /STENTING/STONE REMOVAL

OBSTETRICS & GYNE

PPN OBG 01 Normal delivery (with well baby care)

PPN OBG 02 LSCS ( with well baby care)

PPN OBG 03 LAVH

PPN OBG 04 TAH + BSO + ADHESIOLYSIS ( OPEN OR

LAP)
PPN OBG 05 Instrumental delivery (including well
baby care)
PPN OBG 06 ovarian cystectomy
PPN OBG 07 dilatation and curettage ( D & C) ( DAY
CARE)
PPN OBG 08 Vaginal vault prolapse repair

PPN OBG 09 leproscapic ovarian drilling

OPTHALMOLOGY
PPN OPH 01 cataract ( including lens)

ORTHOPAEDICS
PN ORTHO total knee replacement-
01 unilateral(implant excluded)
PN ORTHO total knee replacement-
02 bilateral(implant excluded)
PN ORTHO hip replacement unilateral or implant
03 excluded
PN ORTHO hip replacement bilateral or implant
04 excluded
PN ORTHO
05 fracture neck femur implant excluded
PN ORTHO
06
femur shaft fracture-proximal
/middle/distal-(excluding implant)
PN ORTHO
07
tibia fracture proximal /middle/distal-
ORIF/ CRIF with nailing/locking
PN ORTHO
08
ankle/tibia fracture-ORIF/CRIF with
screws/TPW-(excluding implant)
PN ORTHO arthrodesis - wrist/ankle subtalar -
09 (excluding implant)
PN ORTHO
10 foot fractures -with wires
PN ORTHO
11 foot fractures -with screws
PN ORTHO
12 calcaneal fracture - with plates
PN ORTHO
13
shoulder / humerous /elbow/both
bones forearms fractures-plates ANA
PN ORTHO
14
single forearm fracture /wrist fracture -
with plate (excluding implants)
PN ORTHO
15 scaphoid fracture fixation
PN ORTHO
16 hand- 'k' wires- single fracture
PN ORTHO
17 hand- 'k' wires- multiple fracture
PN ORTHO
18 therapeutic arthroscopy
PN ORTHO
19 arthroscopic surgery
PN ORTHO
20 shoulder-arthroscopy / open - bankart
PN ORTHO shoulder arthroscopy/open- laterjet/
21 bone block
PN ORTHO shoulder-arthroscopy / open - cuff
22 repair
PN ORTHO shoulder-arthroscopy / open - cuff
23 repair with anchors
PN ORTHO shoulder-arthroscopy / open- sub
24 acromial decopressior
PN ORTHO
25 ACL reconstruction /repair
PN ORTHO
26 MCL reconstruction/repair
PN ORTHO
27 ACL & PCL reconstruction /repair
PN ORTHO
28 Laminectomy/disectomy
PN ORTHO
29 stabilization of spinal column
PN ORTHO
30
thoraco / lumbar global fixation/bone
graft ( excluding implants)
PN ORTHO
31 thoraco / lumbar - anterior interbody
fixation/bone graft ( excluding
implants)
PN ORTHO
32 carpel tunnel release- unilateral
PN ORTHO
32 carpel tunnel release- bilateral
PN ORTHO close reduction of fracture of limbs
33 and POP ( day care)
PN ORTHO reduction of compound fractures ( day
34 care)
PN ORTHO close reduction of dislocations (day
35 care)
PN ORTHO
36 implant removal of small bones
PN ORTHO
37 implant removal of femur / tibia
PN ORTHO bone grafting fore non unions-lower
38 limb
PN ORTHO bone grafting fore non unions- upper
39 limb
PN ORTHO
40
ACETABULAR fracture-posterior wall
/column ORIF (including implant)
PN ORTHO
41
ACETABULAR fracture-anterior wall
/column ORIF (including implant)
PN ORTHO pelvis fracture- external fixation
42 (including implant)
PN ORTHO
43 reduction of dislocation in GA
UROLOGY AND NEPHROLOGY
PPN URO 01
PCNL -unilateral
PPN URO 02
PCNL bilateral
PPN URO 03
prostat removal
PPN URO 04
meatotomy ( day care)
PPN URO 05
dialysis (all inclusive)
PPN URO 06
renal transplant surgery (all inclusive)
PPN URO 07
DJ stent removal
PPN URO 08
cystoscopy (therapeutic)
PPN URO 09 cystoscopy urs with DJ stenting
unilateral
PPN URO 10 nefrectomy / nephrolithomy /
pyeliphotomy
PPN URO 11
orchidectomy-unilateral
PPN URO 12
orchidectomy-bilateral
PPN URO 13
ESWL ( day care )
PPN URO 14
URS /Theapeutic
NEUROLOGY
PPN NEU 01
VP shunting
VASCULAR SURGERY
PPN VS 01
vericose veins (surgical as well as laser)
er Private Insurance Companies Cash Patients/ Open Billing

No. of cases done Total Amount Existing Single Proposed Single

Total Amount Paid in the last 2 years Paid Room Rate Room Rate
Percentage
Increase