GOVERNMENT OF ANDHRA PRADESH

ABSTRACT

Health, Medical & Family Welfare – Medical Reimbursement Scheme under

APIMA Rules, 1972 – Further extension of Medical Reimbursement Scheme
from 01.04.2018 to 31.12.2018 – Comprehensive guidelines - Orders –
Issued.

HEALTH MEDICAL AND FAMILY WELFARE (I.1) DEPARTMENT

G.O.RT.No. 345 Dated: 21-08-2018

Read the following:

1. G.O.Ms.No.159, HM&FW(I.1) Department, dt:22.12.2014.

2. G.O.Rt.No.113, HM&FW(I.1) Department, dt:28.02.2015.
3. G.O.Rt.No.254, HM&FW(I.1) Department, dt:27.04.2015.
4. G.O.Rt.No.367, HM&FW(I.1) Department, dt:06.07.2015.
5. G.O.Rt.No.84, HM&FW(I.1) Department, dt:25.02.2016.
6. G.O.Rt.No.147, HM&FW(I.1) Department, dt:26.04.2016.
7. G.O.Rt.No.459, HM&FW(I.1) Department, dt:22.11.2016.
8. G.O.Ms.No.12, HM&FW(I.1) Department, dt.23.01.2017.
9. G.O.Rt.No.283, HM&FW(I.1) Department, dt:12.04.2017.
10. G.O.Rt.No.573, HM&FW(I.1) Department, dt:06.11.2017.
11. G.O.Rt.No.62, HM&FW(I.1) Department, dt:14.02.2018.
12. From the CEO, Dr.NTR VS Trust, e-file No.19031(31)/5/2018-
FOSE-NTRVS, dt:04.07.2018.
13. G.O.Rt.No.291, HM&FW(I.1) Department, dt:12.07.2018.
14. From the CEO, Dr.NTR VS Trust, e-file No.NTRVS-
41034/1/2018-EO-EHS – NTRVS, dt.31.07.2018.

-oSo-
O R D E R:

In the G.O 13th read above, Government have extended the

“Medical Reimbursement Scheme” facility under APIMA Rules,1972 till
31.12.2018, along with Employees Health Scheme (EHS) in parallel duly
specifying some conditions therein.

2. The Chief Executive Officer, Dr.NTR Vaidya Seva Trust in the letter
14th read above, has requested the Government to issue corrigendum to the
G.O issued in the 13th read above.

3. Government after careful examination of the matter here by issue

Comprehensive guidelines for extension of Medical Reimbursement Scheme
facility under APIMA Rules, 1972 as specified hereunder in supersession of
the orders issued in the G.O 13th read above:

I) (a) Extension of Medical Reimbursement Scheme from 01.04.2018 to

31.07.2018 according to APIMA Rules,1972 with CGHS rates.
(b) Continuation of Medical Reimbursement Scheme from 01.08.2018 to
31.12.2018 with EHS package prices replacing CGHS rates.
II) (a) (204) procedures (which are appended to the Annexure to this order)
are now withdrawn from Medical Reimbursement Scheme w.e.f
01.08.2018 and the same shall be continued as cashless under
Employees Health Scheme (EHS).

Page 1 of 13
 (b) The Reimbursement for remaining (1685) procedures shall be as per
EHS rates only w.e.f 01.08.2018.
III) However, the employees working in A.P. Secretariat; HoDs; and Retired
employees and their dependents stationed at Hyderabad along with
the employees working in A.P. Bhavan, New Delhi shall be eligible to
continue Medical Reimbursement facility for all Employees Health
Scheme (EHS) procedures until suitable arrangements are made, as
issued in the G.O.Ms.No.12, HM&FW(I.1) Dept, dt.23.01.2017.
IV) If treatment has taken in any procedure which is not enlisted in EHS
package, the Scrutiny of the concerned Medical Reimbursement bill will
be undertaken at the discretion of the Scrutinizing Authority.
4. All the Scrutinizing Authorities concerned shall take necessary action
accordingly.

5. This order issues with the concurrence of the Finance (FMU, HM&FW)
Deptt., vide their U.O.No.42028/426/FMU-HM & FW/2018, dt.09.07.2018.
(BY ORDER AND IN THE NAME OF THE GOVERNOR OFANDHRA PRADESH)

Dr.POONAM MALAKONDAIAH
SPECIAL CHIEF SECRETARY TO GOVERNMENT
To
The Chief Executive Officer, Dr.NTR Vaidya Seva Trust, AP, Guntur.
All the Superintendents of Teaching Hospitals and District Hospitals
AP, through the Director of Medical Education, AP, Vijayawada.
The Medical Officer, Civil Dispensary, AP Secretariat, Velagapudi.
Copy to:
All the Special Chief Secretaries to Government /Prl. Secretaries/
Secretaries in Secretariat, AP, Amaravathi.
All the Employees and Pensioners Associations through GA (Services
Welfare) Department, AP, Secretariat, Amaravathi .
The Accountant General (A&E), AP, Hyderabad.
The Director of Treasuries and Accounts, AP, Vijayawada.
The PAO, AP, Vijayawada.
All the Heads of the Department.
All the District Collectors in the State.
The Finance (FMU, HM&FW) Department.
The PS to Secretary to Hon’ble CM.
The PS to Spl.CS to Government, HM&FW Department.
Sf/Sc.

// FORWARDED :: BY ORDER //

SECTION OFFICER

(Contd., Annexure)

Page 2 of 13
 Annexure to G.O.Rt.No.345 , HM&FW(I.1) Department,
Dated.21.08.2018
S.No Category
Procedure (C ) Procedure Name Category Name
(new) Code

Laproscopic Surgical
treatment for GENERAL
1 53.62 S1
Incisional Hernia with SURGERY
Mesh

Partial/Subtotal
Gastrectomy with GENERAL
2 43.5.01 S1
anastomosis to SURGERY
Esophagus for ulcer

GENERAL
3 43.3.01 Pyloromyotomy S1
SURGERY

Excision of Small growth GENERAL

4 25.1.02 S1
from Tongue SURGERY

GENERAL
5 63.4 Epididectomy S1
SURGERY

GENERAL
6 4.92 Ganglion Sclerotherapy S1
SURGERY

GENERAL
7 06.39.1 Isthmectomy S1
SURGERY

GENERAL
8 86.3.18 Excision of Fibro Lipoma S1
SURGERY

Excision of Ganglion - GENERAL

9 04.6.03 S1
Small SURGERY

GENERAL
10 26.4 Parotid Duct Repair
SURGERY

Highly Selective GENERAL

11 44.02 S1
Vagotomy SURGERY

Excision of Lingual
12 6.6
Thyroid

Unilateral
GENERAL
13 07.22.1 Adrenelectopmy in S1
SURGERY
nonmalignant conditions

14 22.39 Caldwell-luc(unilateral)

Laproscopic Splenectomy
GENERAL
15 41.5.03 - For other S1
SURGERY
Indications
Laproscopic
Cholecystectomy With GENERAL
16 51.22.7 S1
CBD SURGERY
Repair
Excision of Mammary GENERAL
17 85.21.1 S1
Fistula SURGERY
GENERAL
18 64 Circumcision S1
SURGERY
Selective Vagotomy GENERAL
19 44.03 S1
drainage SURGERY

Page 3 of 13
 Axillo Brachial Bypass Using
20 39.29.8
With Synthetic Graft

21 96.52 Removal of Impacted Ear wax S2 ENT SURGERY

22 21.32 Surgery for Angiofibroma S2 ENT SURGERY

Removal of foreign body in

23 98.11 S2 ENT SURGERY
Ear

Surgical treatment for release

24 25.93 of tongue S2 ENT SURGERY
tie

Cataract surgery SICS + OPHTHALMOLOGY

25 13.71.2 S3
IOL(ECCE+IOL) SURGERY

OPHTHALMOLOGY
26 13.64.2 Yag laser capsulotomy S3
SURGERY

OPHTHALMOLOGY
27 11.31 Pterygium repair S3
SURGERY

OPHTHALMOLOGY
28 86.3.11 Dermoid cyst excision S3
SURGERY

Pterigium + conjunctival OPHTHALMOLOGY

29 11.32 S3
autograft SURGERY

OPHTHALMOLOGY
30 12.1 Iridectomy-Iridotomy S3
SURGERY

Therapeutic Penetrating OPHTHALMOLOGY

31 11.64 S3
Keratoplasty SURGERY

OPHTHALMOLOGY
32 16.63 Dermis Fat Graft S3
SURGERY

Monthly Intravitreal Anti-Vegf

For Macular OPHTHALMOLOGY
33 14.75 S3
Degeneration - Per Injection SURGERY
(Maximum - 6)

Surgical treatment for Other

OPHTHALMOLOGY
34 12.4 disorders of iris and ciliary S3
SURGERY
body

Cataract surgery
OPHTHALMOLOGY
35 13.71.1 phacoemulsification S3
SURGERY
+IOL

Photocoagulation for OPHTHALMOLOGY

36 14.25.1 S3
Retinopathy SURGERY

GYNAECOLOGY
Abdominal Repair for Vault AND
37 70.77.1 S4
Prolapse OBSTETRICS
SURGERY

GYNAECOLOGY
AND
38 67.33 Cryo Surgery S4
OBSTETRICS
SURGERY

GYNAECOLOGY
AND
39 69.92 Intra Uterine Insemination S4
OBSTETRICS
SURGERY

Page 4 of 13
 GYNAECOLOGY
Abdominal Repair With Mesh
AND
40 70.78 for Vault S4
OBSTETRICS
Prolapse
SURGERY

GYNAECOLOGY
Medical Management of AND
41 D25 S4
Fibroids OBSTETRICS
SURGERY

GYNAECOLOGY
Medical Management of Pelvic AND
42 N73.9 S4
Inflammatory Disease OBSTETRICS
SURGERY

GYNAECOLOGY
AND
43 98.16 Hysteroscopic FB removal S4
OBSTETRICS
SURGERY

GYNAECOLOGY
Laproscopic
AND
44 70.77.2 Sacrospinocolpopexy for S4
OBSTETRICS
vault prolapse
SURGERY

ORTHOPEDIC
45 04.5.01 Nerve Repair With Grafting S5 SURGERY AND
PROCEDURES

ORTHOPEDIC
Removal of implants plates
46 78.60.1 S5 SURGERY AND
and nail
PROCEDURES

ORTHOPEDIC
47 81.43 Release of Stiff knee S5 SURGERY AND
PROCEDURES

ORTHOPEDIC
48 93.53.7 Synthetic cast cutting S5 SURGERY AND
PROCEDURES

ORTHOPEDIC
49 81.54 Total knee replacement S5 SURGERY AND
PROCEDURES

ORTHOPEDIC
50 80.42 Release of Stiff Elbow S5 SURGERY AND
PROCEDURES

ORTHOPEDIC
51 83.12 Adductor release S5 SURGERY AND
PROCEDURES

ORTHOPEDIC
52 81.8.02 Shoulder replacement S5 SURGERY AND
PROCEDURES

SURGICAL GASTRO
53 52.4.01 Triple Bypass -Pancreas S6
ENTEROLOGY

CARDIAC AND
54 39.50.3 Peripheral Angioplasty S7 CARDIOTHORACIC
SURGERY

CARDIAC AND
55 0.61 Vertebral Angioplasty S7 CARDIOTHORACIC
SURGERY

Page 5 of 13
 PTCA 3 Additional Stent
56 00.66.8
(00.48)

CARDIAC AND
57 39.50.2 Renal Angioplasty S7 CARDIOTHORACIC
SURGERY

Intersex-Genitoplasty PEDIATRIC
58 64.5 S8
surgery(70.6) SURGERIES

GENITO URINARY
59 64.98 Surgery for Priapism S9
SURGERIES

Bi-lateral illioinguinal block

60 40.24.2 dissection in non malignant
conditions

61 63.92 Vasectomy reversal

Breast reduction for

62 85.3.01 S14 PLASTIC SURGERY
gynacomastia-male

Surgical correction for

63 2.01 S14 PLASTIC SURGERY
Craniosynostosis

Free functional muscle

64 83.77 S14 PLASTIC SURGERY
transfer

65 85.87 Nipple areola reconstruction S14 PLASTIC SURGERY

Surgical Correction of Leprosy

66 82.8
Reconstructive Surgery

Boutonnieries deformity
67 82.89
Repair

Penis reconstruction - micro

68 64.44.2 S14 PLASTIC SURGERY
vascular

69 84.25 Toe transfer S14 PLASTIC SURGERY

70 76.41.1 Corrcetion of lid retraction S14 PLASTIC SURGERY

71 18.6 Ear reconstruction S14 PLASTIC SURGERY

Cochlear Implant Surgery for

COCHLEAR
72 20.96 children S16
IMPLANT SURGERY
below 2 years

Behind Ear Analogue Hearing

COCHLEAR
73 20.95 Aid for S16
IMPLANT SURGERY
Hearing impaired

Local Drug Delivery -

74 24.3.06 Periodontal S18 DENTAL SURGERY
Treatments

Excision Of Precancerous
75 24.4.07 Lesions Under S18 DENTAL SURGERY
L.A

Vertical Sub Sigmoid

76 76.64.2 S18 DENTAL SURGERY
Osteotomy

Fabrication & Insertion Of Cast

77 99.97.8 Partial S18 DENTAL SURGERY
Dentures Framework Per Unit

Page 6 of 13
 Cryosurgery In Dental
78 86.3.02 S18 DENTAL SURGERY
Procedures

Preparation & Cementattion Of

79 23.41.3 Anterior S18 DENTAL SURGERY
All Ceramic Crown

Pre Prosthetic Surgery - Ridge

80 24.4.01 S18 DENTAL SURGERY
Augmentation(Full mouth)

Fabrication & Insertion of Soft

81 99.97.3 Liner S18 DENTAL SURGERY
Denture

82 K13.5.C Medical Management of OSMF S18 DENTAL SURGERY

Fabrication & Insertion Of

83 99.97.1 Complete S18 DENTAL SURGERY
Denture (U & L)

Surgical Management Of TMJ

84 81.2 Ankylosis S18 DENTAL SURGERY
(G.A.)

Fibre Post & Core Restoration

With
85 23.41.5 S18 DENTAL SURGERY
Anterior All Ceramic Crown
(23.4)

Root Coverage Procedure (Per

86 24.2.06 S18 DENTAL SURGERY
Tooth)

Fabrication & Insertion Of

87 23.43.6 Fixed Space S18 DENTAL SURGERY
Maintainers / Space Retainer

88 24.2.03 Gingivectomy-Single Tooth S18 DENTAL SURGERY

Combination Of Intralesional
89 K13.5.B Injection For S18 DENTAL SURGERY
Oral Submucous Fibrosis

Restoration With Composite

90 23.4.04 Veneers S18 DENTAL SURGERY
(Pertooth)

Placement Of Fixed Habit

91 23.42.1 Breaking S18 DENTAL SURGERY
Appliances

Surgical Placement Of Ear

92 24.99.2 S18 DENTAL SURGERY
Prosthesis

Free Gingival Graft-Gum

93 24.3.04 S18 DENTAL SURGERY
Surgery

Fabrication Of Occlusal Night

94 23.43.9 Guard S18 DENTAL SURGERY
(Hard Or Soft)

Marginal Mandibulectomy-
95 76.31.2 S18 DENTAL SURGERY
Osteomyelitis

Fabrication & Cementation Of

96 23.41.2 Metal S18 DENTAL SURGERY
Ceramic Crown (Per Unit)

Page 7 of 13
 Flap Surgery With Bone
97 24.3.03 Grafting (Per S18 DENTAL SURGERY
Quadrant)

Treatment With Fixed

98 24.7.06 S18 DENTAL SURGERY
Retainers

Vestibuloplasty - Maxilla /
99 24.91.1 S18 DENTAL SURGERY
Mandible- G.A.

Segmental Osteotomy
100 76.64.1 S18 DENTAL SURGERY
Mandible

Surgical Closure Oro-Nasal

101 21.82 S18 DENTAL SURGERY
Fistula

102 25.92 Frenectomy S18 DENTAL SURGERY

Root Canal Treatment With

103 23.7.04 Hemisection S18 DENTAL SURGERY
Of Root

Metal Post & Core Restoration

104 23.41.7 With Metal S18 DENTAL SURGERY
Ceramic Crown (23.4)

Fabrication & Cementation Of

105 23.3.01 Inlay & S18 DENTAL SURGERY
Onlay-Ceramic

Surgical Excision With Grafting

106 24.4.10 S18 DENTAL SURGERY
(76.91)

Surgical Placement Of Nose

107 23.6.04 Prosthesis S18 DENTAL SURGERY
With Implants

Fabrication & Insertion Of

108 23.43.7 Removable S18 DENTAL SURGERY
Space Maintainers (Pedo)

Surgical Managemant Of
109 24.4.03 Cyst(<2.5 cm) S18 DENTAL SURGERY
Under L.A.

Fabrication & Insertion Of

110 99.97.2 Complete S18 DENTAL SURGERY
Denture (Upper / Lower)

Fabrication Of Over Dentures

111 99.97.7 With S18 DENTAL SURGERY
Attachments

Fabrication & Insertion Of

112 23.43.1 Removable S18 DENTAL SURGERY
Habit Breaking Appliance

113 24.4.06 Excision Of Growth Under G.A. S18 DENTAL SURGERY

Medical Management of Oral

114 K12.3 S18 DENTAL SURGERY
Ulcers

Medical Management of
115 K13.21.A S18 DENTAL SURGERY
Leukoplakia

Fixed Orthodontics Treatment-

116 24.7.05 Metal S18 DENTAL SURGERY
Braces

Page 8 of 13
 Surgical Placement Of
117 23.6.05 Zygomatic S18 DENTAL SURGERY
Implants Under G.A

Sequestrectomy &
Saucerization Of
118 76.01 S18 DENTAL SURGERY
Osteomyelitis Of Maxilla &
Mandible

Vital Bleaching Procedure For

119 23.4.03 8 Upper S18 DENTAL SURGERY
Teeth

Laser Treatment For

120 86.3.04 Precancerous S18 DENTAL SURGERY
Lesions

Oral Prophylaxis - Extrinsic

121 96.54.1 Stains S18 DENTAL SURGERY
(Upper/ Lower)

Surgical Placement Of Eye

122 95.34 S18 DENTAL SURGERY
Prosthesis

Sub Gingival Curretage Per

123 24.2.01 S18 DENTAL SURGERY
Quadrant

Treatment With Fixed

124 24.7.03 Functional S18 DENTAL SURGERY
Appliances

Hesters Opener Procedure -

125 K13.5.A S18 DENTAL SURGERY
Management of OSMF

Mdical Management Of TMJ

126 M26.69 Dysfunction S18 DENTAL SURGERY
Syndrome (76.94)

Relining / Rebasing of
127 24.9 S18 DENTAL SURGERY
Complete Denture

128 24.4.11 Enucleation Of Cyst/ Tumor S18 DENTAL SURGERY

129 76.31.5 Coronoidectomy S18 DENTAL SURGERY

Fabrication & Insertion Of

130 24.7.10 Obturator & S18 DENTAL SURGERY
Speech Bulb-Acrylic

Treatment with Micro Implants

131 23.6.02 S18 DENTAL SURGERY
(Each)

Preparation And Cementation

132 23.41.1 Of Acrylic S18 DENTAL SURGERY
Crown

133 78.3.03 Alveolar Distraction L.A. S18 DENTAL SURGERY

Medical Management Of
134 G50.0 Trigeminal S18 DENTAL SURGERY
Neuralgia

Fabrication & Insertion Of

135 23.43.5 Removable S18 DENTAL SURGERY
Retainers-Each Arch

Page 9 of 13
 Fabrication Of Over Dentures
136 99.97.5 Without S18 DENTAL SURGERY
Attachments

Pulpotomy & Pulpectomy With

137 23.4.07 S18 DENTAL SURGERY
Ssc

138 24.3.01 Osseous Surgery S18 DENTAL SURGERY

Resection And Reconstruction

139 24.4.02 (Tumor) S18 DENTAL SURGERY
(76.46)

Fabrication & Insertion Of

140 23.43.3 Removable S18 DENTAL SURGERY
Functional Appliance

Anterior Segmental Osteotomy -

141 76.65 Maxilla / S18 DENTAL SURGERY
Mandible (ASO)

Rapid Maxillary Expansion With

142 24.7.01 Hyrax S18 DENTAL SURGERY
Screwifr Palatal Expanders

Vestibuloplasty - Maxilla /
143 24.91.2 S18 DENTAL SURGERY
Mandible- L.A

144 23.11 Root Resection S18 DENTAL SURGERY

145 23.7.03 Apicoectomy S18 DENTAL SURGERY

146 24.3.02 Flap Surgery (Per Quadrant) S18 DENTAL SURGERY

147 24.2.04 Flap Surgery - Single Tooth S18 DENTAL SURGERY

Tooth Coloured Restoration Per

148 23.2.04 S18 DENTAL SURGERY
Tooth

149 24.2.02 Gingivectomy (Per Quadrant) S18 DENTAL SURGERY

Gingival De Pigmentation
150 24.3.05 S18 DENTAL SURGERY
Procedure

Fixed Orthodontics Treatment-

151 24.7.04 Ceramic S18 DENTAL SURGERY
Braces

Fabrication Of Over Dentures -

152 99.97.6 Implant S18 DENTAL SURGERY
Supported (2 units)

Radio Frequency & Thermo

153 86.3.01 Coagulaton For Treatment Of S18 DENTAL SURGERY
Trigeminal Neuralgia

Sinus Lift Procedure Without

154 22.31.1 Grafting S18 DENTAL SURGERY
(22.39)

Sinus Lift Procedure With

155 22.31.2 Grafting S18 DENTAL SURGERY
(22.39/76.91)

Preparation & Cementation Of

156 23.4.05 Anterior S18 DENTAL SURGERY
All Ceramic Laminates

Page 10 of 13
 Surgical Managemant Of Cyst(>
157 24.4.05 2.5 cm) S18 DENTAL SURGERY
Under G.A.

Fibre Post & Core Restoration

158 23.41.6 With Metal S18 DENTAL SURGERY
Ceramic Crown (23.4)

159 93.23.1 Chin Cup Thepary S18 DENTAL SURGERY

160 93.23.2 Head Gear Therapy S18 DENTAL SURGERY

Distraction Osteogenesis-
161 78.3.02 S18 DENTAL SURGERY
Maxilla- G.A.

162 23.2.02 Amalgam Restoration Per Tooth S18 DENTAL SURGERY

Apicoectomy With Grafting

163 23.7.06 S18 DENTAL SURGERY
(76.91)

164 23.2.03 Temporary Filling Per Tooth S18 DENTAL SURGERY

Excision Of Precancerous
165 24.4.09 Lesions With S18 DENTAL SURGERY
Grafting (76.91)

Bilateral Sagittal Split

166 76.64.3 Osteotomy Of S18 DENTAL SURGERY
Mandible (BSSO)

Medical Management Of Lichen

167 L43 S18 DENTAL SURGERY
Planus

Surgical Placement Of Dental

168 23.6.01 Implants S18 DENTAL SURGERY
Under L.A

Fabrication & Cementation Of

169 23.3.02 Inlay & S18 DENTAL SURGERY
Onlay-Metal

Fabrication & Insertion Of

170 23.43.4 Removable S18 DENTAL SURGERY
Partial Denture- Single Tooth

171 23.43.8 Treatment With Inclined Plane S18 DENTAL SURGERY

Fabrication Of Acrylic Splinting

172 24.7.07 Arch ( In S18 DENTAL SURGERY
Auto Polymerizing Acrylic)

Treatment With Temporary

173 24.7.02 Anchorage S18 DENTAL SURGERY
Devices

174 24.4.04 Excision Of Growth Under L.A. S18 DENTAL SURGERY

Excision Of Precancerous
175 24.4.08 Lesions Under S18 DENTAL SURGERY
G.A

Medical Management of
Premalignant
176 K13.21.B Lesions And Conditions S18 DENTAL SURGERY
(Antioxidant Therapy) (
K13.29/K13.5)

Page 11 of 13
 Extraction Of Deep Bony
177 23.19.3 Impacted Tooth S18 DENTAL SURGERY
Under G.A.

Application Of Pit & Fissure

178 23.2.01 Sealants S18 DENTAL SURGERY
(Pedo)

179 23.42.2 Tretament With Expansion Plate S18 DENTAL SURGERY

180 24.91.3 Sulcus Extention Procedure S18 DENTAL SURGERY

Surgical Removal Of Sialolith -

181 26.29.2 S18 DENTAL SURGERY
G.A.

Treatment Under Conscious

182 23.4.02 S18 DENTAL SURGERY
Sedation

183 93.23.3 Face Mask Therapy S18 DENTAL SURGERY

Fabrication & Insertion Of

184 24.7.08 Feeding Plate S18 DENTAL SURGERY
(Acrylic)

Oral Prophylaxis - Calculi

185 96.54.2 S18 DENTAL SURGERY
(Upper/ Lower)

Fabrication & Insertion Of

186 24.7.09 Obturator - S18 DENTAL SURGERY
Acrylic

Surgical Placement Of Nose

187 24.99.1 S18 DENTAL SURGERY
Prosthesis

Fabrication & Insertion Of

188 23.43.2 Removable S18 DENTAL SURGERY
Appliance (Upper / Lower )

Placement Of Stainless Steel

189 23.41.4 Crown (Per S18 DENTAL SURGERY
Tooth)

Crown Lengthening Procedure

190 24.2.05 S18 DENTAL SURGERY
(24.6)

Medical Management Of Myo

FACIAL
191 M79.1 S18 DENTAL SURGERY
Pain Dysfunction Syndrome
(MPDS)

Fabrication & Insertion Of Cast

Partial
192 99.97.4 S18 DENTAL SURGERY
Dentures Framework With
Precission Attachments

193 23.4.01 Flouride Gel Application (Pedo) S18 DENTAL SURGERY

194 76.65.2 Segmental Osteotomy Maxilla S18 DENTAL SURGERY

Distraction Osteogenesis-
195 78.3.01 S18 DENTAL SURGERY
Mandible- G.A.

Atraumatic Restorative
196 23.4.06 S18 DENTAL SURGERY
Treatment

Surgical Removal Of Sialolith -

197 26.29.1 S18 DENTAL SURGERY
L.A.

Page 12 of 13
 Medical Management of Pustular
198 L40 M9 DERMATOLOGY
Psoriasis

Medical Management of Juvenile

199 M08.0 M10 RHEUMATOLOGY
Idiorpathic Arthritis

Post Switch On
Mapping/Initiation Of AVT COCHLEAR IMPLANT
200 95.49.3 S16
And Training Of Child And SURGERY
Mother - Second Installment

Post Switch On
Mapping/Initiation Of AVT COCHLEAR IMPLANT
201 95.49.4 S16
And Training Of Child And SURGERY
Mother - Third Installment

Post Switch On
Mapping/Initiation Of AVT COCHLEAR IMPLANT
202 95.49.5 S16
And Training Of Child And SURGERY
Mother - Fourth Installment

Initial mapping switch on for COCHLEAR IMPLANT

203 95.49.7 S16
auditory verbal therapy SURGERY

Post switch on mapping

/initiation of avt COCHLEAR IMPLANT
204 95.49.8 S16
and Training of child and mother SURGERY
- first installment

Dr. POONAM MALAKONDAIAH

SPECIAL CHIEF SECRETARY TO GOVERNMENT

Page 13 of 13