PhilHealth Circular No. 0035, s.2013 Annex 1 List Of Medical Case Rates

ANNEX 1.LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE P91.3 P91.4 P91.6 P91.8 P91.9 J36 DESCRIPTION Neonatal cerebral irritability Neonatal cerebral depression Hypoxic ischemic encephalopathy of newborn GROUP ABNORMAL SENSORIUM IN THE NEWBORN ABNORMAL SENSORIUM IN THE NEWBORN ABNORMAL SENSORIUM IN THE NEWBORN Case Rate 12,000 12,000 12,000 12,000 12,000 10,000 Professional Fee 3,600 3,600 3,600 3,600 3,600 3,000 Health Care Institution Fee 8,400 8,400 8,400 8,400 8,400 7,000 Other specified disturbances of cerebral status of newborn ABNORMAL SENSORIUM IN THE NEWBORN Disturbance of cerebral status of newborn, unspecified Peritonsillar abscess; Abscess of tonsil; Peritonsillar cellulitis; Quinsy Other diseases of larynx; Abscess of larynx; Cellulitis of larynx; Disease NOS of larynx; Necrosis of larynx; Pachyderma of larynx; Perichondritis of larynx; Ulcer of larynx Retropharyngeal and parapharyngeal abscess; Peripharyngeal abscess Other abscess of pharynx; Cellulitis of pharynx; Nasopharyngeal abscess Other diseases of pharynx; Cyst of pharynx or nasopharynx; Oedema of pharynx or nasopharynx Abscess of lung with pneumonia Abscess of lung without pneumonia; Abscess of lung NOS Abscess of mediastinum Pyothorax with fistula Pyothorax without fistula; Abscess of pleura; Abscess of thorax; Empyema; Pyopneumothorax Cholera due to Vibrio cholerae 01, biovar cholerae Cholera due to Vibrio cholerae 01, biovar eltor Cholera, unspecified Shigellosis due to Shigella dysenteriae; Group A shigellosis [Shiga-Kruse dysentery] Shigellosis due to Shigella flexneri;Group B shigellosis Shigellosis due to Shigella boydii; Group C shigellosis Shigellosis due to Shigella sonnei; Group D shigellosis Other shigellosis Shigellosis, unspecified; ; Bacillary dysentery NOS Enteropathogenic Escherichia coli infection Enterotoxigenic Escherichia coli infection Enteroinvasive Escherichia coli infection Enterohaemorrhagic Escherichia coli infection Other intestinal Escherichia coli infections Campylobacter enteritis Enteritis due to Yersinia enterocolitica Enterocolitis due to Clostridium difficile; Foodborne intoxication by Clostridium difficile; Pseudomembranous colitis Other specified bacterial intestinal infections Bacterial intestinal infection, unspecified. Bacterial enteritis NOS Foodborne staphylococcal intoxication Foodborne Clostridium perfringens [Clostridium welchii] intoxication. Enteritis necroticans. Pig-bel Foodborne Vibrio parahaemolyticus intoxication Foodborne Bacillus cereus intoxication Other specified bacterial foodborne intoxications Bacterial foodborne intoxication, unspecified Balantidiasis; Balantidial dysentery Giardiasis [lambliasis] Cryptosporidiosis Isosporiasis; Infection due to Isospora belli and Isospora hominis; Intestinal coccidiosis; Isosporosis Other specified protozoal intestinal diseases; Intestinal trichomoniasis; Sarcocystosis; Sarcosporidiosis Protozoal intestinal disease, unspecified;Flagellate diarrhoea; Protozoal colitis; Protozoal diarrhoea; Protozoal dysentery Rotaviral enteritis Acute gastroenteropathy due to Norwalk agent; Small round structured virus enteritis Adenoviral enteritis Other viral enteritis Viral intestinal infection, unspecified; Viral enteritis NOS; Viral gastroenteritis NOS; Viral gastroenteropathy NOS Other specified intestinal infections Infectious diarrhea Acute gastroenteritis Gastroenteritis and colitis due to radiation Toxic gastroenteritis and colitis ABNORMAL SENSORIUM IN THE NEWBORN ABSCESS OF RESPIRATORY TRACT J38.7 ABSCESS OF RESPIRATORY TRACT 10,000 3,000 7,000 J39.0 J39.1 J39.2 J85.1 J85.2 J85.3 J86.0 J86.9 A00.0 A00.1 A00.9 A03.0 A03.1 A03.2 A03.3 A03.8 A03.9 A04.0 A04.1 A04.2 A04.3 A04.4 A04.5 A04.6 A04.7 A04.8 A04.9 A05.0 A05.2 A05.3 A05.4 A05.8 A05.9 A07.0 A07.1 A07.2 A07.3 A07.8 ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ABSCESS OF RESPIRATORY TRACT ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 A07.9 A08.0 A08.1 A08.2 A08.3 A08.4 A08.5 A09.0 A09.9 K52.0 K52.1 ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 4,200 Page 1 of 111 ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE K52.2 K52.8 DESCRIPTION Allergic and dietetic gastroenteritis and colitis; Food hypersensitivity gastroenteritis or colitis Other specified noninfective gastroenteritis and colitis; Eosinophilic gastritis or gastroenteritis Noninfective gastroenteritis and colitis, unspecified; Diarrhoea specified as noninfective, or NOS in countries where the conditions can be presumed to be of noninfectious origin; Enteritis specified as noninfective, or NOS in countries where the conditio Irritable bowel syndrome with diarrhoea Acute renal failure with tubular necrosis; Tubular necrosis NOS; Acute Tubular necrosis ; Renal Tubular necrosis Acute renal failure with acute cortical necrosis; Cortical necrosis NOS; Acute Cortical necrosis ; Renal Cortical necrosis GROUP ACUTE GASTROENTERITIS ACUTE GASTROENTERITIS Case Rate 6,000 6,000 Professional Fee 1,800 1,800 Health Care Institution Fee 4,200 4,200 K52.9 ACUTE GASTROENTERITIS 6,000 1,800 4,200 K58.0 N17.0 ACUTE GASTROENTERITIS ACUTE RENAL FAILURE 6,000 19,300 1,800 5,790 4,200 13,510 N17.1 ACUTE RENAL FAILURE 19,300 5,790 13,510 N17.2 N17.8 N17.9 O08.4 Acute renal failure with medullary necrosis; Medullary papillary necrosis, NOS; Acute medullary papillary necrosis; ACUTE RENAL FAILURE Renal medullary papillary necrosis Other acute renal failure Acute renal failure, unspecified; ACUTE RENAL FAILURE ACUTE RENAL FAILURE 19,300 19,300 19,300 19,300 5,790 5,790 5,790 5,790 13,510 13,510 13,510 13,510 Renal failure following abortion and ectopic and molar pregnancy; Oliguria Acute renal failure; Oliguria renal ACUTE RENAL FAILURE shutdown; Oliguria renal tubular necrosis; Oliguria Uraemia Adult respiratory distress syndrome; Adult hyaline membrane disease Other adverse food reactions, not elsewhere classified Angioneurotic oedema; Giant urticaria; Quinke's oedema ADULT RESPIRATORY DISTRESS SYNDROME ALLERGIC REACTIONS ALLERGIC REACTIONS J80 T78.1 T78.3 T78.4 T78.8 T78.9 32,000 6,200 6,200 6,200 6,200 6,200 9,600 1,860 1,860 1,860 1,860 1,860 22,400 4,340 4,340 4,340 4,340 4,340 T88.7 A06.4 A06.0 A06.1 A06.2 A06.3 A06.7 A06.8 E85.8 T78.0 T78.2 T88.6 D50.0 D50.1 D50.8 D50.9 D51.0 D51.8 D51.9 D52.1 D52.9 D53.0 D53.1 D53.2 D53.8 Allergy, unspecified; Allergic reaction NOS; Hypersensitivity ALLERGIC REACTIONS NOS; Idiosyncracy NOS Other adverse effects, not elsewhere classified ALLERGIC REACTIONS Adverse effect, unspecified ALLERGIC REACTIONS Unspecified adverse effect of drug or medicament; Adverse effect of correct drug or medicament properly ALLERGIC REACTIONS administered; Allergic reactiion to correct drug or medicament properly administered; Hypersensitivity to correct drug or medicament properly administe Amoebic liver abscess; Hepatic amoebiasis AMOEBIASIS, HEPATIC Acute amoebic dysentery; Acute amoebiasis; Intestinal AMOEBIASIS, NONHEPATIC amoebiasis NOS Chronic intestinal amoebiasis AMOEBIASIS, NONHEPATIC Amoebic nondysenteric colitis AMOEBIASIS, NONHEPATIC Amoeboma of intestine; Amoeboma NOS AMOEBIASIS, NONHEPATIC Cutaneous amoebiasis AMOEBIASIS, NONHEPATIC Amoebic Appendicitis AMOEBIASIS, NONHEPATIC Other amyloidosis; Localized amyloidosis AMYLOIDOSIS Anaphylactic shock due to adverse food reaction ANAPHYLACTIC SHOCK Anaphylactic shock, unspecified; Allergic shock NOS; ANAPHYLACTIC SHOCK Anaphylactic reaction NOS; Anaphylaxis NOS Anaphylactic shock due to adverse effect of correct drug or ANAPHYLACTIC SHOCK medicament properly administered Iron deficiency anaemia secondary to blood loss (chronic); ANEMIA Posthaemorrhagic anaemia (chronic) Sideropenic dysphagia; Kelly-Paterson syndrome; PlummerANEMIA Vinson syndrome Other iron deficiency anaemias ANEMIA Iron deficiency anaemia, unspecified ANEMIA Vitamin B12 deficiency anaemia due to intrinsic factor deficiency; Addison Anaemia; Biermer Anaemia; ANEMIA CongenitalPernicious Anaemia; Congenital intrinsic factor deficiency Other vitamin B12 deficiency anaemias ANEMIA Vitamin B12 deficiency anaemia, unspecified ANEMIA Drug-induced folate deficiency anaemia ANEMIA Folate deficiency anaemia, unspecified; Folic acid ANEMIA deficiency anaemia NOS Protein deficiency anaemia; Amino-acid deficiency ANEMIA anaemia; Orotaciduric anaemia Other megaloblastic anaemias, not elsewhere classified; ANEMIA Megaloblastic anaemia NOS Scorbutic anaemia ANEMIA Other specified nutritional anaemias; Anaemia associated with deficiency of copper; Anaemia associated with ANEMIA deficiency of molybdenum; Anaemia associated with deficiency of zinc Nutritional anaemia, unspecified; Simple chronic anaemia Anaemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency; Favism; G6PD deficiency anaemia ANEMIA ANEMIA 6,200 1,860 4,340 10,000 6,000 6,000 6,000 6,000 6,000 6,000 11,100 7,600 7,600 7,600 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 3,000 1,800 1,800 1,800 1,800 1,800 1,800 3,330 2,280 2,280 2,280 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 7,000 4,200 4,200 4,200 4,200 4,200 4,200 7,770 5,320 5,320 5,320 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 D53.9 D55.0 10,000 10,000 3,000 3,000 7,000 7,000 Page 2 of 111 ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Anaemia due to other disorders of glutathione metabolism; Anaemia due to enzyme deficiencies, except G6PD, related to the hexose monophosphate [HMP] shunt pathway; Anaemia due to haemolytic nonspherocytic hereditary, type I Anaemia due to disorders of glycolytic enzymes; Haemolytic nonspherocytic hereditary Anaemia, type II; Hexokinase deficiency Anaemia; Pyruvate kinase [PK] deficiency Anaemia; Triose-phosphate isomerase deficiency Anaemia Other anaemias due to enzyme disorders Anaemia due to enzyme disorder, unspecified Mediterranean anaemia; Mediterranean anaemia with other haemoglobinopathy; Thalassaemia minor with other haemoglobinopathy; Thalassaemia mixed with other haemoglobinopathy; Sickle-cell anaemia with crisis; Hb-SS disease with crisis GROUP Case Rate Professional Fee Health Care Institution Fee D55.1 ANEMIA 10,000 3,000 7,000 D55.2 ANEMIA 10,000 3,000 7,000 D55.8 D55.9 D56.9 ANEMIA ANEMIA ANEMIA 10,000 10,000 10,000 3,000 3,000 3,000 7,000 7,000 7,000 D57.0 D57.1 D57.3 D57.8 D58.0 D58.1 ANEMIA 10,000 10,000 10,000 10,000 10,000 10,000 3,000 3,000 3,000 3,000 3,000 3,000 7,000 7,000 7,000 7,000 7,000 7,000 Sickle-cell anaemia without crisis; Sickle-cell anaemia NOS; ANEMIA Sickle-cell disease NOS ; Sickle-cell disorder NOS Sickle-cell trait; Hb-S trait ; Heterozygous Haemoglobin S Other sickle-cell disorders Hereditary spherocytosis; Acholuric (familial) jaundice; Congenital (spherocytic) haemolytic icterus; MinkowskiChauffard syndrome Hereditary elliptocytosis; Congenital Elliptocytosis; Congenital Ovalocytosis; Hereditary Ovalocytosis ANEMIA ANEMIA ANEMIA ANEMIA D58.2 Other haemoglobinopathies; Abnormal haemoglobin NOS; Congenital Heinz body anaemia; Hb-C Disease; Hb-C ANEMIA Disease; Hb-D Disease; Hb-E Disease; Haemoglobinopathy NOS; Unstable haemoglobin haemolytic disease Other specified hereditary haemolytic anaemias; Stomatocytosis Hereditary haemolytic anaemia, unspecified; Acquired haemolytic anaemia Drug-induced autoimmune haemolytic anaemia Other autoimmune haemolytic anaemias; Autoimmune haemolytic disease, cold type; (Autoimmune haemolytic disease, warm type; Chronic cold haemagglutinin disease; Cold agglutinin disease; Cold agglutinin haemoglobinuria; Secondary symptomatic Haemolytic a ANEMIA ANEMIA ANEMIA 10,000 3,000 7,000 D58.8 D58.9 D59.0 10,000 10,000 10,000 3,000 3,000 3,000 7,000 7,000 7,000 D59.1 ANEMIA 10,000 3,000 7,000 D59.2 D59.4 D59.5 Drug-induced nonautoimmune haemolytic anaemia; DrugANEMIA induced enzyme deficiency anaemia Other nonautoimmune haemolytic anaemias; Mechanical ANEMIA Haemolytic anaemia; Microangiopathic Haemolytic anaemia; Toxic Haemolytic anaemia Paroxysmal nocturnal haemoglobinuria [MarchiafavaANEMIA Micheli] Haemoglobinuria due to haemolysis from other external causes; Haemoglobinuria from exertion; Haemoglobinuria ANEMIA march; Haemoglobinuria paroxysmal cold Other acquired haemolytic anaemias Acquired haemolytic anaemia, unspecified; Chronic Idiopathic haemolytic anaemia Transient acquired pure red cell aplasia Constitutional aplastic anaemia; Congenital Pure red cell Aplasia; Pure red cell Aplasia of infants; Primary Pure red cell Aplasia; Blackfan-Diamond syndrome; Familial hypoplastic anaemia; Fanconi's anaemia; Pancytopenia with malformations Drug-induced aplastic anaemia Aplastic anaemia due to other external agents Idiopathic aplastic anaemia Other specified aplastic anaemias Aplastic anaemia, unspecified; Hypoplastic anaemia NOS; Medullary hypoplasia; Panmyelophthisis Acute posthaemorrhagic anaemia Anaemia in neoplastic disease Anaemia in other chronic diseases classified elsewhere Hereditary sideroblastic anaemia; Sex-linked hypochromic sideroblastic anaemia Secondary sideroblastic anaemia due to disease Secondary sideroblastic anaemia due to drugs and toxins Other sideroblastic anaemias; Sideroblastic anaemia NOS; pyridoxine-responsive NEC Sideroblastic anaemia ANEMIA ANEMIA ANEMIA 10,000 10,000 10,000 3,000 3,000 3,000 7,000 7,000 7,000 D59.6 D59.8 D59.9 D60.1 10,000 10,000 10,000 10,000 3,000 3,000 3,000 3,000 7,000 7,000 7,000 7,000 D61.0 ANEMIA 10,000 3,000 7,000 D61.1 D61.2 D61.3 D61.8 D61.9 D62 D63.0* D63.8* D64.0 D64.1 D64.2 D64.3 ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA ANEMIA 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 10,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 3,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 7,000 Page 3 of 111 Primary gout forearm Urate tophus of heart hand Urate tophus of heart pelvic region and thigh Idiopathic gout. Primary gout multiple sites ARTHRITIS NONINFECTIOUS Urate tophus of heart shoulder region Urate tophus of heart upper arm Idiopathic gout.700 9.900 4.900 4. unspecified. Infective arthritis NOS other sites Pyogenic arthritis.91 M00.790 6.900 4.100 2.100 2.96 M00.000 7.910 2.29 M02. Lower leg Pneumococcal arthritis and polyarthritis. unspecified.900 4. Gouty bursitis. site unspecified Seronegative rheumatoid arthritis.900 4. Juvenile rheumatoid arthritis ARTHRITIS NONINFECTIOUS with or without rheumatoid factor site unspecified Juvenile ankylosing spondylitis site unspecified Other juvenile arthritis lower leg Other juvenile arthritis site unspecified Juvenile arthritis.100 2.910 2.700 9.100 2.100 2.89 M06.000 7.06 M08.700 9.000 7.900 4. hand Rheumatoid arthritis.790 6. site unspecified Rheumatoid arthritis.000 7. unspecified Pneumococcal arthritis and polyarthritis.36 M06.000 7.39 M06.100 2. unspecified lower leg Juvenile arthritis.900 4.02 M10.000 7. Juvenile rheumatoid arthritis with or without rheumatoid factor lower leg ANEMIA GROUP Case Rate 10.96 M08.19 M00.790 6.95 M00.99 M05.000 7.100 Health Care Institution Fee 7.82 M00. unspecified. unspecified. unspecified.900 ANEMIA ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS INFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS Juvenile rheumatoid arthritis.790 6.910 2.100 2.000 7.19 M08.10 M10.900 4. unspecified site unspecified ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS M08.000 7.000 7. lower leg Inflammatory polyarthropathy.01 M06.29 7.07 DESCRIPTION Other specified anaemias.790 6.910 2.000 2.900 4.900 4.000 7. unspecified.03 M10.000 7.790 6.100 2.100 2. Site unspecified Arthritis and polyarthritis due to other specified bacterial agents upper arm Pyogenic arthritis.790 6.06 M10.000 7. unspecified. site unspecified Juvenile arthritis with systemic onset.910 2.90 M06.900 4.000 7.000 7.100 2.700 9.99 M06.000 7.000 7.910 2.000 7.790 6.900 4.97 M00.100 2.100 2.000 7. site unspecified Rheumatoid nodule.900 4. Still's disease NOS site unspecified Reactive arthropathy. unspecified.05 M10.100 2.900 4. lower leg Other specified rheumatoid arthritis.910 2.100 2.100 2.790 6.900 4.000 6. unspecified. Leukoerythroblastic anaemia Anaemia.100 2.99 M02.790 4.98 M00.700 9.100 2.100 2.900 4.000 7.100 2. unspecified shoulder region Juvenile arthritis. Infective arthritis NOS ankle and foot Pyogenic arthritis.910 2.790 6.100 2.900 4.000 7.100 2. unspecified.99 M10.95 M06.000 9.900 4.000 7. forearm Rheumatoid arthritis. unspecified.100 2.900 4. unspecified.100 2. Infective arthritis NOS forearm Pyogenic arthritis. pelvic region and thigh Rheumatoid arthritis.900 4. Infantile pseudoleukaemia.91 M06.07 M10. Infective arthritis NOS hand Pyogenic arthritis.000 7.94 M06. shoulder region Seronegative rheumatoid arthritis.910 2.04 M10.000 7.94 M00. site unspecified Adult-onset Still's disease. unspecified.100 4. unspecified.86 M06. Gouty bursitis. Juvenile rheumatoid arthritis ARTHRITIS NONINFECTIOUS with or without rheumatoid factor ankle and foot Juvenile rheumatoid arthritis.700 9.900 4. unspecified.91 M08. shoulder region Rheumatoid arthritis.700 9.93 M00.81 M06.09 M10.98 M06.790 6.ANNEX 1.900 4.19 M08.000 7. Infective arthritis NOS site unspecified Reiter's disease.000 3.900 4.000 7.97 M06.000 7.8 D64.100 2.700 9.910 2.900 Idiopathic gout.86 M08.09 M08.16 M00.700 9.000 7. unspecified.100 2. Infective arthritis NOS multiple sites Pyogenic arthritis.000 7.700 9. Gouty bursitis. unspecified.700 9.90 M00.08 M10.000 7. multiple sites Rheumatoid arthritis.000 10.99 M08.910 2.96 M06.700 9.900 4.100 2.910 2.9 M00.000 7.01 M10.100 2.900 4.900 4.700 9.900 4.87 M06.900 4.000 2.29 M00. ankle and foot Other specified rheumatoid arthritis.900 4.900 4.910 2.790 6.900 4.900 4. site unspecified Other specified rheumatoid arthritis.000 7.900 4. Site unspecified Other streptococcal arthritis and polyarthritis.000 Professional Fee 3. shoulder region Other specified rheumatoid arthritis. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE D64.000 7.000 7. Infective arthritis NOS lower leg Pyogenic arthritis.900 4.000 7. Infective arthritis NOS pelvic region and thigh Pyogenic arthritis.000 7.100 2. unspecified. unspecified.100 2.910 2.700 9. pelvic region and thigh Inflammatory polyarthropathy.100 2.000 7.000 7.700 7.100 2. Primary gout lower leg Urate tophus of heart ankle and foot Urate tophus of heart other sites Urate tophus of heart site unspecified Lead-induced gout multiple sites Drug-induced gout site unspecified ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS Page 4 of 111 .790 6.93 M06.89 M08.000 7.000 7. other sites Rheumatoid arthritis.00 M10.900 4. site unspecified Seropositive rheumatoid arthritis.900 4.100 2.790 6.49 M06.100 2.700 9.100 2.900 4.100 2.910 2. unspecified.09 M06. Infective arthritis NOS shoulder region Pyogenic arthritis.100 2.910 2.900 4. ankle and foot Rheumatoid arthritis. lower leg Rheumatoid arthritis.900 4.790 6.100 2.100 2.45 M06. site unspecified Juvenile rheumatoid arthritis.100 2. 000 7.100 2.900 4.100 2. not elsewhere classified lower leg Monoarthritis.000 7.0 A92.100 2.91 M13.000 7.100 7.96 M13. Unspecified arthropod-borne viral fever.670 5. not elsewhere classified ankle and foot Monoarthritis.100 2.900 4.000 7.900 4.100 2.57 M12.900 4. Arthropathy NOS shoulder region Arthritis.99 M11.90 M11.8 A93. unspecified.93 M10.000 7.000 7. unspecified site unspecified Monoarthritis.000 7.100 2.000 7.85 M13.100 2.900 4.2 A92.900 4.900 4.900 4.100 2.000 7. Arthropathy NOS lower leg Arthritis.16 M13.670 5.100 5.100 8. Arboviral fever NOS. not elsewhere classified.000 7. Allergic arthritis ankle and foot Other specified arthritis.39 M10. Arthropathy NOS ankle and foot Arthritis.900 4.55 M12.81 M13. Allergic arthritis lower leg ARTHRITIS NONINFECTIOUS Other specified arthritis.000 7.000 7.56 M12.06 M13.100 2.000 7.000 7. Arthropathy NOS multiple sites Arthritis.91 M10.000 7. unspecified.900 4.000 7.100 2.000 7.100 2.430 Health Care Institution Fee 4.000 7.900 4.430 2.000 7. Arthropathy NOS other sites Arthritis.430 2.900 4.100 2.000 7.000 7.100 2.900 4. unspecified.88 M13.900 4.900 4.52 M12. unspecified multiple sites Polyarthritis. Allergic arthritis multiple sites Other specified arthritis.000 7. unspecified.87 M13.59 M12.86 M13. Arthropathy NOS pelvic region and thigh Arthritis.8 DESCRIPTION Gout due to impairment of renal function multiple sites Gout due to impairment of renal function lower leg Gout due to impairment of renal function site unspecified Other secondary gout multiple sites Other secondary gout site unspecified Gout. Vesicular stomatitis virus disease [Indiana fever] ARTHROPOD BORNE VIRAL FEVER ARTHROPOD BORNE VIRAL FEVER ARTHROPOD BORNE VIRAL FEVER A94 M15.900 4.430 2.900 4. Allergic arthritis shoulder region GROUP ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS Case Rate 7.00 M13.98 M10. unspecified.100 2. unspecified multiple sites Crystal arthropathy.000 7.000 7.100 8.100 2.100 2.000 7.100 2.100 8.100 2. Arthropathy NOS site unspecified Chikungunya virus disease. unspecified.900 4.100 2.000 7.000 7.100 2.0 Unspecified arthropod-borne viral fever.93 M13.100 2.900 4.670 4.96 M10.100 2.000 7.09 M13.000 7.13 M13.900 4.100 2. Arthropathy NOS upper arm Arthritis.100 2. Allergic arthritis site unspecified Arthritis.ANNEX 1.000 7.900 4.900 4.000 7.99 M12. Transient arthropathy lower leg Other specific arthropathies.100 2. unspecified.900 4.900 4.100 8.900 4.670 Other specified arthritis.000 7.01 M13.000 7.100 2. unspecified upper arm Gout.000 7. unspecified lower leg Gout.000 7. Arbovirus ARTHROPOD BORNE VIRAL FEVER infection NOS Primary generalized (osteo)arthrosis ARTHROSIS 8.100 2.000 7.58 M12.89 M11.100 2.50 M12.900 4. unspecified forearm Gout. Arthropathy NOS hand Arthritis.900 4.900 4.100 2. unspecified shoulder region Polyarthritis. unspecified site unspecified Other specified crystal arthropathies site unspecified Crystal arthropathy.900 4.100 2.900 4.39 M12.000 7. Piry virus disease.100 2.900 4.94 M13.000 7.000 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M10.97 M10.000 8. Venezuelan equine encephalitis.100 2. unspecified shoulder region Gout. unspecified other sites Gout.100 2.000 7.100 2.900 4.900 4. unspecified lower leg Polyarthritis.900 4. not elsewhere classified other sites Other specified arthritis.900 4. Arthropathy NOS forearm Arthritis.900 4.89 M13.90 M10.000 7.100 2.1 A92.100 2.80 M13.670 5.100 2. Transient arthropathy site unspecified Polyarthritis.30 M10.900 4.900 4.900 4.900 4.100 2.17 M13. unspecified.900 4. ARTHROPOD BORNE VIRAL FEVER Venezuelan encephalomyelitis virus disease Other specified mosquito-borne viral fevers Sandfly fever.900 4.1 A93.000 7.100 2.000 7.430 2.100 2.900 4.100 2.000 7.900 4. Pappataci fever.000 7.900 4.900 4. unspecified multiple sites Gout.900 4.000 7.000 7.900 4.000 7.18 M13.100 Professional Fee 2.000 7. unspecified.900 5. unspecified ankle and foot Gout. Allergic arthritis other sites Other specified arthritis.100 2.900 4.40 M10.99 A92.900 4.100 2.900 4.900 Page 5 of 111 .000 7.000 7.430 2.670 5.94 M10.900 4. unspecified.49 M10. unspecified site unspecified Villonodular synovitis (pigmented) lower leg Palindromic rheumatism site unspecified Traumatic arthropathy multiple sites Traumatic arthropathy upper arm Traumatic arthropathy forearm Traumatic arthropathy hand Traumatic arthropathy pelvic region and thigh Traumatic arthropathy lower leg Traumatic arthropathy ankle and foot Traumatic arthropathy other sites Traumatic arthropathy site unspecified Other specific arthropathies.100 2.000 7.900 4. Chikungunya (haemorrhagic) fever O'nyong-nyong fever ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHRITIS NONINFECTIOUS ARTHROPOD BORNE VIRAL FEVER ARTHROPOD BORNE VIRAL FEVER Venezuelan equine fever.430 2.26 M12.92 M13.100 2.90 M13.100 8.02 M13.100 2.95 M13.53 M12.900 4.000 7.100 2. unspecified upper arm Polyarthritis.100 2.100 2.100 2.000 7.92 M10.000 7. not elsewhere classified. Phlebotomus fever Other specified arthropod-borne viral fevers.97 M13.89 M13.100 2.100 2.100 2.54 M12.670 5.900 4.98 M13.000 7. not elsewhere classified forearm Monoarthritis.86 M12. unspecified hand Gout. Allergic arthritis pelvic region and ARTHRITIS NONINFECTIOUS thigh Other specified arthritis.100 2.100 2.36 M10.100 2. 00 DESCRIPTION Bouchard's nodes (with arthropathy) Secondary multiple arthrosis.88 M19. Post-traumatic arthrosis NOS upper arm Post-traumatic arthrosis of other joints.000 7.100 2.000 7.000 7.900 4.000 7.95 M19. unspecified pelvic region and thigh Arthrosis.100 2. SCIATICA 9.900 4.0 M18.3 M15.300 6. Secondary arthrosis NOS site unspecified Other specified arthrosis shoulder region Other specified arthrosis lower leg Other specified arthrosis ankle and foot Other specified arthrosis other sites Other specified arthrosis site unspecified Arthrosis.140 1.400 6.900 4.700 4.19 M19.100 2. unspecified Primary gonarthrosis.100 2.98 M19.96 M19. Extrinsic allergic asthma.99 J45.900 4.000 7.08 ASTHMA IN ACUTE EXACERBATION ASTHMA IN ACUTE EXACERBATION ASTHMA IN ACUTE EXACERBATION ASTHMA IN ACUTE EXACERBATION ATELECTASIS BACK PAIN.900 4. Post-traumatic polyarthrosis Erosive (osteo)arthrosis Other polyarthrosis Polyarthrosis.100 2.3 M17.700 2. Dysplastic coxarthrosis unilateral Coxarthrosis.100 2.90 J46 J98.000 7.000 7.900 4. RADICULOPATHY. RADICULOPATHY.100 2.100 2.1 M16. Secondary gonarthrosis unilateral Gonarthrosis.000 7.100 2.000 Professional Fee 2.92 M19.100 2. Primary arthrosis NOSother sites Primary arthrosis of other joints.400 6.900 4.100 2.920 1.100 2.100 2. Primary arthrosis NOSupper arm Primary arthrosis of other joints.800 6.100 2.01 M54.000 7. in Acute Exacerbation Nonallergic asthma. in Acute Exacerbation Bronchial Asthma in Acute Exacerbation Status asthmaticus.000 7.89 M19.000 9.100 2.100 2.000 7.21 M19. Secondary gonarthrosis NOS.94 M19.06 M19.000 9. Primary arthrosis NOSmultiple sites Primary arthrosis of other joints.900 4.300 9.300 ASTHMA IN ACUTE EXACERBATION J45. Intrinsic nonallergic asthma.700 2.1 M17.100 2.000 7.900 4. Post-traumatic arthrosis NOS shoulder region Post-traumatic arthrosis of other joints.100 2.100 2. unspecified multiple sites Arthrosis.000 7.2 M15.08 M19.900 4.920 1.000 7.000 7. Post-traumatic arthrosis NOS multiple sites Post-traumatic arthrosis of other joints.900 6.100 2.9 M17.900 4.100 2.000 7. Collapse of lung.93 M19.87 M19.400 2.8 M15.000 7.900 4.000 9. bilateral Other primary gonarthrosis.000 7.10 J45.900 4. unspecified lower leg Arthrosis.900 4.000 7.000 7.900 4.900 4.000 7.000 7. Allergic bronchitis NOS.900 4. unspecified Primary arthrosis of first carpometacarpal joints.900 4.000 7.900 4.00 M19.0 M17.100 2.300 6. unspecified other sites Arthrosis. Post-traumatic gonarthrosis NOS. Primary arthrosis NOSsite unspecified Post-traumatic arthrosis of other joints. unspecified forearm Arthrosis. Primary arthrosis NOSpelvic region and thigh Primary arthrosis of other joints.9 M18.86 M19.2 M17.920 6.ANNEX 1. Brock's syndrome Panniculitis affecting regions of neck and back occipitoatlanto-axial region Panniculitis affecting regions of neck and back lumbar region Panniculitis affecting regions of neck and back sacral and sacrococcygeal region ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS ARTHROSIS GROUP Case Rate 7.900 4.900 4.100 2. Dysplastic coxarthrosis NOS. unspecified ankle and foot Arthrosis.02 M19.900 4. Post-traumatic gonarthrosis unilateral Other secondary gonarthrosis. Allergic rhinitis with asthma. Acute severe asthma Pulmonary collapse.000 7.000 7.900 4.10 M19. Generalized osteoarthritis NOS Primary coxarthrosis.4 M15.100 2.000 7. Primary coxarthrosis NOS.000 7.000 7.9 M16.100 2.900 4.100 2.100 2.000 7. RADICULOPATHY.000 7.100 2.100 2.000 7.100 2.900 4.100 2.100 2. Hay fever with asthma.9 M19. SCIATICA BACK PAIN.1 M54.100 2.05 M19.480 4.000 7. Secondary arthrosis NOS shoulder region Other secondary arthrosis.100 2.100 2. Primary gonarthrosis unilateral Post-traumatic gonarthrosis.900 4.100 2.000 7. unspecified upper arm Arthrosis.2 M16.300 6.0 M16.000 7. Primary gonarthrosis NOS.900 4.900 4.80 J45. Atopic asthma.900 4.11 M19.29 M19.100 2. Idiosyncratic asthma.900 4.90 M19. Post-traumatic arthrosis NOS site unspecified Other secondary arthrosis.12 M19.900 4.09 M19.900 4.000 7.900 4.5 M17.000 7. bilateral Other post-traumatic gonarthrosis.000 7.3 M16.000 7.900 4.100 2.000 7.000 7.900 4.900 4. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M15. in Acute Exacerbation Mixed asthma.900 4.700 2.900 4.81 M19.100 2. unspecified site unspecified Predominantly allergic asthma.900 4.97 M19.100 2.900 4.480 4.000 7. unspecified shoulder region Arthrosis. bilateral Other primary coxarthrosis. Atelectasis.000 7.480 Page 6 of 111 .900 4.100 2.100 2. bilateral Other dysplastic coxarthrosis.100 2. unspecified Primary arthrosis of other joints.000 13.900 4.100 2.900 4. unspecified.91 M19.900 4.000 7.06 M54. unspecified hand Arthrosis. Primary coxarthrosis unilateral Coxarthrosis resulting from dysplasia. Primary arthrosis NOSlower leg Primary arthrosis of other joints. SCIATICA BACK PAIN.100 2.000 7. bilateral Arthrosis of first carpometacarpal joint.700 Health Care Institution Fee 4.660 4.000 9. RADICULOPATHY. SCIATICA BACK PAIN.920 1.400 1.400 6.920 1. RADICULOPATHY.920 1.400 6.400 1.ANNEX 1.480 M54.300 6.400 6. SCIATICA BACK PAIN.400 1. RADICULOPATHY. Backache NOS lumbosacral region Dorsalgia.480 4.480 4. Autonomous Neuropathic bladder . SCIATICA BACK PAIN.400 9.41 M54. SCIATICA BACK PAIN.12 BACK PAIN.480 4.920 1.400 6. SCIATICA 6. Backache NOS site unspecified Uninhibited neuropathic bladder. SCIATICA BACK PAIN.480 4.400 6. SCIATICA 6.480 4. Atonic Motor Neuropathic bladder. not elsewhere classified GROUP Case Rate Professional Fee 1. RADICULOPATHY. RADICULOPATHY.37 M54. not elsewhere classified Reflex neuropathic bladder.920 1. Brachial Neuritis or radiculitis NOS.400 6.18 BACK PAIN. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Radiculopathy.920 4.49 M54.14 BACK PAIN.480 4. RADICULOPATHY.480 4.30 M54. Backache NOS lumbar region Dorsalgia.400 6.480 4. Low back strain. thoracic Neuritis or radiculitis NOS .400 6. Lumbosacral.920 1.480 4.920 1. Lumbar Neuritis or radiculitis NOS. Lumbar Neuritis or radiculitis NOS.920 1. Lumbago NOS cervical region Other dorsalgia thoracic region Other dorsalgia sacral and sacrococcygeal region Dorsalgia.400 6.920 4.920 4. SCIATICA 6.480 M54. Brachial Neuritis or radiculitis NOS. Lumbar Neuritis or radiculitis NOS.920 1. Low back strain.920 1. not elsewhere classified. Loin pain. Brachial Neuritis or radiculitis NOS.99 N31.700 2.920 4. Sensory Atonic Motor BLADDER DYSFUNCTION Neuropathic bladder. Lumbosacral.480 M54.480 4.400 1.31 M54. unspecified. RADICULOPATHY. Lumbago NOS Multiple sites in spine Low back pain.920 1. Lumbosacral. thoracic Neuritis or radiculitis NOS .91 M54. SCIATICA BACK PAIN. SCIATICA BACK PAIN. RADICULOPATHY.39 M54.480 M54. RADICULOPATHY.920 1.480 4.920 1. Low back strain. RADICULOPATHY. Brachial Neuritis or radiculitis NOS.480 4. Lumbar Neuritis or radiculitis NOS. Radiculitis NOS lumbar region Radiculopathy.920 4. Loin pain. RADICULOPATHY.480 4. SCIATICA BACK PAIN.920 Health Care Institution Fee 4.480 4.10 BACK PAIN.920 2.920 1. RADICULOPATHY. Radiculitis NOS Multiple sites in spine Radiculopathy.26 M54. thoracic Neuritis or radiculitis NOS . Backache NOS occipito-atlanto-axial region Dorsalgia. Backache NOS cervicothoracic region Dorsalgia. SCIATICA BLADDER DYSFUNCTION BLADDER DYSFUNCTION 6. RADICULOPATHY. Lumbosacral. RADICULOPATHY. RADICULOPATHY. SCIATICA BACK PAIN.35 M54.920 1. SCIATICA BACK PAIN. SCIATICA BACK PAIN.15 BACK PAIN. SCIATICA 6. Lumbar Neuritis or radiculitis NOS.400 6. unspecified.88 M54.000 1.480 4. unspecified. Nonreflex Neuropathic bladder 9. RADICULOPATHY. Lumbosacral. unspecified. SCIATICA BACK PAIN.480 M54. RADICULOPATHY. Radiculitis NOS site unspecified Cervicalgia Cervicalgia Multiple sites in spine Cervicalgia cervical region Cervicalgia lumbar region Sciatica Sciatica Multiple sites in spine Sciatica occipito-atlanto-axial region Sciatica thoracolumbar region Sciatica lumbar region Sciatica lumbosacral region Sciatica sacral and sacrococcygeal region Sciatica site unspecified Lumbago with sciatica Lumbago with sciatica occipito-atlanto-axial region Lumbago with sciatica thoracic region Lumbago with sciatica lumbar region Lumbago with sciatica sacral and sacrococcygeal region Lumbago with sciatica site unspecified Low back pain. RADICULOPATHY.480 4.480 4.400 6. RADICULOPATHY. RADICULOPATHY. RADICULOPATHY. RADICULOPATHY.480 4.400 1.38 M54. SCIATICA BACK PAIN.700 6.2 M54.400 6. Radiculitis NOS thoracolumbar region Radiculopathy. Lumbar Neuritis or radiculitis NOS. unspecified. RADICULOPATHY. SCIATICA 6.400 6.400 6.480 4.920 1. unspecified. SCIATICA BACK PAIN.480 4.400 6.22 M54.000 2. thoracic Neuritis or radiculitis NOS . RADICULOPATHY. Brachial Neuritis or radiculitis NOS.51 M54.400 6. Brachial Neuritis or radiculitis NOS.920 4. Lumbago NOS Low back pain.920 4. SCIATICA 6. Lumbago NOS occipito-atlanto-axial region Low back pain.52 M54.920 1. SCIATICA BACK PAIN.400 6.920 1.84 M54.400 6.920 1.920 1. SCIATICA 6.3 M54. thoracic Neuritis or radiculitis NOS . RADICULOPATHY. RADICULOPATHY. SCIATICA BACK PAIN. Loin pain.480 4. Radiculitis NOS sacral and sacrococcygeal region Radiculopathy. SCIATICA BACK PAIN. RADICULOPATHY.700 4. SCIATICA BACK PAIN.920 1. Lumbosacral.480 M54.400 6. Radiculitis NOS lumbosacral region Radiculopathy. SCIATICA BACK PAIN. RADICULOPATHY. Brachial Neuritis or radiculitis NOS. thoracic Neuritis or radiculitis NOS .5 M54. RADICULOPATHY.480 4.480 M54. Lumbosacral. Lumbosacral.400 6.400 6.400 6.400 6.400 1. Low back strain.480 4.920 1. Brachial Neuritis or radiculitis NOS.920 1.16 BACK PAIN. SCIATICA BACK PAIN.000 9.400 6. Backache NOS sacral and sacrococcygeal region Dorsalgia. RADICULOPATHY.400 M54. Lumbosacral. SCIATICA 6. RADICULOPATHY. RADICULOPATHY. thoracic Neuritis or radiculitis NOS . Lumbar Neuritis or radiculitis NOS. RADICULOPATHY.920 1.400 6.46 M54.36 M54. Radiculitis NOS occipito-atlanto-axial region Radiculopathy.480 4. Brachial Neuritis or radiculitis NOS. Radiculitis NOS thoracic region Radiculopathy.96 M54.400 6.97 M54. SCIATICA BACK PAIN. RADICULOPATHY. RADICULOPATHY.920 1.920 1.1 BACK PAIN.480 4.920 1. SCIATICA BACK PAIN.480 6.400 6. SCIATICA BACK PAIN.920 1. Lumbar Neuritis or radiculitis NOS. SCIATICA BACK PAIN.480 4.20 M54.11 BACK PAIN.920 1.480 4.0 N31.19 M54.480 4. Radiculitis NOS cervical region Radiculopathy. RADICULOPATHY.2 Flaccid neuropathic bladder.300 N31. thoracic Neuritis or radiculitis NOS .400 6. Lumbar Neuritis or radiculitis NOS.400 1. SCIATICA BACK PAIN. RADICULOPATHY. SCIATICA BACK PAIN.480 4. thoracic Neuritis or radiculitis NOS .44 M54. SCIATICA BACK PAIN.400 6. Loin pain.50 M54.4 M54. SCIATICA BACK PAIN.93 M54.17 BACK PAIN.480 M54.920 1. SCIATICA BACK PAIN.300 Page 7 of 111 .480 4.48 M54. RADICULOPATHY. RADICULOPATHY.400 6. SCIATICA BACK PAIN.98 M54. 600 3.000 8.600 2.300 6.530 O91. unspecified Corrosion of unspecified degree of head and neck Burn of unspecified degree of trunk Burn of second degree of trunk Corrosion of first degree of trunk Corrosion of second degree of trunk Burn of second degree of shoulder and upper limb.400 8.680 N61 BREAST INFECTIONS 7.950 5.370 5. except wrist and hand Corrosion of second degree of shoulder and upper limb.550 2.600 3.000 12.400 Professional Fee 2.400 8.530 5.4 T21.400 8.530 8. except wrist and hand Corrosion of first degree of shoulder and upper limb. Sneddon-Wilkinson disease BULLOUS DISORDERS Bullous disorder.950 Subcorneal pustular dermatitis.500 8.530 O92.600 3.6 T25.000 12.500 8.300 6.550 2.600 3.0 L10.3 L12.550 2.440 6.2 BREAST INFECTIONS BREAST INFECTIONS BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BREAST MALIGNANCY BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS BULLOUS DISORDERS 7.600 3.400 8. except ankle and foot Corrosion of first degree of hip and lower limb.500 8.2 BREAST INFECTIONS 7.0 C50.950 5.8 L10.500 8.600 3.000 12.000 9. Mammary abscess gestational or puerperal.300 3.1 C50.550 2.500 8.400 8.700 2.300 6. Acute inf Infection of nipple associated with childbirth.500 8.000 4.950 5. breast Malignant neoplasm of Central portion of breast Malignant neoplasm of Upper-inner quadrant of breast Malignant neoplasm of Lower-inner quadrant of breast Malignant neoplasm of Upper-outer quadrant of breast Malignant neoplasm of Axillary tail of breast Malignant neoplasm of Overlapping lesion of breast Malignant neoplasm of Breast.5 DESCRIPTION Other neuromuscular dysfunction of bladder Neuromuscular dysfunction of bladder.000 12. Gestational abscess of nipple.260 8.700 2.1 L13. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE N31. unspecified.500 8.600 3.370 5.500 8.6 T22.400 5.600 3.900 2.550 2.1 C50. Acute mastitis nonpuerperal.600 3. Overflow incontinence.950 5. except ankle and foot Burn of second degree of ankle and foot BULLOUS DISORDERS BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A Page 8 of 111 .500 8.000 12.900 2.950 5.540 3. Neurogenic bladder dysfunction NOS Bladder disorder.000 9.400 8.900 11.5 T22. Herniation] of brain (stem) Inflammatory disorders of breast.1 L11.000 12.4 C50.6 C50. Puerperal abscess of nipple Abscess of breast associated with childbirth.800 11.5 T24.950 5.000 12.540 3.260 8. Interstitial mastitis gestational or puerperal.9 L12.800 11.000 9. Enuresis NOS Botulism.900 7.550 2.550 2.950 5. Urge incontinence Unspecified urinary incontinence.400 8.400 8.550 2.370 3.4 L10.2 T24. Acute abscess of non puerperal areola.500 8.500 8. Mastitis NOS gestational or puerperal.4 R32 A05.700 1.540 3.400 8.900 2.1 G93.ANNEX 1.700 2.800 11.8 N31.260 8.300 6.9 L11.950 5. Duhring's disease GROUP BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BLADDER DYSFUNCTION BOTULISM BRAIN HERNIATION Case Rate 9.540 3.800 22.4 T24.600 3.9 N32.550 5.8 C50.0 BREAST INFECTIONS 7. unspecified Stress incontinence Other specified urinary incontinence. except wrist and hand Burn of second degree of wrist and hand Corrosion of unspecified degree of wrist and hand Burn of second degree of hip and lower limb.0 L12.2 C50. except ankle and foot Corrosion of second degree of hip and lower limb.000 12. Classical foodborne intoxication due to Clostridium botulinum Compression of brain. Parenchymatous mastitis gestational or puerperal Retracted nipple associated with childbirth Cracked nipple associated with childbirth.8 L13.950 5. Benign mucous membrane pemphigoid Chronic bullous disease of childhood. Chronic abscess of nonpuerperal areola.300 6.530 O91.700 2.260 8.550 2.800 11.000 12. Juvenile dermatitis herpetiformis Acquired epidermolysis bullosa Other pemphigoid Dermatitis herpetiformis.000 12.500 8.950 5. [compression.260 8.260 8.000 12.400 8.2 T22.000 12. unspecified Bullous pemphigoid Cicatricial pemphigoid. Senear-Usher syndrome Other pemphigus Pemphigus. gestational or puerperal Malignant neoplasm of Nipple and areola.600 3.9 N39.400 8.400 8.370 5.400 8.2 L10.950 5.5 T21.1 L10.000 9.550 2.000 12.800 11.000 9. Reflex incontinence.800 11.260 8.6 T23.9 L10.400 8.500 2.2 T21.550 2.540 3. unspecified Pemphigus vulgaris Pemphigus vegetans Pemphigus foliaceus Pemphigus erythematosus.370 5.720 Health Care Institution Fee 6.400 8.9 T20.1 BREAST INFECTIONS 7.540 3.600 3. Chronic abscess of nonpuerperal breast.3 C50. Purulent mastitis gestational or puerperal.370 2.1 L12. Fissure of nipple.800 11.360 15.950 5.500 8.950 5.0 L11.000 12.530 O91.600 3. Subareolar abscess gestational or puerperal Nonpurulent mastitis associated with childbirth.400 8.550 2. Acute abscess nonpuerperal breast.700 2.0 L13. unspecified Acquired keratosis follicularis Transient acantholytic dermatosis [Grover] Acantholytic disorder.800 12.000 12. Lymphangitis of breast gestational or puerperal.0 T21.550 2.600 3.540 3.3 N39.540 3.600 3. NOS. Carbuncle of breast.600 3.0 O92.260 8.000 12.2 L12.900 2.2 T23. 600 10.9 T29.950 5.180 3. Multiple frosbite with tissue necrosis NOS Burn of second degree of head and neck Burn of third degree of head and neck Corrosion of second degree of head and neck Burn of third degree of shoulder and upper limb.420 7.950 5.500 8.550 2.950 5.420 7.420 7.180 3.270 11.950 5.5 T26.3 T31.200 Professional Fee 2.180 3. Secodndegree burn NOS Burn of third degree.3 T31.420 7.600 10.420 7.420 11.180 3.950 5.950 5.180 3.3 T29.600 10.180 3.600 10. Burn NOS Burn of second degree.3 T23.7 T31. body region unspecified.660 Health Care Institution Fee 5.600 10.8 T31.420 7.550 2. except ankle and foot Corrosion of third degree of hip and lower limb.550 2.180 3.950 5.550 2.600 10.2 T32. except ankle and foot Burn of third degree of ankle and foot Burn of cornea and conjunctival sac Burn with resulting rupture and destruction of eyeball Burn of other parts of eye and adnexa Corrosion of cornea and conjunctival sac Burn of larynx and trachea Burn of other parts of respiratory tract.2 T30.6 T23.3 T24. part unspecified Corrosion of respiratory tract.180 3.500 8.3 T23. at least one burn of third degree mentioned Corrosions of multiple regions.420 7.100 12.1 T26.550 2.9 T32.180 3.420 7.180 4.100 16.6 T30.180 3.830 4.9 I47. Corrosion NOS Corrosion of first degree.420 7.180 3.600 10.420 7.180 3.180 3.3 T20.950 5.600 10.600 10.4 T31.180 3.600 10.0 DESCRIPTION Corrosion of first degree of ankle and foot Burn of eyelid and periocular area Burn of eye and adnexa.600 10.950 5. unspecified degree.950 5.950 5.5 T32.180 3.420 7.550 2.3 T26.600 10.3 T32. Frosbite with tissue BURN B of leg NOS.4 T30.500 8.6 T31.600 10.420 7. part unspecified Burn of respiratory tract.600 10.180 3.420 7.7 T31.550 2.420 7.6 T22. unspecified degree.180 3.550 2.0 T30. Second-degree corrosion NOS Corrosion of third degree.420 7.600 10.950 7.600 10.600 10.500 8.420 7.7 T25.270 11.600 10.180 3.0 T27.4 T26.950 5.500 8.600 10. no more than second-degree burns mentioned Burns of multiple regions.1 T30.550 3.550 2.6 T31.500 8.500 8.420 7.420 7.550 2.600 10.180 3.180 3.180 3.1 T32.420 7.420 7.2 T31. Frosbite with tissue necrosis of trunk NOS Burn of third degree of trunk Burns involving 60-69% of body surface Burns involving 70-79% of body surface Burns involving 80-89% of body surface Burns involving 90% or more of body surface Corrosions involving 90% or more of body surface Re-entry ventricular arrhythmia BURN C BURN C BURN C BURN C BURN C BURN C CARDIAC ARRHYTHMIA Page 9 of 111 . Thoracic cavity Burn of mouth and pharynx Burn of oesophagus Burn of other parts of alimentary tract Burn of internal genitourinary organs Corrosion of mouth and pharynx Corrosion of oesophagus Corrosion of other parts of alimentary tract Corrosion of internal genitourinary organs Burns of multiple regions.600 16.550 2.1 T35. Multiple superficial frosbite NOS Frostbite with tissue necrosis involving multiple body regions.600 10.950 5.3 T27.420 7.420 7. Frosbite with tissue necrosis NOS.950 5.270 11. body region unspecified.0 T35.500 8.180 3.600 10. no more than first-degree burns mentioned Burn of unspecified body region.7 T28.950 5.ANNEX 1.600 10.2 T29.550 2.600 10.3 T30.550 2. Thriddegree corrosion NOS Burns involving less than 10% of body surface Burns involving 10-19% of body surface Corrosions involving less than 10% of body surface Corrosions involving 10-19% of body surface Frostbite with tissue necrosis of neck Superficial frostbite involving multiple body regions.500 8. no more than seconddegree corrosions mentioned Burns involving 20-29% of body surface Burns involving 30-39% of body surface Burns involving 40-49% of body surface Burns involving 50-59% of body surface Corrosions involving 20-29% of body surface Corrosions involving 30-39% of body surface Corrosions involving 40-49% of body surface BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN A BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B BURN B GROUP Case Rate 8.500 8.600 10.420 7.600 10. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T25.600 10.500 8. Firstdegree corrosion NOS Corrosion of second degree.180 3.7 T24.500 8.950 5.950 5.0 T32.180 3.8 T29. part unspecified Corrosion of other and unspecified internal organs Burns of multiple regions. except wrist and hand Burn of third degree of wrist and hand Corrosion of second degree of wrist and hand Corrosion of third degree of wrist and hand Burn of third degree of hip and lower limb.420 7.550 2.0 T28.550 2.500 8.180 3.2 T26.600 10.600 10.500 8. body region unspecified.420 7.180 3.420 7.420 7.270 8.500 8.1 T34.500 8.420 7.950 5.180 3.950 5.4 T34.100 16.180 3.2 T28.2 T20.600 10.5 T30.180 3.950 5.9 T27. Third-degree burn NOS Corrosion of unspecified body region. part unspecified Corrosion of eye and adnexa.500 8.550 2.600 10.550 2.180 3.100 16.600 10.550 2.1 T28.1 T20. body region unspecified.540 Frostbite with tissue necrosis of other and unspecified sites.100 16.6 T27.3 T28.270 11.6 T28.420 7.600 10.420 7.0 T31.2 T28.7 T28.950 5.830 4.180 3.550 2.500 8.420 7.500 8.550 2.830 4.0 T26.3 T26.500 8.100 16.9 T21.500 8.420 7.500 10.550 2. body region unspecified.180 3.5 T28.180 3.420 7.270 11.180 3.830 3.830 4.830 4.420 7.600 10. Athetoid cerebral palsy.Cellulitis of Abdominal wall.540 I47.0 I42.200 12.600 9.020 4. unspecified Eosinophilic cellulitis [Wells] Spastic cerebral palsy. Mixed cerebral palsy syndromes Infantile cerebral palsy.880 2.880 2.200 12.Cellulitis of Shoulder Cellulitis of face Cellulitis of trunk.380 9.540 9.600 9.700 22.850 2.3 CELLULITIS CELLULITIS CELLULITIS CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CEREBRAL PALSY CHOLANGITIS 9.200 12.400 13.660 3.400 13.8 I49.540 8.720 6.4 CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA CARDIAC ARRHYTHMIA 12.2 G80.1 G80.540 8.1 L03. Paronychia.800 9.850 2.2 L03.1 P29. nodal rhythm disorder Cardiac arrhythmia.3 G80. Endomyocardial (tropical) fibrosis.500 9.0 G80.880 2.810 6.380 9.0 L03.700 22. Atrial premature beats Junctional premature depolarization Ventricular premature depolarization Other and unspecified premature depolarization. Cellulitis of Head [any part. unspecified.380 9.660 3. Coronary sinus rhythm CARDIAC ARRHYTHMIA disorder.400 13.720 6.1 I49.020 4.890 15. Congenital cardiomyopathy Other restrictive cardiomyopathy Alcoholic cardiomyopathy Cardio myopathy due to drugs and other external agents Other cardiomyopathies Cardio myopathy.2 I47. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Supraventricular tachycardia. Tachycardia-bradycardia syndrome GROUP Case Rate Professional Fee 3. Clostridial myonecrosis CELLULITIS Cellulitis of finger and toe.660 Health Care Institution Fee 8.020 4.4 I42. Spastic tetraplegic cerebral palsy Spastic diplegia.400 22.200 2.200 I49. Atrial Paroxysmal tachycardia. unspecified.2 I42.Cellulitis of Groin.380 9.200 12.3 CARDIAC ARRHYTHMIA 12.6 I42.540 8.540 8.8 G80.600 3.650 6.540 8.8 L03. Premature beats NOS.020 4. Bouveret (-Hoffmann) syndrome ATRIAL FIBRILLATION AND FLUTTER Ventricular fibrillation and flutter Atrial premature depolarization.850 2.850 2.720 6.500 13.7 I42. unspecified.720 6.660 3.380 9. Extrasystolic arrhythmias.660 3.0 P29.3 G80.9 K74.600 9. Perionychia Cellulitis of other parts of limb.880 2. Löffler's endocarditis Endocardial fibroelastosis.240 Page 10 of 111 .540 8.380 9.880 2.400 13.640 2.880 2.600 9. Nodal Paroxysmal tachycardia Ventricular tachycardia Paroxysmal tachycardia.890 15.500 9.0 I49.890 15.600 9.5 I49.4 A46 A48.500 9.9 I48 I49.540 8. Junctional Paroxysmal tachycardia.200 12.600 9.160 6. Secondary cardiomyopathy NOS Neonatal cardiac failure Neonatal cardiac dysrhythmia Neonatal hypertension Transient myocardial ischaemia of newborn CARDIAC ARRHYTHMIA CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOMYOPATHY CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN CARDIOVASCULAR COMPLICATIONS IN THE NEWBORN Other cardiovascular disorders originating in the perinatal period Cauda equina syndrome.720 6.500 9. Spastic cerebral palsy NOS Infantile hemiplegia Dyskinetic cerebral palsy.960 6.1 I42.380 9. Hypertrophic subaortic stenosis Other hypertrophic cardiomyopathy.810 6.540 8.850 3. Cardiac arrhythmia NOS Dilated cardiomyopathy.020 6.650 6.2 P29.Cellulitis of Umbilicus Cellulitis of other sites.200 12.8) Erysipelas CELLULITIS Gas gangrene.200 12.2 I49.9 I42. Atrioventricular [AV] Paroxysmal tachycardia.500 9.540 8.3 I42.810 6.600 9.200 12.020 4. Ectopic beats.380 9.650 6.Cellulitis of Back [any part].810 2.Cellulitis of Perineum. unspecified. Cerebral palsy NOS Primary biliary cirrhosis.810 6.720 6.380 15.ANNEX 1.9 L98.880 8.400 13.400 13. Neurogenic bladder due to cauda CAUDA EQUINA SYNDROME equina syndrome Excludes: cord bladder NOS (G95.4 G80.600 9.020 4.700 8.650 6.020 4.5 I42.700 22. Primary cardiomyopathy NOS. Dystonic cerebral palsy Ataxic cerebral palsy Other infantile cerebral palsy.020 4.660 4.700 22.650 6.Cellulitis of Scalp Cellulitis. Extrasystoles. Nonobstructive hypertrophic cardiomyopathy Endomyocardial (eosinophilic) disease.720 6.200 12.500 9.720 6.660 3.880 2.880 2. Onychia.890 6.660 3.0 L03.850 2. Infection of nail.400 13. Congestive cardiomyopathy Obstructive hypertrophic cardiomyopathy.660 3.200 12.650 9.850 2.4 P29.8 G83. Cellulitis of Hip.400 13. Premature contractions Sick sinus syndrome.400 13. Axilla.540 8.020 4.660 3.9 P29.650 6.8 I42. Cellulitis of Chest wall. Clostridial cellulitis. Ectopic rhythm disorder. Chronic nonsupparative destructive cholangitis CELLULITIS CELLULITIS CELLULITIS CELLULITIS L03.380 9. Congenital spastic paralysis (cerebral).720 Other specified cardiac arrhythmias.660 3.1 I47.200 13. except face].890 15.660 3.3 I49. 5 Q37.300 Professional Fee 3.700 12.340 2. unspecified.390 7.460 5.810 3.390 3.460 5. Abscess of gallbladder without calculus.700 12.340 2.810 3.350 3.890 8.800 7.340 2. unspecified CHROMOSOMAL ABNORMALITIES Turner's syndrome.8 Q35.4 Q99.700 12.810 3. BILATERAL Cleft palate.240 7.340 2.800 7.810 3.0 Q37.200 3.150 10.4 DESCRIPTION Calculus of bile duct with cholangitis.5 with cholangitis Calculus of gallbladder with acute cholecystitis. bilateral Cleft lip.460 5.3 Q91. Empyema of gallbl Chronic cholecystitis Other cholecystitis Trisomy 21.9 Q95.700 12.0 Q36.700 12.340 2.700 12.800 7.4 Q37.7 Q35.8 Q90.810 3.0 11.460 5.810 3.5 Q93.0 N18.890 8.ANNEX 1.800 7.810 3.2 Q37.390 3. Cleft lip NOS Cleft hard palate with bilateral cleft lip Cleft hard palate with unilateral cleft lip.890 8.3 K80.2 with acute cholecystitis Calculus of gallbladder with other cholecystitis.810 3.890 8.9 Q93. female phenotype.340 2.7 Q92.810 3.800 7. Cleft palate with cleft lip NOS Vascular dementia of acute onset CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE CLEFT LIP AND PALATE COGNITIVE DYSFUNCTION 7.150 10. Trisomy 21 NOS Trisomy 18.460 5. Chronic emphysematous bronchitis NOS.9 N19 J44.9 Q97.700 14.890 8. Any condition listed in K80.910 K81.890 8.700 12. BILATERAL.800 7. BILATERAL FISSURE OF CLEFT LIP AND PALATE HARD PALATE.800 7.2 Q90.5 Q35.460 5.960 3.0 Q90.9 Q91.890 10.340 2.5 with cholecystitis (with cholangitis) CHOLANGITIS CHOLECYSTITIS CHOLECYSTITIS CHOLECYSTITIS GROUP Case Rate 13. unspecified Fragile X chromosome.460 5.8 N18.910 7.500 14.810 3.810 3. unspecified Patau's syndrome.810 3.700 12. UNSPECIFIED.340 2. unspecified CHOLECYSTITIS CHOLECYSTITIS CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES 11.340 2. unspecified.800 7.460 5.2 Q93.460 5.800 8.340 2. Cleft hard palate with cleft lip NOS Cleft soft palate with bilateral cleft lip Cleft soft palate with unilateral cleft lip.800 7.3 Q37.1 K81.4 Q93. translocation Edwards' syndrome.340 2. translocation Down's syndrome.9 Q37.460 5.910 7.460 5.0 CLEFT HARD PALATE.890 8.800 7. unspecified.890 8.340 2.1 Q35.540 J44.660 8.700 12.910 8.700 12.340 2.3 Q35.200 3. Cleft soft palate with cleft lip NOS Cleft hard and soft palate with bilateral cleft lip Cleft hard and soft palate with unilateral cleft lip.2 with chronic cholecystitis.0 K80.2 Q99.390 3.9 Q36.540 Q35. Cholecystitis with cholelithiasis NOS Calculus of bile duct with cholecystitis.800 7.810 3. meiotic nondisjunction Trisomy 21. unspecified Sex chromosome abnormality.8 CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12.810 3.660 8. Acute emphysematous cholecystitis without calculus. Angelman syndrome Deletions with other complex rearrangements Deletion from autosomes.890 8.460 5.800 7.890 8.200 2. Any condition listed in K80. Any condition listed in K80.540 J44. Fragile X syndrome Other specified chromosome abnormalities End-stage renal disease Other chronic renal failure Chronic renal failure.700 12.300 11. unspecified Whole chromosome monosomy. meiotic nondisjunction Trisomy 18. Angiocholecystitis without calculus.460 5.910 7.700 12. Cri-du-chat syndrome Other deletions of part of a chromosome.340 2.460 5.800 7. Chronic obstructive bronchitis NOS Chronic obstructive pulmonary disease. mosaicism (mitotic nondisjunction) Chromosome replaced with ring or dicentric Deletion of short arm of chromosome 5.2 Q91.1 Q36.810 3. Chronic obstructive airway disease NOS.340 2.340 2.350 4.810 3.340 2.1 Q37.200 3. Gangrenous cholecystitis CHOLECYSTITIS without calculus. Supparative cholecystitis without calculus. Chronic obstructive lung disease NOS CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHROMOSOMAL ABNORMALITIES CHRONIC KIDNEY DISEASE CHRONIC KIDNEY DISEASE CHRONIC KIDNEY DISEASE CHRONIC KIDNEY DISEASE CHRONIC OBSTRUCTIVE PULMONARY DISEASE J44.700 12.460 5. unspecified Cleft lip.700 12.7 Q93.660 8.890 8.890 8.460 5.740 Page 11 of 111 .800 7. Cleft hard and soft palate with cleft lip NOS Unspecified cleft palate with bilateral cleft lip Unspecified cleft palate with unilateral cleft lip.200 3.460 5. unspecified Klinefelter's syndrome.700 12.890 8.700 12.890 8. unspecified Chronic asthmatic (obstructive) bronchitis NOS.700 12.540 Balanced rearrangement and structural marker.390 3.1 K80.350 4.460 5.9 Q98.500 14.8 Q37.300 12.0 Q35.200 11.300 11.9 F01.0 Acute cholecystitis.9 CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12.800 7.910 K81. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE K80.800 7.800 7.1 CHRONIC OBSTRUCTIVE PULMONARY DISEASE 12.8 N18.300 11. Any condition listed in K80.810 3.500 14.1 Q93.810 3.810 4. BILATERAL PALATOSCHISIS OF HARD PALATE Cleft hard palate Cleft soft palate Cleft hard palate with cleft soft palate Cleft uvula CLEFT PALATE.660 7.890 8.700 12.340 2.150 10. unspecified Trisomy and partial trisomy of autosomes. median Cleft lip.460 5. unilateral.890 8.0 Q91.700 12.390 Health Care Institution Fee 9.500 12.890 8.810 3.9 Q96.150 8.300 3. Uraemia NOS Unspecified renal failure Chronic obstructive/ asthmatic/ emphysematous pulmonary disease with acute lower respiratory infection Chronic obstructive/ asthmatic/ emphysematous pulmonary disease with acute exacerbation.890 8.350 4.890 8. 500 10.500 10.6 DESCRIPTION GROUP Case Rate 8.610 6.4 D13.5 8.0 D16.500 10.9 D13.000 12.610 6.1 D16.6 D13. Benign neoplasm COMPLICATIONS OF BENIGN NEOPLASMS OF THE of Islet cell tumour.600 3. Adenomatosis of colon.150 3.090 6.460 2. Benign COMPLICATIONS OF BENIGN NEOPLASMS OF THE neoplasm of Superior Maxilla.090 COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Anus and anal canal DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Oesophagus DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Stomach DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Duodenum DIGESTIVE SYSTEM Benign neoplasm of Other and unspecified parts of small COMPLICATIONS OF BENIGN NEOPLASMS OF THE intestine DIGESTIVE SYSTEM Benign neoplasm of Liver.150 3.200 12.6 D16.090 6.090 6.740 5.700 8.610 2. Benign neoplasm of Large intestine NOS. Hereditary Polyposis of colon Benign neoplasm of Rectum COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM Professional Fee 2.500 10.1 D12.700 Disorientation.700 2.350 6.0 R41.610 2.090 6.150 3. Senescence COGNITIVE DYSFUNCTION without mention of psychosis.700 2.5 D16.150 2.610 2.4 D12.090 6.350 7. Benign neoplasm of Large intestine NOS.400 8.3 D16.090 6.610 2.600 3.090 Page 12 of 111 . Old age without mention of psychosis. Confusion NOS COGNITIVE DYSFUNCTION Other amnesia. Benign neoplasm of Splenic flexure DIGESTIVE SYSTEM Benign neoplasm of Descending colon Benign neoplasm of Sigmoid colon Benign neoplasm of Colon.500 8.610 2.5 D12. Benign neoplasm of Intrahepatic COMPLICATIONS OF BENIGN NEOPLASMS OF THE bile ducts DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Extrahepatic bile ducts DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Pancreas DIGESTIVE SYSTEM Benign neoplasm of Endocrine pancreas.3 D12. unspecified.700 8.350 7.150 3. Benign neoplasm of Islets of DIGESTIVE SYSTEM Langerhans Benign neoplasm of Ill-defined sites within the digestive COMPLICATIONS OF BENIGN NEOPLASMS OF THE system.400 8.2 D35.610 2.0 D13. Adenomatosis of colon.610 2.700 8.3 D35.090 6.9 D12.Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Ileocaecal valve DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Appendix DIGESTIVE SYSTEM Benign neoplasm of Transverse colon. sacrum and coccyx BONES Benign neoplasm of Bone and articular cartilage.600 3. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE R41.700 8.4 D16. Hereditary Polyposis of colon Benign neoplasm of Rectosigmoid junction. Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Hepatic flexure. unspecified ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Scapula and long bones of upper limb BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Short bones of upper limb BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm ofLong bones of lower limb BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Short bones of lower limb BONES Benign neoplasm of Bones of skull and face.350 7.400 7. Amnesia NOS COGNITIVE DYSFUNCTION Senility.7 D16.400 8.610 2.000 12.8 D12.090 6.8 D16.090 D12.400 8.4 D35.090 6.700 8.500 10.610 6.0 D12.700 8.740 8.ANNEX 1.9 D16.350 7.610 2.350 7.000 12.2 D13.2 D16.610 Health Care Institution Fee 5.090 6.150 3. Benign neoplasm of Spleen Benign lipomatous neoplasm of intra-abdominal organs COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM D13.460 3.150 3.500 10.090 6.700 8. Senile asthenia.9 8. Benign neoplasm of Digestive system NOS.400 8.700 8.7 8.000 12.700 8.700 8.3 D13.500 10.3 R54 D34 D35.700 8.740 5.610 2.600 3.700 8.1 D13.700 8.700 2.610 2.7 D12.700 8.5 D13.350 7.610 2.090 6.700 8. unspecified.610 2.460 2.1 D35.350 7. Benign neoplasm of Orbital BONES bone COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Lower jaw bone BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Vertebral column BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Ribs.150 3.200 8.090 D17.090 6. Benign DIGESTIVE SYSTEM neoplasm of Intestine NOS.150 3.350 7.000 12.090 6.500 10.610 2.000 10.000 12.0 D35.600 3.400 8. COMPLICATIONS OF BENIGN NEOPLASMS OF THE unspecified BONES Benign neoplasm of Caecum.200 8.500 10.350 7. Senile debility COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of thyroid gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Adrenal gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Parathyroid gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Pituitary gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Craniopharyngeal duct ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Pineal gland ENDOCRINE GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF Benign neoplasm of Endocrine gland.610 2.600 3.090 6. sternum and clavicle BONES COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Pelvic bones.600 3.150 3. Benign neoplasm of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Olfactory bulb NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Spinal cord NERVOUS SYSTEM Benign neoplasm of Other specified parts of central COMPLICATIONS OF BENIGN NEOPLASMS OF THE nervous system NERVOUS SYSTEM Benign neoplasm of Central nervous system.7 D33.440 2. infratentorial. Benign neoplasm of Cerebral ventricle.880 2. unspecified GROUP COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE DIGESTIVE SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE FEMALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE MALE GENITAL TRACT COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM Case Rate 8.4 D32. COMPLICATIONS OF BENIGN NEOPLASMS OF THE Central Nervous system NOS NERVOUS SYSTEM Benign neoplasm of Peripheral nerves and autonomic COMPLICATIONS OF BENIGN NEOPLASMS OF THE nervous system NERVOUS SYSTEM Benign neoplasm of Lip.800 14. Benign neoplasm of Brain stem. Benign lipomatous neoplasm of Retroperitoneum Benign neoplasm of of soft tissue of Retroperitoneum Benign neoplasm of of soft tissue of Peritoneum Benign neoplasm of Connective and other soft tissue of abdomen Submucous leiomyoma of uterus Intramural leiomyoma of uterus Subserosal leiomyoma of uterus Leiomyoma of uterus.090 6.ANNEX 1. Benign neoplasm of Parietal lobe.390 10.090 6.3 D33. Benign neoplasm of Fallopian Tubes. unspecified Other Benign neoplasm of Cervix uteri Other Benign neoplasm of Corpus uteri Other Benign neoplasm of Other parts of uterus Other Benign neoplasm of Uterus.1 D26. SALIVARY Benign neoplasm of Minor salivary gland NOS GLANDS 9.800 14.800 14.7 D28.800 14. PHARYNX.600 9.700 7.600 9.610 2.720 6. Benign neoplasm of Cerebellum. Benign neoplasm of Temporal lobe Benign neoplasm of Brain. SALIVARY neoplasm of Mucosa of Lip.2 D29.880 2.600 9. LARYNX.2 D33.360 D33.500 2.850 6.360 10.700 14.9 D26.1 D10.440 4. Benign neoplasm of Skin of scrotum Benign neoplasm of Cerebral meninges Benign neoplasm of Spinal meninges Benign neoplasm of Meninges.800 4.440 4.650 Page 13 of 111 . Benign neoplasm of Frontal lobe.0 COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM 14.600 9.310 2. unspecified Benign neoplasm of ovary Benign neoplasm of Vulva Benign neoplasm of Vagina Benign neoplasm of Uterine tubes and ligaments.360 10.800 2.390 5.800 14. SALIVARY tonsil GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Other and unspecified parts of mouth.880 2. supratentorial.0 14.600 9.650 9.440 4.650 D10.440 4.720 D28.0 D32.440 4. PHARYNX.700 7.4 D25.720 6.720 6.390 5.880 2.880 Health Care Institution Fee 6.720 6.700 7.0 D28.310 4.600 2.600 9.600 9.1 D10.440 4.9 D27 D28.360 6.720 6.090 6. Benign neoplasm of Inner aspect of lip. Benign neoplasm of Cerebrum.1 DESCRIPTION Benign lipomatous neoplasm of spermatic cord Benign lipomatous neoplasm of other sites.700 8.610 2.720 6.880 2.090 6.800 14.0 D20.880 2. Benign lipomatous neoplasm of Peritoneum.440 4.9 D36.850 6.720 6.9 9.310 2.440 4.360 10.360 D33.360 10. Benign neoplasm of Uterine round ligament Benign neoplasm of Other specified female genital organs Benign neoplasm of Female genital organ.880 2.700 8.500 2.0 D29.0 D26.600 9.2 9. LARYNX.360 10.2 D25.440 10.880 2.3 COMPLICATIONS OF BENIGN NEOPLASMS OF THE NERVOUS SYSTEM Benign neoplasm of Cranial nerves.880 6.720 5. PHARYNX.1 D33.1 D29.4 D33.600 9.600 9.610 2.390 5. unspecified.700 9.880 2. Benign neoplasm of Uterine Broad Ligament. unspecified.720 6.700 8.880 2. Meningioma NOS Benign neoplasm of Brain.500 4.360 10.7 D26.800 9.800 14.880 2.360 10.0 D25. Vermilion border of Lip GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE Benign neoplasm of Tongue.720 6. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE D17.Benign neoplasm of Lingual ORAL CAVITY. Benign ORAL CAVITY.440 6.310 2.880 2.360 10. Benign neoplasm of Fourth ventricle Benign neoplasm of Brain.9 D29.600 Professional Fee 2.1 D32. LARYNX.720 6. Benign neoplasm of Occipital lobe. unspecified Benign neoplasm of Penis Benign neoplasm of Prostate Benign neoplasm of Testis Benign neoplasm of Scrotum.610 2.610 2.7 D20.800 14.720 6.600 7.090 6. Benign neoplasm of frenulum of COMPLICATIONS OF BENIGN NEOPLASMS OF THE Lip.1 D21.600 9.720 D28.850 10.1 D25.700 8.6 D17. ORAL CAVITY. 300 8. Angioma NOS Lymphangioma.810 5. Benign neoplasm of ureteric orifice of bladder Benign neoplasm of Urethra Benign neoplasm of Urinary organ.3 5. unspecified Benign neoplasm of Larynx.850 2.650 D11.100 10. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY. PHARYNX.070 A52.320 4. Chronic interstitial myocarditis Myocardial degeneration.650 3. LARYNX.810 5.080 6.0 Benign neoplasm of Parotid gland 9.400 14.4 D30.400 9.850 6. PHARYNX.400 14.100 4.320 2.500 1. Old Atrial thrombosis.030 3.490 2. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY. Myocarditis NOS.3 D30.ANNEX 1. unspecified. any site.4 I51.080 10. Benign neoplasm of suprahyoid portion of Epiglottis Benign neoplasm of Trachea Benign neoplasm of Kidney Benign neoplasm of Renal pelvis Benign neoplasm of Bladder. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY.850 6.650 5.2 I51.850 6.100 10. Benign neoplasm of Pharyngeal tonsil.080 10. Benign neoplasm of Connective and other soft tissue of Great v Late Symptomatic neurosyphilis.9 Benign neoplasm of Pharynx. Acquired auricular septal defect old .000 10. LARYNX.1 D15.100 10.100 10.400 2.080 10.1 5.320 6.030 10. LARYNX.700 2.810 10. PHARYNX. PHARYNX.9 Benign neoplasm of Major salivary gland.300 7. Old Apical thrombosis. not elsewhere classified Intra cardiac thrombosis.030 3.0 I51. acquired.100 10. LARYNX. unspecified Benign lipomatous neoplasm of intrathoracic organs Benign neoplasm of Connective and other soft tissue of thorax.030 3.300 8.7 5.500 2. PHARYNX.650 3.400 14. LARYNX.300 14. Acquired ventricular septal defect old Rupture of chordae tendineae. Chronic Carditis.030 7.3 I51. Late Syphilis of central nervous system NOS.650 D10.5 9.700 3.490 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Benign neoplasm of Nasopharynx.100 3.500 2.070 7.490 4.650 3.650 D14. Senile Degeneration of heart or myocardium. LARYNX. Fatty Degeneration of heart or myocardium fatty. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF BENIGN NEOPLASMS OF THE URINARY SYSTEM COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEART DISEASES Case Rate 9. not elsewhere classified Rupture of papillary muscle.030 3. Benign neoplasm of Connective and other soft tissue of Axilla.070 D21.500 1.850 A52.4 COMPLICATIONS OF HEART DISEASES COMPLICATIONS OF HEMANGIOMA AND LYMPHANGIOMA COMPLICATIONS OF HEMANGIOMA AND LYMPHANGIOMA COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF INTRATHORACIC BENIGN NEOPLASMS COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES 14. PHARYNX.030 3.2 D30. PHARYNX.1 I51.320 4.1 9.080 I51.810 5. Acute carditis.7 Benign neoplasm of Other major salivary glands 9.500 1.080 10.400 14.500 Professional Fee 2.300 8. Tabes dorsalis Neurosyphilis. LARYNX.100 10.500 2.850 Health Care Institution Fee 6.030 3.070 7.3 10.300 8.9 I51.6 D10. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY. unspecified. PHARYNX.490 2. notel sewhere classified.1 D14.9 D17.850 6. Old Venticular thrombosis Myocarditis. Acute pancarditis. any site Benign neoplasm of Bronchus and lung Benign neoplasm of Respiratory system. Benign neoplasm of Urinary system NOS Cardiac septal defect. unspecified.500 2.2 D15. Myocardial fibrosis.8 D18. Old Auricular thrombosis. unspecified 9.400 14. unspecified Benign neoplasm of Thymus Benign neoplasm of Heart Benign neoplasm of Mediastinum Benign neoplasm of Intrathoracic organ.0 D18.080 10. Benign neoplasm of Posterior margin of septum and choanae Benign neoplasm of Hypopharynx GROUP COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY.850 Page 14 of 111 .500 8. Syphilitic Gumma of central nervous system NOS.320 4.4 D15.070 7.0 D15.650 D10.320 4.070 7. Benign neoplasm of Urethral orifice of bladder.7 9. SALIVARY GLANDS COMPLICATIONS OF BENIGN NEOPLASMS OF THE ORAL CAVITY. LARYNX.500 2. Acquired atrial septal defect old.0 D30. Syphiloma of central nervous system NOS Other symptomatic late syphilis 9.320 4. Benign neoplasm of Connective and other soft tissue of Diaphragm.810 5.500 2.300 6.850 A52. Chronic pancarditis Haemangioma.650 D14.000 9.850 6.490 2.3 D14.650 D11.070 7.1 D30.070 7.850 6. Myocardial disease Other ill-defined heart diseases.650 D11. 3 T79.710 3.800 11. immediate shock following injury. Gartner's duct Cyst.540 8.300 9.9 Q65.260 8.540 2. Aplasia cutis congenita Developmental ovarian cyst CONGENITAL ANEMIA CONGENITAL ANEMIA CONGENITAL ANEMIA CONGENITAL BLOOD DISORDERS CONGENITAL BLOOD DISORDERS CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DERMATOLOGIC DISEASES Q82.260 8.0 Q80.300 9. Deviation of nasal septum.340 4.260 8.710 Q67.790 2.8 A55 A56.540 3.300 5.500 5.300 9.800 11. Salt-losing congenital adrenal hyperplasia Anaemia of prematurity Congenital anaemia from fetal blood loss Other congenital anaemias.500 Professional Fee 1. Absence of fallopian tube or broad ligament.510 6.4 Q50.540 3.6 9.000 4.640 10.650 1.510 Other congenital malformations of ovary.540 3.560 4. Cyst epoophoron.260 8.300 2.790 2.460 10.500 5.540 3. Durand-Nicolas-Favre disease.510 Q51.300 9.790 2. Subluxatable hip Plagiocephaly CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM Q50. unspecified Unstable hip.300 5.850 6. not elsewhere classified.9 Q81.540 3.2 P61.2 Q82.0 T79. Esthiomene.850 3. CONGENITAL DISORDERS OF THE Hemifacial atrophy or hypertrophy.510 6. unspecified Hereditary lymphoedema Mastocytosis. Congenital malformation of fallopian tube or bro Agenesis and aplasia of uterus. Accessory ovary. Inherited keratosis palmaris et plantaris.650 2.540 3.800 3.790 2. Accessory skin tags.3 Q82.260 6. Keratosis follicula Other specified congenital malformations of integument.540 3.790 2.800 11. Cutis laxa (hyperelastica).300 3.260 8.650 1.200 15.650 1.200 3. Delayed shock following injury Traumatic anuria.790 2.800 1.650 1.4 T79.9 Q82.510 3.2 Q81. Congenital Dyshaematopoietic anaemia Congenital methaemoglobinaemia Lamellar ichthyosis.300 9.590 1.800 9.7 T79. Climatic or tropical bubo .510 6.1 Q50. Accessory of fallopian tube or broad ligament. Squashed or bent nose.300 9.590 3. Atresia of fallopian tube or broad ligament.2 Q80.8 Q81.1 A59 T79.510 6. Congenital anaemia NOS Congenital dyserythropoietic anaemia.850 A53.4 Other congenital deformities of skull. Lymphogranuloma inguinale Chlamydial infection of pelviperitoneum and other genitourinary organs.540 3.300 9.790 6.200 1.790 2. Depressions in skull.8 E25.800 11.300 9. Crush syndrome. Positive serological reaction for syphilis Gonococcal infection of lower genitourinary tract with periurethral and accessory gland abscess.300 9.850 3.850 3.300 1.260 8. Latent syphilis NOS.300 9.790 1.800 11.790 2. congenital.260 Q84.800 8.3 P61.300 2.4 D74.500 9. Fimbrial cyst Embryonic cyst of broad ligament. Dislocatable hip.500 5.0 A54. Compartment syndrome. Congenital adrenal hyperplasia.800 11.6 Q67.510 6.ANNEX 1.510 6.4 5.560 4.8 Q50. CONGENITAL DISORDERS OF THE FEMALE GENITAL Congenital malformation of ovary NOS.000 11. Renal failure following crushing Traumatic ischaemia of muscle.640 10.1 T79.260 Congenital adrenogenital disorders associated with enzyme deficiency.510 6. Gonococcal skin lesions Chlamydial lymphogranuloma (venereum). unspecified Epidermolysis bullosa dystrophica Other epidermolysis bullosa Epidermolysis bullosa.300 7.640 2.3 9. Benign familial pemphigus [Hailey-Hailey].1 A54. Gonococcal Bartholin's gland abscess GONOCOCCAL PELVIPERITONITIS AND OTHER GONOCOCCAL GENITOURINARY INFECTIONS Gonococcal septicaemia.510 6.0 P61. Dermatoglyphic anomalies. face and jaw.260 8.2 A54.540 3.5 T79. MUSCULOSKELETAL SYSTEM congenital 5.0 Q51. Parovarian Cyst Other congenital malformations of fallopian tube and broad ligament.200 4.300 9.800 15.510 5.800 11.850 3.0 Q82. unspecified as early or late.260 8.510 6.4 D64.500 5. Volkmann's ischaemic contracture Traumatic subcutaneous emphysema Other early complications of trauma GROUP COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF SEXUALLY TRANSMITTED DISEASES COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA COMPLICATIONS OF TRAUMA Case Rate 5.200 15.300 9.510 6.800 2.650 1. Abnormal palmar creases.790 2. Urticaria pigmentosa Incontinentia pigmenti Ectodermal dysplasia (anhidrotic) Other specified congenital malformations of skin.850 3.8 CONGENITAL DERMATOLOGIC DISEASES 11.6 T79.790 2.500 5.710 Page 15 of 111 .510 6. not elsewhere classified Traumatic shock. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Latent syphilis.790 2.800 11. Ovarian streak TRACT Embryonic cyst of fallopian tube.5 CONGENITAL DERMATOLOGIC DISEASES CONGENITAL DISORDERS OF THE FEMALE GENITAL TRACT 11.650 Health Care Institution Fee 3.790 2. Collodion baby Congenital ichthyosis.590 6. 21-Hydroxylase CONGENITAL ANDROGENITAL DISORDER deficiency.3 Q50. Trichomoniasis Air embolism (traumatic) Fat embolism (traumatic) Traumatic secondary and recurrent haemorrhage Post-traumatic wound infection.2 T79.790 8. Congenital absence of uterus Congenital malformation of uterus and cervix.560 1.790 2.510 6. 590 3.2 Q78.390 3.0 CONGENITAL GASTROINTESTINAL DISORDERS 11.910 7.910 7.390 3. Imperforate anus Congenital absence. Congenital anomaly NOS of upper alimentary tract.590 3.0 Q78.910 Q40.300 11. Cloaca NOS GROUP CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL DISORDERS OF THE MUSCULOSKELETAL SYSTEM CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS Case Rate 5.590 1.300 1. Jackson's membrane.1 Q41.590 1.300 11.710 Q68.910 7. Sternomastoid tumour.390 3.710 Q76.710 3. atresia and stenosis of rectum without fistula.300 3.910 Q40.390 3. Contracture of sternocleidomastoid muscle.710 3.390 3.910 7.9 5.9 Q42.390 7.910 7. Osteopoikilosis Osteochondrodysplasia. Duplication of stomach.300 5. Imperforate jejunum Congenital absence.910 7.4 Q43. Congenital dilatation of colon Congenital malformations of intestinal fixation. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE Q67.300 1. Incomplete rotation of caecum a Duplication of intestine Ectopic anus Congenital fistula of rectum and anus Persistent cloaca.910 Q40.910 7.3 Q42.300 11.390 3.0 Q41. Congenital or infantile stric Congenital hiatus hernia. unspecified. Congenital peritoneal adhesions [bands].1 Q42.910 7. Congenital or infantile spasm of pylorus. unspecified.300 11.6 Q39. Osteodystrophy NOS Other congenital malformation syndromes with other skeletal changes Atresia of oesophagus without fistula.6 Q67. Congenital (aganglionic) megacolon Other congenital functional disorders of colon.300 5.390 7. Failure of rotation of caecum and colon.2 Q42. Congenital displacement of stomach.2 CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS 11. atresia and stenosis of jejunum.9 CONGENITAL GASTROINTESTINAL DISORDERS 11.590 Health Care Institution Fee 3.300 11. sternomastoid torticollis. Oesophageal pouch Congenital malformation of oesophagus. Persistent vitelline duct Hirschsprung's disease.910 7. atresia and stenosis of large intestine.390 3. Chondrodystrophy NOS.910 Q40.300 Professional Fee 1.910 7.910 7.390 3.300 3.390 3.390 3.910 7.300 11.0 Q42.300 11.910 7. atresia and stenosis of intestine NOS Congenital absence.300 11.300 3.300 5. Atresia of oesophagus NOS Atresia of oesophagus with tracheo-oesophageal fistula.300 11.5 Q43.910 Q43. Displacement of cardia through oesophageal hiatus Other specified congenital malformations of stomach.5 Q39.8 Q78. Atresia of oesophagus with broncho-oesophageal fistula Congenital tracheo-oesophageal fistula without atresia.910 7.910 Q43.390 7.390 3. Persistent omphalomesenteric duct.390 3.390 3.710 3. part unspecified.7 CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS 11. Fragilitas ossium Osteopetrosis. Congenital or infantile constriction of pylorus. Hemivertebra fusion or failure of segmentation with scoliosis Osteogenesis imperfecta. atresia and stenosis of small intestine.300 11.0 5.300 11.300 3.910 7. Congenital anomalous omental adhesions [bands] .0 Q43. Microgastria Congenital malformation of upper alimentary tract.300 5.9 Q43. Congenital absence.710 7.910 7.590 1. Congenital pigeon chest Congenital deformity of sternocleidomastoid muscle.910 7.590 1.300 11. atresia and stenosis of duodenum Congenital absence.6 Q43. atresia and stenosis of ileum Congenital absence.590 1.910 Page 16 of 111 .9 Q87.390 3. unspecified Congenital hypertrophic pyloric stenosis. atresia and stenosis of rectum with fistula Congenital absence. Congenital tracheo-oesophageal fistula NOS Diverticulum of oesophagus.390 3.390 7.390 7.300 11.300 11.300 11.300 5.300 5.710 3.390 7. Congenital funnel chest Pectus carinatum.300 11. Congenital or infantile stenosis of pylorus.3 CONGENITAL GASTROINTESTINAL DISORDERS 11.1 Q39.2 Q39.3 Q78.1 CONGENITAL GASTROINTESTINAL DISORDERS 11. Apple peel syndrome. Megalogastria. Imperforate rectum Congenital absence. Albers-Schönberg syndrome Other specified osteochondrodysplasias. Congenital diverticulum of stomach.390 3.0 Q39.300 11.910 7. Congenital deformity NOS of upper alimentary tract Congenital absence. Aganglionosis. atresia and stenosis of anus without fistula.300 3.ANNEX 1. Congenital. congenital Congenital scoliosis due to congenital bony malformation.300 11.710 3.390 3.1 Q43.300 11.300 3.2 Q41. Malrotation of colon. atresia and stenosis of anus with fistula Congenital absence.300 3.390 7. part unspecified Meckel's diverticulum.390 3. Congenital or infantile hypertrophy of pylorus.710 3.390 3.590 1.7 DESCRIPTION Pectus excavatum. Congenital hourglass stomach.910 Q41.2 CONGENITAL GASTROINTESTINAL DISORDERS 11. 120 8.480 3.480 8.300 11.600 11.120 8. Intrahepatic gallbladder Atresia of bile ducts Congenital stenosis and stricture of bile ducts Choledochal cyst Other congenital malformations of bile ducts. Biliary duct Duplication.390 3. Absence of alimentary tract NOS.120 8.910 7. Microcolon. Aortopulmonary window Other congenital malformations of cardiac septa.300 11.600 11.8 Q21.9 Q21.2 Q79.1 Q22. Congenital aortic insufficiency CONGENITAL GASTROINTESTINAL DISORDERS Q45.1 CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES 11.390 7.300 11.2 Q44.3 Q79.7 Congenital malformation of intestine.8 CONGENITAL GASTROINTESTINAL DISORDERS 11. Transpositio GROUP Case Rate Professional Fee Health Care Institution Fee Q43.600 11.600 11. Septal (heart) defect NOS Pulmonary valve atresia Congenital pulmonary valve stenosis Congenital pulmonary valve insufficiency.5 Q20.2 Q22. Absence of diaphragm.600 11.480 3. Congenital diverticulitis.480 3.300 11.120 8.390 3. Malposition. aplasia and hypoplasia of gallbladder. Eisenmenger's defect.600 11.600 11. unspecified.600 11. Transposition of appendix.300 11. complete. Congenital anomaly NOS of digestive system .120 Q21.600 11.120 8.480 3. unspecified Ventricular septal defect Atrial septal defect.ANNEX 1.300 3. unspecified.910 Other congenital malformations of liver.1 Q20.5 Q44. unspecified CONGENITAL GASTROINTESTINAL DISORDERS Agenesis. Eventration of diaphragm Exomphalos. Congenital diverticulum. intestine.910 7. Patent or persistent foramen ovale.600 3.910 7.9 Q44.600 11.2 CONGENITAL HEART DISEASES 11.120 Page 17 of 111 .120 8.300 11. Congenital CONGENITAL GASTROINTESTINAL DISORDERS absence of gallbladder Other congenital malformations of gallbladder.4 Q22.600 11. Patent or persistent ostium secundum defect (type II).600 11. Ventricular septal defect with pulmonary stenosis or atresia.480 3. Dextrotransposition of aorta.120 8. Transposition of great vessels (complete) Double inlet ventricle. Omphalocele Gastroschisis Prune belly syndrome Other congenital malformations of abdominal wall Common arterial trunk. Taussig-Bing syndrome Double outlet left ventricle Discordant ventriculoarterial connection.390 7.480 3.4 Q79.910 7.300 3.300 3.600 11. Congenital absence of liver. Congenital aortic stenosis Congenital insufficiency of aortic valve.480 3.910 7.9 Q79. Congenital blind loop syndrome.120 8. Ostium primum atrial septal defect (type I) Tetralogy of Fallot.390 3.480 3.120 8.4 Q21.1 Q79.0 Q22. Alagille's syndrome. Dolichocolon. aplasia and hypoplasia of pancreas. congenital of digestive organs NOS Congenital malformation of digestive system.480 3.120 8. Endocardial cushion defect. partial.300 11.120 8.600 11.600 11.600 3.390 3.300 11. Accessory hepatic duct. Congenital malformation of diaphragm NOS.120 8.120 8. Congenital malformation of bile duct NOS.390 3.480 3.390 7.910 7.600 11.120 8.600 3. Pentalogy of Fallot Congenital malformation of cardiac septum. Cystic duct Duplication Cystic disease of liver.390 3.480 3.390 3. Congenital absence of pancreas Other specified congenital malformations of digestive system.480 3.390 3.600 11. colon.120 8. Ventricular inversion Congenital malformation of cardiac chambers and connections.390 3.300 3.600 11. Single ventricle Discordant atrioventricular connection.300 11.0 Q44. Megaloappendix.910 Q45. dextroposition of aorta and hypertrophy of right ventricle. Congenital CONGENITAL GASTROINTESTINAL DISORDERS hepatomegaly.9 Q22.390 3.390 3.910 Q45.910 7.0 11.4 Q20.480 3. Common ventricle.120 8. Tricuspid atresia Ebstein's anomaly Hypoplastic right heart syndrome Other congenital malformations of tricuspid valve Congenital stenosis of aortic valve.480 3.8 Q23. Persistent truncus arteriosus Double outlet right ventricle.390 3.300 11. Aortopulmonary septal defect. Laevotransposition. Congenital malformation of gallbladder NOS.910 7.2 Q20.8 CONGENITAL GASTROINTESTINAL DISORDERS 11.0 Q23.120 8.390 3. Congenital malformation of liver NOS Agenesis.5 Q22. Sinus venosus defect Atrioventricular septal defect.300 11.390 7.3 Q20.300 11. Fibrocystic disease of liver CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS 11.5 Q20.910 7. Corrected transposition.910 Q43.480 3.480 3.480 3.910 8.910 7.1 CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL GASTROINTESTINAL DISORDERS CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES 11.390 3. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Other specified congenital malformations of intestine.4 Q44.6 Q22. Accessory liver. Bicuspid aortic valve.3 Q44.480 7. Congenital deformity NOS of digestive system Congenital diaphragmatic hernia Other congenital malformations of diaphragm.120 8.600 11. Cor triloculare biatriatum.1 Q44.6 Q44.0 Q20.120 Q21. Congenital aortic atresia.480 8.390 3.910 7. Absence of alimentary tract NOS. Megaloduodenum.300 11.120 8.0 Q79.910 7.120 8. Aortic septal defect.300 11.3 Q21. Congenital pulmonary valve regurgitation Congenital tricuspid stenosis.480 3.480 3. Duplication of digestive organs NOS.910 7.480 3. Coronary sinus defect.0 Q21.300 11.910 7.600 11. Common atrioventricular canal. 120 8.120 Q25.3 Q24.120 8. Uhl's disease Congenital malformation of heart.480 8. Other congenital malformations of aortic and mitral valves CONGENITAL HEART DISEASES Congenital malformation of aortic and mitral valves. Nontoxic ongenital parenchymatous Goitre Congenital hypothyroidism without goitre.600 3.120 Q25.8 CONGENITAL HEART DISEASES 11.100 9.900 3.480 3.120 8.6 11.ANNEX 1.9 Q24. anomaly of pulmonary artery.600 3.480 8. neurological type.120 8. Hemicephaly.600 11.000 13. Micrencephalon CONGENITAL HEART DISEASES CONGENITAL HYPOTHYROIDISM CONGENITAL HYPOTHYROIDISM 11.480 3.970 8.0 Q01. Aplasia of aorta. Supravalvular aortic stenosis CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES Professional Fee 3.600 11.600 11.480 3.900 9.2 Q01.120 8.120 Q25.1 Q25.7 CONGENITAL HEART DISEASES 11. unspecified. Persistent left posterior cardinal vein.900 3.0 E03.100 9.120 Q24. congenital of pulmonary artery.4 CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES 11. Aplasia of thyroid (with myxoedema).1 Q00. Acrania. Congenital dilatation of aorta.100 9. Congenital hypothyroidism NOS Anencephaly.600 11.480 3.3 DESCRIPTION GROUP Case Rate 11. hypoplasia of pulmonary artery.8 Other congenital malformations of great veins. Congenital diverticulum of left ventricle.000 13.4 Congenital mitral stenosis. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE Q23.600 Q23.900 3.480 3. Hydromicrocephaly.480 8.480 2.600 11. Absence of aorta. Acephaly. unspecified CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES 11. unspecified Congenital stenosis of vena cava. Persistent ductus arteriosus Coarctation of aorta.600 11.480 Health Care Institution Fee 8. neurological type Congenital hypothyroidism with diffuse goitre.4 Other congenital malformations of aorta.900 3. Absence of inferior vena cava .000 2.5 Q25.2 Q23.120 8. Anomaly of inferior vena cava NOS.120 8. Patent ductus Botallo.600 3.930 E03. Congenital mitral atresia CONGENITAL HEART DISEASES Congenital mitral insufficiency CONGENITAL HEART DISEASES Hypoplastic left heart syndrome. Postductal coarctation of aorta Atresia of aorta Stenosis of aorta. Azygos CONGENITAL HEART DISEASES continuation of inferior vena cava.8 Q02 CONGENITAL HYPOTHYROIDISM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM 9.000 13.2 Q25.480 3.600 11.120 Q26.480 3.8 Q23.600 11.120 8. pulmonary arteriovenous aneurysm Other congenital malformations of great arteries Congenital malformation of great arteries. Persisten Atresia of pulmonary artery Stenosis of pulmonary artery Other congenital malformations of pulmonary artery.100 Page 18 of 111 .2 Q24.930 6. unspecified.970 3. Aneurysm of sinus of valsalva (rupture).120 8. Malposition of heart. Hypoplasia of aorta.600 3.9 Q25.600 11.600 11.120 6.120 Q26. Endemic cretinism.120 8.600 11. Preductal coarctation of aorta.6 11.0 Q24.600 11. Congenital aneurysm of aorta. Absence of superior vena cava .480 8.0 Q01.120 Q23.120 8.480 3. Anomaly of superior vena cava NOS Congenital iodine-deficiency syndrome.4 Q24.600 11.000 13. agenesis of pulmonary artery.0 Q26.480 8. Congenital atrophy of thyroid.480 8.120 8.480 3.600 3. Congenital stenosis of inferior vena cava.120 8. Congenital malformation of pericardium.120 8.600 3.5 Q24. unspecified Dextrocardia Cor triatriatum Pulmonary infundibular stenosis Congenital subaortic stenosis Malformation of coronary vessels.900 13. Congenital malformation of myocardium. or marked hypoplasia of aortic orifice or valve. with hypoplasia of ascending aorta and defective development of left ventricle CONGENITAL HEART DISEASES (with mitral valve stenosis or atresia).600 11.480 8.0 11.480 3. CONGENITAL HEART DISEASES Double aortic arch [vascular ring or aorta]. Amyelencephaly.100 9.480 3. Atresia.900 3.0 Q25.120 8. Nontoxic congenital Goitre NOS.120 11.000 13.600 9.900 6. Congenital coronary (artery) aneurysm Congenital heart block Other specified congenital malformations of heart.900 3.600 3.100 9. Congenital disease NOS of heart Patent ductus arteriosus. aneurysm.480 8. Hemicephaly Frontal encephalocele Nasofrontal encephalocele Occipital encephalocele Encephalocele of other sites Microcephaly.9 Q26.120 Q24.3 CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES CONGENITAL HEART DISEASES 11.120 8.480 3.930 9.2 Q26.120 8.600 3.600 3.8 Q25.480 3.9 E00.1 Q01. Congenital stenosis ofsuperior vena cava Total anomalous pulmonary venous connection Anomalous pulmonary venous connection.480 8.120 Q25.600 11.480 3.480 3.480 3. Scimitar syndrome Congenital malformation of great vein.480 3. aberrant pulmonary artery.600 11. Congenital anomaly NOS of heart.970 2.600 11. 000 13.100 9.8 CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM 13. Congenital deformity of forehead.8 13.6 Q04.4 Q05. congenital. Congenital anomaly NOS of nervous system. Agenesis of corpus callosum Holoprosencephaly Other reduction deformities of brain. Thoracolumbar spina bifida with hydrocephalus Lumbar spina bifida with hydrocephalus.100 9.900 3.100 Q04. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Malformations of aqueduct of Sylvius.000 13.100 9. Macrogyria Congenital malformation of brain.100 9. Dorsal spina bifida with hydrocephalus.100 9.100 9.4 Q04.900 3.900 9.4 Q06.100 Q74.900 9.ANNEX 1. Congenital absence of vertebra unspecified or not associated with scoliosis.9 Congenital malformation of spinal cord. Congenital kyphosis unspecified o CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM 13. unspecified.900 9.100 Q76. Aplasia of part of brain.000 3.100 Q75.0 Q03.000 13.000 13.000 3.000 3.000 13. Congenital disease or lesion NOS of nervous system Arthrogryposis multiplex congenita Craniosynostosis.100 9.900 9. not associated with scoliosis.100 Q06. Franceschetti Syndrome. Stenosis of aqueduct of sylvius Atresia of foramina of Magendie and Luschka. Hydranencephaly. Lumbosacral spina bifida with hydrocephalus Unspecified spina bifida with hydrocephalus Thoracic spina bifida without hydrocephalus.0 Q06.900 9. unspecified.100 Q05.100 9. Obstruction. Congenital multiple anomalis NOS of brain Thoracic spina bifida with hydrocephalus. unspecified Amyelia Diastematomyelia Hydromyelia.000 13.900 3.900 3.2 Q04.000 3. unspecified. Congenital disease of lesion NOS of brain. Porencephaly.900 3.900 9.000 3.900 9.0 13.4 CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM 13. Congenital deformity NOS of nervous system.100 Q07. Congenital anomaly NOS of brain.2 Q06. BRAIN/NERVOUS SYSTEM Congenital disease or lesion NOS of spinal cord or meninges Arnold-Chiari syndrome Congenital malformation of nervous system. DandyWalker syndrome Congenital malformations of corpus callosum.000 3. Agyria.000 13. Absence of part of brain.900 3.000 13. Trigonocephaly Craniofacial dysostosis. Dorsal NOS spina bifida.900 3.900 3.000 3. Lissencephaly.7 Q05.000 13.900 3. Congenital anomaly of face bones NOS. Treacher Collins Syndrome Other specified congenital malformations of skull and face bones.1 Q04.900 3.900 3.000 13.000 3.000 13. Congenital anomaly of skull NOS Spina bifida occulta Other congenital malformations of spine.0 Q75.900 3.0 13.100 9. Thoracolumbar NOS spina bifida Lumbar spina bifida without hydrocephalus. Crouzon's disease Hypertelorism Mandibulofacial dysostosis.9 Q76.6 Q05. Hydrorachis Other specified congenital malformations of spinal cord GROUP CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM CONGENITAL MALFORMATIONS OF THE BRAIN/NERVOUS SYSTEM Case Rate 13.000 13.100 9. Lumbosacral spina bifida NOS Sacral spina bifida without hydrocephalus Spina bifida.000 13.100 9.900 3.9 Q06.000 13. Schizencephaly Other specified congenital malformations of brain.9 13. Agenesis of part of brain.000 13. Congenital anomaly NOS of spinal cord or meninges.000 13.900 3.900 3. unspecified. Congenital fusion of spine unspecified or not associated with scoliosis.100 9.100 9.900 3.100 9.100 Q04.900 3.000 13. Absence of skull bone.1 Q75. Platybasia Congenital malformation of skull and face bones.000 13. ]Imperfect fusion of skull.3 13.000 13.900 9.9 13. Anomaly of aqueduct of sylvius. Microgyria.1 Q05.000 3.000 Professional Fee 3.2 Q75.100 9.900 3.100 9.3 Q75.000 13.100 9.900 3.900 Health Care Institution Fee 9.8 13.100 Q07.000 13.900 9.8 Q05.4 Q75.000 3.100 Q03. Congenital deformity NOS of brain.900 3.100 Page 19 of 111 .900 9. Acrocephaly. Oxycephaly.2 Q05. Hypoplasia of part of brain .0 Q04.100 9.900 3.100 9. CONGENITAL MALFORMATIONS OF THE Congenital deformity NOS of spinal cord or meninges. Pachygyria Septo-optic dysplasia Congenital cerebral cysts.100 9.100 9. congenital of aqueduct of sylvius. 010 Q15. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE.700 Professional Fee 6.4 Q14. Absence of uvula.800 2. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE. Glaucoma of newborn. Congenital deformity NOS of eye Congenital renal failure. Congenital malformation of mouth NOS Other congenital malformations of pharynx.2 Q31.290 1.6 Q38.100 1.190 Q32.000 4.190 Q30. not elsewhere classified.700 21. Congenital vitreous opacity Congenital malformation of retina.290 1.100 9.370 6.1 Q30. larynx or thyroid cartilage.000 3. Congenital absence of nose Fissured.010 3. Single cyst of kidney Polycystic kidney.010 3. Congenital retinal aneurysm Congenital malformation of posterior segment of eye.700 6. unilateral Renal agenesis.730 2.290 1.700 6. Buphthalmos.010 3.8 11.300 3.370 6.290 2.300 9. Congenital cyst of kidney.200 1.510 Health Care Institution Fee 15.100 9.9 21.300 4.0 Q61.300 4. Congenital polycystic lung disease Sequestration of lung Agenesis of lung.190 15.800 2. autosomal recessive.190 15.1 Q60.0 Q33.000 11.3 Q31.370 6. Congenital absence of respiratory organ .000 4. Macrophthalmos in congenital glaucoma.730 2.370 6.2 Q60.190 15. unspecified Macroglossia Congenital malformations of palate.2 Q12.730 3.370 6.0 Congenital glaucoma.3 Q33. Congenital malformation of larynx.200 1. bilateral Renal agenesis.8 Q34. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE. glottis. unspecified CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE. Congenital stenosis of posterior nares Agenesis and underdevelopment of nose.100 9.300 4. notched and cleft nose Laryngocele Congenital laryngomalacia Other congenital malformations of larynx.730 2.5 11. epiglottis.300 1.510 6. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE.700 21.700 Q31. Microcornea.300 4. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE Q32.700 21. congenital.1 Q14.700 21.010 3.730 2.510 15.800 3.300 3.290 1.700 7. larynx or thyroid cartilage.290 1.1 4.730 2.010 3.000 11.300 3. CONGENITAL OPHTHALMOLOGIC DISORDERS Macrocornea with glaucoma.300 7.510 6. glottis.700 7. lobe Congenital bronchiectasis Hypoplasia and dysplasia of lung Congenital cyst of mediastinum Other specified congenital malformations of respiratory system.9 P96. Absence of cricoid cartilage. unspecified Potter's syndrome Congenital single renal cyst.100 9.190 15. with glaucoma.700 21.300 1.290 7.190 Q33. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL MALFORMATIONS OF THE ORAL CAVITY CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS 21.000 4. Atresia of bronchus.300 4.010 Q15. Diverticulum of RESPIRATORY TRACT bronchus.510 6.300 4. Congenital malformations of lung] of bronchus Congenital cystic lung.000 11.100 9.4 Q13. Agenesis of cricoid cartilage.8 Q12. Congenital cystic lung disease.000 11.5 Q60.6 Q61.290 1.1 Q34. Congenital anomaly NOS of eye.100 9.3 Q60.370 6. infantile type CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL OPHTHALMOLOGIC DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS 4.9 11.2 Q33. Absence of posterior nares.730 2. CONGENITAL MALFORMATIONS OF THE LOWER Congenital malformation NOS of bronchus. unspecified Renal hypoplasia. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE.730 2. Atresia of cricoid cartilage. epiglottis.510 6.4 Q33. congenital stenosis of anterior nares. unspecified.000 3. Congenital honeycomb lung.510 6. Absence of anterior nares.4 Other congenital malformations of bronchus. Absence of bronchus.000 4.5 Q38. Hydrophthalmos.2 Q38. Uraemia of newborn Renal agenesis.300 3.370 Page 20 of 111 .0 Q60. Polycystic kidney. Absence of lung.190 15. epiglottis.300 3.300 7.370 6.ANNEX 1.190 15.510 6. High arched palate Other congenital malformations of mouth.200 1.100 9. Congenital anomaly NOS of respiratory organ Choanal atresia.000 4.700 7.0 DESCRIPTION Congenital tracheomalacia GROUP CONGENITAL MALFORMATIONS OF THE LOWER RESPIRATORY TRACT Case Rate 21.9 Q38.200 1.370 6.010 6. Congenital malformation of pharynx NOS Coloboma of lens Spherophakia Other congenital corneal malformations.190 15.010 3. unspecified. glottis.510 15. Congenital malformation of cornea NOS.700 Q31.700 21.290 3.0 Q30. unilateral Renal hypoplasia.700 21.510 6.6 Q34. Peter's anomaly Congenital malformation of vitreous humour.100 9. UPPER RESPIRATORY TRACT CONGENITAL MALFORMATIONS OF THE NOSE.8 Q15.0 Q14. Atresia of nasopharynx Congenital malformation of respiratory system.700 2.800 2.0 Q60. Agenesis of bronchus. Congenital malformation of palate NOS. Keratoglobus.700 7.730 2. Megalocornea with glaucoma Other specified congenital malformations of eye Congenital malformation of eye. 730 2.100 9.100 9. Congenital hernia of bladder.370 6.730 2. Congenital occlusion of ureterovesical orifice. Accessory urethra. Impervious urethra Malformation of urachus.730 6. Congenital arteriovenous precerebral aneurysm (nonruptured) Other malformations of precerebral vessels.100 Professional Fee 2.100 3.960 8. autosomal dominant.370 6.4 CONGENITAL URINARY TRACT DISORDERS 9.370 Q64.370 A50. Congenital dilatation of ureter Other obstructive defects of renal pelvis and ureter. Late congenital neurosyphilis [juvenile neurosyphilis]. Early mucocutaneous congenital syphilis.100 9.960 A50.840 2.9 Q62. Early congenital syphilitic oculopathy. Arteriovenous aneurysm Other specified congenital malformations of peripheral vascular system.840 8. Early congenital syphilitic laryngitis. Juvenile tabes dorsalis.800 9. Ectopic of ureter of ureteric orifice.730 6.370 6. Fibrocystic renal degeneration or disease Cystic kidney disease. Extroversion of bladder Congenital posterior urethral valves Other atresia and stenosis of urethra and bladder neck.730 6.370 6.8 Q64. Ear Early congenital syphilis.960 A50.730 6.1 CONGENITAL VASCULAR DISEASES 12.730 6.370 6.730 2.6 CONGENITAL URINARY TRACT DISORDERS 9. Congenital aneurysm (peripheral). Accessory bladder. Fibrocystic kidney.5 Q61.730 3.100 9.2 CONGENITAL SYPHILIS 12.100 2.840 8. unspecified.0 Q62. Congenital varix Congenital malformation of peripheral vascular system.840 8.730 6.840 3.730 2.600 6.100 2.8 Q61. Meckel-Gruber syndrome Congenital hydronephrosis Congenital vesico-uretero-renal reflux Accessory kidney Lobulated. Congenital renal calculi Early cutaneous congenital syphilis: . Congenital bladder neck obstruction.370 6.370 Duplication of ureter.730 2.100 9.370 Q64.3 Q63. Congenital anomaly NOS of urinary system. Patent urachus.370 6.7 Other congenital malformations of bladder and urethra. Double of ureter CONGENITAL URINARY TRACT DISORDERS Malposition of ureter. fused and horseshoe kidney Ectopic kidney.0 Q63.000 3. unspecified.100 9.100 9. unspecified. Impervious ureter Congenital megaloureter. Juvenile taboparetic neurosyphilis Other late congenital syphilis. Syphilitic saddle nose Congenital syphilis.370 Q64. Dementia paralytica juvenilis.370 8. Congenital prolapse of urethra. Congenital malformation of bladder or urethra CONGENITAL URINARY TRACT DISORDERS NOS. Congenital occlusion of ureter. Anomaly of artery or vein NOS Arteriovenous malformation of precerebral vessels. Cyst of urachus.370 6.4 Q61.100 9.730 2.730 2.730 8.1 Q64.370 6. Congenital stricture of urethra.5 A50.370 Q62. Early visceral congenital syphilis.100 9.ANNEX 1.9 Q62.100 9.0 CONGENITAL VASCULAR DISEASES CONGENITAL VASCULAR DISEASES 12.800 3. Ectopia vesicae. unspecified.3 CONGENITAL URINARY TRACT DISORDERS 9.000 12. Congenital prolapse of bladder (mucosa).100 9. Juvenile general paresis . Congenital syphilis NOS less than two years after birth. Deviation of ureter or ureteric orifice.370 6.0 CONGENITAL SYPHILIS 12. Congenit Other specified congenital malformations of urinary system CONGENITAL URINARY TRACT DISORDERS Congenital malformation of urinary system.100 2. Congenital stricture of vesicourethral orifice. Accessory of ureter.370 Q64.7 Q63.5 CONGENITAL URINARY TRACT DISORDERS CONGENITAL URINARY TRACT DISORDERS 9.800 3. Malrotation of kidney Hyperplastic and giant kidney Other specified congenital malformations of kidney.960 6. Absence of artery or vein NEC. Polycystic kidney.2 Q63.100 9. Early congenital syphilitic osteochondropathy. symptomatic.600 8.2 CONGENITAL URINARY TRACT DISORDERS CONGENITAL URINARY TRACT DISORDERS 9.600 3. Atresia of artery or vein NEC.960 A50.100 9. Congenital displaced kidney.3 Q62.730 2.1 Q63. Congenital stricture.000 3.400 8.2 Q61. Sponge kidney NOS Other cystic kidney diseases. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE Q61. Prolapse of urachus Q62. unspecified Atresia and stenosis of ureter.370 6.370 6.730 2. anomalous of ureter or ureteric orifice Exstrophy of urinary bladder. Congenital malformation of precerebral vessels NOS.100 2.100 12.730 2. Congenital occlusion of ureteropelvic junction. Congenital stricture of urinary meatus.2 Q62.730 2.100 9.100 2.370 6. unspecified Renal dysplasia Medullary cystic kidney. Displacement of ureter or ureteric orifice.730 2.100 2. Congenital ureterocele GROUP CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS CONGENITAL RENAL DISORDERS Case Rate 9.370 Q64. adult type Polycystic kidney.3 9. Implantation.730 2.600 3.370 6. Congenital precerebral aneurysm (nonruptured) CONGENITAL URINARY TRACT DISORDERS CONGENITAL VASCULAR DISEASES CONGENITAL VASCULAR DISEASES 9.000 2. Congenital deformity NOS of urinary system Congenital renal artery stenosis Peripheral arteriovenous malformation.800 12.370 6.8 CONGENITAL VASCULAR DISEASES 12.1 Q27.400 Page 21 of 111 .730 2.8 DESCRIPTION Polycystic kidney.370 6.400 Q27.9 Q28.3 Q61.400 Q27.000 3.730 2.800 3.100 9. Aberrant subclavian artery.100 9.9 Q27.730 Health Care Institution Fee 6.600 8.730 2. artery.1 CONGENITAL SYPHILIS CONGENITAL SYPHILIS CONGENITAL URINARY TRACT DISORDERS 12.000 12.400 8.4 CONGENITAL SYPHILIS 12.400 Q28.600 8. 400 7.400 7.140 4. telangiectasia Systemic sclerosis induced by drugs and chemicals Systemic sclerosis.800 13.400 7. Cystic fibrosis with combined manifestations Cystic fibrosis.180 5.1 M35.0 M35.9 G50.140 4.400 8.220 2.220 2.800 13. (o)esophageal dysfunction. Arteriovenous malformation of brain NOS.140 4.500 7.180 5.1 E84.0 M34.660 9.140 4.8 E84.800 13.1 M33.110 5.220 2. unspecified Juvenile dermatomyositis Other dermatomyositis Polymyositis Dermatopolymyositis.300 7.400 7.140 4.800 13.800 13.9 M35.660 9.660 9.3 M30.220 2.8 H46 H47.220 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee 3.650 6. Disorder of 1st cranial nerve CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER Disorders of glossopharyngeal nerve.740 6.500 9.800 13.180 5.400 7.800 7.660 9.9 M33.400 7.660 9.660 9.140 4.660 9.9 12. Hypocomplementaemic vasculitis Necrotizing vasculopathy.400 7.0 G50.650 6.140 4.190 2.140 4.140 4.600 Health Care Institution Fee 8.300 7.140 4.1 G51.9 M34.800 13.180 5.220 2.0 J05.3 M31.1 M30.140 4.800 13.2 Arteriovenous malformation of cerebral vessels.800 13.800 13.180 5.190 8.460 2.400 7.660 9.300 3. Pituitary-dependent hyperadrenocorticism Nelson's syndrome Drug-induced Cushing's syndrome Ectopic ACTH syndrome Other Cushing's syndrome Cushing's syndrome.0 G52.650 6.800 13. Compression of optic nerve.1 M31.2 M30.800 13.140 4.140 4.8 M31.180 5.140 4.660 9.140 4.660 9.660 9.180 5.660 9.660 9.190 2.220 2.220 2.220 2. Syndrome of paroxysmal facial pain. Disorder of 9th CRANIAL NERVE DISORDER cranial nerve. unspecified.400 9. unspecified Disorders of olfactory nerve.2 M34.1 E24.140 4.660 9.850 2. Optic neuropathy.140 4.180 5.140 4.9 E84.600 4.660 5.660 9. Retrobulbar neuritis NOS Disorders of optic nerve.0 E24. Congenital cerebral aneurysm. Goodpasture's syndrome Thrombotic microangiopathy. Congenital malformation of cerebral vessels NOS Polyarteritis nodosa Polyarteritis with lung involvement [Churg-Strauss].660 9.800 13.400 7.9 G52.4 M35.8 M31.800 13. unspecified Cystic fibrosis with pulmonary manifestations Cystic fibrosis with intestinal manifestations Cystic fibrosis with other manifestations.140 4. Disorder of pneumogastric [10th] CRANIAL NERVE DISORDER nerve Disorders of multiple cranial nerves.0 M31.4 G51. unspecified SICCA SYNDROME [SJÖGREN] CONGENITAL VASCULAR DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES CONNECTIVE TISSUE DISEASES 12.400 7. unspecified Progressive systemic sclerosis CR(E)ST syndrome.2 M31.ANNEX 1.3 G51. Optic papillitis.180 5.800 13.500 9.180 5.500 9.140 4.500 9.850 2.800 13.4 M31.180 5. Tic douloureux Other disorders of trigeminal nerve Bell's palsy.220 2. Haemorrhage in optic nerve sheath.2 M33. Collagen (vascular) disease NOS Trigeminal neuralgia. CONGENITAL VASCULAR DISEASES Congenital arteriovenous cerebral aneurysm (nonruptured) Other malformations of cerebral vessels.800 13.140 4.660 9.220 2.220 2. Allergic granulomatous angiitis Juvenile polyarteritis Mucocutaneous lymph node syndrome [Kawasaki] Other conditions related to polyarteritis nodosa.660 9.8 G51.660 9. sclerodactyly.3 M35.200 9.2 M35.140 4.800 13. not elsewhere classified.110 Other overlap syndromes.6 M31.220 2.660 9.800 13.800 13.800 13.110 5.140 4. Polyneuritis cranialis Disorders of other specified cranial nerves Optic neuritis.800 13.0 M33.180 5.000 Q28.180 5.650 6.180 5.400 7.190 2.0 G51. Thrombotic thrombocytopenic purpura Lethal midline granuloma Wegener's granulomatosis. except ischaemic.8 M35.8 G51.300 7.400 7.800 13.850 2.220 2. Raynaud's phenomenon.800 13.140 4.1 M34.220 2. Combination of calcinosis.2 G52.650 5.140 4. Mixed connective tissue disease CONNECTIVE TISSUE DISEASES Behçet's disease Polymyalgia rheumatica Diffuse (eosinophilic) fasciitis Other specified systemic involvement of connective tissue Systemic involvement of connective tissue.660 9.660 9.800 13.650 6.0 E84.0 E24.660 9.110 5.660 9.850 2.400 7.7 G52.800 13.8 E24.660 9.140 2.000 13.3 E24. nonruptured.660 9.0 M30.800 13.140 4.140 4. unspecified CUSHING'S SYNDROME CUSHING'S SYNDROME CUSHING'S SYNDROME CUSHING'S SYNDROME CUSHING'S SYNDROME CYSTIC FIBROSIS CYSTIC FIBROSIS CYSTIC FIBROSIS CYSTIC FIBROSIS Page 22 of 111 .850 2. Facial palsy Geniculate ganglionitis Clonic hemifacial spasm Facial myokymia Other disorders of facial nerve Disorder of facial nerve.400 Q28.180 5. Polyangiitis overlap syndrome Hypersensitivity angiitis. Necrotizing respiratory granulomatosis Aortic arch syndrome [Takayasu] Other giant cell arteritis Other specified necrotizing vasculopathies.3 M30. Obstructive laryngitis NOS CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CRANIAL NERVE DISORDER CROUP Pituitary-dependent Cushing's disease. Ischaemic optic neuropathy Acute obstructive laryngitis [croup].660 9.1 G52. Overproduction of CUSHING'S SYNDROME pituitary ACTH.850 2.500 9. Glossopharyngeal neuralgia Disorders of vagus nerve.400 7.2 E24. Systemic Autoimmune disease NOS. disseminated. Demyelination in optic neuritis Acute and subacute haemorrhagic leukoencephalitis [Hurst] Other specified acute disseminated demyelination Acute disseminated demyelination.740 4.000 7.120 8.800 15.740 11.1 11.000 3.000 3. .1 DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMA OR KETOSIS 15.480 3. Progressive isolated aphasia Senile degeneration of brain. Periaxial encephalitis.000 4.1 G30.000 3.600 11.1 DESCRIPTION Alzheimer's disease with early onset Alzheimer's disease with late onset Other Alzheimer's disease Dementia in alzheimer's disease.600 11.480 3.000 7.800 4.480 3.120 8. DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DEMYELINATING DISEASE OF CENTRAL NERVOUS SYSTEM DENGUE FEVER DENGUE FEVER DENGUE. Multiple sclerosis of brain stem. Lewy body (ies) dementia. Pick's disease.740 11.120 8.060 11. Multiple sclerosis NOS.120 8.740 11.000 10.000 7. SEVERE DIABETES INSIPIDUS DIABETES INSIPIDUS 10.0 Insulin-dependent diabetes mellitus with acididosis/ ketoacidosis without mention of coma.000 G32.000 16.600 11. Multiple sclerosis.9 A90 A91. Lewy body (ies) disease. Alcoholic encephalopathy.600 3.800 4.2 G37. Multiple sclerosis of cord. SYSTEM Dysfunction of autonomic nervous system due to alcohol Other specified degenerative diseases of nervous system.740 11. Schilder's disease Central demyelination of corpus callosum Central pontine myelinolysis Acute transverse myelitis in demyelinating disease of central nervous system. generalized Neuromyelitis optica [Devic].000 11.120 8.1 15. Adult-onset diabetes mellitus With DIABETES MELLITUS WITH COMA OR KETOSIS coma .000 10.120 7.000 7.8 G37. unspecified Diffuse sclerosis.1 E11.060 Page 23 of 111 .000 3.2 Degeneration of nervous system due to alcohol.9 G37. not elsewhere classified GROUP DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM DEGENERATIVE DISEASES OF CENTRAL NERVOUS SYSTEM Case Rate 10.480 3.030 3.740 11.000 G35 11.8 G30. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE G30.480 3. Diabetic ketoacidosis without mention of coma.ANNEX 1.000 3.060 E12. Obese DIABETES MELLITUS WITH COMA OR KETOSIS diabetes mellitus With ketoacidosis without mention of coma.120 8.8 10.3 E23. unspecified Dengue without warning signs Dengue with warning signs Severe dengue Diabetes insipidus Nephrogenic diabetes insipidus Insulin-dependent diabetes mellitus with coma. Nonketotic diabetes mellitus With com Non-insulin-dependent diabetes mellitus with ketoacidosis without mention of coma. unspecified Circumscribed brain atrophy.480 3.800 4.0 E13.600 10.0 G37.000 G31.000 10. Ketosis-prone diabetes (mellitus) with coma.000 7.000 Health Care Institution Fee 7.000 7.480 3.060 15.000 7. Subacute necrotizing encephalopathy [Leigh] Other specified degenerative disorders of nervous system in diseases classified elsewhere Multiple sclerosis.0 G30.000 3.600 11.000 7.000 10.120 8.600 11.480 3.000 7.480 3.030 8.3 G37.600 11.1 A91.100 3. Adult-onset diabetes mellitu Malnutrition-related diabetes mellitus with coma.120 8.000 10.000 3.120 8.8 G36. Grey-matter degeneration [Alpers].800 4.0 G31. Alcoholic cerebellar ataxia. Insulindependent malnutrition-related diabetes mellitus with coma . Type I diabetes (mellitus) with coma. Nonobese diabetes (mellitus) With coma .000 10.000 3. Brittle diabetes (mellitus) with coma.000 G31.0 DIABETES MELLITUS WITH COMA OR KETOSIS 15.740 4.480 8.070 E10.2 N25.4 G37. Multiple sclerosis.0 E13.200 7.100 10.600 11. Maturity-onset diabetes mellitus With coma .8* 10.9+F00. Acute transverse myelitis NOS Subacute necrotizing myelitis Other specified demyelinating diseases of central nervous system Demyelinating disease of central nervous system.000 3.1 G36. Juvenile-onset diabetes (mellitus) withcoma .600 11.9* G31. Diabetic acididosis DIABETES MELLITUS WITH COMA OR KETOSIS without mention of coma.0 G36.800 3.060 E10. Alcoholic cerebellar degeneration.070 7. DEGENERATIVE DISEASES OF CENTRAL NERVOUS Alcoholic cerebral degeneration. Non-insulin-dependent diabetes mellitus with coma. Obese diabetes mellitus With coma .480 3. Nonobese diabetes (mellitus) With ketoacidosis without mention of coma.600 11.000 Professional Fee 3.800 4.600 11.480 3.000 10.800 15.060 E11.120 G36.1 G37. Non-insulin-dependent malnutrition-related diabetes mellitus with coma Other specified diabetes mellitus with coma Other specified diabetes mellitus with acididosis/ ketoacidosis without mention of coma 15.060 11.120 8. 820 E11. Pelger-Huët Granulocyte Anomaly or Syndrome. Leukocytosis.820 E12.0 E14.090 6. diabetes NOS with acididosis/ ketoacidosis without mention of coma Insulin-dependent diabetes mellitus with Diabetic gangrene/ ulcer INSULIN-DEPENDENT DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Insulin-dependent diabetes mellitus with multiple complications Insulin-dependent diabetes mellitus with unspecified complications Non-insulin-dependent diabetes mellitus with Diabetic gangrene/ ulcer.6 12.3 D73.780 3.2 D73. Agranulocytic angina.ANNEX 1.740 3. P Other specified disorders of white blood cells.820 8.5 E14. Congenital dysphagocytosis.100 3. Noninsulin-dependent malnutrition-related diabetes mellitus with unspecified complicati Other specified diabetes mellitus with Diabetic gangrene/ ulcer OTHER SPECIFIED DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Unspecified diabetes mellitus.820 6. Torsion DISEASES OF BLOOD AND BLOOD FORMING of spleen ORGANS 12.600 12. Periodic Neutropenia.600 3.600 12. Kostmann's disease.7 DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS 12.100 3.610 8.600 Professional Fee 4. Chronic (childhood) granulomatous disease.630 8.820 8. Obese diabetes mellitus With multiple complications . May-Hegglin Granulation Anomaly or Syndrome.820 8.470 D72.6 E10. diabetes NOS with multiple complications Pharyngeal diphtheria. Matur Malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer. Symptomatic Monocytosis.780 3. Alder Granulocyte Anomaly or Syndrome.800 12.820 E11.780 8.100 12. Alder Granulation Anomaly or Syndrome. Insulin-dependent malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer. Drug-induced Neutropenia.610 2.100 3.090 6.780 8.6 DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS 12.780 3.5 DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS 12.5 DISEASES OF BLOOD AND BLOOD FORMING ORGANS DISEASES OF BLOOD AND BLOOD FORMING Abscess of spleen ORGANS DISEASES OF BLOOD AND BLOOD FORMING Cyst of spleen ORGANS Infarction of spleen.780 Health Care Institution Fee 11. Insulin-dependent malnutrition-related diabetes mellitus with unspecified complications.780 8. Adult-onset diabetes mellitus With multiple complications . Cell membrane receptor complex [CR3] defect. Nonobese diabetes (mellitus) With multiple complications .6 E14.780 3.780 2. Toxic Neutropenia.7 A36.600 12.600 12.470 D73. Mat NON-INSULIN-DEPENDENT DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Non-insulin-dependent diabetes mellitus with multiple complications .630 8.800 15.470 8.5 DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS 12.610 2. Progressive septic granulomatosis.600 3.820 8.600 3.5 E13.060 8. Congenital Neutropenia.470 8. Neutropenia NOS. Symptomatic Lymphocytosis.100 3.470 D71 DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12. Adult-onset diabetes mellitus with Diabetic gangrene/ ulcer.820 8. Lymphopenia.9 DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIPHTHERIA DIPHTHERIA DIPHTHERIA 12.630 8.8 DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS 12.780 8. Nontraumatic Splenic rupture.600 3.630 3.0 A36. Diphtheritic membranous angina.470 Page 24 of 111 .3 A36.820 E12.630 3.820 E11.820 E12. Infantile genetic agranulocytosis. Nonobese diabetes (mellitus) with Diabetic gangrene/ ulcer. Myelocytic Leukaemoid reaction.4 D73.600 8.8 DESCRIPTION Unspecified diabetes mellitus. Chronic congestive splenomegaly GROUP DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMA OR KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS DIABETES MELLITUS WITH COMPLICATIONS OTHER THAN COMA AND KETOSIS Case Rate 15.060 11.7 E10.780 3. diabetes NOS with Diabetic gangrene/ ulcer UNSPECIFIED DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Unspecified diabetes mellitus. Primary Splenic Neutropenia.740 4. Obese diabetes mellitus with Diabetic gangrene/ ulcer.600 12.700 3.630 3.470 D72. unspecified Agranulocytosis.780 3. Cyclic Neutropenia.700 8.0 DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12.600 3.820 8. Tonsillar diphtheria Cutaneous diphtheria Diphtheria. Lymphocytic Leukaemoid reaction.780 8.090 D70 DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12.600 3.630 8. Other disorders of white blood cells Genetic anomalies of leukocytes.700 8.100 12.1 E10.5 E10.780 8.820 E13. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE E14. Functional disorders of polymorphonuclear neutrophils.600 12. May-Hegglin Granulocyte Anomaly or Syndrome.780 3.100 12.630 8. Noninsulin-dependent malnutrition-related diabetes mellitus with Diabetic gangrene/ ulcer MALNUTRITION-RELTAED DIABETES MELLITUS WITH OTHER SPECIFIED COMPLICATIONS Malnutrition-related diabetes mellitus with unspecified complications.6 E14. Monocytic Leukaemoid reaction.470 8. diabetes NOS with coma Unspecified diabetes mellitus.8 DISEASES OF BLOOD AND BLOOD FORMING ORGANS 12.820 8.600 12.100 3. 810 Page 25 of 111 .490 2.1 H70.120 3. unspecified Cellulitis of external ear.280 7.120 3.100 12. Cellulitis of external auditory canal Malignant otitis externa Other infective otitis externa.3 H60.810 5. Chronic tympanitis Other specified disorders of tympanic membrane Disorder of tympanic membrane.0 DESCRIPTION Other diseases of spleen.490 8.490 2. ORGANS Xanthogranuloma Oesophagitis. Compression of oesophagus.120 3.2 H70.280 7.700 2. DISEASES OF ESOPHAGUS Constriction of oesophagus. Cholesteatoma tympani.490 2.400 10.0 H83.810 5.100 3.470 8.4 K22. DISEASES OF ESOPHAGUS Mallory-Weiss syndrome Barrett's esophagus. Cellulitis of auricle.300 9.810 6.490 2.100 12.700 2. Stricture of oesophagus.630 Health Care Institution Fee 8.280 7.000 9. Spasm of oesophagus Gastro-oesophageal laceration-haemorrhage syndrome.490 2.630 3.8 D76.000 9. Emotional Polycythaemia.3 K22.630 8.1 H60.400 10.630 3.280 7.4 H83.100 12.2 K22.000 9. Cyst of palatine papilla 8. Acquired Polycythaemia due to high ORGANS altitude.470 5. Achalasia NOS.120 3.700 1.300 6. Fibrosis of spleen NOS. DISEASES OF ESOPHAGUS Chemical oesophagitis.400 10. Benign Polycythaemia.300 8.280 7.120 3. Cyst DISEASES OF ORAL CAVITY.470 8.100 8. unspecified Acute mastoiditis. Stenosis of oesophagus.7 K22.630 3. Oesophagitis NOS. infection-associated ORGANS Other histiocytosis syndromes.120 2.630 3.100 Professional Fee 3.470 8. Reticulohistiocytoma (giantDISEASES OF BLOOD AND BLOOD FORMING cell).400 10.8 H68. Dentigerous cyst.300 8.400 10.400 10. Acute tympanitis. Peptic oesophagitis Achalasia of cardia.280 7. Fungal ulcer of oesophagus. AND JAW 12. Haemorrhage of oesophagus NOS Disease of oesophagus.000 6. not elsewhere classified ORGANS Haemophagocytic lymphohistiocytosis. Hand-Schüller-Christian disease.200 6.8 H73.400 10.0 Familial erythrocytosis.490 2.860 3.810 8. Familial Polycythaemia Secondary polycythaemia. Acute inflammation of petrous bone. Eruption Cyst.300 3. Bullous myringitis Chronic myringitis.0 D76. Fistula of mastoid Petrositis.280 7.280 7. Acquired Polycythaemia due to erythropoietin.630 3. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE D73. Acquired Polycythaemia due to fall in DISEASES OF BLOOD AND BLOOD FORMING plasma volume.120 3. Acquired Polycythaemia due to stress.9 H60. Swimmer's ear Cholesteatoma of external ear. Perisplenitis.630 3.280 7. Peptic ulcer of oesophagus Oesophageal obstruction. Stenosis of Eustachian tube.300 2.9 K09.ANNEX 1.120 3.120 3. Diffuse DISEASES OF ESOPHAGUS oesophageal spasm. Perforation of oesophagus.630 2.470 D75. Cardiospasm DISEASES OF ESOPHAGUS Ulcer of oesophagus.280 7. Corksrew oesophagus.810 5.9 H74. Cyst of median AND JAW palatal.0 H70.700 2.120 3.400 10.9 D75.1 D75. Compression of Eustachian tube. Postinflammatory perforation of ear drum Acute myringitis.860 1.490 2.300 8. Primordial cyst.400 8. Keratosis obturans of external ear (canal) Labyrinthitis Other specified diseases of inner ear Obstruction of Eustachian tube. Ulcer of oesophagus due to ingestion of drugs and medicaments.8 D74. SALIVARY GLANDS.1 D76.490 5. Barret's disease. Sinus histiocytosis with massive lymphadenopathy.810 8.0 H73.470 8.490 5.300 8.0 K22.2 D75.300 6.100 12. Rupture of oesophagus DISEASES OF ESOPHAGUS Dyskinesia of oesophagus.470 8.280 5.400 10.400 10.300 8.120 3.8 H70.200 10.490 5. Splenitis NOS Methaemoglobinaemia.630 3.8 H74. Cyst of nasopalatine. Keratocyst DISEASES OF ESOPHAGUS DISEASES OF ESOPHAGUS DISEASES OF ESOPHAGUS DISEASES OF EXTERNAL EAR DISEASES OF EXTERNAL EAR DISEASES OF EXTERNAL EAR DISEASES OF EXTERNAL EAR DISEASES OF INNER EAR DISEASES OF INNER EAR DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF MIDDLE EAR AND MASTOID DISEASES OF ORAL CAVITY.340 7.400 10.470 8.300 6. Persistent posttraumatic perforation of ear drum.470 12. unspecified Developmental odontogenic cysts. Lateral periodontal cyst. unspecified GROUP DISEASES OF BLOOD AND BLOOD FORMING ORGANS DISEASES OF BLOOD AND BLOOD FORMING ORGANS DISEASES OF BLOOD AND BLOOD FORMING ORGANS Case Rate 12.300 2.810 5.100 12.6 K22.100 12.3 K20 K22. Gingival cyst.810 K09.280 7. Chronic ORGANS Histiocytosis X DISEASES OF BLOOD AND BLOOD FORMING Haemophagocytic syndrome.1 H73.280 7. Chronic inflammation of petrous bone Other mastoiditis and related conditions Mastoiditis. Ulcer of oesophagus NOS.120 3.300 2.120 3.400 10.8 K22. Cyst of incisive canal.400 10.1 H69.490 2.300 8.810 5.9 H71 H73. Eosinophilic DISEASES OF BLOOD AND BLOOD FORMING granuloma. Abscess of oesophagus.1 K22. Stricture of Eustachian tube Eustachian tube disorder. Abscess of mastoid. unspecified Cholesteatoma of middle ear. of globulomaxillary.810 5. Perforation of tympanic membrane.100 12.2 D76. Ulcer of oesophagus due to ingestion of DISEASES OF ESOPHAGUS chemicals.470 8. Barett's syndrome Other specified diseases of oesophagus.2 H60.300 4. Follicular cyst. unspecified Other specified disorders of middle ear and mastoid Disorder of middle ear and mastoid.300 8.9 H70.280 7. Empyema of mastoid Chronic mastoiditis. diffuse Otitis externa . Caries of mastoid.1 Developmental (nonodontogenic) cysts of oral region. Erosion of oesophagus. Haemorrhagic Otitis externa .340 4.810 5. SALIVARY GLANDS. Hypoxaemic Polycytha DISEASES OF BLOOD AND BLOOD FORMING Essential thrombocytosis ORGANS DISEASES OF BLOOD AND BLOOD FORMING Other specified diseases of blood and blood-forming organs ORGANS DISEASES OF BLOOD AND BLOOD FORMING Langerhans' cell histiocytosis.120 3. 980 1. Supparative neonatal osteomyelitis of jaw.300 2. SALIVARY GLANDS. AND JAW DISEASES OF ORAL CAVITY.620 4.300 8. Impacted gallstone of bile duct NOS unspecified or without cholangitis or cholecystitis.810 5. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Other cysts of jaw.490 5. SALIVARY GLANDS. Acute DISEASES OF ORAL CAVITY.7 K31.8 K74.860 6. Chronic osteitis of jaw. SALIVARY GLANDS.620 6. Sialectasia. AND JAW Case Rate 8. AND JAW Inflammatory conditions of jaws.810 4. neonatal osteomyelitis of jaw.2 DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9.810 5.940 2. Stenosis of duodenum.490 5.300 8.600 6.3 K31. not elsewhere classified Gastric diverticulum Obstruction of duodenum.810 K11. Impacted gallstone of cystic Calculus of bile duct without cholangitis or cholecystitis.810 K13.490 2.600 9.810 K09. AND JAW DISEASES OF ORAL CAVITY. AND JAW DISEASES OF ORAL CAVITY.490 2.490 5. Cellulitis of floor of mouth. Pyloric stenosis NOS Hourglass stricture and stenosis of stomach Pylorospasm.810 K13. SALIVARY GLANDS.800 9. AND JAW DISEASES OF ORAL CAVITY. AND JAW DISEASES OF ORAL CAVITY.940 6. Stenosis of salivary duct. Fibrous dysplasia of jaw. Stricture of salivary duct Disease of salivary gland.940 6. Mikulicz' disease. unspecified Calculus of gallbladder without cholecystitis.2 8. AND JAW DISEASES OF ORAL CAVITY.8 DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9.810 K11. Alveolar osteitis. Cholelithiasis unspecified or without cholecystitis.300 8.5 K11. Eosinophilic granuloma of oral mucosa. Unilateral condylar hypoplasia Sialoadenitis Abscess of salivary gland Fistula of salivary gland Sialolithiasis. Stafne's cyst. AND JAW DISEASES OF ORAL CAVITY. Lymphoepithelial cyst of mouth. Sialoadenopathy NOS Cellulitis and abscess of mouth.5 8.4 K11.300 6.9 K10.490 2.620 4.800 2. Alveolitis of jaws. SALIVARY GLANDS. Granuloma pyogenicum of oral mucosa.300 8.3 DISEASES OF ORAL CAVITY.2 K10.300 8.490 2.1 8. Torus palatinus Giant cell granuloma. Submandibular abscess Granuloma and granuloma-like lesions of oral mucosa.860 Page 26 of 111 . Acute osteoradionecrosis o DISEASES OF ORAL CAVITY. SALIVARY GLANDS.980 1. AND JAW DISEASES OF ORAL CAVITY. SALIVARY GLANDS. Epidermoid cyst of mouth. SALIVARY GLANDS.860 K80. SALIVARY GLANDS. Gastrocolic fistula.620 4.6 K31. SALIVARY GLANDS.600 6. Dermoid cyst of mouth.490 2.620 4. central.810 5. Traumatic cyst of jaw Other cysts of oral region. Aneurysmal cyst of jaw. Benign lymphoepithelial lesion of salivary gland.600 6.6 8. Gastroptosis.490 2. Stone of salivary gland or duct Mucocele of salivary gland.8 8.490 5. Constriction of duodenum.490 Health Care Institution Fee 5. Ranula Other diseases of salivary glands.980 1. not elsewhere classified.490 5.810 5. AND JAW DISEASES OF ORAL CAVITY.980 1.2 K11.810 5. SALIVARY GLANDS. Cherubism of jaw. Mucous retention cyst of salivary gland.5 DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9. SALIVARY GLANDS. Impacted gallstone of common duct Other cholelithiasis DISEASES OF ORAL CAVITY. Nasolabial cyst Cyst of oral region.490 5.8 8.4 8.300 2. Necrotizing sialometaplasia. AND JAW DISEASES OF ORAL CAVITY.0 K10.300 2.980 1. Giant cell granuloma NOS GROUP DISEASES OF ORAL CAVITY.4 K74. Achlorhydria.800 2. Torus mandibularis.300 8.5 K31.810 K10. Supparative osteitis of jaw.300 2. Stricture of duodenum. Cyst of jaw NOS. SALIVARY GLANDS. SALIVARY GLANDS.2 K09.810 8. Choledocholithiasis unspecified or without cholangitis or cholecystitis. Recurrent colic of gallbladder unspecified or without cholecystitis. SALIVARY GLANDS.4 K31. Epstein's pearl.940 6.490 1.490 2.3 K11. Acute osteitis of jaw. Focal oral mucinosis Adult hypertrophic pyloric stenosis.940 5.300 2.ANNEX 1.2 K31.860 K80.600 6. SALIVARY GLANDS.860 K80. SALIVARY GLANDS. Chronic duodenal ileus Fistula of stomach and duodenum. Calculus of salivary gland or duct.9 K12. Verrucous xanthoma of oral mucosa Other and unspecified lesions of oral mucosa.490 5. Dry socket AND JAW Other specified diseases of jaws. Cholecystolithiasis unspecified or without cholecystitis.600 6.810 K10.600 6. Nasoalveolar cyst.980 1.980 1.490 5.810 K11. unspecified Developmental disorders of jaws. Exostosis of jaw. Mucous extravasation cyst of salivary gland. AND JAW DISEASES OF ORAL CAVITY.620 4.7 K31.300 2.800 2. Unilateral condylar hyperplasia.600 6.300 8. unspecified. SALIVARY GLANDS. Gastrojejunocolic fistula Polyp of stomach and duodenum Other specified diseases of stomach and duodenum.300 Professional Fee 2. Latent bone cyst of jaw.810 5.300 2. AND JAW DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF STOMACH AND DUODENUM DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT 8.1 K31. AND JAW DISEASES OF ORAL CAVITY.980 2.300 2.8 8.620 4. Haemorrhagic cyst of jaw. Chronic neonatal AND JAW osteomyelitis of jaw.810 5.810 K09. AND JAW DISEASES OF ORAL CAVITY.490 5.800 2. Hourglass contraction of stomach Secondary biliary cirrhosis Biliary cirrhosis.300 2.620 4. 600 12. Suppurative cholangitis Obstruction of bile duct.170 9.780 3.860 K83.800 2.600 12.100 13. Dissecting aneurysm of aorta (ruptured) [any part] Aortic aneurysm of unspecified site without mention of rupture.930 3.1 I74.930 3.100 13. Ascending cholangitis.930 3.800 9. unspecified.170 9.1 K82.8 9.820 8. Adhesions of cystic duct or gallbladder. Hypertrophy of bile duct.6 I77. Fibrosis of DISEASES OF THE PANCREAS pancreas.0 I74.3 K82. Superior vena cava syndrome DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM DISEASES OF VASCULAR SYSTEM 12.780 3. Secondary cholangitis. Haemorrhagic pancreatitis. Stricture of bile duct without calculus Fistula of bile duct.820 Acute pancreatitis.600 12. Occlusion of bile duct without calculus.100 13.600 12.860 6.8 I85.940 2.100 13.170 9.8 Other specified diseases of pancreas.100 13.820 8.100 13. Cholecystocolic fistula. Fat necrosis of pancreas Other specified diseases of pulmonary vessels.940 Health Care Institution Fee 6.170 9.100 13.930 3. Aseptic pancreatic necrosis.0 DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9.780 3.930 3. Stricture of cystic duct or gallbladder without calculus Hydrops of gallbladder. Ulcer of bile duct Acute pancreatitis. unspecified. Strawberry gallbladder Other specified diseases of gallbladder.170 9.930 3.820 8.600 3.780 8.100 13. Other diseases of pancreas DISEASES OF THE PANCREAS Alcohol-induced chronic pancreatitis Other chronic pancreatitis. Stenosing cholangitis.930 9. Infective necrosis of pancreas.170 9.100 13. Pancreatic infantilism.9 I74.5 K83.940 2.930 3.170 9. Subacute pancreatitis. Aortitis NOS.600 3.930 3. Hyaline necrosis of aorta Embolism and thrombosis of abdominal aorta. Rupture of cystic duct or gallbladder Fistula of gallbladder. Stricture of vein.ANNEX 1. Dilatation of aorta.860 K82.3 DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS 12.820 8. Pancreatitis NOS. Stenosis of cystic duct or gallbladder without calculus. Stricture of pulmonary vessel Dissection of aorta [anypart]. Nonfunctionin Cholangitis. Recurrent chronic pancreatitis.100 3. Aneurysm of aorta.170 9.170 9.930 3.100 13. Peripheral arterial embolism Embolism and thrombosis of iliac artery Embolism and thrombosis of other arteries Embolism and thrombosis of unspecified artery Coeliac artery compression syndrome Arteritis. unspecified.4 I74.940 6.0 I87. Acute recurrent pancreatitis.100 13. Primary cholangitis.860 6. Pancreatic necrosis NOS. Hypertrophy of cystic duct or gallbladder. Choledochoduodenal fistula Spasm of sphincter of Oddi Biliary cyst Other specified diseases of biliary tract.780 8.930 3.170 9.3 I74.0 K86.4 K83.2 K85.820 8. Atrophy of bile duct.9 I77. Abscess of pancreas.820 8. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Obstruction of gallbladder.600 3.8 I74.170 9. Rupture of pulmonary vessel.2 K82.100 13. Occlusion of cystic duct of gallbladder without calculus. Calculus of pancreas. Atrophy of cystic duct or gallbladder. Relapsing chronic pancreatitis Cyst of pancreas Pseudocyst of pancreas DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS DISEASES OF THE PANCREAS K86.940 2. Leriche's syndrome Embolism and thrombosis of other and unspecified parts of aorta Embolism and thrombosis of arteries of upper extremities Embolism and thrombosis of arteries of lower extremities Embolism and thrombosis of arteries of extremities.2 I74. Endarteritis NOS Other specified disorders of arteries and arterioles Oesophageal varices with bleeding Compression of vein.9 K86.800 2.0 K85.1 K86. Gallstone pancreatitis Alcohol-induced acute pancreatitis Other acute pancreatitis GROUP Case Rate Professional Fee 2.600 12. Cholecystoduodenal fistula Cholesterolosis of gallbladder.820 8. Acute necrosis of pancreas.1 K83.4 I77.3 K83.170 9.170 9.780 3.8 9. Infectious chronic pancreatitis.0 DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT DISEASES OF THE GALLBLADDER AND BILIARY TRACT 9.820 K85.780 3. Cholangitis NOS.100 13.800 9.860 6.800 2.800 2.820 8.170 Page 27 of 111 .940 2.780 8.940 6.940 6.780 3.100 13.930 3.170 9.930 3. Aortic bifurcation syndrome.8 I71.940 2.860 6.600 12.170 9. Cyst of cystic duct or gallbladder.2 K86.1 13. Atrophy of pancreas.860 K85 DISEASES OF THE PANCREAS 12.800 K82.0 I71.600 12. Supparative pancreatitis Idiopathic acute pancreatitis Biliary acute pancreatitis.4 9. Sclerosing cholangitis. Inferior Vena cava syndrome.860 K82.860 6.800 9.1 K85.780 3. Mucocele of gallbladder Perforation of gallbladder.800 9.600 12. Stenosis of bile duct without calculus.930 3.780 3.930 3.860 6. Cirrhosis of pancreas.800 9.940 2.820 I28.940 6.800 9. Stenosis of pulmonary vessel.940 2. Chronic pancreatitis NOS.8 K85. Dyskinesia of cystic duct or gallbladder. Adhesions of bile duct.860 K83.5 I74.800 9.930 3. Recurrent cholangitis.100 13.860 6. 9 M81.930 6.8 M85. unspecified Postmenopausal bleeding Primary hyperaldosteronism.200 6. Alkaptonuria. Postsurgical malabsorption osteomalacia in adults Aluminium bone disease Other adult osteomalacia Other adult osteomalacia Ankle and foot Other adult osteomalacia Site unspecified Adult osteomalacia.430 1.600 10.370 2.6 N95.0 E26.900 9.38 E75.600 7.370 2. Disseminated retinitis.380 1.180 3.95 M81.530 5.900 10.900 7.370 2.370 2.380 2.530 5.370 2.8 H31. Autoimmune adrenalitis Addisonian crisis. Disseminated chorioretinitis. Metachromatic leukodystrophy.370 2.420 Page 28 of 111 .100 Postoophorectomy osteoporosis with pathological fracture DISORDER OF BONE DENSITY AND STRUCTURE Postsurgical malabsorption osteoporosis with pathological fracture Postmenopausal osteoporosis Postmenopausal osteoporosis Other Postoophorectomy osteoporosis Drug-induced osteoporosis Drug-induced osteoporosis Multiple site Idiopathic osteoporosis Pelvic region and thigh Idiopathic osteoporosis Other Localized osteoporosis [Lequesne] Other osteoporosis. Bielschowsky-Jansky Disease.900 7.530 5.8 M83.900 7. Abnormality of cortisol-binding globulin Classical phenylketonuria Other hyperphenylalaninaemias Disorders of tyrosine metabolism.5 E75.3 M81. Batten Disease.2 M85.370 2.900 9.2 DISORDER OF LIPID STORAGE DISORDER OF LIPID STORAGE DISORDERS ASSOCIATED WITH MENOPAUSE DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF ADRENAL GLAND DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM 8.600 2.530 5.530 5. Adrenal infarction. Choroidal haemorrhage expulsive Postmenopausal osteoporosis with pathological fracture GROUP Case Rate Professional Fee 1.900 7.3 M80.900 7.370 2.1 E27. unspecified Osteoporosis.370 2.930 6.370 2.900 7.100 8.900 7.600 10.6 M81. Krabbe Disease.670 5.370 2. Other disorders of adrenal gland Primary adrenocortical insufficiency. Tyrosinaemia.4 DISORDER OF LIPID STORAGE 8.8 E70.430 Health Care Institution Fee 3.530 5.0 M85.900 7.ANNEX 1.180 5.370 2.530 5.900 7.900 7.530 5.530 5.670 E75.370 2. Niemann-Pick Disease.8 M81.420 7.98 M83. unspecified Other Adult osteomalacia due to malabsorption.900 7.2 M83.370 2.930 6.900 7.08 M81. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Disseminated chorioretinal inflammation.1 M81.530 5.900 7.420 7.430 5.0 M81.970 2.88 M89.530 5.900 7.900 7.900 8. Adrenal haemorrhage.65 M85.900 7.530 5.900 7.970 2.900 7. Adrenocortical crisis Drug-induced adrenocortical insufficiency Other and unspecified adrenocortical insufficiency.2 E27.930 6.370 2. Wolman's disease Lipid storage disorder.530 5.100 6.670 4. unspecified Adult osteomalacia.900 7. Hyperostosis of bones.3 E27.900 9.370 2.1 E70. Adrenocortical insufficiency NOS.5 M85.380 1.370 2.930 6. Hypoaldosteronism Other specified disorders of adrenal gland. pielmeyer-Vogt Disease Other lipid storage disorders.87 M83.370 2.530 5. Adrenal crisis.530 5.89 M81.930 6. Hyperostosis of bones.0 E70.900 7.530 5. Cerebrotendinous cholesterosis [van Bogaert-Scherer-Epstein].900 7. Bartter's syndrome Hyperaldosteronism. unspecified Pelvic region and thigh Osteoporosis.370 2.370 2.000 9.970 2.900 9.88 M81.900 7. Harada's disease Choroidal haemorrhage and rupture.670 H30.370 2.55 M85.370 2. Senile osteoporosis Other osteoporosis.220 3.530 5.530 5. Addison's disease.370 2.800 2. Senile osteoporosis Site unspecified Osteoporosis.63 M85.970 2. Disseminated retinochoroiditis Other chorioretinal inflammations.6 M85.970 2.970 2.370 2. Primary aldosteronism due to adrenal hyperplasia (bilateral) Secondary hyperaldosteronism Other hyperaldosteronism.900 7.370 2.370 2.900 9.220 3. Ochronosis.530 5.1 M85. Tyrosinosis DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF BONE DENSITY AND STRUCTURE DISORDER OF LIPID STORAGE E75.4 M83. Sulfatase deficiency Neuronal ceroid lipofuscinosis.900 7.40 M81.0 M80. except skull Other specified disorders of bone density and structure. Choroidal haemorrhage NOS.930 6. unspecified.0 E26.900 7.370 2.100 2.530 5. Disseminated choroiditis.220 5.900 7.530 5. Senile osteoporosis Other Other osteoporosis.430 2. Gaucher Disease.530 5.9 M83.370 2.9 E27.970 3.900 7.370 2.900 9.1 E26.89 M83.530 5.530 5. Faber's syndrome.55 M81.530 5.900 9.530 5.1 H30.930 6.530 5.370 2.8 E26.2 DISODERS OF CHOROID AND RETINA DISODERS OF CHOROID AND RETINA DISODERS OF CHOROID AND RETINA DISORDER OF BONE DENSITY AND STRUCTURE 4.99 M85.900 7. Kufs Disease.530 5.900 7.600 4.4 M81.530 5.58 M81. Hypertyrosinaemia. Fabry(-Anderson) Disease.4 E27.530 5.530 5.600 4.530 5.900 7.970 2.370 2.900 7.530 5.900 7.530 5.180 3.370 2.900 9. Conn's syndrome.370 2.970 2.900 7. except skull Other Hypertrophy of bone Other Other sphingolipidosis.530 5.370 2.370 2.930 7.900 7.1 M80. unspecified Site unspecified Fibrous dysplasia (monostotic) Skeletal fluorosis Multiple site Hyperostosis of skull Aneurysmal bone cyst Aneurysmal bone cyst Pelvic region and thigh Other cyst of bone Other cyst of bone Forearm Other cyst of bone Pelvic region and thigh Other specified disorders of bone density and structure. OcularAlbinism.740 1.420 7.3 DISORDERS OF AMINO ACID METABOLISM E70.060 4.ANNEX 1.1 DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM 10.180 7.270 4. ß-Glucuronidase deficiency. Lowdensity-lipoprotein-type [LDL] hyperlipoproteinaemia Pure hyperglyceridaemia. group B.630 7. Cystinosis.980 4. Sarcosinaemia Congenital lactase deficiency GROUP Case Rate 10. Essential fructosuria. type IV.630 E76.060 E74. Mucopolysaccharidosis VII.060 4. unspecified Other disorders of glucosaminoglycan metabolism DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM 10.3 E76.620 E78.2 E72. Cystinuria. Hypercholesterolaemia with endogenous hype Hyperchylomicronaemia.180 3. Cross Syndrome.600 1. Hypervalinaemia.1 6.600 1.0 E71.600 1.900 1.600 10.270 7. Hurler Syndrome. Endogenous hyperglyceridaemia. Argininosuccinic aciduria. type I.740 3.420 7. Fredrickson's hyperlipoproteinaemia. Galactosaemia Other disorders of intestinal carbohydrate absorption. Lowe's syndrome Disorders of urea cycle metabolism. DISORDERS OF CARBOHYDRATE METABOLISM McArdle Disease.980 4.420 7.600 10. Familial hypercholesterolaemia. Propionic acidaemia Disorders of fatty-acid metabolism.900 10. Hartnup's disease.600 1.2 Other mucopolysaccharidoses.3 E72. HurlerScheie Syndrome.3 DISORDERS OF AMINO ACID METABOLISM 10.420 E70.270 7.420 4. Hermansky-Pudlak Syndrome Other disorders of aromatic amino-acid metabolism. von Gierke Disease.980 4.900 3. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Albinism.740 4.900 10.or floatingbetalipoproteinaemia.800 3. Isovaleric acidaemia.180 7.8 10.620 E78. Familial combined hyperlipidaemia DISORDERS OF LIPOPROTEIN METABOLISM 6.600 3. Mucopolysaccharidosis. DISORDERS OF LIPOPROTEIN METABOLISM Very-low-density-lipoprotein-type [VLDL] hyperlipoproteinaemia Mixed hyperlipidaemia.8 E71.800 5. Hyperprebetalipoproteinaemia'. Hyperhydroxyprolinaemia.620 E78. Fredrickson's DISORDERS OF LIPOPROTEIN METABOLISM hyperlipoproteinaemia type III. Scheie Syndrome Mucopolysaccharidosis. Tauri Disease.060 E74.420 E72.800 5. Disorders of tryptophan metabolism Maple-syrup-urine disease Other disorders of branched-chain amino-acid metabolism.8 E77. Cardiac glycogenosis. Morquio-like Syndrome. Severe Maroteaux-Lamy Syndrome. Citrullinaemia.600 3.600 10. type IIb. group A. DISORDERS OF LIPOPROTEIN METABOLISM Hyperbetalipoproteinaemia. Mixed hyperglyceridaemia Other hyperlipidaemia.180 1.0 E76. Argininaemia.0 DISORDERS OF AMINO ACID METABOLISM 10.420 7. Hyperlipidaemia.2 6.630 E76.180 3.1 5.180 Health Care Institution Fee 7.2 E74. Hyperlipidaemia.980 4. Fructose-1. type II.5 E73.980 4. Adrenoleukodystrophy [Addison-Schilder].900 3. Broad. Hyperleucine-isoleucinaemia. Cori Disease. Hyperammonaemia Disorders of lysine and hydroxylysine metabolism Disorders of glycine metabolism.180 3. Galactokinase DISORDERS OF CARBOHYDRATE METABOLISM deficiency.270 3.1 E74.180 7.180 3.740 1.6-diphosphatase deficiency. type Iia. Fanconi(-de Toni)(-Debré) syndrome. Non-ketotic hyperglycinaemia. Disorders of histidine metabolism. Pompe Disease.600 Professional Fee 3. Liver phosphorylase deficiency Disorders of fructose metabolism.0 Pure hypercholesterolaemia.620 Page 29 of 111 .600 1.600 3. Hunter's syndrome DISORDERS OF CARBOHYDRATE METABOLISM DISORDERS OF CARBOHYDRATE METABOLISM DISORDERS OF GLYCOPROTEIN METABOLISM DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM DISORDERS OF GLYCOSAMINOGLYCAN METABOLISM 5.420 7. Methylmalonic acidaemia.3 E74. type III. Oculocutaneous Albinism Chediak(-Steinbrinck)-Higashi Syndrome. Hers Disease. Hyperbetalipoproteinaemia with prebetalipoproteinaemia.060 4. METABOLISM Mild Maroteaux-Lamy Syndrome. Fredrickson's hyperlipoproteinaemia. Sucrase deficiency Other specified disorders of carbohydrate metabolism Other disorders of glycoprotein metabolism Mucopolysaccharidosis.800 10. Mucopolysaccharidosis IV.630 7.620 E78. Mucopolysaccharidosis.630 E78. Hyperprolinaemia type II.4 6. Hyperlipidaemia.060 7. Fredrickson's hyperlipoproteinaemia. Muscle carnitine palmityltransferase deficiency Disorders of amino-acid transport.600 10. Andersen Disease. Hereditary fructose DISORDERS OF CARBOHYDRATE METABOLISM intolerance Disorders of galactose metabolism. type I. Fredrickson's DISORDERS OF LIPOPROTEIN METABOLISM hyperlipoproteinaemia. DISORDERS OF GLYCOSAMINOGLYCAN Mucopolysaccharidosis VI.8 E76.0 DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF AMINO ACID METABOLISM DISORDERS OF CARBOHYDRATE METABOLISM 10.270 3.420 E71.3 6.600 10.800 5. Glucose-galactose malabsorption.180 3.420 E72.740 1. Forbes Disease. Hyperprolinaemia (type I) . group D.600 5.0 Glycogen storage disease.740 7. type V. Fredrickson's hyperlipoproteinaemia.800 1. 600 7.1 H44.320 5.190 2.0 H43.860 6.260 Other disorders of mineral metabolism DISORDERS OF MINERAL METABOLISM Acute inflammation of orbit.9 E21.280 7.600 7. Hereditary coproporphyria Porphyria NOS.800 9. Acid phosphatase deficiency.300 7.000 7.320 5. Acute intermittent (hepatic) Porphyria Gilbert's syndrome Crigler-Najjar syndrome Other disorders of bilirubin metabolism.400 5.600 7. Vitamin-D-resistant osteomalacia.510 8.320 5.0 E21.16 M43.850 2.02 M43.300 9.0 H05.800 7.940 2.190 2. Familial hypocalciuric hypercalcaemia.0 Hypopituitarism.280 2.600 7.Cellulitis of orbit.15 M43. Wilson's disease Disorders of iron metabolism.190 4. Panophthalmitis. Osteomyelitis of orbit.04 M43. DISORDERS OF MINERAL METABOLISM Hypomagnesaemia Disorders of calcium metabolism.03 M43.190 5.190 2.0 E80.ANNEX 1.280 7. Absolute glaucoma.860 6.400 10.8 E20.190 2.620 5. Menkes' steely hair disease.280 7. Parasitic endophthalmitis NOS.400 P60 M42.8 E83. Vitamin-D-resistant rickets Disorders of magnesium metabolism. Parathyroid tetany Primary hyperparathyroidism. Menkes' kinky hair disease.2 E80.280 2.600 22.800 9.4 E80.110 5. Rotor's syndrome Other disorders of purine and pyrimidine metabolism.5 E83.17 DISSEMINATED INTRAVASCULAR COAGULATION DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES 32. DISORDERS OF MINERAL METABOLISM Hypophosphatasia.280 2.6 DISORDERS OF LIPOPROTEIN METABOLISM 6. Isolated deficiency of pituitary hormone.110 Disorders of zinc metabolism.790 2. Tenonitis of DISORDERS OF ORBIT orbit Exophthalmic conditions.600 7.540 8.280 2.980 2.300 2.0 E20.280 2.0 H44.940 2.600 7.2 DISORDERS OF LIPOPROTEIN METABOLISM DISORDERS OF MINERAL METABOLISM DISORDERS OF MINERAL METABOLISM 6.900 6.510 6.600 7.8 H05.320 5.600 7. Hypogonadotropic hypogonadism. Acquired Fibrinolytic haemorrhage.280 2.510 6.320 5.110 5.600 7. DISORDERS OF THE PITUITARY GLAND Isolated deficiency of growth hormone. Kallmann's syndrome. Atrophy of globe.300 1.300 9.190 2. Purpura fulminans. Oedema of orbit Hereditary erythropoietic porphyria.2 E80. Fibrinolytic Purpura.400 3. Idiopathic growth hormone deficiency. Sympathetic uveitis Degenerated conditions of globe.280 2.800 9.320 5. Isolated deficiency of gonadotropin.650 6. Congenital erythropoietic porphyria.110 6.650 6.3 7.790 2.510 6.280 D65 DISSEMINATED INTRAVASCULAR COAGULATION 32.500 9. Haemorrhage of orbit.10 M43. Displacement of globe (lateral) DISORDERS OF ORBIT NOS.860 4.12 M43.120 7.940 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Lipoprotein deficiency. Phthisis bulbi Disseminated intravascular coagulation [defibrination syndrome].4 E83. Lorai Vitreous prolapse Vitreous haemorrhage Purulent endophthalmitis.280 2.2 7. Consumption coagulopathy.600 2. unspecified Syndrome of inappropriate secretion of antidiuretic hormone DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PORPHYRIN AND BILIRUBIN METABOLISM DISORDERS OF PURINE AND PYRIMIDINE METABOLISM DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PARATHYROID DISORDERS OF THE PITUITARY GLAND E23.510 6.320 5.860 6. unspecified.600 9.5 E22.790 2.540 5.320 5.1 E83. Hereditary xanthinuria Idiopathic hypoparathyroidism Other hypoparathyroidism Hypoparathyroidism.620 E78.09 M43.300 11.120 3. Acrodermatitis enteropathica DISORDERS OF MINERAL METABOLISM Disorders of phosphorus metabolism.600 1.000 9.280 2. Hypoalphalipoproteinaemia.5 10.320 5.790 3. Disseminated intravascular coagulation of fetus and newborn. High-density lipoprotein deficiency.800 3. Abscess of orbit.300 9.110 5.100 2.940 2.320 Page 30 of 111 . Erythropoietic protoporphyria Other porphyria.280 2.790 2.400 10.790 2.120 3.850 2.1 M43.07 M43.940 2.510 6.120 3.800 2. Idiopathic hypercalciuria DISORDERS OF MINERAL METABOLISM E83. Vitreous abscess Other endophthalmitis. Diffuse or disseminated intravascular coagulation [DIC] .260 H43. Osteitis fibrosa cystica generalisata [von Recklinghausen's disease of bone] Other specified disorders of parathyroid gland Disorder of parathyroid gland.300 9.800 9.300 7. Haemochromatosis GROUP Case Rate Professional Fee Health Care Institution Fee E78. Fertile eunuch syndrome.4 E21. Abetalipoproteinaemia.280 2. Periostitis of orbit.000 9.110 5.280 7.600 7.320 5.300 9. Familial Hypobetalipoproteinaemia.0 E83. Dubin-Johnson syndrome. Lecithin cholesterol acyltransferase deficiency.110 E83.300 7.1 H44.400 10. Familial hypophosphataemia. Acquired Afibrinogenaemia.300 9.6 E79. Defibrination syndrome of fetus or newborn Adult osteochondrosis of spine Spondylolysis cervical region Spondylolysis cervicothoracic region Spondylolysis thoracic region Spondylolysis lumbar region Spondylolysis lumbosacral region Spondylolysis site unspecified Spondylolisthesis Multiple sites in spine Spondylolisthesis cervical region Spondylolisthesis thoracolumbar region Spondylolisthesis lumbar region Spondylolisthesis lumbosacral region DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE DISORDERS OF VITREOUS BODY AND GLOBE 11.300 7.500 9. Hyperplasia of parathyroid.320 5.280 22. Tangier disease Other disorders of lipoprotein metabolism Disorders of copper metabolism. Hypermagnesaemia.400 10.600 7.980 4.8 E20.06 M43.600 7.860 6.120 3.5 E80. 320 5. Posterior cervical sympathetic syndrome Cervicobrachial syndrome Cervicobrachial syndrome cervical region Cervicobrachial syndrome site unspecified Spinal instabilities Spinal instabilities cervical region Spinal instabilities thoracic region Spinal instabilities lumbar region Spinal instabilities lumbosacral region Spinal instabilities sacral and sacrococcygeal region Spinal instabilities site unspecified Coccygodynia Coccygodynia sacral and sacrococcygeal region Other specified dorsopathies Other specified dorsopathies lumbar region Other specified dorsopathies lumbosacral region Other specified dorsopathies site unspecified Dorsopathy.280 2. Struck by lightning NOS Effects of electric current.19 M43.280 2.320 5.130 2. Curvature of spine NOS thoracolumbar region Deforming dorsopathy.280 2.320 5.320 5.620 1.320 5.68 M43.800 7.2 M53.800 5.86 M53.7 T75. Cornual pregnancy.600 7.320 5.320 5.280 2.320 5.320 5. unspecified. Intraligamentous pregnancy.280 2.0 O00.600 7.2 O00.340 2.1 O00.320 5.800 7. unspecified thoracolumbar region Dorsalgia Drowning and nonfatal submersion.600 7.280 2. Swimmer's cramp Abdominal pregnancy Tubal pregnancy.600 7.86 M43.320 5.280 2.97 M43. Shock from electric current DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DROWNING ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ECTOPIC PREGNANCY ELECTRICAL SHOCK ELECTRICAL SHOCK Page 31 of 111 .600 7.280 2.280 2.600 7.320 5.600 7. unspecified Dorsopathy. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M43.320 5.42 M43. unspecified.600 7.87 M43.600 7.320 5. unspecified.600 7.600 7.600 7.280 2.280 2.320 5.600 7.18 M43.280 2.96 M43. Fallopian pregnancy.0 M53.600 7.280 2.280 2.600 7.280 2.85 M43.60 M43.320 5.280 2. Ankylosis of spinal joint cervical region Other fusion of spine.280 2.3 M53.800 7. Immersion.66 M43.320 5.8 M53.600 7.600 7.600 7.600 7.87 M53.400 5.340 2.340 1.280 2.280 2. Ankylosis of spinal joint lumbosacral region Other fusion of spine.320 5.280 2.600 7.24 M53.280 2.320 5.780 3.320 5.280 2.600 7.29 M43. unspecified cervical region Dorsopathy. Ankylosis of spinal joint site unspecified Other recurrent atlantoaxial subluxation cervical region Other recurrent atlantoaxial subluxation site unspecified Torticollis Multiple sites in spine Torticollis cervical region Torticollis thoracic region Torticollis lumbar region Torticollis sacral and sacrococcygeal region Torticollis site unspecified Other specified deforming dorsopathies Other specified deforming dorsopathies cervical region Other specified deforming dorsopathies thoracolumbar region Other specified deforming dorsopathies lumbar region DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES DORSOPATHIES GROUP Case Rate 7.280 2.280 2.600 7.320 4.280 2.22 M53.89 M43.600 7.460 5. Curvature of spine NOS lumbar region Deforming dorsopathy. Rupture of fallopian tube due to pregnancy Ovarian pregnancy Other ectopic pregnancy.320 5.320 5.620 Health Care Institution Fee 5.320 5.800 7.600 7.280 2.95 M43.280 2.8 M43.95 M54 T75.320 5.600 7.100 7.280 2.320 5. unspecified.320 5.280 2.600 7.600 7.320 5.280 2.600 7. Ankylosis of spinal joint lumbar region Other fusion of spine.600 7.340 2.280 2. Curvature of spine NOS site unspecified Cervicocranial syndrome.64 M43.600 7.62 M43.320 5.600 7.4 DESCRIPTION Spondylolisthesis sacral and sacrococcygeal region Spondylolisthesis site unspecified Other fusion of spine. unspecified. Mural pregnancy Ectopic pregnancy.320 5.320 5.49 M43.280 2.600 7.280 2.600 7.460 5.320 5.280 2.69 M43.8 O00.600 7.460 5.600 7.1 O00.280 2.340 2.600 7.320 5.280 2.29 M53.400 Professional Fee 2.600 7.1 M53.280 2.280 2.600 7.92 M53.460 3.38 M53.88 M43.26 M43.9 M53.600 7.600 7.320 5.600 7.280 2. Curvature of spine NOS Deforming dorsopathy.340 2.780 Other specified deforming dorsopathies lumbosacral region DORSOPATHIES Other specified deforming dorsopathies sacral and sacrococcygeal region Other specified deforming dorsopathies site unspecified Deforming dorsopathy.22 M43.600 7.280 2.600 7.460 5.28 M53.600 7. Curvature of spine NOS thoracic region Deforming dorsopathy.320 5.94 M43.280 2.280 2.280 2.320 5.320 5. unspecified Maternal care for viable fetus in abdominal pregnancy Effects of lightning.99 M53.600 7.280 2.89 M53.320 5.0 T75.ANNEX 1.320 5.280 2.600 7.19 M53. Curvature of spine NOS lumbosacral region Deforming dorsopathy.970 5. Cervical pregnancy.27 M43.320 5.82 M43.320 5.320 5.320 5.320 5.9 O36.460 5.12 M53.27 M53.280 2.600 7.9 M43.800 7.26 M53.600 7.280 2.320 5.320 5. Electrocution.280 2.320 5. unspecified. Shock from lightning.320 5. 390 5.460 G40. Salaam attacks. Localizationrelated partial idiopathic epilepsy and epileptic syndromes with seizures of localized onset.390 5.8 G23.0 G24.1 I67.340 2.980 15.800 2.810 5.810 5.0 G92 G93.340 5.800 8.5 Other generalized epilepsy and epileptic syndromes. Epileptic seizures related to alcohol.490 2.2 EPILEPSY 7.490 2.4 N80. Attacks without alteration of consciousness . Epilepsy with grand mal seizures on awakening.340 5. Epilepsies and epileptic syndromes undetermined as to whether they are focal or generalized Epilepsy.980 7. Symptomatic early myoclonic.390 5.980 J98.460 G40. unspecified Carcinomatous neuromyopathy in Drug-induced dystonia Idiopathic familial dystonia.700 7.390 5. Localization-related partial symptomatic epilepsy and epileptic syndromes with simple partial seizures. Emphysematous bleb Interstitial emphysema.800 7.8 G40.460 5.700 7.4 N80. Juvenile absence epilepsy.460 G40.300 8.ANNEX 1.8 G21.390 5. Encephalopathy.490 2. Unilateral transparency of lung Panlobular emphysema.340 5.420 Health Care Institution Fee 7.310 2.420 3.810 5.300 8. Bullous lung emphysema.200 22.0 EPILEPSY 7. Epileptic seizures NOS Malignant neuroleptic syndrome Other drug-induced secondary parkinsonism Other secondary parkinsonism Secondary parkinsonism.340 2.6 G40.300 8. Benign myoclonic epilepsy in infancy.400 11.300 8.2 J98. Attacks with alteration of consciousness.400 11.9 EMPHYSEMA 11.340 5.700 7.0 G23.490 2. Localization-related partial symptomatic epilepsy and epileptic syndromes with complex partial seizures.300 2.9 G23.540 15. unspecified Hallervorden-Spatz disease. Epileptic fits NOS.810 5.400 22.7 G40.810 5.300 8. Epilepsia partialis continua [Kozhevnikof].200 22.490 2.540 15.660 6.810 5. Vesicular lung emphysema. Orofacial dyskinesia Other dystonia EPILEPSY EPILEPSY EPILEPSY EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS 7. Epilepsy with myoclonic absences.310 2.300 8. not elsewhere classified Hypertensive encephalopathy Endometriosis of uterus.800 2.200 22.700 9.390 5.0 N80. Epilepsy with myoclonicEPILEPSY astatic seizures. West's syndrome Special epileptic syndromes.300 8. Juveni EMPHYSEMA EMPHYSEMA EMPHYSEMA EMPHYSEMA GROUP Case Rate 11.340 2.460 G40.340 5.9 J05.800 2. Epileptic seizures related to drugs.340 5.1 G21.300 8.1 J43.460 7.340 2.400 11.420 3.910 7.700 7. Infantile spasms.700 7.310 2.310 2.980 7.4 G40.490 2.800 7. Panacinar emphysema Centrilobular emphysema Other emphysema Emphysema.9 G21.490 5.1 G24. unspecified (with or without petit mal) EPILEPSY Petit mal.420 3. Sim Localization-related focal symptomatic epilepsy and epileptic syndromes with complex partial seizures.800 7.980 7.300 8.300 8. Epileptic convulsions NOS. Calcification of basal ganglia Degenerative disease of basal ganglia.3 EPILEPSY 7. Childhood absence epilepsy [pyknolepsy].700 3.460 5. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE J43.400 Professional Fee 3. Mediastinal emphysema Compensatory emphysema Human immunodeficiency virus [HIV] disease resulting in encephalopathy.3 B22.390 5.540 5.310 2.660 2.4 G24.2 N80. Bullous pulmonary emphysema.700 7.310 2. Epiglottitis NOS Localization-related focal idiopathic epilepsy and epileptic syndromes with seizures of localized onset.810 Page 32 of 111 . Epileptic seizures related EPILEPSY to hormonal changes.1 EMPHYSEMA EMPHYSEMA ENCEPHALOPATHY ENCEPHALOPATHY ENCEPHALOPATHY ENCEPHALOPATHY ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS ENDOMETRIOSIS EPIGLOTTITIS 11.460 G40.200 7.300 8.420 3.1 EPILEPSY 7. Adenomyosis Endometriosis of ovary Endometriosis of fallopian tube Endometriosis of pelvic peritoneum Endometriosis of rectovaginal septum and vagina Endometriosis of intestine Other endometriosis Endometriosis. Lung emphysema NOS.3 G24.8 7. unspecified Acute epiglottitis. without grand mal seizures Other epilepsy.2 J43. unspecified.0 J43. Epileptic seizures related to sleep deprivation.460 5.1 N80. unspecified.490 2.9 G24.400 3.660 6. Epileptic Grand mal seizures.810 5.540 15.420 7.310 2.490 2. Benign childhood epilepsy with centrotempor Localization-related focal symptomatic epilepsy and epileptic syndromes with simple partial seizures. Human immunodeficiency virus [HIV] dementia Toxic encephalopathy Anoxic brain damage.660 6.310 2.300 8.390 6. Lennox-Gastaut syndrome.8 N80.5 N80.810 5. Unilateral emphysema. Vesucular pulmonary emphysema. ofte Generalized idiopathic epilepsy and epileptic syndromes.400 11.420 6. Idiopathic dystonia NOS Spasmodic torticollis Idiopathic orofacial dystonia.460 5.700 7.800 2.810 5.490 2.8 DESCRIPTION MacLeod's syndrome.810 5.790 G40. Pigmentary pallidal degeneration Progressive supranuclear ophthalmoplegia [SteeleRichardson-Olszewski] Other specified degenerative diseases of basal ganglia.980 7. Benign familial neonatal convulsions.490 2.980 J43.810 5.3 N80.810 5.490 2.0 G21.800 2.490 2.1 G23. unspecified. Pulmonary emphysema NOS.800 2. 700 6.0 K21.500 1.9 R56.610 2.190 8.700 11.500 1.700 13.ANNEX 1.950 5.41 S22.1 P92. Metabolic Alkalosis.090 6.100 2.700 11.510 3.090 9. primary capsular with pseudoexfoliation of lens glaucoma.610 2.490 2.5 G25.4 S22.3 S22.700 8. Neonatal diarrhoea NOS Other specified perinatal digestive system disorders.700 8.9 R50. Residual stage chronic simple glaucoma.100 11.190 8.700 8.960 3. Other metabolic disorders Fracture of thoracic vertebra.090 6.950 6.610 2.0 P76.9 P76.550 2.700 11.510 3.550 H40.700 8.700 11.100 6. part unspecified (closed) Gangrene and necrosis of lung Pyoderma gangrenosum.090 6.090 6.10 S22.610 2. Meconium peritonitis Neonatal haematemesis and melaena due to swallowed maternal blood Noninfective neonatal diarrhoea. Primary chronic simple glaucoma.810 5.510 3.090 6. Acidosis NOS.090 6.1 E87.8 P92. Phagedenic pyoderma Gangrene.190 8.0 R56.550 2. Reflux oesophagitis Gastro-oesophageal reflux disease without oesophagitis.950 4.200 13.2 GLAUCOMA 6.700 11.090 4. Potassium [K] overload Hypokalaemia.550 2.700 8.500 1.550 H40. Potassium [K] excess.810 5.4 E87. Residual Primary angle-closure glaucoma.4 P92. Respiratory Acidosis Alkalosis.610 2.00 S22. unspecified Febrile convulsions Other and unspecified convulsions.190 8.510 3.190 8.9 P77 P78.700 11. unspecified Necrotizing enterocolitis of fetus and newborn Perinatal intestinal perforation.490 2.20 S22.190 8.90 J85. Alkalosis NOS.490 2.550 2.9 G25. Dyskinesia NOS Myoclonus. Restless legs syndrome.8 P76.610 2.270 4. Primary chronic angle-closure glaucoma .3 E87. unspecified.300 7.550 H40.950 5.510 3. Fracture of thoracic spine NOS (closed) Multiple fractures of thoracic spine (closed) Fracture of sternum Fracture of sternum (closed) Fracture of rib Fracture of rib (closed) Fracture of rib (open) Multiple fractures of ribs Multiple fractures of ribs (closed) Multiple fractures of ribs (open) Fracture of other parts of bony thorax (closed) Fracture of bony thorax.0 P78. Acute residual stage angle-closure glaucoma .9 E87. unspecified Fever.700 11.550 2.3 GLAUCOMA 6.700 8.610 2.950 5. unspecified.300 8.610 2.950 4.1 P76.950 5.950 5. Metabolic Acidosis.550 2.2 P78.80 S22.090 6.3 G25.490 2. Ocular hypertension Primary open-angle glaucoma. Lactic Acidosis. Residual stage capsular with pseudoexfoliation of lens. Primary acute angleclosure glaucoma .090 6.190 8.40 S22.000 7.610 2.550 2. Seizure (convulsive) NOS Regurgitation and rumination in newborn Slow feeding of newborn Overfeeding of newborn Other feeding problems of newborn Feeding problem of newborn. Pyrexia NOS Hypo-osmolality and hyponatraemia Acidosis.490 2.100 2. Electrolyte imbalance NOS.500 Professional Fee 2.0 L88 R02 K21. Oesophageal reflux NOS Meconium plug syndrome Transitory ileus of newborn Other specified intestinal obstruction of newborn Intestinal obstruction of newborn.2 S22.31 S22. Hyperchloraemia.500 2.950 5. Residual stage chronic angle-closure glaucoma.190 8.960 3.3 P78.090 6.100 2. Chorea NOS Other specified extrapyramidal and movement disorders.950 4.000 8.300 8.1 GLAUCOMA 6.960 1.200 13.700 8. Dermatitis gangrenosa.240 4.300 8.6 E87.510 3. Potassium [K] deficiency Fluid overload Other disorders of electrolyte and fluid balance.500 8.550 Page 33 of 111 .090 6.900 5.270 8.700 8.610 2. Primary intermittent angle-cloure glaucoma.510 1.700 8.240 9.510 3.610 2. not elsewhere classified Gastro-oesophageal reflux disease with oesophagitis.090 6. Primary low-tension glaucoma.610 2.090 6.500 8.200 6.0 FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX FRACTURES OF THE BONES OF THE THORAX GANGRENE GANGRENE GANGRENE GASTROESOPHAGEAL REFLUX DISEASE GASTROESOPHAGEAL REFLUX DISEASE GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GASTROINTESTINAL DISORDERS OF THE NEWBORN GLAUCOMA 8.090 6.700 8. Congenital cirrhosis of liver.9 H40. Stiff-man syndrome Extrapyramidal and movement disorder.610 2.2 E87.700 8.30 S22.8 P78.810 4.5 E87.190 8.830 1.700 11.8 P92.090 6. Hypochloraemia.700 8.700 8. Respiratory Alkalosis Mixed disorder of acid-base balance Hyperkalaemia. Peptic ulcer of newborn Perinatal digestive system disorder.830 3.190 4. Drug-induced myoclonus Other chorea.550 Health Care Institution Fee 5.610 3.700 7.8 DESCRIPTION Dystonia.610 2.700 8.950 S22.810 5.900 6. not elsewhere classified.810 5. unspecified Glaucoma suspect.2 P92.300 8.610 2.500 8.700 11.700 8.8 G25.500 8.610 2.950 5. Hyperpyrexia NOS. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE G24.240 9.000 8.900 4.7 E87.500 8.510 3.510 3. Fit NOS.500 8.500 8.090 6. Residu Glaucoma secondary to eye trauma GROUP EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS EXTRAPYRAMIDAL AND MOVEMENT DISORDERS FEBRILE SEIZURES FEBRILE SEIZURES FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEEDING PROBLEMS NEWBORN FEVER OF UNKNOWN ORIGIN FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES FLUID AND ELECTROLYTE DISTURBANCES Case Rate 8. 000 3. Acute renal disease NOS with Diffuse crescentic glomerulonephritis (Extracpillary glomerulonephritis) GLAUCOMA GLAUCOMA GLAUCOMA GLAUCOMA GROUP Case Rate 6. other Rapidly progressive nephritic syndrome. types 1 and 3.000 3. Acute glomerulonephritis.000 N01. Acute nephritis.000 7. Diffuse mesangial proliferative glomerulonephritis Rapidly progressive nephritic syndrome. Haematuria with morphological lesion specified with Minor glomerular abnormality Recurrent and persistent haematuria including Benign familial Haematuria. unspecified Acute nephritic syndrome including Acute glomerular disease. Acute glomerulonephritis. GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis.000 N01.000 7. rapidly progressive glomerular disease.000 N01.ANNEX 1.000 7. Acute GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES renal disease NOS with Other (Proliferative glomerulonephritis NOS) Acute nephritic syndrome including Acute glomerular disease.9 10.000 7.000 Professional Fee 1.000 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES N00.000 3. rapidly progressive glomerulonephritis.5 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.2 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.500 6.000 7.550 4. Acute glomerulonephritis.000 7.9 N00. Acute nephritis.000 Page 34 of 111 .0 10.950 1. Acute renal disease NOS with Diffuse membranous glomerulonephritis Acute nephritic syndrome including Acute glomerular disease. GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis.1 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Acute glomerulonephritis.000 N02. Acute nephritis.000 3.000 3.2 10.000 10.000 3.000 7. Acute nephritis.000 N01. rapidly progressive glomerulonephritis. Haematuria with morphological lesion specified with Diffuse membranous glomerulonephritis 10.8 N00. Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood. Acute glomerulonephritis. Acute nephritis. Acute glomerulonephritis.3 10.000 N02. GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis. Acute glomerulonephritis.000 N00.7 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Acute nephritis. Focal and segmental glomerular lesions Rapidly progressive nephritic syndrome. Acute nephritis.000 3.000 3.4 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 Health Care Institution Fee 4. Acute nephritis. Acute glomerulonephritis.0 DESCRIPTION Glaucoma secondary to eye inflammation Glaucoma secondary to other eye disorders Other glaucoma Glaucoma.950 1.000 3. Unspecified Recurrent and persistent haematuria including Benign familial Haematuria.000 7.000 7.000 N00.000 3.000 3. rapidly progressive glomerulonephritis.000 3. GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis.000 3. Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood.8 H40.500 10.500 6. rapidly progressive glomerulonephritis.550 4. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE H40. Acute renal disease NOS with Diffuse mesangial proliferative glomerulonephritis Acute nephritic syndrome including Acute glomerular disease. rapidly progressive glomerular disease. rapidly progressive glomerular disease. Acute renal disease NOS with Diffuse endocapillary proliferative glomerulonephritis Acute nephritic syndrome including Acute glomerular disease.950 1.000 N01.0 10. Acute renal disease NOS with Diffuse mesangiocapillary glomerulonephritis (Membranoproliferative glomerulonephritis. rapidly progressive glomerulonephritis. Acute renal disease NOS.000 7.550 4.000 7.000 7.4 H40. Acute nephritis.5 H40. focal and segmental sclerosis) & Focal glom Acute nephritic syndrome including Acute glomerular disease. Diffuse mesangiocapillary glomerulonephritis Rapidly progressive nephritic syndrome.000 7. or NOS) Acute nephritic syndrome including Acute glomerular disease.500 6. with Minor glomerular abnormality Acute nephritic syndrome including Acute glomerular disease. Minor glomerular abnormality Rapidly progressive nephritic syndrome.8 10.000 3. Acute GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES renal disease NOS.5 10.550 7.000 7.1 10.000 3.9 Acute nephritic syndrome including Acute glomerular disease. Unspecified renal biopsy Rapidly progressive nephritic syndrome. with Focal and segmental glomerular lesions (with focal and segmental hyalinosis. rapidly progressive glomerulonephritis.000 7.000 7.000 N00. GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis. Acute renal disease NOS. rapidly progressive glomerular disease. rapidly progressive glomerular disease.000 3. GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES rapidly progressive nephritis.3 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 N02.000 7. rapidly progressive glomerular disease.000 N01.000 N00.000 N00.000 3.000 N00. Haematuria with morphological lesion specified with Focal and segmental glomerular lesions Recurrent and persistent haematuria including Benign familial Haematuria. Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood.950 3. Acute glomerulonephritis.1 10. 000 7.000 7. with Diffuse mesangial proliferative glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease. with Minor glomerular abnormality Chronic nephritic syndrome including Chronic glomerular disease. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee N02.0 N04.000 3.000 N03. Chronic nephritis. chronic renal disease NOS.8 10.000 3.000 10.000 3. Minimal change lesion Nephrotic syndrome: Focal and segmental glomerular lesions.000 10. Chronic nephritis.2 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 7. Chronic nephritis.000 N05.000 3.000 N03.3 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.9 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 N03. Chronic glomerulonephritis. Focal and segmental sclerosis.3 N04.000 7.000 7. with Unspecified renal biopsy Nephrotic syndrome: Minor glomerular abnormality.000 3. Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood.000 3.4 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Chronic glomerulonephritis. Haematuria with morphological lesion specified with Diffuse mesangiocapillary glomerulonephritis Recurrent and persistent haematuria including Benign familial Haematuria.000 7. chronic renal disease NOS. Haematuria with morphological lesion specified with Unspecified renal biopsy Chronic nephritic syndrome including Chronic glomerular disease. Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood. Chronic glomerulonephritis.000 7.000 3.000 10.000 3.000 N03.0 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Chronic nephritis.000 N02. Chronic nephritis. Glomerulonephritis. Chronic glomerulonephritis.000 N03. Chronic nephritis.000 7.0 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Chronic nephritis. chronic renal disease NOS.1 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.5 Recurrent and persistent haematuria including Benign familial Haematuria.7 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 N04. chronic renal disease NOS.000 7.000 3.7 N04.000 N05.000 7.000 N03. chronic renal disease NOS.000 10. Membranoproliferative glomerulonephritis.000 7.000 7.000 7.000 7. Chronic nephritis. Nephritis NOS with Minor glomerular abnormality. withDiffuse membranous glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease.2 N04.000 3. chronic renal disease NOS.000 Page 35 of 111 . or NOS Nephrotic syndrome: Diffuse crescentic glomerulonephritis. with Other (Proliferative glomerulonephritis NOS) Chronic nephritic syndrome including Chronic glomerular disease.8 N04.000 3.000 7.000 3.000 10.000 3.000 7. Chronic glomerulonephritis.000 10. Chronic glomerulonephritis. with Diffuse crescentic glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease. chronic renal disease NOS. Chronic nephritis.000 7.8 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 3.000 3.5 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 3.000 3. with Focal and segmental glomerular lesions Chronic nephritic syndrome including Chronic glomerular disease. Haematuria with morphological lesion specified with other (Proliferative glomerulonephritis NOS) Recurrent and persistent haematuria including Benign familial Haematuria. types 1 and 3.000 3.000 N02. focal and segmental sclerosis) & Focal glomerulonephritis 10.000 N03.000 3.1 N04. Focal and segmental hyalinosis.000 7.000 3. Chronic glomerulonephritis.1 Unspecified nephritic syndrome including Glomerular disease. chronic renal disease NOS.000 3. Chronic glomerulonephritis. Extracapillary glomerulonephritis Nephrotic syndrome: Other Nephrotic syndrome:Unspecified Unspecified nephritic syndrome including Glomerular disease.000 7.000 N04. Nephritis NOS with Focal and GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES segmental glomerular lesions (with focal and segmental hyalinosis.000 N03.ANNEX 1.5 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.4 N04. Benign familial Haematuria of GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES childhood. with Diffuse endocapillary proliferative glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease.000 3.000 7. chronic renal disease NOS.000 N03. Chronic glomerulonephritis.000 10. with Diffuse mesangiocapillary glomerulonephritis Chronic nephritic syndrome including Chronic glomerular disease. Focal glomerulonephritis Nephrotic syndrome: Diffuse membranous glomerulonephritis Nephrotic syndrome: Diffuse mesangial proliferative glomerulonephritis Nephrotic syndrome: Diffuse endocapillary proliferative glomerulonephritis Nephrotic syndrome: Diffuse mesangiocapillary glomerulonephritis.000 7.000 7.000 3.9 10. Glomerulonephritis.000 7. minimal change lesion 10.9 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. 000 10.000 2.000 7. medicament or GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES biological substance Toxic nephropathy.000 7.000 3.000 3. Old bucket-handle tear multiple sites GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES HAND.7 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.3 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 Health Care Institution Fee 7. not elsewhere classified with Diffuse mesangiocapillary glomerulonephritis. Infection of kidney NOS Persistent proteinuria.000 7.000 10.000 3. unspecified Derangement of meniscus due to old tear or injury.0 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 Professional Fee 3.000 7.000 10. types 1 and 3.000 10.000 7.000 3. not elsewhere classified with Unspecified renal biopsy Acute tubulo-interstitial nephritis. Chronic interstitial nephritis NOS.000 N07.8 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Glomerulonephritis.000 3. Acute infectious interstitial nephritis. not elsewhere classified with Minor glomerular abnormality Hereditary nephropathy.8 N06. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Unspecified nephritic syndrome including Glomerular disease. Pyelitis NOS. not specified as acute or chronic.000 7. or NOS Unspecified nephritic syndrome including Glomerular disease.000 3.000 3.9 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. not elsewhere classified with Diffuse membranous glomerulonephritis Hereditary nephropathy.000 7. Nephritis NOS with Diffuse endocapillary proliferative glomerulonephritis Unspecified nephritic syndrome including Glomerular disease.000 N05.000 10.200 3.000 N07.000 3.000 7. pyelonephritis. Nephritis NOS with Unspecified renal biopsy Isolated proteinuria with specified morphological lesion with morphological lesion specified with Minor glomerular abnormality Isolated proteinuria with specified morphological lesion with Other (Proliferative glomerulonephritis NOS) Isolated proteinuria with specified morphological lesion with Unspecified renal biopsy Hereditary nephropathy. types 1 and 3. Membranoproliferative glomerulonephritis.0 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Nephritis NOS with Diffuse membranous glomerulonephritis Unspecified nephritic syndrome including Glomerular disease. Glomerulonephritis. Nephritis NOS with Diffuse mesangiocapillary glomerulonephritis. Nephritis NOS with Other (Proliferative glomerulonephritis NOS) Unspecified nephritic syndrome including Glomerular disease. not elsewhere classified Balkan nephropathy.9 N39.6 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 3.000 N12 N14. Glomerulonephritis.2 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES N05.000 N11.5 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 N05. FEET AND JOINT DEFORMITIES Page 36 of 111 . Glomerulonephritis.000 3. Acute pyelitis. not elsewhere classified with Diffuse mesangial proliferative glomerulonephritis Hereditary nephropathy. unspecified.000 3.000 N05.000 7.000 7.000 7. Pyelonephritis NOS Analgesic nephropathy GROUP Case Rate 10. Balkan endemic nephropathy Other specified renal tubulo-interstitial diseases Renal tubulo-interstitial disease.000 3.000 N06.000 3.000 9.000 3.000 N05.000 7.000 10. Glomerulonephritis. Glomerulonephritis.000 3.000 7.440 Nephropathy induced by other drugs. unspecified.000 N06.000 7.000 7.2 N14.000 7.0 N14. medicaments and GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES biological substances Nephropathy induced by unspecified drug. Nephritis NOS with Diffuse mesangial proliferative glomerulonephritis Unspecified nephritic syndrome including Glomerular disease.000 7.000 10.000 7.000 10. Glomerulonephritis.000 N05.2 N07. type 2 Unspecified nephritic syndrome including Glomerular disease.000 3.000 3. Nephritis NOS with Dense deposit disease Membranoproliferative glomerulonephritis. Chronic pyelonephritis NOS Tubulo-interstitial nephritis.9 N07.000 3.0 N15. Extracapillary glomerulonephritis Unspecified nephritic syndrome including Glomerular disease.000 N05.2 M23.20 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 3.000 3.000 7. unspecified Orthostatic proteinuria.000 7.000 3.9 N10 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 3. Interstitial nephritis NOS.8 N15. focal and segmental sclerosis) & Focal glomerulonephritis Hereditary nephropathy.000 7.9 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 N07.000 10.000 10.000 N05.000 7. Membranoproliferative glomerulonephritis. Chronic pyelitis NOS.000 7. Acute pyelonephritis Chronic tubulo-interstitial nephritis.4 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. or NOS Hereditary nephropathy.3 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10. Glomerulonephritis. not elsewhere classified with Focal and segmental glomerular lesions (with focal and segmental hyalinosis.ANNEX 1.000 7.000 7.000 10.000 7.1 N14.000 3.000 6.000 3. Nephritis NOS with Diffuse crescentic glomerulonephritis.000 3.000 7.1 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.000 10.000 N07.5 GLOMERULAR AND INTERSTITIAL KIDNEY DISEASES 10.4 N15.1 N39.760 7.000 10.000 3.000 3. 5 HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEADACHE SYNDROMES HEART CONDUCTION DISORDERSS HEART CONDUCTION DISORDERSS HEART CONDUCTION DISORDERSS HEART CONDUCTION DISORDERSS 5. basilar.650 1.3 G43.440 6.440 6. Old bucket-handle tear Anterior cruciate ligament or Anterior HAND. Complete heart block NOS.65 M24. Atrioventricular conduction.50 M24.440 6. FEET AND JOINT DEFORMITIES HEADACHE SYNDROMES G43. Heart block HEART CONDUCTION DISORDERSS NOS. FEET AND JOINT DEFORMITIES HAND.760 6. FEET AND JOINT DEFORMITIES HAND.500 5. Congestive heart disease.690 3. Chronic paroxysmal hemicrania.46 M23. FEET AND JOINT DEFORMITIES HAND.6 M24.1 G44.200 9.0 9.440 6.650 3.610 8.440 3. Right venticular failure (secondary to left heart failure) Advanced congestive heart failure.0 G44.650 1. Stokes-Adams syndrome Rheumatic heart disease.00 HEART CONDUCTION DISORDERSS 12.760 2. unspecified. FEET AND JOINT DEFORMITIES HAND.200 9.2 M24.760 2. Tension headache NOS Chronic post-traumatic headache Drug-induced headache.760 2.500 2. Grave congestive heart failure.440 6.3 G44.690 3.710 8.440 6.200 9.850 3.690 4.200 9.200 Professional Fee 2.9 I09.650 1.650 1. FEET AND JOINT DEFORMITIES knee. not elsewhere classified.08 M24.500 5.200 2.850 3. FEET AND JOINT DEFORMITIES HAND.200 9.440 6.80 M23. Sinoatrial NOS. FEET AND JOINT DEFORMITIES HAND.200 9. Atrioventicular conduction. complete.850 3.440 6.41 M24.500 5.760 2. FEET AND JOINT DEFORMITIES Other internal derangements of knee. Migraine with prolonged aura.7 M24.5 M23. FEET AND JOINT DEFORMITIES HAND.300 15.710 4.850 3. Migraine with acute-onset aura.1 HEADACHE SYNDROMES 5.0 I50.760 2.500 5. Old bucket-handle tear Posterior cruciate ligament or Posterior HAND.440 M23.610 I45.990 10.760 2.650 1.440 6.2 G44.440 6.990 HEART CONDUCTION DISORDERS.9 M23.8 G43. Chronic tension-type headache.66 M24. Instability secondary to old ligament injury.25 M23. accesory. Lown-Ganong-Levine syndrome.700 3.760 2.500 5.500 1.440 6.91 M24.690 3.9 G44. Migraine equivalents.2 I44.200 5. Facial pain NOS Atrioventricular block.200 9.8 R51 I44.760 2.69 M24.300 12. Sinoauricular block Pre-excitation syndrome. FEET AND JOINT DEFORMITIES HAND.300 12. Migraine.4 I45.300 12. FEET AND JOINT DEFORMITIES HAND. FEET AND JOINT DEFORMITIES HAND.760 1.760 2.690 8.440 6.850 3. FEET AND JOINT DEFORMITIES HAND. Migraine with typical aura Status migrainosus Complicated migraine Other migraine.710 4.760 2.850 3.4 G44. FEET AND JOINT DEFORMITIES HAND. accelerated.850 3.440 M23.650 3.300 12.650 1.200 9.850 3.610 10.440 6.500 5. Ophthalmoplegic migraine.440 6. Severe congestive heart failure HEART FAILURE HEART FAILURE Page 37 of 111 . FEET AND JOINT DEFORMITIES 9. Atrioventicular [AV] dissociation.610 8.440 6.300 3. Ligamentous laxity NOS Recurrent dislocation and subluxation of joint Recurrent dislocation and subluxation of joint shoulder region Contracture of joint multiple sites Contracture of joint hand Contracture of joint lower leg Ankylosis of joint Ankylosis of joint pelvic region and thigh Ankylosis of joint lower leg Ankylosis of joint site unspecified Protrusio acetabuli Other specific joint derangements.3 I44. unspecified Cluster headache syndrome. HEART FAILURE Rheumatic heart failure Congestive heart failure. FEET AND JOINT DEFORMITIES Internal derangement of knee. Familial hemiplegic Migraine.200 9.88 G43. FEET AND JOINT DEFORMITIES HAND.ANNEX 1.200 9. FEET AND JOINT DEFORMITIES horn of medial meniscus Derangement of meniscus due to old tear or injury.440 6.200 9.850 3.850 Chronic instability of knee HAND.440 6. FEET AND JOINT DEFORMITIES HAND.2 G43.200 9.610 I45. Chronic cluster headache.760 2.200 9. Interference dissociation HAND.1 M24.500 5.760 2.440 6.300 1.610 8. FEET AND JOINT DEFORMITIES horn of medial meniscus Derangement of meniscus due to old tear or injury. Old bucket-handle tear Posterior horn of lateral meniscus Loose body in kneeOther and unspecified lateral meniscus HAND. unspecified.6 HEART CONDUCTION DISORDERSS 12. Rheumatic carditis.850 G43. Migraine aura without headache.56 M24.850 8. not elsewhere classified.760 Health Care Institution Fee 6.650 1.760 2.200 9.8 I45.54 M24.440 6.690 3.700 15.760 2.760 2.4 M24.690 3.200 9.760 2. unspecified Anterior cruciate ligament or Anterior horn of medial meniscus Loose body in joint other sites Other articular cartilage disorders Disorder of ligament.200 9.9 I50. Vascular headache NOS Tension-type headache. Episodic Cluster headache Vascular headache. Episodic tension headache.990 10.760 2. Wolff-Parkinson-White syndrome Other specified HEART CONDUCTION DISORDERSs.200 9. Anomalous atrioventicular excitation. Retinal migraine Migraine.500 5. Snapping knee multiple sites Internal derangement of knee HAND.650 1.760 2.22 Derangement of meniscus due to old tear or injury.610 8.650 1.21 M23.500 5.700 15. Irritable hip other sites Migraine without aura [common migraine] Migraine with aura [classical migraine].760 2. Laxity of ligament of HAND. FEET AND JOINT DEFORMITIES HAND.850 3.500 5. Third-degree block Other and unspecified atrioventricular block. Atrioventricular block NOS Left anterior fascicular block Other specified heart blockl. not elsewhere classified Other specified headache syndromes Headache.650 6. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate 9. Atrioventicular conduction pre-excitation.200 9.650 1.500 12.200 9. 950 1.520 2.340 2.520 2.880 5.800 7.550 4.800 7.100 4. trapped or adherent placenta. unspecified Haemarthrosis multiple sites Haemarthrosis shoulder region Haemarthrosis pelvic region and thigh Haemarthrosis lower leg Haemarthrosis ankle and foot Haemarthrosis other sites Haemarthrosis site unspecified Other instability of joint other sites Effusion of joint multiple sites Effusion of joint shoulder region Effusion of joint lower leg Effusion of joint ankle and foot Haemolytic-uraemic syndrome Delayed or excessive haemorrhage following abortion and ectopic and molar pregnancy. Haemorrhage associated with retained.400 8.800 2.520 2. Acute pulmonary oedema with mention of heart disease NOS or heart failure.400 8.520 1. Intravascular coagulation Third-stage haemorrhage.520 2.47 D59.000 2.4 T67.500 6.100 5. except rheumatic.340 2. Placenta accreta without haemorrhage Retained portions of placenta and membranes without haemorrhage.900 4.000 2. Cardiac.38 M25.1 I37.880 5.950 1.8 I37.800 7.100 4.0 I34.0 O73. Regurgitation HEART VALVE DISORDERS mitral valve NOS or of specified cause. except rheumatic Mitral (valve) prolapse. Retained placenta NOS Other immediate postpartum haemorrhage.880 5.550 4.550 4.880 5. Fibrinolysis postpartum Retained placenta without haemorrhage.880 5.550 4.520 2.01 M25.550 4.1 15.340 2.1 I35. without haemorrhage Fetal blood loss from vasa praevia Fetal blood loss from ruptured cord HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEAT EXHAUSTION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMARTHROSIS/JOINT EFFUSION HEMOLYTIC UREMIC SYNDROME HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGE IN PREGNANCY AND POST PARTUM PERIOD HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN O72.520 2.400 8.1 P50.100 2.800 7.520 2.800 7.340 2. Acute oedema of lung with mention of heart disease NOS or heart failure. unspecified Pulmonary valve stenosis Pulmonary valve insufficiency.880 5.340 2. Aortic valve HEART VALVE DISORDERS regurgitation NOS or of specified cause.460 5.800 7.460 5.340 2.400 8.0 I36.140 4. Haemorrhage associated with retained portions of placenta or membranes. unspecified Nonrheumatic tricuspid (valve) stenosis Nonrheumatic tricuspid (valve) insufficiency.400 8.2 T67.1 7.400 8.800 7.520 2.400 8.800 7.520 2.9 15.550 4. except rheumatic Other nonrheumatic tricuspid valve disorders Nonrheumatic tricuspid valve disorder.0 7.2 I35.3 O08.40 M25.400 8.200 7.880 4.900 O72.880 5.400 8.800 7.460 5. unspecified Aortic (valve) stenosis HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS HEART VALVE DISORDERS GROUP Case Rate Professional Fee Health Care Institution Fee I50.950 2.460 5.880 5. Tricuspid valve regurgitation of specified cause.100 4. Afibrinogenaemia.950 1.000 7.340 2.500 6.460 5. Retained products of conception following delivery.000 2.00 M25. Afibrinogenaemia postpartum. Heat collapse Heat cramp Heat exhaustion.3 O73.500 6.05 M25.8 I34.2 I34. Incompetence Aortic valve NOS or of specified cause.400 6. heart or myocardial HEART FAILURE failure NOS Mitral (valve) insufficiency.900 Aortic (valve) insufficiency. HEART FAILURE Cardiac asthma with mention of heart disease NOS or heart failure.990 I50.460 Page 38 of 111 .100 2.8 I35.1 8.1 I34. Siriasis.900 5.5 T67. Heat prostation due to salt (and water) depletion Heat exhaustion.710 10.520 2.800 20.100 2. except rheumatic Aortic (valve) stenosis with insufficiency Other aortic HEART VALVE DISORDERS Aortic valve disorder.06 M25.460 5.9 I35. following delivery Postpartum coagulation defects.500 6.0 I37.9 M25.550 5.400 8.340 6.700 4.0 P50.460 5. unspecified.340 2.000 2.520 2.520 2. except rheumatic.9 I36.9 T67.520 2.880 5.460 5.340 2.700 4.000 7.800 7.000 7.400 8.46 M25.ANNEX 1.520 2.08 M25.460 5.500 7.41 M25. except rheumatic Other pulmonary HEART VALVE DISORDERS Pulmonary valve disorder. Thermoplegia Heat syncope.1 7.060 2.460 5.1 I36.340 2.900 O72.340 2.880 5.400 8. Pulmonary valve regurgitation NOS or of specified cause.09 M25.2 7.900 O72. Incompetence mitral valve NOS or of specified cause.950 1.500 6.800 7.880 5. Left heart fai Heart failure. Heat apoplexy. Heat prostration due to water depletion Heat exhaustion due to salt depletion.8 I36.710 10. Defibrination syndrome.500 6.880 5.460 14.3 T67.400 8.880 5.07 M25.400 8.460 5.880 5.460 5. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Left ventricular failure.340 4. Haemorrhage following delivery of placenta.880 5. except rheumatic. Incompetence tricuspid valve of specified cause.520 2.1 T67.9 I37. Heat pyrexia.400 8.900 4. unspecified Heat stroke and sunstroke. Floppy mitral valve syndrome Nonrheumatic mitral (valve) stenosis Other nonrheumatic mitral HEART VALVE DISORDERS Nonrheumatic mitral valve disorder.520 2. unspecified.0 I35. Postpartum atomic haemorrhage NOS Delayed and secondary postpartum haemorrhage.880 5.880 5. Heat prostration NOS Effect of heat and light.990 I34.950 1.950 1. anhydrotic.0 T67. Incompetence pulmonary valve NOS or specified cause.800 7.400 8.400 8.520 2. except rheumatic. Retained products of concepcion NOS.340 2. AC globulin Deficiency.9 P51. Henoch(Schönlein) Purpura. unspecified Haemorrhagic disease of fetus and newborn. Haemorrhagic Purpura. Haemophilia B Von Willebrand's disease.460 5.340 2.800 12.800 7.800 7.340 2.800 7.840 3.960 D68. Factor IX Deficiency (with functional defect).800 7. Increase in anti-VIIIa.460 5.ANNEX 1.340 2. Deficiency of factor V [labile].8 P55.800 12.2 P50.800 2.800 3. Haemophilia NOS.4 D68. Ecchymoses in fetus or newborn.460 5.840 8. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE P50. Deficiency of coagulation factor due to vitamin K deficiency Other specified coagulation defects.1 P61.460 P61.840 3. neonatal thrombocytopenia due to exchange transfusion.6 P54. Plasma thromboplastin HEMORRHAGIC CONDITIONS component [PTC] Deficiency.800 2.460 5.800 7.340 2. Idiopathic Purpura.1 P55. unspecified GROUP HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN HEMORRHAGIC AND HEMATOLOGIC DISEASES OF THE NEWBORN Case Rate 7.5 P61.460 5. Deficiency of factor II [prothrombin].800 2.8 P54.340 2.800 7.800 3.340 2.340 2.1 12.840 8.960 D68. Hyperheparinaemia.460 5.9 P55. Increase in anti-Ixa.2 P54.340 2.800 7. Classical Haemophilia Hereditary factor IX deficiency. Vitamin K deficiency of newborn Neonatal haematemesis Neonatal rectal haemorrhage Other neonatal gastrointestinal haemorrhage Neonatal adrenal haemorrhage Neonatal cutaneous haemorrhage.9 P53 P54.460 5.340 2. Pseudomenses Other specified neonatal haemorrhages Neonatal haemorrhage. Petechiae in fetus or newborn.960 Page 39 of 111 .3 HEMORRHAGIC CONDITIONS 12.800 7.460 5. Anaphylactoid Purpura.800 7. Factor VIII deficiency with vascular defect.840 3.9 D69.2 HEMORRHAGIC CONDITIONS 12.840 8.800 3. Increase in antithrombin.800 7.800 7. Vascular haemophilia Hereditary factor XI deficiency. Bruising in fetus or newborn.800 7.960 Hereditary factor VIII deficiency.460 5. Proaccelerin Deficiency. unspecified Rh isoimmunization of fetus and newborn ABO isoimmunization of fetus and newborn Other haemolytic diseases of fetus and newborn Haemolytic disease of fetus and newborn.460 8.800 7.800 12. Deficiency of coagulation factor due to liver disease.0 D68.800 12.960 8.960 8.840 5.9 7. Increase in anti-XIa Acquired coagulation factor deficiency.8 P61.960 D68.800 7. Neonatal thrombocytopenia due to isoimmunization Polycythaemia neonatorum Transient neonatal neutropenia Other transient neonatal disorders of coagulation Other specified perinatal haematological disorders Perinatal haematological disorder. Deficiency of factor I [fibrinogen].460 5.0 P55.800 Professional Fee 2. Haemophilia A.8 D68.840 3.340 5.460 5.0 HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS 12.840 8.340 5. Fetal haemorrhage NOS Umbilical haemorrhage of newborn.800 7. Congenital afibrinogenaemia. Angiohaemophilia.4 DESCRIPTION Fetal blood loss from placenta Fetal blood loss.840 8.460 5.0 7. Presence of systemic lupus erythematosus [SLE] inhibitor Coagulation defect.800 3.460 5.460 5.6 P61.460 5.800 12.460 5.340 5.800 7. Superficial haematomata in fetus or newborn Neonatal vaginal haemorrhage.800 7.340 2. unspecified Transient neonatal thrombocytopenia. Deficiency factor VIII (with HEMORRHAGIC CONDITIONS functional defect).340 2. AllergicVasculitis HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS D67 12.340 2. unspecified.340 2.460 5.9 D66 7. Neonatal thrombocytopenia due to idiophatic maternal thrombocytopenia.800 3. Vascular Purpura.460 P54.960 8.5 7.340 2.340 2. unspecified Allergic purpura. Christmas disease.960 8. Deficiency of fac Haemorrhagic disorder due to circulating anticoagulants. Nonthrombocytopenic Purpura.460 P54.3 P54.340 2. Increase in anti-Xa. Haemophilia C Plasma thromoplastin antecedent [PTA] deficiency Hereditary deficiency of other clotting factors.800 2.0 P54.340 2. Haemorrhage during long term use of anticoagulants.960 D68.340 Health Care Institution Fee 5.460 P61.340 3. 980 5.0 E05.430 2.300 6.2 G91. Grey platelet syndrome.950 5.100 8.430 2.300 6.100 8.180 6.300 17.500 8.8 Qualitative platelet defects.000 9. Hereditary Capillary fragility.800 12.600 17.0 I15.9 Q03.1 E05. Purpura NOS.510 6.700 2.100 8.0 I11.0 O01. Senile HEMORRHAGIC CONDITIONS Purpura. HEMORRHAGIC CONDITIONS Haemorrhagic Thromboasthenia.900 2.430 14.300 17.8 E05. Iodine-deficiency-related nodular goitre Iodine-deficiency-related (endemic) goitre.800 3.550 2. Hypertensive heart disease NOS Hypertensive renal disease with renal failure.620 12.700 2.000 9.9 20. Other nonthrombocytopenic purpura.670 5.700 2.110 9.700 2. unspecified Other congenital hydrocephalus Congenital hydrocephalus. Complete hydatidiform mole Incomplete and partial hydatidiform mole Hydatidiform mole.2 I13.000 9.670 5.430 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee 3.8 E02 E03.9 P56.430 2.400 9.550 2.670 5.8 Q03.9 O01.960 8.220 2.110 12. HEPATIC FAILURE HEPATIC FAILURE HEPATIC FAILURE HYDATIDIFORM MOLE HYDATIDIFORM MOLE HYDATIDIFORM MOLE HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROCEPHALUS HYDROPS FETALIS HYDROPS FETALIS HYDROPS FETALIS HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTENSIVE EMERGENCY/URGENCY HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPERTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM HYPOTHYROIDISM 20.0 G91.300 6.300 9.0 I12.300 6.900 3. unspecified Renovascular hypertension Hypertension secondary to other renal disorders Hypertension secondary to endocrine disorders Other secondary hypertension Secondary hypertension.190 5. Alcoholic hepatic failure with or without hepatic coma Acute and subacute hepatic failure Chronic hepatic failure Hepatic failure Classical hydatidiform mole. Thrombocytopathy .2 E03.190 5.700 2.000 9.9 I11.000 9.4 E05. Toxic diffuse goitre Thyrotoxicosis with toxic single thyroid nodule.0 I13.550 2.400 7.100 5.190 5.190 3.430 2.500 8. Hypertensive heart failure Hypertensive heart disease without (congestive) heart failure. Overproduction of thyroid-stimulating hormone Thyrotoxicosis.980 1.950 5.500 8.960 8.500 8.000 9. Evans' syndrome Other specified haemorrhagic conditions.420 4.300 5.980 1.500 8.840 3.550 2.1 E01.430 2. Hypertensive renal failure Hypertensive renal disease without renal failure. unspecified Other iodine-deficiency-related thyroid disorders and allied conditions Subclinical iodine-deficiency hypothyroidism Hypothyroidism due to medicaments and other exogenous substances Myxoedema coma Other specified hypothyroidism Hypothyroidism.840 8.950 5.3 E05.2 E05.500 8.000 8.420 14.840 Health Care Institution Fee 8.300 6.000 9.100 6.180 6.110 12.300 17. Vascular pseudohaemophilia HEMORRHAGIC CONDITIONS HEMORRHAGIC CONDITIONS 12.1 I10.110 12. unspecified Other hydrocephalus Hydrocephalus.600 6. Trophoblastic disease NOS.700 2.500 8.550 2.2 I10.950 5.110 12.300 6.430 2.2 D69.790 2.9 I12.180 14. Hereditary Thromboasthenia. unspecified.620 4.300 6.600 6.100 9.700 2.300 17.300 6.4 Alcoholic hepatic failure.300 6.1 I13. Simplex Purpura Idiopathic thrombocytopenic purpura.550 2.000 9. Vesicular mole NOS Communicating hydrocephalus Obstructive hydrocephalus Normal-pressure hydrocephalus Post-traumatic hydrocephalus.700 2.600 20.600 6.840 3.300 6.700 2. Toxic nodular goitre NOS Thyrotoxicosis from ectopic thyroid tissue Thyrotoxicosis factitia Thyroid crisis or storm Other thyrotoxicosis.1 K72. Hypertensive renal disease NOS Hypertensive heart and renal disease with (congestive) heart failure Hypertensive heart and renal disease with renal failure Hypertensive heart and renal disease with both (congestive) heart failure and renal failure Hypertensive heart and renal disease.000 9. Chronic alcoholic hepatic HEPATIC FAILURE failure.670 Page 40 of 111 .0 E01.430 2. Bernard-Soulier [giant platelet] syndrome.700 2.1 I15.800 12.950 5.500 8. unspecified.9 P83.100 8.180 5.110 12.300 6.670 5.0 K72.190 5.180 6.220 2.2 E01.0 P56.3 D69.190 5.8 E03. Acute alcoholic hepatic failure. Alcoholic hepatic failure NOS.300 17.3 G91.1 O01.620 4.000 9.700 2.600 6.300 13. Subacute alcoholic hepatic failure.800 12.670 5. Exophthalmic or toxic goitre NOS. malignant hypertension Hypertensive heart disease with (congestive) heart failure.000 9.100 8. unspecified.8 I15.550 2.5 E03.9 I15.670 5.000 9.700 2. Hyperthyroidism NOS.5 E05.1 G91.9 E05.180 1.950 5. unspecified Hydrops fetalis due to isoimmunization Hydrops fetalis due to other and unspecified haemolytic disease Hydrops fetalis not due to haemolytic disease.8 G91.600 20.420 K72.000 7.2 I15.960 K70.700 2.100 8.ANNEX 1. stage II Essential Hypertension.100 8.9 G91.300 6. Graves' disease.9 I13.100 8.950 5.960 D69. Thyrotoxicosis with toxic uninodular goitre Thyrotoxicosis with toxic multinodular goitre.000 13.670 5. Glanzmann's disease.700 2.550 2.300 6.1 D69.700 2. unspecified Thyrotoxicosis with diffuse goitre.000 9.9 E01. Thyroiditis Iodine-deficiency-related diffuse (endemic) goitre Iodine-deficiency-related multinodular (endemic) goitre. Hydrops fetalis NOS Hypertension.670 5.420 14.300 6.000 9.950 5. 480 3. unspecified Common variable immunodeficiency with predominant abnormalities of B-cell numbers and function Common variable immunodeficiency with predominant immunoregulatory T-cell disorders Common variable immunodeficiency.480 3.600 11. unspecified Other specified immunodeficiencies Immunodeficiency. unspecified Severe combined immunodeficiency [SCID] with low T.000 9.120 8.120 D89.600 11.600 11.600 D82.480 3.000 9.700 2.120 8.120 8.700 2.120 8.300 Page 41 of 111 . Mixed Cryoglobulinaemia.700 2.1 11.480 3.0 N49.000 2.480 3.0 D83.600 11.120 D80.000 2.300 N48.480 3.700 8.3 D82. Polyclonal gammopathy NOS IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY 11.9 D82. X-linked agammaglobulinaemia [Bruton] (with growth hormone deficiency) Selective deficiency of immunoglobulin A [IgA] Transient hypogammaglobulinaemia of infancy Other immunodeficiencies with predominantly antibody defects.0 N48.120 8.120 8.480 3. Secondary Cryoglobulinaemia.1 D86.700 2.000 9.700 6.600 11.480 8.300 6.480 3.120 8. Autosomal recessive agammaglobulinaemia (Swiss type). not elsewhere classified Disorder involving the immune mechanism.5 N48.120 8.480 3.300 6.120 8.480 3. Carbuncle of unspecified male genital organ.480 3.480 3.8 D86. Abscess of corpus cavernosum and penis.600 11.480 3.120 8.120 8.600 3.600 11. Abscess of unspecified male genital organ.480 3.000 3.600 11. Vasitis Inflammatory disorders of scrotum Inflammatory disorders of other specified male genital organs.9 D86. Cavernitis (penis) of corpus cavernosum and penis Ulcer of penis Induratio penis plastica.0 D80. Cryoglobulinaemic purpura.000 2.600 11.6 D81.600 11.0 Immunodeficiency following hereditary defective response IMMUNODEFICIENCY to Epstein-Barr virus.600 11.8 D89.600 11.9 D89.8 D84.120 6.300 6.2 D80.120 8. Vesiculitis NOS Inflammatory disorders of spermatic cord.480 3.8 9. unspecified Polyclonal hypergammaglobulinaemia.000 9.8 D80.700 2. Carbuncle of corpus cavernosum and penis.120 8.9 INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT 9.2 D89. Inflammation of multiple sites in male genital organs Inflammatory disorder of unspecified male genital organ. Cryoglobulinaemic vasculitis Hypergammaglobulinaemia.ANNEX 1. unspecified.120 8.7 D80.600 11.120 8. Peyronie's disease.600 11.9 D84.600 11. Immune disease NOS Leukoplakia of penis.4 D82.6 N49. unspecified.9 D81.1 D81. Thymic alymphoplasia.000 9.480 3.1 Cryoglobulinaemia. Plastic induration of penis Inflammatory disorders of seminal vesicle.120 8.600 9.480 3. unspecified Sarcoidosis of lymph nodes Sarcoidosis of other and combined sites. unspecified Other specified disorders involving the immune mechanism.600 11.300 6. tunica vaginalis and vas deferens. X-linked lymphoproliferative disease Hyperimmunoglobulin E [IgE] syndrome Immunodeficiency associated with major defect. Kappa light chain deficiency Immunodeficiency with predominantly antibody defects.480 3.480 3. Pharyngeal pouch syndrome.300 6.480 3.0 D82.480 8.and B-cell numbers Major histocompatibility complex class I deficiency.1 D83.120 D89. Boil of corpus cavernosum and INFLAMMATION/INFECTION OF THE MALE penis. Kraurosis of penis Balanoposthitis. Essential Cryoglobulinaemia.600 3.2 N49.300 N48.600 11.1 IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY 11.600 11.120 8.480 3. Cellulitis GENITAL TRACT of corpus cavernosum and penis.600 11.2 Other inflammatory disorders of penis.120 8. Benign hypergammaglobulinaemic purpura. Balanitis IMMUNODEFICIENCY IMMUNODEFICIENCY IMMUNODEFICIENCY INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT 11.9 N48.600 11.700 6. Balanitis xerotica obliterans.300 N49.120 8. Severe combined immunodeficiency disorder [SCID] NOS Wiskott-Aldrich syndrome. Idiopathic Cryoglobulinaemia.480 3. Boil of unspecified male genital organ.700 2. Thymic aplasia or hypoplasia with immunodeficiency GROUP Case Rate Professional Fee 3.120 8.480 Health Care Institution Fee 8.1 N49. Uveoparotid fever [Heerfordt] Sarcoidosis.000 9.480 2.600 11. Cellulitis of unspecified male genital organ INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT INFLAMMATION/INFECTION OF THE MALE GENITAL TRACT 9.700 6. Immunodeficiency with thrombocytopenia and eczema Di George's syndrome.300 6. Primary IMMUNODEFICIENCY Cryoglobulinaemia.9 D83. Bare lymphocyte syndrome Combined immunodeficiency.600 11.120 8. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Hereditary hypogammaglobulinaemia.120 8. Granulomatous enteritis NOS Ulcerative (chronic) enterocolitis Ulcerative (chronic) ileocolitis Ulcerative (chronic) proctitis Ulcerative (chronic) rectosigmoiditis Mucosal proctocolitis Other ulcerative colitis Ulcerative colitis.0 K51.120 10.600 2. Crohn's disease [regional enteritis] of duodenum.400 4.370 K50.480 6.980 4. unspecified.400 14.9 G04.400 14.080 10.600 21.100 9. Regional colitis.620 4.320 10. Concretio cordis.1 INFLUENZA 6. Chronic Endocarditis NOS. myelitis and encephalomyelitis in other diseases classified elsewhere INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA IN DISEASES CLASSIFIED ELSEWHERE Intracranial and intraspinal phlebitis and thrombophlebitis.320 1. INFLUENZA Influenzal (broncho) pneumonia.480 4. Ventriculitis (cerebral) NOS Encephalitis. acute or subacute.9 K51.1 21.120 15.600 21. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee K50.1 K51. Valvular incompetence of unspecified valve NOS or of specified cause. Influenzal laryngitis.370 6.600 21.8 K50.400 14. Pericardial calcification 9. acute or subacute.400 14.5 K51. Crohn's disease [regional enteritis] of colon.0 INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLUENZA 14.0 Crohn's disease of small intestine.080 10.600 14. Myoendocarditis.080 I38 INFLAMMATORY DISEASES OF THE HEART 14.9 G05. Influenzal pha J10. Staphylococcal pericarditis.8 I40.730 2. Postimmunization [Encephalitis.400 14.100 2. Crohn's disease [regional enteritis] of rectum Other Crohn's disease.370 6.400 14. except rheumatic or con Infective myocarditis.620 Page 42 of 111 .100 9. influenza virus identified. valve unspecified. Subacute infective endocarditis INFLAMMATORY DISEASES OF THE HEART NOS. Streptococcal pericarditis. not elsewhere classified Other encephalitis.370 6.080 10. Subacute bacterial endocarditis. Accretio cordis.400 6.400 4.3 K51. Crohn's disease [regional enteritis] INFLAMMATORY BOWEL DISEASE of ileum. Acute bacterial endocarditis. acute or subacute Endocarditis.080 4.080 10.2 K51. Septic [embolism.100 21.600 1.8 I30.370 6. influenza virus identified.620 Influenza with pneumonia.100 9. Viral pericarditis. Acute infective endocarditis NOS. Regional enteritis NOS.730 2.080 10.320 4.600 21.120 15.100 9.600 4. unspecified Influenza A H5N1 (Avian influenza) INFLAMMATORY DISEASES OF THE HEART 14. except rheumatic or congenital. Subacute lenta endocarditis.100 9.730 2.ANNEX 1.600 6.320 4. thrombophlebitis. unspecified Chronic adhesive pericarditis.0 I40.370 6. unspecified. myelitis and encephalomyelitis.730 2.8 G04. influenza virus identified.0 G04.0 Acute and subacute infective endocarditis. Endocarditis. Pneumococcal pericarditis. thrombosis] of intracranial or intraspinal venous sinuses and veins Acute nonspecific idiopathic pericarditis Infective pericarditis.120 15. Valvular insufficiency of unspecified valve NOS or of specified cause. phlebitis. influenza virus identified. Granulomatous colitis. Crohn's disease [regional enteritis] of jejunum.730 2.080 I40.1 G04.400 6.100 9. Adhesive mediastinopericarditis Chronic constrictive pericarditis. influenza virus indentified Influenza with other respiratory manifestations. Regional ileitis.320 10.2 G04.080 10.320 4. unspecified.8 K51.0 I31.400 4.320 15.730 6.370 6.9 14.320 4. Terminal ileitis Crohn's disease of large intestine. Ulcerative enteritis NOS Acute disseminated encephalitis.320 4.730 2. myelitis and encephalomyelitis.0 I30. endophlebitis.370 6.080 10.980 10.980 1. Crohn's disease [regional enteritis] of large bowel.080 I33.080 10.480 6. Periendocarditis. Pyopericarditis Other forms of acute pericarditis Acute pericarditis.100 2.370 15.600 21.1 I30.100 9.080 I33.320 4.320 4. influenza virus identified.730 2.100 9.480 6.1 INFLAMMATORY BOWEL DISEASE 9. Crohn's disease NOS.120 15.120 15. Purulent pericarditis.400 14. Acute lenta endocarditis.370 K50.400 14.8* G07* INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY BOWEL DISEASE INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART INFLAMMATORY DISEASES OF THE HEART 9.1 I40.9 I31. Postinfectious encephalitis and encephalomyelitis NOS Encephalitis.480 6. Influenza.9 J09 J10. Postimmunization Encephalomyelitis Tropical spastic paraplegia Bacterial meningoencephalitis and meningomyelitis.120 G08 I30.370 6.320 4. Acute malignant endocar Acute endocarditis.320 10. Adherent pericardium. Septic myocarditis Isolated myocarditis Other acute myocarditis Acute myocarditis. Crohn's disease of both small and large intestine Crohn's disease [regional enteritis].120 15.480 6. Acute upper respiratory influenzal infection.480 6.600 21.730 6. unspecified.480 6.730 6.730 2. 510 6.300 9. Anoxia due to high altitude. virus not identified Unspecified effects of radiation Heat fatigue. Encephalopathy due to influenza.520 2.790 2. Barotrauma NOS.300 1.510 6.300 9.0 9.790 2.980 2. Influenzal Acute upper respiratory infection.160 2. virus not identified. lower back and pelvis Dislocation of shoulder joint. Influenza NOS.510 6.510 6.620 J11.7 S46.980 4.300 9.510 6.200 7.790 2.510 6.620 6.9 T70.6 T67.0 S43.0 S43.200 7.3 T70.4 S43.510 T75.040 Sprain and strain of other and unspecified parts of shoulder INJURIES TO THE MUSCLES AND TENDONS AND girdle.200 7.200 7.790 2.620 J11.1 INFLUENZA 6.520 5.8 S46. Alpine sickness.040 5.510 6.040 5. influenza virus identified. sprain and strain of Acromioclavicular ligament GROUP Case Rate Professional Fee Health Care Institution Fee J10.200 7.4 S56.0 T70.300 9.790 2. transient Other effects of heat and light Hypothermia Immersion hand and foot.160 2.2 S46. influenza virus identified Influenza with pneumonia. Influenzal (broncho) pneumonia.160 2.160 2.790 2. Mountain sickness Caisson disease [decompression sickness].600 1. unspecified or specific virus not identified.160 2. Influenzal laryngitis.510 6. unspecified Otitic barotrauma.0 T69.300 9.ANNEX 1.790 2.510 12.620 J11.160 2.040 5.200 2.300 9. Compressed-air disease.040 5. unspecified or specific virus not identified.510 6.600 1. Influen Influenza with other manifestations. Aero-otitis media.040 5. Sprain and strain of shoulder girdle NOS JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of tendon of the rotator cuff of shoulder JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of muscle and tendon of long head of biceps JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of muscle and tendon of other parts of biceps JOINTS Injury of multiple muscles and tendons at shoulder and INJURIES TO THE MUSCLES AND TENDONS AND upper arm level JOINTS Injury of other muscles and tendons at shoulder and upper INJURIES TO THE MUSCLES AND TENDONS AND arm level JOINTS Injury of unspecified muscle and tendon at shoulder and INJURIES TO THE MUSCLES AND TENDONS AND upper arm level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of elbow JOINTS Injury of flexor muscle and tendon of thumb at forearm INJURIES TO THE MUSCLES AND TENDONS AND level JOINTS Page 43 of 111 . LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Influenza with other manifestations.400 7.790 2.4 T70. Acute influenzal myocarditis. influenza virus identified. virus not identified. Traumatic jet injection (industrial) Other effects of air pressure and water pressure.040 5.040 5.880 12.9 S53.200 7.300 9.200 7.0 S16 S39.8 T70.5 S43.300 9.200 7.1* T66 T67.300 9. Acute influenzal myocarditis.600 9.7 S46.200 7.790 2.160 2.200 7.8 INFLUENZA 6.9 T75.600 1. Effects of change in ambient atmospheric pressure on sinuses Other and unspecified effects of high altitude. Dislocation of Glenohumeral joint Sprain and strain of shoulder joint.400 18.510 6.980 4.510 6.040 5. Influenzal gastroentiritis. unspecified or specific virus not identified. unspecified Effects of vibration.2 INFLUENZA INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS CAUSES INJURIES TO NEURAL STRUCTURES AND NERVES INJURIES TO NEURAL STRUCTURES AND NERVES INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS 6. Diver's palsy or paralysis Effects of high-pressure fluids.790 5.880 5.8 INFLUENZA 6.0 S46.040 5.160 2.040 5. Sprain and strain of Rotator cuff capsule Sprain and strain of acromioclavicular joint. Effects of weightlessness Concussion and oedema of cervical spinal cord Concussion and oedema of lumbar spinal cord Injury of muscle and tendon at neck level Injury of muscle and tendon of abdomen.790 2.8 T68 T69. Influenzal gastroenteritis.980 4.200 7.160 2.620 J11.0 S34.160 2.160 6. Trench foot Effect of reduced temperature.200 7. unspecified or specific virus not identified. Hypobaropathy. sprain and strain of Coracohumeral (ligament).300 9. Blast injury syndrome Effect of air pressure and water pressure.300 9.200 7.510 6.160 2.1 S46. influenza virus identified. Encephalopathy due to influenza.300 18.160 2. Effects of abnormal gravitation [G] forces.2 T70.040 5.040 5.0 INFLUENZA 6. unspecified o Acute influenzal myocarditis.8 S14.160 2. Traumatic vasospastic syndrome.980 4.790 4.790 2. Vartigo from infrasound Other specified INJURIES DUE TO ENVIRONMENTAL AND OTHER EXTERNAL FACTORS causes.790 2.600 1. Pneumatic hammer syndrome.300 9.8+ I41.040 5. unspecified or specific virus not identified Influenza with other respiratory manifestations. virus not identified. Sprain and strain of JOINTS Radiocarpal ligament Sprain and strain of finger(s).040 5.000 2.200 9.040 5. JOINTS Talofibular (ligament). Tropical pulmonary eosinophilia NOS Alveolar and parietoalveolar conditions.160 2.5 S93. Tarsometatarsal (ligament) Injury of muscle and tendon of long flexor muscle of toe at ankle and foot level Injury of unspecified muscle and tendon at ankle and foot level Multiple dislocations.160 2.1 S76. Sprain and strain involving tibial collateral ligament of JOINTS knee Sprain and strain involving anterior cruciate ligament of INJURIES TO THE MUSCLES AND TENDONS AND knee.000 14.040 5.800 9. Deltoid (ligament).160 2.200 7.160 5. Lung dropsy Pulmonary eosinophilia.9 S73.160 2.160 2.160 2.200 7.6 S66.6 S63.040 5.200 7.040 5. Internal collateral (ligament).1 S76.040 5.200 4.000 4.040 5.5 S83.3 S76. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE S56.000 14. metatarsophalangeal (joint(s) Sprain and strain of other and unspecified parts of foot including Tarsal (ligament).4 S83. Diffuse pulmonary fibrosis. Cryptogenic fibrosing alveolitis.200 7. Sprain and strain involving posterior cruciate JOINTS ligament of knee INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of other and unspecified parts of knee JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of other muscles and tendons at lower leg level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of unspecified muscle and tendon at lower leg level JOINTS Sprain and strain of ankle including Calcaneofibular INJURIES TO THE MUSCLES AND TENDONS AND (ligament).200 7.200 7.160 2.040 7.6 S96.3 S63. Acute intestinal infarction.160 2. Eosinophilic asthma.200 7.850 6.160 2. Pulmonary alveolar microlithiasis Other interstitial pulmonary diseases with fibrosis.160 2.800 J84.3 S66.800 9.9 Injury of long flexor muscle and tendon of other finger(s) at INJURIES TO THE MUSCLES AND TENDONS AND forearm level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of other flexor muscle and tendon at forearm level JOINTS Injury of extensor or abductor muscles and tendons of INJURIES TO THE MUSCLES AND TENDONS AND thumb at forearm level JOINTS Sprain and strain of wrist.040 5.040 5.200 7. Mesentric artery embolism.8 S66.200 Professional Fee 2.040 5. Acute fulminant ischaemic colitis. Sprain and strain of INJURIES TO THE MUSCLES AND TENDONS AND Interphalangeal joint. Sprain and strain of Carpal joint.200 2. injury of Patellar INJURIES TO THE MUSCLES AND TENDONS AND ligament (tendon) JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of adductor muscle and tendon of thigh JOINTS Injury of muscle and tendon of the posterior muscle group INJURIES TO THE MUSCLES AND TENDONS AND at thigh level JOINTS Injury of other and unspecified muscles and tendons at INJURIES TO THE MUSCLES AND TENDONS AND thigh level JOINTS Sprain and strain involving fibular collateral ligament of INJURIES TO THE MUSCLES AND TENDONS AND knee. Sprain and strain of Phalanx.160 5.160 2.1 J84.040 9.9 J81 J82 J84. Sprain and strain of Thumb INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of other and unspecified parts of hand JOINTS Injury of flexor muscle and tendon of other finger at wrist INJURIES TO THE MUSCLES AND TENDONS AND and hand level JOINTS Injury of extensor muscle and tendon of other finger at INJURIES TO THE MUSCLES AND TENDONS AND wrist and hand level JOINTS Injury of intrinsic muscle and tendon of other finger at wrist INJURIES TO THE MUSCLES AND TENDONS AND and hand level JOINTS Injury of multiple flexor muscles and tendons at wrist and INJURIES TO THE MUSCLES AND TENDONS AND hand level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Injury of other muscles and tendons at wrist and hand level JOINTS Injury of unspecified muscle and tendon at wrist and hand INJURIES TO THE MUSCLES AND TENDONS AND level JOINTS INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of hip JOINTS Injury of quadriceps muscle and tendon.4 7. Passive pulmonary congestion.160 2. INJURIES TO THE MUSCLES AND TENDONS AND Sprain and strain of Radiocarpal joint. hand. Mesentric INTESTINAL DISORDERS vein embolism.200 7.0 S96.2 S76.ANNEX 1.5 S66.160 2.200 7.040 5. hand.040 S93.040 5.200 7.040 S63.200 7. Mesentric artery infarction.200 7.0 7.200 4.040 5.200 7.040 5. Loffler's pneumonia. sprains and strains. not elsewhere classified. Idiopathic pulmonary fibrosis INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INJURIES TO THE MUSCLES AND TENDONS AND JOINTS INTERSTITIAL PULMONARY DISEASE INTERSTITIAL PULMONARY DISEASE INTERSTITIAL PULMONARY DISEASE 7.9 T03. Mesentric a 9.200 7.160 2.8 J84.160 2. Acute oedema of lung.040 5.200 4.160 Health Care Institution Fee 5. unspecified Pulmonary oedema.040 5.1 S56.200 2.160 2. Interstitial INTERSTITIAL PULMONARY DISEASE pneumonia NOS Acute vascular disorders of intestine.040 5. Tibiofibular .6 S86.160 2. distal (ligament) Sprain and strain of toe(s) including Interphalangeal (joint(s).200 7.160 2.200 2.8 S86.800 9.200 5.160 5.160 2.200 7.7 S66.160 2.200 7.040 5.650 Page 44 of 111 .1 S66.200 2.200 14.200 7.2 S56.5 DESCRIPTION GROUP Case Rate 7.200 7.040 S93. Hamman-Rich syndrome. Mesentric vein infarction.160 5.200 7. Acute small intestine ischaemia.000 14.200 4.040 5. Alveolar proteinosis.040 5. unspecified.0 Other specified interstitial pulmonary diseases INTERSTITIAL PULMONARY DISEASE Interstitial pulmonary disease.200 7.800 9.4 S83.040 5. Sprain and strain JOINTS Metacarpophalangeal joint.500 2.160 2.800 K55.000 14.040 5.160 2.160 4.040 7.9 INTERSTITIAL PULMONARY DISEASE 14. Intussusception or invagination of intestine. unspecified Coeliac disease.850 2.ANNEX 1. Malabsorption due to intolerance to starch Other intestinal malabsorption Intestinal malabsorption. Intussusception or invagination of rectum Volvulus.070 K56. unspecified INTESTINAL OBSTRUCTION 10.070 Page 45 of 111 .8 K63. Ischaemic enterocolitis NOS Diverticular disease of small intestine with perforation and INTESTINAL DISORDERS abscess.850 2.100 10.030 3. Occlusion of colon or INTESTINAL OBSTRUCTION intestine.500 9. Ischaemic enteritis NOS.500 9.1 K63.500 2.230 1. Diverticular disease of small intestine with peritonitis Diverticular disease of small intestine without perforation or abscess.4 INTESTINAL MALABSORPTION 4.1 K90. not elsewhere classified.4 K56.850 2.8 K59.850 6.6 K56.100 10. with perforation and abscess.100 1.850 6.5 K63.850 2.070 7. Sprue NOS.230 1. Ischaemic stricture of intestine. Diverticular disease of both small and large intestine with peritonitis Diverticular disease of both small and large intestine without perforation or abscess.4 K63. Diverticular disease of intestine NOS with peritonitis Diverticular disease of intestine.100 4.230 1.100 10.870 K90. Chronic ischaemic enteritis.9 K59.650 6. Malabsorption due to intolerance to protein.0 K63. Intussusception or invagination of bowel.650 6.030 3.870 2.070 K56.500 9.3 K63.030 7.870 7.100 4.070 7.7 Other and unspecified intestinal obstruction. not elsewhere classified.650 6.9 K63.850 6.650 6.500 2.850 2.100 3. Atony of colon Functional intestinal disorder.850 2. Paralysis of intestine Intussusception.9 INTESTINAL DISORDERS 9.3 INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL DISORDERS INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION 9.500 9.2 K55.850 6.070 K56.870 2. Obstructive ileus NOS.070 7.850 6.500 9. Gluten-sensitive enteropathy. Enterolith. Ischaemic colitis INTESTINAL DISORDERS NOS.100 2. unspecified. Mesentric vascular insufficiency Angiodysplasia of colon GROUP Case Rate Professional Fee Health Care Institution Fee K55. Diverticular disease of colon NOS Diverticular disease of both small and large intestine with perforation and abscess.870 2. not elsewhere classified.850 6. Chronic ischaemic colitis.850 6.500 4. Imfaction of faecal Intestinal adhesions [bands] with obstruction.0 9.070 7. Diverticular disease of small intestine NOS Diverticular disease of large intestine with perforation and abscess.500 9. Peritoneal adhesions [bands] with intestinal obstruction INTESTINAL DISORDERS K57.850 1. Stenosis of colon or intestine.650 K57.1 INTESTINAL DISORDERS 9. Enterotenosis.500 2. Toxic megacolon Other specified functional intestinal disorders. Tropical steatorrhoea Blind loop syndrome.650 6. Diverticular disease of intestine NOS Megacolon.030 7.100 4.030 2.500 9.100 10.500 2.650 K57. Stricture of colon or intestine Ileus.650 K57.8 K90. Primary ulcer of small intestine Enteroptosis Polyp of colon Other specified diseases of intestine Disease of intestine.230 1. unspecified Abscess of intestine Nontraumatic perforation of intestine Fistula of intestine Ulcer of intestine.100 3. without perforation or abscess. Diverticular disease/ Diverticulitis/ Diverticulosis/ Diverticulum of colon with peritonitis Diverticular disease of large intestine without perforation or abscess. Nontropical sprue Tropical sprue.850 6.850 6.100 4.100 3.500 2. Torsion of colon or intestine.3 K59.8 INTESTINAL DISORDERS 9.650 K55.9 K56.500 9.2 K63.500 9. Malabsorption due to intolerance to fat.5 INTESTINAL DISORDERS 9. Twist of colon or intestine Gallstone ileus.500 9.650 Vascular disorder of intestine.650 6. Obstruction of intestine by gallstone Other impaction of intestine.030 7. Paralysis of bowel.850 2.650 6.650 K57. Intussusception or invagination of colon. part unspecified.1 INTESTINAL OBSTRUCTION 10. Paralysis of colon. Chronic ischaemic enterocolitis.0 INTESTINAL MALABSORPTION INTESTINAL MALABSORPTION INTESTINAL OBSTRUCTION 4. Strangulation of colon or intestine.100 10.230 3.500 2.500 9. Idiopathic steatorrhoea.500 9.850 2.3 K56.850 2.650 K57. Dilatation of colon.2 K56.870 2.850 2.650 6. Mesentric atherosclerosis.0 K90.500 2. Blind loop syndrome NOS Pancreatic steatorrhoea Malabsorption due to intolerance.650 K57. Diverticular disease of both small and large intestine NOS Diverticular disease of intestine.100 1.500 2.850 2.650 6.650 K57.850 2.870 K90. unspecified Paralytic ileus.3 INTESTINAL DISORDERS 9. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Chronic vascular disorders of intestine.230 6.650 6.650 6.2 K90.650 6.030 3.230 2.5 INTESTINAL OBSTRUCTION INTESTINAL OBSTRUCTION INTESTINAL OBSTRUCTION INTESTINAL OBSTRUCTION 10.500 2. Malabsorption due to intolerance to carbohydrate.030 3.2 INTESTINAL DISORDERS 9.1 9.650 2.9 K90. part unspecified. Impaction of colon.4 INTESTINAL DISORDERS 9. 4 S04. Intracranial abscess or granulom Intraspinal abscess and granuloma.800 8.160 S06. traumatic haemorrhage cerebellar.800 8. not elsewhere classified Injury of muscle and tendon of head Traumatic rupture of ear drum Multiple injuries of head Other specified injuries of head Unspecified injury of head.800 8.640 6.00 S06.160 6.640 2.01 S06. injury of Vagus [10th] nerve Injury of unspecified cranial nerve Injury of conjunctiva and corneal abrasion without mention of foreign body Concussion.160 S06. of fetus and newborn. Focal traumatic intracerebral INTRACRANIAL INJURIES haemorrhage (with open intracranial wound) Epidural haemorrhage. brain injury NOS (without open intracranial wound) Intracranial injury.640 2.160 6.51 S06.160 6.160 S06. injury of.640 2. traumatic haemorrhage intracranial NOS (without open intracranial wound) Other intracranial injuries.160 6.800 8.160 Injury of optic nerve and pathways.640 2.800 2. unspecified 27. Injury of Optic chiasm.530 G06.640 2. unspecified.800 8. Extradural haemorrhage.370 19.800 8.800 8.60 S06.640 2. Focal cerebral. Traumatic compression of brain NOS (without open intracranial wound) Diffuse brain injury.6 27. injury of 3rd cranial nerve Injury of abducent nerve.800 2.800 8. Cerebral contusion NOS.640 6.160 6.800 8. Extradural haemorrhage.160 6.640 2.160 6. Abscess (embolic)(of) otogenic.800 8.9 P52.800 8.640 6.2 S09.800 8. Cerebral laceration NOS. Abscess INTRACRANIAL AND INTRASPINAL ABSCESS AND (embolic)(of) cerebral.9 S05.80 8.90 S06.800 8. Abscess (embolic)(of) brain [any part].920 Page 46 of 111 .680 6. Abscess (embolic) of spinal cord [any part]. Commotio cerebri (without open intracranial wound) Concussion.160 6.640 2.160 6.41 S06.50 S06. Focal cerebral.640 2.640 2.160 6.800 8.1 S09. Injury of Visual cortex Injury of oculomotor nerve.600 2.800 8.640 2.ANNEX 1.530 G06.640 2.370 19.20 Injury of other cranial nerves.0 S09.640 2.640 19.640 2.0 S04.640 2. Subependymal haemorrhage (without intraventricular extension) INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES 8.900 8.800 8. Intraspinal abscess or granuloma epidural. unspecified.900 8. Intraspinal abscess or granuloma extradural.640 6. Injury of nose NOS Intraventricular (nontraumatic) haemorrhage.30 Focal brain injury. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee G06. injury of 6th cranial nerve Injury of facial nerve.800 2. traumatic haemorrhage cerebellar. Focal traumatic intracerebral INTRACRANIAL INJURIES haemorrhage (without open intracranial wound) Focal brain injury.800 2.81 S06.10 S06.800 8. Focal cerebral contusion.8 S09. injury of 7th cranial nerve Injury of acoustic nerve.800 8.640 2.160 S06.640 6.160 6. epidural. grade 1. traumatic (without open intracranial wound) Epidural haemorrhage.91 S09. Focal cerebral contusion.160 6.640 2.2 S04.530 6.640 2. Injury of face NOS.21 INTRACRANIAL INJURIES 8. Cerebral contusion NOS.800 8.70 S06.640 2.640 2. injury of Glossopharyngeal [9th] nerve.0 INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE NEWBORN 8.160 6.160 6.160 6.0 Intracranial abscess and granuloma.640 2. Cerebral laceration NOS.160 6.8 S04. Traumatic compression of brain NOS (without open intracranial wound) INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES 8.800 8.160 17.1 S04. injury of 8th cranial nerve INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES INTRACRANIAL INJURIES S04.31 8.800 8. Injury of ear NOS.160 S06. Focal cerebral laceration.160 6.800 8.160 6. Intraspinal abscess or granuloma subdural Encephalitis. myelitis and encephalomyelitis in Extradural and subdural abscess.800 8.800 8. traumatic (with open intracranial wound) Traumatic subdural haemorrhage (without open intracranial wound) Traumatic subdural haemorrhage (with open intracranial wound) Traumatic subarachnoid haemorrhage (without open intracranial wound) Traumatic subarachnoid haemorrhage (with open intracranial wound) Intracranial injury with prolonged coma (without open intracranial wound) Other intracranial injuries.160 6.640 2.160 6. Abscess (embolic)(of) cerebellar.160 6.800 8.1 INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA INTRACRANIAL AND INTRASPINAL ABSCESS AND GRANULOMA 27. GRANULOMA IIntracranial abscess or granuloma.800 8. traumatic haemorrhage intracranial NOS (with open intracranial wound) Intracranial injury.640 2.40 S06.7 S09. Focal cerebral laceration.370 2.640 2. INTRACRANIAL INJURIES Injury of 2nd cranial nerve. injury of Hypoglossal [12th] nerve.160 6.61 S06.5 S04.640 2.800 25. INTRACRANIAL INJURIES injury of Olfactory [1st] nerve. Commotio cerebri (with open intracranial wound) Traumatic cerebral oedema (without open intracranial wound) Diffuse brain injury.160 6. injury of Auditory nerve.800 2.0 S06.900 8. brain injury NOS (with open intracranial wound) Injury of blood vessels of head.160 6.640 7.160 6. 0 ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18.900 18.670 13.230 13.900 18.920 I21. Nontransmural myocardial infarction NOS Acute myocardial infarction.5 I23. grade 2.900 18. Acute subsequent infarction of anterolateral wall.900 5.900 5.900 5. Acute subsequent infarction of diaphragmatic wall.600 7.400 Unstable angina. Acute Subsequent infarction of anterior wall NOS. unspecified THE NEWBORN Acute transmural myocardial infarction of anterior wall [or duration of <4 weeks] KILLIPS stage unspecified.230 13.9 INTRAVENTRICULAR HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN THE NEWBORN INTRAVENTRICULAR Unspecified intraventricular (nontraumatic) haemorrhage HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN of fetus and newborn THE NEWBORN INTRAVENTRICULAR Intracerebral (nontraumatic) haemorrhage of fetus and HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN newborn THE NEWBORN INTRAVENTRICULAR Subarachnoid (nontraumatic) haemorrhage of fetus and HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN newborn THE NEWBORN INTRAVENTRICULAR Cerebellar (nontraumatic) and posterior fossa haemorrhage HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN of fetus and newborn THE NEWBORN INTRAVENTRICULAR Other intracranial (nontraumatic) haemorrhages of fetus HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN and newborn THE NEWBORN INTRAVENTRICULAR Intracranial (nontraumatic) haemorrhage of fetus and HEMORRHAGE/INTRACRANIAL HEMORRHAGE IN newborn. Acute apical-lateral ISCHEMIC HEART DISEASE WITH MYOCARDIAL transmural infarction [or duration of <4 weeks] KILLIPS II.920 25.680 17. INFARCTION Acute basal-lateral transmural infarction [or duration of <4 weeks] KILLIPS I Acute transmural myocardial infarction of unspecified site.4 I23.4 I21.230 I21.920 P52.900 5.900 12.230 13.0 18.230 13.670 5.920 25.900 18.3 I23.600 Professional Fee 7.230 8. Acute subsequent infarction of anteroseptal wall Subsequent myocardial infarction of inferior wall.670 5.0 ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION Haemopericardium as current complication following acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL myocardial infarction INFARCTION Atrial septal defect as current complication following acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL myocardial infarction INFARCTION Ventricular septal defect as current complication following ISCHEMIC HEART DISEASE WITH MYOCARDIAL acute myocardial infarction INFARCTION Rupture of cardiac wall without haemopericardium as ISCHEMIC HEART DISEASE WITH MYOCARDIAL current complication following acute myocardial infarction INFARCTION Rupture of chordae tendineae as current complication following acute myocardial infarction Rupture of papillary muscle as current complication following acute myocardial infarction Other current complications following acute myocardial infarction Dressler's syndrome.1 18.680 17. Acute ISCHEMIC HEART DISEASE WITH MYOCARDIAL transmural infarction of anterior wall NOS [or duration of INFARCTION <4 weeks] KILLIPS stage unspecified.680 17.680 17.2 18.3 I21. ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL Angina worsening effort.920 25.230 I21. INFARCTION Preinfarction syndrome Page 47 of 111 .0 I23. Acute myocardial infarction of basal-lateral wall.900 18. Acute transmural infarction ISCHEMIC HEART DISEASE WITH MYOCARDIAL of diaphragmatic wall [or duration of <4 weeks] KILLIPS I.900 18.900 18. of fetus and newborn.4 P52.900 18.8 ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18.8 P52. Acute myocardial infarction NOS [or duration of <4 weeks] KILLIPS I Subsequent myocardial infarction of anterior wall.670 13.670 13.5 P52.900 18.230 13.230 I21.670 5.900 18.900 5. Acute myocardial infarction of high lateral wall.670 5.600 7.900 5.670 13. Intermediate coronary syndrome.670 13.2 I23.920 25. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Intraventricular (nontraumatic) haemorrhage.670 5.6 P52.230 13.680 17.600 13.9 I23. unspecified [or duration of <4 weeks] KILLIPS I.670 5.230 13. Postmyocardial infarction syndrome ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18.600 7.1 I23.670 5. ISCHEMIC HEART DISEASE WITH MYOCARDIAL Transmural myocardial infarction NOS INFARCTION Acute subendocardial myocardial infarction. Angina crescendo.900 5.680 17.600 7. Acut Subsequent myocardial infarction of unspecified site ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 25.000 5. Acute anteroapical transmural infarction [or Acute transmural myocardial infarction of inferior wall [or duration of <4 weeks] KILLIPS I.230 13.9 18.680 Health Care Institution Fee 17.670 13.920 25.670 5.230 I22.230 I22.670 13.1 P52.ANNEX 1. Acute subsequent infarction of anteroapical wall.670 5. Acute myocardial infarction of lateral wall NOS.670 5.600 7.600 7.230 13. Subependymal haemorrhage with intraventricular extension GROUP Case Rate 25.1 ISCHEMIC HEART DISEASE WITH MYOCARDIAL INFARCTION 18. INFARCTION Acute transmural infarction of inferior wall NOS [or duration of <4 weeks] Acute transmural myocardial infarction of other sites [or duration of <4 weeks] KILLIPS II.670 3.1 I20.230 13. Acute subsequent infarction of inferolateral wall.3 P52. Acute myocardial infarction of apical-lateral wall.230 I22. Acute subsequent infarction of inferoposterior wall Subsequent myocardial infarction of other sites. Angina de novo effort.230 I22. Acute subsequent infarction of inferior wall NOS.8 I24. 300 3.800 11.540 3.400 7.9 A27.180 5.800 8.160 7. TT leprosy Hansen's disease: Borderline tuberculoid leprosy.400 7. I leprosy Hansen's disease : Tuberculoid leprosy. Laennec's cirrhosis Alcoholic liver disease.400 7.800 11.260 8.800 8.ANNEX 1.5 A30.800 8. Prolonged physiological jaundice.540 3. Toxic liver disease with focal nodular hyperplasia.400 8.8 P59.8 I20.220 2.640 2.260 8.180 5.640 2. Toxic liver disease with hepatic granulomas.400 8.220 2.9 K73.400 8. BT leprosy Hansen's disease: Borderline lepromatous leprosy.220 2.540 3.220 2.800 3.8 A30.260 K71.180 5.180 5.160 6.260 8. Coronary artery embolism not resulting in myocardial infaction.9 I24.180 5. Stenocardia Angina pectoris. unspecified Neonatal jaundice due to bleeding Neonatal jaundice due to infection Neonatal jaundice due to polycythaemia Neonatal jaundice due to drugs or toxins transmitted from JAUNDICE IN THE NEWBORN mother or given to newborn Neonatal jaundice due to other specified excessive JAUNDICE IN THE NEWBORN haemolysis Neonatal jaundice due to excessive haemolysis.600 2.2 P59.2 A30.540 8.160 6.540 3. Intense physiological jaundice.5 K71. BL leprosy Hansen's disease: Lepromatous leprosy. Prinzmetal Angina .180 5.220 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Angina pectoris with documented spasm.400 7.180 6.300 3.640 2.160 6.8 I25.180 5. Coronary artery occlusion not resulting in myocardial infarction.220 2.800 11. unspecified Alcoholic fatty liver Alcoholic hepatitis Alcoholic fibrosis and sclerosis of liver Alcoholic cirrhosis of liver.400 5. Toxic liver disease with lupoid hepatitis Toxic liver disease with hepatitis.700 7. not elsewhere classified JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN LEPROSY LEPROSY LEPROSY LEPROSY LEPROSY LEPROSY LEPROSY LEPTOSPIROSIS MODERATE TO SEVERE LEPTOSPIROSIS MODERATE TO SEVERE LEPTOSPIROSIS MODERATE TO SEVERE LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I K71.0 K71.800 8.000 11.5 I25.800 11.180 5.260 8.600 3.1 I20.400 8.640 3.800 11.8 P58.9 K70.400 7.8 I25.800 11.600 3.800 3. LL leprosy Other forms of leprosy Leprosy. Angina NOS.000 12.000 Professional Fee 3.540 3.800 11.000 3.400 I20. Jaundice due to delayed conjucation associated with preterm delivery Inspissated bile syndrome Neonatal jaundice from other and unspecified hepatocellular damage Neonatal jaundice from breast milk inhibitor Neonatal jaundice from other specified causes Neonatal jaundice.260 8.3 K70. unspecified Leptospirosis icterohaemorrhagica. unspecified. Angina of effort.000 11.180 5.9 P57.1 A30.000 11.9 P58.540 3.400 8.180 5. Variant Angina Other forms of angina pectoris.220 2. Chronic Ischaemic heart disease NOS Kernicterus due to isoimmunization Other specified kernicterus Kernicterus.800 11.260 8.1 P58. spasm-induced Angina .400 7.260 Page 48 of 111 .260 8. Co Other forms of acute ischaemic heart disease.540 8.800 3. Leptospirosis due to Leptospira interrogans serovar icterohaemorrhagiae Other forms of leptospirosis Leptospirosis.0 A27.260 8.400 7.180 5.220 2.260 8.400 8.160 6.540 3. unspecified Chronic persistent hepatitis.6 I25.400 7.540 3.800 8.220 2. Acute hepatic failure due to drugs.2 P58.160 6.640 2.8 LIVER DISEASES I 11.160 6.180 5. Toxic liver disease with veno-occlusive disease of liver Toxic liver disease. Chronic hepatic failure due to drugs Toxic liver disease with acute hepatitis Toxic liver disease with chronic persistent hepatitis Toxic liver disease with chronic active hepatitis. not elsewhere classified Toxic liver disease with other disorders of liver.220 2.300 3.4 A30.700 7.800 11.2 K71.0 P57.600 3. Cholestatis with hepatocyte injury.6 12.180 5.640 2.1 P59.0 LIVER DISEASES I LIVER DISEASES I 11.8 A27.540 3.000 7.9 K71.600 3.4 P58. unspecified JAUNDICE IN THE NEWBORN Neonatal jaundice associated with preterm delivery. Anginal syndrome.400 7.640 2.800 11.1 K71.800 11.600 8.400 7.3 P59.9 A30.220 2.400 7.3 P58.220 2.800 8. Angiospastic Angina . unspecified Toxic liver disease with cholestasis.1 K70. NOS Hansen's disease: Indeterminate leprosy.180 5.260 Chronic ischaemic heart disease.9 P59.000 12.400 8.0 12.260 8.0 A30.600 Health Care Institution Fee 8.220 2.800 11. Alcoholic cirrhosis NOS. Pure cholestasis Toxic liver disease with hepatic necrosis.220 2.540 3.2 K70. Toxic liver disease with peliosis hepatis.000 12. Coronary failure.0 K70.540 3.3 K71. NOS.400 7.0 P59.540 8.260 8. Hyperbilirubinaemia of prematurity.400 I24.600 3.000 12.400 7. Ischaemic chest pain Coronary thrombosis not resulting in myocardial infarction.600 3. unspecified. unspecified.220 2.8 P57. Coronary insufficiency Ischaemic cardiomyopathy Silent myocardial ischaemia Other forms of chronic ischaemic heart disease GROUP ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION ISCHEMIC HEART DISEASE WITHOUT MYOCARDIAL INFARCTION JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN JAUNDICE IN THE NEWBORN Case Rate 12. Coronary vein embolism not resulting in myocardial infarction. Cardiac Angina .000 12.400 7.700 8.000 12. 500 16.1 K75. unspecified Malignant neoplasm of Urethra Malignant neoplasm of Urinary organ.2* DESCRIPTION Chronic active hepatitis.6+I98.1 K74.8 I89.550 Malignant neoplasm of renal pelvis.230 4. Cirrhosis of liver NOS.530 4.800 11.0 C67. not elsewhere classified.500 16.0 C40.100 14.100 14.800 11.8 K75. Chronic Mesenteric lymphadenitis Lymphangitis.260 8.9 K71.100 3.9 C68.530 4. Malignant neoplasm of MALIGNANT NEOPLASM OF URINARY TRACT Pelviureteric junction.800 Professional Fee 3.0 LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LYMPHADENITIS LYMPHATIC VESSELS DISORDER LYMPHATIC VESSELS DISORDER LYMPHATIC VESSELS DISORDER MALIGNANT NEOPLASM OF URINARY TRACT 15.800 11.230 4. Cryptogenic cirrhosis of liver.260 8. Hepatic abscess NOS.500 4. Macronodular cirrhosis of liver.260 10.230 4. Haematogenic hepatic abscess.550 11.230 4. Focal nodular hyperplasia of liver.100 15.3 C40.570 4. unspecified Toxic liver disease with chronic lobular hepatitis Toxic liver disease with fibrosis and cirrhosis of liver Hepatic fibrosis Hepatic fibrosis with hepatic sclerosis Other and unspecified cirrhosis of liver.540 Health Care Institution Fee 8.2 K75.800 11.230 4. Chronic Lymphangitis.9 C64 C65 C66 C67.530 4.570 10.950 4. Mixed type cirrhosis of liver.870 9.1 I89.6 K76.800 11.950 4.950 4. Hepatitis NOS Fatty (change of) liver.800 11.230 4.870 9. Subacute Lymphangitis Other specified noninfective disorders of lymphatic vessels and lymph nodes.2 K76. not elsewhere classified Other specified diseases of liver.540 3. Lupoid hepatitis NEC Other chronic hepatitis.100 15.570 10.500 16.0 C79.550 11.100 6.100 14.870 9. not elsewhere classified Autoimmune hepatitis Other specified inflammatory liver diseases Inflammatory liver disease.570 K74.100 14.260 8.570 K76. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE K73.2 K73.570 10.870 9.0 I89.670 2. Acute Mesenteric lymphadenitis.670 2.870 9.540 3.540 3.230 4.760 6.870 9.950 4.540 3.230 4.9 C79.8 K76. unspecified Hepatic sclerosis Oesophageal varices in other and unspecified cirrhosis of liver Abscess of liver. Lymphangitis NOS.530 4.0 K74. Cardiac sclerosis of liver Central haemorrhagic necrosis of liver Infarction of liver Peliosis hepatis. Micronodular cirrhosis of liver.260 8.800 15.870 9.100 14.900 14.100 14.870 9.1 K76.900 8.570 10.550 11.570 10.100 4.7 I88.550 11. Malignant neoplasm of ARTICULAR CARTILAGE Orbital bone Page 49 of 111 .230 9.100 16.230 4.870 9.870 9. Malignant MALIGNANT NEOPLASMS OF BONE AND neoplasm o f Superior maxilla.6 C67.230 4.5 C67.9 K76.870 9.260 8.870 9.230 6.230 6.260 8.4 K76. Chronic passive congestion of liver. Pylephlebitic hepatic abscess Phlebitis of portal vein.3 K75.2 C40. Lymphogenic hepatic abscess.500 16. not elsewhere classified Chronic hepatitis.540 3.500 16. Hepatic angiomatosis Portal hypertension Hepatorenal syndrome Nonspecific mesenteric lymphadenitis. Hepatoptosis Liver disease.230 4.100 15.260 8. Portal cirrhosis of liver. Malignant neoplasm of Urinary system NOS Secondary malignant neoplasm of kidney and renal pelvis Secondary malignant neoplasm of bladder and other and unspecified urinary organs Malignant neoplasm of Scapula and long bones of upper limb MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASM OF URINARY TRACT MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND Malignant neoplasm of Short bones of upper limb ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND Malignant neoplasm of Long bones of lower limb ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND Malignant neoplasm of Short bones of lower limb ARTICULAR CARTILAGE Malignant neoplasm of Bone and articular cartilage of limb.1 C67.7 C67. Lipomelanotic reticulosis Noninfective disorder of lymphatic vessels and lymph nodes.800 11.870 11.530 4.3 C67.2 LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II LIVER DISEASES II 11.260 8.950 4.6 LIVER DISEASES II 15.ANNEX 1.100 14.100 15.100 14.0 K76. Cholangitic hepatic abscess. unspecified.870 9.800 8.540 3.100 14.7 K74.540 3.870 9.0 C68.230 4.100 14. unspecified.530 4.540 3.260 8.530 10.100 14. Malignant neoplasm of Internal urethral orifice Malignant neoplasm of Ureteric orifice Malignant neoplasm of Urachus Malignant neoplasm of Overlapping lesion of bladder Malignant neoplasm of Bladder.260 8.800 11. except renal pelvis & renal calyces LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I LIVER DISEASES I GROUP Case Rate 11.4 K75.570 10.260 8.1 C40. Disease of lymphatic vessels NOS Malignant neoplasm of kidney.9 C41. Malignant neoplasm of Renal calyces Malignant neoplasm of ureter Malignant neoplasm of Trigone of bladder Malignant neoplasm of Dome of bladder Malignant neoplasm of Lateral wall of bladder Malignant neoplasm of Anterior wall of bladder Malignant neoplasm of Bladder neck.800 11.100 14.100 14.570 10.540 3.230 4.530 8.670 4.540 3.530 4.230 4. Cardiac cirrhosis (socalled) of liver.800 11.950 10.260 K75.570 10.260 8.230 4.040 2. unspecified.100 15.540 4.530 2.8 C67.0 K75.540 3.260 8. Pylephlebitis Nonspecific reactive hepatitis Granulomatous hepatitis.3 K76.100 14.540 3.8 K73.800 11.4 K71.530 4.9 K74.550 11.100 15. Chylocele (nonfilarial).100 15.100 14.870 9.230 4.1 C40.900 8.800 11. Postnecrotic cirrhosis of liver.800 11.100 15. MALIGNANT NEOPLASMS OF BONE AND unspecified ARTICULAR CARTILAGE Malignant neoplasm of Bones of skull and face.540 3.2 C67. 260 4.260 4.500 16. unspecified Secondary malignant neoplasm of bone and bone marrow Malignant neoplasm of Cerebral meninges Malignant neoplasm of Spinal meninges Malignant neoplasm of Meninges.550 11.9 C16 DESCRIPTION Malignant neoplasm of Mandible.900 16.070 5.200 14.070 5.830 9.500 16.200 14.940 9. Malignant neoplasm of Cardiac orifice.830 11.830 11.500 16.7 C71.940 9.260 Health Care Institution Fee 11.0 Malignant neoplasm of Cardia.500 16.1 C72.260 4.830 11.940 9.260 4.550 11. unspecified Malignant neoplasm of Cerebrum.070 5.900 16. Malignant neoplasm of Supratentorial NOS Malignant neoplasm of Frontal lobe Malignant neoplasm of Temporal lobe Malignant neoplasm of Parietal lobe Malignant neoplasm of Occipital lobe Malignant neoplasm of Cerebral ventricle Malignant neoplasm of Cerebellum GROUP MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF BONE AND ARTICULAR CARTILAGE MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM Case Rate 16.900 14.200 Professional Fee 4.830 11.830 11.900 16.260 4. Malignant neoplasm of MALIGNANT NEOPLASMS OF CENTRAL NERVOUS Fourth Ventricle.4 C15.950 4.500 16.3 C15.940 9. Malignant neoplasm of Gastro-oesophageal junction.070 5.4 C15.070 5.070 5. Malignant neoplasm of Cardio-oesophageal MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS junction.900 16. Malignant neoplasm of Nervous system NOS Secondary malignant neoplasm of brain and cerebral meninges Secondary malignant neoplasm of other and unspecified parts of nervous system Malignant neoplasm of Cervical part of oesophagus Malignant neoplasm of Abdominal part of oesophagus Malignant neoplasm of Upper third of oesophagus Malignant neoplasm of Middle third of oesophagus Malignant neoplasm of Lower third of oesophagus Malignant neoplasm of Overlapping lesion of oesophagus Malignant neoplasm of Oesophagus.8 C72.260 9. unspecified Dermato(poly)myositis in Malignant neoplasm of stomach MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF CENTRAL NERVOUS SYSTEM MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS C16.500 16.830 11.070 5.950 4.1 C41.5 C70.830 11.950 4.0 C70.070 5.900 16.070 5.500 16.900 16. unspecified.830 11.940 9.260 4.070 5.830 11.900 16.830 11.070 4.8 C15. except lobes and ventricles.070 5.950 4.950 4. Malignant neoplasm of Lower jaw bone Malignant neoplasm of Vertebral column Malignant neoplasm of Ribs.830 11.830 11.200 14.3 C79.900 16.830 11.950 4.900 16.200 14.9 C79.070 5.5 C15.830 11.900 16.070 5.550 11.070 5.940 9.4 C71.8 C41.830 11.900 16.2 C71.900 16.6 C71.8 C71.900 16.900 16.900 16. Malignant neoplasm of Infratentorial NOS SYSTEM Malignant neoplasm of Overlapping lesion of brain Malignant neoplasm of Brain.940 9.200 14.830 11. unspecified Malignant neoplasm of Spinal cord Malignant neoplasm of Cauda equina Malignant neoplasm of Olfactory nerve.3 C41.5 C71.070 5.950 5.2 C15.070 5.ANNEX 1.9 C71.9 C79.830 11.070 5.900 16.9 C72. sacrum and coccyx Malignant neoplasm of Overlapping lesion of bone and articular cartilage Malignant neoplasm of Bone and articular cartilage.1 C71.900 16.900 16.940 Page 50 of 111 .0 C72.940 Malignant neoplasm of Brain stem.900 16.830 11. sternum and clavicle Malignant neoplasm of Pelvic bones.550 11.200 4.550 11.3 C71.1 C70. Malignant neoplasm of Olfactory bulb Malignant neoplasm of Optic nerve Malignant neoplasm of Acoustic nerve Malignant neoplasm of Other and unspecified cranial nerves.070 5.900 16.900 16.200 14.830 11.900 16.550 11.070 5.070 5.3 C72.200 14.4 C41.260 4.0 C71.4 C72.550 11.830 11.830 11.070 5.2 C72.2 C41. Malignant neoplasm of Cranial nerve NOS Malignant neoplasm of Overlapping lesion of brain and other parts of central nervous system Malignant neoplasm of Central nervous system.830 11.5 C72. Malignant neoplasm of Oesophagus and stomach 14. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C41.070 5.0 C15. 260 4.940 C22.260 4. Malignant neoplasm of Hepatic duct Malignant neoplasm of Ampulla of Vater Malignant neoplasm of Overlapping lesion of biliary tract Malignant neoplasm of Biliary tract.940 9.260 4.200 14.260 4.260 4.260 4. Malignant neoplasm of Gastric antrum Malignant neoplasm of Pylorus.940 9.2 C16.200 14.8 C24.200 14.260 4.940 Page 51 of 111 .3 C18.200 14.260 4.200 14.200 14. Malignant neoplasm of Ileocaecal valve Malignant neoplasm of Appendix Malignant neoplasm of Ascending colon Malignant neoplasm of Hepatic flexure Malignant neoplasm of Transverse colon Malignant neoplasm of Splenic flexure Malignant neoplasm of Descending colon GROUP MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS Case Rate 14.940 9.260 4.260 4.940 9.260 4.200 14.5 C18.260 4.200 14.940 9.0 C21. unspecified Malignant neoplasm of Stomach. Malignant neoplasm of Common bile duct.200 Professional Fee 4. anus and anal canal. unspecified Malignant neoplasm of gallbladder Malignant neoplasm of Extrahepatic bile duct.200 14.260 4.200 14.260 4. Malignant neoplasm of Cystic duct. Malignant neoplasm of Prepylorus.200 4.940 9.200 14.3 C16.940 9.9 C23 14.2 C22.9 C19 C20 C21.940 9. Malignant neoplasm of Rectal ampulla Malignant neoplasm of Anus.200 14.260 4.7 C22. Malignant neoplasm of Biliary duct or passage NOS.940 9. unspecified Malignant neoplasm of Duodenum Malignant neoplasm of Jejunum Malignant neoplasm of Ileum Malignant neoplasm of Small intestine. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C16. Malignant neoplasm MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS of Sigmoid flexure Malignant neoplasm of Overlapping lesion of colon Malignant neoplasm of Colon.940 9.0 C17.260 Health Care Institution Fee 9.200 14.940 9. unspecified Malignant neoplasm of Head of pancreas MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14.200 4.200 14.200 14.940 Malignant neoplasm of Sigmoid colon.1 C24.200 14.260 9. unspecified Malignant neoplasm of Anal canal.200 14.940 9.940 9.940 9.200 14.ANNEX 1.940 9.200 14. unspecified Malignant neoplasm of Greater curvature of stomach.1 C22.940 C24.200 4.260 4.0 MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14. Malignant neoplasm of Large intestine NOS Malignant neoplasm of rectosigmoid junction.940 9.0 C18.940 9.200 14. Malignant neoplasm of Rectosigmoid colon Malignant neoplasm of rectum.9 C18. Malignant neoplasm of pyloric canal Malignant neoplasm of Lesser curvature of stomach.200 14.200 14.200 14.9 C17. Cholangiocarcinoma Hepatoblastoma Angiosarcoma of liver.940 9.940 9.200 14.940 9.9 C25. unspecified.6 C16.200 14.4 C16.2 C17.200 14.940 9.200 14.260 4.4 C18.940 9.940 9.260 4.260 4.8 Malignant neoplasm of Overlapping lesion of rectum.940 9.940 9.260 9.200 14.5 C16.260 4.200 14.0 MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14.260 4.940 C24.4 C22.200 14. Kupffer cell sarcoma Other sarcomas of liver Other specified carcinomas of liver Liver.200 14.260 4.1 C16.260 4.940 9.200 14.940 9. unspecified Malignant neoplasm of Caecum.200 14.2 C18.260 4.200 14.1 DESCRIPTION Malignant neoplasm of Fundus of stomach Malignant neoplasm of Body of stomach Malignant neoplasm of Pyloric antrum.260 4. Malignant neoplasm of Anal sphincter MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS C21.260 4.1 C17.260 4.940 9.260 4.200 4.0 C22.940 9.260 4.260 4. Malignant neoplasm of Colon with rectum.260 4.3 C22.940 9.7 C18.1 C18. MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS Malignant neoplasm of Anorectum Liver cell carcinoma.6 C18.260 4.940 9.940 9. Malignant neoplasm of Anorectal junction.8 C18.260 4.260 9.940 9.260 4.260 9. Hepatocellular carcinoma Hepatoma Intrahepatic bile duct carcinoma.940 9. 900 5.940 9. unspecified MALIGNANT NEOPLASMS OF EYE Malignant neoplasm of Labium majus.420 11.980 Page 52 of 111 .260 4.260 Health Care Institution Fee 9.2 C77.2 C78. Malignant neoplasm of Mastoid air cells Malignant neoplasm of Cornea Malignant neoplasm of Retina Malignant neoplasm of Choroid Malignant neoplasm of Ciliary body.200 14.830 11.260 4.200 14.940 9.980 7.400 11.070 5.0 MALIGNANT NEOPLASMS OF EARS AND NOSE 10. Mesothelioma of Mesocolon. Mesothelioma of Pelvic Peritoneum Malignant neoplasm of Specified parts of peritoneum. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C25.070 5.200 14.7 C25.940 C48. Malignant neoplasm of Eustachian tube. Malignant neoplasm of Mesocolon.090 5.200 4.900 11.200 4.9 Malignant neoplasm of Ill-defined sites within the digestive system.1 C69. Mesothelioma of Omentum.200 4.940 9.070 3.940 9.940 C48. unspecified.900 3.200 14.830 11.980 7.2 C51.940 9. unspecified Malignant neoplasm of Intestinal tract.940 9.260 4.200 14.3 C25.200 14.830 11.9 C26.ANNEX 1.940 9.260 4. Malignant neoplasm of Cartilage of nose.260 4.260 4.420 3. Malignant neoplasm of Lacrimal sac.260 4. Malignant neoplasm of Alimentary canal or tract MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS NOS.4 C69.900 16.1 14.210 C30.900 16.830 7.4 C25. Malignant neoplasm of Vestibule of nose Malignant neoplasm of Middle ear.2 C76.210 11. Malignant neoplasm of Gastrointestinal tract NOS Mesothelioma of peritoneum.420 3.9 C51. Malignant neoplasm of Intestine NOS Malignant neoplasm of Spleen Malignant neoplasm of Overlapping lesion of digestive system MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS C26.200 14.1 14. Malignant neoplasm of Septum of nose.200 14.4 C78.200 14.200 14. MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS Mesothelioma of Parietal Peritoneum.3 C69.070 5.9 16.2 C25.830 11. Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS neoplasm of Neck of pancreas Malignant neoplasm of Overlapping lesion of pancreas Malignant neoplasm of Pancreas.260 4.200 Professional Fee 4.940 9.900 16. Malignant MALIGNANT NEOPLASMS OF FEMALE GENITAL neoplasm of External female genitalia NOS.420 3. Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS neoplasm of Parietal Peritoneum.5 C78.260 4.300 3.940 9.200 14.200 4. Malignant neoplasm of Omentum.2 C69.260 9.200 14.900 16.260 4.8 C25.260 4. part unspecified.7 C78. Mesothelioma of Mesentery.980 7.070 5.940 9. Malignant neoplasm of Retro-ocular Malignant neoplasm of Eye. Malignant neoplasm of Connective tissue of orbit.090 7.200 14. Malignant ascites NOS Secondary malignant neoplasm of liver Secondary malignant neoplasm of other and unspecified digestive organs Malignant neoplasm of Nasal cavity. unspecified Malignant neoplasm of Abdomen Secondary and unspecified malignant neoplasm of Intraabdominal lymph nodes Secondary malignant neoplasm of small intestine Secondary malignant neoplasm of large intestine and rectum Secondary malignant neoplasm of retroperitoneum and peritoneum.070 11.830 C69. Malignant neoplasm of Nasolacrimal duct MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS 14.200 14.300 16.8 14.200 14.940 9.0 C51. Malignant neoplasm of Retrobulbar tissue.1 C69.1 C25.070 7.6 C78.260 9. Malignant neoplasm of Inner ear.1 C51.200 14. Malignant neoplasm of Extraocular muscle.940 9.260 4.400 11.940 9. Malignant neoplasm of Mesentery. Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL of Bartholin's [greater vestibular] gland TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Labium minus TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Clitoris TRACT Malignant neoplasm of Vulva.940 C45.940 C30.260 4.940 9.6 Malignant neoplasm of Orbit.0 C26. Malignant neoplasm of nasal Concha. Malignant neoplasm of Peripheral MALIGNANT NEOPLASMS OF EYE nerves of orbit.8 DESCRIPTION Malignant neoplasm of Body of pancreas Malignant neoplasm of Tail of pancreas Malignant neoplasm of Pancreatic duct GROUP MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS Case Rate 14.400 11.940 9. Malignant MALIGNANT NEOPLASMS OF DIGESTIVE ORGANS neoplasm of Islets of Langerhans Malignant neoplasm of Other parts of pancreas. Malignant neoplasm of Pelvic peritoneum Malignant neoplasm of Peritoneum.940 Malignant neoplasm of Endocrine pancreas. Malignant neoplasm of Internal nose.940 9. Malignant TRACT neoplasm of Pudendum 16. Malignant neoplasm of Eyeball Malignant neoplasm of Lacrimal gland and duct.260 4.5 MALIGNANT NEOPLASMS OF EARS AND NOSE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE MALIGNANT NEOPLASMS OF EYE 10.260 4.260 9.260 9.260 4.830 C69.1 C26.400 5. 400 11. ORAL CAVITY. unspecified Malignant neoplasm of Hard palate MALIGNANT NEOPLASMS OF LIP.400 Professional Fee 3.500 3.980 C00. Malignant neoplasm of Upper lip NOS.050 8. ORAL CAVITY. PHARYNX MALIGNANT NEOPLASMS OF LIP. Malignant TRACT neoplasm of Utero-ovarian Malignant neoplasm of Female genital organ.420 3.980 7. Malignant neoplasm of Lip.450 3.980 7.400 11.420 3.500 11.3 11.980 7.500 11. Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL of Uterine ligament NOS TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Uterine adnexa.420 3.400 11.4 C57.450 3. ORAL CAVITY.450 8. Malignant neoplasm of Tubo-ovarian. Choriocarcinoma NOS.980 7.420 3. Malignant neoplasm of Wolffian body or duct MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT C57.420 3.500 3.500 3. Malignant neoplasm MALIGNANT NEOPLASMS OF FEMALE GENITAL of Lower uterine segment TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Endometrium TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Myometrium TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Fundus uteri TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Overlapping lesion of corpus uteri TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Corpus uteri.980 7. ORAL CAVITY.450 8. ORAL CAVITY.0 11.450 3.8 Malignant neoplasm of Overlapping lesion of female genital MALIGNANT NEOPLASMS OF FEMALE GENITAL organs. part unspecified TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of ovary TRACT Malignant neoplasm of Fallopian tube. ORAL CAVITY.6 11.400 11.400 11.500 3. ORAL CAVITY.420 3. Malignant neoplasm of lipstick area. Malignant neoplasm of Anterior two-thirds of dorsal PHARYNX surface of tongue Malignant neoplasm of Border of tongue.9 C58 C79. unspecified Malignant neoplasm of Floor of mouth.980 7.1 C03.420 3. unspecified Malignant neoplasm of Upper gum Malignant neoplasm of Lower gum Malignant neoplasm of Gum.0 C54.050 8.3 C54. Malignant neoplasm of Middle third of tongue PHARYNX NOS.450 3.0 C00.1 C54. ORAL CAVITY.9 C54. ORAL CAVITY.0 C57. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C52 C53.450 3.400 11.980 7.050 8.450 8.400 3.500 11.400 11.450 3. Malignant neoplasm of Anterior two-thirds of ventral PHARYNX surface of tongue. unspecified TRACT Malignant neoplasm of Isthmus uteri.420 3.400 11.9 C55 C56 C57. unspecified PHARYNX Malignant neoplasm of base of Dorsal surface of tongue . unspecified TRACT Malignant neoplasm of Other specified female genital organs. Malignant neoplasm of Uterine tube TRACT Malignant neoplasm of Parametrium.400 11.050 11.980 7.9 C05. MALIGNANT NEOPLASMS OF LIP. ORAL CAVITY.500 11. Malignant neoplasm of Frenulum linguae Malignant neoplasm of Anterior two-thirds of tongue.8 C02. PHARYNX MALIGNANT NEOPLASMS OF LIP.0 C53. ORAL CAVITY. Malignant MALIGNANT NEOPLASMS OF LIP.400 11. ORAL CAVITY.500 11. unspecified TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of uterus.500 11.9 C04. PHARYNX MALIGNANT NEOPLASMS OF LIP.2 C54. PHARYNX lip.450 8.400 11.450 3.420 3.400 11.420 3.050 8.450 8.050 8.400 11.9 C03.420 3.980 7.420 3.500 3.400 11.980 7.ANNEX 1.400 11. ORAL CAVITY.050 8.0 C02. PHARYNX MALIGNANT NEOPLASMS OF LIP.2 Malignant neoplasm of External upper lip. unspecified.450 3.050 Page 53 of 111 .050 11. PHARYNX 11. ORAL CAVITY.4 C02.420 3. MALIGNANT NEOPLASMS OF LIP.400 11. Malignant neoplasm of Fixed part of tongue NOS.980 7. vermilion border MALIGNANT NEOPLASMS OF LIP.3 C57.050 C02.450 3.500 3. part MALIGNANT NEOPLASMS OF LIP.420 3.8 C53. ORAL CAVITY.980 7. MALIGNANT NEOPLASMS OF LIP. Malignant MALIGNANT NEOPLASMS OF FEMALE GENITAL neoplasm of Oviduct.500 11.1 C53. unspecified.980 C57.050 8.980 7.420 7.8 C54. PHARYNX MALIGNANT NEOPLASMS OF LIP.420 7.980 7. Malignant neoplasm of Mobile part of tongue NOS Malignant neoplasm of Lingual tonsil Malignant neoplasm of Overlapping lesion of tongue Malignant neoplasm of Tongue.420 Health Care Institution Fee 7.980 7. Malignant neoplasm of Female genitourinary tract NOS Malignant neoplasm of placenta.1 C02.980 7.980 MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Endocervix TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Exocervix TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Overlapping lesion of cervix uteri TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL Malignant neoplasm of Cervix uteri. neoplasm of Tip of tongue PHARYNX Malignant neoplasm of Ventral surface of tongue.050 C02.050 8.420 3.9 C01 C02. PHARYNX Malignant neoplasm of Posterior third of tongue Malignant neoplasm of Dorsal surface of base of tongue.420 3. Malignant neoplasm of Upper lip.400 11. PHARYNX MALIGNANT NEOPLASMS OF LIP.420 3.400 3. Chorionepithelioma NOS Secondary malignant neoplasm of ovary MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT MALIGNANT NEOPLASMS OF FEMALE GENITAL TRACT 11.0 C03.400 11.050 11.500 11. Malignant neoplasm of Upper MALIGNANT NEOPLASMS OF LIP.450 8.050 8.980 7.420 3.7 DESCRIPTION Malignant neoplasm of vagina GROUP Case Rate 11.980 7.500 11. PHARYNX MALIGNANT NEOPLASMS OF LIP. 0 C08. Malignant neoplasm of Aryepiglottic fold.050 8. PHARYNX MALIGNANT NEOPLASMS OF LIP. face and neck.450 4.450 8.050 C07 C08. ORAL CAVITY. Malignant neoplasm of Pharyngeal tonsil Malignant neoplasm of Lateral wall of nasopharynx.450 8.500 3.3 MALIGNANT NEOPLASMS OF LIP.050 C77. ORAL CAVITY. Malignant neoplasm of Adenoid.1 C05.050 C06. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. ORAL CAVITY.1 11. hypopharynx Malignant neoplasm of Hypopharynx.050 8. Minor Malignant neoplasm of minor salivary gland. face and neck.730 9. Malignant neoplasm of Oral cavity NOS Malignant neoplasm of parotid gland Malignant neoplasm of Submandibular gland. ORAL CAVITY. unspecified PHARYNX Malignant neoplasm of Superior wall of nasopharynx.050 8.0 DESCRIPTION Malignant neoplasm of Soft palate Malignant neoplasm of Palate. PHARYNX MALIGNANT NEOPLASMS OF LYMPHOID. Malignant neoplasm of Aryepiglottic fold.450 8.9 11.500 3. ORAL CAVITY. Malignant neoplasm of Hypopharyngeal wall NOS MALIGNANT NEOPLASMS OF LIP.450 8.500 11.500 13.050 Malignant neoplasm of Cheek mucosa.450 3.0 C14.450 Health Care Institution Fee 8.500 11. Malignant neoplasm of Pharyngeal recess Malignant neoplasm of Anterior wall of nasopharynx. ORAL CAVITY. Malignant neoplasm of Faucial Tonsil.500 11. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. ORAL CAVITY. ORAL CAVITY. Malignant neoplasm of Pharynx.3 11. PHARYNX Case Rate 11.050 8. PHARYNX MALIGNANT NEOPLASMS OF LIP.500 3.050 8. of Buccal mucosa NOS.9 11. hypopharyngeal aspect hypopharynx .050 C06.450 3. ORAL CAVITY. unspecified Malignant neoplasm of Aryepiglottic fold. unspecified.050 9.170 4. ORAL CAVITY. ORAL CAVITY.450 3. Malignant neoplasm of Lower buccal sulcus.0 C10. Malignant neoplasm of Posterior margin of nasal choana.050 C11. PHARYNX MALIGNANT NEOPLASMS OF LIP.450 8. and pharynx PHARYNX Malignant neoplasm of Head.450 3.0 B21. Malignant neoplasm of Oropharynx. of Branchial cyst PHARYNX MALIGNANT NEOPLASMS OF LIP.050 8. Malignant neoplasm of Major Salivary gland NOS Malignant neoplasm of Tonsillar fossa Malignant neoplasm of Tonsil. Malignant neoplasm of Palatine Tonsil Malignant neoplasm of Vallecula MALIGNANT NEOPLASMS OF LIP.050 C09.500 3.050 8.500 3.1 11.900 13.9 C09.050 C10.500 11. Malignant neoplasm MALIGNANT NEOPLASMS OF LIP.050 8.450 3.450 8.500 11.450 3.0 11.450 8. ORAL CAVITY.4 C10.450 8.2 11.050 8. ORAL CAVITY.050 C11.450 3.050 8. Malignant neoplasm MALIGNANT NEOPLASMS OF LIP. PHARYNX 11. Malignant neoplasm of Tonsil NOS. HEMATOPOIETIC AND RELATED TISSUE 11. PHARYNX 11. PHARYNX MALIGNANT NEOPLASMS OF LIP. Malignant neoplasm of Posterior wall of oropharynx PHARYNX Malignant neoplasm of Branchial cleft.0 MALIGNANT NEOPLASMS OF LIP.500 11. unspecified PHARYNX Malignant neoplasm of Overlapping lesion of lip.3 C10.500 11.ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C05.500 3.050 C11.170 8.450 8.500 11.9 C11. PHARYNX MALIGNANT NEOPLASMS OF LIP.050 C11.050 8. Malignant neoplasm of Posterior Nasopharyngeal surface of soft palate.450 8.0 MALIGNANT NEOPLASMS OF LIP. Malignant neoplasm of Supraclavicular lymph nodes Human immunodeficiency virus [HIV] disease resulting in Burkitt's lymphoma Human immunodeficiency virus [HIV] disease resulting in other types of non-Hodgkin's lymphoma Human immunodeficiency virus [HIV] disease resulting in other malignant neoplasms of lymphoid.500 3.450 3.2 11. Malignant MALIGNANT NEOPLASMS OF LIP. ORAL CAVITY.500 11. ORAL CAVITY. ORAL CAVITY. PHARYNX MALIGNANT NEOPLASMS OF LIP.730 9.450 8.500 11.500 3.8 C76. Malignant neoplasm of Fossa of Rosenmüller. PHARYNX MALIGNANT NEOPLASMS OF LIP. Malignant neoplasm of A nterior Nasopharyngeal surface of soft palate.500 3. Malignant neoplasm of Nose NOS PHARYNX Secondary and unspecified malignant neoplasm of Lymph nodes of head.050 8.050 C13.050 8.9 MALIGNANT NEOPLASMS OF LIP.500 3. Malignant neoplasm of Upper buccal sulcus. PHARYNX 11.450 3. PHARYNX MALIGNANT NEOPLASMS OF LIP. marginal zone. PHARYNX MALIGNANT NEOPLASMS OF LIP.500 11.500 11.9 C14. ORAL CAVITY.2 B21. haematopoietic and related tissue MALIGNANT NEOPLASMS OF LIP. PHARYNX MALIGNANT NEOPLASMS OF LIP. Malignant neoplasm of Upper Labial sulcus.450 3. ORAL CAVITY.900 3.170 4.500 3.900 13. PHARYNX C06. PHARYNX MALIGNANT NEOPLASMS OF LIP.050 C13.500 11.500 3. Malignant neoplasm of Opening of auditory tube.450 3. M Malignant neoplasm of Nasopharynx. oral cavity MALIGNANT NEOPLASMS OF LIP.450 3. unspecified site. Malignant neoplasm of Lower Labial sulcus Malignant neoplasm of Retromolar area Malignant neoplasm of Mouth. Malignant neoplasm of Internal PHARYNX cheek Malignant neoplasm of Vestibule of mouth. ORAL CAVITY. ORAL CAVITY. ORAL CAVITY. unspecified. ORAL CAVITY. ORAL CAVITY.500 Professional Fee 3.450 3. ORAL CAVITY.9 C06. ORAL CAVITY. PHARYNX MALIGNANT NEOPLASMS OF LIP. unspecified. neoplasm of Cheek NOS. PHARYNX MALIGNANT NEOPLASMS OF LIP. unspecified. ORAL CAVITY.1 B21.1 C08.450 8. PHARYNX MALIGNANT NEOPLASMS OF LIP. Malignant neoplasm of Submaxillary gland Malignant neoplasm of Sublingual gland Malignant neoplasm of Major salivary gland. hypopharynx NOS.730 Page 54 of 111 .1 11. ORAL CAVITY. Malignant neoplasm of Roof of nasopharynx Malignant neoplasm of Posterior wall of nasopharynx. unspecified GROUP MALIGNANT NEOPLASMS OF LIP. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9.900 13.9 C84.170 4. Burkitt's tumour HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4. Malignant reticuloendotheliosis. Other and unspecified T-cell lymphomas HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.2 C83.730 9.0 C90.7 C83.730 9. Hodgkin's MALIGNANT NEOPLASMS OF LYMPHOID.170 4. unspecified HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4. unspecified type. Lymphosarcoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9.170 4.2 C91.170 Health Care Institution Fee 9. Malignant plasma cell tumour NOS. HEMATOPOIETIC AND RELATED TISSUE Page 55 of 111 .170 4.730 9.170 4.730 9.730 9.170 4. Lymphoma MALIGNANT NEOPLASMS OF LYMPHOID.900 13.730 9.900 13.730 9.170 4.170 4. Lymphoblastic diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9.730 9.900 13.1 C84.730 9. follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4.9 C82. Mixed small and large cell diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.4 C91.900 13.0 C92.170 4. unspecified HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.9 C83.730 9.730 9. cell.3 C83.900 13. Chloroma.170 4.730 9. Immunoblastic diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 C81.5 C91.900 13. Hodgkin's disease( Nodular sclerosis) HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.730 9.900 13.900 13.170 4. unspecified HEMATOPOIETIC AND RELATED TISSUE Other specified types of non-Hodgkin's lymphoma. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. Small cell diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4. MALIGNANT NEOPLASMS OF LYMPHOID.7 C82.900 13. B-cell lymphoma.900 13.170 4.ANNEX 1.2 C91.730 9.170 4.4 C83.900 13.170 4.900 13.170 4.730 9.170 4.730 9. HEMATOPOIETIC AND RELATED TISSUE Microglioma Non-Hodgkin's lymphoma.900 13.730 9.7 C85.900 13.4 C84.170 4. follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.9 C92.170 4. Diffuse non-Hodgkin's lymphoma.170 4.900 13.900 13. Leukaemic reticuloendotheliosis Adult T-cell leukaemia Other lymphoid leukaemia Lymphoid leukaemia. unspecified.730 9.900 13.730 9.1 C91.1 C92.170 4. Lymphoepithelioid lymphoma. Nodular MALIGNANT NEOPLASMS OF LYMPHOID.900 13.900 13. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate 13. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. disease (Lymphocytic-histiocytic predominance) HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.9 C90.900 13. follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE Mixed small cleaved non-Hodgkin's lymphoma and large MALIGNANT NEOPLASMS OF LYMPHOID.900 13.730 9. Mycosis fungoides HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.5 C85.730 9.730 9. Hodgkin's disease. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.1 C85.730 9.170 4.170 4.730 9.900 13. Small cleaved cell.170 4.170 4. Malignant reticulosis.900 Professional Fee 4. Peripheral T-cell lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.1 C90.170 4.170 4.730 9.900 13.0 C83. Kahler's disease.900 13.900 13. NOS HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9. Large cell.2 C82. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.170 4.170 4.1 C82.900 13.1 C81.4 Hodgkin's disease (Lymphocytic predominance).0 C85.900 13. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.900 13.0 C84.730 9. Sézary's disease HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4.3 C91. Plasma cell leukaemia HEMATOPOIETIC AND RELATED TISSUE Extramedullary Plasmacytoma.170 4.7 C91.2 C92.3 C92.5 C83. Lennert's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9.730 9.170 4. non-Hodgkin's lymphoma NOS HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4.730 9.0 C81.900 13.3 C84.900 13.900 13.170 4. Plasmacytoma NOS . Other types of diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. Multiple myeloma.8 C83. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4. Granulocytic sarcoma Acute promyelocytic leukaemia MALIGNANT NEOPLASMS OF LYMPHOID.900 13. unspecified Acute myeloid leukaemia Chronic myeloid leukaemia Subacute myeloid leukaemia Myeloid sarcoma.730 9. Other types of follicular non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE Follicular non-Hodgkin's lymphoma. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. Myelomatosis HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. Large cell diffuse non-Hodgkin's lymphoma HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.0 C82. Solitary myeloma Chronic lymphocytic leukaemia Subacute lymphocytic leukaemia Prolymphocytic leukaemia Hairy-cell leukaemia.730 9.730 9.730 9.730 9.170 4.900 13. 600 16. Acute erythraemic myelosis.420 7.2 C63.9 C48.170 4. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.9 C61 C62.900 13. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. haematopoietic and related tissue Malignant neoplasm of lymphoid.170 4.020 4.380 9. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9.170 4.170 4.730 9.2 C96. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.5 C76.7 C45.8 DESCRIPTION Acute myelomonocytic leukaemia Other myeloid leukaemia Myeloid leukaemia. unspecified Acute monocytic leukaemia Chronic monocytic leukaemia Monocytic leukaemia.900 13.3 MALIGNANT NEOPLASMS OF OTHER SITES 16. Male genitourinary tract NOS Mesothelioma of pericardium Mesothelioma of other sites Mesothelioma.020 4.900 13.730 9.7 C92.0 C76. Malignant neoplasm of Groin NOS.900 13. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.3 C76.830 4.170 4. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.100 4. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.170 4. Malignant neoplasm of Tunica vaginalis Malignant neoplasm of Male genital organ.900 13.0 C94.0 C63.170 4.100 16.400 13.100 16.100 Professional Fee 4. unspecified Letterer-Siwe disease.ANNEX 1.100 16.020 4.730 9.020 4. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.100 16.730 9.270 11. unspecified Acute erythraemia and erythroleukaemia. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.830 4.380 9.730 9.170 4.900 13.170 4.900 13.5 C95.100 4. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. Mast cell sarcoma Other specified malignant neoplasms of lymphoid.420 7. unspecified Malignant neoplasm of Penis.730 9.600 10.900 13. unspecified Malignant neoplasm of Retroperitoneum Malignant neoplasm of Pelvis.170 4.380 9.400 13.020 4.420 11.830 11.180 3. Histiocytic medullary reticulosis Malignant mast cell tumour. unspecified Secondary malignant neoplasm of adrenal gland Secondary malignant neoplasm of other specified sites GROUP MALIGNANT NEOPLASMS OF LYMPHOID.900 13. Nonlipid reticuloendotheliosis. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.830 4.900 13. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MALE GENITAL TRACT MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF MESOTHELIUM MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES Case Rate 13.730 9.100 16.7 C76. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.900 13.170 4.900 13.4 C94. Acute megakaryocytic Leukaemia Acute panmyelosis Acute myelofibrosis Acute leukaemia of unspecified cell type.900 13.400 13.020 3. Di Guglielmo's disease Acute megakaryoblastic leukaemia. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. Nonlipid reticulosis Malignant histiocytosis.730 9.0 C96.270 11.830 11.020 4.400 13.830 4. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.730 9.9 C60. Malignant mastocytosis.9 C79. Malignant neoplasm of Sites overlapping systems within the pelvis.400 13.730 9.380 7. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.1 C93.400 10.180 3.0 C62.180 4. Malignant neoplasm of Skin of penis NOS Malignant neoplasm of prostate Malignant neoplasm of Undescended testis. Ectopic testis .1 C62. such as rectovaginal (septum) & rectovesical (septum) Malignant neoplasm of Upper limb Malignant neoplasm of Lower limb Malignant neoplasm of Other ill-defined sites Malignant neoplasm of Overlapping lesion of other and illdefined sites Secondary and unspecified malignant neoplasm of Axillary and upper limb lymph nodes.9 C45.900 13. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID. haematopoietic and related tissue.380 9.7 C95. Malignant neoplasm of Skin of scrotum Malignant neoplasm of Seminal vesicle.5 C92.900 13.730 9.1 C95.830 Health Care Institution Fee 9.730 9.7 C96.380 9.7 C63. Blast cell leukaemia.600 10. HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.9 C93. Secondary and unspecified malignant neoplasm of Pectoral lymph nodes Secondary and unspecified malignant neoplasm of Lymph node.900 13.2 C95.170 4.2 C94.730 9.170 4.420 7.0 C93.730 9.270 11.020 4.380 9.2 C45.270 Page 56 of 111 . HEMATOPOIETIC AND RELATED TISSUE MALIGNANT NEOPLASMS OF LYMPHOID.380 9.170 4.1 C63.020 4.170 4.270 11. Stem cell leukaemia Chronic leukaemia of unspecified cell type Subacute leukaemia of unspecified cell type Other leukaemia of unspecified cell type Leukaemia.900 13.4 C76.400 13.8 MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES MALIGNANT NEOPLASMS OF OTHER SITES 16.380 9.170 4.170 4.9 C94.7 C79.830 4.400 13. unspecified.730 9.900 13.020 4.380 9.270 11.730 9.600 10.9 C63.730 9.170 4. Malignant neoplasm of Retained testis Malignant neoplasm of Descended testis.270 C77.730 9.270 C77.730 9. Malignant mastocytoma.830 4.400 13. unspecified.180 3. unspecified Malignant neoplasm of Epididymis Malignant neoplasm of Spermatic cord Malignant neoplasm of Scrotum. Malignant neoplasm of Scrotal Testis Malignant neoplasm of Testis.100 16.900 13.0 C95.170 4.170 4.400 13. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C92.1 C96.9 C96.270 11. 220 C32.3 C38.1 14. Respiratory tract NOS INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Mesothelioma of pleura INTRATHORACIC ORGANS Malignant neoplasm of Thorax. Malignant neoplasm of False vocal cord.220 Malignant neoplasm of Glottis. unspecified MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES MALIGNANT NEOPLASMS OF PERIPHERAL NERVES 13.220 10.300 13.310 9.0 C39. laryngeal aspect.220 10.380 9.600 14.2 C47.310 9. Malignant neoplasm of Intrathoracic NOS.1 C77.600 14.220 10.220 7.0 C38.380 4.220 10.300 13.220 10.9 C37 C38.5 C47.8 C39.380 4.8 C34.300 13.2 C32.220 10.220 MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Middle lobe. Multiple cancer].600 14. Malignant neoplasm INTRATHORACIC ORGANS of Extrinsic larynx.380 4.300 14.600 14.300 13.9 C33 C34.220 10. Malignant neoplasm of Carina.380 4. unspecified Malignant neoplasm of Peripheral nerves and autonomic nervous system.6 C47. Malignant neoplasm MALIGNANT NEOPLASMS OF RESPIRATORY AND of Epiglottis (suprahyoid portion) NOS.380 4.3 C32.600 14.380 4.600 4.3 C34. Malignancy.380 4. MALIGNANT NEOPLASMS OF PERIPHERAL NERVES including shoulder Malignant neoplasm of Peripheral nerves of lower limb. Malignant neoplasm Malignant neoplasm of Subglottis Malignant neoplasm of Laryngeal cartilage Malignant neoplasm of Larynx. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Malignant neoplasm without specification of site.220 10.600 10.220 10.180 4.9 C45.220 10.4 C38.310 10.8 C39. MALIGNANT NEOPLASMS OF PERIPHERAL NERVES including hip Malignant neoplasm of Peripheral nerves of thorax Malignant neoplasm of Peripheral nerves of abdomen Malignant neoplasm of Peripheral nerves of pelvis Malignant neoplasm of Peripheral nerves of trunk.990 3.600 14.300 13. Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Axilla NOS. Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Pericardium INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Anterior mediastinum INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Mediastinum.600 14.310 9. Generalized malignancy. face and MALIGNANT NEOPLASMS OF PERIPHERAL NERVES neck Malignant neoplasm of Peripheral nerves of upper limb.600 14.600 3.0 C34. Malignant neoplasm of true Vocal cord NOS INTRATHORACIC ORGANS Malignant neoplasm of Supraglottis: Malignant neoplasm of Aryepiglottic fold.380 4.600 14.220 10.380 4. part MALIGNANT NEOPLASMS OF RESPIRATORY AND unspecified INTRATHORACIC ORGANS Malignant neoplasm of Overlapping lesion of respiratory MALIGNANT NEOPLASMS OF RESPIRATORY AND and intrathoracic organs INTRATHORACIC ORGANS Malignant neoplasm of Ill-defined sites within the MALIGNANT NEOPLASMS OF RESPIRATORY AND respiratory system.310 9.220 10.600 14.310 9.830 11.380 4. Generalized cancer.310 9.1 C38.380 3. Malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Intrinsic larynx.600 14.ANNEX 1. Malignant neoplasm of Primary GROUP Case Rate Professional Fee Health Care Institution Fee C80 MALIGNANT NEOPLASMS OF OTHER SITES 16.600 4.380 4.380 4.220 10.600 14.600 14. part unspecified INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Pleura INTRATHORACIC ORGANS Malignant neoplasm of Overlapping lesion of heart. unspecified Malignant neoplasm of trachea Malignant neoplasm of Main bronchus.220 10.2 14.3 C47.600 14.1 C78.300 13.380 4.1 C47.600 14.990 3.600 14. Malignant cachexia.990 3.0 C47.220 10.380 4.990 3.600 14. Unspecified site whether primary or secondary [Cancer.380 4.600 14.0 C76. Carcinomatosis. INTRATHORACIC ORGANS Malignant neoplasm of Thoracic NOS Secondary and unspecified malignant neoplasm of MALIGNANT NEOPLASMS OF RESPIRATORY AND Intrathoracic lymph nodes INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Secondary malignant neoplasm of lung INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Secondary malignant neoplasm of mediastinum INTRATHORACIC ORGANS Secondary malignant neoplasm of pleura.220 10.990 3. Carcinoma. Malignant pleural MALIGNANT NEOPLASMS OF RESPIRATORY AND effusion NOS INTRATHORACIC ORGANS Page 57 of 111 .600 14. bronchus or lung INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Lower lobe.1 C78.220 10.380 4.220 10.420 10.300 13.380 4.380 4.4 C47.9 C32. unspecified INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of thymus INTRATHORACIC ORGANS Malignant neoplasm of Heart.990 3.100 4.380 10.380 10.380 4.600 14.310 9.380 4.220 10.990 4.990 3.0 Malignant neoplasm of Peripheral nerves of head.0 C78. bronchus or lung INTRATHORACIC ORGANS Malignant neoplasm of Overlapping lesion of bronchus and MALIGNANT NEOPLASMS OF RESPIRATORY AND lung INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND Malignant neoplasm of Bronchus or lung. bronchus or lung MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS C32.380 4. MALIGNANT NEOPLASMS OF RESPIRATORY AND mediastinum and pleura INTRATHORACIC ORGANS Malignant neoplasm of Upper respiratory tract.600 14.380 4.220 10.600 14.600 14.2 C34.1 C34.270 C47.220 10. Malignant neoplasm of Hilus of lung Malignant neoplasm of Upper lobe.220 10. 420 3.000 3.420 3.040 2. Malignant neoplasm of Connective and soft tissue of Abdominal wall.050 8.510 3. Physical retardation due to malnutrition Unspecified protein-energy malnutrition.400 8.420 3.2 C31.510 3.510 3.500 11.700 11.0 C46.400 C49.700 11.980 7.190 8. Malignant neoplasm of Connective and soft tissue of Groin.800 6.190 8.000 12.500 11.2 11. unspecified GROUP MALIGNANT NEOPLASMS OF RESPIRATORY AND INTRATHORACIC ORGANS MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SINUSES MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES Case Rate 14.760 4.5 C75.000 12. Malignant neoplasm of Antrum (Highmore).980 7.510 3.000 12. Malignant neoplasm of Connective and soft tissue of Back NOS Malignant neoplasm of Overlapping lesion of connective and soft tissue Malignant neoplasm of Connective and soft tissue.1 O10.3 MALIGNANT NEOPLASMS OF SOFT TISSUES 12. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE C78.760 Page 58 of 111 .050 8.400 8.1 C75.400 11. Malignant neoplasm of Connective and soft tissue of Diaphragm.220 8.700 6.190 8.400 C49.050 8.600 3.500 11.1 C49.9 B21. Severe protein-energy malnutrition.050 8. Nutritional stunting.420 3. Malignant neoplasm of Connective and soft tissue of Axilla. Severe protein-energy MALNUTRITION malnutrition with signs of both kwashiorkor and marasmus Unspecified severe protein-energy malnutrition Moderate protein-energy malnutrition Mild protein-energy malnutrition Retarded development following protein-energy malnutrition.8 C49.600 8.450 3. Malignant neoplasm of Connective and soft tissue of Perineum Malignant neoplasm of Connective and soft tissue of trunk.9 C49.700 11.0 DESCRIPTION Secondary malignant neoplasm of other and unspecified respiratory organs Malignant neoplasm of Maxillary sinus.000 11.510 3.190 Nutritional marasmus.040 2. unspecified Malignant neoplasm of Parathyroid gland Malignant neoplasm of Pituitary gland Malignant neoplasm of Pineal gland Malignant neoplasm of Aortic body and other paraganglia Malignant neoplasm of Endocrine gland.0 E44. unspecified Kwashiorkor MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES C49.420 3. including hip Malignant neoplasm of Connective and soft tissue of thorax.400 Malignant neoplasm of Connective and soft tissue of head.600 3. Malignant neoplasm of Connective and soft tissue of Buttock.000 12.400 11.2 12.3 C31.190 8.800 6.400 11.1 C74.400 11. Malignant neoplasm of Connective and soft tissue of Hypochondrium Malignant neoplasm of Connective and soft tissue of pelvis. unspecified Malignant neoplasm of thyroid gland Malignant neoplasm of Cortex of adrenal gland Malignant neoplasm of Medulla of adrenal gland Malignant neoplasm of Adrenal gland.450 3.400 11.500 11.600 3.050 8.420 3. unspecified.800 3.9 C73 C74.700 11.8 C31.700 11.980 7.400 8.420 3.0 C31. intermediate form.4 MALIGNANT NEOPLASMS OF SOFT TISSUES 12.980 8.040 8.980 7.600 3.400 7.3 C31.510 3. Malignant neoplasm of Connective tissue of eyelid Malignant neoplasm of Connective and soft tissue of upper limb.400 11.510 8.6 C49.600 3.5 MALIGNANT NEOPLASMS OF SOFT TISSUES 12.0 C75.600 8.400 8.050 8.3 C75.510 2. childbirth and the puerperium Pre-existing hypertensive renal disease complicating pregnancy childbirth and the puerperium MALNUTRITION MALNUTRITION MALNUTRITION MALNUTRITION MALNUTRITION MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS E42 E43 E44.420 3.9 C75.000 Professional Fee 4.980 7. unspecified HUMAN IMMUNODEFICIENCY VIRUS [HIV] DISEASE RESULTING IN KAPOSI'S SARCOMA Kaposi's sarcoma.450 3.500 11.600 11.420 3.600 Health Care Institution Fee 10. Malnutrition NOS.400 11. face and neck.190 8.000 12. Severe malnutrition with marasmus MALNUTRITION Marasmic kwashiorkor.190 8.000 3.980 7.000 3. Nutritional short stature.190 4.000 3.400 11.1 E45 E46 O10.760 4. Malignant neoplasm of Antrum (maxillary) Malignant neoplasm of Ethmoidal sinus Malignant neoplasm of Frontal sinus Malignant neoplasm of Sphenoidal sinus Malignant neoplasm of Overlapping lesion of accessory sinuses Malignant neoplasm of Accessory sinus.0 O10.600 8.600 8.980 7.450 3.400 C49.380 3.1 C31.0 C74.400 11.600 3.450 3.9 E40 E41 MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF SOFT TISSUES MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALIGNANT NEOPLASMS OF THYROID AND OTHER ENDOCRINE GLANDS MALNUTRITION 12.700 3. Protein-energy imbalance NOS Pre-existing essential hypertension complicating pregnancy child birth and the puerperium Pre-existing hypertensive heart disease complicating pregnancy.980 7. including shoulder Malignant neoplasm of Connective and soft tissue of lower limb.ANNEX 1.700 11.500 12.450 3. Malignant neoplasm of Connective tissue of MALIGNANT NEOPLASMS OF SOFT TISSUES ear.400 C49. Malignant neoplasm of Connective and soft tissue of Great vessels Malignant neoplasm of Connective and soft tissue of abdomen.400 8. complicating pregnancy Vomiting of pregnancy. Cerebrovenous sinus thrombosis in pregnancy Venous complication in pregnancy.040 2.760 4.800 6.3 O10.800 6. childbirth and the puerperium Pre-existing hypertensive disorder with superimposed proteinuria Gestational proteinuria Gestational oedema with proteinuria Gestational [pregnancy-induced] hypertension wihtout significant proteinuria.760 O10.800 2.800 6.800 6.9 O11 O12. childbirth and the puerperium Unspecified pre-existing hypertension complicating pregnancy.760 Other abnormal findings on antenatal screening of mother MATERNAL COMORBIDITIES CONDITIONS Abnormal finding on antenatal screening of mother.760 4.760 4.760 4.3 O26.760 4.0 O15.040 2.040 2.040 4.040 2. Vomiting due to disease classified elsewhere. Peripheral neuritis pregnancy-related.760 4.760 4.9 O28. unspecified Pregnancy care of habitual aborter Retained in trauterine contraceptive device in pregnancy Herpes gestationis Maternal hypotension syndrome.800 6. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Pre-existing hypertensive heart and renal disease complicating pregnancy.2 O24.760 4.800 6.800 6.800 6.1 O12.760 4.9 O26. Haemorrhage specified as due to threatened abortion Other haemorrhage in early pregnancy Haemorrhage in early pregnancy.800 6.800 6.800 6.040 2.800 6.040 2.800 6.800 6.760 4.040 2. Mild pre-eclampsia Moderate pre-eclampsia Severe pre-eclampsia Pre-eclampsia.760 4.800 6.8 O26.0 O24.760 4. antepartum Cerebral venous thrombosis in pregnancy.040 4.040 2.800 6.2 O21.800 6.1 O15.040 2.040 2.0 O20.800 6.1 O24. mild or unspecified.9 O16 O20. Excessive vomiting starting after 22 completed weeks of gestation Other vomiting complicating pregnancy.760 4.760 4.800 2. childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS Subluxation of symphysis (pubis) in pregnancy childbirth and the puerperium Other specified pregnancy-related conditions.800 6.040 2.5 O22. unspecified Mild hyperemesis gravidarum.760 4.760 4.800 6.2 O13 O14.3 O24.040 2.040 2.040 2. insulin-dependent Pre-existing diabetes mellitus.040 2. Hyperemesis gravidarum.800 6.040 2. non-insulin-dependent Pre-existing malnutrition-related diabetes mellitus Pre-existing diabetes mellitus.800 6.040 2.ANNEX 1.760 Liver disorders in pregnancy.760 4.0 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS O21. unspecified Eclampsia in pregnancy Eclampsia in labour Eclampsia.800 6.3 O28.760 4.4 O10.760 4.760 4.8 O21.040 2.040 2.040 2. childbirth and the puerperium Pre-existing secondary hypertension complicating pregnancy.800 6.040 2.760 4.760 4.040 2.760 4.760 4. Gestational thrombosis NOS Infections of kidney in pregnancy Infections of other parts of urinary tract in pregnancy Pre-existing diabetes mellitus.800 6.040 2. Eclampsia NOS Unspecified maternal hypertension Threatened abortion.040 2.760 O21.8 O30.800 6.4 O24.2 O26.800 6.040 2.1 Hyperemesis gravidarum with metabolic disturbance.800 6.800 6.040 2.800 6. Supine hypotensive syndrome MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6. unspecified Other complications of anaesthesia during pregnancy Twin pregnancy Triplet pregnancy MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS Page 59 of 111 .760 4.5 O28.8 O28. with metabolic disturbance such as carbohydrate depletion.040 2.800 6. unspecified.800 6.040 2.040 2.800 2. Gestational diabetes mellitus NOS Diabetes mellitus in pregnancy.040 2.9 O21. unspecified as to time period.760 4. Renal disease pregnancy-related Pregnancy-relatedcondition.800 Professional Fee 2. starting before the end of the MATERNAL COMORBIDITIES CONDITIONS 22nd week of gestation.040 2.800 6.040 2.3 O22.9 O22. Exhaustion and fatigue pregnancy-related.760 4.760 4.040 2. Deep-vein thrombosis.800 6.800 6.760 4. Gestational phlebitis NOS. Gestational hypertension NOS.9 O23.9 O29.800 6.800 6.0 O30.9 O15. Hyperemesis gravidarum.040 2.760 4.6 O26.760 4.040 2.760 4.040 2.0 O14.800 6.040 2.760 4. starting before the end of the 22nd week of gestation GROUP Case Rate 6.800 6. elctrolyte imbalance Late vomiting of pregnancy.040 2.760 4.800 6. Gestational phlebopathy NOS. unspecified Deep phlebothrombosis in pregnancy.040 2.800 6.4 O26.760 4.040 2.760 4.040 2.760 4.3 O24. dehydration.760 4.8 O20.040 2.800 6.1 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.760 4.800 6.0 O23.5 O26.760 4.7 6.800 6.040 2.1 O14.040 2.040 4.760 4.800 6.760 4. unspecified Diabetes mellitus arising in pregnancy.040 2.760 4.040 Health Care Institution Fee 4.760 4. unspecified Abnormal haematological finding on antenatal screening of mother Abnormal ultrasonic finding on antenatal screening of mother Abnormal chromosomal and genetic finding on antenatal screening of mother MATERNAL COMORBIDITIES CONDITIONS O26.760 4.0 O28. 760 4.800 6.760 O33.760 O33.800 6.6 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.0 6.040 2.800 2.040 4.760 O34.800 6.760 4.760 O34.3 Maternal care due to uterine scar from previous surgery.760 4. Maternal care for polyp of cervix.8 O32.ANNEX 1. Maternal care for rigid perineum.040 2. Fetal ascites causing disproportion. Transverse presentation Maternal care for face.800 2.760 4. Maternal care for Uterus bicornis Maternal care for tumour of corpus uteri.800 6.800 6. Pelvic deformity causing disproportion NOS Maternal care for disproportion due to generally contracted pelvis. Maternal MATERNAL COMORBIDITIES CONDITIONS care for prolapse of gravid uterus. unspecified.760 O33.800 2. Fetal hydrops causing disproportion.7 MATERNAL COMORBIDITIES CONDITIONS 6. MATERNAL COMORBIDITIES CONDITIONS Maternal care for Shirodkar suture with or without mention of cervical incompetence Maternal care for other abnormalities of cervix.760 O34.040 2.040 2.760 4.040 2.040 4.9 O31. Fetal meaningomyelocele causing disproportion. Maternal care for acquired stenosis of vagina.760 O34.800 2. Fetus compressus Continuing pregnancy after abortion of one fetus or more Continuing pregnancy after intrauterine death of one fetus or more Other complications specific to multiple gestation Maternal care for unstable lie Maternal care for breech presentation Maternal care for transverse and oblique lie.760 O33. Maternal care for incarceratiion of gravid uterus.5 O32. Failure of head to enter pelvic brim Maternal care for multiple gestation with malpresentation of one fetus or more Maternal care for compound presentation Maternal care for other malpresentation of fetus Maternal care for malpresentation of fetus. brow and chin presentation Maternal care for high head at term.0 O32. Maternal care for uterine fibroid MATERNAL COMORBIDITIES CONDITIONS 6. Fetopelvic disproportion NOS Maternal care for congenital malformation of uterus.800 6.040 4.5 6. MATERNAL COMORBIDITIES CONDITIONS Maternal care for scar from previous Maternal care for cervical incompetence.040 2. unspecified Maternal care for disproportion due to deformity of maternal pelvic bones.040 4.760 Page 60 of 111 .0 O31. Maternal care for previous surgery MATERNAL COMORBIDITIES CONDITIONS to cervix.8 O32. Maternal care for cerclage with or without mention of cervical incompetence. Oblique presentation.760 4.040 4. Maternal care for fibrosis of perineum.040 2.040 Health Care Institution Fee 4.6 O32.8 O30. Maternal care for tumour of vulva 6.2 O32.9 O33.760 O34.760 4.040 2.760 4. unspecified.800 6. Fetal tumour causing disproportion O33. Maternal care for congenital stenosis of vagina.800 2. Outlet contraction pelvis causing disproportion Maternal care for disproportion of mixed maternal and fetal origin Maternal care for disproportion due to unusually large fetus.800 2. Multiple pregnancy NOS Papyraceous fetus. Contracted pelvis NOS causing disproportion GROUP MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS Case Rate 6.040 4.760 O33.800 2.800 6.040 2.3 MATERNAL COMORBIDITIES CONDITIONS 6.800 2. Maternal care for previous surgery to vagina.800 6.800 6. Cephalopelvic MATERNAL COMORBIDITIES CONDITIONS disproportion NOS.760 4.800 2. Conjoined twins.800 6.040 2.800 6.800 Professional Fee 2.9 Maternal care for disproportion.4 O32.7 6.800 2.760 O34. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE O30.2 Maternal care for disproportion due to inlet contraction of MATERNAL COMORBIDITIES CONDITIONS pelvis.040 2.760 4.040 4.1 O31.040 2.5 O33.4 6.0 DESCRIPTION Other multiple gestation Multiple gestation. Maternal for polyp of corpus uteri.760 4.040 2. Maternal care for tumour of cervix Maternal care for other abnormalities of gravid uterus.760 4.6 6.760 4.760 O34.760 4.800 6.800 6.760 Maternal care for disproportion due to hydrocephalic fetus MATERNAL COMORBIDITIES CONDITIONS Maternal care for disproportion due to other fetal deformities.800 6.800 2. Maternal care for septate MATERNAL COMORBIDITIES CONDITIONS vagina.800 6. Maternal care for retroversion of gravid uterus Maternal care for abnormality of vagina.800 6.760 4.760 4.040 4.040 2. Fetal disproportion NOS 6.1 O34. Maternal care for tumour of vagina Maternal care for abnormality of vulva and perineum. Mid-cavity contraction pelvis causing disproportion.800 6. Maternal care for MATERNAL COMORBIDITIES CONDITIONS previous surgery to perineum or vulva.1 O32.040 4.3 O32.800 2.040 4.040 4.040 2.040 4.800 2.1 MATERNAL COMORBIDITIES CONDITIONS 6.040 4.040 2. Inlet contraction (pelvis) causing disproportion Maternal care for disproportion due to outlet contraction of pelvis.760 4.2 MATERNAL COMORBIDITIES CONDITIONS 6. Maternal care for double uterus. Maternal care for stricture or stenosis of cervix.2 O31.760 4.040 2.040 2. Disproportion of fetal origin with normally formed fetus.4 O33. Maternal care for rigid pelvic floor Maternal care for abnormality of pelvic organ. Placental infarction Placental disorder.040 4.800 6.9 O40 O41.760 4.800 6.760 O36.800 6.1 MATERNAL COMORBIDITIES CONDITIONS 6.760 4.760 4.760 O35.0 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.040 2.800 6.040 4. Maternal care for suspected fetal spina bifida Maternal care for (suspected) hereditary disease in fetus MATERNAL COMORBIDITIES CONDITIONS 6.040 2.5 6.760 4. Circumvallate placenta Other placental disorders.760 4.040 2.040 4.800 2.1 O43.800 6.800 6. Maternal care for suspected damage to fetus from MATERNAL COMORBIDITIES CONDITIONS maternal listeriosis.800 6.760 4.9 O42.040 2. Isoimmunization NOS (with hydrops fetalis) Maternal care for hydrops fetalis.8 O43. partial NOS or with haemorrhage. unspecified.800 6.760 4.760 Other specified disorders of amniotic fluid and membranes MATERNAL COMORBIDITIES CONDITIONS Disorder of amniotic fluid and membranes.8 MATERNAL COMORBIDITIES CONDITIONS 6. Maternal care for known or suspected small-for-dates Maternal care for excessive fetal growth.040 4. unspecified GROUP Case Rate Professional Fee Health Care Institution Fee O34. Low implantation of placenta.760 O35. Maternal care for known or suspected placental insufficiency.9 MATERNAL COMORBIDITIES CONDITIONS 6.760 4.800 6. Maternal care for cystocele. marginal NOS or with haemorrhage. Anti-D [Rh] antibodies. Maternal care for suspected damage to MATERNAL COMORBIDITIES CONDITIONS fetus from maternal cytomegalovirus infection. Maternal care for pendulous abdomen. Abnormal placenta NOS.3 O36.760 Page 61 of 111 .760 O36.800 2. Low implantation of placenta.0 O43.4 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.800 2.8 O41.760 O35.1 O42.0 6.760 4.800 2. Placenta praevia.800 2.800 2.040 2. total NOS or with haemorrhage MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS O44.800 6. Chorioamnionitis.8 O36.040 4. Membranitis.800 6.760 O34.1 MATERNAL COMORBIDITIES CONDITIONS 6.800 6. unspecified Maternal care for rhesus isoimmunization. Hydrops fetalis NOS.760 4. Hydrops fetalis not associated with isoimmunization Maternal care for signs of fetal hypoxia Maternal care for intrauterine death Maternal care for poor fetal growth.0 O42.760 O35.040 2.6 O36.800 2. NOS or with haemorrhage. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Maternal care for other abnormalities of pelvic organs.760 4.ANNEX 1.800 6.040 2.800 6.760 4. NOS or with haemorrhage Placenta praevia with haemorrhage.1 O41. labour delayed by therapy Premature rupture of membranes.0 Maternal care for (suspected) central nervous system malformation in fetus. Maternal care for suspected damage to fetus from drug addiction MATERNAL COMORBIDITIES CONDITIONS 6.760 O35. Maternal care for suspected fetal MATERNAL COMORBIDITIES CONDITIONS anencephaly. Oligohydramnios without mention of rupture of membrane Infection of amniotic sac and membranes. Placenta praevia. unspecified Placenta praevia specified as without haemorrhage.040 4.760 4.760 4. Maternal care for rectocele.800 6.040 2.760 O35. unspecified POLYHYDRAMNIOS.2 O36.9 O44.760 4.800 2.040 4.9 O36.800 6.760 O36.040 2.5 MATERNAL COMORBIDITIES CONDITIONS 6. Twin-to-twin transfusion Malformation of placenta. Placental dysfunction.040 2.800 2.800 2.040 2.040 4. Maternal care for suspected damage to fetus from maternal rubella Maternal care for (suspected) damage to fetus by drugs. Placenta praevia.9 O43. ABO isoimmunization.040 2. Fetomaternal transfusion.760 4. Maternal care for known or suspected light-for-dates.0 O41.2 6.760 4.8 Maternal care for other (suspected) fetal abnormality and damage. Placentitis MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6. Premature rupture of membranes Premature rupture of membranes on set of labour within 24 hours Premature rupture of membranes on set of labour after 24 hours Premature rupture of membranes.040 2. unspecified MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS Placental transfusion syndromes.760 O36.040 4.040 4.2 O42.040 4.040 4.800 6.040 2.040 4.040 2.800 2. Rh incompatibility (with hydrops fetalis) Maternal care for other isoimmunization.800 2.800 6.040 2. MATERNAL COMORBIDITIES CONDITIONS Maternofetal transfusion. Maternal care for suspected damage to fetus from maternal toxoplasmosis Maternal care for (suspected) fetal abnormality and damage. HYDRAMNIOS Oligohydramnios.760 4. Maternal care for known or suspected large-for-dates Maternal care for other specified fetal problems Maternal care for fetal problem.800 2.040 2. Amnionitis.800 6.3 Maternal care for (suspected) damage to fetus from viral disease in mother.040 2. Maternal care for previous pelvic floor repair.040 2.760 4. 040 4. childbirth and the puerperium Viral hepatitis complicating pregnancy.8 O46.7 O99.040 2.8 A87. childbirth and the puerperium Other maternal infectious and parasitic diseases complicating pregnancy.2 6.760 4.760 4.760 O99.800 6.6 O99.800 2. childbirth and the puerperium Endocrine.760 4.040 2.040 4.040 2.760 4. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee O45.760 4.700 25.800 6.760 4.040 2.760 4.760 4.760 4.040 2.4 O99. childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.760 O99.040 4.800 6.040 2.760 4.760 4.800 6.800 6.800 6.040 2.040 4.8 O45.760 4.760 O45.0 O98. childbirth and the puerperium Gonorrhoeacomplicatingpregnancychildbirthandthepuerpe rium Other infections with apredominantly sexual mode of transmission complicating pregnancy. MATERNAL COMORBIDITIES CONDITIONS childbirth and the puerperium Diseases of the respiratory system complicating pregnancy. childbirth and the puerperium Syphilis complicating pregnancy.760 4.3 O98.800 6.800 6.800 6.800 6.040 2.6 Z35.760 4.040 2.800 2.800 6.760 4. childbirth and the puerperium Unspecified maternal infectious or parasitic disease complicating pregnancy.760 4.040 7. Antepartum haemorrhage (excessive) associated w Other antepartum haemorrhage Antepartum haemorrhage.8 O60.040 2.1 O47.040 2.2 O98.760 O46.040 2.760 17.760 4.800 6. childbirth and the puerperium Other viral diseases complicating pregnancy. Antepartum haemorrhage (excessive) associated with afibrinogenaemia.800 6.800 6.760 4.760 4.2 Z35.800 2. childbirth and the puerperium Mental disorders and diseases of the nervous system complicating pregnancy.040 2.040 2.ANNEX 1. childbirth and the puerperium Preterm labor.760 O98.040 2.5 Z35.800 6.040 2.5 O98. Post-term Tuberculosis complicating pregnancy. not resulting to delivery Supervision of normal first pregnancy Supervision of other normal pregnancy Supervision of normal pregnancy.700 2.800 6.040 2. childbirth and the puerperium Protozoal diseases complicating pregnancy.760 4.800 6.040 2.5 O99.800 6. unspecified Other viral meningitis Viral meningitis. Abruptio placentae with (excessive) haemorrhage associated with afibrinogenaemia.800 6. MATERNAL COMORBIDITIES CONDITIONS childbirth and the puerperium Diseases of the digestive system complicating pregnancy.1 Z35.760 4.760 4.040 2.800 2.800 6.9 6.9 A87.1 Other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism MATERNAL COMORBIDITIES CONDITIONS complicating pregnancy.040 2.760 4.760 4.800 6.800 6.040 2.8 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.040 2. unspecified Prolonged pregnancy. MATERNAL COMORBIDITIES CONDITIONS childbirth and the puerperium Diseases of the skin and subcutaneous tissue complicating pregnancy.040 2.7 Z35.800 2.760 4.800 2.800 6.0 MATERNAL COMORBIDITIES CONDITIONS 6. unspecified Supervision of pregnancy with history of infertility MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS Supervision of pregnancy with history of abortive outcome MATERNAL COMORBIDITIES CONDITIONS Supervision of pregnancy with other poor reproductive or obstetric history Supervision of pregnancy with grand multiparity Supervision of elderly primigravida Supervision of very young primigravida Supervision of high-risk pregnancy due to social problems Supervision of other high-risk pregnancies Supervision of high-risk pregnancy.3 O99.800 6. unspecified MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS MENINGITIS MENINGITIS Page 62 of 111 .800 6.040 4. childbirth and the puerperium Anaemia complicating pregnancy. Abruptio Other premature separation of placenta Premature separation of placenta. unspecified False labour before 37 completed weeks of gestation False labour at or after 37 completed weeks of gestation False labour.760 4.8 Z34.800 6.4 Z35.040 2.0 Z34.760 4. Abruptio placentae with MATERNAL COMORBIDITIES CONDITIONS (excessive) haemorrhage associated with disseminated intravascular coagulation.760 4.8 Z35.800 6. childbirth and the puerperium MATERNAL COMORBIDITIES CONDITIONS 6.0 Z34.710 7.0 MATERNAL COMORBIDITIES CONDITIONS MATERNAL COMORBIDITIES CONDITIONS 6.040 2.040 2. unspecified.760 4.040 2.9 Z35.0 O47. nutritional and metabolic diseases complicating MATERNAL COMORBIDITIES CONDITIONS pregnancy.040 2.040 4.760 4. Antepartum haemorrhage (excessive) associated with disseminated intravascular coagulation.040 2.4 O98.6 O98.760 O46.040 2.800 6.760 O99. Post-dates.800 6.800 2.800 6.1 O98.040 2.760 4.9 6.0 Premature separation of placenta with coagulation defect.800 6.990 17.800 6.800 6.760 4.9 O47.040 2.710 4.040 2. childbirth and the puerperium Other specified diseases and conditions complicating pregnancy.800 25.9 O99.990 Diseases of the circulatory system complicating pregnancy. Abruptio placenta NOS Antepartum haemorrhage with coagulation defect.9 O48 O98.0 Z35.760 4.040 4. Heavy periods NOS. Meningitis due to Haemophilus influenzae Pneumococcal meningitis Streptococcal meningitis Staphylococcal meningitis Other bacterial meningitis.800 19.600 7.600 1.0 G03.980 1.800 7.710 7.710 Health Care Institution Fee 17.600 6.620 4.9 A39.980 1. shortened MENSTRUAL IRREGULARITIES intervals between menstrual bleeding.0 F06.990 17.1 G00.800 7.340 5.8 DESCRIPTION Haemophilus meningitis. Regular intermenstrual bleeding MENSTRUAL IRREGULARITIES Excessive bleeding in the premenopausal period.460 5.860 13.860 13.9 F06.0 Bacterial meningitis. Hypomenorrhoea NOS Excessive and frequent menstruation with regular cycle.600 7.460 5.990 17.0 N91. Senile dementia depressed or paranoid type.340 2.460 5.800 7.980 1. unspecified.700 19.620 4. Irregular periods NOS Postcoital and contact bleeding MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES 6. Polymenorrhoea MENINGITIS MENINGITIS MENINGITIS MENINGITIS MENINGOCOCCAL INFECTION MENINGOCOCCAL INFECTION MENINGOCOCCAL INFECTION MENINGOCOCCAL INFECTION MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES 25.3 Excessive and frequent menstruation with irregular cycle.460 5.700 25.600 6.990 13.700 Professional Fee 7.8 G03.460 5.800 6. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE G00. Meningitis due to Klebsiella MENINGITIS MENINGITIS MENINGITIS MENINGITIS MENINGITIS GROUP Case Rate 25.710 7.620 4.460 5. Menopausal menorrhagia or MENSTRUAL IRREGULARITIES metrorrhagia.620 4. Meningitis due to Escherichia coli.800 1. nonalcoholic Delirium not superimposed on dementia.460 5.980 2.700 25.710 5. Failure to start menstruation at puberty.0 F05.1 N92. Irregular.800 2.2 G00.800 7.700 25.340 2.980 1.600 6. unspecified.9 F01.340 2.980 4. unspecified.620 4.980 1. Metrorrhagia Excessive menstruation at puberty. unspecified.340 2.710 7.6 N93. Pubertal menorrhagia. Puberty bleeding Ovulation bleeding.620 6. Schizophrenialike psychosis in epilepsy Organic mood [affective] disorders Organic anxiety disorder Mild cognitive disorder Other specified mental disorders due to brain damage and dysfunction and to physical disease.340 2.460 Other specified abnormal uterine and vaginal bleeding.620 4.710 7.980 1. Secondary amenorrhoea.460 Page 63 of 111 . Meningitis suppurative NOS Nonpyogenic meningitis. Meningococcal bacteraemia NOS Meningococcal infection.600 6.800 19.460 5. unspecified.600 6.800 7.700 25.620 N92.2 F06.620 4.460 5. Menometrorrhagia.710 7.940 5. unspecified Other specified conditions associated with female genital organs and menstrual cycle Unspecified condition associated with female genital organs and menstrual cycle Multi-infarct dementia.710 7.710 7.460 5.0 N93. Menorrhagia NOS.340 2.340 2.9 N91.8 N94.700 25. MENINGITIS Meningitis pyogenic NOS.940 5.800 7.800 7.8 F01. Arachnoiditis (spinal) NOS Acute meningococcaemia Chronic meningococcaemia Meningococcaemia.600 6.860 4.3 F06.990 17.800 19.940 1.600 6. Paranoid and paranoid-hallucinatory organic states. so described Other delirium Other delirium Organic hallucinosis.2 N91.700 25. Irregular intermenstrual bleeding. Korsakov's psychosis or syndrome.700 25.3 A39.990 G00.620 4.340 4. Amenorrhoea.1 F01.600 6.8 N93.620 4.8 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.2 A39.990 17.9 G03.9 N94. Absence of menstruation NOS Oligomenorrhoea.990 17.460 5. Senile psychosis NOS Organic amnesic syndrome. Presenile dementia NOS. Meningitis due to Friedländer bacillus. not induced by alcohol and other psychoactive substances.620 5. Climateric menorrhagia or metrorrhagia. Nonbacterial meningitis Chronic meningitis Meningitis due to other specified causes Meningitis.340 2.980 1.800 7.1 G03.980 1.8 F05.5 N92.990 17.980 4.620 4.620 N92.340 2.800 7.620 4.5 N92.4 A39.340 2. unspecified. unspecified.3 G00. Preclimateric menorrhagia or metrorrhagia.800 7.990 17. Predominantly cortical dementia Other vascular dementia Vascular dementia. MENSTRUAL IRREGULARITIES Dysfunctional or functional uterine or vaginal bleeding NOS Abnormal uterine and vaginal bleeding.800 7.700 25.600 1.460 5.980 1.980 17.980 4. unspecified Unspecified dementia.600 1. Meningitis purulent NOS.ANNEX 1. Irregular bleeding NOS. Senile dementia NOS.990 17.800 7.0 G00.600 6.2 N92.710 7.340 2. Absence of menstruation in a woman who had previously menstruated.600 6.860 13.4 F06.940 5.4 6. Organic hallucinatory state (nonalcoholic) Organic delusional [schizophrenia-like] disorder.7 F06. Presenile psychosis NOS. Excessive bleeding MENSTRUAL IRREGULARITIES associated with onset of menstrual periods.600 6.620 N92. Meningococcal disease NOS Primary amenorrhoea. Epileptic psychosis NOS MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENSTRUAL IRREGULARITIES MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS F04 F05.980 1.980 1.1 N91. Premenopausal menorrhagia or metrorrhagia Other specified irregular menstruation Irregular menstruation.9 F03 6.340 2. 340 2.800 7. Limbic epilepsy personalitySyndrome .340 2.800 7.800 7.340 2.800 7.460 5.4 F10.800 7. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Unspecified mental disorder due to brain damage and dysfunction and to physical disease. nonpsychotic Unspecified organic personality and behavioural disorder due to brain disease.8 F10.460 F07.460 5.460 5.800 7.460 5.460 5.800 7.460 5.1 F07.460 5.9 F11.2 F14.340 2.340 2.4 F13. Organic mental disorder NOS Organic personality disorder.340 2.460 5.460 F07.460 5.460 5.340 2.800 7.340 2.1 F10.0 F12.340 5.1 F13.460 5.340 2.9 F15. Organic brain syndrome NOS.460 5. Symptomatic Psychosis NOS Mental and behavioural disorders due to use of alcohol in acute intoxication Mental and behavioural disorders due to use of alcohol:harmful use Mental and behavioural disorders due to use of alcohol: dependency syndrome Mental and behavioural disorders due to use of alcohol:withdrawal state Mental and behavioural disorders due to use of alcohol: withdrawal state with delirium Mental and behavioural disorders due to use of alcohol: psychotic disorder Mental and behavioural disorders due to use of alcohol: amnesic syndrome Mental and behavioural disorders due to use of alcohol: residual and late-onset psychotic disorder Mental and behavioural disorders due to use of alcohol: other mental and behavioural disorders Mental and behavioural disorders due to use of alcohol: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of opioids: harmful use Mental and behavioural disorders due to use of opioids: dependence syndrome Mental and behavioural disorders due to use of opioids: psychotic disorder Mental and behavioural disorders due to use of opioids: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of cannabinoids: acute intoxication Mental and behavioural disorders due to use of cannabinoids: psychotic disorder Mental and behavioural disorders due to use of sedatives or hypnotics: harmful use Mental and behavioural disorders due to use of sedatives or hypnotics: dependence syndrome Mental and behavioural disorders due to use of sedatives or hypnotics: withdrawal state Mental and behavioural disorders due to use of sedatives or hypnotics: withdrawal state with delirium Mental and behavioural disorders due to use of sedatives or hypnotics: psychotic disorder Mental and behavioural disorders due to use of sedatives or hypnotics: residual and late-onset psychotic disorder Mental and behavioural disorders due to use of cocaine: acute intoxication Mental and behavioural disorders due to use of cocaine: dependence syndrome Mental and behavioural disorders due to use of cocaine: psychotic disorder Mental and behavioural disorders due to use of cocaine: amnesic syndrome Mental and behavioural disorders due to use of cocaine: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of other stimulants.5 F14.3 F13.800 7.800 7. damage and dysfunction. Postcontusional syndrome (encephalopathy).460 5.340 5. Organic pseudoretarded personality.460 5.460 5.460 5.340 2.460 F06.800 7.800 7.3 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.460 5.800 7.460 5.340 2.ANNEX 1.7 F10.2 F11.800 7.340 2.0 MENTAL AND BEHAVIORAL DISORDERS 7. Organic pseudopsychopathic personality.800 7.9 F12.460 5.460 5.340 2.2 F13.800 Professional Fee 2.340 2. Organic Psychosis NOS.0 F14.800 7.340 2.460 5.340 2.340 2.460 5.800 7. Lobotomy Syndrome.1 F15.340 2.3 F10.800 2.800 7.340 2.460 5.340 2.800 7. Frontal lobe Syndrome.5 F13.7 F14.340 2.800 7.800 7.460 5.800 7.460 5.2 F10.2 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.800 7.800 7.800 2.340 2.460 5.340 5.0 F15.340 2. including caffeine: withdrawal state GROUP Case Rate 7.340 2.340 2.0 F10.1 F11. Post-traumatic brain syndrome.5 F10.9 MENTAL AND BEHAVIORAL DISORDERS F07.460 5.800 7.340 Health Care Institution Fee 5.800 7.340 2.800 7.800 7. Organic psychosyndrome Unspecified organic or symptomatic mental disorder.460 5.2 F15.460 5.460 5.800 7.800 2.800 7.460 Page 64 of 111 . including caffeine: dependence syndrome Mental and behavioural disorders due to use of other stimulants.800 7.340 2.340 2.340 2.6 F10.460 5.340 2. Postleucotomy Syndrome Postencephalitic syndrome Postconcussional syndrome.340 2.800 7.340 2.5 F11.6 F14.5 F13.340 2.800 7. including caffeine: harmful use Mental and behavioural disorders due to use of other stimulants.460 5.460 5. including caffeine: acute intoxication Mental and behavioural disorders due to use of other stimulants.9 F09 F10. 460 F19. unspecified Schizotypal disorder.340 2.340 5.460 5.8 DESCRIPTION Mental and behavioural disorders due to use of other stimulants.1 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.0 F18.460 5.460 5. Schizotypal personality disorder Delusional disorder.340 2. Hebephrenia Catatonic schizophrenia.340 5.460 Page 65 of 111 .460 F21 MENTAL AND BEHAVIORAL DISORDERS 7.2 MENTAL AND BEHAVIORAL DISORDERS 7.340 5. including caffeine: unspecified mental and behavioural disorder Mental and behavioural disorders due to use of hallucinogens: acute intoxication Mental and behavioural disorders due to use of hallucinogens: harmful use Mental and behavioural disorders due to use of hallucinogens: dependence syndrome Mental and behavioural disorders due to use of hallucinogens: psychotic disorder Mental and behavioural disorders due to use of tobacco: dependence syndrome Mental and behavioural disorders due to use of tobacco: withdrawal state Mental and behavioural disorders due to use of volatile solvents: acute intoxication Mental and behavioural disorders due to use of volatile solvents: withdrawal state with delirium Mental and behavioural disorders due to use of volatile solvents: amnesic syndrome Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances.340 5.3 F18.340 5. Schizophrenic catalepsy.0 MENTAL AND BEHAVIORAL DISORDERS 7.460 5.460 5.800 7. Cenesthopathic schizophrenia. Paranoid state. Schizophrenic flexibilitas cerea Undifferentiated schizophrenia. including caffeine: other mental and behavioural disorders Mental and behavioural disorders due to use of other stimulants.340 2.460 5.460 5.460 5.2 F17.340 2.8 7. including caffeine: psychotic disorder Mental and behavioural disorders due to use of other stimulants.800 7. Disorganized schizophrenia.9 F16.800 2.460 5. misuse of drugs MENTAL AND BEHAVIORAL DISORDERS NOS: residual and late-onset psychotic disorder Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances.460 5.800 7.460 5.800 2.800 7.800 7.340 5. misuse of drugs NOS: dependence syndrome Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances. Sensitiver Beziehungswahn Other persistent delusional disorders.0 F20.340 2.800 2.2 F20.340 2.460 5. Schizophrenia prepsychotic. misuse of drugs MENTAL AND BEHAVIORAL DISORDERS NOS: other mental and behavioural disorders Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances. misuse of drugs MENTAL AND BEHAVIORAL DISORDERS NOS: unspecified mental and behavioural disorder Paranoid schizophrenia. Latent schizophrenic reaction.460 5. Paranoid psychosis.460 5.340 5.340 2.8 MENTAL AND BEHAVIORAL DISORDERS 7. Schizophrenia borderline.340 5. Schizophrenic catatonia.340 2. misuse of drugs NOS: psychotic disorder GROUP MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS Case Rate 7.800 7.460 F22.340 2. Schizophreniform psychosis NOS Schizophrenia.6 F19.460 F19.5 F15.800 2.800 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE F15.340 2.460 5.460 F19. Paraphrenia (late).340 5.3 F20.1 F16.460 5.800 2.460 F19.800 2.2 F16.1 F20. misuse of drugs NOS: harmful use Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances.340 2.340 2.460 F19.340 Health Care Institution Fee 5.7 Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances.800 2. Delusional dysmorphophobia. Chronic undifferentiated schizophrenia.800 7.5 F17.9 7.460 5. Schizophrenia pseudoneurotic. Atypical schizophrenia Residual schizophrenia.9 F20.800 7. Paranoia.4 F18.8 F20.340 2.340 5.800 7. Schizophrenia prodromal.460 5. Schizophreniform disorder NOS.340 2.800 7.340 2.ANNEX 1.340 2.340 2.340 2.5 MENTAL AND BEHAVIORAL DISORDERS 7. Bouffée délirante without symptoms of schizophrenia or unspecified.340 5. Paranoia querulans Acute polymorphic psychotic disorder without symptoms of schizophrenia. Involutional paranoid state.800 7.800 7.460 F23.800 Professional Fee 2. Schizophrenia pseudopsychopathic.800 2.800 7.460 F15.3 MENTAL AND BEHAVIORAL DISORDERS 7.0 MENTAL AND BEHAVIORAL DISORDERS 7.800 7.5 F20.460 5. Schizophrenia latent.460 F19. Catatonic stupor. Restzustand (schizophrenic).800 7.340 2.0 F16. Paraphrenic schizophrenia Hebephrenic schizophrenia.800 7. misuse of drugs NOS: withdrawal state Mental and behavioural disorders due to multiple drug use and use of other psychoactive substances.800 2. Cycloid psychosis without symptoms of schizophrenia or unspecified MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.460 F22.800 2. Schizophrenic residual state Simple schizophrenia Other schizophrenia.800 7.6 F20.800 7.800 7. 2 Acute polymorphic psychotic disorder with symptoms of schizophrenia.460 5.2 F31.800 7.460 5. Schizoaffective psychosis NOS Other nonorganic psychotic disorders.460 5. Brief schizophreniform psychosis.800 7.340 2. Psychogenic paranoid psychosis Other acute and transient psychotic disorders Acute and transient psychotic disorder. manic type.800 7. mixed type. unspecified Mild depressive episode Moderate depressive episode Severe depressive episode without psychotic symptoms. Atypical depression.7 F31.9 F31. MENTAL AND BEHAVIORAL DISORDERS Paranoid reaction.340 2.460 5.340 5.340 2. manic type. current episode severe depression with psychotic symptoms Bipolar affective disorder.460 5. Single episodes of reactive depressive psychosis Other depressive episodes. current episode manic with psychotic symptoms Bipolar affective disorder.340 2.800 7.800 2.2 7.3 F32.0 F30.9 Severe depressive episode with psychotic symptoms.460 5.340 2. Single episodes of major depression with psychotic symptoms. Cycloid psychosis with symptoms of schizophrenia Acute schizophrenia-like psychotic disorder. recurrent MENTAL AND BEHAVIORAL DISORDERS without psychotic symptoms.6 F31.9 F28 F29 F30.Brief schizophreniform MENTAL AND BEHAVIORAL DISORDERS disorder.340 2.340 2.800 2.460 5.460 5.1 F32. Mania with moodcongruent psychotic symptoms. Cycloid personality.460 F33.340 5.340 2.340 2. Schizophreniform psychosis.1 F30. unspecified.460 5.340 5.800 7.460 5. current episode severe with psychotic symptoms including Endogenous depression with psychotic symptoms.800 2.3 7.340 2.340 2.340 5.460 F33.460 F25.800 7. Single MENTAL AND BEHAVIORAL DISORDERS episodes of "masked" depression NOS Depressive episode. Major depression.800 7.460 5.1 F23.800 2.1 MENTAL AND BEHAVIORAL DISORDERS 7.460 5.800 7. Vital depression] single episode without psychotic symptoms MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7. Endogenous depression without psychotic symptoms.800 7.460 5. MENTAL AND BEHAVIORAL DISORDERS depressed type with psychotic symptoms.800 7.800 7.0 7.1 F31. manic type Schizoaffective disorder.ANNEX 1. current episode manic without psychotic symptoms Bipolar affective disorder.340 Health Care Institution Fee 5.460 5.800 7.340 2.340 5. Mania with moodincongruent psychotic symptoms. Recurrent severe episodes of major depression with Other recurrent depressive disorders Recurrent depressive disorder.340 5. unspecified. unspecified. currently in remission Other bipolar affective disorders.Acute (undifferentiated) schizophrenia. Schizoaffective psychosis.340 5.800 7.800 7. Mania NOS Bipolar affective disorder. MENTAL AND BEHAVIORAL DISORDERS Depressive disorder NOS Recurrent depressive disorder.800 7.2 F30.8 F33. Recurrent manic episodes NOS Bipolar affective disorder.800 2.2 F25.800 7.800 7.3 F31. depressive type Schizoaffective disorder.800 7.9 F32. Schizophrenic reaction Other acute predominantly delusional psychotic disorders.800 2.340 2.460 F25. Chronic hallucinatory psychosis Unspecified nonorganic psychosis.8 F32.340 2.800 7. Folie à deux.460 5. Monopolar depression NOS Cyclothymia.460 5. Single MENTAL AND BEHAVIORAL DISORDERS episodes of psychotic depression.5 F31.800 7. Schizophreniform psychosis.460 F32.9 F34.800 7.460 5. Induced psychotic disorder Schizoaffective disorder. Psychosis NOS Hypomania Mania without psychotic symptoms Mania with psychotic symptoms.2 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.340 2.340 5.9 F24 F25.460 5. depressive type.340 2.460 5. Reactive psychosis Induced delusional disorder.340 2.800 2. Schizoaffective psychosis.340 2.800 7.800 7.340 2.460 7.800 7. Bipolar II disorder.340 2.460 5.800 7.340 2.8 F23.800 2.460 5.8 F25. Major depression. depressed type without psychotic sympto Recurrent depressive disorder.340 2.340 2.800 7. depressive type.460 5.8 F31.460 5. current episode mixed Bipolar affective disorder.0 F31. Cyclothymic personality MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.460 5. current episode mild or moderate depression Bipolar affective disorder.460 5. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee 2. [Agitated depression. current episode severe without psychotic symptoms.460 F33.800 7.460 F23. Cyclic schizophrenia. Affective personality disorder. Brief reactive psychosis NOS.3 F23.340 2. Manic-depressive psychosis. Single episodes of psychogenic depressive psychosis.340 2.0 F32.340 5.460 F23. Manic-depressive psychosis. Manic stupor Manic episode. current episode hypomanic Bipolar affective disorder.340 2. unspecified. Induced paranoid disorder.800 2. Oneirophrenia.460 Page 66 of 111 .460 5.340 2.800 7.0 7. Mixed schizophrenic and affective psychosis Other schizoaffective disorders Schizoaffective disorder. unspecified. Depression NOS.460 5. Bouffée délirante with symptoms of MENTAL AND BEHAVIORAL DISORDERS schizophrenia. 460 F45. Laxative habit Unspecified behavioural syndromes associated with physiological disturbances and physical factors.340 5. Psychogenic forms of cough.340 2.8 F42.800 7. mild mental subnormality with the statement of no. unspecified. Bulimia NOS.340 2.8 F44. Hypochondriacal neurosis.460 5. Clumsy child syndrome.1 F42. Abuse of vitamins.340 2. Depressive personality disorder. not elsewhere classified.8 F80.460 5.800 7.460 5.1 F78.460 5.800 7.9 F43.9 F50. Psychogenic torticollis.460 Abuse of non-dependence-producing substances.800 7.800 2.800 7.800 7. Multiple personality.460 5.340 2.800 7. Da Costa's syndrome.800 7. Traumatic neurosis Adjustment disorders.1 F43.800 2.800 7.9 F55 7. Psychogenic physiological dysfunction NOS Mild mental retardation. Neurotic depression.340 2. Nosophobia Somatoform autonomic dysfunction.3 MENTAL AND BEHAVIORAL DISORDERS 7.800 7.460 5. Dhat syndrome. Psychogenic dysmenorrhoea. Psychogenic backache. Somatoform pain disorder Other somatoform disorders.800 2.340 2. or minimal.1 F53.460 5. Developmental dyspraxia MENTAL AND BEHAVIORAL DISORDERS F59 7.340 2.340 2.2 F43.460 F70. Psychogenic dysphonia Other dissociative [conversion] disorders.9 MENTAL AND BEHAVIORAL DISORDERS 7.460 5. Cardiac neurosis.9 F45. including writer's cramp.460 5. Psychogenic Persistent somatoform pain disorder. Hospitalism in children Other reactions to severe stress Dissociative amnesia Dissociative motor disorders.340 5.460 F45. Psychic shock Post-traumatic stress disorder. not elsewhere classified.0 MENTAL AND BEHAVIORAL DISORDERS 7.460 5.460 5. unspecified Acute stress reaction including Acute crisis reaction.2 F42. Teethgrinding Somatoform disorder. Dysmorphophobia (nondelusional).800 7. Psychogenic headache.800 7.800 2.340 5.340 2.1 F42.340 5.460 5. Occupational neurosis.460 5.9 F78.340 2.460 5.340 2.800 7.340 5.460 Page 67 of 111 . Depression postnatal MENTAL AND BEHAVIORAL DISORDERS NOS.800 2. Briquet’s disorder. including "globus hystericus".800 7. unspecified. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Dysthymia. feeble-mindedness.0 F45.340 2.800 7.800 7.3 F82 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.800 7. Body dysmorphic disorder.460 F45.340 2.800 Professional Fee 2.460 5.2 MENTAL AND BEHAVIORAL DISORDERS 7.800 7. mental subnormality NOS with other impairments of behaviour Acquired aphasia with epilepsy [Landau-Kleffner] Specific developmental disorder of motor function.0 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS 7.340 5. Multiple psychosomatic disorder Undifferentiated somatoform disorder.340 2.800 2.8 F48.460 5. Persistent anxiety depression Predominantly compulsive acts [obsessional rituals] Mixed obsessional thoughts and acts Other obsessive-compulsive disorders Obsessive-compulsive disorder. Combat fatigue.340 5.460 5.800 7.8 MENTAL AND BEHAVIORAL DISORDERS 7.340 2. Abuse of herbal or folk remedies. unspecified MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS F53.340 2.460 F72. Depressive neurosis.1 MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS F45. Grief reaction.340 5.460 5.800 7. Hyperorexia nervosa GROUP Case Rate 7. Crisis state.8 F78. Psychosomatic disorder NOS Other specified neurotic disorders. Hypochondriasis. Undifferentiated psychosomatic disorder Hypochondriacal disorder.2 F53. Psychalgia.340 2.460 5.460 5.460 5.460 5. severe mental subnormality without mention of impairment of behaviour Other mental retardation with significant impairment of behaviour requiring attention or treatment Other mental retardation with other impairments of behaviour Other mental retardation without mention of impairment of behaviour Unspecified mental retardation. Abuse of MENTAL AND BEHAVIORAL DISORDERS steroids or hormones.460 Mild mental and behavioural disorders associated with the puerperium.800 2. Developmental coordination disorder.340 Health Care Institution Fee 5.800 7.4 MENTAL AND BEHAVIORAL DISORDERS 7.340 2. Ganser's syndrome. mental deficiency NOS. Puerperal psychosis NOS Puerperal mental disorder. Abuse of antacids.340 2.8 F44.800 7.4 F44. Neurocirculatory asthenia Psychogenic forms of aerophagy.340 2. Psychogenic dysphagia. unspecified Somatization disorder. Psychasthenic neurosis. Psychogenic syncope Neurotic disorder.800 2.340 2.ANNEX 1.800 2.340 5.800 2. Psychogenic confusion.460 5.460 5.460 F34. Acute reaction to stress. Psychogenic twilight state Dissociative [conversion] disorder.340 2. Psychasthenia.460 5.460 F45.340 2. Psychogenic forms of diarrhea. Psychogenic pruritus.0 F44. impairment of behaviour Severe mental retardation. Neurosis NOS Bulimia nervosa. Depression postpartum NOS Severe mental and behavioural disorders associated with the puerperium.800 7.0 F43.800 7.460 F48.800 7.340 5. Gastric neurosis . Culture shock. Psychogenic forms of dyspepsia. Psychogenic aphonia.340 2.9 F79.340 2. 790 2.300 9.300 9. MISCARRIAGE Fleshy mole. Psychogenic encopresis Mental disorder.500 1. Kanner's syndrome Rett's syndrome Other childhood disintegrative disorder.460 5. without complication Spontaneous abortion.300 9. Transitory neonatal hypoglycaemia Transitory disorder of carbohydrate metabolism of fetus and newborn.300 9.4 O03.300 9.800 7.510 6.460 5.0 P81. not elsewhere classified.790 2.1 P74.300 9.790 2.2 P72. Mental illness NOS Disorders of plasma-protein metabolism.1 O02. not METABOLIC DISORDERS OF THE NEWBORN elsewhere classified.1 P71.9 F89 F90.510 6.510 6.510 6.790 2.340 2.790 2.510 6.700 10.490 7.790 2.790 2. unspecified Environmental hyperthermia of newborn Other specified disturbances of temperature regulation of newborn Disturbance of temperature regulation of newborn.0 O02.0 F98.700 10. Transitory congenital goitre with normal function Transitory neonatal hyperthyroidism.9 P71.300 9.500 Page 68 of 111 . Infantile psychosis.800 7. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE F84.460 5. Launois-Bensaude adenolipomatosis.460 5. unspecified Hypothermia of newborn.300 9. Developmental disorder NOS Other hyperkinetic disorders Depressive conduct disorder Nonorganic encopresis.460 5.000 5.790 2.790 2.500 3.340 2.300 9.790 2.300 9.510 6. Disintegrative psychosis.9 P70.460 5.8 P81.510 6.340 2. Symbiotic psychosis Asperger's syndrome.0 P71.510 6.300 9.500 3. Dementia infantilis.700 9. Urticaria neonatorum METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN O02.510 6. a-1-Antitrypsin deficiency.510 Other transitory neonatal disorders of thyroid function.9 P81.0 P70.340 3.0 E88.300 9.300 9. neonatal thyrotoxicosis GROUP MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS MENTAL AND BEHAVIORAL DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN METABOLIC DISORDERS OF THE NEWBORN Case Rate 7.490 6. unspecified Neonatal goitre.300 Professional Fee 2.800 7.9 P72.510 6.300 9.4 P83.510 6.000 5.790 2. Autistic disorder.340 2. not elsewhere classified.300 9.9 Blighted ovum and nonhydatidiform mole.510 6.790 2.300 9.9 P80.800 7.1 P72.790 2.300 9.800 7.300 9.700 10.300 9.790 2. not otherwise specified. unspecified Spontaneous abortion. Early fetal death with retention of dead fetus Other specified abnormal products of conception Abnormal product of conception.790 2.790 2.1 P70. Noninfective mastitis of newborn Other specified conditions of integument specific to fetus and newborn.800 7.000 5.790 2.790 2.210 3.000 5.3 P71.5 F84. Bronze baby syndrome.790 2.500 1. Pathological ovum Missed abortion.800 10. Incontinence of faeces of nonorganic origin.510 6.300 9.510 6. Heller's syndrome. Bisalbuminaemia Lipodystrophy.510 6.790 2.460 7.3 P70.4 P74.8 P72.340 2.9 P74. complete or unspecified.2 P70.510 6.210 2.300 9. Neonatal tetany NOS Transitory neonatal hypoparathyroidism Transitory neonatal disorder of calcium and magnesium metabolism.9 P83.300 9.790 2.8 P74.000 1.790 2.0 P74. Schizoid disorder of childhood Pervasive developmental disorder.510 6. not elsewhere classified. incomplete.8 O02.500 3. unspecified Cow's milk hypocalcaemia in newborn Other neonatal hypocalcaemia Neonatal tetany without calcium or magnesium deficiency.340 2.500 1.490 7.1 P83. Neonatal scleroderma.8 DESCRIPTION Childhood autism. Intrauterine mole NOS.510 6. unspecified.790 2. without complication MISCARRIAGE MISCARRIAGE MISCARRIAGE MISCARRIAGE MISCARRIAGE 5. Maternal diabetes mellitus (pre-existing) affecting fetus or newborn with hypoglycaemia Neonatal diabetes mellitus Iatrogenic neonatal hypoglycaemia Other neonatal hypoglycaemia.510 6.500 1.800 7.510 6.340 2.790 2.210 3.300 9.1 F99 E88.510 6.510 6.460 5.510 6.8 F92. Infantile autism.0 F84.510 6. Carneous mole.000 5.460 5.510 6.500 3. Transitory neonatal hypothyroidism Other specified transitory neonatal endocrine disorders Transitory neonatal endocrine disorder.790 2. Functional encopresis. unspecified Unspecified disorder of psychological development.490 7.300 9.2 F84. Autistic psychopathy.8 E88.790 2. Lipodystrophy NOS Other specified metabolic disorders.300 9.3 F84. Fever of newborn NOS Neonatal erythema toxicum Breast engorgement of newborn.500 1.790 2.340 2.510 6.4 P71.300 9.2 P74. Trimethylaminuria Metabolic disorder. unspecified Late metabolic acidosis of newborn Dehydration of newborn Disturbances of sodium balance of newborn Other transitory electrolyte disturbances of newborn Other transitory metabolic disturbances of newborn Transitory metabolic disturbance of newborn.500 3.0 P72.9 O03.300 9.1 E88.300 9.4 P70.800 7.510 6.510 6.500 3.340 2.790 2. unspecified Syndrome of infant of mother with gestational diabetes Syndrome of infant of a diabetic mother.790 Health Care Institution Fee 5.210 3.460 5.ANNEX 1.800 7. 070 4.070 4. complicated Delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and MISCARRIAGE WITH COMPLICATIONS ectopic and molar pregnancy. Pelvic peritonitis.000 1. Defibrination syndrome.9 DESCRIPTION Other abortion.070 4.070 4.830 6. Pelvic peritonitis. Embolism NOS. complete or unspecified. Salpingooophoritis.000 5. Defibrination syndrome. Oliguria Acute re Failed medical abortion without complication.070 4. complicated by Genital tract and pelvic infection with Genital tract and pelvic MISCARRIAGE WITH COMPLICATIONS infection following abortion and ectopic and molar pregnancy.900 2.4 O05.900 2. Intravascular coagulation 6.500 1.830 O05.000 1. Oophoritis. Pelvic peritonitis.4 O06.830 O03. Intravascular coagulation Spontaneous abortion.900 2.900 2. Salpingitis.0 Other abortion. complete.900 2.830 Page 69 of 111 . without complication Other abortion.830 O05.6 O03.500 O07. without complication Unspecified abortion or induced abortion NOS.900 2. with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy. Endometritis. Afibrinogenaemia. Septic shock.8 MISCARRIAGE 5. Oophoritis. complicated by Genital tract and pelvic infection with Endometritis and/or Oophoritis and/or Parametritis and/or Pelvic peritonitis and/or MISCARRIAGE WITH COMPLICATIONS Salpingitis and/or Salpingo-oophoritis and/or Sepsis and/or Septic shock and/or Septicae Other abortion. incomplete.500 O07. incomplete. complete or unspecified.900 2. MISCARRIAGE Parametritis. complicated by genital tract and pelvic infection with Endometritis. complete or unspecified.500 O07.9 O06. Salpingo Spontaneous abortion. incomplete.500 3. Pulmonary embolism. Intravascular coagulation Spontaneous abortion.070 4. incomplete.000 5. Salpingitis. complete or unspecified.830 O03.3 MISCARRIAGE 5. Oliguri 5.0 Failed medical abortion. Circulatory collapase. complicated Delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and ectopic and molar pregnancy.000 5. complicated Delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and ectopic and molar pregnancy.3 MISCARRIAGE WITH COMPLICATIONS 6. Septicaemia Failed medical abortion with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy.070 4. Salpin Spontaneous abortion. Renal failure following abortion and ectopic and molar pregnancy. Circulatory collapase.2 MISCARRIAGE WITH COMPLICATIONS 6. incomplete. Parametritis.830 O03. Oophoritis.500 3. Afibrinogenaemia. Postoperative Shock. Circulatory collapase. Blood-clot embolism. Postoperative Shock. Endometritis.500 Health Care Institution Fee 3. Defibrination syndrome. Afibrinogenaemia.500 3.070 4.500 O07. Renal failure following abortion and ectopic and mola Other and unspecified failed attempted abortion without complication. Sepsis. Renal failure following abortion and ectopic and molar preg 6.000 1. with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy.900 2.070 4. complicated by Genital tract and pelvic infection with Genital tract and pelvic infection following abortion and ectopic and molar pregnancy. Failed attempted abortion NOS Spontaneous abortion.830 6. Amniotic fluid embolism.900 2. Pyaemic embo Spontaneous abortion.0 MISCARRIAGE WITH COMPLICATIONS 6.500 3.500 3. Circulatory collapase.500 3. Renal failure following abortion and ectopic and molar pregnancy.1 MISCARRIAGE WITH COMPLICATIONS 6. without complication MISCARRIAGE MISCARRIAGE MISCARRIAGE MISCARRIAGE GROUP Case Rate 5.5 O03. Postoperative Shock. incomplete.000 Professional Fee 1. incomplete. Parametritis. with other complicated by Embolism with Embolism following abortion and ectopic and molar pregnancy. Postoperative Shock.500 3.000 1. Failed medical abortion NOS Other and unspecified failed attempted abortion with other and unspecified complications with with Shock following abortion and ectopic and molar pregnancy.830 O03.070 4.500 1. incomplete.000 1. complicated by Embolism with Embolism NOS or Air embolism or Amniotic fluid embolism or Blood-clot embolism or Pulmonary embolism or Pyaemic embolism or Septic or septicopyaemic embolism or Soap embolism Spontaneous abortion. complete or unspecified.500 O03.500 3.1 MISCARRIAGE WITH COMPLICATIONS 6. MISCARRIAGE WITH COMPLICATIONS Air embolism.500 O07.8 MISCARRIAGE WITH COMPLICATIONS 6.900 2.ANNEX 1.9 MISCARRIAGE 5. Salpingitis.830 O03. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE O05.7 Spontaneous abortion.4 MISCARRIAGE 5. Parametritis. without complication Unspecified abortion or induced abortion NOS.500 1. 550 4. MISCARRIAGE WITH COMPLICATIONS Circulatory collapase.7 Unspecified abortion or induced abortion NOS.070 4. SOFT TISSUE DISORDERS MUSCLE.830 O06.3 6.950 1.00 M60. TENDON.070 4.500 6.500 6.0 M60.070 4.950 1.550 4.070 4. Renal failure following abortion and ectopic and molar pregnancy. complete.950 1. Defibrination syndrome. TENDON.900 2.070 4.830 6.830 O08.900 2. Renal failure following abortion and ectopic and Unspecified abortion or induced abortion NOS.900 2.900 2. Intravascular coagulation Other and unspecified failed attempted abortion complicated by genital tract and pelvic infection with MISCARRIAGE WITH COMPLICATIONS Endometritis.900 2. Postoperative Shock. SOFT TISSUE DISORDERS MUSCLE.900 2.1 O07. SOFT TISSUE DISORDERS MUSCLE.900 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee O05.900 2.900 2.5 O07.500 6. complicated by Genital tract and pelvic infection or Endometritis and/or Oophoritis and/or Parametritis and/or Pelvic peritonitis and/or Salpingitis and/or Salpingo-oophoritis and/or 6.830 O06.950 1.07 M60. complete.950 1.0 Other abortion. Postoperative Shock Other complications following abortion and ectopic and molar pregnancy.830 O06.070 4.830 O06. TENDON. Tropical pyomyositis Pelvic region and thigh Infective myositis.070 4.950 1.070 4. with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy.8 MISCARRIAGE WITH COMPLICATIONS 6. SOFT TISSUE DISORDERS 6. Septic shock.830 O06. TENDON.950 1.900 2. incomplete.550 4. Postoperative MISCARRIAGE WITH COMPLICATIONS Shock.830 6. Tropical pyomyositis Infective myositis.900 2. Defibrination syndrome. SOFT TISSUE DISORDERS MUSCLE.550 4.2 6. Urinary tract infection Infective myositis. complicated Delayed or excessive haemorrhage with MISCARRIAGE WITH COMPLICATIONS Afibrinogenaemia or Defibrination syndrome or Intravascular coagulation Unspecified abortion or induced abortion NOS. incomplete.830 O07. Oophoritis. SOFT TISSUE DISORDERS MUSCLE.8 O06. incomplete.950 1. TENDON.05 M60. Tropical pyomyositis Ankle and foot Infective myositis.500 6.500 6. Circulatory collapase.830 O08.500 2. Renal failure following abortion and ectopic and m 6. TENDON. with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy. Afibrinogenaemia. Tropical pyomyositis Other Infective myositis. Circulatory collapase.8 M60.02 M60. Oliguria Acute Unspecified abortion or induced abortion NOS.830 O06. Afibrinogenaemia.830 6. complete.500 6.01 M60. TENDON. SOFT TISSUE DISORDERS MUSCLE.550 Page 70 of 111 .500 6.6 Failed medical abortion complicated by delayed or excessive haemorrhage. complicated by Delayed or excessive haemorrhage or MISCARRIAGE WITH COMPLICATIONS Afibrinogenaemia or Defibrination syndrome or Intravascular coagulation Unspecified abortion or induced abortion NOS.06 M60.070 4. Sepsi. complicated by Embolism or Embolism NOS with Air embolism or Amniotic fluid embolism or Blood-clot MISCARRIAGE WITH COMPLICATIONS embolism or Pulmonary embolism or Pyaemic embolism or Septic or septicopyaemic embolism or Soap e Unspecified abortion or induced abortion NOS. complicated by Embolism or Embolism NOS or Air embolism or Amniotic fluid embolism or Blood-clot MISCARRIAGE WITH COMPLICATIONS embolism or Pulmonary embolism or Pyaemic embolism or Septic or septicopyaemic embolism or Soap emboli Unspecified abortion or induced abortion NOS. SOFT TISSUE DISORDERS MUSCLE.070 4. Tropical pyomyositis Lower leg Infective myositis. Salpingitis.5 MISCARRIAGE WITH COMPLICATIONS 6.950 4. Cardiac arrest. complete. or unspecified. Septicaemia Other and unspecified failed attempted abortion complicated by delayed or excessive haemorrhage with Delayed or excessive haemorrhage following abortion and MISCARRIAGE WITH COMPLICATIONS ectopic and molar pregnancy. Postoperative Shock.070 4. Tropical pyomyositis Site unspecified MISCARRIAGE WITH COMPLICATIONS MUSCLE. complete.830 4.070 4.550 4. SOFT TISSUE DISORDERS MUSCLE. Intravascular coagulation Shock following abortion and ectopic and molar pregnancy. MISCARRIAGE WITH COMPLICATIONS Circulatory collapase.3 6.ANNEX 1.900 6. Parametritis.900 2. complicated by Genital tract and pelvic infection with Endometritis and/or Oophoritis and/or Parametritis and/or MISCARRIAGE WITH COMPLICATIONS Pelvic peritonitis and/or Salpingitis and/or Salpingooophoritis and/or Sepsis and/ Unspecified abortion or induced abortion NOS.1 6. Tropical pyomyositis Upper arm Infective myositis. with other and unspecified complications with Shock following abortion and ectopic and molar pregnancy.830 6.900 2. Tropical pyomyositis Multiple site Infective myositis.550 4.500 6.070 1.070 4. Tropical pyomyositis Shoulder region Infective myositis.550 4.6 O06. TENDON. incomplete.550 4. Afibrinogenaemia with Delayed or excessive haemorrhage following abortion and ectopic and MISCARRIAGE WITH COMPLICATIONS molar pregnancy.09 6. Pelvic peritonitis. TENDON.08 M60. Salpingo-oophoritis. 500 6.550 4.55 M61.550 4. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.48 M62.500 6.950 1.550 4.550 4. SOFT TISSUE DISORDERS MUSCLE.500 6.500 6. TENDON.97 M62.550 4. TENDON.950 1.98 M62. SOFT TISSUE DISORDERS MUSCLE.500 6. TENDON. TENDON.550 4.500 6.500 6. SOFT TISSUE DISORDERS Case Rate 6. TENDON.56 M62. SOFT TISSUE DISORDERS MUSCLE.950 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M60.550 4.59 M62.950 1.500 6. TENDON.950 1. SOFT TISSUE DISORDERS MUSCLE.550 4. unspecified Ankle and foot Disorder of muscle. SOFT TISSUE DISORDERS MUSCLE. not elsewhere classified.550 4.950 1. SOFT TISSUE DISORDERS MUSCLE.90 M65.950 1. SOFT TISSUE DISORDERS MUSCLE. TENDON. SOFT TISSUE DISORDERS MUSCLE. TENDON.950 1.13 M65. SOFT TISSUE DISORDERS MUSCLE.2 M65. TENDON. unspecified Upper arm GROUP MUSCLE. TENDON. SOFT TISSUE DISORDERS MUSCLE. TENDON.500 6.500 6.950 1.66 M62.90 M60.500 6.500 6. TENDON.500 6.500 6.550 4. SOFT TISSUE DISORDERS MUSCLE. TENDON.500 6.8 M62.2 M60.550 4. SOFT TISSUE DISORDERS MUSCLE.950 1.61 M62.500 6.90 M62. TENDON.950 1.550 4. TENDON.89 M65. Myositis ossificans associated with burns Other ossification of muscle Pelvic region and thigh Other ossification of muscle Site unspecified Calcification and ossification of muscle. SOFT TISSUE DISORDERS MUSCLE.950 1. TENDON. unspecified Lower leg Myositis. TENDON.950 1. unspecified Diastasis of muscle Diastasis of muscle Pelvic region and thigh Diastasis of muscle Other Other rupture of muscle (nontraumatic) Contracture of muscle Other Contracture of muscle Site unspecified Muscle wasting and atrophy.950 1. unspecified Multiple site Synovitis and tenosynovitis.550 4.500 6. unspecified Shoulder region Synovitis and tenosynovitis.950 1.950 1.950 1.9 M62. SOFT TISSUE DISORDERS MUSCLE.550 4.98 M60.550 4. SOFT TISSUE DISORDERS MUSCLE.500 6.1 M65.80 M62.950 1.99 M61. SOFT TISSUE DISORDERS MUSCLE.81 M60.950 1.550 4.89 M60.550 4.950 1.500 6.49 M62. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. not elsewhere classified Foreign body granuloma of soft tissue.500 6.500 6.550 4.86 M65.500 6. TENDON. TENDON.8 M60.550 4.550 4.500 6.84 M65.80 M60. TENDON.86 M62.550 4. SOFT TISSUE DISORDERS MUSCLE.9 M65. TENDON. SOFT TISSUE DISORDERS MUSCLE.500 6.950 1. TENDON. TENDON. not elsewhere classified. unspecified Synovitis and tenosynovitis.950 1.500 6.950 1. TENDON.500 6.500 6.500 6. TENDON. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. TENDON. SOFT TISSUE DISORDERS MUSCLE.550 4.87 M65. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.950 1.500 6. unspecified Site unspecified Calcification and ossification of muscles associated with burns. SOFT TISSUE DISORDERS MUSCLE. TENDON. TENDON. unspecified Pelvic region and thigh Disorder of muscle.550 4. SOFT TISSUE DISORDERS MUSCLE.550 4. TENDON.27 M60.Nodular tendinous disease Radial styloid tenosynovitis [de Quervain] Other synovitis and tenosynovitis Other synovitis and tenosynovitis Multiple site Other synovitis and tenosynovitis Hand Other synovitis and tenosynovitis Lower leg Other synovitis and tenosynovitis Ankle and foot Other synovitis and tenosynovitis Site unspecified Synovitis and tenosynovitis. SOFT TISSUE DISORDERS MUSCLE. TENDON.550 4.550 4.550 4.500 6. unspecified Lower leg Disorder of muscle.550 4.950 1.950 1.500 6.950 1. TENDON.550 4.550 4.500 6.550 4. SOFT TISSUE DISORDERS MUSCLE.1 M62. SOFT TISSUE DISORDERS MUSCLE.500 6. TENDON. TENDON.550 4.91 M60.67 M62.500 6.ANNEX 1. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.92 DESCRIPTION Interstitial myositis Interstitial myositis Shoulder region Foreign body granuloma of soft tissue. TENDON.550 4. TENDON. unspecified Other Disorder of muscle.29 M65. SOFT TISSUE DISORDERS MUSCLE. TENDON. SOFT TISSUE DISORDERS MUSCLE.20 M65. TENDON. TENDON.950 1. not elsewhere classified Forearm Foreign body granuloma of soft tissue.96 M62.550 4.550 4.550 4.950 1.950 1.550 4.65 M62.91 M65.550 4.950 1.60 M62.950 1.500 6.550 4.550 4. TENDON. TENDON.950 1.550 4.23 M60.550 4.500 6.550 4. TENDON.500 6.500 6. SOFT TISSUE DISORDERS MUSCLE.85 M62.950 1.62 M62. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.950 1.0 M62. SOFT TISSUE DISORDERS MUSCLE. TENDON.550 4.88 M60.950 1. SOFT TISSUE DISORDERS MUSCLE.500 6.9 M62.500 6.950 1.500 6. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.950 1. TENDON. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.500 6.950 1. SOFT TISSUE DISORDERS MUSCLE. TENDON.69 M62. unspecified Other Myositis.950 1.550 4.21 M60.950 1.950 1. SOFT TISSUE DISORDERS MUSCLE.99 M65.63 M62.950 1.500 6.950 1.950 1. TENDON. SOFT TISSUE DISORDERS MUSCLE.550 4. unspecified Upper arm Myositis.500 Professional Fee 1.500 6. SOFT TISSUE DISORDERS MUSCLE.550 4.950 1. TENDON.550 4.500 6.950 1. TENDON. TENDON.89 M62. SOFT TISSUE DISORDERS MUSCLE.3 M65. unspecified Multiple site Disorder of muscle.950 1.550 4.500 6.550 4.550 4.550 4.950 1.500 6. TENDON. SOFT TISSUE DISORDERS MUSCLE. TENDON. SOFT TISSUE DISORDERS MUSCLE.500 6. SOFT TISSUE DISORDERS MUSCLE. TENDON. SOFT TISSUE DISORDERS MUSCLE.500 6.500 6.550 4.500 6.500 6.500 6. TENDON. TENDON.59 M61. unspecified Shoulder region Myositis.1 M60.80 M65.550 4.950 1. TENDON.950 1.550 4.22 M65.500 6.500 6.950 1.550 4. SOFT TISSUE DISORDERS MUSCLE. TENDON. not elsewhere classified Ankle and foot Other myositis Other myositis Multiple site Other myositis Shoulder region Other myositis Other Other myositis Site unspecified Myositis.550 4. TENDON.950 1.950 1.550 4.500 6.550 4.550 4. SOFT TISSUE DISORDERS MUSCLE.950 1.950 1.550 4.950 1.92 M60.550 4. SOFT TISSUE DISORDERS MUSCLE.950 1.68 M62.500 6.950 1. TENDON. SOFT TISSUE DISORDERS MUSCLE.950 1. TENDON.05 M62.950 1.550 4.96 M60. TENDON.550 4. SOFT TISSUE DISORDERS MUSCLE. unspecified Myositis.950 1.550 4. unspecified Site unspecified Abscess of tendon sheath Other infective tenosynovitis Other infective (teno)synovitis Forearm Calcific tendinitis Calcific tendinitis Multiple site Calcific tendinitis Upper arm Calcific tendinitis Pelvic region and thigh Calcific tendinitis Site unspecified Trigger finger. TENDON. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.500 6.550 4.11 M60.550 4. SOFT TISSUE DISORDERS MUSCLE.550 4.95 M62.500 6. unspecified Disorder of muscle.500 6.8 M65.500 6.550 4.550 4.500 6. TENDON. TENDON. SOFT TISSUE DISORDERS MUSCLE.500 6. SOFT TISSUE DISORDERS MUSCLE.550 4.3 M61.950 1. TENDON. Disuse atrophy NEC Lower leg Muscle wasting and atrophy.950 1.500 6.950 1. unspecified Multiple site Myositis.550 4. SOFT TISSUE DISORDERS MUSCLE.500 6.08 M62.950 1.500 6. SOFT TISSUE DISORDERS MUSCLE. TENDON. unspecified Shoulder region Disorder of muscle.950 1.500 6. SOFT TISSUE DISORDERS MUSCLE.950 1. SOFT TISSUE DISORDERS MUSCLE. TENDON.4 M65. TENDON.500 6.500 6. unspecified Pelvic region and thigh Myositis. TENDON.88 M62. TENDON.0 M65. TENDON. TENDON. TENDON.950 Health Care Institution Fee 4. not elsewhere classified Shoulder region Foreign body granuloma of soft tissue.950 1.95 M60.25 M65. Disuse atrophy NEC Site unspecified Muscle strain Multiple site Muscle strain Shoulder region Muscle strain Upper arm Muscle strain Forearm Muscle strain Pelvic region and thigh Muscle strain Lower leg Muscle strain Ankle and foot Muscle strain Other Muscle strain Site unspecified Muscle (sheath) hernia Muscle (sheath) hernia Multiple site Muscle (sheath) hernia Pelvic region and thigh Muscle (sheath) hernia Lower leg Muscle (sheath) hernia Other Muscle (sheath) hernia Site unspecified Disorder of muscle.550 4. TENDON.9 M60.950 1. TENDON.500 6.500 6.500 6.950 1. TENDON.550 Page 71 of 111 . SOFT TISSUE DISORDERS MUSCLE.950 1. SOFT TISSUE DISORDERS MUSCLE.950 1.91 M62.500 6. SOFT TISSUE DISORDERS MUSCLE.550 4.950 1.950 1. TENDON. TENDON.950 1.5 M76.91 M71.500 6.500 6. not elsewhere classified Other bursitis. unspecified Shoulder region Bursopathy. Fibromatosis NOS Other Fibroblastic disorder.950 1.950 1.500 6. unspecified. SOFT TISSUE DISORDERS MUSCLE.550 4.5 M67. SOFT TISSUE DISORDERS MUSCLE. Fibromatosis NOS Site unspecified Adhesive capsulitis of shoulder. TENDON.500 6. Synovial cyst NOS Other bursal cyst.550 4.550 4. TENDON.550 4. TENDON.550 4. Tennis elbow Calcaneal spur Other enthesopathy of foot Other enthesopathies. SOFT TISSUE DISORDERS MUSCLE.ANNEX 1.550 4.550 4. SOFT TISSUE DISORDERS MUSCLE. TENDON. TENDON.500 Professional Fee 1.8 M71.950 1.950 1.950 1. TENDON. TENDON.950 1. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS Case Rate 6. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.98 M72.500 6.80 DESCRIPTION Synovitis and tenosynovitis.950 Health Care Institution Fee 4. Trochanteric tendinitis Other bursitis of hip. SOFT TISSUE DISORDERS MUSCLE.0 M67.550 4.4 M67. SOFT TISSUE DISORDERS MUSCLE. not elsewhere classified Shoulder region Other specified bursopathies Bursopathy.500 6. TENDON. Calcified bursa of shoulder Impingement syndrome of shoulder Bursitis of shoulder Other shoulder lesions Shoulder lesion. TENDON. SOFT TISSUE DISORDERS MUSCLE.950 1.550 4.9 M79.500 6.950 1.550 Page 72 of 111 .500 6.950 1. SOFT TISSUE DISORDERS MUSCLE.0 M76. Toxic synovitis Ganglion.950 1.950 1.8 M67.550 4. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. TENDON.4 M76.500 6. TENDON.500 6. TENDON.0 M77. SOFT TISSUE DISORDERS MUSCLE.5 M75. TENDON. TENDON. Fasciitis NOS. unspecified Forearm Synovitis and tenosynovitis.96 M65.500 6.950 1.500 6.550 4. overuse and pressure Unspecified soft tissue disorder related to use. SOFT TISSUE DISORDERS MUSCLE.6 M76.550 4. TENDON.950 1. Posterior tibial tendinitis Enthesopathy of lower limb.2 M72.550 4.550 4. unspecified. SOFT TISSUE DISORDERS MUSCLE.5 M70.0 M75. SOFT TISSUE DISORDERS MUSCLE.500 6.500 6.550 4. SOFT TISSUE DISORDERS MUSCLE.500 6. SOFT TISSUE DISORDERS MUSCLE.550 4. Rupture at musculotendinous junction.500 6.500 6. unspecified Site unspecified Rupture of popliteal cyst Spontaneous rupture of other tendons Spontaneous rupture of unspecified tendon. SOFT TISSUE DISORDERS MUSCLE.500 6.5 M71. TENDON.550 4.950 1. TENDON. SOFT TISSUE DISORDERS MUSCLE.0 M66.97 M65. overuse and pressure Other infective bursitis Synovial cyst of popliteal space [Baker] Other bursal cyst.500 6. TENDON. TENDON.500 6. Bone spur NOS.950 1.950 1. TENDON.500 6.550 4.500 6.550 4.0 M70.3 M77. TENDON. Supraspinatus syndrome Bicipital tendinitis Calcific tendinitis of shoulder.500 6.500 6. nontraumatic Short Achilles tendon (acquired) Other contracture of tendon (sheath) Synovial hypertrophy. SOFT TISSUE DISORDERS MUSCLE.500 6.550 4.500 6.550 4. SOFT TISSUE DISORDERS MUSCLE.950 1.500 6. TENDON. SOFT TISSUE DISORDERS MUSCLE.2 M71.950 1. TENDON.950 1.0 M72.950 1. TENDON.550 4. Fasciitis NOS.500 6. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. Anterior tibial syndrome.31 M71. unspecified Chronic crepitant synovitis of hand and wrist Bursitis of hand Olecranon bursitis Other bursitis of elbow Prepatellar bursitis Other bursitis of knee Trochanteric bursitis. unspecified Lower leg Synovitis and tenosynovitis.7 M76. SOFT TISSUE DISORDERS MUSCLE.500 6. SOFT TISSUE DISORDERS MUSCLE.500 6.550 4. Synovial cyst NOS Shoulder region Other bursitis.500 6. unspecified Medial epicondylitis Lateral epicondylitis. TENDON.550 4.950 1. unspecified Pelvic region and thigh Synovitis and tenosynovitis. unspecified Site unspecified Palmar fascial fibromatosis [Dupuytren] Plantar fascial fibromatosis.550 4.950 1.500 6. Tendinitis NOS Other specified soft tissue disorders Multiple site GROUP MUSCLE.500 6.500 6.950 1. NOT ELSEWHERE CLASSIFIED. TENDON. TENDON.500 6. Capsulitis NOS. SOFT TISSUE DISORDERS MUSCLE. excluding foot Gluteal tendinitis Psoas tendinitis Iliotibial band syndrome Tibial collateral bursitis [Pellegrini-Stieda] Patellar tendinitis Achilles tendinitis.950 1. SOFT TISSUE DISORDERS MUSCLE. Other fibroblastic disorders.550 4.550 4.500 6. SOFT TISSUE DISORDERS MUSCLE. TENDON.950 1.3 M67.950 1.3 M76.500 6.2 M70. not elsewhere classified Transient synovitis.550 4. Achilles bursitis Peroneal tendinitis Other enthesopathies of lower limb. SOFT TISSUE DISORDERS MUSCLE.950 1. TENDON. SOFT TISSUE DISORDERS MUSCLE.950 1.950 1.500 6.2 M67.550 4.550 4.7 M70.950 1. excluding foot.950 1.950 1.500 6.4 M70.950 1.500 6.93 M65.950 1. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. TENDON. TENDON.550 4.500 6. SOFT TISSUE DISORDERS MUSCLE.550 4. Rotator cuff or supraspinatus tear or rupture complete)(incomplete). TENDON. SOFT TISSUE DISORDERS MUSCLE.99 M72.950 1.500 6. unspecified.550 4. SOFT TISSUE DISORDERS MUSCLE.950 1.500 6.950 1. Fibromatosis NOS Fibroblastic disorder. SOFT TISSUE DISORDERS MUSCLE. TENDON. TENDON.500 6. TENDON.550 4.550 4.950 1.550 4.550 4. Periarthritis NOS. SOFT TISSUE DISORDERS MUSCLE.500 6.550 4.9 M71. TENDON. TENDON. SOFT TISSUE DISORDERS MUSCLE.8 M75.3 M71.950 1. unspecified Enthesopathies of lower limb.500 6.950 1.550 4.550 4.9 M76 M76.9 M72.99 M66. TENDON.950 1. TENDON.950 1.550 4.950 1. unspecified Bursopathy.950 1. TENDON.9 M70.550 4.8 M77.550 4. SOFT TISSUE DISORDERS MUSCLE.500 6. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.550 4.500 6.500 6.95 M65.550 4.950 1. TENDON.9 M71.950 1.950 1.4 M75. SOFT TISSUE DISORDERS MUSCLE.51 M71.99 M75. TENDON. SOFT TISSUE DISORDERS MUSCLE. TENDON.3 M75. SOFT TISSUE DISORDERS MUSCLE.500 6. SOFT TISSUE DISORDERS MUSCLE.950 1.500 6. TENDON.950 1. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.950 1.950 1.550 4.550 4. SOFT TISSUE DISORDERS MUSCLE.550 4. unspecified Ankle and foot Synovitis and tenosynovitis. TENDON.500 6.500 6. TENDON. TENDON.8 M76.550 4.500 6. SOFT TISSUE DISORDERS MUSCLE. TENDON. unspecified Hand Synovitis and tenosynovitis.500 6.94 M65. TENDON. TENDON.500 6.500 6. not specified as traumatic. unspecified.950 1.550 4. SOFT TISSUE DISORDERS MUSCLE.550 4. SOFT TISSUE DISORDERS MUSCLE.950 1. TENDON.550 4.950 1.9 M77. SOFT TISSUE DISORDERS MUSCLE. TENDON.1 M75. TENDON.500 6.550 4. Ganglion of joint or tendon (sheath) Other specified disorders of synovium and tendon Disorder of synovium and tendon.500 6.550 4.500 6.500 6. TENDON.1 M67. TENDON. Periarthritis of shoulder Rotator cuff syndrome.1 M71.2 M75.6 M70.550 4. TENDON. TENDON. Ischial bursitis Other soft tissue disorders related to use. TENDON.3 M70. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M65.4 M66.550 4. Plantar fasciitis FASCIITIS. TENDON. not elsewhere classified Enthesopathy.950 1.550 4. TENDON.950 1. SOFT TISSUE DISORDERS MUSCLE.500 6. TENDON. SOFT TISSUE DISORDERS MUSCLE.550 4.1 M70.950 1.1 M76.5 M77.950 1.500 6. TENDON. SOFT TISSUE DISORDERS MUSCLE.950 1.1 M77.950 1. SOFT TISSUE DISORDERS MUSCLE.88 M72.500 6. TENDON. SOFT TISSUE DISORDERS MUSCLE. TENDON. Fasciitis NOS.500 6.950 1.500 6.550 4. Abscess of fascia Other Fibroblastic disorder.5 M72.550 4. SOFT TISSUE DISORDERS MUSCLE.550 4. Frozen shoulder.950 1.550 4. SOFT TISSUE DISORDERS MUSCLE. SOFT TISSUE DISORDERS MUSCLE.550 4.950 1.500 6.550 4.950 1.550 4.550 4.8 M70. SOFT TISSUE DISORDERS MUSCLE. TENDON. TENDON. 900 11.900 2.390 5.390 5.530 5. NEURALGIA. NEURALGIA. MulticoreDisease . Myopathy myotubula Primary disorder of muscle.700 7.770 1.130 4.21 M79.770 1. Minicore Disease .3 P00.770 1.900 5.950 1.550 4. capuloperoneal with early contractures [EmeryDreifuss].950 1.15 M79. Muscular dystrophy MYOPATHIES benign.530 5. NEURALGIA.700 7.120 5.770 1. unspecified MUSCLE.550 4. Dystrophia myotonica [Steinert].530 G71. NEURALGIA.310 2.770 3.700 7. unspecified Other Soft tissue disorder.370 5.900 5. unspecified Multiple site Rheumatism.500 6.0 G70.530 5.950 1. NEURALGIA. Hereditary myopathy NOS Drug-induced myopathy Alcoholic myopathy Myopathy due to other toxic agents Periodic paralysis.130 4. RHEUMATISM MYALGIA.01 M79. SOFT TISSUE DISORDERS MUSCLE.12 M79. SOFT TISSUE DISORDERS MUSCLE. TENDON.95 M79.130 4. NEURALGIA. SOFT TISSUE DISORDERS MUSCLE.530 18.900 5.28 M79.530 5.130 4.950 1.900 5.07 M79. NEURALGIA.900 5.900 5. TENDON.370 2.0 G70.500 6.530 5. RHEUMATISM MYALGIA.740 2.370 2. NEURALGIA.370 5. unspecified Other Rheumatism. unspecified Site unspecified Other postprocedural musculoskeletal disorders Transient neonatal myasthenia gravis Myasthenia gravis Congenital and developmental myasthenia Other specified myoneural disorders Myoneural disorder.4 G72. RHEUMATISM MYALGIA.530 5.19 M79. childhood type.00 M79.900 2. NEURALGIA. SOFT TISSUE DISORDERS MUSCLE. NEURALGIA.900 Professional Fee 1.310 2. RHEUMATISM MYALGIA. RHEUMATISM MYALGIA.500 6. RHEUMATISM MYALGIA. Myotonia.3 MYOPATHIES 7.550 4. not elsewhere classified Other specified myopathies Myopathy. Fibretype disproportion.900 5. RHEUMATISM MYALGIA. TENDON.0 Muscular dystrophy.500 6.770 1.900 5.4 MYOPATHIES MYOPATHIES MYOPATHIES NEONATAL CEREBRAL ISCHEMIA NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS 7.1 G72.130 4.900 5.130 4.22 M79.770 1.900 2. unspecified Pelvic region and thigh Neuralgia and neuritis.800 7.500 6. NEURALGIA.900 5.550 4.82 M79.950 1. Myotonia.02 M79.87 M79.530 Other specified soft tissue disorders Pelvic region and thigh MUSCLE. RHEUMATISM MYALGIA.900 5.130 4.05 M79. NEURALGIA. unspecified Pelvic region and thigh Rheumatism.130 4. Muscular dystrophy autosomal recessive. RHEUMATISM MYALGIA.09 M79.500 6.ANNEX 1. Congenital muscular dystrophy NOS.770 1.370 2.9 P91. Periodic paralysis (familial) myotonic.81 M79.130 4. unspecified Neonatal cerebral ischaemia Fetus and newborn affected by maternal hypertensive disorders Fetus and newborn affected by maternal renal and urinary tract diseases Fetus and newborn affected by maternal infectious and parasitic diseases Fetus and newborn affected by other maternal circulatory and respiratory diseases Fetus and newborn affected by maternal nutritional disorders 7.0 P00.370 2. drug-induced.600 7.770 1.370 2.530 G72. Central coreDisease .9 DESCRIPTION Other specified soft tissue disorders Shoulder region Other specified soft tissue disorders Upper arm Other specified soft tissue disorders Hand GROUP MUSCLE. resembling Duchenne or Becker. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M79. NEURALGIA.2 P00.39 M96. unspecified.500 6.900 5.130 8.130 4.530 G71.530 G71. RHEUMATISM MYALGIA. RHEUMATISM MYALGIA.130 4. RHEUMATISM MYALGIA.550 4. RHEUMATISM MYASTHENIA GRAVIS NEWBORN MYOPATHIES MYOPATHIES MYOPATHIES MYOPATHIES G71.370 2.8 G70.86 M79.950 1.770 1.900 5. unspecified Site unspecified Rheumatism. TENDON. TENDON.88 M79. NEURALGIA.480 2.370 5.130 4.770 1.500 6.530 5. unspecified Shoulder region Neuralgia and neuritis. TENDON. unspecified Upper arm Rheumatism.900 5. RHEUMATISM MYALGIA. congenita NOS.900 2. unspecified Shoulder region Rheumatism.130 4.770 1. TENDON.370 2. NEURALGIA. RHEUMATISM MYALGIA. Muscular dystrophy benign [Becker].700 2. symptomatic.900 7.16 M79. SOFT TISSUE DISORDERS Other specified soft tissue disorders Lower leg Other specified soft tissue disorders Ankle and foot Other specified soft tissue disorders Other Other specified soft tissue disorders Site unspecified Soft tissue disorder.85 M79.130 4.900 7.390 5.770 1.1 MYOPATHIES 7.950 1. NEURALGIA. SOFT TISSUE DISORDERS Case Rate 6.8 G72.130 4. RHEUMATISM MYALGIA.0 P00.950 1.390 5.550 4.370 2.770 1.2 G70. chondrodystrophic.500 5.08 M79. SOFT TISSUE DISORDERS MUSCLE.370 7. unspecified Multiple site Neuralgia and neuritis. Periodic paralysis (familial) normokalaemic Inflammatory myopathy.900 7.950 1.370 5.8 P94.900 7.770 1. unspecified Upper arm Neuralgia and neuritis.900 7. TENDON. RHEUMATISM MYALGIA. SOFT TISSUE DISORDERS MUSCLE. TENDON.130 4.130 4.130 4. SOFT TISSUE DISORDERS MYALGIA.0 G72.370 5.900 5.20 M79.950 1.310 2.550 4.530 5.900 25. unspecified Pelvic region and thigh Soft tissue disorder. Myotonia.1 P00. NEURALGIA.10 M79.18 M79. Neuromyotonia [Isaac Congenital myopathies.9 G72.770 1.91 M79.84 M79.900 7.770 1. unspecified Site unspecified Panniculitis. NEURALGIA. unspecified Other Neuralgia and neuritis. Congenital muscular dystrophy with specific morphological abnormalities of the muscle fibre. Myotonia.550 4.25 M79.2 MYOPATHIES 7. TENDON. NEURALGIA.900 5.2 MYOPATHIES MYOPATHIES MYOPATHIES MYOPATHIES 7.530 G72.770 1.390 Page 73 of 111 .900 5.89 M79. congenital recessive [Becker].130 4.500 6.060 5.950 1.900 7.900 5. SOFT TISSUE DISORDERS MUSCLE.900 5.130 4.29 M79.500 6.900 2.130 4. unspecified Ankle and foot Rheumatism. SOFT TISSUE DISORDERS MUSCLE. Muscular dystrophy distal. congenita dominant [Thomsen]. NEURALGIA. Myotonia. TENDON.550 4. RHEUMATISM MYALGIA.900 5.550 4.770 1. RHEUMATISM MYALGIA. NEURALGIA.500 6. RHEUMATISM MYALGIA. unspecified Site unspecified Myalgia Multiple site Myalgia Shoulder region Myalgia Upper arm Myalgia Pelvic region and thigh Myalgia Lower leg Myalgia Other Myalgia Site unspecified Neuralgia and neuritis. Periodic paralysis (familial) hyperkalaemic. NEURALGIA. Periodic paralysis (familial) hypokalaemic.550 4. RHEUMATISM MYALGIA. SOFT TISSUE DISORDERS MUSCLE.770 1. TENDON.310 5.370 Health Care Institution Fee 4. unspecified Shoulder region Soft tissue disorder.770 1.98 M79.550 4.11 M79. Myotonic disorders.99 M79.310 2.900 5.950 1. RHEUMATISM MYALGIA.770 1. Myotonia.700 7.900 7. Breech presentation before labor.390 5.390 5. caesarian section or surgical induction. Vasa praevia Fetus and newborn affected by chorioamnionitis.390 P02.9 P02.700 7.8 P03.390 5. Abdominal pregnancy Fetus and newborn affected by multiple pregnancy. Hydramnios Fetus and newborn affected by ectopic pregnancy.310 2.4 P03.700 2.700 2. Triplet pregnance.9 P04.2 P04.390 5.700 7.310 2.390 5.700 7.310 2.390 5.700 7.310 2.310 2.700 7. Membranitis.390 5.5 P00.700 7.700 7.310 5.390 Page 74 of 111 . External version NEONATE AFFECTED BY MATERNAL FACTORS before labour.310 2.390 5.310 2.1 Fetus and newborn affected by other forms of placental separation and haemorrhage.310 2.700 7. Antepartum haemorrhage.390 5. Cytotoxic drugs Fetus and newborn affected by maternal use of tobacco Fetus and newborn affected by maternal use of alcohol NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS P02.390 P01. Placental and cord abnormalities resulting in twin-to-twin or other transplacental transfusion 7. Entanglement of NEONATE AFFECTED BY MATERNAL FACTORS cord.700 7.390 5. Accidental haemorrhage. Amnionitis. malposition and disproportion during labour and delivery. Face presentation before labour.5 NEONATE AFFECTED BY MATERNAL FACTORS 7.310 2.700 2.6 P03.390 5.700 7. Knot in cord Fetus and newborn affected by other and unspecified conditions of umbilical cord.6 P02.2 P03.700 7.310 Health Care Institution Fee 5.310 2.310 5. Abruptio placentae.700 2.390 5.700 7.310 2.0 7.390 5.700 7.390 5.390 5.ANNEX 1.9 P01.7 Fetus and newborn affected by malpresentation before labour.390 5.390 5.310 2.700 7.310 2.310 2.6 P00.700 7. Short cord.390 P03.700 7.310 5.3 NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS 7.5 P01. not elsewhere classified Fetus and newborn affected by other maternal conditions Fetus and newborn affected by unspecified maternal condition Fetus and newborn affected by incompetent cervix Fetus and newborn affected by premature rupture of membranes Fetus and newborn affected by oligohydramnios Fetus and newborn affected by polyhydramnios.310 2.390 5. fetus Fetus and newborn affected by maternal complication of pregnancy.390 5.700 2.2 NEONATE AFFECTED BY MATERNAL FACTORS 7.1 P04.390 5. Persistent occipitoposterior. unspecified Fetus and newborn affected by maternal anaesthesia and analgesia in pregnancy.700 Professional Fee 2.700 7.310 2. Twin pregnancy Fetus and newborn affected by maternal death GROUP NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS Case Rate 7.390 5.700 7.390 P02. Transverse lie Fetus and newborn affected by forceps delivery Fetus and newborn affected by delivery by vacuum extractor [ventouse] Fetus and newborn affected by caesarean delivery Fetus and newborn affected by precipitate delivery Fetus and newborn affected by abnormal uterine contractions Fetus and newborn affected by other specified complications of labour and delivery Fetus and newborn affected by complication of labour and delivery.7 P00.390 5.700 7.1 P03.700 7. labour and delivery Fetus and newborn affected by other maternal medication.310 2.700 7.700 2. unspecified Fetus and newborn affected by placenta praevia NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS NEONATE AFFECTED BY MATERNAL FACTORS 7. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE P00.390 5. Placental dysfunction.310 2.1 P01. Unstable lie before labour Fetus and newborn affected by other maternal complications of pregnancy.310 2. Transverse lie before labour.8 P01.8 P02. Placental insufficiency Fetus and newborn affected by placental transfusion syndromes.5 P03.390 P02.310 2.310 2.310 2.310 2.3 P02.390 5. unspecified Fetus and newborn affected by breech delivery and extraction Fetus and newborn affected by other malpresentation.310 5.310 5.700 7. Cancer chemotherapy.310 2.3 P01.390 5.700 7.310 5.310 2. Spontaneous abortion.700 7. Placentitis Fetus and newborn affected by other abnormalities of membranes Fetus and newborn affected by abnormality of membranes.700 7. Maternal blood loss.390 5.700 7.700 7.2 P01.390 Fetus and newborn affected by prolapsed cord NEONATE AFFECTED BY MATERNAL FACTORS Fetus and newborn affected by other compression of umbilical cord.7 P02.3 P03.8 P00.310 5.310 2. Pre Fetus and newborn affected by other and unspecified morphological and functional abnormalities of placenta.9 P03.6 DESCRIPTION Fetus and newborn affected by maternal injury Fetus and newborn affected by surgical procedure on mother Fetus and newborn affected by other medical procedures on mother.310 2.0 P04.4 P01.4 P02.0 P01.700 7.390 5.390 5.390 P01.310 2.310 2.390 5.390 5.0 7.310 2.700 2.700 7. Cord (tightly) around neck. Placental infarction. NEONATE AFFECTED BY MATERNAL FACTORS Damage to placenta from amniocentesis.700 7. Contracted pelvis. 540 8.200 12.660 8.540 Neoplasm of uncertain or unknown behaviour of Appendix NEOPLASMS OF UNKNOWN BEHAVIOR Neoplasm of uncertain or unknown behaviour of Colon Neoplasm of uncertain or unknown behaviour of Rectum.540 8.9 D41.5 P04.200 12.660 8.660 3.540 8.ANNEX 1.7 NEOPLASMS OF UNKNOWN BEHAVIOR 12. Neoplasm of uncertain or unknown behaviour of Anal canal.200 12. Neoplasm of uncertain or unknown behaviour of Rectosigmoid junction Neoplasm of uncertain or unknown behaviour of Liver.660 3.540 8.200 12.200 3.660 3.390 Fetus and newborn affected by maternal use of nutritional NEONATE AFFECTED BY MATERNAL FACTORS chemical substances Fetus and newborn affected by other maternal noxious NEONATE AFFECTED BY MATERNAL FACTORS influences Neoplasm of uncertain or unknown behaviour of Lip.660 8. Invasive Hydatidiform mole.200 3.200 3. unspecified Neoplasm of uncertain or unknown behaviour of Prostate Neoplasm of uncertain or unknown behaviour of Testis Neoplasm of uncertain or unknown behaviour of Other male genital organs.660 3.0 12.540 D38. Neoplasm of uncertain or unknown behaviour of Skin of male genital organs Neoplasm of uncertain or unknown behaviour of Male genital organ.540 8.3 NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR 12.0 D41.200 3.660 8.3 D37.660 3.5 12.310 2.540 8.0 D39.660 3.540 D37.200 12. Malignant Hydatidiform mole Neoplasm of uncertain or unknown behaviour of Other female genital organs. Neoplasm of uncertain or unknown behaviour of Suprahyoid portion of Epiglottis Neoplasm of uncertain or unknown behaviour of Trachea.660 3.660 8. Neoplasm of uncertain or unknown behaviour of Aryepiglottic fold NOS.540 8.660 8.2 12.540 D37.200 12.660 3.200 3.660 3. oral cavity and pharynx.660 3.200 12.540 8.540 Page 75 of 111 .7 D40. Neoplasm of uncertain or unknown behaviour of Middle Neoplasm of uncertain or unknown behaviour of Respiratory organ.660 3.3 D38. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE P04.390 5.1 D37.700 7.2 D41.540 D38. Neoplasm of uncertain or unknown behaviour of Anus NOS.540 8.200 12.200 12.200 12.540 8.700 Professional Fee 2.200 12.200 12.1 D38.660 3.540 D38.660 3.200 12.540 8.9 D40.0 12.2 D37. Neoplasm of NEOPLASMS OF UNKNOWN BEHAVIOR uncertain or unknown behaviour of hypopharyngeal aspect of Aryepiglottic fold .1 D41.7 12.200 3.6 NEOPLASMS OF UNKNOWN BEHAVIOR 12. Neoplasm of uncertain or unknown behaviour of Skin of female genital organs Neoplasm of uncertain or unknown behaviour of Female genital organ. Neoplasm of un Neoplasm of uncertain or unknown behaviour of Stomach Neoplasm of uncertain or unknown behaviour of Small intestine NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR D37. Neoplasm of uncertain or NEOPLASMS OF UNKNOWN BEHAVIOR unknown behaviour of Cartilage of nose.540 8.9 Neoplasm of uncertain or unknown behaviour of Digestive NEOPLASMS OF UNKNOWN BEHAVIOR organ.540 8.660 3. bronchus and lung Neoplasm of uncertain or unknown behaviour of Pleura Neoplasm of uncertain or unknown behaviour of Mediastinum Neoplasm of uncertain or unknown behaviour of Thymus NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR 12. unspecified Neoplasm of uncertain or unknown behaviour of Larynx.4 D37.200 12.660 8.2 D38.660 8.660 3. gallbladder and bile ducts.660 8.540 8. Neoplasm of uncertain or unknown behaviour of laryngeal NEOPLASMS OF UNKNOWN BEHAVIOR aspect of Aryepiglottic fold.540 8. Neoplasm NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR D37.540 8.660 3.540 8.540 D39.200 3.5 Neoplasm of uncertain or unknown behaviour of Other respiratory organs.200 3. Neoplasm of uncertain or unknown behaviour of Accessory sinuses.660 8.4 12. NEOPLASMS OF UNKNOWN BEHAVIOR Chorioadenoma destruens.200 12. unspecified Neoplasm of uncertain or unknown behaviour of Kidney Neoplasm of uncertain or unknown behaviour of Renal pelvis Neoplasm of uncertain or unknown behaviour of Ureter Neoplasm of uncertain or unknown behaviour of Urethra NEOPLASMS OF UNKNOWN BEHAVIOR D39.660 3. Neoplasm of uncertain or unknown behaviour of Anal sphincter.310 Health Care Institution Fee 5.660 8.200 12.200 3.540 D37.0 D40.200 12.200 12.200 3. Neoplasm of uncertain or unknown behaviour of Ampulla of Vater Neoplasm of uncertain or unknown behaviour of Other digestive organs. unspecified Neoplasm of uncertain or unknown behaviour of Uterus Neoplasm of uncertain or unknown behaviour of Ovary NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR 12.540 Neoplasm of uncertain or unknown behaviour of Placenta.540 D38.200 3.540 8.1 D40.660 3.6 D39.8 DESCRIPTION GROUP Case Rate 7.1 D39. 200 12.200 12.0 D42.4 D44.0 NEOPLASMS OF UNKNOWN BEHAVIOR 12.540 8.3 D43.540 D44. haematopoietic and related tissue GROUP NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR Case Rate 12.660 3.660 3. Preleukaemia syndrome NOS Histiocytic and mast cell tumours of uncertain and unknown behaviour.660 3. Myeloproliferative disease.540 8.9 NEOPLASMS OF UNKNOWN BEHAVIOR 12. supratentorial.660 8.200 12.540 D47.540 D43. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE D41.200 12.540 8.660 8.200 3.200 12.1 D47.7 NEOPLASMS OF UNKNOWN BEHAVIOR 12.540 8.200 12.540 8.660 3. Mast cell tumour NOS. unspecified Neoplasm of uncertain or unknown behaviour of Cerebral meninges Neoplasm of uncertain or unknown behaviour of Spinal meninges Neoplasm of uncertain or unknown behaviour of Meninges.540 8. Idiopathic haemorrhagic thrombocythaemia Other specified neoplasms of uncertain or unknown behaviour of lymphoid.660 3. unspecified.660 8.9 D45 D46 D46.540 8.200 Professional Fee 3. Neoplasm of uncertain or unknown behaviour of Cerebrum. NEOPLASMS OF UNKNOWN BEHAVIOR haematopoietic and related tissue.200 3.540 8.200 12.660 3.200 12. infratentorial.660 3. unspecified.200 12.7 D44. Megakaryocytic Myelosclerosis with myeloid metaplasia Monoclonal gammopathy Essential thrombocythaemia.540 8.200 12.0 Neoplasm of uncertain or unknown behaviour of lymphoid.540 8.4 D43.7 D46.200 12.540 8.540 8.200 12.540 8.200 12.200 3.200 3. Neop Neoplasm of uncertain or unknown behaviour of Brain.540 8.540 8. Neoplasm of uncertain or unknown behaviour of Brain stem.2 D47. Mastocytoma NOS Chronic myeloproliferative disease. Myelodysplasia NOS. unspecified Polycythaemia vera Myelodysplastic syndromes Other myelodysplastic syndromes Myelodysplastic syndrome.9 D48.9 DESCRIPTION Neoplasm of uncertain or unknown behaviour of Bladder Neoplasm of uncertain or unknown behaviour of Urinary organ.660 Health Care Institution Fee 8.540 8.540 D43.660 3. unspecified Neoplasm of uncertain or unknown behaviour of Brain.660 3.660 3.660 8. unspecified Neoplasm of uncertain or unknown behaviour of Cranial nerves Neoplasm of uncertain or unknown behaviour of Spinal cord Neoplasm of uncertain or unknown behaviour of Other parts of central nervous system Neoplasm of uncertain or unknown behaviour of Central nervous system. Myelodysplastic syndrome NOS.540 D47.1 D44.3 NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR 12.9 NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR 12.3 D44.540 D43.660 8.660 8.200 12.1 D42.200 12.7 NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR NEOPLASMS OF UNKNOWN BEHAVIOR 12. Lymphoproliferative disease NOS Neoplasm of uncertain or unknown behaviour of Bone and NEOPLASMS OF UNKNOWN BEHAVIOR articular cartilage 12.540 8.660 3.200 12.200 3.660 3.6 D44.200 3.200 12. Neoplasm of uncertain or unknown behaviour of Central Nervous system NOS Neoplasm of uncertain or unknown behaviour of Thyroid gland Neoplasm of uncertain or unknown behaviour of Adrenal gland Neoplasm of uncertain or unknown behaviour of Parathyroid gland Neoplasm of uncertain or unknown behaviour of Pituitary gland Neoplasm of uncertain or unknown behaviour of Craniopharyngeal duct Neoplasm of uncertain or unknown behaviour of Pineal gland Neoplasm of uncertain or unknown behaviour of Carotid body Neoplasm of uncertain or unknown behaviour of Aortic body and other paraganglia Neoplasm of uncertain or unknown behaviour of Pluriglandular involvement.200 3. Neoplasm of uncertain or unknown behaviour of Cerebellum.660 3.660 3.660 3.540 8.200 3.540 Page 76 of 111 . Multiple endocrine adenomatosis Neoplasm of uncertain or unknown behaviour of Endocrine gland.540 8.660 3.200 12.660 3.540 8.660 3.540 D47. unspecified. Neoplasm of uncertain or unknown behaviour of Frontal lobe.2 D43.660 3.200 12.0 D44.660 3.540 D47. Haemorrhagic thrombocythaemia.8 D44.540 8.1 NEOPLASMS OF UNKNOWN BEHAVIOR 12.660 8.5 D44.660 3.540 8. Myelofibrosis with myeloid metaplasia.ANNEX 1. Neoplasm of uncertain or unknown behaviour of Fourth ventricle Neoplasm of uncertain or unknown behaviour of Brain.200 12.4 D41.660 3.660 3.200 12.200 3.540 8.2 D44. unspecified.540 D43.200 12. Neoplasm of uncertain or unknown behaviour of Cerebral ventricle.0 NEOPLASMS OF UNKNOWN BEHAVIOR 12.200 12.660 8.9 D42.660 8. 830 11.1 P07.370 2.900 7.8 N83. Prematurity NOS Exceptionally large baby. group B Sepsis of newborn due to other and unspecified streptococci Sepsis of newborn due to Staphylococcus aureus Sepsis of newborn due to other and unspecified staphylococci Sepsis of newborn due to Escherichia coli Sepsis of newborn due to anaerobes Other bacterial sepsis of newborn Bacterial sepsis of newborn. "Growth" NOS .070 5. Neoplasm NOS. Other fetus or infant heavy.3 D48.900 16.900 16.370 2. Fetus or infant with gestation period of 42 completed weeks or more (294 days or more).900 7.9 N85.510 3. New growth NOS.1 7.ANNEX 1. Usually implies a birth weight of 4500 g or more.370 2. unspecified Extremely low birth weight.190 8.100 4.200 3.9 P07.370 5.LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED.500 9.550 2.830 11.8* P05. Neoplasm of uncertain or unknown behaviour of Peripheral nerves of orbit Neoplasm of uncertain or unknown behaviour.200 3.0 P08.700 8.9 G55.000 7.8 N85.370 2.000 2.or large-for-dates.900 3. NEOPLASMS OF UNKNOWN BEHAVIOR 12.530 5. Neoplasm of uncertain or unknown behaviour of eyelid Neoplasm of uncertain or unknown behaviour of Peripheral NEOPLASMS OF UNKNOWN BEHAVIOR nerves and autonomic nervous system Neoplasm of uncertain or unknown behaviour of NEOPLASMS OF UNKNOWN BEHAVIOR Retroperitoneum Neoplasm of uncertain or unknown behaviour of NEOPLASMS OF UNKNOWN BEHAVIOR Peritoneum Neoplasm of uncertain or unknown behaviour of Breast.440 Page 77 of 111 .5 P36.540 D48.370 2.510 3.550 2.830 P07.510 3.700 11. Less than 28 completed weeks (less than 196 completed days) of gestation.760 8. Other low birth weight.8 P36.550 2. Shoulder-girdle neuritis Other nerve root and plexus disorders Nerve root and plexus disorder. Fibrosis of uterus NOS Noninflammatory disorder of uterus.530 11.070 5.4 12.190 8.370 2. Parsonage-Aldren-Turner syndrome.LOW BIRTH less than 37 completed weeks (196 completed days but less WEIGHT/PRETERM than 259 completed days) of gestation.2 NEWBORN COMPLICATED-POSTTERM 7.530 5.510 3.700 11.900 7. Tumour NOS Brachial plexus disorders.190 8.LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED.540 D48. unspecified.830 11.9 N83.0 P36.660 8.530 5.530 5.530 5.550 2.3 G54.900 4. Thoracic outlet syndrome Lumbosacral plexus disorders Cervical root disorders. Postmaturity NOS Sepsis of newborn due to streptococcus.830 11.900 16.0 P05.2 P05.070 8.LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED. Birth weight 999 g or less. not elsewhere classified Neuralgic amyotrophy.1 G54.900 7.530 5.510 3. Other heavy for gestational age infants.540 8.9 G54.500 2. Post-term infant.900 7.830 P08. unspecified.830 11. not elsewhere classified Lumbosacral root disorders.500 8.2 G54. not elsewhere classified Thoracic root disorders.1 NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NEWBORN SEPSIS NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NONINFLAMMATORY DISORDERS OF THE FEMALE GENITAL TRACT NUTRITIONAL DISORDER NUTRITIONAL DISORDER 11.1 Neoplasm of uncertain or unknown behaviour of Connective and other soft tissue.250 P36.3 P36. Bitot's spot in the young child NEWBORN COMPLICATED-LARGE BABY NEWBORN COMPLICATED-LARGE BABY 16.370 2.0 G54. unspecified Nerve root and plexus compressions in other diseases classified elsewhere Light for gestational age Small for gestational age Fetal malnutrition without mention of light or small for gestational age Slow fetal growth.700 11.540 D48.0 E50.070 11.830 11. Broad ligament laceration syndrome [Allen-Masters] Noninflammatory disorder of ovary.950 5.440 6.950 6.5 G54.LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED.900 16.0 P07.200 3.8 G54.200 9. Neoplasm of uncertain or unknown behaviour of Connective tissue of breast.660 8.700 11.1 P05.LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED.200 7.900 7. unspecified Other noninflammatory disorders of ovary.190 8.200 12.4 G54. Disorder of uterus NOS Vitamin A deficiency with conjunctival xerosis Vitamin A deficiency with Bitot's spot and conjunctival xerosis.7 NEOPLASMS OF UNKNOWN BEHAVIOR 12.700 11. fallopian tube and broad ligament.700 11. acquired. Extreme immaturity. Atrophy of uterus.540 5. Neoplasm of uncertain or unknown behaviour of Heart.900 16.500 8.500 8.190 5.1 P36.950 5.2 NEOPLASMS OF UNKNOWN BEHAVIOR NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NERVE ROOT AND PLEXUS DISORDERS NEWBORN COMPLICATED.900 16.660 3.070 5.200 12.LOW BIRTH WEIGHT/PRETERM 12.530 5.900 16.or large-for-dates regardless of period of gestation.540 D48.660 3.760 2.900 7.190 8. Cystosarcoma phyllodes Neoplasm of uncertain or unknown behaviour of Other specified sites.900 5. not heavy.070 5. Birth weight 1000-2499 g.LOW BIRTH WEIGHT/PRETERM NEWBORN COMPLICATED.100 2.660 8.200 3. unspecified Other specified noninflammatory disorders of uterus.900 P08.660 8.510 3.950 5. Neoplasm of uncertain or NEOPLASMS OF UNKNOWN BEHAVIOR unknown behaviour of Connective tissue of ear.2 D48.530 5.3 Other preterm infants. 28 completed weeks or more but NEWBORN COMPLICATED.510 3. fallopian tube and broad ligament.190 8.700 11.4 P36.510 2.540 8.9 E50.370 2.900 7.250 5. not heavy for gestational age.200 3.070 5.070 5. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee D48.660 2.190 8. Neoplasm of uncertain or unknown behaviour of Eye.6 12.2 P36. 440 6.200 9.440 6.760 2.100 9.1 E63.0 E55.100 9.9 E64.1 E56.100 9.5 with infection.530 9.440 6. epididymitis and epididymo-orchitis with abscess.900 3.000 13.900 Health Care Institution Fee 6.440 6. unspecified.200 9.900 3.8 E56.910 2.000 13.760 2.200 9.760 4.100 9.000 13.000 13.700 7. Scurvy Rickets.100 9.81 DESCRIPTION OTHER MANIFESTATIONS OF VITAMIN A DEFICIENCY Vitamin A deficiency.000 13.9 E53.700 9.000 13.080 2.900 3.9 E54 E55.910 2.80 M86.440 6.790 6. Pantothenic acid Deficiency. Infantile Osteomalacia.200 9.760 2.700 9.200 9. Brodie's abscess Multiple site Other osteomyelitis.9 M86.790 6.200 9.200 9.700 9. Brodie's abscess Other osteomyelitis.000 13.200 9.100 9.200 9.440 6.000 13.15 M86.200 9.100 9.900 3.440 6.900 3.900 3.200 9.370 3.440 9.440 6.200 9. unspecified Imbalance of constituents of food intake Other specified nutritional deficiencies Nutritional deficiency.50 M86.100 9.600 9.6 M86. not elsewhere classified Hydronephrosis with renal and ureteral calculous obstruction Other and unspecified hydronephrosis Hydroureter Kinking and stricture of ureter without hydronephrosis Pyonephrosis. Urinary tract obstruction NOS Orchitis.000 13.760 2.200 9.900 3.200 9. Obstructive uropathy with infection Vesicoureteral-reflux-associated uropathy.760 2.9 E58 E60 E61. Orchitis NOS Acute haematogenous osteomyelitis Other acute osteomyelitis Other acute osteomyelitis Pelvic region and thigh Other acute osteomyelitis Ankle and foot Other acute osteomyelitis Site unspecified Subacute osteomyelitis Subacute osteomyelitis Site unspecified Chronic osteomyelitis with draining sinus Other chronic haematogenous osteomyelitis Other chronic haematogenous osteomyelitis Multiple site Other chronic osteomyelitis Other chronic osteomyelitis Multiple site Other chronic osteomyelitis Shoulder region Other chronic osteomyelitis Upper arm Other chronic osteomyelitis Forearm Other chronic osteomyelitis Pelvic region and thigh Other chronic osteomyelitis Lower leg Other chronic osteomyelitis Ankle and foot Other chronic osteomyelitis Other Other chronic osteomyelitis Site unspecified Other osteomyelitis. Folic acid Deficiency.760 2.000 13.100 9. Cyanocobalamin Deficiency.100 9.200 9.910 2.200 13.760 2.900 13.760 2.17 M86.8 E63. Deficiency of vitamin C.760 2.760 2.100 9.790 6.8 M86.760 2.760 2.100 9.760 2.200 9.100 9.9 E67.910 2.900 3.7 N13.790 6.900 3.100 9.760 2.910 2.000 13.000 13.700 9.000 13.6 N13.1 E53. Vesicoureteral reflux NOS.9 E56.3 N13.440 6.3 E66.200 9. Vitamin B12 Deficiency Vitamin B deficiency.2 N13.900 3.700 9. Pickwickian syndrome Hydronephrosis with ureteropelvic junction obstruction Hydronephrosis with ureteral stricture.100 9.19 M86.000 13. unspecified Ascorbic acid deficiency.760 2.700 9.200 9.790 6.370 2.440 6.100 9.100 9. Juvenile Osteomalacia Vitamin D deficiency.900 3.0 E56. Hypovitaminosis A NOS Dry Beriberi Wernicke's encephalopathy Other manifestations of thiamine deficiency Thiamine deficiency.2 E51.000 Professional Fee 2.900 3.900 3.9 N45.440 6.000 13.440 6.200 9.760 2.790 6.760 2.60 M86.440 6.440 6.440 6.1 N13.9 E51.440 6. Folate Deficiency.100 9.1 E61.0 N13.61 M86.900 3. Abscess of epididymis or testis Orchitis. unspecified.760 2. Epididymitis NOS. unspecified Dietary calcium deficiency Dietary zinc deficiency Iron deficiency Magnesium deficiency Vanadium deficiency Deficiency of nutrient element.2 N13.9 E63.1 E67.0 E67.5 N13.760 2.440 6.200 9.100 9.200 9.65 M86.5 M86.790 6.900 3.440 6.900 3.910 2.200 9.440 6.66 M86.4 N13.910 2. Vesicoureteral reflux with scarring Other obstructive and reflux uropathy Obstructive and reflux uropathy.900 3. Brodie's abscess Shoulder region GROUP NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER NUTRITIONAL DISORDER OBESITY HYPOVENTILATION OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES OBSTRUCTIVE UROPATHIES ORCHITIS ORCHITIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS Case Rate 9.760 2.8 N13.700 9.760 2.67 M86.62 M86.910 2.8 E50.760 2.900 3. Conditions in N13.440 6.200 9. Avitaminosis D Deficiency of vitamin E Deficiency of vitamin K Deficiency of other vitamins Vitamin deficiency. active.8 E53.0 N45.2 E61.100 9.4 M86.530 5.790 6.900 7.ANNEX 1.100 9. Vitamin B6 deficiency Deficiency of other specified B group vitamins. unspecified Pyridoxine deficiency.440 6.1 M86.1 E51.440 6.520 6.910 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE E50. unspecified Sequelae of unspecified nutritional deficiency Hypervitaminosis A Hypercarotenaemia Hypervitaminosis D Extreme obesity with alveolar hypoventilation.910 2.000 13.700 9.000 13.69 M86.900 3.200 9.440 6.700 9. unspecified.440 6.29 M86.760 2.100 Page 78 of 111 .790 6. Biotin Deficiency.760 2. epididymitis and epididymo-orchitis without abscess.68 M86.900 3.440 6.440 6.100 9.200 9.790 5.760 2.760 2.900 3.760 2.200 9.200 9.000 13.63 M86.440 6.0 M86.900 3.8 E51.200 9.6 E61.440 6.2 M86.000 13.0-N13.760 2.000 13.000 13.000 13. 100 9. unspecified .000 13. Shoulder-hand syndrome.900 8.100 9. Periostitis without mention of osteomyelitis Hand Osteomyelitis.900 3.230 6.900 9.8 A31.000 13.100 9.900 8.900 3.0 A49.100 9.000 8.000 3. Infection of bone NOS.900 3.9 A42.160 6.0 M88.160 6.0 M89.230 6.640 9.230 6.94 M86. unspecified.100 M86.670 2.640 2.900 3.000 13. Mycobacteriosis NOS.100 M86.100 9.8 A49.230 6. unspecified Cutaneous nocardiosis Nocardiosis.6 M89.670 2.100 9.900 8.3 A49.1 M89. Periostitis without mention of osteomyelitis Multiple site Osteomyelitis. Infection of bone NOS.91 M87. unspecified Other specified bacterial diseases Staphylococcal infection. OSTEOMYELITIS AND OSTEONECROSIS Periostitis without mention of osteomyelitis Ankle and foot Osteomyelitis.000 13.900 3.900 8.230 6.9 M86.670 2. Marie-Bamberger disease.900 3.100 9.7 A42.9 A48.160 HIV DISEASE RESULTING IN OTHER BACTERIAL INFECTIONS OTHER BACTERIAL DISEASES Algoneurodystrophy.800 8. unspecified. Marie-Bamberger disease.90 DESCRIPTION Other osteomyelitis. Infection of bone NOS.1 A42.640 6.86 M87.100 6.160 6.9 B20.000 13.160 6.230 6.000 3. Verruga peruana Bartonellosis.100 9.900 8.8 Osteomyelitis.230 6.160 6.000 13.230 6. Infantile cortical hyperostoses. Post-traumatic subperiosteal ossification Other specified disorders of bone.230 6. unspecified.670 2. Brodie's abscess Other Osteomyelitis.92 M86.670 2. Sudeck's atrophy.230 6.230 6. Infection of bone NOS.800 8.100 9.85 OTHER BONE DISORDERS 8.900 3.800 8.100 9.900 2.640 2.5 M89.670 2. unspecified Other bacterial infections of unspecified site Bacterial infection.000 13.000 13. unspecified.640 2.96 OSTEOMYELITIS AND OSTEONECROSIS 13.100 9.000 13. unspecified.670 2.100 9.900 3. Periostitis without mention of osteomyelitis Pelvic region and thigh Osteomyelitis.670 2.1 A44.000 13.900 8.670 2.01 M89.000 3.160 6. Listeriosis (listerial foodborne infection) Pulmonary actinomycosis Abdominal actinomycosis Cervicofacial actinomycosis Actinomycotic septicaemia Other forms of actinomycosis Actinomycosis. Infantile cortical hyperostoses.2 A49.0 A42. Periostitis without mention of osteomyelitis Site unspecified Idiopathic aseptic necrosis of bone Pelvic region and thigh Osteonecrosis due to previous trauma Other osteonecrosis Other osteonecrosis Pelvic region and thigh Other osteonecrosis Lower leg Osteonecrosis. unspecified.000 13.900 Health Care Institution Fee 9.900 3.230 6.900 8. unspecified Osteonecrosis.900 8.900 3.2 M89. unspecified.100 9.100 M86.800 8.900 3. Pachydermoperiostosis Other hypertrophic osteoarthropathy. Sympathetic reflex dystrophy Shoulder region Other disorders of bone development and growth Other hypertrophic osteoarthropathy.48 M89.800 8.800 3.8 A42. unspecified Multiple site Osteonecrosis. unspecified Site unspecified Paget's disease of skull Paget's disease of bone. Atypical mycobacterium infection Not Otherwise Specified.670 2.900 8.640 2. Infection of bone NOS.640 2.900 8.900 3.230 6.100 M86.900 8. unspecified. Sympathetic reflex dystrophy Algoneurodystrophy. Shoulder-hand syndrome.91 OSTEOMYELITIS AND OSTEONECROSIS 13. Pachydermoperiostosis Other Osteolysis Osteolysis Hand Osteopathy after poliomyelitis Other specified disorders of bone.640 2.900 3.000 13. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M86.4 M89.900 8. unspecified Pelvic region and thigh Osteonecrosis.900 8. Periostitis without mention of osteomyelitis Shoulder region Osteomyelitis. Post-traumatic subperiosteal ossification Pelvic region and thigh OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS M89.000 13. unspecified Cutaneous and mucocutaneous bartonellosis.100 9.640 2.670 2.230 6.800 2.85 M87.670 2. Infection of bone NOS.230 6.900 8.900 3.800 8.8 A49.800 8. Periostitis without mention of osteomyelitis Upper arm Osteomyelitis.670 2.100 9. Periostitis without mention of osteomyelitis Osteomyelitis.670 2.900 8.230 6.9 A44. Infection of bone NOS.98 M86.100 9.800 8. unspecified Shoulder region Osteonecrosis.900 8.900 3.2 A42. Sudeck's atrophy. unspecified.900 9.97 M86. Periostitis without mention of osteomyelitis Lower leg GROUP OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS Case Rate 13.88 M86.000 13.1 A43.ANNEX 1. unspecified. Bacteraemia NOS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES OTHER BACTERIAL DISEASES 13.640 2. Infection of bone NOS. unspecified Mycoplasma infection.900 9.670 2.54 M89.670 2.2 M87.670 2.9 A43.99 M88.230 6.230 6.95 M87.160 Page 79 of 111 .900 3.000 13.100 9.000 13.900 8.160 6. unspecified. Periostitis without mention of osteomyelitis Other Osteomyelitis.900 8. unspecified Haemophilus influenzae infection.000 Professional Fee 3.160 6.90 M87.05 M87.670 2.99 M87.95 OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS OSTEOMYELITIS AND OSTEONECROSIS 13.000 13.900 3. Infection of bone NOS.670 2.900 8.9 M87.9 A31. unspecified Other mycobacterial infections Mycobacterial infection. Infection of bone NOS.100 9.8 M87.230 6.900 3.000 13. 560 4.600 11. Infantile cortical hyperostoses.640 10. Chronic Cerebral ischaemia Other lacunar syndrome in unspecified cerebrovascular disease Other vascular syndrome in unspecified cerebrovascular disease Chlamydial infection of pharynx Active stage of trachoma.500 8.640 2.640 6.800 8. Rubinstein-Taybi Syndrome.480 8.640 10. Cockayne Syndrome.160 6.120 8.480 8.600 2.480 6.200 8.800 2. Sotos.550 2. nail patella Syndrome.640 10. VAT Congenital malformation syndromes involving early overgrowth. Binswanger's disease Moyamoya disease Nonpyogenic thrombosis of intracranial venous system. nonruptured Cerebral aneurysm. Post-traumatic subperiosteal ossification Other Other specified disorders of bone.200 15.120 Q87. unspecified Site unspecified JUVENILE OSTEOCHONDROSIS OF HEAD OF FEMUR [LEGGCALVÉ-PERTHES] OTHER JUVENILE OSTEOCHONDROSIS OF HIP AND PELVIS.560 4.480 3.560 4.160 M89.0 M94.800 8. Noonan.200 15.200 15.1 A71. Syndrome Prader-Willi Syndrome.ANNEX 1.640 2.600 11.160 6. Chlamydiosis NOS Tuberous sclerosis. acquired Cerebral atherosclerosis.8 M99.600 3.1 I67.200 15. Zellweger Syndrome Congenital malformations of spleen.5 I67. Acute cerebrovascular insufficiency NOS.640 10.600 11. Syn Congenital malformation syndromes predominantly involving limbs. JUVENILE OSTEOCHONDROSIS AFTER REDUCTION OF CONGENITAL DISLOCATION OF HIP Chondrocostal junction syndrome [Tietze] Other specified disorders of cartilage Other biomechanical lesions Biomechanical lesion. Laurence-Moon(Bardet)-Biedl Syndrome.200 15.0 Q89.560 2.800 15. Epiloia Congenital malformation syndromes predominantly affecting facial appearance.160 6. Cerebral aneurysm NOS.950 5.120 8.9 A74.560 4. Klippel-TrénaunayWeber Syndrome.800 8. not elsewhere classified Other specified cerebrovascular diseases.1 Q89. Syndrome Weaver Syndrome Marfan's syndrome Other specified congenital malformation syndromes. nonruptured.1 OTHER CONGENITAL MALFORMATIONS 11.160 6. Aarskog Syndrome.640 2.0 OTHER CONGENITAL MALFORMATIONS 11.7* I67. Congenital splenomegaly Congenital malformations of adrenal gland Congenital malformations of other endocrine glands.9 Q85.640 2.640 Health Care Institution Fee 6. Post-traumatic subperiosteal ossification Lower leg Other specified disorders of bone.640 10.160 6. Alpor Syndrome. Trachomatous follicular conjunctivitis. De Lange Syndrome . Nonpyogenic thrombosis of intracrannial venous sinus Cerebral arteritis.1 OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER BONE DISORDERS OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CEREBROVASCULAR DISEASES OTHER CHLAMYDIAL DISEASES OTHER CHLAMYDIAL DISEASES OTHER CHLAMYDIAL DISEASES OTHER CHLAMYDIAL DISEASES OTHER CONGENITAL MALFORMATIONS 8.88 OTHER BONE DISORDERS 8.120 Q87.160 6.640 10.600 11. thrombocytopenia Syndrome with absent radius [TAR].640 6.9 I65. Congenital malformation of parathyroid or thyroid gland. Post-traumatic subperiosteal ossification Ankle and foot Other specified disorders of bone. unspecified Occlusion and stenosis of carotid artery Dissection of cerebral arteries.600 3.550 2.200 15.480 3.120 Page 80 of 111 . oro-facial-digital Syndrome. Trachomatous Granular conjunctivitis.120 Q87.640 2.550 2.1 M91.120 8. Cerebral arteriovenous fistula.640 2. unspecified Other Disorder of bone.600 3.2 I67.480 3.98 M89. Infantile cortical hyperostoses.120 8.800 8. Moebius Syndrome.800 Professional Fee 2.800 2. Infantile cortical hyperostoses. Atheroma of cerebral arteries Progressive vascular leukoencephalopathy.640 5. Robin Syndrom Congenital malformation syndromes predominantly associated with short stature.500 8.87 OTHER BONE DISORDERS 8. Infantile cortical hyperostoses.120 8. unspecified Pelvic region and thigh Disorder of bone.640 2.89 M89. Thyroglossal cyst GROUP Case Rate 8.160 M89. Cyclopia. Beckwith-Wiedemann Syndrome. Acrocephalosyndactyly [Apert].200 15.4 Q87.800 8.8 M99. Holt-Oram Syndrome.160 10. Active stage of trachoma.480 3. Persistent thyroglossal duct.9+G46.950 5.4 A71. sirenomelia Syndrome.600 11.200 15.560 4.560 4.640 10.560 4.640 2.8 Q89.7 I67.950 5. Dubowitz Syndrome.560 4.9+G46.950 8.8 M94. Syndrome Goldenhar. unspecified Chlamydial infection.560 4. Nonpyogenic thrombosis of cerebral vein.160 6.0 I67.800 8.600 3. Acrocephalopolysyndactyly. Cryptophthalmos syndrome.120 Q87.800 8.640 4.800 8.2 OTHER CONGENITAL MALFORMATIONS 11.160 6.8 I67.480 3. Post-traumatic subperiosteal ossification Site unspecified Disorder of bone.560 4.640 2. Robinow-Silverman-Smith Syndrome . Trachomatous pannus Trachoma.2 I67.640 10.2 OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS 11. Bourneville's disease.550 3.800 8.6 I67.200 15.500 8.95 M89. Russell-Silver.640 10. Asplenia (congenital). not elsewhere classified.480 8.86 OTHER BONE DISORDERS M89.160 6.480 8.200 15.3 I67. unspecified.8* A56. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Other specified disorders of bone.500 11.99 M91.640 10.160 M89.3 Q87. 340 2. Atrophyof corpus cavernosum and penis .460 5.480 3.0 N83.800 7.480 3. Hypertrophy of corpus cavernosum OTHER DISORDERS OF THE MALE GENITAL TRACT and penis .0 I82.8 I82.2 I82.920 4.340 2.1 I82.4 OTHER DISORDERS OF GLUCOSE REGULATION OTHER DISORDERS OF GLUCOSE REGULATION 8. Hypoglycaemic coma NOS Drug-induced hypoglycaemia without coma Other hypoglycaemia.800 7.1 Q52. Multiple congenital anomalies NOS.9 I81 I82.8 6. Increased secretion from endocrine pancreas of growth hormone-releasing hormone.680 8. Pancreatic endocrine cell hyperplasia OTHER DISORDERS OF GLUCOSE REGULATION NOS OTHER DISORDERS OF THE FEMALE GENITAL Vesicovaginal fistula TRACT Follicular cyst of ovary.460 5.800 7.800 7.400 12.430 5. Thrombosis of corpus cavernosum and penis 8.670 E16.720 2.9 I80.3 I80.3 Q52.100 8.800 7. Posthypoglycaemic coma encephalopathy Increased secretion of glucagon.720 3.720 3.720 3.800 6.340 2.720 3.430 5.720 3.400 12. Hyperinsulinism NOS.720 3.7 Q89. OTHER DISORDERS OF THE FEMALE GENITAL Hypoplasia of uterus and cervix TRACT OTHER DISORDERS OF THE FEMALE GENITAL Doubling of vagina.340 2.460 5. Increased secretion from endocrine pancreas of pancreatic polypeptide.680 8. Hyperplasia of pancreatic endocrine cells with glucagon excess.400 12.460 5.800 7. Deep vein thrombosis NOS Phlebitis and thrombophlebitis of lower extremities.670 E16.460 5.460 5.ANNEX 1.100 7.100 8.2 I80.680 8.3 Q51.8 N47 Disorder of pancreatic internal secretion.680 8.400 12.670 E16.460 5.680 8.430 Health Care Institution Fee 8.800 7.600 12.680 8.430 2.8 Q52.800 7.480 N48.8 Q89.100 Professional Fee 3. Functional nonhyperinsulinaemic hypoglycaemia. Functional Hyperinsulinism.0 I80.6 N83.680 5.100 2.670 E16.400 12.430 2.800 7.720 3.7 N89.8 OTHER DISORDERS OF GLUCOSE REGULATION 8.480 Page 81 of 111 .460 5.400 12. Hyperinsulinism with hypoglycaemic coma.600 11. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE Q89.920 5. Congenital deformity NOS Phlebitis and thrombophlebitis of superficial vessels of lower extremities Phlebitis and thrombophlebitis of femoral vein Phlebitis and thrombophlebitis of other deep vessels of lower extremities.120 8.120 8.460 5. Cyst of graafian follicle.120 8.680 8.340 2.460 4.100 2. not elsewhere classified.400 1.800 7. Multiple congenital deformities NOS Other specified congenital malformations Congenital malformation. Embolism or thrombosis of lower extermity NOS Phlebitis and thrombophlebitis of other sites Phlebitis and thrombophlebitis of unspecified site Portal vein thrombosis.2 Q51. OTHER DISORDERS OF THE FEMALE GENITAL Haemorrhagic follicular cyst of ovary TRACT OTHER DISORDERS OF THE FEMALE GENITAL Acquired atrophy of ovary and fallopian tube TRACT OTHER DISORDERS OF THE FEMALE GENITAL Haematosalpinx TRACT OTHER DISORDERS OF THE FEMALE GENITAL Haematoma of broad ligament TRACT OTHER DISORDERS OF THE FEMALE GENITAL Haematometra.400 12.720 3.4 Q89.680 8.340 2.680 8.680 8.3 E16.720 3.600 11.430 5.800 7. Hyperplasia of pancreatic endocrine cells with glucagon excess Abnormal secretion of gastrin. Hyperplasia of pancreatic islet beta cells NOS. unspecified. Thoracopagus Multiple congenital malformations.2 Q52.340 2.100 2. phimosis and paraphimosis. Septate vagina TRACT OTHER DISORDERS OF THE FEMALE GENITAL Congenital rectovaginal fistula TRACT OTHER DISORDERS OF THE FEMALE GENITAL Imperforate hymen TRACT Other specified congenital malformations of female OTHER DISORDERS OF THE FEMALE GENITAL genitalia TRACT Redundant prepuce.7 Q51.340 1.1 I80.340 2.400 12. Pygopagus.720 3.670 5.340 2.460 5. Portal (vein) obstruction Budd-Chiari syndrome Thrombophlebitis migrans Embolism and thrombosis of vena cava Embolism and thrombosis of renal vein Embolism and thrombosis of other specified veins Embolism and thrombosis of unspecified vein Nondiabetic hypoglycaemic coma. Dicephaly.3 I82.340 2.720 3. Drug-induced insulin coma in nondiabetic.400 2.1 OTHER DISORDERS OF GLUCOSE REGULATION 8.400 12.800 7.400 12.8 I80.600 11.9 E15 E16. Congenital anomaly NOS. Hypergastrinaemia Other specified disorders of pancreatic internal secretion.680 8. Craniopagus.0 N83.480 3. unspecified. Haematocolpos with haematometra or OTHER DISORDERS OF THE FEMALE GENITAL haematosalpinx TRACT OTHER DISORDERS OF THE FEMALE GENITAL Other doubling of uterus' Doubling of uterus NOS TRACT OTHER DISORDERS OF THE FEMALE GENITAL Bicornate uterus TRACT Other congenital malformations of uterus and cervix. Nondiabetic hypoglycaemic coma.3 N83. Monster NOS.400 8.340 2. Tight foreskin Other specified disorders of penis.340 2.460 5.480 3. unspecified.340 2. Increased secretion from endocrine pancrea GROUP OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER CONGENITAL MALFORMATIONS OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF CIRCULATORY SYSTEM OTHER DISORDERS OF GLUCOSE REGULATION OTHER DISORDERS OF GLUCOSE REGULATION Case Rate 11.9 N82.7 N85. Adherent OTHER DISORDERS OF THE MALE GENITAL TRACT prepuce.430 2.0 DESCRIPTION Conjoined twins.400 12.670 5.400 12.460 5.800 7.720 3. Haematosalpinx with haematometra TRACT Haematocolpos.120 8. Isletcell hyperplasia NOS.670 5. Double monster.460 5.680 8. 480 4.8 G93.920 4.800 4. epididymis.4 G93.2 G90.9 G96. Neurogenic orthostatic hypotension [Shy-Drager] Autonomic dysreflexia Disorder of autonomic nervous system.0 Atrophy of testis Vascular disorders of male genital organs.9 G94.3 G90.740 4.060 11.480 Q55.480 Q56. unspecified Other specified diseases of spinal cord.060 8.480 Q55.740 4.1 6.480 Q55. Oedema of spinal cord.000 12. unspecified OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM G95.000 12. Cerebral Meningeal adhesions.060 11.920 4.000 12.920 4.480 11. unspecified.2 G93.740 4.400 OTHER DISORDERS OF NERVOUS SYSTEM.7 G93.2 P94. seminal vesicle.060 11.920 4.0 G96. NOT ELSEWHERE OTHER DISORDERS OF THE NERVOUS SYSTEM CLASSIFIED.740 4.1 P94. testis [except atrophy].920 1. Congenital malformation of testis or scrotum NOS.060 11.400 6.800 15.600 3.800 15.060 11. unspecified.740 4. Bernard(-Horner) syndrome Multi-system degeneration.800 15.000 12.ANNEX 1.400 1. Retractile testis.800 15. seminal vesicle.060 11. Atrophy of scrotum.9 OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM 15.920 4. Congenital malformation of penis NOS.1 OTHER DISORDERS OF THE NERVOUS SYSTEM 15.060 11.8 Other specified disorders of male genital organs.740 4.1 P91.2 G95.800 15.800 1.0 6.740 4.740 4.920 4.800 15.800 15.800 15.480 Q55. Cord bladder NOS.060 11.060 11. Haematocele of male genital organs NOS.800 12.060 11. Nonpyogenic intraspinal phlebitis and thrombophlebitis.9 Congenital malformation of male genital organ. Myelopathy radiation-induced Disease of spinal cord.800 15.800 15.060 11.400 1.480 4.4 OTHER DISORDERS OF THE MALE GENITAL TRACT 6.060 11.8* G95. Benign myalgic encephalomyelitis Encephalopathy.400 8.800 15.0 G93.920 4. Arterial thrombosis of spinal cord.800 15. Absence or aplasia of prostate.060 11.8 G95.4 G90.060 11.3 G90.060 Cerebral cysts.600 3.400 1.9 G98 P90 P91. acquired hydrocephalus OTHER DISORDERS OF THE MALE GENITAL TRACT OTHER DISORDERS OF THE MALE GENITAL TRACT OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM OTHER DISORDERS OF THE NERVOUS SYSTEM 6. testis [except atrophy].740 4.740 3. Male pseudohermaphroditism NOS Pseudohermaphroditism.060 11.740 4.060 11.060 11.800 15. unspecified OTHER SPECIFIED DISORDERS OF BRAIN IN DISEASES CLASSIFIED ELSEWHERE Syringomyelia and syringobulbia Vascular myelopathies.1 OTHER DISORDERS OF THE MALE GENITAL TRACT 6.400 8. spermatic cord.740 4. Spinal Meningeal adhesions Other specified disorders of central nervous system Disorder of central nervous system. Hypertrophy of OTHER DISORDERS OF THE MALE GENITAL TRACT scrotum.. Congenital deformity NOS of male genital organ Male pseudohermaphroditism.740 11.8 G96. epididymis. Acute infarction of spinal cord (embolic)(nonembolic).400 6. Testis migrans Other congenital malformations of vas deferens. elopathy drug-induced. Porencephalic cyst. spermatic cord.600 11.800 15.600 3.740 4.2 OTHER DISORDERS OF THE MALE GENITAL TRACT 6.600 3. unspecified Reye's syndrome Other specified disorders of brain Disorder of brain. Haematomyelia. unspecified Idiopathic peripheral autonomic neuropathy.1 G96.800 15.740 4.800 15.400 1.480 N50.920 Health Care Institution Fee 4.9 G93.740 4.740 4.1 Q56.400 8. Subacute necrotic myelopathy Cord compression.600 3.740 4.3 G93. Absence or aplasia of spermatic cord. Haemorrhage of male genital organs.740 4.400 8.2 P94.000 4.480 N50.400 1.920 4.800 15. unspecified OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN Page 82 of 111 .060 G95.740 4.920 1. NERVOUS SYSTEM DISORDER NOS Convulsions of newborn Acquired periventricular cysts of newborn Neonatal cerebral leukomalacia Congenital hypertonia Congenital hypotonia. Arachnoid cyst.060 11. Curvature of penis (lateral). Monorchism Hypoplasia of testis and scrotum.800 15.400 1. Congenital malformation of vas deferens.060 11. Thrombosis of male genital organs DESCRIPTION GROUP OTHER DISORDERS OF THE MALE GENITAL TRACT Case Rate 6. acquired OTHER DISORDERS OF THE NERVOUS SYSTEM Benign intracranial hypertension Postviral fatigue syndrome.0 G90.060 11. Myelopathy NOS Cerebrospinal fluid leak Disorders of meninges.740 4. unspecified. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE N50. tunica vaginalis and vas deferens.400 8.060 11.400 Professional Fee 1.000 12.740 4. Hypoplasia of penis OTHER DISORDERS OF THE MALE GENITAL TRACT OTHER DISORDERS OF THE MALE GENITAL TRACT 6.800 15.740 4.400 1. not elsewhere classified. Congenital anomalyNOS of male genital organ OTHER DISORDERS OF THE MALE GENITAL TRACT . Fusion of testes Other congenital malformations of testis and scrotum. Polyorchism.740 4.800 15.480 Q55. not elsewhere classified.1 G90.400 15. Carotid sinus syncope Familial dysautonomia [Riley-Day] Horner's syndrome.800 15.0 Q55.6 OTHER DISORDERS OF THE MALE GENITAL TRACT 6. seminal vesicles and prostate. Nonspecific floppy baby syndrome Disorder of muscle tone of newborn. seminal vesicles or prostate NOS Other congenital malformations of penis. tunica vag Absence and aplasia of testis. Phosphate-losing tubular disorders.9 E32. unspecified.500 Professional Fee 3.500 8.200 10.900 10. Nonsuppurative Thyroiditis Chronic thyroiditis with transient thyrotoxicosis Autoimmune thyroiditis.8 J98.550 2.650 N25.4 OTHER RESPIRATORY DISORDERS 10. unspecified OTHER RESPIRATORY DISORDERS OTHER RESPIRATORY DISORDERS OTHER RESPIRATORY DISORDERS OTHER SPIROCHAETAL DISEASES OTHER SPIROCHAETAL DISEASES OTHER SPIROCHAETAL DISEASES 10. Endocrine Disturbance NOS.450 9. Secondary hyperparathyroidism of renal origin Disorder resulting from impaired renal tubular function.160 6. Pleural thickening Chylous effusion.630 7.200 3.550 2. unspecified Cyst of kidney.640 2. Hyperkeratosis of carate pinta.900 10.270 3.140 J98.450 9.550 2. not elsewhere classified Other specified conditions originating in the perinatal period Condition originating in the perinatal period. Renal tubular acidosis NOS. Hernia of mediastinum.800 3.630 7.9 E07. Riedel Thyroiditis Thyroiditis. lymphocytic thyroiditis. Pulmolithiasis OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER ENDOCRINE DISORDERS OTHER NEPHROPATHY 8. Chyliform effusion Fibrothorax Other specified pleural conditions.800 8. Erythematous plaques of carate pinta.400 8.9 A67.0 E06.050 4. Paralysis of diaphragm. unspecified.1 J94.0 E32.850 5.160 Page 83 of 111 . Fibrosis of mediastinum. acquired Pleural plaque without asbestos.8 J94.900 10.8 P96.200 8. Broncholithiasis.050 3.500 2. acquired.630 6. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE P96.8 E32.1 A68.450 9. Progeria Endocrine disorder.500 8.400 5. Transient hashitoxicosis.0 J94.6 J98.000 12.500 13.0 Other chronic thyroiditis.000 12.950 5.550 Health Care Institution Fee 8.9 10. Chronic OTHER DISORDERS OF THE THYROID Fibrous Thyroiditis.9 A66. Haemorrhage of thyroid.950 5.140 J98.8 E29.3 DESCRIPTION Complications of intrauterine procedures.500 8.0 E07.500 10.2 E06.900 10.200 2.630 7.1 E07.140 J98. Pineal gland dysfunction. Lung disease NOS. C-cell hyperplasia of thyroid.1 E06.630 7. Struma lymphomatosa GROUP OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE NEWBORN OTHER DISORDERS OF THE THYROID OTHER DISORDERS OF THE THYROID OTHER DISORDERS OF THE THYROID OTHER DISORDERS OF THE THYROID Case Rate 12. Granulomatous Thyroiditis. Tracheobronchial collapse.050 4. Ligneous Thyroiditis.9 E34.640 7. Chronic respiratory disease NOS Yaws.950 5.0 E31. unspecified.5 Diseases of mediastinum. not elsewhere classified.050 4.600 3.630 7. Familial dyshormogenetic goitre.550 3.1 E29.0 E34.630 7. OTHER DISORDERS OF THE THYROID Pendred's syndrome Other specified disorders of thyroid. Diaphragmatitis.550 2.500 9.900 9. Acquired cystic lung disease. Abscess of thyroid.600 2. Infarction of thyroid. unspecified OTHER DISORDERS OF THE THYROID Hypersecretion of calcitonin.650 N25. Hormone Disturbance NOS Renal osteodystrophy.140 7.060 7.500 13.060 3.850 2. Defective biosynthesis of testicular androgen NOS.270 3.270 3.450 7. unspecified Autoimmune polyglandular failure Polyglandular hyperfunction Polyglandular dysfunction.650 9.850 6.060 2.8 E34.800 8. Solitary cyst of kidney.600 3. Pintids of carate pinta Relapsing fever.630 7.630 7.0 OTHER NEPHROPATHY OTHER NEPHROPATHY OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER PLEURAL CONDITIONS OTHER RESPIRATORY DISORDERS 9.1 E31.650 6.850 4.270 3.000 8. 5-a-Reductase deficiency (with male OTHER ENDOCRINE DISORDERS pseudohermaphroditism).270 3.060 3. Relaxation of diaphragm Other specified respiratory disorders Respiratory disorder. Hashimoto's thyroiditis . Calcification of bronchus.270 2.9 J98.950 7. unspecified Intermediate lesions of pinta.140 6.640 2.5 P96.500 10.900 10.050 4.200 3.630 7. unspecified Carcinoid syndrome Other specified endocrine disorders.630 7.9 E06. Suppurative Thyroiditis Subacute thyroiditis. Sick-euthyroid syndrome Adrenogenital disorder.5 E06.550 2.950 5.270 3. Hydrothorax Pleural condition.9 N25. Renal rickets.400 8.900 10.900 10.140 7.9 N28.500 13.900 10. unspecified Diseases of bronchus. Lightwood-Albright syndrome.950 5.450 9.500 13.550 2.270 3.630 7.9 E31.900 10.900 10. Mediastinitis of mediastinum Disorders of diaphragm.270 3.1 J92. Pyogenic Thyroiditis. Stenosis of bronchus.500 8. Ulcer of bronchus. Tracheobronchial dyskinesia Other disorders of lung.900 10. OTHER DISORDERS OF THE THYROID Hypersecretion of thyrocalcitonin Dyshormogenetic goitre.500 8. Chronic Thyroiditis NOS.9 J94.950 5.ANNEX 1.950 E06. Testicular hypogonadism NOS Testicular dysfunction.900 10.950 5.500 8. Pleural plaque NOS. Congenital debility NOS Acute thyroiditis.9 E28. Azotaemic osteodystrophy. Hypertrophy of thymus Other diseases of thymus Disease of thymus. Calcification of lung. Renal short stature Other disorders resulting from impaired renal tubular function.060 6.8 OTHER NEPHROPATHY 9. not elsewhere classified. Retraction of OTHER RESPIRATORY DISORDERS mediastinum. Multiple cyst of kidney. acquired.200 10.630 7.160 6.270 3. Lymphadenoid goitre. unspecified Persistent hyperplasia of thymus.500 2.270 3.060 7.500 8. Adrenogenital OTHER ENDOCRINE DISORDERS syndrome NOS Other ovarian dysfunction OTHER ENDOCRINE DISORDERS Testicular hypofunction.270 3.270 3. unspecified.550 2. de Quervain Thyroiditis. Hyperchromic lesions of carate pinta. Giant-Cell Thyroiditis.8 E25. Abnormality of thyroidOTHER DISORDERS OF THE THYROID binding globulin.500 13. Endometritis.340 2. Otitis media NOS.000 9.340 2.640 2. Salpingooophoritis. Otitis media. Serous Otitis media. Acute abcess of broad ligament.9 N83.460 5. Chronic atticoantral disease Other chronic suppurative otitis media.000 9. Haemorrhagic corpus luteum cyst Other and unspecified ovarian cysts.460 H65.800 7.700 6.700 2.360 3. chronic transudative Other chronic nonsuppurative otitis media.3 N94.300 6.360 3.0 N73.800 2.9 H65.460 5.460 5.440 1.000 9. Trench mouth. Otitis media.800 7.000 9. Chronic tubotympanal catarrh OTITIS MEDIA OTITIS MEDIA 7.300 6.800 2. Acute Necrotizing Ulcerative Gingivostomatitis. Otitis media with Acute suppurative otitis media Chronic tubotympanic suppurative otitis media.640 2. Transudative Otitis media.000 9.300 6.4 OTITIS MEDIA 7.000 2.340 5.800 7.3 H66. unspecified GROUP Case Rate 8. chronic seromucinous. Purulent otitis media NOS Otitis media.9 N72 OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OTITIS MEDIA OVARIAN CYSTS OVARIAN CYSTS PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES 7. Cancrum oris.700 2.8 N73.160 A69.800 2.800 7. Sepsis. Endocervicitis with or without erosion or ectropion.1 OTITIS MEDIA 7. Otitis media.000 2.700 2. Vincent's angina.300 6. Oophoritis. Simple cyst of ovary Acute salpingitis and oophoritis Chronic salpingitis and oophoritis. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Necrotizing ulcerative stomatitis.8* PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES PELVIC INFLAMMATORY DISEASES 9.340 2.640 Health Care Institution Fee 6. Vincent’s gingivitis Lyme disease.3 N73.000 9. Otitis media.340 5.340 2.700 6. chronic allergic. Otitis media.800 7.300 O08.2 H65.1 OTHER SPIROCHAETAL DISEASES 8. Acute pelvic cellulitis.000 9.460 5. unspecified. Salpingitis.300 6.1 N70.460 5. Noma. chronic with effusion (nonpurulent) Nonsuppurative otitis media.900 9. Spirochaetal stomatitis.160 5. Acute a Chronic mucoid otitis media.460 5. Secretory Otitis media .700 2. Acute otitis media.800 2.700 5.300 6.000 9.700 2. Seromucinous otitis media.360 3.0 N94.160 6. Mucoid Otitis media .2 H66.1 N83.5 N94.300 N94.000 9. Subacute Sanguinous allergic otitis media.4 H66.6 PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN PELVIC PAIN 4.700 2.5 N73.800 7.000 9.2 N70. Otitis media. Exudative Otitis media .700 2. S ubacute otitis media.800 2.0 H66.0 OTHER SPIROCHAETAL DISEASES OTHER SPIROCHAETAL DISEASES OTITIS MEDIA 8.440 1. Chronic Otitis media NOS Corpus luteum cyst.300 6. unspecified Female pelvic peritoneal adhesions Other specified female pelvic inflammatory diseases Female pelvic inflammatory disease. Subacute mucoid allergic otitis media.340 6.2 N94.1 H66.800 4.300 6.1 N73. Acute Otitis media NOS.300 6.0 OTHER SPIROCHAETAL DISEASES A69.700 2.370 2.0 N71.340 5. chronic mucinous.000 9.000 9.300 6. unspecified.360 3.800 2.000 9.340 2.700 2.800 4. Pelvic peritonitis. chronic exudative.300 6. Benign chronic suppurative otitis media. Female pelvic infection or inflammation NOS Female pelvic inflammatory disorders in other diseases classified elsewhere Genital tract and pelvic infection following abortion and ectopic and molar pregnancy.460 5.460 H65. Allergic Otitis media .800 4. Septic shock. unspecified.9 N71. chronic secretory.440 3. Otitis media.800 7.700 2.300 6. Hydrosalpinx Salpingitis and oophoritis. female Chronic parametritis and pelvic cellulitis Unspecified parametritis and pelvic cellulitis Female acute pelvic peritonitis Female chronic pelvic peritonitis Female pelvic peritonitis.9 OTITIS MEDIA 7.ANNEX 1. Acute Necrotizing Ulcerative gingivitis. Exocervicitis with or without erosion or ectropion Acute parametritis and pelvic cellulitis.460 H66.000 9.700 2.340 2. unspecified Acute inflammatory disease of uterus Chronic inflammatory disease of uterus Inflammatory disease of uterus. Catarrhal Otitis media.530 6. Acute and subacute secretory otitis media Other acute nonsuppurative otitis media.440 1. Chronic suppurative otitis media NOS Suppurative otitis media. Retention of ovary.000 2.700 2.340 2.440 1. unspecified Acute serous otitis media. Acute Mucoid allergic otitis media.1 N94.300 6.460 H65.000 9.2 A69. Stomatitis gangrenosa Other Vincent's infections. Glue ear.360 3.300 N73. Acute abscess of parametrium.360 3. Acute allergic Sanguinous otitis media. chronic nonsuppurative NOS.1 N71.800 4.800 4.4 N73.700 2.2 N73. Septicaemia Mittelschmerz Dyspareunia Vaginismus Premenstrual tension syndrome Primary dysmenorrhoea Secondary dysmenorrhoea Dysmenorrhoea.640 6. Fusospirochaetal gangrene.700 2. unspecified.800 8.0 N70. unspecified Inflammatory disease of cervix uteri.6 N73.440 1.800 7.360 Page 84 of 111 . Chronic tubotympanic disease Chronic atticoantral suppurative otitis media.800 4.0 PELVIC INFLAMMATORY DISEASES 9.3 Chronic serous otitis media. Erythema chronicum migrans due to Borrelia burgdorferi Spirochaetal infection.340 2.160 A69.460 H65.440 1. Cervicitis with or without erosion or ectropion.460 5.300 6. Otitis media. Fusospirochaetal pharyngitis . Parametritis.800 7.300 6.800 1.340 5.9 N74.4 N94.700 2.800 Professional Fee 2. 960 K28.1 PEPTIC ULCER DISEASE WITH HEMORRHAGE 12.0 K27.840 3.840 3.840 3.800 3.800 Professional Fee 3.2 K25. with perforation Acute Peptic/ Gastroduodenal ulcer.800 12.840 8.0 PEPTIC ULCER DISEASE WITH HEMORRHAGE 12.800 12.800 12. chronic or unspecified with haemorrhage Gastric/ Peptic/ Pyloric ulcer/ erosion.4 K27.2 K27.800 3.840 3.960 8.800 3.960 K28.800 3.840 3.840 8.960 8. acute / Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer with hemorrhage Gastric ulcer.4 K25.840 8. with haemorrhage Chronic or unspecified Peptic/ Gastroduodenal ulcer.800 12.1 K26.ANNEX 1.800 3.960 K28.840 3.960 K28.960 8.840 8.4 Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal PEPTIC ULCER DISEASE WITH HEMORRHAGE peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer o Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal PEPTIC ULCER DISEASE WITH HEMORRHAGE peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer o Chronic or unspecified Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal PEPTIC ULCER DISEASE WITH HEMORRHAGE peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer o Acute haemorrhagic gastritis. with haemorrhage Acute Peptic ulcer / Gastroduodenal ulcer.960 Page 85 of 111 .800 12.960 8.840 8.6 PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE 12.800 12.5 K25.800 12.960 K28.960 K28.840 8.960 8.960 8. site unspecified.5 12. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Gastric ulcer.6 K26.6 12.0 12.840 3.800 12. site unspecified with perforation Chronic or unspecified Peptic/ Gastroduodenal ulcer.960 8.800 3.800 3.840 3.800 12. acute/ Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer with perforation Gastric ulcer.5 K27.1 K27. chronic or unspecified with both haemorrhage and perforation Duodenal ulcer. site unspecified.840 8.800 12.800 12.960 K25.840 Health Care Institution Fee 8.1 PEPTIC ULCER DISEASE WITH HEMORRHAGE 12.960 8.840 3.960 K28.800 12. acute / Acute erosion of duodenum/ Duodenal peptic ulcer/ Postpyloric peptic ulcer with perforation Chronic Duodenal/ Postpyloric ulcer/ erosion.960 8. site unspecified.960 8. or unspecified with both haemorrhage and perforation Acute Peptic ulcer/ Gastroduodenal ulcer NOS.960 8. with both haemorrhage and perforation Chronic or unspecified Peptic/ Gastroduodenal ulcer.3 PEPTIC ULCER DISEASE WITH HEMORRHAGE 12. acute / Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer with both haemorrhage and perforation Gastric/ Peptic/ Pyloric ulcer/ erosion.800 12.960 8.840 3.960 K26.800 3. or unspecified with perforation Chronic Duodenal/ Postpyloric ulcer/ erosion.800 3. or unspecified with haemorrhage Chronic Duodenal/ Postpyloric ulcer/ erosion. Acute erosive gastritis with haemorrhage PEPTIC ULCER DISEASE WITH HEMORRHAGE 12.800 3.840 3.960 8.960 K29. acute / Acute erosion of duodenum/ Duodenal peptic ulcer/ Postpyloric peptic ulcer with haemorrhage Duodenal ulcer.800 3.960 K25.840 8.6 K27.2 PEPTIC ULCER DISEASE WITH HEMORRHAGE 12. chronic or unspecified with perforation Gastric/ Peptic/ Pyloric ulcer/ erosion.840 3.0 PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE PEPTIC ULCER DISEASE WITH HEMORRHAGE 12.4 K26.5 K26. with both haemorrhage and perforation Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal Acute Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stomal GROUP Case Rate 12.840 8.840 8.840 3. site unspecified.0 PEPTIC ULCER DISEASE WITH HEMORRHAGE K25.840 8. site unspecified. 270 4.830 1. unspecified Congenital tuberculosis Congenital toxoplasmosis. without haemorrhage or perforation Peptic/ Gastroduodenal ulcer.9 P35.9 K26.100 1. site unspecified.830 1.700 12.5 P37.890 8.270 4. Haemophilus influenzae. unspecified Duodenitis Gastroduodenitis.700 12.700 12.830 1.100 6.0 P35.810 3. Gastric atrophy GROUP Case Rate 6.810 3.270 4.890 8.5 K29.100 6.830 1. acute / Acute erosion of stomach/ Pylorus peptic ulcer / Stomach peptic ulcer without haemorrhage or perforation Gastric/ Peptic/ Pyloric ulcer/ erosion.700 12.7 K29. Menetrier's disease Gastritis.7 PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6.100 6.3 K29.4 P23.830 1. group B Congenital pneumonia due to Escherichia coli Congenital pneumonia due to Pseudomonas Congenital pneumonia due to other bacterial agents.3 P35.100 6.100 6.4 K29.3 P37.100 Professional Fee 1.100 6.270 4.700 12.890 8.810 3. without haemorrhage or perforation Duodenal/ Postpyloric ulcer/ erosion.890 8. Chronic Antral gastritis.270 8.830 1.890 8.700 12.6 P23.890 8.890 8.100 12.2 P23.810 3.700 12.810 3. Congenital varicella [chickenpox] Congenital viral disease.100 6.700 12.3 K27.890 8. unspecified as acute or chronic.2 PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6. unspecified as acute or chronic.830 Health Care Institution Fee 4.0 P39.810 3.810 3.700 12.9 PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE K28.7 K25.5 P23.830 1.890 8.100 6.890 8.700 12.810 4.2 K29. unspecified Congenital pneumonia due to viral agent Congenital pneumonia due to Chlamydia Congenital pneumonia due to staphylococcus Congenital pneumonia due to streptococcus. Giant hypertrophic gastritis.810 3.1 K29.700 12.100 6. acute / Acute erosion of duodenum/ Duodenal peptic ulcer/ Postpyloric peptic ulcer without haemorrhage or perforation Chronic Duodenal/ Postpyloric ulcer/ erosion.830 1.830 1. unspecified as acute or chronic.270 4.810 3.9 P23.830 1.890 8.100 1.3 K26.890 8.890 8.700 12.810 3.810 3.7 K27.270 4.830 4.830 1.270 4.830 1.270 4.2 P35.100 6.100 6.700 12.810 3.270 4. Ophthalmia neonatorum NOS Intra-amniotic infection of fetus. PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE Chronic Fundal gastritis Other gastritis.9 P38 P39.810 3.890 8.890 8.700 12. without haemorrhage or perforation Acute Peptic/ Gastroduodenal ulcer.700 12.890 8.890 8. Congenital rubella pneumonitis Congenital cytomegalovirus infection Congenital herpesviral [herpes simplex] infection Congenital viral hepatitis Other congenital viral diseases.1 P35. without haemorrhage or perforation Chronic Peptic/ Gastroduodenal ulcer.700 12. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Gastric ulcer.270 4.830 1.9 P37. Streptococcus.810 3.830 1.270 4. without haemorrhage or perforation Duodenal ulcer.8 K29.700 12.0 P23.700 12.890 8.890 8. unspecified.810 3. Neonatal chlaydial conjunctivitis. unspecified Omphalitis of newborn with or without mild haemorrhage Neonatal infective mastitis Neonatal conjunctivitis and dacryocystitis.3 P23.270 4.9 K27.700 12.810 3. Mycoplasma.100 6. Hydrocephalus due to congenital toxoplasmosis Congenital falciparum malaria Neonatal candidiasis PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS Other specified congenital infectious and parasitic diseases PERINATAL INFECTIONS Congenital infectious and parasitic disease. site unspecified. not elsewhere classified PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS Page 86 of 111 .830 3.270 K29.810 3.1 P37.830 4.1 P23.8 P37.270 4.890 8. chronic without haemorrhage or perforation Gastric/ Peptic/ Pyloric ulcer/ erosion.8 P35.890 8.1 P39.830 1.270 K28. without haemorrhage or perforation Chronic Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal peptic ulcer or erosion/ Stom Unspecified as acute or chronic Gastrojejunal ulcer/ Anastomotic peptic ulcer or erosion/ Gastrocolic peptic ulcer or erosion/ Gastrointestinal peptic ulcer or erosion/ Gastrojejunal peptic ulcer or erosion/ Jejunal peptic ulcer or erosion/ Marginal pepti Other acute gastritis Alcoholic gastritis Chronic superficial gastritis Chronic atrophic gastritis.810 3.9 PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE 6.810 3.100 6.700 12.270 4.810 3.270 4.700 12. except group B Congenital pneumonia Congenital rubella syndrome. Klebsiella pneumonia.830 1.890 8.700 12.810 3.700 12.6 K29.890 8.100 6.810 3.100 6.ANNEX 1.270 K25.7 K26. Granulomatous PEPTIC ULCER DISEASE WITHOUT HEMORRHAGE gastritis.810 3.3 K25.100 6.890 Chronic gastritis.270 4.0 P37.700 1. high risk Parainfluenza virus pneumonia.2+ J17.500 4.63 J15.8 Q85.000 32.200 14.500 10.500 4.560 K65. high risk Viral pneumonia. PeutzJeghers Syndrome.810 3.400 22.000 32.43 J15.400 22.890 8.4 P39.13 J18.000 9.240 3.0+ J17.000 32.000 15. high risk Pneumonia due to staphylococcus.240 3.240 7.000 32. high risk Pneumonia [bronchopneumonia]due to Streptococcus pneumoniae.000 15.8* PNEUMONIA HIGH RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK 32. Adhesions of intestine.500 4.500 4.500 10.000 15.400 22.000 15.810 Health Care Institution Fee 8.290 10.1+ J17. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE P39.0* A42.000 32.600 10.400 22.000 32.600 9. high risk Pneumonia due to Mycoplasma pneumoniae. Adhesions of abdominal wall. high risk Hypostatic pneumonia.400 22.93 PNEUMONIA HIGH RISK 32.290 7. Peritonitis due to bile.700 4. 2010 update) Nosocomial pneumonia Pneumonia in typhoid fever Pneumonia in salmonella infection Pneumonia in tularemia Pneumonia in anthrax Pulmonary mycobacterial infection.000 32.500 10.8 K66.600 9.500 10. unspecified Other phakomatoses. Chronic proliferative peritonitis.000 32.240 7.600 9.93 J16.500 10. high risk Respiratory syncytial virus pneumonia.0* A37. unspecified GROUP PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS PERINATAL INFECTIONS Case Rate 12. Sturge-Weber(-Dimitri)Syndrome.500 10.810 3.03 J18.810 3. high risk Human metapneumovirus pneumonia. high risk Pneumonia due to other streptococci.500 10.200 32.940 22.0* A37.000 4.240 4. Acute Other peritonitis.600 9.500 4.23 14.000 32. Pneumonia due to Serratia marcescens.03 J15. von Hippel-Lindau Syndrome Phakomatosis. Peritonitis due to urine Peritonitis.400 22. high risk Pneumonia due to Klebsiella pneumoniae. high risk Bronchopneumonia.99. unspecified.8 K65. Mesentric fat necrosis.53 J15.000 32.700 12. Subphrenic abscess.0* A69.600 9.600 9.0 Peritoneal adhesions.600 9.0* A48. Mesentric saponification.600 9.8+ J17.800 3. Empiric Management.0 A37. Adhesions PERITONEAL DISORDERS of male pelvis. Subhepatic abscess.800 10.500 10. Abscess of omentum.000 15.400 22. Abdominopelvic abscess.700 Professional Fee 3.500 10.400 10.600 9.700 12.9 J90 J91* B20.000 15.600 9. Retroperitoneal abscess.500 4.400 J18.400 22. high risk Pneumonia due to other aerobic Gram-negative bacteria.600 9.000 15.500 4.000 15.000 15. Hamartosis NOS Pleural effusion.9 Q85.33 J12. high risk Pneumonia due to Escherichia coli.500 10.500 4.000 32.73 J15. high risk Pneumonia [bronchopneumonia] due to Haemophilus influenzae.000 32.000 15.0+ J17.000 15.0* A22.6 J12. high risk Lobar pneumonia.800 14.0* A31.33 J15.500 10.800 3.23 J12.600 9.500 10.000 32.ANNEX 1.400 22. high risk Pneumonia due to Pseudomonas. Acute Generalized peritonitis.03 J18.600 4.000 15. Pleurisy with effusion Pleural effusion in conditions classified elsewhere HIV DISEASE RESULTING IN PNEUMOCYSTIS CARINII PNEUMONIA Adenoviral pneumonia.000 32.600 9.410 10.0* A54.0* A21.500 4.890 8.000 32.03 J12.8* A70+ J17.260 9.400 22.500 4.3 J15.940 9.400 22.400 22.600 9. and Prevention of Communityacquired Pneumonia in Immunocompetent Adults.400 22.500 PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK RISK RISK Page 87 of 111 .600 9. Adhesive bands Other specified disorders of peritoneum Disorder of peritoneum. PERITONITIS Subdiaphragmatic abscess.3 P39.500 4.800 10.400 22.400 22.0* A37.600 9.260 4.500 4.000 32.9+ J17.2+ J17. high risk Bacterial pneumonia [bronchopneumonia]. Adhesions of omentum.1+ J17.3 J14.000 32.400 22. Infection due to Mycobacterium avium.0+ J17.600 9.13 J15.9 10.0+ J17.000 15.410 3. Mycobacterium kansasii Pneumonia in whooping cough due to Bordatella pertusis Pneumonia in whooping cough due to Bordatella parapertusis Pneumonia in whooping cough due to Bordatella species other than pertusis or parapertusis Pneumonia in whooping cough Pneumonia in actinomycoses Legionnaires' disease Pneumonia in nocardiosis Pneumonia in gonorrhea Pneumonia in spirochaetal Pneumonia in ornithosis PERITONITIS PERITONITIS PHAKOMATOSES PHAKOMATOSES PLEURAL EFFUSION PLEURAL EFFUSION PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK PNEUMONIA HIGH RISK 14.000 32.600 9. not elsewhere classified.400 22.8+ J17. Neonatal pyoderma Other specified infections specific to the perinatal period Infection specific to the perinatal period. not elsewhere classified.400 22.23 J15.700 12.600 9. Y95 A01. unspecified PERITONEAL DISORDERS PERITONEAL DISORDERS 10. Adhesions of diaphragm.890 8.9 DESCRIPTION Neonatal urinary tract infection Neonatal skin infection.290 K65. high risk Chlamydial pneumonia. group B. high risk Pneumonia due to streptococcus. This is equivalent to CAP.500 10.890 K66.410 4. high risk Community-acquired pneumonia IV (This classification utilized the American Thoracic Society recommendation. Mesenteric abscess.560 7.600 9. MesentericAdhesions.500 10.0* A02. Abscess of peritoneum. Retrocaecal abscess.1 A53.560 9.700 10.000 32.13 J12.000 15.93 J13.000 9.700 14.8+ J17.500 22.500 4.8 P39.400 J18.0 Acute peritonitis.400 22. Mycobacterium intracellulare [Battey bacillus]. Adhesions of stomach.560 7.560 K66.400 22.000 32.600 22. high risk in the Philippine Clinical Practice Guidelines on the Diagnosis.500 4.000 15. ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE A78+ J17.8* B01.2+ J17.1* B05.2+ J17.1* B06.8+ J17.1* B25.0+ J17.1* B37.1+ J17.2* B38.0+ J17.2* B38.1+ J17.2* B38.2+ J17.2* B39.0+ J17.2* B39.1+ J17.2* B39.2+ J17.2* B39.9+ J17.2* B44.0+ J17.2* B44.1+ J17.2* B58.3+ J17.3* B65.0+ J17.3* B65.1+ J17.3* B65.2+ J17.3* B65.8+ J17.3* B65.9+ J17.3* B77.8+ J17.3* I00+ J17.8* J12.02 J12.12 J12.22 J12.32 J12.92 J13.2 J14.2 J15.02 J15.12 J15.22 J15.32 J15.42 J15.52 J15.62 J15.72 J15.92 J16.02 J18.02 J18.12 J18.22 DESCRIPTION Pneumonia in Q fever Pneumonia in varicella Pneumonia in measles Pneumonia in rubella Pneumonia in cytomegalovirus disease Pneumonia in candidiasis Pneumonia in acute pulmonary coccidiomycosis Pneumonia in chronic pulmonary coccidiomycosis Pneumonia in pulmonary coccidioidomycosis Pneumonia in acute pulmonary histoplasmosis capsulati Pneumonia in chronic pulmonary histoplasmosis capsulati Pneumonia in pulmonary histoplasmosis capsulati Pneumonia in histoplasmosis Pneumonia in invasive pulmonary aspergillosis Pneumonia in other pulmonary aspergillosis Pneumonia in taxoplasmosis Pneumonia in schistosomiasis due to Schistosoma hematobium GROUP PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK RISK RISK RISK RISK Case Rate 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 15,000 Professional Fee 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 4,500 Health Care Institution Fee 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 10,500 PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK PNEUMONIA MODERATE RISK Pneumonia in schistosomiasis due to Schistosoma mansoni PNEUMONIA MODERATE RISK Pneumonia in schistosomiasis due to Schistosoma japonicum Pneumonia in schistosomiasis due to Schistosoma intercalatum; mattheei; mekongi Pneumonia in schistosomiasis Pneumonia in ascariasis Pneumonia in rheumatic fever Adenoviral pneumonia, moderate risk Respiratory syncytial virus pneumonia, moderate risk Parainfluenza virus pneumonia, moderate risk Human metapneumovirus pneumonia, moderate risk Viral pneumonia, moderate risk Pneumonia [bronchopneumonia] due to Streptococcus pneumoniae, moderate risk Pneumonia [bronchopneumonia]due to Haemophilus influenzae, moderate risk Pneumonia due to Klebsiella pneumoniae, moderate risk Pneumonia due to Pseudomonas, moderate risk Pneumonia due to staphylococcus, moderate risk Pneumonia due to streptococcus, group B, moderate risk Pneumonia due to other streptococci, moderate risk Pneumonia due to Escherichia coli, moderate risk Pneumonia due to other aerobic Gram-negative bacteria; Pneumonia due to Serratia marcescens, moderate risk Pneumonia due to Mycoplasma pneumoniae, moderate risk Bacterial pneumonia [bronchopneumonia], moderate risk Chlamydial pneumonia, moderate risk Bronchopneumonia, moderate risk Lobar pneumonia, moderate risk Hypostatic pneumonia, moderate risk Community-acquired pneumonia III (This classification utilized the American Thoracic Society recommendation. This is equivalent to CAP, moderate risk in the Philippine Clinical Practice Guidelines on the Diagnosis, Empiric Management, and Prevention of Community- acquired Pneumonia in Immunocompetent Adults, 2010 update) Spontaneous tension pneumothorax Other spontaneous pneumothorax Other pneumothorax Pneumothorax, unspecified Poisoning by Otheropioids; Poisoning by Codeine; Poisoning by Morphine Poisoning by Other synthetic narcotics; Poisoning by Pethidine Poisoning by Other and unspecified narcotics Poisoning by Cannabis (derivatives) Poisoning by Other and unspecified psychodysleptics [hallucinogens]; Poisoning by Mescaline; Poisoning by Psilocin; Poisoning by Psilocybine Poisoning by Inhaled anaesthetics Poisoning by Intravenous anaesthetics; Thiobarbiturates PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK RISK RISK RISK RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE RISK PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE PNEUMONIA MODERATE RISK RISK RISK RISK J18.92 PNEUMONIA MODERATE RISK 15,000 4,500 10,500 J93.0 J93.1 J93.8 J93.9 T40.2 T40.4 T40.6 T40.7 T40.9 T41.0 T41.1 PNEUMOTHORAX PNEUMOTHORAX PNEUMOTHORAX PNEUMOTHORAX POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM 15,300 15,300 15,300 15,300 6,700 6,700 6,700 6,700 6,700 6,700 6,700 4,590 4,590 4,590 4,590 2,010 2,010 2,010 2,010 2,010 2,010 2,010 10,710 10,710 10,710 10,710 4,690 4,690 4,690 4,690 4,690 4,690 4,690 Page 88 of 111 ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T41.3 T41.5 T42.0 T42.1 T42.2 T42.3 T42.4 T42.6 DESCRIPTION Poisoning by Local anaesthetics Poisoning by Therapeutic gases; Carbon dioxide; Oxygen Poisoning by Hydantoin derivatives Poisoning by Iminostilbenes; Carbamazepine Poisoning by Succinimides and oxazolidinediones Poisoning by Barbiturates Poisoning by Benzodiazepines Poisoning by Other antiepileptic and sedativehypnoticdrugs; Poisoning by Methaqualone;Poisoning by Valproic acid GROUP POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM Case Rate 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 Professional Fee 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 Health Care Institution Fee 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 T42.7 Poisoning by Antiepileptic and sedative-hypnotic drugs, POISONING CAUSED BY ANESTHETICS AND DRUGS unspecified; Poisoning by Draught sleeping NOS; Poisoning AFFECTING THE NERVOUS SYSTEM by Sleeping drug NOS;Poisoning by Sleeping tablet NOS Poisoning by Antiparkinsonism drugs and other central muscle-tone depressants; Poisoning by Amantadine Poisoning by Other and unspecified antidepressants POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM 6,700 2,010 4,690 T42.8 T43.2 T43.3 T43.4 T43.5 T43.6 T43.9 T44.1 T44.2 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Phenothiazine antipsychotics and neuroleptics AFFECTING THE NERVOUS SYSTEM Poisoning by Butyrophenone and thioxanthene POISONING CAUSED BY ANESTHETICS AND DRUGS neuroleptics AFFECTING THE NERVOUS SYSTEM Poisoning by Other and unspecified antipsychotics and POISONING CAUSED BY ANESTHETICS AND DRUGS neuroleptics AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Psychostimulants with abuse potential AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Psychotropic drug, unspecified AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Other parasympathomimetics [cholinergics] AFFECTING THE NERVOUS SYSTEM Poisoning by Ganglionic blocking drugs, not elsewhere POISONING CAUSED BY ANESTHETICS AND DRUGS classified AFFECTING THE NERVOUS SYSTEM Poisoning by Other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, not elsewhere classified; Poisoning byPapaverine Poisoning by Predominantly α-adrenoreceptor agonists, not elsewhere classified; Poisoning by Metaraminol Poisoning by Predominantly ß-adrenoreceptor agonists, not elsewhere classified Poisoning by α-Adrenoreceptor antagonists, not elsewhere classified Poisoning by ß-Adrenoreceptor antagonists, not elsewhere classified Poisoning by Other and unspecified drugs primarily affecting the autonomic nervous system; Drug stimulating both α-and ß-adrenoreceptors Poisoning by Antiallergic and antiemetic drugs POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM T44.3 6,700 2,010 4,690 T44.4 T44.5 T44.6 T44.7 T44.9 T45.0 T45.1 T45.2 T45.3 T50.7 Y46.2 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 6,700 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 2,010 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 4,690 Y46.6 Y47.0 Y47.1 Y47.9 Poisoning by Antineoplastic and immunosuppressive drugs; POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Antineoplastic antibiotics; Poisoning by AFFECTING THE NERVOUS SYSTEM Cytarabine POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Vitamins, not elsewhere classified AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Enzymes, not elsewhere classified AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS Poisoning by Analeptics and opioid receptor antagonists AFFECTING THE NERVOUS SYSTEM Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Hydantoin derivatives Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Other and unspecified antiepileptics Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Barbiturates, not elsewhere classified Drugs, medicaments and biological substances causing POISONING CAUSED BY ANESTHETICS AND DRUGS adverse effects in therapeutic AFFECTING THE NERVOUS SYSTEM use: Benzodiazepines Drugs, medicaments and biological substances causing adverse effects in therapeutic POISONING CAUSED BY ANESTHETICS AND DRUGS use: Sedative, hypnotic and antianxiety drug, AFFECTING THE NERVOUS SYSTEM unspecified;sleeping draught NOS;sleeping drug NOS;sleeping tablet NOS 6,700 2,010 4,690 6,700 2,010 4,690 6,700 2,010 4,690 6,700 2,010 4,690 Page 89 of 111 ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other antipsychotics and neuroleptics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Psychodysleptics [hallucinogens] Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Other parasympatholytics [anticholinergics and antimuscarinics] and spasmolytics, not elsewhere classified;papaverine Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Beta-adrenoreceptor antagonists, not elsewhere classified Poisoning by Penicillins Poisoning by Cefalosporins and other ß-lactam antibiotics Poisoning by Chloramphenicol group Poisoning by Macrolides Poisoning by Tetracyclines Poisoning by Aminoglycosides; Streptomycin Poisoning by Rifamycins Poisoning by Other systemic antibiotics Poisoning by Systemic antibiotic, unspecified Poisoning by Sulfonamides Poisoning by Antimycobacterial drugs Poisoning by Antimalarials and drugs acting on other blood protozoa Poisoning by Anthelminthics Poisoning by Antiviral drugs Poisoning by Other specified systemic anti-infectives and antiparasitics; Poisoning by Hydroxyquinoline derivatives Poisoning by Systemic anti-infective and antiparasitic, unspecified Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Penicillins Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Cefalosporins and other betalactam antibiotics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Chloramphenicol group Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Tetracyclines Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Rifamycins Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Other systemic antibiotics Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Systemic antibiotic, unspecified Sulfonamides Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Antimycobacterial drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Antiviral drugs Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic antibiotics: Other specified systemic anti-infectives and antiparasitics; hydroxyquinoline derivatives Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Systemic anti-infective and antiparasitic, unspecified Drugs, medicaments and biological substances causing adverse effects in therapeutic use: Local antifungal, anti-infective and anti-inflammatory drugs, not elsewhere classified Poisoning by Salicylates Poisoning by 4-Aminophenol derivatives Poisoning by Other nonsteroidal anti-inflammatory drugs [NSAID] GROUP POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM Case Rate 6,700 Professional Fee 2,010 Health Care Institution Fee 4,690 Y49.5 Y49.6 6,700 2,010 4,690 Y51.3 POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM 6,700 2,010 4,690 Y51.7 T36.0 T36.1 T36.2 T36.3 T36.4 T36.5 T36.6 T36.8 T36.9 T37.0 T37.1 T37.2 T37.4 T37.5 T37.8 T37.9 Y40.0 POISONING CAUSED BY ANESTHETICS AND DRUGS AFFECTING THE NERVOUS SYSTEM POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS 6,700 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 7,300 2,010 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 2,190 4,690 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 5,110 Y40.1 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y40.2 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y40.4 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y40.6 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y40.8 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y40.9 Y41.0 Y41.1 POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTIBIOTICS 7,300 7,300 7,300 2,190 2,190 2,190 5,110 5,110 5,110 Y41.5 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y41.8 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y41.9 POISONING CAUSED BY ANTIBIOTICS 7,300 2,190 5,110 Y56.0 POISONING CAUSED BY ANTIBIOTICS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS 7,300 2,190 5,110 T39.0 T39.1 T39.3 7,400 7,400 7,400 2,220 2,220 2,220 5,180 5,180 5,180 Page 90 of 111 not elsewhere classified. Poisoning by Alkalizing agents.5 POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL Poisoning by Stimulant laxatives DRUGS POISONING CAUSED BY GASTROINTESTINAL Poisoning by Saline and osmotic laxatives DRUGS Poisoning by Other laxatives.300 2.490 2.220 2.300 1.500 12.750 8.890 4.0 POISONING CAUSED BY CARDIOVASCULAR DRUGS 12.200 6. not elsewhere classified. medicaments and biological substances causing adverse effects in therapeutic use: Analgesic.490 2.400 7. Poisoning by Rauwolfia Poisoning by Antihyperlipidaemic and antiarteriosclerotic drugs Poisoning by Peripheral vasodilators.410 4.750 8.300 1.7 T46.5 POISONING CAUSED BY CARDIOVASCULAR DRUGS 12.500 3. medicaments and biological substances.1 T50.ANNEX 1.9 POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS 12.400 Professional Fee 2.220 5.4 T48.180 5.750 3.Poisoning by Guanethidine. Poisoning by Intestinal atonia POISONING CAUSED BY GASTROINTESTINAL drugs DRUGS POISONING CAUSED BY GASTROINTESTINAL Poisoning by Digestants DRUGS Poisoning by Other antacids and anti-gastric-secretion drugs 8.340 Y55. medicaments and biological substances causing adverse effects in therapeutic use: Antitussives Drugs.860 4.1 T46.200 6. antipyretic and antirheumatic.890 4.810 5. Poisoning by Acidifying agents.1 T47.750 8.theophylline Poisoning by Mineralocorticoids and their antagonists Poisoning by Loop [high-ceiling] diuretics Poisoning by Carbonic-anhydrase inhibitors. Poisoning by Salbutamol Drugs.750 3.750 T48. theobromine. Poisoning by Immunoglobulin. benzothiadiazides and other diuretics.300 8.750 8.4 T47.300 6. βadrenoreceptor agonists used in asthma theraphy.750 8. not elsewhere classified: aminophylline.750 Y52.0 T47.6 T46.750 3.2 Drugs.810 5.4 6.3 6.810 5.6 6.8 DESCRIPTION Poisoning by Other nonopioid analgesics and antipyretics. unspecified Poisoning by Cardiac-stimulant glycosides and drugs of similar action Poisoning by Calcium-channel blockers Poisoning by Other antidysrhythmic drugs.500 3.750 3.340 Y55.220 2.Poisoning by Nicotimic acid (derivatives) Poisoning by Other and unspecified agents primarily affecting the cardiovascular system Drugs.3 T47. Poisoning by Parathy Poisoning by HistamineH2-receptor antagonists POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM 12. medicaments and biological substances causing adverse effects in therapeutic use: Expectorants Drugs.750 8.810 5.860 1.0 T50. medicaments and biological substances causing adverse effects in therapeutic use: Antiasthmatics.890 1.500 12.400 7.340 4.750 8.300 6.0 T46.4 6.300 6.490 5.300 8.750 Y52. unspecified Other analgesics and antipyretics Drugs.300 8.410 T50. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T39. Poisoning by Lipotropic drugs.340 Y55.340 T50.Poisoning by Acetazolamide Poisoning by Drugs affecting uric acid metabolism Poisoning by Other and unspecified drugs. antipyretic and anti-inflammatory drug.860 4.3 T48.810 Page 91 of 111 .750 T46.860 4.410 4.200 1. Poisoning by Dipyridamole Poisoning by Other antihypertensive drugs.400 2.500 3.9 POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM 6.200 1.500 3.340 4.3 12.180 Y45.300 8.490 2.200 1. Poisoning by Clonidine.410 4. medicaments and biological substances causing adverse effects in therapeutic POISONING CAUSED BY CARDIOVASCULAR DRUGS use: Other antidysrhythmic drugs.2 T47.340 4.500 12. salbutamol.490 2. not elsewhere classified.410 T47.180 5.500 3.490 2.750 3.860 1.890 1.890 1. Poisoning by Immunologicals.2 T50.750 8.750 8.180 T46.5 T48.220 Health Care Institution Fee 5.9 Y45.500 12.200 6.500 12. not elsewhere classified Poisoning by Coronary vasodilators.860 1.6 POISONING CAUSED BY DRUGS AFFECTING THE PULMONARY SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM POISONING CAUSED BY DRUGS AFFECTING THE RENAL SYSTEM 6.750 8.860 4.2 T46.810 5. not elsewhere classified Poisoning by Nonopioid analgesic.8 T39.300 8.200 1. medicaments and biological substances causing adverse effects in therapeutic use: Cardiac-stimulant glycosides and drugs of similar action GROUP POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY ANTI-INFLAMMATORY AGENTS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS POISONING CAUSED BY CARDIOVASCULAR DRUGS Case Rate 7.9 7.750 T46. not elsewhere classified Poisoning by Antitussives Poisoning by Expectorants Poisoning by Anti-common-cold drugs Poisoning by Antiasthmatics. Toxic effect of Propyl AND HEAVY METALS alcohol [1-proponol] Page 92 of 111 .mixtures and substitutes Drugs.3 POISONING CAUSED BY HORMONES 8.190 2.190 2. Poisoning by Natural blood and blood products.950 Y45. medicaments and biological substances causing adverse effects in therapeutic use: Insulin and oral hypoglycaemic [antidiabetic] drugs Drugs. not elsewhere classified.300 2.300 2. vitamin K and other coagulants Poisoning by Glucocorticoids and synthetic analogues Poisoning by Thyroid hormones and substitutes Poisoning by Antithyroid drugs Poisoning by Insulin and oral hypoglycaemic [antidiabetic] drugs Poisoning by Oral contraceptives.500 2.2 POISONING CAUSED BY HORMONES 8.8 T47.6 T38.8 POISONING CAUSED BY HEMATOLOGIC AGENTS 7.500 8.110 5.300 7.920 1.950 5. antiestrogens.500 2.0 T51.400 2.550 5.500 8.550 5.0 T38.480 4.110 T38.550 2.550 2.110 5.810 5. antiandrogens.950 Y45.5 POISONING CAUSED BY HORMONES 8.500 2.500 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T47.550 5.490 2.9 Y44.500 6.7 8.0 POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES POISONING CAUSED BY HORMONES 8.110 T45.110 5.2 POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS 7. Poisoning by Multipleand-single-ingredient preparations Poisoning by Other estrogens and progestogens.490 2.400 6.480 Toxic effect of 2-Propanol. medicaments and biological substances causing adverse effects in therapeutic use: Antithyroid drugs Drugs.810 5.950 5. medicaments and biological substances causing adverse effects in therapeutic use: Oral contraceptives.500 2.550 2.810 5.300 7. Toxic effect of Isoprophyl aclohol Toxic effect of Fusel oil.2 T38.4 T45.190 5.190 2.950 5.Toxic effect of Ethyl alcohol GROUP POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY GASTROINTESTINAL DRUGS POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS POISONING CAUSED BY HEMATOLOGIC AGENTS Case Rate 8.300 8. Mixtures and substitutes Poisoning by Antigonadotrophins.950 5.550 5.920 1. medicaments and biological substances causing adverse effects in therapeutic use: Other nonsteroidal anti-inflammatory drugs [NSAID] Drugs.550 2.190 5. medicaments and biological substances causing adverse effects in therapeutic use: Anticoagulant antagonists.6 T45.550 5. medicaments and biological substances causing adverse effects in therapeutic use: Propionic acid derivatives.110 Y44.300 7.2 POISONING CAUSED BY HORMONES 8.1 DESCRIPTION Poisoning by Antidiarrhoeal drugs Poisoning by Other agents primarily affecting the gastrointestinal system Poisoning by Agent primarily affecting the gastrointestinal system.490 2.300 7.950 Y42.propanoic acid derivatives Drugs.550 5.300 2.500 2. medicaments and biological substances causing adverse effects in therapeutic use: Salicylates Drugs.9 T48.300 Professional Fee 2.110 T45.550 1.500 8.8 T45.7 Y42.950 Y45.500 8.920 5.190 2.3 T38. Toxic POISONING CAUSED BY ORGANIC SUBSTANCES effect of Butyl alcohol [1-butanol]. medicaments and biological substances causing adverse effects in therapeutic use: Glucocorticoids and synthetic analogues Drugs. Poisoning by Tamoxifen Poisoning by Androgens and anabolic congeners Drugs. Toxic effect of Amyl alcohol.300 2.6 T47.550 2.500 8.480 4. unspecified Poisoning by Skeletal muscle relaxants [neuromuscular blocking agents] Drugs.490 Health Care Institution Fee 5.2 T51.810 Y53.3 POISONING CAUSED BY HORMONES 8.550 2. unspecified Drugs.550 2.110 5.3 POISONING CAUSED BY HEMATOLOGIC AGENTS 7.490 2.550 2.950 5. Poisoning by Plasma substitute Primarily systemic and haematological agent.500 2.1 T38.950 5.300 8.500 8.950 4.multiple-and single-ingredient preparations Drugs. Poisoning by Liver preparations and other antianaemic agents. medicaments and biological substances causing adverse effects in therapeutic use: 4-Aminophenol derivatives Toxic effect of Ethanol.500 2. medicaments and biological substances causing adverse effects in therapeutic use: Other estrogens and progestogens.400 6.5 T51.190 5.550 5.300 7.4 POISONING CAUSED BY HORMONES 8.1 POISONING CAUSED BY HORMONES 8.950 Y45. medicaments and biological substances causing adverse effects in therapeutic use: Other agents primarily affecting the gastrointestinal system Poisoning by Iron and its compounds Poisoning by Anticoagulants Poisoning by Fibrinolysis-affecting drugs Poisoning by Anticoagulant antagonists. vitamin K and other coagulants Poisoning by Other primarily systemic and haematological agents.ANNEX 1.5 T38.190 5.950 Y42.4 T38.950 5.950 Y42.5 T45.950 Y42.810 5.500 8.3 POISONING CAUSED BY HORMONES POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS 8.950 5. medicaments and biological substances causing adverse effects in therapeutic use: Anticoagulants Drugs.550 5.300 8.500 8. 920 1.920 1.400 6.1 T54.0 T59.400 Professional Fee 1.920 1.7 T59.9 T58 T59.920 1.400 6.920 4.480 4.920 1.920 1.400 1.0 T56.480 4.920 1.480 4.920 1.920 1. unspecified AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other corrosive organic compounds AND HEAVY METALS Toxic effect of Corrosive acids and acid-like substances.1 T56.400 6.8 T57.400 6. POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Potassium hydroxide.480 4.480 4.920 1.480 4.8 T57.4 POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other organic solvents AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Organic solvent.480 4.2 T52. POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Acid hydrochlorie.400 6.480 4.3 T57. fumes and vapours AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Gases.480 4.400 6.920 1.1 T53.480 4.5 T56.920 1.400 6.400 6.2 T60.920 1.480 4.400 1.480 4. unspecified AND HEAVY METALS Toxic effect of Carbon tetrachloride.480 4. fumes and vapours.8 T52.480 T52.1 T60.400 6.400 6.480 4.400 6.480 4.400 6.9 T60.920 1.400 6.9 T55 T56.4 T52.920 1.920 1.400 6.920 1.480 4. Toxic effect of Paraffin wax.480 4.920 1.480 4.480 4.920 1.480 4.400 6.0 T57.Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES Tetrachloromethane AND HEAVY METALS Toxic effect of Chloroform.400 6.920 1.400 6. unspecified Toxic effect of Petroleum products.480 4. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T51. Toxic effect of Thallium AND HEAVY METALS 6.920 4. Toxic effect of POISONING CAUSED BY ORGANIC SUBSTANCES Trichloromethane AND HEAVY METALS Toxic effect of Dichloromethane.920 1.Toxic effect of Sodium AND HEAVY METALS hydroxide POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Corrosive substance.400 6.920 1.480 4.3 T60.400 1.480 4.400 6.480 Page 93 of 111 .480 4.9 T54. Toxic effect of Toluene [methylbenzene].920 1.400 6.Toxic effect of Acid AND HEAVY METALS sulfurie Toxic effect of Corrosive alkalis and alkali-like substances.480 4.920 1.0 6.400 6.480 T52.400 6.920 1. unspecified AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of soaps and detergents AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Lead and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Mercury and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Zinc and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other metals AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Arsenic and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Phosphorus and its compounds AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Hydrogen cyanide AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other specified in organic substances AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Inorganic substance.400 6.920 Health Care Institution Fee 4.9 DESCRIPTION Toxic effect of Other alcohols Toxic effect of Alcohol.480 4.2 POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS 6.6 T53.Toxic effect of Methylene POISONING CAUSED BY ORGANIC SUBSTANCES chloride AND HEAVY METALS Toxic effect of Other halogen derivatives of aliphatic POISONING CAUSED BY ORGANIC SUBSTANCES hydrocarbons AND HEAVY METALS Toxic effect of Halogen derivative of aliphatic and aromatic POISONING CAUSED BY ORGANIC SUBSTANCES hydrocarbons.480 4.400 6.400 6. unspecified AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of carbon monoxide from all sources AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Nitrogen oxides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Formal dehyde AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Lacrimogenic gas.480 4.480 4.920 1.3 T59.8 T51.480 4.480 4. Toxic effect of Petroleum spirits Toxic effect of Homologues of benzene.480 4.400 6.0 T53.920 1.0 T60.920 1.920 1.480 4.920 1.400 6. Toxic effect of Tear gas AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Chlorine gas AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Carbon dioxide AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other specified gases.4 T53.8 T59.920 1.3 T54.4 T59.920 1.480 4.400 6.920 4.400 6.400 6.400 6. Toxic effect of Xylene [dimethylbenzene] Toxic effect of Ketones GROUP POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS Case Rate 6. Toxic effect of Petroleum ether.400 6.ANNEX 1.1 T57.400 6. Toxic effect of Petroleum naphtha. unspecified AND HEAVY METALS Toxic effect of Organophosphate and carbamate POISONING CAUSED BY ORGANIC SUBSTANCES insecticides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Halogenated insecticides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Other insecticides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Herbicides and fungicides AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES Toxic effect of Rodenticides.480 4. Toxic effect of Gasoline [petrol]. Toxic effect of Kerosine [paraffin oil].400 6.480 T54.920 1.9 T53.400 6.920 1.920 1.2 T59. 0 T61. PLANTS POISONING OTHERS 5.8 T62. PLANTS POISONING FROM ANIMALS.Toxic effect of Sea-snake venom Toxic effect of Venom of other reptiles.700 5. venomous Toxic effect of contact with fish Toxic effect of contact with other marine animals.4 T63.0 DESCRIPTION Toxic effect of Other pesticides Toxic effect of Pesticide.0 T62.590 1.990 3.490 5.300 5.920 1.710 1.990 3. medicaments and biological substances causing adverse effects in therapeutic use: Tetanus vaccine GROUP POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY ORGANIC SUBSTANCES AND HEAVY METALS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS POISONING CAUSED BY TOPICAL AGENTS Case Rate 6.590 1. topically applied Othertopical agents.ANNEX 1. PLANTS POISONING FROM ANIMALS.710 1.700 5. PLANTS POISONING FROM ANIMALS.990 3.480 4. PLANTS POISONING FROM ANIMALS.710 1.300 5.300 2.400 1. INSECTS.990 3.300 2. PLANTS POISONING FROM ANIMALS. INSECTS.2 T61.300 5.590 1.700 5.700 8. Toxic effect of Trinitrotoluene Toxic effect of Carbondisulfide Toxic effect of Paints and dyes.920 1.8 T63.400 5.2 Y43.990 3. Shellfish.710 3. PLANTS POISONING FROM ANIMALS. PLANTS POISONING FROM ANIMALS.8 T61.710 3. Toxic effect of Lizard venom Toxic effect of Venom of scorpion Toxic effect of Venom of spider Toxic effect of Venom of other arthropods.4 T65. INSECTS. PLANTS POISONING FROM ANIMALS. Poisoning by Eye. Spermicides Poisoning by Topical agent. demulcents and protectants Toxic effect of Ciguatera fish poisoning Toxic effect of Scombroid fish poisoning.700 5. nose and throat anti-infectives Poisoning by Dental drugs.2 6.300 1.1 T62.710 1. INSECTS.3 POISONING OTHERS 8. INSECTS. medicaments and biological substances causing adverse effects in therapeutic use: Antiallergic and antiemetic drugs Drugs. Sea anemone.6 T65. unspecified Toxic effect of Cyanides Toxic effect of Nitro derivatives and aminoderivatives of benzene and its homologues.920 1. medicaments and biological substances causing adverse effects in therapeutic use: Emollients. Jellyfish.300 5.990 3.400 6.590 1.400 6.700 5.9 T62.0 T63.590 1.9 T65.810 Y54.590 1.3 T63.2 T62. PLANTS POISONING FROM ANIMALS. PLANTS POISONING FROM ANIMALS.810 Y58. medicaments and biological substances causing adverse effects in therapeutic use: BCG vaccine Drugs.990 3.300 2. demulcents and protectants Poisoning by Keratolytics.700 5.490 5.8 T60.9 T64 T65.6 T63.810 Y54.Toxic effect of Insect bite or sting. Toxic effect of Nitrobenzene.990 3. INSECTS.990 5. INSECTS.5 T49. unspecified Toxic effect of Snake venom.4 POISONING OTHERS 8. PLANTS POISONING FROM ANIMALS.2 T49. INSECTS.9 Y56.710 1.700 5. INSECTS. INSECTS.700 5.990 3. INSECTS.710 1.990 3.990 3.300 2. PLANTS POISONING FROM ANIMALS.490 5.710 3.990 3. INSECTS.300 5.700 5. INSECTS.0 POISONING OTHERS 8.400 Professional Fee 1.590 1. INSECTS. INSECTS.3 T61.710 1.920 1.590 1. PLANTS POISONING FROM ANIMALS.700 5.480 3. PLANTS POISONING FROM ANIMALS.710 1.990 3.480 4.400 6.710 3. INSECTS.990 3.710 1.700 5.480 T65. Venom of amphibian Toxic effect of contact with unspecified venomous animal Toxic effect of aflation and other mycotoxin food contaminants Toxic effect of Tobacco and nicotine Drugs.490 5. INSECTS. medicaments and biological substances causing adverse effects in therapeutic use: Agents affecting uric acid metabolism Drugs.1 T63.710 1. medicaments and biological substances causing adverse effects in therapeutic use: Local astringents and local detergents Drugs.480 T65. medicaments and biological substances causing adverse effects in therapeutic use: Oxytocic drugs.990 3. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T60.700 5. Starfish Toxic effect of contact with other venomous animals.700 5. unspecified Drugs. PLANTS POISONING FROM ANIMALS.810 Page 94 of 111 .810 Y55.710 Y56.710 1. medicaments and biological substances causing adverse effects in therapeutic use: Otorhinolaryngological drugs and preparations Drugs.0 POISONING OTHERS 8. keratoplastics and other hair treatment drugs and preparations Poisoning by Ophthalmological drugs and preparations.710 1. medicaments and biological substances causing adverse effects in therapeutic use: Benzothiadiazine derivatives Drugs.710 1.8 POISONING OTHERS 8. PLANTS POISONING FROM ANIMALS.300 5.300 2.480 4.300 5. Toxic effect of Aniline [benzenamine]. PLANTS POISONING FROM ANIMALS.700 5.810 Y56.700 5.710 2.480 4.490 3.700 5.700 5.710 1.990 3. not elsewhere classified Toxic effect of other specified substances Poisoning by Local astringents and local detergents Poisoning by Emollients.710 3.920 Health Care Institution Fee 4.810 Y58.6 POISONING OTHERS 8. INSECTS.400 6.9 T63.2 T63.5 T63.3 6.0 POISONING CAUSED BY TOPICAL AGENTS POISONING FROM ANIMALS.700 5. INSECTS.990 3. PLANTS POISONING FROM ANIMALS.8 T49.3 T49.300 5.710 3.7 T49.700 5.300 1.700 5.590 4.710 1.710 1.990 3.920 4.710 3. PLANTS POISONING FROM ANIMALS.ergot alkaloids Drugs. PLANTS POISONING FROM ANIMALS.4 T49.710 3.490 5.1 T61.300 2.8 T49.710 1.990 3.710 1. INSECTS.710 1.490 5.710 1.990 3. INSECTS.Toxic effect of Histamine-like syndrome Toxic effect of Other fish and shellfish poisoning Toxic effect of other seafoods Toxic effect of unspecified seafood Toxic effect of Ingested mushrooms Toxic effect of Ingested berries Toxic effect of Other ingested (parts of) plant(s) Toxic effect of Other specified noxious substances eaten as food Toxic effect of Noxious substance eaten as food.920 1. 180 3.420 3.300 9.000 10.180 3.8 O71. Radiation-induced polyneuropathy Polyneuropathy.600 10.510 6. Inhalation of stomach contents or secretions NOS due to anaesthesia during labour and delivery.9 POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS 9.0 E89.9 G61.560 1. Air embolism.180 3.790 2.200 5.1 N84.2 G62.420 7.0 N84.300 2. Postirradiation hypothyroidism.0 POST PARTUM COMPLICATIONS 9. Obstetric injury to urethra Obstetric haematoma of pelvis. FEMALE GENITAL TRACT POLYPS.3 O71. Cardiac arrest due to anaesthesia during labour and delivery.300 9.300 2.7 O71. Hereditary motor and sensory neuropathy.420 7.9 Z39.510 O74.420 7.180 3. Mucous polyp of cervix Polyp of vagina Polyp of vulva.200 5. FEMALE GENITAL TRACT POLYPS.510 6. Embolism NOS.180 3.810 Y59.420 7. Soap embolism Metabolic disorders following abortion and ectopic and molar pregnancy Complication following abortion and ectopic and molar pregnancy.8* G64 N84. Nelaton's syndrome. Polyp of uterus NOS Polyp of cervix uteri.ANNEX 1.420 7.180 3.3 N84.640 3. Puerperal phlebopathy NOS. Morvan's disease.180 7.790 6.200 3.9 G62.790 2.300 9.0 O71.510 Obstetric laceration of cervix. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Drugs.490 Health Care Institution Fee 5.510 6.300 2.2 POST PARTUM COMPLICATIONS 9.420 7.640 O08.510 6.790 2.510 6.600 10. Disease Déjerine-Sottas.510 6. Polyp of endometrium.790 6.560 1.790 2.640 3.600 10.300 9.180 3.600 10.180 3. unspecified Aspiration pneumonitis due to anaesthesia during labour and delivery.420 7. types I-IV. Obstetic shock Other specified complications of labour and delivery Complication of labour and delivery. Obstetric haematoma of perineum.210 Page 95 of 111 .790 6.200 5.1 G62.510 6. Septic or septicopyaemic embolism.560 1. Pyaemic embolism.8 G60.510 O08.2 N84.560 7.640 3.600 10. Amniotic fluid embolism.420 7.510 6.9 O87.300 9. Hypertrophic POLYNEUROPATHIES neuropathy of infancy.infective polyneuritis.0 G61. Peroneal muscular atrophy hypert Refsum's disease Neuropathy in association with hereditary ataxia Idiopathic progressive neuropathy Other hereditary and idiopathic neuropathies.300 9. unspecified GROUP Case Rate 8.180 1.790 6.600 10.600 10.560 1.300 2.790 2.180 3.600 5. Neuropathy NOS Polyneuropathy in other diseases classified elsewhere Other disorders of peripheral nervous system.0 POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POSTPARTUM CARE FOR DELIVERIES IN TRANSIT POSTPROCEDURAL DISORDERS 9. Sensory neuropathy dominantly inherited.510 6.9 10. Obstetric haematoma of vagina.790 2.8 O75.510 O74.420 7.2 O71. Acute infective polyneuritis Other inflammatory polyneuropathies Inflammatory polyneuropathy. unspecified Drug-induced polyneuropathy Alcoholic polyneuropathy Polyneuropathy due to other toxic agents Other specified polyneuropathies. unspecified Other intrapartum haemorrhage.9 POISONING OTHERS G60.1 O71.790 2.3 G60.600 10.090 6.180 3.510 6.2 POST PARTUM COMPLICATIONS 9. unspecified.8 G62.790 2. FEMALE GENITAL TRACT POLYPS.2 G60. Acute post.300 9. Peroneal muscular atrophy axonal type. Rupture of uterus not stated as occuring before onset of labour Post partum inversion of uterus POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYNEUROPATHIES POLYPS.420 7.300 9. unspecified Embolism following abortion and ectopic and molar pregnancy.8 N84.510 6.180 3. Sensory neuropathy recessively inherited Hereditary and idiopathic neuropathy. Pulmonary embolism.180 3.510 1. Disease CharcotMarie-Tooth.300 Professional Fee 2.420 7.600 10.300 9.8 O71. Cardiac failure due to anaesthesia during labour and delivery Other complications of anaesthesia during labour and delivery Shock during or following labour and delivery.300 2.1 G60.790 2.0 G62.420 G60.510 6.0 Hereditary motor and sensory neuropathy. unspecified. Disorder of peripheral nervous system NOS Polyp of corpus uteri.790 2.180 3.300 9. Puerperal thrombosis NOS Care and examination immediately after delivery Postprocedural hypothyroidism. Polyp of labia Polyp of other parts of female genital tract Polyp of female genital tract.300 9. Postsurgical hypothyroidism POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS POST PARTUM COMPLICATIONS O74. Mendelson's syndrome due to anaesthesia during labour and delivery Cardiac complications of anaesthesia during labour and delivery. Obstetric haematoma of vulva Other specified obstetric trauma Obstetric trauma.5 O08.180 3. FEMALE GENITAL TRACT POLYPS. Excessive intrapartum haemorrhage Rupture of uterus before on set of labour Rupture of uterus during labour.600 10.200 5.560 1.8 G61. medicaments and biological substances causing adverse effects in therapeutic use: Vaccine or biological substance.300 9.1 O75.5 O71.9 O67.790 2.300 2.600 10.790 2. unspecified Guillain-Barré syndrome. unspecified Venous complication in the puerperium. FEMALE GENITAL TRACT POLYPS. Annular detachment of cervix POST PARTUM COMPLICATIONS Other obstetric injury to pelvic organs.790 2.600 3. Obstetric injury to bladder.640 3. Blood-clot embolism.790 600 3.420 7.400 7.510 6.790 2.600 10.640 3.300 9.8 O75.420 7.600 10. Puerperal phlebitis NOS.300 9.420 7.200 5.600 10. FEMALE GENITAL TRACT 10.510 6.9 G63. 300 10.210 7.210 7. Elephantiasis due to mastectomy.300 10.300 10.300 10.210 7. Hypovolaemic during or following a procedure. instrument. Postvagotomy syndrome Postsurgical malabsorption.210 7.9 N99.090 3.210 T81.210 7. not elsewhere classified Postprocedural disorder of digestive system.300 10.210 7.8 I97. Endotoxic shock during or following a procedure. Postsurgical blind loop syndrome Postoperative intestinal obstruction Colostomy and enterostomy malfunction Postcholecystectomy syndrome Other postprocedural disorders of digestive system.210 7.090 3.300 10.2 J95. Emphysema POSTPROCEDURAL DISORDERS (subcutaneous) resulting from a procedure. Obstruction of tracheostomy airway.300 3. Obliteration of lymphatic vessels due POSTPROCEDURAL DISORDERS to mastectomy Tracheostomy malfunction.1 J95. endoscope.210 7.9 H95. Accidental perforation of nerve by catheter.300 10.210 7.8 H59.090 3.300 3.2 K91. Dumping syndrome. Haemorrhage at any site resulting from a procedure Shock during or resulting from a procedure not elsewhere classified. Residual ovary syndrome Postprocedural disorder of genitourinary system. endoscope.210 Postprocedural hypoparathyroidism.300 10.210 7.300 10.300 10.2 E89.300 10.090 3. not elsewhere classified. Septic shock during or following a procedure.4 J95.210 7.9 K91.4 K91.090 3. POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS J95.300 10.8 10.210 T81.210 J95. Postgastrectomy syndrome. unspecified Vomiting following gastrointestinal surgery Postgastric surgery syndromes.090 3.090 7.2 Accidental puncture and laceration during a procedure not elsewhere classified.4 Infection following a procedure.210 7.090 3.210 7.300 10.090 7. Accidental perforation of blood vessel by catheter.1 K91.090 3.090 3. Postcatheterization urethral stricture Postprocedural pelvic peritoneal adhesions Other postprocedural disorders of genitourinary system. Intra-abdominal abscess postprocedural abcess.090 3.210 7.8 H59. Parathyroprival tetany POSTPROCEDURAL DISORDERS Postprocedural hypopituitarism.090 3.8 K91.300 10.300 10.210 T81. POSTPROCEDURAL DISORDERS Sepsis of tracheostomy stoma.0 10. probe during a POSTPROCEDURAL DISORDERS procedure.300 10.3 K91.210 7.9 T81.090 3.300 10.210 7.210 7. Collapse NOS during or following a procedure.0 N99.090 7.1 POSTPROCEDURAL DISORDERS 10. Intra-abdominal POSTPROCEDURAL DISORDERS subphrenic postprocedural abcess.300 3.0 K91.210 7.210 7.300 10.210 7.300 10.300 10.300 Professional Fee 3. Complication of inhalation therapy.300 10.300 10.090 3.090 7. not elsewhere classified.090 3.1 G97.4 N99.300 3.210 7.300 3.300 10.210 7.2 DESCRIPTION GROUP Case Rate 10. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE E89.300 10.210 7. Septica Other complications of procedures.210 Page 96 of 111 . Postirradiation hypopituitarism Postprocedural ovarian failure Postprocedural testicular hypofunction Postprocedural adrenocortical hypofunction.210 T81.090 3.0 H59.090 3.0 I97. Rupture of operation wound POSTPROCEDURAL DISORDERS 10.8 N99.090 3. unspecified POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS Other postprocedural disorders of ear and mastoid process POSTPROCEDURAL DISORDERS Postcardiotomy syndrome POSTPROCEDURAL DISORDERS Postmastectomy lymphoedema syndrome.300 10.210 7.0 10.300 10.090 3.090 3. Haemorrhage from tracheostomy stoma.3 10.300 3.210 7.210 7.090 7.300 10.8 J95. Persistent postoperative fistula 10.090 3.090 3. Chorioretinal scars after surgery for detachment Postprocedural disorder of eye and adnexa. unspecified Postprocedural renal failure Postprocedural urethral stricture.3 E89. instrument.090 3.210 7.4 E89. Intra-abdominal wound postprocedural abcess.ANNEX 1.300 10.090 3.210 7.5 J95.6 E89.210 T81.210 7.090 3.090 3.090 3.090 7. probe Disruption of operation wound. Postprocedural adreno-medullary hypofunction Other postprocedural endocrine and metabolic disorders Other reaction to spinal and lumbar puncture Other postprocedural disorders of nervous system Vitreous syndrome following cataract surgery Other postprocedural disorders of eye and adnexa.090 7.300 10.090 3. Intraabdominal stitch postprocedural abscess.090 3. Dehiscene of operation wound. Tracheo-oesophageal fistula following tracheostomy Acute pulmonary insufficiency following thoracic surgery Acute pulmonary insufficiency following nonthoracic surgery Mendelson's syndrome Postprocedural subglottic stenosis Other postprocedural respiratory disorders Postprocedural respiratory disorder.210 7.300 10.8 G97.1 N99.5 E89. not elsewhere classified.090 3.090 3.090 3.090 3. not elsewhere classified.210 7. unspecified Haemorrhage and haematoma complicating a procedure.300 3.5 K91. not elsewhere classified.210 7.090 Health Care Institution Fee 7.300 10.300 10. 4 10.090 3.300 3.210 7.210 7.090 7.210 Page 97 of 111 .210 7.9 T84.300 3.7 T84.090 7. Failure due to heart valve prosthesis.5 T84.210 T83. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Mechanical complication of heart valve prosthesis. Complication of internal prosthetic device.0 due to intraperitonael dialysis catheter.7 POSTPROCEDURAL DISORDERS 10.090 7.0 due to Bile-duct prosthesis.090 3.8 T84.300 10.300 10.300 3.5 POSTPROCEDURAL DISORDERS 10. Conditions listed in T82. Displacement due to heart valve prosthesis.090 7.2 T84.090 3.300 3. Embolism due to cardiac and vascular prosthetic devices.3 Mechanical complication of coronary artery bypass and POSTPROCEDURAL DISORDERS valve grafts Mechanical complication of other vascular grafts.300 10.300 10.090 7.210 7. Conditions listed in T82.210 7. implant and graft.090 3. implants and grafts Unspecified complication of genitourinary prosthetic device. Fibrosis d Mechanical complication of other urinary devices and implants.090 3.090 3. Malposition due to heart valve Mechanical complication of cardiac electronic device.210 T85.0 due to aortic (bifurcation) graft POSTPROCEDURAL DISORDERS (replacement). implant and graft in urinary system Other complications of genitourinary prosthetic devices.2 T82. implants and grafts. implants and grafts Conditions listed in T82.210 T82. Leakage due to heart valve prosthesis. implants and grafts.6 T84. Conditions listed in T82. arterivenous Shunt surgically created.300 3. not elsewhere classified Unspecified complication of internal prosthetic device.210 T85.210 T85.090 3.210 T82.210 T82.210 7. implants and grafts.210 T82.210 7.4 T84. implants and grafts.0 T84.300 3.090 3.0 oesophageal antireflux device Mechanical complication of other specified internal prosthetic devices. Infusion cat Infection and inflammatory reaction due to other cardiac and vascular devices.300 10. Conditions listed in T82.210 10.090 3.0 due to pulse generator (battery) GROUP Case Rate Professional Fee Health Care Institution Fee T82.210 7. Complication due to cardiac and vascular prosthetic devices.9 T85.300 10. implants and grafts Other complications of internal orthopaedic prosthetic devices.0 due to Urinary electronic stimultor device.090 3.210 T82.1 POSTPROCEDURAL DISORDERS 10.090 7.300 3.0 due to electrodes.300 10.210 7.3 T83. implants and grafts Infection and inflammatory reaction due to internal joint prosthesis Infection and inflammatory reaction due to internal fixation device [any site] Infection and inflammatory reaction due to other internal orthopaedic prosthetic devices.300 3. implants and grafts Unspecified complication of internal orthopaedic prosthetic device.1 T83.210 7.300 10.300 10. implant and graft Mechanical complication of ventricular intracranial (communicating) shunt Mechanical complication of other ocular prosthetic devices.300 3. Implants and grafts.300 10. Condition listed in T82.090 3. Conditions listed in T82.210 7.0 POSTPROCEDURAL DISORDERS 10.6 POSTPROCEDURAL DISORDERS 10.300 10.0 due to corneal graft.0 due to prosthetic orbit of eye Mechanicalcomplicationofgastrointestinalprostheticdevices implantsand. Artificial heart.8 T85.210 7.210 7.090 7.1 T84.7 T85.5 POSTPROCEDURAL DISORDERS 10.2 T83.0 due to arteriovenous fistula surgically created.090 3. Conditions listed in T82.300 3.210 7.300 10.090 7. Conditions listed in T82.210 7.0 POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS 10.300 3.300 10.090 7. Ballon counterpulsation device.ANNEX 1. Conditions listed Infection and inflammatory reaction due to other internal prosthetic devices.300 10. Concditions listed in T82. implants and graft NOS POSTPROCEDURAL DISORDERS 10.090 3.300 10. Condition listed in T82.210 T82.8 POSTPROCEDURAL DISORDERS 10.300 10.090 7.3 POSTPROCEDURAL DISORDERS 10.090 7.300 3. implants and grafts Other complications of internal prosthetic devices. Conditions listed in T82.090 7. implants and grafts Other complications of cardiac and vascular prosthetic devices.5 T83.210 T85.090 3.300 3.9 POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS POSTPROCEDURAL DISORDERS 10.090 7.300 10.090 3. Urinary sphincter implant.210 7. Mechanical breakdown due to heart valve prosthesis. implants and grafts Mechanical complication of internal joint prosthesis Mechanical complication of internal fixation device of bones of limb Mechanical complication of internal fixation device of other bones Mechanical complication of other internal orthopaedic devices.090 3.8 T83. Urinary stent Mechanical complication of graft of urinary organ Mechanical complication of intrauterine contraceptive device Infection and inflammatory reaction due to prosthetic device.0 due to epidural and subdural infusion catheter.090 3.0 due to arterial (carotid) (femoral) graft (bypass) Mechanical complication of vascular dialysis catheter Mechanical complication of other cardiac and vascular devices and implants.210 7. 1 O90.440 6. Hypertrophy of prostate (benign).760 6.420 7.0 9. Prostatic stone Congestion and haemorrhage of prostate Atrophy of prostate Other specified disorders of prostate Disorder of prostate.4 O90. Cervicitis PUERPERAL COMPLICATIONS following delivery.180 3.180 3. Inhalation of stomach contents or secretions NOS due to anaesthesia during the puerperium Mendelson's syndrome due to anaest PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS 10.760 2.9 Cardiac complications of anaesthesia during the puerperium.200 6.760 2.0 O87.200 9.600 10.200 9.420 7. Puerperal pulmonary embolism NOS Pulmonary complications of anaesthesia during the puerperium.2 N41.600 10. Genital varices in the puerperium Amniotic fluid embolism Obstetric blood-clot embolism.180 3.600 10. unspecified.270 7. Pelvic thrombophlebitis. postpartum Haemorrhoids in the puerperium Other venous complications in the puerperium.600 10.1 O89. Deep-vein thrombosis.200 9. Hepatorenal syndrome following labour and delivery Postpartum thyroiditis Other complications of the puerperium.420 7.760 2.2 N42.4 O89.420 7.420 7.420 7.9 N42.8 O88. Puerperal septicaemia Infection of obstetric surgical wound.180 7.9 P20.760 2.1 O88.200 9.420 7.440 6.4 O86.2 O85 O86. Infected perineal repair following delivery PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PROSTATE DISORDERS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS 9.0 O90. Disruption of wound of perineal laceration.180 3.600 10.270 3.600 10. Puerperal endometritis.440 6.600 10.180 3.180 3.600 10. Acute prostatitis Chronic prostatitis Abscess of prostate Prostatocystitis Other inflammatory diseases of prostate Inflammatory disease of prostate.8 O87.180 3.600 3.200 9. unspecified Eclampsia in the puerperium Puerperal sepsis.270 3.420 7. Vaginitis following delivery Urinary tract infection following delivery Other genitourinary tract infections following delivery.760 2.180 3. Puerperal fever.040 3.200 9.ANNEX 1.420 7.440 6. Prostatitis NOS Calculus of prostate.180 3.630 Page 98 of 111 .600 10. Disruption of wound of episiotomy.420 7. Enlargement of prostate (benign).440 6. Puerperal genitourinary tract infection NOS Pyrexia of unknown origin following delivery.630 7.180 3. Median bar (prostate).440 6.2 Other infection of genital tract following delivery.3 N41. Cardiac failure due to anaesthesia during the puerperium Central nervous system complications of anaesthesia during the puerperium.200 9.3 O86.600 10.180 7.420 7.8 N41.420 10.0 N42. Adenofibromatous hypertrophy of prostate.760 7.600 10.8 N42.180 3.180 7. Cardiac arrest due to anaesthesia during the PUERPERAL COMPLICATIONS puerperium.420 7.420 7. Adenoma (benign)of prostate . Infected caesarean section wound following delivery. Myoma of prostate.9 O90.200 9.2 O89.180 3.1 N41.600 2.8 O90.2 O90. Puerperal peritonitis. Obstetric pulmonary embolism NOS.1 O87. unspecified PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PUERPERAL COMPLICATIONS PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN 10.760 2.600 10.200 9.0 PUERPERAL COMPLICATIONS 10. Puerperal infection NOS.900 10.420 7.600 10.440 6.2 O86. postpartum.440 N41. Secondary perineal tear Haematoma of obstetric wound Cardiomyopathy in the puerperium Postpartum acute renal failure. unspecified Disruption of caesarean section wound Disruption of perineal obstetric wound.420 7. Cerebral anoxia due to anaesthesia PUERPERAL COMPLICATIONS during the puerperium Spinal and epidural anaesthesia-induced headache during PUERPERAL COMPLICATIONS the puerperium Other complications of anaesthesia during the puerperium PUERPERAL COMPLICATIONS Complication of anaesthesia during the puerperium.180 3.600 10.760 2.180 3.600 10. Fibroadenoma of prostate.600 10.420 7.1 P20.760 2. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee N40 Hyperplasia of prostate.420 7.3 O90.0 P20.180 3.5 O90.440 6.180 3.420 7.180 3. Puerperal pyrexia NOS Other specified puerpera linfections Superficial thrombophlebitis in the puerperium Deep phlebothrombosis in the puerperium.180 3.760 2.600 10.760 2.1 N42.600 3.0 N41.180 6. not elsewhere classified Complication of the puerperium.900 3.900 10.760 2.420 O89.420 7.420 7.600 10.180 3.600 10.420 O86.180 3.180 3.600 10.200 2.420 O89.420 7. Aspiration pneumonitis due to anaesthesia during the puerperium. Fibroma of PROSTATE DISORDERS prostate.600 3.200 9.440 6.180 3.600 10.9 O15.180 3.630 7.2 O87.800 10.8 O89. unspecified Intrauterine hypoxia first noted before onset of labour Intrauterine hypoxia first noted during labour and delivery Intrauterine hypoxia.420 7.440 6.600 10.600 10.1 O86.440 4.420 7. 900 10. Resorption PULMONARY COMPLICATIONS IN THE NEWBORN atelectasis without respiratory distress syndrome Cyanotic attacks of newborn PULMONARY COMPLICATIONS IN THE NEWBORN P28.0 P22.0 P24.0 P27.3 P24.9 P25.900 10. Normal respiration not established within one minute.9 10.270 7. leep apnoea of newborn PULMONARY COMPLICATIONS IN THE NEWBORN NOS Other apnoea of newborn Respiratory failure of newborn Other specified respiratory conditions of newborn.630 7. NOS.0 PULMONARY COMPLICATIONS IN THE NEWBORN 10.270 Health Care Institution Fee 7. Asphyxia.270 3.270 7.630 7.900 10. but heart rate 100 or above. Pulse less than 100 per minute at birth and falling or steady.9 P22. Pulmonary dysmaturity PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN Bronchopulmonary dysplasia originating in the perinatal PULMONARY COMPLICATIONS IN THE NEWBORN period Other chronic respiratory diseases originating in the perinatal period. Pulmonary immaturity NOS Other and unspecified atelectasis of newborn.630 7.270 3.900 10.630 7.270 7.630 P21.300 24.630 7.9 10.630 P28.270 3.300 3.270 3.630 7. Neonatal aspiration pneumonia NOS Interstitial emphysema originating in the perinatal period Pneumothorax originating in the perinatal period Pneumomediastinum originating in the perinatal period Other conditions related to interstitial emphysema originating in the perinatal period Tracheobronchial haemorrhage originating in the perinatal period Massive pulmonary haemorrhage originating in the perinatal period Other pulmonary haemorrhages originating in the perinatal period Unspecified pulmonary haemorrhage originating in the perinatal period Wilson-Mikity syndrome.4 P28.630 7.270 3.900 10.9 P24.270 3. partial.0 P25.2 P24.270 3.900 10.270 3. Asphyxia with 1-minute Apgar score 4-7.270 3.630 7. unspecified Neonatal aspiration of meconium PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN 10.900 10.1 P26.900 10. Congenital pulmonary fibrosis.900 10.630 7.270 3.630 P21.8 P27.630 7.270 7.3 P29.630 7.270 3.630 7.900 24. Atelectasis.900 10.630 P28.900 10.270 3. Pulmonary embolism NOS Page 99 of 111 .900 3. secondary.900 10.900 3.1 P27.900 10. Asphyxia with 1-minute apgar score 0-3.900 10. tone absent.270 3. PULMONARY COMPLICATIONS IN THE NEWBORN unspecified Pulmonary embolism with mention of acute cor pulmonale.290 7.270 3.270 3.8 P29.900 10.1 Mild and moderate birth asphyxia.900 10.270 3.270 3.270 3.270 3.270 3.0 10. PULMONARY COMPLICATIONS IN THE NEWBORN some muscle tone present.900 10.900 3.900 10. Atelectasis. Anoxia. NOS.Aspiration PULMONARY COMPLICATIONS IN THE NEWBORN of liquor (amnii) Neonatal aspiration of blood Neonatal aspiration of milk and regurgitated food Other neonatal aspiration syndromes Neonatal aspiration syndrome.010 17.270 3. Primary failure to expand terminal respiratory units.9 I26.630 7. Pulmonary hypoplasia PULMONARY COMPLICATIONS IN THE NEWBORN associated with short gestation.9 P27.1 P22.270 3. congenital laryngeal stridor NOS.630 7.900 P21.1 P25. NOS Respiratory distress syndrome of newborn.900 3.2 P28.270 3.630 7.3 P28.270 3.1 P24.900 10. White asphyxia GROUP Case Rate Professional Fee 3.630 7. Ventilator PULMONARY COMPLICATIONS IN THE NEWBORN lung in newborn Unspecified chronic respiratory disease originating in the PULMONARY COMPLICATIONS IN THE NEWBORN perinatal period Primary atelectasis of newborn.270 7.630 7.630 7.8 P26.630 7.2 P25. Blue asphyxia Birth asphyxia. Hypoxia.630 7. respiration absent or gasping.8 P24.8 P22. Persistent pulmonary hypertension of newborn Cardiovascular disorder originating in the perinatal period. Delayed closure of ductus PULMONARY COMPLICATIONS IN THE NEWBORN arteriosus.270 3. PULMONARY EMBOLISM Acute cor pulmonale NOS Pulmonary embolism without mention of acute cor PULMONARY EMBOLISM pulmonale. some response to stimulation.900 10.630 Neonatal aspiration of amniotic fluid and mucus. Snuffles in newborn PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN PULMONARY COMPLICATIONS IN THE NEWBORN Persistent fetal circulation.630 7.900 10. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Severe birth asphyxia.1 10.ANNEX 1.630 7.270 3. NOS.900 10.290 7.900 10.900 10.270 3.630 7. Atelectasis.630 7.630 7.900 10.900 10. unspecified.8 P26. colour poor.900 10.630 7.900 10.630 7.0 I26.0 P26. unspecified.270 3. Hyaline membrane disease Transient tachypnoea of newborn Other respiratory distress of newborn Respiratory distress of newborn.010 Primary sleep apnoea of newborn.630 7.5 P28.630 17. 230 4.100 14.700 14.300 7.410 4. Pulmonary artery hypertension Other specified pulmonary heart diseases Pulmonary heart disease.290 10.8 14. Abscess of bladder Urethral abscess.290 10.2 I27.300 9. Abscess of urethral gland Coalworker's pneumoconiosis. Hypersensitivity pneumonitis NOS Bronchitis and pneumonitis due to chemicals. Cheese-washer's lung.700 4.290 10. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE I27.870 9.8 D60. Bagasse pneumonitis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Mushroom-worker's lung AGENTS Air-conditioner and humidifier lung.870 9. ureter].290 10.170 4.290 10.410 4.700 14.880 4.290 10. fumes and vapours.270 7.5 PYELONEPHRITIS RED CELL APLASIA RED CELL APLASIA RED CELL APLASIA RENAL INFARCT RENAL/BLADDER ABSCESS RENAL/BLADDER ABSCESS RENAL/BLADDER ABSCESS 10.0 D60.700 14.410 4.410 10. Renal infarct Renal and perinephric abscess Other cystitis.100 Professional Fee 4.410 4.8 J64 J65 J66.410 10.170 4.700 14.720 9. fumes and vapours.100 14. Haymaker's lung.290 10.410 4.0 J62. gases.2 14. Chronic pyelonephritis associated with anomaly of [pelviureteric junction.290 10.230 4.700 14.300 7.410 7.900 7.7 14.190 2.8 J67. fumes and vapours.410 4.8 D60.410 4.700 14.230 Health Care Institution Fee 9. Chronic pyelonephritis associated with kinking of [pelviureteric junction.870 9.700 14. Reactive airways dysfunction syndrome. Allergic alveolitis due RESPIRATORY CONDITIONS DUE TO EXTERNAL to fungi.290 J68.290 10.700 4.8 I27.900 14.630 N11. Hyperactive airway disease RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS J67. Bagasse disease.730 9.190 2.290 10.410 4.3 14.1 J67.1 N30.870 N11.110 6.700 4.700 3.700 14. Embolism of renal artery. Thrombosis of renal artery.290 10. Coalworker's lung Pneumoconiosis due to asbestos and other mineral fibres.9 N28.630 N11.410 10.900 3.290 Page 100 of 111 .3 J63. ureter].290 J67.290 10. Abscess of Cowper's gland.410 4.290 10.290 10.290 J67.700 14.1 I27.700 14. Silicosis RESPIRATORY CONDITIONS DUE TO EXTERNAL NOS AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Aluminosis (of lung) AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Graphite fibrosis (of lung) AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Siderosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Pneumoconiosis due to other specified inorganic dusts AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Unspecified pneumoconiosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Pneumoconiosis associated with tuberculosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Cannabinosis AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Airway disease due to other specific organic dusts AGENTS Farmer's lung. not elsewhere classified Other acute and subacute respiratory conditions due to chemicals. Periurethral Abscess .230 4. thermophilic actinomycetees and other organisms AGENTS growing in ventilation (air-conditioning) systems Hypersensitivity pneumonitis due to other organic dusts. pyeloureteric junction.700 14.410 4. unspecified. Harvester's lung.410 4.410 4.100 14.8 J63.290 10. Anthracosis.290 10.290 RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Pneumoconiosis due to talc dust AGENTS Pneumoconiosis due to other dust containing silica.0 Nonobstructive reflux-associated chronic pyelonephritis.900 13.270 2. fumes and vapours. Anthracosilicosis.700 14.410 4. Chronic Cor pulmonale NOS GROUP PULMONARY HEART DISEASE PULMONARY HEART DISEASE PULMONARY HEART DISEASE PULMONARY HEART DISEASE PULMONARY HEART DISEASE Case Rate 14.410 4.700 4.190 2.0 I27.4 J63. pyeloureteric junction.8 N34.0 J60 J61 J62.700 14. Chr Other chronic tubulo-interstitial nephritis.1 PYELONEPHRITIS 10.410 10.0 J68.ANNEX 1.870 9.0 N15.700 14. Asbestosis 10. Nonobstructive chronic pyelonephritis NOS Chronic acquired pure red cell aplasia Other acquired pure red cell aplasias Acquired pure red cell aplasia.270 7.230 4.630 5.700 14.110 5.900 13.170 4.9 J68. gases.700 14.0 J63.730 10. Sequoiosis Hypersensitivity pneumonitis due to unspecified organic dust.900 3. Acute chemical bronchitis Acute pulmonary oedema due to chemicals. Abscess of Littré's gland.700 14. Chronic cardiopulmonary disease. Occlusion of renal artery. unspecified Ischaemia and infarction of kidney. gases. Coffee-worker's lung.100 14. Furrier's lung. Obstruction of renal artery.2 J66.9 DESCRIPTION Primary pulmonary hypertension Kyphoscoliotic heart disease Other secondary pulmonary hypertension. Acute Chemical pulmonary oedema Upper respiratory inflammation due to chemicals.410 4.1 J68.600 13. PYELONEPHRITIS Chronic Pyelonephritis associated with vesicoureteral reflux Chronic obstructive pyelonephritis. gases. Extrinsic allergic alveolitis NOS.730 9. Mouldy RESPIRATORY CONDITIONS DUE TO EXTERNAL hay disease AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL Bagassosis.0 J67. Fishmealworker's lung.290 10.110 5.410 4.410 4. gases.960 8.0 I01. Other acute rheumatic heart disease. fumes and vapours.700 14.290 22.1 I07. acute or subacute involvement GROUP Case Rate Professional Fee Health Care Institution Fee J68.0 I07.070 7.070 7. Hollenhorst's plaque.2 I01.960 8.290 10.030 3.400 5.0 I05.070 7.840 3.9 I06.800 12.8 I06.960 8.840 3. Diffuse emphysema due to inhalation of chemicals.800 12. Retinal artery branch occlusion . Chronic emphysema due to inhalation of chemicals.030 3.000 32.290 10.700 14.030 3.800 12. Tricuspid valve disorder RHEUMATIC HEART DISEASE NOS Page 101 of 111 .8 J70. Acute rheumatic pericarditis RHEUMATIC FEVER Acute rheumatic endocarditis.100 10. Aspiration pneumonia due to milk.700 14. Radiation pneumonitis Acute drug-induced interstitial lung disorders Drug-induced interstitial lung disorders.100 12. Chronic obliterative bronchi Other respiratory conditions due to chemicals. Mitral stenosis with incompetence or regurgitation Other mitral valve diseases.960 Acute rheumatic pericarditis.030 3.ANNEX 1.840 3.400 22. Lipid pneumonia Pneumonitis due to other solids and liquids. unspecified Rheumatic fever without mention of heart involvement.800 12.960 8.100 10. Chronic mitral valve disorder NOS Rheumatic aortic stenosis.9 I00 I01.4 RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS 14.1 J96.700 4. Pneumonitis due to aspiration of blood Acute pulmonary manifestations due to radiation.310 2.2 J70.700 32.960 8.840 3.100 10.600 9.700 14.9 I02.410 10. Aspiration pneumonia due to gastric secretions.2 I05.2 I06.410 10.070 7. unspecified Central retinal artery occlusion Other retinal artery occlusions.800 12.9 I05.030 3.410 4.1 I05.1 I06.290 J69. Rheumatic aortic stenosis with incompetence or regurgitation Other rheumatic aortic valve diseases Rheumatic aortic valve disease unspecified. Acute rheumatic pancarditis Acute rheumatic heart disease unspecified. fumes and vapours.070 8. Retinal vein occlusion tributary Retinal vascular occlusion.700 14.1 H34.0 I06. Rheumatic mitral incompetence.840 5.840 3. Rheumatic aortic valve obstruction Rheumatic aortic insufficiency.030 3. Retinal central vein occlusion .960 8.0 J70.9 H34. Mitral valve failure Mitral valve disease unspecified.290 J69. gases. Rheumatic mitral valve obstruction Rheumatic mitral insufficiency.700 4. Acute rheumatic valvulitis Acute rheumatic myocarditis.840 3.700 7. Retinal artery partial occlusion.960 8. Rheumatic mitral regurgitation Mitral stenosis with insufficiency.070 7. Rheumatic chorea NOS Mitral stenosis.100 10.8 I05.8 H34.0 I02. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Chronic respiratory conditions due to chemicals.070 7. fumes and vapours Unspecified respiratory condition due to chemicals.840 3.840 3. gases.2 14.840 3.030 3. Aspiration pneumonia due to NOS.9 I07. Chorea NOS with heart involvement Rheumatic chorea without heart involvement.000 7.700 14. Acute rheumatic heart disease Rheumatic chorea with heart involvement.8 J68.9 J96.9 RETINAL VASCULAR OCCLUSION RETINAL VASCULAR OCCLUSION RHEUMATIC FEVER 7.390 7.8 J70.310 2.800 2.700 7. gases. Acute rheumatic carditis. Aspiration pneumonia due to regurgitated food.700 4. Retinal microembolism Other retinal vascular occlusions.600 9. fumes and vapours Pneumonitis due to food and vomit.960 8. fumes and vapours. Retinal artery occlusion.8 I01.700 4.290 10. unspecified Respiratory conditions due to other specified external agents Respiratory conditions due to unspecified external agent Acute respiratory failure Chronic respiratory failure Respiratory failure.840 3. Active rheumatic heart disease. gases.310 3.800 12.800 12. rheumatic.290 10. Arthritis. Rheumatic aortic regurgitation Rheumatic aortic stenosis with insufficiency. Aspiration pneumonia due to vomit Pneumonitis due to oils and essences.400 22.100 10.290 10.410 4.700 14.290 10.1 I01.800 12.410 4.290 J68.9 RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY CONDITIONS DUE TO EXTERNAL AGENTS RESPIRATORY FAILURE RESPIRATORY FAILURE RESPIRATORY FAILURE RETINAL VASCULAR OCCLUSION RETINAL VASCULAR OCCLUSION 14.800 12.800 12.000 32.310 10.410 10.800 12.700 10.100 10.030 3.960 8.960 8.410 9.390 H34.100 10.410 4.0 J96.390 5.410 4.410 4.840 3.800 12.840 3.4 J70. Rheumatic tricuspid valve RHEUMATIC HEART DISEASE insufficiency Tricuspid valve disease unspecified.290 10. Rheumatic aortic incompetence.600 2. Retinal vein occlusion partial.0 14.070 7.960 8. Rheumatic tricuspid valve stenosis RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC FEVER RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE Tricuspid insufficiency.960 8. Rheumatic aortic valve disease NOS Tricuspid stenosis.390 5. Retinal vein occlusion incipient.410 4.1 J69. 9 U04.400 22.100 2.950 5.960 8.3 A41.000 32.550 8.2 A41.960 I09.0 T91.800 12.960 4.950 5. Involvement of both mitral and aortic valves whether specified as rheumatic or of unspecified origin Disorders of both mitral and tricuspid valves Disorders of both aortic and tricuspid valves Combined disorders of mitral aortic and tricuspid valves Other multiple valve diseases Multiple valve disease.400 22. unspecified.800 Professional Fee 3.000 7.000 32.400 22.550 2.210 7.3 I69. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Disorders of both mitral and aortic valves.800 12.960 8.500 8.700 10.550 2.500 8.550 2.ANNEX 1.490 7.800 12.300 10.550 2.550 2. group A Septicaemia due to streptococcus.700 10.1 I08.8 A40.000 7.840 2.8 T90.840 Health Care Institution Fee 8.8 B94.400 22.9 A48.1 I69.400 22.840 3.000 32.600 9.0 I09.9 I09.810 22.490 7. Septic shock Toxic shock syndrome Sequelae of subarachnoid haemorrhage Sequelae of intracerebral haemorrhage Sequelae of other nontraumatic intracranial haemorrhage Sequelae of cerebral infarction Sequelae of stroke.490 7.550 2. unspecified.600 9.090 3.950 5.0 T90.0 B90.600 9.3 RHEUMATIC HEART DISEASE RICKETTSIOSES RICKETTSIOSES RICKETTSIOSES RICKETTSIOSES RICKETTSIOSES SARS SCARLET FEVER SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEPSIS SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CEREBROVASCULAR DISEASES 12.840 3.8 B90.840 3.300 10.490 5. Chronic rheumatic mediastinopericarditis.000 32.000 10. Rheumatic disease of pulmonary valve Epidemic louse-borne typhus fever due to Rickettsia prowazekii.700 10. unspecified Spotted fever due to Rickettsia rickettsii.800 12. group B Septicaemia due to Streptococcus pneumoniae.090 3.960 8.840 8. Chronic rheumatic valvulitis Chronic rheumatic pericarditis.000 32.950 5.800 3.600 9. Cl assical typhus fever.000 32. unspecified Septicaemia due to Staphylococcus aureus Septicaemia due to other specified staphylococcus.2 RHEUMATIC HEART DISEASE 12.000 32.5 A41.2 I69.900 4.1 RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE RHEUMATIC HEART DISEASE I09.500 8.0 I69.400 22.700 10.0 A41.400 22. Sao Paulo fever Trench fever .100 2.600 9.9 T91.000 32.0 A40.900 4.800 12. SEQUELAE OF TUBERCULOSIS NOS Sequelae of viral encephalitis Sequelae of viral hepatitis Sequelae of other specified infectious and parasitic diseases Sequelae of unspecified infectious or parasitic disease Sequelae of inflammatory diseases of central nervous system Sequelae of other nutritional deficiencies Sequelae of superficial injury of head Sequelae of open wound of head Sequelae of fracture of skull and facial bones Sequelae of intra cranial injury Sequelae of other specified injuries of head Sequelae of unspecified injury of head Sequelae of superficial injury and open wound of neck and trunk Sequelae of fracture of spine Sequelae of other fracture of thorax and pelvis Sequelae of injury of spinal cord SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFECTIOUS AND PARASITIC DISEASES SEQUELAE OF INFLAMMATORY DISEASE OF THE CENTRAL NERVOUS SYSTEM SEQUELAE OF NUTRITIONAL DEFICIENCIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES Page 102 of 111 .640 2.400 22.600 9.210 7.3 I69.3 A40.5 T90.1 B94.490 9.0 A79.9 A77.950 Sequelae of other and unspecified cerebrovascular diseases SEQUELAE OF CEREBROVASCULAR DISEASES SEQUELAE OF CENTRAL NERVOUS SYSTEM TUBERCULOSIS SEQUELAE OF TUBERCULOSIS OF OTHER ORGANS SEQUELAE OF RESPIRATORY AND UNSPECIFIED TUBERCULOSIS.0 I08.800 7.900 4.210 3.3 I08.700 10.960 I08.840 3. Rheumatic adherent pericardium.960 8.500 8.4 I69.600 3.000 32.210 3.800 12.000 8.700 8.210 3.840 3.400 22.550 2.960 8.8 T90.210 3.800 12.100 2.210 3.210 2.500 8.500 3. Wolhynian fever Rickettsiosis.210 7.210 7.210 7.160 5.950 5.800 8.090 3. Chronic rheumatic myopericarditis Other specified rheumatic heart diseases.100 2.8 I08.550 2.600 9.950 5. Gramnegative septicaemia NOS Other specified septicaemia Septicaemia.600 9.550 2.000 7.8 A75.000 32.600 9. Rickettsial infection NOS Severe Acute Respiratory Syndrome (SARS) Scarlet fever.960 8.9 A41.0 A79.400 22. Quintan fever.2 I08.500 8.000 8. not specified as haemorrhage or infarction GROUP Case Rate 12.400 7.1 A40.1 A41.960 8.2 T90.500 8.1 T91.600 9.840 3.300 10.490 7.9 B94.210 3.950 5.400 2.900 5.300 10.600 9.210 7. valve unspecified.9 A38 A40.700 10.100 2.490 7.600 9. Chronic rheumatic endocarditis.090 3.500 8.490 7. Scarlatina Septicaemia due to streptococcus.000 32.950 5. Rocky Mountain spotted fever.000 7.840 3.500 8.400 22.000 32.8 B90.4 A41.400 22.950 5.2 T91.0 A75.9 G09 E64.400 22. Pneumococcal septicaemia Other streptococcal septicaemia Streptococcal septicaemia.1 T90.8 A41.090 3.300 10.2 B94. Epidemic louse-borne typhus Typhus fever.600 6.000 32.300 10. Septicaemia due to coagulase-negative staphylococcus Septicaemia due to unspecified staphylococcus Septicaemia due to Haemophilus influenzae Septicaemia due to anaerobes Septicaemia due to other Gram-negative organisms.300 32.900 4. unspecified Rheumatic myocarditis Rheumatic diseases of endocardium.600 9.090 3. 1 M43.6 M45 M46.600 9.500 32.950 5.550 2.500 8.950 5.210 3.70 S02. Transposition of abdominal viscera.240 2.5 M43. Ankylosis of spinal joint Other recurrent vertebral subluxation Torticollis Ankylosing spondylitis.000 32.600 9.2 T95.950 5.500 8.210 3.300 8.300 8. not specified by body regions GROUP SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES Case Rate 8.700 10. Sleep apnoea. Sleep apnoea.300 8.950 5.500 8.490 7. Fracture of Frontal bone.0 T95. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE T92. part unspecified Sleep apnoea.700 10. Dextrocardia with situs inversus.9 T88.690 S02.810 5.11 S02.950 5.700 3.500 8.950 5.50 S02.950 5.0 SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES SLEEP APNEA SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES 10.550 2.210 3.210 3.500 8.400 22.010 4.490 S02. corrosion and frostbite of upper limb Sequelae of burn.700 10.490 7.0 S02.210 3.490 2.210 3.700 10.490 7.0 T93.700 10.0 R57.2 T93.2 DESCRIPTION Sequelae of open wound of upper limb Sequelae of fracture of arm Sequelae of other specified injuries of upper limb Sequelae of open wound of lower limb Sequelae of fracture of femur Sequelae of other fractures of lower limb Sequelae of dislocation sprain and strain of lower limb Sequelae of other specified injuries of lower limb Sequelae of injuries involving multiple body regions Sequelae of injuries.80 S02. Fracture of Occiput.700 10.490 7.700 10.400 22.490 7.1 T92.600 Health Care Institution Fee 5. part unspecified Open Fracture of skull and facial bones.700 10.210 3. Shock due to anaesthesia in which the correct sustance was properly administered Situs inversus.490 2.300 3.210 3.210 3.500 8. Transposition of thoracic visce Fracture o f vault of skull.700 10.950 5.490 7.550 2.800 8.500 8.550 2. Fracture of temporal bone CLOSED FRACTURE OF BASE OF SKULL/ ANTERIOR FOSSA/ MIDDLE FOSSA/ POSTERIOR FOSSA/ OCCIPUT/ ORBITAL ROOF/ ETHMOID SINUS/ FRONTAL SINUS/ SPHENOID/ TEMPORAL BONE OPEN FRACTURE OF BASE OF SKULL/ ANTERIOR FOSSA/ MIDDLE FOSSA/ POSTERIOR FOSSA/ OCCIPUT/ ORBITAL ROOF/ ETHMOID SINUS/ FRONTAL SINUS/ SPHENOID/ TEMPORAL BONE closed fracture of nasal bones open fracture of nasal bones Closed fracture of orbital floor Open fracture of orbital floor Closed Fracture of malar and maxillary bones Open Fracture of malar and maxillary bones Closed Fracture of tooth Closed Fracture of mandible Open Fracture of mandible Closed Multiple fractures involving skull and facial bones Open Multiple fractures involving skull and facial bones closed Fractures of other skull and facial bones including Alveolus.490 2. Situs inversus or transverses abdominalis.600 9.10 SKULL FRACTURES 10.500 8.810 5.810 5.490 7.210 3.500 8.500 8.210 3.41 S02.600 9.400 22.700 10.490 7.0 T94.1 R57. corrosion and frostbite Sequelae of certain early complications of trauma Cardiogenic shock Hypovolaemic shock Other shock.21 S02.490 7.300 8.490 2. Orbit NOS.000 32.1 T95.950 5.1 T93.700 10. posterior fossa.550 2.700 10. Rheumatoid arthritis of spine Spinal enthesopathy.000 Professional Fee 2. Failure of peripheral circulation NOS Shock due to anaesthesia.490 7.950 22.01 SKULL FRACTURES SKULL FRACTURES SKULL FRACTURES 10. Fracture of Sphenoid.550 2.550 2.210 7.810 5. Disorder of ligamentous or muscular attachments of spine 10.81 S02.950 5.90 S02.490 7.700 2. corrosion and frostbite of head and neck SEQUELAE OF TRAUMA INJURIES Sequelae of burn.000 32.31 S02.810 Page 103 of 111 .950 5. Fracture of ethmoid sinus & frontal sinus. Endotoxic shock Shock.950 5.950 5.700 10.00 S02.40 S02. Orbit NOS.3 T93.560 5.810 5.000 32.700 3.30 S02. Fracture of SKULL FRACTURES orbital roof.700 10.490 7.550 2.550 9.20 S02.210 3.2 R57.210 3.700 3.550 2.300 8.490 7.550 2. Palate open Fractures of other skull and facial bones including Alveolus.490 S02.700 10.210 3. Situs inversus or transversus thoracis.700 10. Fracture of Parietal bone CLOSED FRACTURE OF VAULT OF SKULL/ FRONTAL BONE/ PARIETAL BONE OPEN FRACTURE OF VAULT OF SKULL/ FRONTAL BONE/ PARIETAL BONE SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SEQUELAE OF TRAUMA INJURIES SHOCK SHOCK SHOCK SHOCK SHOCK Q89.71 S02.550 2.0 T92.8 T95.400 22.8 R57.2 M43.500 8.210 7.490 7.500 8.61 S02.91 G47.950 5.550 2.490 7. obstructive Spondylolysis Spondylolisthesis Other fusion of spine.490 7.550 2.950 5.500 8.490 7.490 7.210 3.210 3.810 5.500 8.3 SITUS INVERSUS 6.ANNEX 1.210 7.490 S02.550 2.0 M43. middle fossa.1 Fracture of base of skull: Fracture of anterior fossa. Mirrorimage atrial arrangement with situs inversus.210 3.490 2.9 T98.490 7.3 M43.8 T94. Palate Closed Fracture of skull and facial bones.550 2.300 8.500 8.490 2.700 10.8 T93.700 10.210 3. corrosion and frostbite of lower limb Sequelae of other specified burn corrosion and frostbite Sequelae of unspecified burn. unspecified.60 S02.3 T95. central.400 Sequelae of burn. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.300 8.490 2.490 5.300 2.810 5.490 2.810 5.22 M47. unspecified lumbar region SPONDYLOPATHIES Discitis.490 2.92 M46. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.810 5. Thoracic spondylosis without myelopathy or radiculopathy thoracolumbar region Cervical spondylosis without myelopathy or radiculopathy. Thoracic spondylosis without myelopathy or radiculopathy Multiple sites in spine Cervical spondylosis without myelopathy or radiculopathy.300 8.810 5.98 M46.810 5.490 2.490 2.810 Page 104 of 111 .300 8.490 2.300 8. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.490 5.300 8.47 M46.85 8.810 5.84 8.19 M46.810 5.97 M46.300 8.490 5.810 5.300 2.29 DESCRIPTION Sacroiliitis.300 8. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.300 8.1+G99.490 5.36 M46.300 8.300 8. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.810 5.26 M47. unspecified cervical region Inflammatory spondylopathy.28 M46.300 2.9 M46.86 8.810 M47.300 8.16 M46.81 8.810 M47. Thoracic spondylosis without myelopathy or radiculopathy cervical region Cervical spondylosis without myelopathy or radiculopathy.490 2.490 2. unspecified sacral and sacrococcygeal region SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES Inflammatory spondylopathy. unspecified lumbosacral region Inflammatory spondylopathy. Thoracic spondylosis without myelopathy or radiculopathy lumbar region Cervical spondylosis without myelopathy or radiculopathy.810 M47.2 M46.80 8.810 5.300 2. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.490 2.490 2.810 M47.810 5.300 8.46 M46.810 5.810 5. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.810 5. Thoracic spondylosis without myelopathy or radiculopathy occipito-atlanto-axial region Cervical spondylosis without myelopathy or radiculopathy.27 M47.490 5.300 8. unspecified SPONDYLOPATHIES Discitis.300 2.3 M46. unspecified site unspecified SPONDYLOPATHIES Other infective spondylopathies SPONDYLOPATHIES Other specified inflammatory spondylopathies SPONDYLOPATHIES Other specified inflammatory spondylopathies lumbosacral SPONDYLOPATHIES region Inflammatory spondylopathy. unspecified site unspecified SPONDYLOPATHIES Other spondylosis with myelopathy Myelopathy in Other spondylosis with myelopathy Other spondylosis with radiculopathy Other spondylosis with radiculopathy Multiple sites in spine Other spondylosis with radiculopathy cervical region Other spondylosis with radiculopathy lumbar region Other spondylosis with radiculopathy lumbosacral region Other spondylosis with radiculopathy site unspecified SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES M47.300 8. unspecified lumbosacral region SPONDYLOPATHIES Discitis.300 8. Thoracic spondylosis without myelopathy or radiculopathy cervicothoracic region Cervical spondylosis without myelopathy or radiculopathy.810 5.810 5.99 M47.300 2.810 Osteomyelitis of vertebra sacral and sacrococcygeal region SPONDYLOPATHIES Osteomyelitis of vertebra site unspecified Infection of intervertebral disc (pyogenic) Infection of intervertebral disc (pyogenic) lumbar region SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES Discitis. not elsewhere classified site unspecified Osteomyelitis of vertebra SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES GROUP Case Rate 8.87 M46.1 M47.490 2. Thoracic spondylosis without myelopathy or radiculopathy Cervical spondylosis without myelopathy or radiculopathy.490 2.490 2.82 8.490 2.300 8. Thoracic spondylosis without myelopathy or radiculopathy lumbosacral region 8.2* M47.2 M47.300 8. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M46. not elsewhere classified lumbar region Sacroiliitis.300 8.490 2.490 2.300 8.810 M47.490 2.300 8.20 M47.300 8.ANNEX 1.300 8.810 5.83 8.490 5.8 Cervical spondylosis without myelopathy or radiculopathy. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.490 5.300 8.810 5.490 2.300 Professional Fee 2.490 Health Care Institution Fee 5.810 M47.300 2.490 2.87 8.300 2.810 5.810 5.490 2.49 M46. not elsewhere classified Sacroiliitis. Thoracic spondylosis without myelopathy or radiculopathy thoracic region Cervical spondylosis without myelopathy or radiculopathy.490 5.810 5. unspecified SPONDYLOPATHIES Inflammatory spondylopathy. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.300 8.810 5.810 5.810 5.810 5.490 2.490 2.300 8.5 M46.8 M46.300 8.810 M47.810 5.490 2.29 M46.300 8.490 5.490 2.490 2.490 2.490 2.810 5.810 M47.4 M46.300 2.1 M46. 600 15.05 M48.490 2.810 5.810 5.99 M49. unspecified Spondylosis.300 2.300 8.400 11.9 L51.490 2.1 M48.9 M48.04 M48. unspecified thoracic region Spondylosis.300 8.490 2. unspecified thoracolumbar region Spondylosis.300 8.810 7.600 26.810 5.490 2. Caudal stenosis thoracolumbar region Spinal stenosis.490 3.490 2.810 5.600 15.600 Grand mal status epilepticus.98 M48.54 M48.1 I60.810 5.920 10.0* M49.490 2.99 M48.490 2.300 8.490 5.85 M48.2 M48. Caudal stenosis cervicothoracic region Spinal stenosis.HEMORRHAGIC STROKE .490 2.300 8.300 8.810 5.680 4.300 8. unspecified Spondylopathy.300 8.95 M47.8 M48.810 5.810 5.3 8. Stress fracture of vertebra Collapsed vertebra NOS.490 2.490 2.490 2.810 5. Pemphigus neonatorum.89 8.810 M47. unspecified lumbosacral region Spondylosis.2 I60. unspecified Bullous erythema multiforme.03 M48.300 8.95 M48.07 M48.810 5.810 5.060 4.490 2.3 M48.600 15.300 8. Stevens-Johnson syndrome Subarachnoid haemorrhage from carotid siphon and bifurcation Subarachnoid haemorrhage from middle cerebral artery STATUS EPILEPTICUS STATUS EPILEPTICUS STATUS EPILEPTICUS STATUS EPILEPTICUS STEVEN JOHNSONS SYNDROME STROKE .600 12.88 8.810 5.1 G41.680 3.57 M48. Wedging of vertebra NOS thoracic region Collapsed vertebra NOS.490 2.810 5. Caudal stenosis lumbosacral region Spinal stenosis.810 5.690 11.810 5.300 8.810 5. Caudal stenosis lumbar region Spinal stenosis.300 2.600 15.680 4.300 8.490 2.810 5. unspecified thoracolumbar region Spondylopathy.810 5.490 2.300 8.000 38. Caudal stenosis Spinal stenosis.490 2.810 5.300 8.00 M48.810 5.96 M48.HEMORRHAGIC artery Subarachnoid haemorrhage from posterior communicating STROKE .300 8.96 M47.300 8.490 2.810 5.490 5.810 5.920 8.300 8. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy. Wedging of vertebra NOS lumbar region Collapsed vertebra NOS.490 2.810 5.300 8.300 8. unspecified site unspecified Spinal stenosis.16 M48. Caudal stenosis site unspecified Ankylosing hyperostosis [Forestier].810 5.490 2. Ritter's disease SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES SPONDYLOPATHIES STAPHYLOCCOCAL SCALDED SKIN SYNDROME GROUP Case Rate Professional Fee Health Care Institution Fee M47. unspecified cervical region Spondylopathy.0 G41.300 8.600 26.HEMORRHAGIC Subarachnoid haemorrhage from anterior communicating STROKE .0 M48.300 8.810 M47.810 5.80 M48. unspecified lumbar region Spondylosis.490 2. Wedging of vertebra NOS Collapsed vertebra NOS.810 5.810 5.000 2.490 2.810 5.810 5.490 2.89 M48.08 M48.490 2.300 8.300 8.300 8.300 8.810 5. Lumbosacral spondylosis without myelopathy or SPONDYLOPATHIES radiculopathy.86 M48. Tonic-clonic status epilepticus STATUS EPILEPTICUS Petit mal status epilepticus. Thoracic spondylosis without myelopathy or radiculopathy site unspecified Spondylosis.490 2.300 8.400 11.300 8.000 38. Caudal stenosis cervical region Spinal stenosis.810 5.000 38.810 5.300 10.490 2. Caudal stenosis thoracic region Spinal stenosis.9 M47.300 8.920 10.32 M48.300 8.300 8.4 M48.5 M48. Diffuse idiopathic skeletal hyperostosis [DISH] Ankylosing hyperostosis [Forestier].300 8. unspecified Multiple sites in spine Spondylosis.140 10.06 M48.600 26.300 38.0 I60.97 M47. unspecified cervical region Spondylosis.920 10.490 2.300 8. unspecified site unspecified Pott's curvature Spondylopathy in other diseases classified elsewhere Staphylococcal scalded skin syndrome.490 2.610 26. Thoracic spondylosis without myelopathy or radiculopathy sacral and sacrococcygeal region Cervical spondylosis without myelopathy or radiculopathy.400 11.90 M47.400 5.1 I60.810 5.490 2.09 M48.8 G41.490 2.490 2.490 2.ANNEX 1. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Cervical spondylosis without myelopathy or radiculopathy. unspecified lumbar region Spondylopathy.300 8.490 2.810 5.810 5.810 5.490 2.490 2.92 M47. Caudal stenosis Multiple sites in spine Spinal stenosis. Diffuse idiopathic skeletal hyperostosis [DISH] lumbar region Kissing spine Traumatic spondylopathy Traumatic spondylopathy cervical region Fatigue fracture of vertebra.490 2.94 M47.810 5.810 5.56 M48.920 10. Epileptic absence status Complex partial status epilepticus Other status epilepticus Status epilepticus. Wedging of vertebra NOS lumbosacral region Ossification of posterior longitudinal ligament Ossification of posterior longitudinal ligament Multiple sites in spine Ossification of posterior longitudinal ligament thoracolumbar region Ossification of posterior longitudinal ligament lumbar region Ossification of posterior longitudinal ligament site unspecified Spondylopathy.300 8.300 8.490 2.490 2.810 5.300 8.490 2.300 8. unspecified sacral and sacrococcygeal region Spondylopathy.200 15.HEMORRHAGIC artery Page 105 of 111 .300 8.2 G41.680 4.810 5.92 M48. Caudal stenosis sacral and sacrococcygeal region Spinal stenosis.490 2.8* L00 G41.02 M48.680 4.300 8.490 2.300 8. 6 DESCRIPTION Subarachnoid haemorrhage from basilar artery Subarachnoid haemorrhage from vertebral artery Subarachnoid haemorrhage from other intracranial arteries.000 38.000 38.ANNEX 1.600 I60.400 11. Ataxia telangiectasia [Louis-Bar] STROKE .1 10.HEMORRHAGIC STROKE . Hereditary NERVOUS SYSTEM cerebellar disease. Cerebral lobe haemorrhage.2 I61.HEMORRHAGIC 38.600 19.000 38. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE I60.000 38.120 7.INFARCTION STROKE .3 10. Familial motor neuron disease.400 3.4 I60. Spinal muscular atrophy adult form Spinal muscular atrophy childhood form.HEMORRHAGIC STROKE .280 G12. Progressive spinal muscular atrophy Spinal muscular atrophy. Congenital ruptured berry aneurysm NOS. Hereditary cerebellar ataxia SYSTEMIC ATROPHIES INVOLVING CENTRAL NOS.400 26. unspecified Acute Subdural haemorrhage.4 I63.9+G46. Multiple involvement of intracranial arteries Subarachnoid haemorrhage from intracranial artery.HEMORRHAGIC STROKE .7* I64 G10 G11.400 11.HEMORRHAGIC STROKE . unspecified Cerebral infarction due to thrombosis of precerebral arteries GROUP STROKE .9 I63.0 STROKE .000 28.2 SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM 10.600 19.000 28. Progressive bulbar palsy.9 I62. Friedreich's ataxia (autosomal recessiv Cerebellar ataxia with defective DNA repair.400 11.000 11.120 7.0 I62.3 I63.280 G12.000 38. unspecified Intracerebral haemorrhage in brain stem Intracerebral haemorrhage in cerebellum Intracerebral haemorrhage.400 8.000 28.000 28.600 26.400 11.000 38.000 28.8 I60.HEMORRHAGIC STROKE .400 8.HEMORRHAGIC Case Rate 38. multiple localized Other intracerebral haemorrhage Intracerebral haemorrhage. Huntington's chorea Congenital nonprogressive ataxia Early-onset cerebellar ataxia including Early-onset cerebellar ataxia with essential tremor. unspecified Intracerebral haemorrhage in hemisphere.120 7.600 26.HEMORRHAGIC STROKE .280 G11.600 26.000 28.400 11.HEMORRHAGIC STROKE .HEMORRHAGIC STROKE .120 7.000 38.600 19.600 19.120 26.INFARCTION of precerebral arteries Cerebral infarction due to thrombosis of cerebral arteries Cerebral infarction due to embolism of cerebral arteries Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries Cerebral infarction due to cerebral venous thrombosis.400 11.600 26.8 I61.280 Page 106 of 111 .400 3.7 STROKE .600 26. Subarachnoid haemorrhage from communicating artery NOS Other subarachnoid haemorrhage.1 I63.000 38. Meningeal haemorrhage. Progressive bulbar palsy of childhood [Fazio-Londe].400 11.600 19.600 26. Rupture of cerebral arteriovenous malformation Subarachnoid haemorrhage.000 38.000 28.5 I61.HEMORRHAGIC STROKE . unspecified Other lacunar syndrome in unspecified cerebral infarction Stroke. Spinal muscular atrophy distal.000 38.120 7.HEMORRHAGIC STROKE .600 26.INFARCTION SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM G11. unspecified. cortical.600 26.600 26.600 19. Hereditary cerebellar degeneration.400 Health Care Institution Fee 26.6 I61. type II.400 11.400 3. Deep intracerebral haemorrhage Intracerebral haemorrhage in hemisphere.400 3.0 I61.HEMORRHAGIC STROKE . type Motor neuron disease.600 26. type I [WerdnigHoffman] Other inherited spinal muscular atrophy. nonpyogenic Other cerebral infarction Cerebral infarction.INFARCTION STROKE .600 19.INFARCTION STROKE .280 G12.INFARCTION STROKE .600 19.120 3.600 19. Subarachnoid haemorrhage from cerebral artery NOS.600 26.120 7.1 I62.280 Cerebral infarction due to embolism of precerebral arteries STROKE .5 I63.400 11.120 7.000 38.000 Professional Fee 11.000 38.HEMORRHAGIC STROKE .000 28.HEMORRHAGIC STROKE .5 I60.400 8.600 26.HEMORRHAGIC STROKE .9 I63.400 8. not specified as hemorrhage or infarction Huntington's disease.400 10. Spinal muscular atrophy juvenile form.9 10.000 38.400 8.HEMORRHAGIC STROKE .280 G11. unspecified SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM 10.400 11.280 G12.600 I60.2 I63. Primary Lateral sclerosis .400 8.000 10.400 8.280 7.400 11.400 11.000 28.INFARCTION Cerebral infarction due to unspecified occlusion or stenosis STROKE .8 I63.6 I63.400 8. unspecified. Superficial intracerebral haemorrhage Intracerebral haemorrhage in hemisphere.400 3.000 38.INFARCTION 38.HEMORRHAGIC STROKE .600 7. Early-onset cerebellar ataxia with myoclonus [Hunt's ataxia].000 38. Nontraumatic epidural haemorrhage Intracranial haemorrhage (nontraumatic).400 11.400 3.INFARCTION STROKE .0 I63. subcortical.9 I61.600 26.600 19.400 3.1 SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM 10.400 11. Earlyonset cerebellar ataxia with retained tendon reflexes.000 28.400 11.400 3.3 I61.0 10.1 I61. intraventricular Intracerebral haemorrhage. AmyotrophicLateral sclerosis.400 8.4 I61.000 28.9 Hereditary ataxia. Nontraumatic Subdural haemorrhage Nontraumatic extradural haemorrhage.INFARCTION STROKE .600 26.400 8.600 19.400 11.400 8. Hereditary cerebellar syndrome Infantile spinal muscular atrophy.INFARCTION STROKE .600 26. 330 8.3 P12.8 P12.500 16.770 2.120 7.900 7. EXTRAPULMONARY tuberculosis.800 13.5 TUBERCULOSIS.800 13.800 13.900 3.0 P10.8 P15. unspecified Birth injury to femur Fracture of clavicle due to birth injury Birth injuries to other parts of skeleton Birth injury to skeleton. confirmed bacteriologically and histologically. EXTRAPULMONARY 11.2 P11. confirmed bacteriologically & histologicaly.660 9.190 2.500 16.570 8.300 7.1 P11.280 L93. Tuberculosis of hilar lymph nodes.660 9.140 4. confirmed bacteriologically and histologically .3 P10.2 P10.330 A15.4 P15. lymph nodes.140 4.680 4. Subdural haematoma (localized) due to birth injury Cerebral haemorrhage due to birth injury Intraventricular haemorrhage due to birth injury Subarachnoid haemorrhage due to birth injury Tentorial tear due to birth injury Unspecified intracranial laceration and haemorrhage due to birth injury Other specified brain damage due to birth injury Unspecified brain damage due to birth injury Birth injury to central nervous system.660 9.9 A33 A34 A35 R29. confirmed bacteriologically & histologically Other respiratory tuberculosis.600 5.190 2.2 M32. Mediastinal tuberculosis.900 3.660 9.680 1.600 15.600 5.330 11.660 9.190 2. PARALYSIS AGITANS.300 7.ANNEX 1.600 5.140 4.920 3.330 8.300 7.140 4.600 5.800 13.900 11.300 13. unspecified Erb's paralysis due to birth injury Other brachial plexus birth injuries Birth injury to face.2 G45.110 5.660 9.660 9.9 P11. Carpopedal spasm Alpha thalassaemia Beta thalassaemia.8 P13.500 5.190 2.0 L93.140 4.4 TUBERCULOSIS. trachea and bronchus.800 13.140 4.950 4.660 A15.140 4.660 9.confirmed bacteriologically and histologically.800 13. HEMIPARKINSONISM.2 D56. EXTRAPULMONARY [Tuberculosis of pleura.900 16.950 4.800 13.330 8. Thalassaemia major.570 3.680 1.570 3.140 8.110 5.8 M32.570 8. Tetanus NOS Tetany.140 4.660 9.800 13.550 11.140 4.140 4.900 3.600 5.570 3.9 P14.800 3.0 P14.3 D56.9 P13.0 P12.140 4.4 P13.680 1.660 9. Lupus erythematosus Subacute cutaneous lupus erythematosus Lupus erymatosus profundus.2 G45. unspecified Cephalhaematoma due to birth injury Bruising of scalp due to birth injury Other birth injuries to scalp Birth injury to scalp.330 8.900 11. unspecified.330 8.110 5.900 11.680 1.140 4. Transient cerebral ischaemia NOS Subdural haemorrhage due to birth injury.3 P15.800 13.9 P10.140 4. Cooley's anaemia.190 2.920 3.900 11.8 G45.4 G45.800 13.800 13. Tuberculous empyema.1 G45.660 9.140 4.330 11.4 P10. Tuberculosis of bronchus.300 7.920 3.400 3.660 9. EXTRAPULMONARY 11. Tuberculosis of mediastinal. IDIOPATHIC PARKINSONISM OR PARKINSON'S DISEASE.300 7.140 4.140 4.9 11. confirmed bacteriologically and histologically. Tuberculosis of glottis. 11. confirmed bacteriologically and histologically.110 5. confirmed bacteriologically and histologically.110 5.0 M32.660 9.140 4.190 4. Tuberculosis of larynx.800 13.800 13. unspecified Tuberculosis of intrathoracic lymph nodes. confirmed bacteriologically and histologically.800 13.660 9.570 4. confirmed bacteriologically and histologically TUBERCULOSIS.950 1.800 13.570 8. Severe beta thalassaemia.1 D56.0 D56.660 9.920 3.800 13.330 A15.800 13.3 G45.0 G45.900 3.2 P13.660 9.660 9. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION PARKINSON'S DISEASE.660 9.330 Page 107 of 111 .920 11.140 4. Tuberculosis of nose. Delta-beta thalassaemia Thalassaemia trait Hereditary persistence of fetal haemoglobin [HPFH] Other thalassaemias Toxic epidermal necrolysis [Lyell] Vertebro-basilar artery syndrome Hemispheric carotid artery syndrome Multiple and bilateral precerebral artery syndromes Amaurosis fugax Transient global amnesia Other transient cerebral ischaemic attacks and related syndromes Transient cerebral ischaemic attack.570 3.800 13.550 11. unspecified Tetanus neonatorum Obstetrical tetanus Other tetanus.900 11.660 9.550 3. confirmed bacteriologically & histologicaly.800 13.300 7.660 9.6 A15.800 13.660 9.1 L93. Tuberculo GROUP Case Rate Professional Fee Health Care Institution Fee G20 SYSTEMIC ATROPHIES INVOLVING CENTRAL NERVOUS SYSTEM SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS SYSTEMIC LUPUS ERYTHEMATOSUS TETANUS TETANUS TETANUS TETANUS THALASSEMIA THALASSEMIA THALASSEMIA THALASSEMIA THALASSEMIA THALASSEMIA TOXIC EPIDERMAL NECROLYSIS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRANSIENT CEREBRAL ISCHEMIC ATTACKS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS TRAUMA RELATED TO BIRTH PROCESS 10.660 9. Thalassaemia intermedia. Spasm of cerebral artery. confirmed bacteriologically & histologicaly.140 4.9 P12.680 1.570 3.5 P15. Nasopharyngeal TUBERCULOSIS.8 L51.130 5.550 11. Lupus panniculitis Drug-induced systemic lupus erythematosus Other forms of systemic lupus erythematosus Systemic lupus erythematosus.140 4. Facial congestion due to birth injury Birth injury to external genitalia Other specified birth injuries Birth injury. PARKINSONISM OR PARKINSON'S DISEASE NOS.800 13.110 5. PRIMARY PARKINSONISM OR PARKINSON'S DISEASE Discoid lupus erythematosus.1 P10.140 4.8 Tuberculous pleurisy.140 4.570 8.800 13.920 3.190 2.950 4.0 D56.110 9.4 D56.500 16. 940 6.0 TUBERCULOSIS. Tuberculo Tuberculosis of lung.530 4.100 15. NOS.570 3. EXTRAPULMONARY TUBERCULOSIS. Tuberculous empyema. Mediastinal tuberculosis.800 2. confirmed by culture only. Tuberculous fibrosis of lung. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION GROUP Case Rate Professional Fee Health Care Institution Fee A16.940 6. Tuberculosis of glottis. Tuberculous pneumonia. bacteriologically and histologically negative.530 4. confirmed histologically only.570 A15. confirmed bacteriologically and histologically Respiratory tuberculosis unspecified. Tuberculosis of pleura.900 3.3 TUBERCULOSIS. Tubercu Tuberculosis of lung. Tuberculous Bronchiectasis. confirmed but unspecified whether bacteriologically or histologically.330 A16. Lupus vulgaris.570 10.900 11. EXTRAPULMONARY 11. peritoneum and mesenteric glands. Tuberculous pneumothorax. without mention of bacteriological or histological confirmation.900 3.9 TUBERCULOSIS.5 A16.330 8.860 6. NOS. MILIARY TUBERCULOSIS.800 2. EXTRAPULMONARY bacteriological or histological confirmation. without mention of bacteriological or histological confirmation.940 2. NOS.3 Tuberculosis of intrathoracic lymph nodes.330 11. Tuberculous fibrosis of lung. Tuberculosis of larynx.900 15.860 A15. Scrofuloderma Acute miliary tuberculosis of a single specified site Acute miliary tuberculosis of multiple sites Acute miliary tuberculosis. Tuberculous adenitis Tuberculosis of intestines. Tuberculosis of bronchus. bacteriologically and histologically negative.0 A19.860 A15. NOS without mention of bacteriolog Tuberculous peripheral lymphadenopathy.100 3.900 3. NOS.2 TUBERCULOSIS.570 8.330 10. confirmed by cul TUBERCULOSIS. without mention of bacteriological or histological confirmation. confirmed histologically only. EXTRAPULMONARY 11.800 9. without TUBERCULOSIS. PULMONARY 9. Tuberculous fibrosis of lung. EXTRAPULMONARY TUBERCULOSIS.940 6.800 2.900 3.530 8.940 6. NOS.570 8.8 Tuberculous pleurisy. NOS. NOS without mention of bacteriological or TUBERCULOSIS. Tuberculous bronchiectasis.940 6. Lupus vulgaris. without mention of bacteriologic 11. bacteriologically and histologically negative. MILIARY TUBERCULOSIS.860 Page 108 of 111 . PULMONARY 9. Nasopharyngeal tuberculosis.570 10. confirmed but unspecified whether bacteriologically or histologically Primary respiratory tuberculosis. Tuberculosis of intrathoracic lymph nodes. confirmed by culture only.900 3.2 A19. unspecified Other miliary tuberculosis Miliary tuberculosis Tuberculosis of lung.570 8.860 A16.1 A19. confirmed by unspecified means.9 TUBERCULOSIS.860 A15. without mention of bact 9. Tuberculous Bronchiectasis .2 A18. confirmed by culture only.570 8. PULMONARY Tuberculous pneumonia. Tuberculous pneumonia.100 15.100 15. MILIARY TUBERCULOSIS.860 A16. .570 10.800 2. NOS. Tuberculous pneumothorax Tuberculosis of lung. bac Tuberculosis of lung.860 A16. confirmed by sputum microscopy with or without culture. without mention of bacteriological or histological onfirmation.8 A19. NOS.570 10.0 TUBERCULOSIS.330 A18. EXTRAPULMONARY mention of bacteriological or histological confirmation.940 6. confirmed histologically only. confirmed bacteriologically and histologically Tuberculosis of lung. Tuberculous fibrosis of lung. Tuberculous Bronchiectasis. Tuberculosis of hilar lymph nodes NOS without mention of TUBERCULOSIS. PULMONARY 9.800 2. Tuberculous fibrosis of lung. PULMONARY TUBERCULOSIS. Lupus exedens. bacteriological and histological examination not done.4 TUBERCULOSIS.2 Tuberculosis of lung. confirmed by culture only.860 A15. confirmed by sputum microscopy with or without culture. confirmed histologically only.570 8. bacteriological and histological examination not done.530 4. PULMONARY 9. PULMONARY 9.1 TUBERCULOSIS. without mention of bacteriological or his Other respiratory tuberculosis.800 2.ANNEX 1.530 4. EXTRAPULMONARY histological confirmation. Tuberculous Bronchiectasis.4 A19. without mention of bacteriological or histological onfirmation.800 2. MILIARY 11. without mention of bacteriological or histological confirmation. PULMONARY 9. without mention of bacteriological or histological confirmation.570 4. Tuberculous Bronchiectasis. MILIARY TUBERCULOSIS.330 A18. Tuberculosis of retroperitoneal lymph nodes Erythema tuberculous induratum. Tuberculous fibrosis of lung.940 6. Tuberculous fibrosis of lung. TUBERCULOSIS. confirmed by sputum microscopy with or without culture.100 15. Lupus exedens. Tuberculous Bronchiectasis. PULMONARY 9.1 TUBERCULOSIS.800 2.330 A16.3 11. bacteriological and histological examination not done.7 A15. NOS. NOS.940 6. 340 2.800 7.300 2.910 N28. SCIATICA DUE TO INTERVERTEBRAL DISC DISORDER Other specified intervertebral disc displacement Lumbago due to displacement of intervertebral disc Other specified intervertebral disc degenerations Schmorl's node GROUP Case Rate Professional Fee 2.000 3.390 3.2 M51.000 3.2 M50.340 2.000 7.800 7.460 5.460 5.000 10.000 7.000 10.000 11.9 A01. unspecified Other specified disorders of kidney and ureter.300 7.000 10.8 M51. Ureteritis cystica.1 M51.460 5.340 2.0 M99.2 A01.500 7.000 3.460 5.000 3. Tuberculosis NOS Typhoid fever Paratyphoid fever A Paratyphoid fever B Paratyphoid fever C Paratyphoid fever.000 10. unspecified Urinary tract infection.800 7.460 5.800 7.000 10.000 7.250 5. Respiratory tuberculosis NOS.390 6.340 2.0 M50.500 7. RIB CAGE Subluxation complex (vertebral) Osseous stenosis of neural canal Intervertebral disc stenosis of neural canal VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS Page 109 of 111 .000 7.1 M99.460 5.390 3.2 A02.000 10.800 7.ANNEX 1.000 7.250 2.800 7.3 N30.250 2.1 M50. Nephropathy NOS.910 7.940 Health Care Institution Fee 6.5 URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] URINARY TRACT INFECTION [ADMISSIBLE] VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS 11.9 N26 N27.2 N30.460 5.250 5. Pyeloureteritis cystica.000 7.340 2.000 10.000 3.300 11. Renal disease NOS Other disorders of kidney and ureter in other diseases classified elsewhere Acute cystitis Chronic Interstitial cystitis Other chronic cystitis Trigonitis.460 5.340 2.000 7.000 3.0 N27.500 7.0 A01.390 3.000 7. Salmonellosis Salmonella septicaemia Localized salmonella infections Other specified salmonella infections Salmonella infection.4 M51.800 10.250 2.300 11.340 2.800 7.000 3.910 7.250 2. Primary respiratory tuberculosis NOS. unspecified Unspecified contracted kidney. bilateral Small kidney.8 TUBERCULOSIS.460 5.000 3. unspecified.300 11.800 7.910 7.9 N29.3 M50.300 11.9 N39. unilateral Small kidney.340 2.4 A02.800 3. Hypertrophy of kidney.800 7.340 2. without mention of bacteriological or histological confirmation. Urethrotrigonitis Cystitis.860 7.9 N28.340 2.800 7.500 7. Nephroptosis.910 7. Ureterocele Disorder of kidney and ureter. Megaloureter. site not specified Cervical disc disorder with radiculopathy Other cervical disc displacement Other cervical disc degeneration Other cervical VERTEBRAL DISC DISORDERS LUMBAR AND OTHER INTERVERTEBRAL DISC DISORDERS WITH RADICULOPATHY.000 7.000 7.8* N30.7 TUBERCULOSIS.250 5. unspecified. Pyelitis cystica.940 3.3 A01.390 3.910 5.910 7.3 M51.460 5.000 10.000 3.340 2.390 2.1 N27.250 5.500 7.8 M99. Primary tuberculous complex Respiratory tuberculosis unspecified.8 A02.460 5.250 5.250 5.0 A02. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE DESCRIPTION Primary respiratory tuberculosis without mention of bacteriological or histological confirmation.340 7.860 A16.460 5.800 7.000 3.390 3.1 A02.1 N30. Infection due to Salmonella paratyphi NOS Salmonella enteritis. PULMONARY 9.3 M99.460 Other specified intervertebral VERTEBRAL DISC DISORDERS VERTEBRAL DISC DISORDERS SEGMENTAL AND SOMATIC DYSFUNCTION. Atrophy of kidney (terminal).500 7.300 11.000 10.800 A16.250 2. Renal sclerosis NOS Small kidney.0 N30.340 2. PULMONARY TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER TYPHOID FEVER URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY URINARY TRACT ATROPHY/HYPERTROPHY 9.800 7.1 A01.250 2. 370 2.540 3.370 2.540 3.1 B16.530 5.900 7.330 Health Care Institution Fee 5.800 11.9 A80. Vertiginous syndrome NOS Labyrinthine fistula Labyrinthine dysfunction.800 11.800 5.530 5.2 DESCRIPTION Connective tissue and disc stenosis of intervertebral foramina Ménière's disease. Vertigo NOS GROUP VERTEBRAL DISC DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS VERTIGINOUS DISORDERS Case Rate 7.1 B17.9 B17.1 H83.530 5. indigenous VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM Page 110 of 111 . Light-headedness.540 3. Hypersensitivity of labyrinth.800 11.900 7.540 3.460 3.0 B16.990 3.800 11.540 3.700 5.260 8.1 A80.990 5.540 3.370 2.9 H83. wild virus.800 11. HEPATITIS NONA NON-B (ACUTE)(VIRAL) NEC CHRONIC VIRAL HEPATITIS B WITH DELTA-AGENT CHRONIC VIRAL HEPATITIS B WITHOUT DELTA-AGENT.9 B19.1 B18.710 1.800 11.9 B16.260 8.800 11.540 6.330 6.990 3.710 1.540 3.540 3. UNSPECIFIED UNSPECIFIED VIRAL HEPATITIS HEPATIC WITH COMA UNSPECIFIED VIRAL HEPATITIS WITHOUT HEPATIC COMA.0 H81.800 11.2 B17.700 5.800 11.7 H81.8 A99 B15.0 B15.710 1.4 A98. imported Acute paralytic poliomyelitis.260 8.4 H81.990 3. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE M99.1 A98.900 7.540 3.710 1.260 8.0 B17.700 5.2 B16.990 3.990 3.2 B18.990 3.540 3.540 3.800 11.710 2. Aural Vertigo .770 Junin haemorrhagic fever.340 1.0 B19.260 8.700 5. HEPATITIS A (ACUTE)(VIRAL) NOS ACUTE HEPATITIS B WITH DELTA-AGENT (COINFECTION) WITH HEPATIC COMA ACUTE HEPATITIS B WITH DELTA-AGENT (COINFECTION) WITHOUT HEPATIC COMA ACUTE HEPATITIS B WITHOUT DELTA-AGENT WITH HEPATIC COMA ACUTE HEPATITIS B WITHOUT DELTA-AGENT AND WITHOUT HEPATIC COMA. Peripheral NOS Vertigo Vertigo of central origin.260 8.260 8.260 8.700 5.260 8. Bolivian haemorrhagic fever VIRAL HEMORRHAGIC FEVER Ebola virus disease Other specified viral haemorrhagic fevers Unspecified viral haemorrhagic fever ACUTE HEPATITIS A WITH HEPATIC COMA ACUTE HEPATITIS A WITHOUT HEPATIC COMA.260 8.710 1.260 8.800 11.260 8.800 11. wild virus.1 H81.3 H81.540 3.540 3.540 3. Otogenic Vertigo.770 14. Labyrinthine hydrops.370 3.260 8.2 H81.900 7.530 8.8 B18.370 2. unspecified.700 5. Central positional nystagmus Other disorders of vestibular function Disorder of vestibular function.800 11.540 3. Lermoyez' syndrome.800 11.8 B18.540 3.990 3.990 3.530 5.700 7.710 1.710 1.800 21. VIRAL HEPATITIS NOS Acute paralytic poliomyelitis.710 1.700 5.ANNEX 1.700 5. Loss of function Of labyrinth Dizziness and giddiness.990 3. HEPATITIS B (ACUTE)(VIRAL) NOS VIRAL HEMORRHAGIC FEVER VIRAL HEMORRHAGIC FEVER VIRAL HEMORRHAGIC FEVER VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS VIRAL HEPATITIS ACUTE DELTA-(SUPER)INFECTION OF HEPATITIS B CARRIER VIRAL HEPATITIS ACUTE HEPATITIS C ACUTE HEPATITIS E OTHER SPECIFIED ACUTE VIRAL HEPATITIS.8 H81. Hypofunction of labyrinth.260 8.900 11.100 21. Ménière's syndrome or vertigo Benign paroxysmal vertigo Vestibular neuronitis Other peripheral vertigo. CHRONIC (VIRAL) HEPATITIS B CHRONIC VIRAL HEPATITIS C OTHER CHRONIC VIRAL HEPATITIS CHRONIC VIRAL HEPATITIS.710 1.260 8. Argentinian haemorrhagic fever VIRAL HEMORRHAGIC FEVER Machupo haemorrhagic fever.700 5.800 11.260 14.100 Professional Fee 2.0 B18.2 R42 A96.260 8.0 A96.800 11. 700 11.510 3.770 14.600 10.100 21.1 A81.8 A86 A88.510 3. Ophthalmic tularaemia Pulmonary tularaemia Gastrointestinal tularaemia.7 A22.510 3.330 6. unspecified.330 6.0 A28.330 6.100 21. Melioidosis septicaemia Rat-bite fever.190 8.190 8.190 8.510 3. unspecified VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM WHOOPING COUGH WHOOPING COUGH WHOOPING COUGH WHOOPING COUGH ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES ZOONOTIC BACTERIAL DISEASES Page 111 of 111 .510 3.100 21.8 A26.330 6.770 14.1 A37. Dawson's inclusion body encephalitis .510 3.330 6.510 3.190 8.190 8.190 Unspecified viral encephalitis. unspecified Other forms of erysipeloid Erysipeloid.510 3.9 A26.510 3.700 11.600 10.190 8.770 14.8 A37.770 14.700 11.190 8.190 8.510 3.510 3.330 6.100 21.0 A83.1 A82. unspecified Bubonic plague Plague.9 A85.5 A83.510 3.100 21.180 3.1 A25.190 8.330 6.8 A89 A37.770 14.420 8.510 3.190 8.190 8. unspecified Cutaneous anthrax.700 11.770 14.2 A81.330 6.510 3.0 A20. unspecified.0 A81.100 21.2 A83.510 3.0 A82.770 14.330 6.0 A22.330 6.3 A21.770 14.180 3.190 8.100 21.770 14. unspecified Ulceroglandular tularaemia.1 A23.770 14.700 11.190 8.9 A21.9 A82.100 10. unspecified Pasteurellosis Cat-scratch disease.100 21.770 7.ANNEX 1.190 8.330 3.700 Professional Fee 6. Malignant carbuncle. Infection due to Pseudomonas mallei.9 DESCRIPTION Acute poliomyelitis. LIST OF MEDICAL CASE RATES FIRST CASE RATE ICD CODE A80.510 3.770 14.510 3.330 6.2 A22.770 14.700 11.510 3.700 11.9 A20.0 A37.9 A24.190 8.700 11.770 14.100 21. Viral encephalomyelitis NOS. Melioidosis pneumonia .700 11. California meningoencephalitis La Crosse encephalitis Other mosquito-borne viral encephalitis Mosquito-borne viral encephalitis.700 11.700 11.9 A83.8 A28.420 7.700 11.0 A21.330 6.770 14. Multifocal leukoencephalopathy NOS Atypical virus infection of central nervous system. unspecified Arthropod-borne viral encephalitis. Ophthalmic tularaemia Oculoglandular tularaemia.770 14. Prion disease of central nervous system NOS Sylvatic rabies Urban rabies Rabies.1 A21.9 A81.770 14.330 6.180 3.190 8. unspecified Creutzfeldt-Jakob disease. Abdominal tularaemia Tularaemia.770 14.700 11.700 11.9 A23.100 21.510 3.510 Health Care Institution Fee 14.700 11.100 21.9 A28.100 21.330 6. unspecified Glanders. unspecified Japanese encephalitis Eastern equine encephalitis California encephalitis.190 8. unspecified Brucellosis due to Brucella abortus Brucellosis. Malignant pustule Gastrointestinal anthrax Anthrax septicaemia Anthrax.100 21.190 8.100 21. Subacute spongiform encephalopathy Subacute sclerosing panencephalitis.100 21.700 11.100 21.700 11.700 11.700 11.2 A21.510 3. Malleus Acute and fulminating melioidosis.2 A85.190 8. Cat-scratch fever Other specified zoonotic bacterial diseases. not elsewhere classified Zoonotic bacterial disease.330 6.0 A24. Encephalitis lethargic.600 11.510 3.190 8.330 6. Von Economo-Cruchet disease GROUP VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM Case Rate 21.330 6.1 A28.180 3. VIRAL INFECTION OF CENTRAL NERVOUS SYSTEM Viral meningoencephalitis NOS Other specified viral infections of central nervous system Unspecified viral infection of central nervous system Whooping cough due to Bordetella pertussis Whooping cough due to Bordetella parapertussis Whooping cough due to other Bordetella species Whooping cough.700 11.8 A83. Other specified viral encephalitis.700 11.9 A22.420 7.100 21.190 8.420 7.600 10. Van Bogaert's sclerosing leukoencephalopathy Progressive multifocal leukoencephalopathy.