Microsoft word - cir - 203.doc

Ref.No.NB.HRMD.PPD. / C- 21 /Med In (A, B & C)/2005-06 26 October 2005 The Chief General Manager/General Manager/ Officer - in - charge / The Principal National Bank for Agriculture All Regional Offices/Sub-Office, Port Blair/ Zonal Audit Cell, Kolkata/ All Training Establishments All Head Office Departments, Mumbai All EDs' Secretariats, Mumbai/New Delhi/Guwahati. Dear Sir, Staff - Groups 'A', 'B' & 'C' - Medical Facilities - Schedules for reimbursement of Hospitalisation, Operation and Pathological/Radiological etc. investigation charges Please refer to our circulars No.NB.HRMD.PPD.C-18 /Med IN(B&C)/2001-02 and NB.HRMD.PPD.C-19 /Med IN(A)/2001-02 both dated 16 June 2001 on the captioned subject. 2. We have since reviewed the position and the revised rates for reimbursement of the cost of various items of medical expenses involved in outdoor/indoor treatment, classified as per the following details are furnished in Annexures I to V. Outdoor treatment taken by officers and their eligible family members from Bank's Medical Officers,General Medical Practitioners and Specialists Non-hospitalisation OPD treatment / procedures 3. At present operations are categorised as Minor, Less Major, Major and Super Major. On a review, in light of the emerging developments in the field of surgery, one more category of operation viz, Major Plus has been included in between the Major and Super Major categories. An illustrative list of operations classified as such has been furnished in Anneuxre VI. 4. The rates prescribed are indicative maximum up to which medical claims can be settled. While settling the claims, offices should ensure the reasonableness of the respective items of claims preferred taking into account the relative rates prevailing in their respective centres. 5. The revised rates will be applicable for treatment taken from 01 October 2005 onwards. 6. Other instructions governing the matter shall remain unchanged. 7. The contents of this circular may please be brought to the notice of all the staff/officers attached to your office/department and the Bank's Medical Officer at your centre. A copy of this circular with enclosures may be provided to the local units of Officers' Association and Employees' Association. Yours faithfully, Sd/- (R Padmanabhan) Dy. General Manager Encls.: As Above Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Abnormal Haemoglobin study (Electrophoresis) Any Fluid for Cytology/Fluids for Malignant (CSF, Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Cardiac Injury Profile / Panel, Cardiac Enzyme Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
CBC without indices (RBC, HB, WBC, TC, CBC) Cold Agglutination Test for Virus Pneumonia Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Culture (Any) (Blood, fluid , CSF, urine, pus, fungus) Culture (Bectec) (Blood, ascitic fluid, pus, swab, Extended Lipid Profile (including Apolipo Protein) Fluid routine (Any) (CSF, Ascitic, Pleural etc.) Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Lung Function Test/Pulmonary Function Test (PFT) Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Partial Thromboplastin Time (Activated PTT) Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Skin scraping (Leprosy or Hensen Bacillus) Skin scraping (Nasal scraping for leprosy) Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Total Body Profile (General Body Profile) Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure incurred for pathological investigations
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups
'B' and 'C'
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure II
Schedule for reimbursement of expenditure incurred for special investigations and treatment
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees in
Officers in Grades
Groups 'B'
A. CARDIAC
# For ordinary Stress Test (Master Steps Telemetry) three times ECG charges to be reimbursed.
## This includes i) Cath Lab charges, ii) Machine (Instrument) charges, iii) all consumables and iv) professional fees.
B. NEUROLOGICAL
coronory and Fluorescein angiography for eye renogram) (Carotoid /renal / aortogram Angio of limb) @ When coronory angiography is done along with any of Renal or Carotid angiography, Rs. 1000/- may be reimbursed in addition to Coronary angiography charges (item B-5).
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure II
Schedule for reimbursement of expenditure incurred for special investigations and treatment
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees in
Officers in Grades
Groups 'B'
D. RADIATION
Professional/Consultation Fees (Once only) $ Normally radiation treatment is given 5 days a week over a period of 6 to 7 weeks E. CHEMOTHERAPY
Administration Charges (per cycle including Chemo consumables) Notes :(a) Planning charges to be reimbursed only once.
(b) Procedure/ Chemo administration charges may be admitted per cycle irrespective of number of days for each cycle- number of cycles should be mentioned at the time of submitting the claim.
(c) Day care to be treated as indoor treatment and bed charges to be reimbursd separately (d) Pathological investigation charges to be reimbursed separately.
F. NUCLEAR SCANNING
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure II
Schedule for reimbursement of expenditure incurred for special investigations and treatment
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees in
Officers in Grades
Groups 'B'
G. MRI /CT SCAN
pelvis/spine / neck/ joints/ upper abdomen Notes :(a) Charges for ophthalmic exercises not admissible. ( b) Gonioscopy to be considered along with consultation charges. I. DIAGNOSTIC SCOPIES
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure II
Schedule for reimbursement of expenditure incurred for special investigations and treatment
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees in
Officers in Grades
Groups 'B'
Reterigrade Cholangio Panereaticography) J. THERAPEUTIC SCOPY*
Oesophagoscopy/Duodenoscopy/ Gastroscopy (OGD) * This includes ( i) OT Charges ( ii) Computerisation Charges, ( iii) Professional Charges, (iv) Consumables excluding costof stent reference to be made to GAD,Head Office, if stent is used.
# (a) Upper GI scopy includes foreign body removal, sclerotherapy including cost of injuction(b) If banding is done in oesophageal varices, reference is to be made to GAD, Head Office.
(c) If glue is used in the Gastric hemorrhage, refer is to be made to GAD, Head Office.
$ ERCP for sphincterotomy, CBD stenting , Pancreatic duct stenting, CBD stone extraction, Pancreatic stone extraction,BD removal from CBD or stent removal/ retrival.
K. SONOGRAPHY
Abdominal, Pelvis)* Single organ thyroid, scrotum, breast, orbit , wrist, pelvis etc. Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure II
Schedule for reimbursement of expenditure incurred for special investigations and treatment
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees in
Officers in Grades
Groups 'B'
@ If portable X- Ray is done, Rs. 150/- only to be reimbursed additionally towards portable charges and not for each X- Ray.
M. DENTAL
N. DIALYSIS
medicines and all other material used for dialysis) medicines) when artificial kidney is used Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annuxure III
Schedule for Reimbursment of expenditure incurred on hospitalisation treatment
(Effective from 01 October 2005)
(Amount in Rs.)
Name of the Investigation
Employees
Officers in Grades
in Groups 'B'
'A' &'B'
# includes Cath Lab charges, Machine (instrument) charges, all consumables and professional fees.
* ECG and visit charges in ICCU/ICU/IPCU are to be reimbursed separately.
$ Officers in Grade 'E' are eligible for difference under MAF Scheme as available to Officers in Grade 'F'. ** This includes stoppage charges, Doctor's. fees, Machine charges, all consumable items, either one sitting or more irrespective of size of stone and reimbursable once in a year.
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure on outdoor
treatment taken from Bank's Medical Officers/ General
Medical Practitioners and Specialists
(Effective from 01 October 2005)
Maximum amount
reimbursable
(Amount in Rs.)
A. Visit charges
(a) For visits by CMO to the residence of Officers in Krishi Vikas Sadan
(b) For visits by CMO/other BMOs to the residence of Officers at places (c) For visits by General Medical Practitioners to the residence of Officers (d) For first visit by Specialist to the residence Of Officers (e) For second visit to the residence of Officers (applicable only in cases B. Consultation * / Examination charges at the clinic of the doctor
Second consultation and subsequent Consultation (not more than 5 in the year) * Considering the nature of ailment, charges for repeated consultations
with GMP/Specialist may be admitted on the recommendation of BMO
C. Cost of drugs (powder/tablets and mixtures/ antibiotic capsules
supplied by medical practitioner)
D (a) Injection administration charges
(b) Cost of injection (where the name is not specified)
E. Dressing (Ordinary ) charges for minor injuries/ boils etc.
irrespective of number of wounds dressed
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Schedule for reimbursement of expenditure on outdoor
treatment taken from Bank's Medical Officers/ General
Medical Practitioners and Specialists
(Effective from 01 October 2005)
Maximum amount
reimbursable
(Amount in Rs.)
F. Treatment taken under the Homoeopathic / Ayurvedic system of
medicines ( cf.
circulars No. NB.HRMD-PPD/574/M.4/94-95 dated 23 June 1994 and
NB.HRMD-PPD/C52/ M-4/97-98 dated 30 September 1997)

(b) Cost of medicines supplied by the doctor (Maximum for seven days only)
G. Vaccines
(a) BCG
Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure V
Schedule for reimbursement of Non-Hospitalisation OPD Treatment / Procedure charges
(Effective from 01 October 2005)
Maximum amount reimbursable
(Amount in Rs.)
Excision of small cyst, Lipoma, biopsy of lymph gland, Chalasion (any excision under local anaesthesia or similar operation) Injection intra articular (C injection) Hydrocortisone / Depo-Medrol Injection of piles (including cost of injection) puncture (including cost of consumables) Removal of toe/thumb nail under local anaesthesia Figure of 8 bandage for fracture clavicle (including cost of consumables) Annexure to Cir. No. 203/PPD-27/2005 dated 26 Oct. 2005 Annexure VI
Classification of Operations
1. ABDOMEN / GENERAL
MINOR
1. Lymphnode biopsy from the neck under general anesthesia (GA) 2. Buccal mucosa biopsy 3. Removal of mucocele from oral mucosa under GA 4. External abscess drainage or cyst removal under general anesthesia 5. Big Lipoma/subceous cyst excision under general anesthesia 6. Stretching of anal canal / Anal sphincterotomy (for piles, fissure), 7. Liver biopsy 8. Rectal biopsy 9. Excision of polyp 10. Excision of lymph nodes from axilla/neck 11. Excision of breast lump - lumpectomy 12. Suturing of wound under GA.
LESS MAJOR
Submandibular salivery gland excision & pilonidal sinus 1. Exploratory laparotomy 2. Colostomy 3. Splenectomy 4. Cholecystectomy including Laprascopy 5. Suturing of peptic ulcer / intestinal perforation 6. Drainage of subphrenic abscess 7. Excision of tumors with skin grafting 8. Repair of faecal fistula 9. Surgery for phyloric stenosis (Operation gastro jejunostomy or jejuno - 10. Surgery for achalasia cardia 11. Surgery for rectal prolapse 12. Groin node dissection 13. Appendicectomy 14. Inguinal hernia operation - unilateral (including the cost of mesh) - cases involving bilateral operation to be referred to GAD, Head Office. 15. Wide excision of lip for basal cell/squameous cell carcinoma 16. Operation for hair lip 17. Operation for cleft palate 18. Partial laryngectomy 19. Partial thyroidectomy (Hemi) 20. Partial glossectomy 21. Partial Mandibulectomy 22. Parotid gland removal 23. Surgery for tempero - mandibular joint 24. Mastoidectomy 25. Radical Neck Dissection
MAJOR PLUS
Total/Partial gastrectomy with Anastomosis Resection of pyloro duodenal mass with reconstruction Biliary tract reconstruction for stricture Total thyroidectomy with or without block dissection for cancer of thyroid. 10. Total glossectomy 11. Hemimandibulectomy with reconstruction 12. Maxillectomy with reconstruction 13. Oesophageal resection with reconstruction 14. Laryngectomy Total 15. Parotidectomy Total 16. Uvulo Palato Pharyngoplasty (UPPP)
LESS MAJOR

Rib Resection / wire removal / resuturing Operation for gynecomastia - (If done for both sides at the same sitting an additional 40% of schedule rate may be
MAJOR PLUS
10. Excision of chest wall tumor/excision of ribs with reconstruction 11. Lobectomy/Pneumonectomy
LESS MAJOR
Functional endoscopic sinus surgery (FESS)
LESS MAJOR
Cataract surgery (either Pheco or conventional with or without Intra Ocular Lens - IOL) Simple vitrectomy for vitreal infection or vitreous hemorrhage Glaucoma surgery with cataract in the same sitting with or without IOL
MAJOR PLUS

Surgery for complicated retina detachment GYNAECOLOGY
D & C with biopsy report (Non pregnant case) Cervical polypectomy/cervical biopsy + Diathermy cautary under GA Incomplete abortion - Removal of remaining product of conception 10. Fenton operation 11. Perineal abscess with our without MTP
LESS MAJOR
Diagnostic laparoscopy for pelvic inflammation and endometriosis Aspiration of ovarian cyst with cytology of fluid Cone biopsy of cervix for suspected carcinoma in situ. Operation for third degree perineal tear Perineal abscess due to low fistula in Ano Total hysterectomy (Vaginal or Abdominal) with our without bilateral salphingo oopherectomy V.V.F. Repair (Vasico Vaginal Fistula Repair) Surgery for chocolate cyst of ovary bigger than two inches diameter supported by previous sonography
MAJOR PLUS
Wertheims operation for Cervix cancer (Radical hysterectomy for Cancer of body of uterus) Malginant ovarian tumor (panhystrectomy with omentectomy) Operative Laparoscopy for removal of ectopic pregnancy. NEURO SURGERY (Head)

LESS MAJOR
Surgery for spasticity - Facial Nerve Decompression MAJOR PLUS
10. Posterior fusion for AAD (Atlanto Axial Dislocation) Anterior approach Discoidectomy - Cervical ORTHOPAEDIC
Debridement and suturing under general anesthesia Removal of implant under general anesthesia Closed reduction and plastering under general anesthesia including cost of plaster material either supplied by the doctor or purchased from the chemist (item like sofroll, plaster of paris etc.) Incision and drainage under general anesthesia
LESS MAJOR
Internal fixation long bone with or without bone grafting External fixation of long bone (llizarov) includng cost of plates, screws etc. Surgery for disarticulation of any joint (hip, knee, elbow, wrist, ankle etc.) Congenital deformity - corrective surgery (CTEV) High tibial osteotomy/Corrective osteotomy
MAJOR PLUS
Bone tumor excision with grafting/reconstruction (malignant) for spinal cord extradural and intradural tumor URO GENITAL

LESS MAJOR
Hydrocele operation - (For bilateral done at the same time an additional 50% of the schedule rate may be reimbursed) Operation for kidney stone i.e. P.C.N.L. including U.R.S.
MAJOR PLUS

Source: http://www.nabnet.in/repository/circulars/2007/internal/2005/HRMD-PPD/Cir%20-%20203.pdf