Chief Minister's Comprehensive Health Insurance Scheme

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Follow Up Procedure Guidelines - genito

SERIAL NUMBER Procedure 1st Qtr Per Qtr (for next 3 Qtrs) Requirements while submitting for follow-up Preauth Requirements while submitting for follow-up Claims
29 FP0029 : Open pylolithotomy 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory), Uroflowmetry, Urine culture
30 FP0030 : Open Nephrolithotomy 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
31 FP0031 : Open Cystolithotomy 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
32 FP0032 : Laparoscopic Pylolithotomy 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
33 FP0033 : Cystolithotripsy 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
34 FP0034 : PCNL 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
35 FP0035 : ESWL 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
36 FP0036 : URSL 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
37 FP0037 : Endoscope Removal of Stone in Bladder 800 400 Previous Discharge Summary (USG Abdomen, Urine Analysis-Mandatory)
38 FP0038 : Transurethral resection of prostate (TURP) 800 400 Previous Discharge Summary (Clinical Evaluation, Uroflowmetry, PSA Level If Indicated-Mandatory)
39 FP0039 : TURP Cyst lithotripsy 800 400 Previous Discharge Summary (Clinical Evaluation, Uroflowmetry, PSA Level If Indicated-Mandatory) USGabdomen in 2 nd quarter
40 FP0040 : Open prostatectomy 800 400 Previous Discharge Summary (Clinical Evaluation, Uroflowmetry, PSA Level If Indicated-Mandatory)