Total Hip Replacement - Medco
Total Hip Replacement - Medco
Package name Procedure name HBP 1.0 code HBP 2.0 code Package price*
Total Hip Replacement Cemented S500091 SB038A 35000
Mandatory document Total Hip Total Hip Total Hip Total Hip
Replacement - Replacement - Replacement - Replacement -
Cemented Cementless Hybrid Revision
i. At the time of Pre-
authorisation
a. Clinical notes with Yes Yes Yes Yes
indication for surgery
b. X-ray / CT of Hip labelled Yes Yes Yes Yes
with patient ID, date
and side (Left/ Right)
c. Pre-op X – ray of the No No No Yes
affected hip shows
implant
ii. At the time of claim
submission
a. Indoor case papers Yes Yes Yes Yes
b. Post op clinical Yes Yes Yes Yes
photograph
c. Post op X-ray showing Yes Yes Yes Yes
the implant. The X-ray is
labelled with patient ID,
date and side (Left/
Right)
d. Invoice / bar code of Yes Yes Yes Yes
implant
e. Detailed OT note Yes Yes Yes Yes
3.2 Below mentioned are the scenarios where a provision would be built in TMS for pop-
ups:
I. Does the Post-op X- ray / CT of hip show the presence of implant? – Yes
II. If the patient is undergoing Revision hip replacement, does the pre-op X-ray/ CT of hip
show the presence of implant? - Yes
Till the time the functionality is being developed, the processing doctors shall check the above
manually.
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