A-3 Table of Surgical Procedures (TOSP)

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A-3 Table of Surgical Procedures (TOSP) Annex A-3 Ministry of Health TABLE OF SURGICAL PROCEDURES (Updated as of 12 January 2016) A-3-1 CONFIDENTIAL Annex A-3 TABLE OF CONTENTS SA - Integumentary ........................................................................... 3 SB - Musculoskeletal ....................................................................... 11 SC - Respiratory .............................................................................. 32 SD - Cardiovascular ........................................................................ 35 SE - Hemic & Lymphatic ................................................................. 42 SF - Digestive .................................................................................. 44 SG - Urinary .................................................................................... 58 SH - Male Genital ............................................................................ 63 SI - Female Genital ......................................................................... 66 SJ - Endocrine ................................................................................. 74 SK - Nervous ................................................................................... 75 SL - Eye ........................................................................................... 83 SM - ENT ......................................................................................... 90 The Table of Surgical Procedures (TOSP) is an exhaustive list of procedures with table ranking 1A to 7C, for which Medisdave / MediShield Life can be claimed. Any procedures not listed or without a table ranking 1A to 7C are not claimable. Specifically, Minor Surgical Procedures (procedures with table ranking “MSP”) are procedures which the TOSP review committee decided to be non- claimable. The list of MSPs is non-exhaustive, i.e. procedures not in the TOSP and not a MSP are still not claimable. A-3-2 CONFIDENTIAL SA - INTEGUMENTARY S/N New Description Table Classification Current Code code 1 SA700B Botulinum toxin therapy for movement disorders MSP Existing SA700B 2 SA800B Breast (nipple), Various lesions, Graft and/or flap 4B Uptabled / SA800B reconstruction (bilateral) Description Change 3 SA801B Breast (nipple), Various lesions, Graft and/or flap 4A Uptabled / SA801B reconstruction (unilateral) Description Change 4 SA803B Breast, Diffuse hypertrophy, Reduction >250g 4B Existing SA803B (unilateral) 5 SA802B Breast, Diffuse Hypertrophy, Reduction 6A Uptabled SA802B Mammoplasty >500g (bilateral) 6 SA805B Breast, drooping, mastopexy/reduction 4A Existing SA805B (unilateral) 7 SA804B Breast, Drooping, mastopexy/reduction (bilateral) 5B Uptabled SA804B 8 SA701B Breast, Ductal Lesions, Microdochectomy 3A Existing SA701B (bilateral) 9 SA702B Breast, Ductal Lesions, Microdochectomy 2C Existing SA702B (unilateral) 10 SA806B Breast, Gynecomastia, Reduction (bilateral) 4A Existing SA806B 11 SA807B Breast, Gynecomastia, Reduction (unilateral) 3A Existing SA807B 12 SA808B Breast, Hypoplasia, Augmentation Mammoplasty 4A Existing SA808B (prosthetic and bilateral) 13 SA809B Breast, Hypoplasia, Augmentation Mammoplasty 3A Existing SA809B (prosthetic and unilateral) 14 SA811B Breast, Inverted Nipple, Surgical Eversion 2C Existing SA811B (unilateral) 15 SA810B Breast, Inverted Nipples, Surgical Eversion 3A Existing SA810B (bilateral) 16 SA812B Breast, Lump (single), Excision biopsy 2C Existing SA812B 17 SA705B Breast, Lump, more than 4 cm (removal) with 4A Existing SA705B parenchymal flap closure (unilateral/bilateral) 18 SA703B Breast, Lump, Percutaneous Biopsy under MRI 2C Existing SA703B 19 SA813B Breast, Lumps (multiple/bilateral), Excision 3A Existing SA813B biopsy 20 SA706B Breast, Lumps, Imaging Guided Vacuum 2C Existing SA706B assisted Biopsy / Mammotome, > 1 lesions 21 SA704B Breast, Lumps, Imaging Guided Vacuum 2B Existing SA704B assisted Biopsy / Mammotome, Single lesion 22 SA814B Breast, Post mastectomy, implant/expander 5A Existing SA814B reconstruction (bilateral) 23 SA815B Breast, Post mastectomy, implant/expander 4A Existing SA815B reconstruction (unilateral) 24 SA816B Breast, Post Mastectomy, latissmus dorsi 6C Existing SA816B pedicled flap with or without implant reconstruction (bilateral) 25 SA817B Breast, Post Mastectomy, latissmus dorsi 5C Existing SA817B pedicled flap with or without implant reconstruction (unilateral) 26 SA818B Breast, Post Mastectomy, Reconstruction using 7A Existing SA818B pedicled Transverse Rectus Abdominis Musculocutaneous Flap (bilateral) A-3-3 CONFIDENTIAL SA - INTEGUMENTARY S/N New Description Table Classification Current Code code 27 SA713B Breast, Post mastectomy, reconstruction using 6A Existing SA713B pedicled transverse rectus abdominis musculocutaneous flap (unilateral) 28 SA819B Breast, Post mastectomy, reconstruction using 7C Existing SA819B transverse rectus abdominis free musculocutaneous flap (unilateral) 29 SA820B Breast, Post Prosthetic Contraction, 3A Existing SA820B Capsulotomy (bilateral) 30 SA821B Breast, Post Prosthetic Contraction, 2C Existing SA821B Capsulotomy (unilateral) 31 SA825B Breast, Tumor (malignant), Radical mastectomy 5C Existing SA825B with/without Axiliary Clearance 32 SA826B Breast, Tumor (malignant), Simple Mastectomy 4A Existing SA826B 33 SA824B Breast, Tumor (malignant), Simple Mastectomy 5A Existing SA824B with Axiliary Clearance, with/without Sentinel Node Biopsy 34 SA827B Breast, Tumor (malignant), Simple Mastectomy 4C Existing SA827B with Sentinel Node Biopsy/ Axiliary Node Sampling 35 SA822B Breast, Tumor (malignant), Wide Excision/ 3B Existing SA822B Lumpectomy/Segmental Mastectomy/ Partial Mastectomy 36 SA823B Breast, Tumor (malignant), Wide Excision/ 4B Existing SA823B Lumpectomy/Segmental Mastectomy/ Partial Mastectomy, with Axiliary Clearance, with/without Sentinel Node Biopsy 37 SA707B Breast, Tumor (malignant), Wide Excision/ 3C Existing SA707B Lumpectomy/Segmental Mastectomy/ Partial Mastectomy, with Sentinel Node Biopsy/ Axiliary Node Sampling 38 SA708B Breast, Various Lesions, Percutaneous MSP Existing SA708B Aspiration under Ultrasound 39 SA828B Breast, Various lesions, Subcutaneous 4A Existing SA828B mastectomy bilateral, excluding gynaecomastia 40 SA830B Breast, Various lesions, subcutaneous 3C Existing SA830B mastectomy unilateral, excluding gynaecomastia 41 SA829B Breast, Various Lesions, Trucut Biopsy 1A Existing SA829B 42 SA709B Breast, Various Lesions, Trucut Biopsy, 1C Existing SA709B ultrasound guided or stereotactic (multiple) 43 SA710B Breast, Various Lesions, Trucut Biopsy, 1B Existing SA710B ultrasound guided or stereotactic (single) 44 SA711B Breast, Various Lesions, wire localisation, 3B Existing SA711B excision (multiple) 45 SA712B Breast, Various Lesions, wire localisation, 3A Existing SA712B excision (single) 46 SA800F Fascia (deep), Rupture with Herniated Muscle, 1B Existing SA800F Repair 47 SA800H Hand, Burns (major), Excision and Split Skin 4A Existing SA800H Graft 48 SA800M Mucous membrane (ear/nose/eyelid) 3A Existing SA800M avulsion/complex laceration, full thickness repair 49 SA801M Mucous Membrane, Deep Laceration/Multiple 3A Existing SA801M Lacerations, Repair A-3-4 CONFIDENTIAL SA - INTEGUMENTARY S/N New Description Table Classification Current Code code 50 SA802M Mucous Membrane, Superficial Laceration 1B Existing SA802M equal/less than 7cm, Repair 51 SA803M Mucous Membrane, Superficial Laceration(s) 2B Existing SA803M more than 7 cm, Repair 52 SA804M Mucous Membrane, Tumor/Cyst/Ulcer/Scar, 2B Existing SA804M Excision 53 SA805M Muscle and Deep Tissue, Foreign Body, 2C Existing SA805M Removal 54 SA700R Radiotherapy, Endoluminal Brachytherapy: 2B Existing SA700R Oesophagus, Nasopharyngeal carcinoma (NPC), Hepatobiliary, Cardiac, Lung, Others 55 SA701R Radiotherapy, Interstitial brachytherapy 4B Existing SA701R (with/without open surgery) 56 SA702R Radiotherapy, Interstitial brachytherapy (without 5A Existing SA702R open surgery): Prostate 57 SA703R Radiotherapy, Intracavitary Brachytherapy 2C Existing SA703R (Multi-channel): Cervix, Others 58 SA704R Radiotherapy, Intracavitary Brachytherapy 2A Existing SA704R (Single channel): Endometrium, others 59 SA705R Radiotherapy, Intra-operative Radiotherapy 3A Existing SA705R (electrons or kilovoltage): Breast, Sarcoma, Upper GI, Lower GI, Other sites 60 SA849S Skin & Subcutaneous, Pre-septal/PeriOrbital 2A Existing SA849S Dermoid/Lesion, Excision 61 SA804S Skin & subcutaneous, Scar revision - face & 1C Existing SA804S neck (< 3cm) 62 SA700S Skin (Upper Limb), Open Wound, Major 2A Existing SA700S Desloughing 63 SA803S Skin and Subcutaneous 3B Existing SA803S tissue(ear/nose/eyelid/face) complex lacerations, repair 64 SA842S Skin and Subcutaneous tissue, Lacerations 3B Existing SA842S (deep >3cm/multiple) lacerations, repair/toilet & suture, with/without debridement 65 SA800S Skin and Mucous Membrane, Various Lesions, 1B Existing SA800S Excision Biopsy 66 SA805S Skin and Subcutaneous Tissue (face and neck), 2B Existing SA805S Scar of more than 3cm, Revision 67 SA806S Skin and Subcutaneous Tissue, Burns, 2A Existing SA806S Escharotomy (extensive) 68 SA807S Skin and Subcutaneous Tissue, Burns, 1A Existing SA807S Escharotomy (limited) 69 SA808S Skin and Subcutaneous Tissue, Burns, Excision 5A Existing SA808S and Major Flap Repair 70 SA809S Skin and Subcutaneous Tissue, Burns, Excision 4A Existing SA809S and Major Full Thickness Graft 71 SA810S Skin and Subcutaneous Tissue, Burns, Excision 3A Existing SA810S and Small Full Thickness Graft 72 SA811S Skin and Subcutaneous Tissue,
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