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Medical Schemes Act, 1998 (Act No. 131 of 1998)

Regulations

Regulations in terms of the Medical Schemes Act

Annexures

Annexure A

Heart and Vasculature

 

CODE:

155E

DIAGNOSIS:

MYOCARDITIS; CARDIOMYOPATHY; TRANSPOSITION OF GREAT VESSELS; HYPOPLASTIC LEFT HEART SYNDROME.

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT; CARDIAC TRANSPLANT



CODE:

108E

DIAGNOSIS:

PERICARDITIS

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT



CODE:

907E

DIAGNOSIS:

ACUTE AND SUBACUTE ISCHEMIC HEART DISEASE, INCLUDING MYOCARDIAL INFARCTION AND UNSTABLE ANGINA

TREATMENT:

MEDICAL MANAGEMENT; SURGERY; PERCUTANEOUS PROCEDURES



CODE:

284E

DIAGNOSIS:

ACUTE PULMONARY HEART DISEASE AND PULMONARY EMBOLI

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT



CODE:

35E

DIAGNOSIS:

ACUTE RHEUMATIC FEVER

TREATMENT:

MEDICAL MANAGEMENT



CODE:

908E

DIAGNOSIS:

ANEURYSM OF MAJOR ARTERY OF CHEST, ABDOMENI NECK, -UNRUPTURED OR RUPTURED NOS

TREATMENT:

SURGICAL MANAGEMENT



CODE:

26E

DIAGNOSIS:

ARTERIAL EMBOLISM/THROMBOSIS: ABDOMINAL AORTA, THORAC1C AORTA

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT



CODE:

204E

DIAGNOSIS:

CARDIAC FAILURE: ACUTE OR RECENT DETERIORATION OF CHRONIC CARDIAC FAILURE

TREATMENT:

MEDICALTREATMENT



CODE:

98E

DIAGNOSIS:

COMPLETE, CORRECTED AND OTHER TRANSPOSTION OF GREAT VESSELS

TREATMENT:

REPAIR



CODE:

97E

DIAGNOSIS:

CORONARY ARTERY ANOMALY

TREATMENT:

ANOMALOUS CORONARY ARTERY LIGATION



CODE:

309E

DIAGNOSIS:

DISEASES AND DISORDERS OF AORTIC VALVE NOS

TREATMENT:

AORTIC VALVE REPLACEMENT



CODE:

210E

DIAGNOSIS:

DISEASES OF ENDOCARDIUM; ENDOCARDITIS

TREATMENT:

MEDICAL MANAGEMENT



CODE:

314E

DIAGNOSIS:

DISEASES OF MITRAL VALVE

TREATMENT:

VALVULOPLASTY; VALVE REPLACEMENT; MEDICAL MANAGEMENT



CODE:

902E

DIAGNOSIS:

DISORDERS OF ARTERIES: VISCERAL

TREATMENT:

BYPASS GRAFT; SURGICAL MANAGEMENT



CODE:

18E

DIAGNOSIS:

DISSECTING OR RUPTURED AORTIC ANEURYSM

TREATMENT:

SURGICAL MANAGEMENT



CODE:

915E

DIAGNOSIS:

GANGRENE; SEVERE ATHEROSCLEROSIS OF ARTERIES OF EXTREMITIES; DIABETES MELLITUS WITH PERIPHERAL CIRCULATORY DISEASE

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT INCLUDING AMPUTATION



CODE:

294E

DIAGNOSIS:

GIANT CELL ARTERITIS, KAWASAKI DISEASE, HYPERSENSITIVITY ANGIITIS

TREATMENT:

MEDICAL MANAGEMENT



CODE:

450E

DIAGNOSIS:

HEREDITARY HEMORRHAGIC TELANGIECTASIA

TREATMENT:

EXCISION



CODE:

901E

DIAGNOSIS:

HYPERTENSION - ACUTE LIFE-THREATENING COMPLICATIONS AND MALIGNANT HYPERTENSION; RENAL ARTERY STENOSIS AND OTHER CURABLE HYPERTENSION

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT



CODE:

111E

DIAGNOSIS:

INJURY TO MAJOR BLOOD VESSELS - TRUNK, HEAD AND NECK, AND UPPER LIMBS

TREATMENT:

REPAIR



CODE:

19E

DIAGNOSIS:

INJURY TO MAJOR BLOOD VESSELS OF EXTREMITIES

TREATMENT:

LIGATION



CODE:

903E

DIAGNOSIS:

LIFE-THREATENING CARDIAC ARRHYTHMIAS

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT, PACEMAKERS, CARDIOVERSION



CODE:

900E

DIAGNOSIS:

LIFE-THREATENING COMPLICATIONS OF ELECTIVE CARDIAC AND MAJOR VASCULAR PROCEDURES

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT



CODE:

497E

DIAGNOSIS:

MULTIPLE VALVULAR DISEASE

TREATMENT:

SURGICAL MANAGEMENT



CODE:

355E

DIAGNOSIS:

OTHER ANEURYSM OF ARTERY - PERIPHERAL

TREATMENT:

SURGICAL MANAGEMENT



CODE:

905E

DIAGNOSIS:

OTHER CORRECTABLE CONGENITAL CARDIAC CONDITIONS

TREATMENT:

SURGICAL REPA!R; MEDICAL MANAGEMENT



CODE:

100E

DIAGNOSIS:

PATENT DUCTUS ARTERIOSUS; AORTIC PULMONARY FISTULA - PERSISTENT

TREATMENT:

LIGATION



CODE:

209E

DIAGNOSIS:

PHLEBITIS & THROMBOPHLEBITIS, DEEP

TREATMENT:

LIGATION AND DIVISION; MEDICAL MANAGEMENT



CODE:

914E

DIAGNOSIS:

RHEUMATIC PERICARDITIS; RHEUMATIC MYOCARDITIS

TREATMENT:

MEDICAL MANAGEMENT



CODE:

16E

DIAGNOSIS:

RUPTURE OF PAP1LLARY MUSCLE

TREATMENT:

MEDICAL AND SURGICAL MANAGEMENT



CODE:

627E

DIAGNOSIS:

SHOCK / HYPOTENSION - LIFE THREATENING

TREATMENT:

MEDICAL MANAGEMENT; VENTILATION



CODE:

99E

DIAGNOSIS:

TETRALOGY OF FALLOT (TOF)

TREATMENT:

TOTAL REPAIR TETRALOGY



CODE:

93E

DIAGNOSIS:

VENTRICULAR SEPTAL DEFECT - PERSISTENT

TREATMENT:

CLOSURE