COMMON CASE RATES FOR PRIMARY CARE FACILITIES-INFIRMARIES:

ICD 10
CODE

DIAGNOSIS

A01.0
A08.4
A09.0
A09.9
A16.2
A16.9
A90
A91.1
B05.2J17
.1*
B05.9
B06.8J17
.1*
B06.9
B09
B77.9
B82.9
E14.9
E43

Typhoid Fever
Viral Gastroenteritis
Infectious Diarrhea
Acute Gastroenteritis
Pulmonary Tuberculosis
Kochs Infection
Dengue Without Warning Signs
Dengue With Warning Signs
Pneumonia In Measles

E44.1
E86.1
E86.2
E87.5
E87.6
H81.1
I10.1
I10.9
I11.0
I11.9
I25.1
I25.9
J06.9
J18.02
J18.12

CASE
RATE

PROFESSION
AL FEE

HEALTH
CARE
INSTITUTI
ON FEE

7,000
4,200
4,200
4,200
6,860
6,860
7,000
7,000
10,500

2,100
1,260
1,260
1,260
2,058
2,058
2,100
2,100
3,150

4,900
2,940
2,940
2,940
4,802
4,802
4,900
4,900
7,350

Measles Without Complications

Pneumonia In Rubella

5,390
10,500

1,617
3,150

3,773
7,350

Rubella Without Complications

Viral Exanthem
Ascariasis
Intestinal Parasitism
Diabetes Mellitus
Unspecified Severe ProteinEnergy Malnutrition
Mild Protein-Energy
Malnutrition
Moderate Dehydration
Severe Dehydration
Hyperkalemia
Hypokalemia
Benign Paroxysmal Vertigo
Hypertension Stage II
Essential Hypertension,
Malignant Hypertension
Hypertensive Heart Disease
With Heart Failure
Hypertensive Heart Disease
Not In Failure
Coronary Artery Disease
Ischemic Heart Disease
Acute Upper Respiratory
Infection
Bronchopneumonia, Moderate
Risk
Lobar Pneumonia, Moderate

2,800
2,800
2,800
2,800
2,800
8,190

840
840
840
840
840
2,457

1,960
1,960
1,960
1,960
1,960
5,733

8,190

2,457

5,733

2,800
2,800
5,950
5,950
3,990
6,300
6,300

840
840
1,785
1,785
1,197
1,890
1,890

1,960
1,960
4,165
4,165
2,793
4,410
4,410

6,300

1,890

4,410

6,300

1,890

4,410

2,800
8,400
2,800

840
2,520
840

1,960
5,880
1,960

10,500

3,150

7,350

10,500

3,150

7,350

J18.92

J45.90
K21.9
K29.1
K29.7
K30
K31.8
L02.9
L03.9
N20.0
N30.0
N30.9
N39.0
N40
R56.0

Risk
Community Acquired
Pneumonia III
(Community Acquired
Pneumonia, Moderate Risk)
Bronchial Asthma In Acute
Exacerbation
Gastroesophageal Reflux
Disease
Acute Gastritis
Gastritis
Dyspepsia
Acid Peptic Disease
Abscess
Cellulitis
Nephrolithiasis
Acute Cystitis
Cystitis
Urinary Tract Infection
Benign Prostatic Hypertrophy
Febrile Convulsions

10,500

3,150

7,350

6,300

1,890

4,410

4,270

1,281

2,989

4,270
4,270
2,800
4,620
2,800
6,720
2,800
5,250
5,250
5,250
6,440
4,900

1,281
1,281
840
1,386
840
2,016
840
1,575
1,575
1,575
1,932
1,470

2,989
2,989
1,960
3,234
1,960
4,704
1,960
3,675
3,675
3,675
4,508
3,430

EXAMPLE OF CASE RATES NOT YET ALLOWED:

DIAGNOSIS
Acute Pyelonephritis
Pyelonephritis
Cholecystitis
Sepsis
Chronic Obstructive Pulmonary Disease
In Acute Exacerbation
Chronic Obstructive Pulmonary Disease
Acute Myocardial Infarction
Chronic Kidney Disease
Acute Glomerulonephritis
Amoebiasis

ICD 10 CODE
N10
N12
K81.9
A41.9
J44.1
J44.9
I21.9
N18.9
N00.9
A06.9

COMMON SECOND CASE RATES FOR PRIMARY CARE FACILITIESINFIRMARIES:

ICD
10/RVS
CODE
11040
11041
11042
11043

11044

DESCRIPTION

Debridement; skin, partial

thickness
Debridement; skin, full
thickness
Debridement; skin and
subcutaneous tissue
Debridement; skin,
subcutaneous tissue and
muscle
Debridement; skin,
subcutaneous tissue, muscle
and bone

CASE
RATE

PROFESSIO
NAL FEE

HEALTH
CARE
INSTITUTI
ON FEE

3,640

840

2,800

3,640

840

2,800

5,680

1,680

4,000

8,020

2,520

5,500

8,020

2,520

5,500

COMMON CASE RATES FOR PROCEDURES:

RVS
CODE
10060
11040
11041
11042
11043

11044

PROCEDURE

Incision And Drainage Of

Abscess
Debridement; skin, partial
thickness
Debridement; skin, full
thickness
Debridement; skin and
subcutaneous tissue
Debridement; skin,
subcutaneous tissue and
muscle
Debridement; skin,
subcutaneous tissue, muscle

CASE
RATE

PROFESSIO
NAL FEE

HEALTH
CARE
INSTITUTI
ON FEE

2,548

588

1,960

2,548

588

1,960

2,548

588

1,960

3,976

1,176

2,800

5,614

1,764

3,850

5,614

1,764

3,850

and bone