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PlanSalud of Clinica Ricardo Palma, in its continuous search to provide our members with excellence in comprehensive health services, has expanded the list of special benefits associated with special coverage for Outpatient Care, Hospitalization and Emergency, as it is stated in the Eleventh Clause: Special Benefits.

Below are the procedures covered at 50 per cent :

Special Benefits Nuclear Medicine

 

Code Description
1262 Neuronavigator
1263 Cusa Ultrasonic Aspirator System
1265 Atraumatic Negative Pressure Kit
1277 Pressure Therapy Equipment
1279 Polygraph Stimulator And Radio Frequency Generator
1285 Multimodal Intraoperative Neurophysiological Monitoring Equipment
1441 Cerebral Ventricular Neuroendoscope
1443 Counterpulsation Balloon Kit
1445 Minimally Invasive Tumorectomy Equipment
121104 Reconstruction Of Cartilages And Ligaments Of The Hip Via Artorscopic
450116 Total Body External Irradiation
450117 Total Surface Irradiation
450120 Stereotaxic Surgery (From 1 To 4 Isocentres)
450121 Stereotaxic Surgery (From 4 To 8 Isocentres)
350120 Total Body Tracking With Mibi
350121 Thyrogen Application
350211 Spect Cerebral With Trodat – Tc99m
350421 Myocardial Perfusion With Mibi-Tc99m Physical Stress
350422 Myocardial Perfusion With Mibi-Tc99m Pharmacological Stress
350514 Gastric Emptying: Quantification (Solids)
350904 Therapy With Lutetium 177
001810 Special studies of nuclear medicine – D1
001811 Special studies of nuclear medicine – D2
001812 Special studies of nuclear medicine – T1
001813 Special studies of nuclear medicine – T2

 

Special Benefits Radiotherapy

 

Code Description
450126 High Rate Image Guided Intracavitary Brachytherapy Session
450127 High Rate Interstitial Brachytherapy Session
450128 Prostate Brachytherapy Session
450129 Brain Radiosurgery (Package)
450130 Extracerebral Radiosurgery – Sbrt (Package)
450131 Magnetic Calibration

Special benefits in Advanced Echocardiography Unit

 

Code Description
230401 3D Advanced Transthoracic Echocardiogram
230402 3D Advanced Transthoracic Echocardiogram + Myocardial Strain
230403 3D Advanced Transthoracic Echocardiogram + Bubble Test
230404 3D Advanced transesophageal echocardiogram
230405 3D Advanced transesophageal echocardiogram + Bubble Test
230406 3D Interventional advanced transesophageal echocardiography
230407 Physical Stress Echocardiogram
230408 Pharmacological Stress Echocardiogram

 

Special benefits in Radiology

 

Code Description
48.41.03 TAVI protocol
48.41.03 Coronary angiotomography
48.41.04 Calcium score

 

Special benefits in Pain Therapy

 

Code Description
22.04.01 Cervical Sympathetic Neurolytic Blockade (Sympatectomy)
22.04.02 Non-Neurolytic Lumbar Sympathetic Blockade
22.04.03 Neurolytic Blockade of the Celiac Plexus
22.04.09 Facet or Intra-articular Blocks/Cervical Vertebral Medial Branch
22.04.04 Facet or Intra-articular Blocks/Medial Vertebral Dorsal Branch
22.04.05 Facet or Intra-articular Blocks/Lumbar Vertebral Medial Branch
22.04.06 Epidural Post Surgical Analgesia with Catheter
22.04.07 Postoperative Pain Control Through Epidural and/or Regional Catheters Implanted in the Surgical Act (Includes Placement of Elastomeric Pump)
22.04.08 Post Surgical Analgesia with Upper Limb Plexus Block
22.04.10 Joint Lock of Shoulder, Knee and Small Joints
22.04.11 Treatment Through Upper Limb Plexus Catheters (Includes Placement of Elastomeric Pump)
22.04.12 Post Surgical Analgesia With Lower Limb Plexus Block
22.04.13 Treatment Through Lower Limb Plexus Catheters (Includes Placement of Elastomeric Pump)
22.04.14 Post Surgical Analgesia with Peripheral Plexus Block with Catheter
22.04.15 Iontophoresis. Seven Session Package. With Monitoring Control and Sealing of Venous or Spinal Reservoirs
22.04.16 Non-Neurolytic Subarachnoid Blocks
22.04.17 Peripheral Neurolytic Blocks Under Image Control
22.04.18 Implantation of Catheters for Postoperative Pain Control Outside of the Surgical/Anesthetic Act. Epidurals. Maximum 7 Days Pca (Patient Controlled Analgesia). Infusion Pump
22.04.19 Spinal cord stimulation. Programming, Telemetry and Cryoanalgesia Control
22.04.20 Coxo-Femoral or Sacroiliac Joint Block Under Image Control
22.04.21 Spheno-Palatine Ganglion Block
22.04.22 Non-Neurolytic Cervico-Thoracic Block (Stellate Ganglion), Under Image Control
22.04.23 Non-Neurolytic Splanchnic Block under Image Control
22.04.24 Non-Neurolytic Hypogastric Plexus or Odd Ganglion Block
22.04.25 Transforaminal Epidural Non-Neurolytic Block, Under Image Control
22.04.26 Long-Term Spinal Catheter Implant
22.04.27 Spinal Electrode Implantation for Spinal Cord Stimulation
22.04.28 Neurolytic Blockade of the Hypogastric Plexus or Odd Ganglio V
22.04.29 Neurolytic Blockade of the V Splanchnic Nerves
22.04.30 Radiofrequency of Peripheral Nerves Under Image Control V
22.04.31 Implante, Recambio o Retirada de Reservorio Epidural o Intratecal V
22.04.32 Implantation, Replacement or Removal of Epidural or Intrathecal Pouch V
22.04.33 Radiofrequency of Posterior Vertebral Joints (Medial Branch). One or Several
22.04.34 Radiofrequency of the Cervical, Thoracic, Lumbar or Sacral Sympathetic
22.04.35 Radiofrequency of Dorsal Root Ganglia: Cervical, Dorsal, Lumbar or Sacral
22.04.36 Radiofrequency of the Posterior Roots Via Lateral Epidural Route
22.04.37 Radiofrequency of the Intervertebral Disc. One or Several
22.04.38 Radiofrequency and Other Gasser Ganglion Therapies
22.04.39 Radiofrequency of the Splanchnic Nerves VI
22.04.40 Radiofrequency of the VI Sacroiliac Joint
22.04.41 VI Percutaneous Discectomy
22.04.42 Epidural Radiofrequency with LV Stimulation Catheter
22.04.43 Percutaneous Cervical Cordotomy VI
22.04.44 Deep Muscle Blockade for Analgesia, Under Image Control

 

Special benefits in Electrophysiology

 

Code Description
230223 Single-chamber or Dual-chamber Definitive Pacemaker Telemetry
230224 Single or Dual Chamber Cardiodefibrillator Telemetry
230225 Resynchronizer Telemetry with Cardiac Defibrillator
230226 Telemetría de Holter Subcutáneo
230227 Subcutaneous Holter Telemetry
230228 Holter de 12 Derivadas de 48 Horas
230229 48 Hour 12 Derivative Holter
230230 Implante de Resincronizador Cardiaco con Desfibrilador
230231 Cardiac Resynchronizer Implantation with Defibrillator
230232 Percutaneous Closure of the Left Appendage
230233 Subcutaneous Holter Implant
230234 Tilt Test