CMScript: Focus on Substance Use Disorders
How do medical schemes treat substance abuse and what is covered under PMB regulations? The PMB regulations include substance abuse and the use of drugs under the following Diagnostic Treatment Pairs (DTP): DTP Code DTP Description Treatment 182T Abuse or dependence on Psychoactive substance, including alcohol Hospital-based management up to 3 weeks/year 910T Acute
CMScript: Focus on Glaucoma
Glaucoma is a PMB condition, which means that all medical schemes are required by law to pay for the diagnosis, treatment, and care of glaucoma regardless of the member’s benefit option. Treatment and care of Glaucoma is explained in terms of the PMB Regulations. Glaucoma is
CMScript 13 of 2021: Hepatocellular carcinoma
As part of PMB level of care, medical schemes must fund the diagnosis and treatment of treatable Hepatocellular carcinoma HCC, which falls under DTP code 950G. For those patients who are diagnosed with HCC that is not treatable according to the PMB Regulations, DTP code 260S
CMScript 12 of 2021: Lung Cancer
“Cancer of lung, bronchus, pleura, trachea, mediastinum & other respiratory organs – treatable” are included in the Prescribed Minimum Benefit conditions under Diagnosis and Treatment Pair (DTP) code 950D. Lung cancer develops when lung cells grow uncontrollable and abnormal. These cells then grow into a mass
CMScript 11 of 2021: COVID-19 & vaccines
All medical schemes are required by law to pay for the diagnosis, treatment, care and vaccination costs for COVID-19 as a PMB irrespective of the plan type or option. Details about what constitutes PMB level of care for COVID-19 can be obtained from the PMB