non payment for cast (pmb)

<p>Enquiry of non-payment claim for DR Visser as the code (G80-G83) Cerebral palsy and other paralytic syndromes •(G80) Infantile cerebral palsy, •(G81) Hemiplegia and •(G82) Paraplegia and tetraplegia and •(G83) Other paralytic syndromes indicates approved PMB by Bonitas.</p> <p>Service date 02-12-2016 total R2930.04 (Limb cast) Take note “regulation 8 of medical Scheme act. The medical aid/scheme is legally obliged to pay in full. Failure to pay in full by the Scheme is a transgression of the law.</p> <p>Your feedback” The following claim has not been authorised as Prescribed Minimum Benefits (PMB) as criteria for funding has not been met. The unpaid claim will be reassessed upon receipt of more clinical information from the treating doctor”What clinical information must be given to put a cast on my foot after my operation related to my disability foot” IS SO SILLY, she is as confused as me!!!! My answer is still not been answered.</p> <p>This is a plaster “limb cast (gips) to keep my bones in place after Operations. WAS I SUPPOSED NOT TO HAVE A CAST AND BE LEFT WITH BROKEN FACTURES NOT BEEN STABILISED First hospital authorization indicated that operation was forHEMIPLEGIC CEREBRAL PALSY G80.2 SECOND HOSPITAL operation clearly was used and must be an indicator that I am a hemiplegic cerebral palsy.The fact that original Prof Mennen indicated g81.1 and all related codes supporting hemiplegia documents was sent to Bonitas and approved as PMB. BONITAS PMB approved letter was for paraplegia/quadriplegia and is so far fetch as I am not paraplegia but hemiplegic (disabled on right side. Thus where did this paraplegia/quadriplegia approval code was obtained from is a mystery. All this codes are related to G81.1 AS REQUESTED FOR SAID APPROVAL from Prof MENNEN.</p> <p>Home > 2016/17 ICD-10-CM Diagnosis Codes > Diseases of the nervous system G00-G99 > Cerebral palsy and other paralytic syndromes G80-G83 > Cerebral palsy G80-The following ICD-10-CM Index entries contain back-references to ICD-10-CM G80.2:•Hemiplegia G81.9-con******* (cerebral) G80.8 ******* G80.2******* G81.1-con******* G80.2•Palsy - see also Paralysis G83.9cerebral (con*******) G80.9 hemiplegic G80.8******* G80.2******* G80.1hemiplegic G80.2</p> <p>As I mentioned (CODE G80) Infantile cerebral palsy, •(G81) Hemiplegia and •(G82) Paraplegia and tetraplegia and •(G83) Other paralytic syndromes indicates, all codes from G80 UNTIL G83 IS PMB CLASSIFIED BY MEDICAL COUNCIL AS PMB. I contacted the Medical Council wrt this codes which they confirmed is PMB classified.</p>