List of PMB conditions and their prescribed treatment

Below is a list of the Categories (Diagnosis and Treatment Pairs) constituting the Prescribed Minimum Benefits (PMB) Package under Section 29(1)(o) of the Medical Schemes Act (listed by Organ-System chapter).

IMPORTANT: For an explanation of general treatments (example: “Medical Management”) please click here

NOS means “not otherwise specified”.

BRAIN AND NERVOUS SYSTEM

CODE	CONDITION	TREATMENT For more in-depth explanation, click here
906A	Acute generalised paralysis, including polio and Guillain-Barre	Medical management; ventilation and plasmapheresis
341A	Basal ganglia, extra-pyramidal disorders; other dystonias	NOS Initial diagnosis; initiation of medical management
950A	Benign and malignant brain tumours, treatable	Medical and surgical management which includes radiation therapy and chemotherapy
49A	Compound/ depressed fractures of skull	Craniotomy/ craniectomy
213A	Difficulty in breathing, eating, swallowing, bowel, or bladder control due to non-progressive neurological (including spinal) condition or injury	Medical and surgical management; ventilation
83A	Encephalocele; congenital hydrocephalus	Shunt; surgery
902A	Epilepsy (status epilepticus, initial diagnosis, candidate for neurosurgery)	Medical management; ventilation; neurosurgery
211A	Intraspinal and Intracranial abscess	Medical and surgical management
905A	Meningitis – acute and subacute	Medical and surgical management
513A	Myasthenia gravis; muscular dystrophy; neuro-myopathies NOS	Initial diagnosis; initiation of medical management; therapy for acute complications and exacerbations
510A	Peripheral nerve injury with open wound	Neuroplasty
940A	Reversible CNS abnormalities due to other systemic disease Medical and surgical management
1A	Severe / moderate head injury: hematoma / oedema with loss of consciousness	Medical and surgical management; ventilation
84A	Spina Bifida	Surgical management
941A	Spinal cord compression, ischaemia or degenerative disease NOS	Medical and surgical management
901A	Stroke – due to hemorrhage, or ischaemia	Medical management; surgery
28A	Subarachnoid and intracranial hemorrhage / hematoma; compression of brain	Medical and surgical management
305A	Tetanus	Medical management; ventilation
265A	Transient cerebral ischaemia; life-threatening cerebrovascular conditions NOS	Evaluation; medical management; surgery
109A	Vertebral dislocations/ fractures, open or closed with injury to spinal cord	Repair /reconstruction; medical management; inpatient rehabilitation up to 2 months
684A	Viral meningitis, encephalitis, myelitis and encephalomyelitis	Medical management

EYE

CODE	CONDITION	TREATMENT
47B	Acute orbital cellulitis	Medical and surgical management
394B	Angle-closure glaucoma	Iridectomy; laser surgery; medical and surgical management
586B	Bell’s palsy; exposure keratoconjunctivitis	Tarsorrhaphy; medical and surgical management
950B	Cancer of the eye and orbit – treatable	Medical and surgical management, which includes radiation therapy and chemotherapy
901B	Cataract; aphakia	Extraction of cataract; lens implant
911B	Corneal ulcer; Superficial injury of eye and adnexa	Conjunctival flap; medical management
405B	Glaucoma associated with disorders of the lens	Surgical management
386B	Herpes zoster & herpes simplex with ophthalmic complications	Medical management
389B	Hyphaema	Removal of blood clot; observation
485B	Inflammation of lacrimal passages	Incision; medical management
909B	Open wound of eyeball and other eye structures	Medical and surgical management
407B	Primary and open angle glaucoma with failed medical management	Trabeculectomy; other surgery
419B	Purulent endophthalmitis	Vitrectomy
922B	intraocular foreign body	Surgical management
904B	Retinal detachment, tear and other retinal disorders	Vitrectomy; laser treatment; other surgery
906B	Retinal vascular occlusion; central retinal vein occlusion	Laser surgery
409B	Sympathetic uveitis and degenerative disorders and conditions of globe; sight threatening thyroid optopathy	Enucleation; medical management; surgery

EAR, NOSE, MOUTH AND THROAT

CODE	CONDITION	TREATMENT
33C	Acute and chronic mastoiditis	Mastoidectomy; medical management
482C	Acute otitis media	Medical and surgical management, including myringotomy
900C	Acute upper airway obstruction, including croup, epiglottitis and acute laryngotracheitis	Medical management; intubation; tracheostomy
950C	Cancer of oral cavity, pharynx, nose, ear, and larynx – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
241C	Cancrum oris	Medical and surgical management
38C	Choanal atresia	Repair of choanal atresia
133C	Cholesteatoma	Medical and surgical management
910C	Chronic upper airway obstruction, resulting in cor pulmonale	Medical and surgical management
901C	Cleft palate and/or cleft lip without airway obstruction	Repair
12C	Deep open wound of neck, including larynx; fracture of larynx or trachea, open	Medical and surgical management; ventilation
346C	Epistaxis – not responsive to anterior packing	Cautery / repair / control hemorrhage
521C	Foreign body in ear and nose	Removal of foreign body; and medical and surgical management
29C	Foreign body in pharynx, larynx, trachea, bronchus & esophagus	Removal of foreign body
339C	Fracture of face bones, orbit, jaw; injury to optic and other cranial nerves	Medical and surgical management
219C	Leukoplakia of oral mucosa, including tongue	Incision/excision; medical management
132C	Life-threatening diseases of pharynx NOS, including retropharyngeal abscess	Medical and surgical management
457C	Open wound of ear-drum	Tympanoplasty; medical management
240C	Peritonsillar abscess	Incision and drainage of abscess; tonsillectomy; medical management
347C	Sialoadenitis; abscess / fistula of salivary glands	Surgery
543C	Stomatitis, cellulites and abscess of oral soft tissue; Vincent’s angina	Incision and drainage; medical management

RESPIRATORY

CODE	CONDITION	TREATMENT
903D	Bacterial, viral, fungal pneumonia	Medical management, ventilation
158D	# Respiratory failure, regardless of cause #	Medical management; oxygen; ventilation
157D	Acute asthmatic attack; pneumonia due to respiratory syncytial virus in persons under age 3	Medical management
125D	Adult respiratory distress syndrome; inhalation and aspiration pneumonias	Medical management; ventilation
315D	Atelectasis (collapse of lung)	Medical and surgical management; ventilation
340D	Benign neoplasm of respiratory and intrathoracic organs	Biopsy; lobectomy; Medical management; radiation therapy
950D	Cancer of lung, bronchus, pleura, trachea, mediastinum & other respiratory organs – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
170D	Empyema and abscess of lung	Medical and surgical management
934D	Frank haemoptysis	Medical and surgical management
203D	Hypoplasia and dysplasia of lung	Medical and surgical management
900D	Open fracture of ribs and sternum; multiple rib fractures; flail chest	Medical and surgical management, ventilation
5D	Pneumothorax and haemothorax	Tube thoracostomy / thoracotomy

HEART AND VASCULATURE

CODE	CONDITION	TREATMENT
155E	Myocarditis; cardiomyopathy; transposition of great vessels; hypoplastic left heart syndrome	Medical and surgical management; cardiac transplant
108E	Pericarditis	Medical and surgical management
907E	Acute and subacute ischemic heart disease, including myocardial infarction and unstable angina	Medical management; surgery; percutaneous procedures
284E	Acute pulmonary heart disease and pulmonary emboli	Medical and surgical management
35E	Acute rheumatic fever	Medical management
908E	Aneurysm of major artery of chest, abdomen, neck, – Unruptured or ruptured NOS	Surgical management
26E	Arterial embolism/thrombosis: abdominal aorta, thoracic aorta	Medical and surgical management
204E	Cardiac failure: acute or recent deterioration of chronic cardiac failure	Medical treatment
98E	Complete, corrected and other transposition of great vessels	Repair
97E	Coronary artery anomaly	Anomalous coronary artery ligation
309E	Diseases and disorders of aortic valve NOS	Aortic valve replacement
210E	Diseases of endocardium; endocarditis	Medical management
314E	Diseases of mitral valve	Valvuloplasty; valve replacement; medical management
902E	Disorders of arteries: visceral	Bypass graft; surgical management
18E	Dissecting or ruptured aortic aneurysm	Surgical management
915E	Gangrene; severe atherosclerosis of arteries of extremities; diabetes mellitus with peripheral circulatory disease	Medical and surgical management including amputation
294E	Giant cell arteritis, Kawasaki disease, hypersensitivity angiitis	Medical management
450E	Hereditary hemorrhagic telangiectasia	Excision
901E	Hypertension – acute life-threatening complications and malignant hypertension; renal artery stenosis and other curable hypertension	Medical and surgical management
111E	Injury to major blood vessels – trunk, head and neck, and upper limbs	Repair
19E	Injury to major blood vessels of extremities	Ligation
903E	Life-threatening cardiac arrhythmias	Medical and surgical management, pacemakers, cardioversion
900E	Life-threatening complications of elective cardiac and major vascular procedures	Medical and surgical management
497E	Multiple valvular disease	Surgical management
355E	Other aneurysm of artery – peripheral	Surgical management
905E	Other correctable congenital cardiac conditions	Surgical repair; medical management
100E	Patent ductus arteriosus; aortic pulmonary fistula – persistent	Ligation
209E	Phlebitis & thrombophlebitis, deep Ligation and division;	medical management
914E	Rheumatic pericarditis; rheumatic myocarditis	Medical management
16E	Rupture of papillary muscle	Medical and surgical management
627E	Shock / hypotension – life-threatening	Medical management; ventilation
99E	Tetralogy of Fallot (TOF)	Total repair tetralogy
93E	Ventricular septal defect – persistent	Closure

GASTRO-INTESTINAL SYSTEM

CODE	CONDITION	TREATMENT
920F	Anal Fissure; Anal fistula Fissurectomy ; Fistulectomy;	medical management
41F	Abscess of intestine	Drain abscess; medical management
489F	Acquired hypertrophic pyloric stenosis and other disorders of the stomach and duodenum	Surgical management
254F	Acute diverticulitis of colon	Medical and surgical management, including colon resection
124F	Acute vascular insufficiency of intestine	Colectomy
337F	Amoebiasis; typhoid	Medical management
264F	Anal and rectal polyp	Excision of polyp
9F	Appendicitis	Appendectomy
952F	Cancer of retroperitoneum, peritoneum, omentum & mesentery – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
950C	Cancer of the gastro-intestinal tract, including oesophagus, stomach, bowel, rectum, anus – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
95F	Congenital anomalies of upper alimentary tract – excluding tongue	Medical and surgical management
214F	Oesophageal stricture	Dilatation; surgery
516F	Oesophageal varices	Medical management; surgical shunt; sclerotherapy
902F	Gastric or intestinal ulcers with hemorrhage or perforation	Surgery; endoscopic diagnosis; medical management
901F	Gastroenteritis and colitis with life-threatening haemorrhage or dehydration, regardless of cause	Medical management
6F	Hernia with obstruction and/or gangrene; uncomplicated hernias under age 18	Repair; bowel resection
20F	Intestinal obstruction without mention of hernia; symptomatic foreign body in stomach, intestines, colon & rectum	Excision; surgery; medical management
232F	Paralytic ileus	Medical management
498F	Peritoneal adhesion	Surgical management
3F	Peritonitis, regardless of cause	Medical and surgical management
555F	Rectal prolapse	Partial colectomy
292F	Regional enteritis; idiopathic proctocolitis – acute exacerbations and complications only	Medical and surgical management
900F	Rupture of intra-abdominal organ	Repair; splenectomy; resection
507F	Thrombosed and complicated haemorrhoids	Haemorrhoidectomy; incision

LIVER, PANCREAS AND SPLEEN

CODE	CONDITION	TREATMENT
325G	Acute necrosis of liver	Medical management
327G	Acute pancreatitis	Medical management, and where appropriate, surgical management
36G	Budd-Chiari syndrome, and other venous embolism and thrombosis	Thrombectomy / ligation
910G	Calculus of bile duct with cholecystitis	Medical management; cholecystectomy; other open or closed surgery
950G	Cancer of liver, biliary system and pancreas – treatable	Medical and surgical management
255G	Cyst and pseudocyst of pancreas	Drainage of pancreatic cyst
156G	Disorders of bile duct	Excision; repair
910G	Gallstone with cholecystitis and/or jaundice	Medical management; cholecystectomy; other open or closed surgery
743G	Hepatorenal syndrome	Medical management
27G	Liver abscess; pancreatic abscess	Medical and surgical management
911G	Liver failure; hepatic vascular obstruction; inborn errors of liver metabolism; biliary atresia	Liver transplant, other surgery, medical management
231G	Portal vein thrombosis	Shunt

MUSCULOSKELETAL SYSTEM; TRAUMA NOS

CODE	CONDITION	TREATMENT
353H	Abscess of bursa or tendon	Incision and drainage
32H	Acute osteomyesliti	Medical and surgical management
950H	Cancer of bones – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
206H	Chronic osteomyelitis	Incision and drainage
902H	Closed fractures/ dislocations of limb bones / epiphyses – excluding fingers and toes	Reduction / relocation
85H	Congenital dislocation of hip; coxa vara and valga; congenital clubfoot	Repair / reconstruction
147H	Crush injuries of trunk, upper limbs, lower limbs, including blood vessels	Surgical management; ventilation; acute renal dialysis
491H	Dislocations / fractures of vertebral column without spinal cord injury	Medical management; surgical stabilisation
500H	Disruptions of the achilles / quadriceps tendons	Repair
178H	Fracture of hip	Reduction; hip replacement
445H	Injury to internal organs	Medical and surgical management
900H	Open fracture / dislocation of bones and joints	Reduction / relocation; medical and surgical management
34H	Pyogenic arthritis	Medical and surgical management
901H	Traumatic amputation of limbs, hands, feet, and digits	Replantation / amputation

SKIN AND BREAST

CODE	CONDITION	TREATMENT
465J	Acute lymphadenitis	Incision and drainage; medical management
900J	Burns, greater than 10% of body surface, or more than 5% involving head, neck, hands, perineum	Debridement; free skin graft; medical management
950J	Cancer of breast – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
954J	Cancer of skin, excluding malignant melanoma – treatable
952J	Cancer of soft tissue, including sarcomas and malignancies of the adnexa – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
349J	Cellulitis and abscesses with risk of organ or limb damage or septiceamia if untreated; necrotizing fasciitis	Medical and surgical management
901J	Disseminated bullous skin disease, including pemphigus, pemphigoid, epidermolysis bullosa, epidermolytic hyperkeratosis	Medical management
951J	Lethal midline granuloma	Medical management, which includes radiation therapy
953J	Malignant melanoma of skin – treatable	Medical and surgical management, which includes radiation therapy
373J	Non-superficial open wounds – non life-threatening	Repair
356J	Pyoderma; body, deep-seated fungal infections	Medical management
112J	Toxic epidermal necrolysis and staphylococcal scalded skin syndrome; Stevens-Johnson syndrome	Medical management

ENDOCRINE, METABOLIC AND NUTRITIONAL

CODE	CONDITION	TREATMENT
331K	Acute thyroiditis	Medical management
951K	Benign and malignant tumours of pituitary gland with/without hypersecretion syndromes	Medical and surgical management; radiation therapy
30K	Benign neoplasm of islets of Langerhans	Excision of tumour; medical management
950K	Cancer of endocrine system, excluding thyroid – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
952K	Cancer of thyroid – treatable; carcinoid syndrome	Medical and surgical management, which includes chemotherapy and radiation therapy
61K	Congenital hypothyroidism	Medical management
902K	Disorder of adrenal secretion NOS	Medical management; adrenalectomy
447K	Disorders of parathyroid gland; benign neoplasm of parathyroid gland	Medical and surgical management
904K	Hyper and hypothyroidism with life-threatening complications or requiring surgery	Medical management, Surgery
31K	Hypoglycemic coma; hyperglycemia; diabetic ketoacidosis	Medical management
236K	Iron deficiency; vitamin and other nutritional deficiencies – life-threatening	Medical management
901K	Life-threatening congenital abnormalities of carbohydrate, lipid, protein and amino acid metabolism	Medical management
903K	Life-threatening disorders of fluid and electrolyte balance, NOS	Medical management

URINARY AND MALE GENITAL SYSTEM

CODE	CONDITION	TREATMENT
354L	Abscess of prostate	Turp; drain abscess
904L	Acute and chronic pyelonephritis; renal and perinephric abscess	Medical and surgical management
903L	Acute glomerulonephritis and nephritic syndrome	Medical management
954L	Cancer of penis and other male genital organ – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
953L	Cancer of prostate gland – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
950L	Cancer of testis – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
952L	Cancer of urinary system including kidney and bladder – treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
906L	Congenital anomalies of urinary system – symptomatic and life-threatening	Nephrectomy / repair
901L	End stage renal disease regardless of cause	Dialysis and renal transplant where Department of Health criteria are met only (see criteria published in GPS 004-9001)
900L	Hyperplasia of the prostate, with acute urinary retention or obstructive renal failure	Transurethral resection; medical management
905L	Obstruction of the urogenital tract, regardless of cause	Catheterisation; surgery; endoscopic removal of obstructing agent: lithotripsy
436L	Torsion of testis	Orchidectomy; repair
43L	Trauma to the urinary system including ruptured bladder	Cystorrhaphy; suture; repair
289L	Ureteral fistula (intestinal)	Nephrostomy
359L	Vesicoureteral reflux	Medical management; replantation

FEMALE REPRODUCTIVE SYSTEM

CODE	CONDITION	TREATMENT
539M	Abscesses of Bartholin’s gland and vulva	Incision and drainage; medical management
288M	Acute pelvic inflammatory disease	Medical and surgical management
954M	Cancer of Cervix – treatable	Medical and surgical management, which includes radiation therapy and chemotherapy
952M	Cancer of ovary – treatable	Medical and surgical management, which includes radiation therapy and chemotherapy
950M	Cancer of uterus – treatable	Medical and surgical management, which includes radiation therapy and chemotherapy
953M	Cancer of vagina, vulva and other female genital organs NOS – treatable	Medical and surgical management, which includes radiation therapy and chemotherapy
960M	Cervical and breast cancer screening	Cervical smears; periodic breast examination
645M	Congenital abnormalities of the female genitalia	Medical and surgical management
266M	Dysplasia of cervix and cervical carcinoma-in-situ; cervical condylomata	Medical and surgical management
53M	Ectopic pregnancy	Surgery
460M	Fistula involving female genital tract	Closure of fistula
951M	Hydatidiform mole; choriocarcinoma	D & C; hysterectomy; chemotherapy
902M	Infertility (Explanatory Note 9 of Annexure A of Regulations)	Medical and surgical management
528M	Menopausal management, anomalies of ovaries, primary and secondary amenorrhoea, female sex hormones abnormalities NOS, including hirsutism	Medical and surgical management, including hormone replacement therapy
434M	Non-inflammatory disorders and benign neoplasms of ovary, fallopian tubes and uterus	Salpingectomy; oophorectomy; hysterectomy; medical and surgical management
237M	Sexual abuse, including rape	Medical management; psychotherapy
903M	Spontaneous abortion	Medical and surgical manegment
435M	Torsion of ovary	Oophorectomy; ovarian cystectomy
530M	Uterine prolapse; cystocele	Surgical repair
296M	Voluntary termination of pregnancy	Induced abortion; medical and surgical management

PREGNANCY AND CHILDBIRTH

CODE	CONDITION	TREATMENT
67N	# Low birth weight (under 1000g) with respiratory difficulties	# Medical management not including ventilation
967N	# Low birth weight (under 2500 grams & > 1000g) with respiratory difficulties	# Medical management, including ventilation; intensive care therapy
71N	Birth trauma for baby	Medical management; surgery
901N	Congenital systemic infections affecting the newborn	Medical management, ventilation
904N	Haematological disorders of the newborn	Medical management
54N	Necrotizing enterocolitis in newborn	Medical and surgical management
74N	Neonatal and infant GIT abnormalities and disorders, including malrotation and atresia	Medical and surgical management
902N	Neonatal endocrine, metabolic and toxin-induced conditions	Medical management
903N	Neurological abnormalities in the newborn	Medical management
52N	Pregnancy	Antenatal and obstetric care necessitating hospitalisation, including delivery
56N	Respiratory conditions of newborn	Medical management; ventilation

HAEMATOLOGICAL, INFECTIOUS AND MISC SYSTEMIC CONDITIONS

CODE	CONDITION	TREATMENT
50S	Syphilis – congenital, secondary and tertiary	Medical management
168S	# HIV-infection	# HIV voluntary counseling and testing Co-trimoxazole as preventative therapy Screening and preventative therapy for TB, Diagnosis and treatment of sexually transmitted infections Pain management in palliative care Treatment of opportunistic infections, Prevention of mother-to-child transmission of HIV Post-exposure prophylaxis following occupational exposure or sexual assault Medical management and medication, including the provision of anti-retroviral therapy, and ongoing monitoring for medicine effectiveness and safety, to the extent provided for in the national guidelines applicable in the public sector
260S	# Imminent death regardless of diagnosis	# Comfort care; pain relief; hydration
113S	Acquired haemolytic anaemias	Medical management
901S	Acute leukemias, lymphomas	Medical management, which includes chemotherapy, radiation therapy, bone marrow transplantation
277S	Anaerobic infections – life threatening	Medical management; hyperbaric oxygen
48S	Anaphylactic shock	Medical management; ventilation
900S	Aplastic anemia; agranulocytosis; other life-threatening hereditary immune deficiencies	Bone marrow transplantation; medical management
197S	Botulism	Medical management
338S	Cholera; rat-bite fever	Medical management
196S	Chronic Granulomatous disease	Medical management, which includes radiation therapy
916S	Coagulation defects	Medical management
246S	Cysticercosis; other systemic cestode infection	Medical management
903S	Deep-seated (excluding nail infections), disseminated and systemic fungal infections	Medical management; surgery
44S	Erysipelas	Medical management
179S	Hereditary angioedema; angioneurotic oedema	Medical and surgical management
174S	Hereditary haemolytic anaemias (e.g. sickle cell); dyserythropoietic anemia (congenital)	Medical management
201S	Herpetic encephalitis; Reye’s syndrome	Medical management
913S	Immune compromise NOS and associated life-threatening infections NOS	Medical management
912S	Leprosy and other systemic mycobacterial infections, Excluding tuberculosis	Medical management
336S	Leptospirosis; spirochaetal infections NOS	Medical management
252S	Life-threatening anaemia NOS	Medical management; transfusion
908S	Life-threatening conditions due to exposure to the elements, including hypo and hyperthermia; lighting strikes	Medical management
907S	Life-threatening rickettsial and other arthropod-borne diseases	Medical management
172S	Malaria; trypanosomiasis; other life-threatening parasitic disease	Medical management
904S	Metastatic infections; septiceamia	Medical management
910S	Multiple myeloma and chronic leukaemias	Medical management which includes chemotherapy and radiation therapy
247S	Poisoning by ingestion, injection, and non-medicinal agents	Medical management
911S	Sexually transmitted diseases with systemic involvement not elsewhere specified	Medical management
128S	Tetanus; anthrax; Whipple’s disease	Medical management
122S	Thalassemia and other haemoglobinopathies – treatable	Medical management; bone marrow transplant
316S	Toxic effect of gasses, fumes, and vapors	Medical therapy
11S	Tuberculosis	Diagnosis and acute medical management; successful transfer to maintenance therapy in accordance to DOH guidelines
937S	Tumour of internal organ (excludes skin): unknown whether benign or malignant	Biopsy
15S	Whooping cough, diptheria	Medical management

MENTAL ILLNESS

CODE	CONDITION	TREATMENT
182T	Abuse or dependence on Psychoactive substance, including alcohol	Hospital-based management up to 3 weeks/year
910T	Acute delusional mood, anxiety, personality, perception disorders and organic mental disorder caused by drugs	Hospital-based management up to 3 days
901T	Acute stress disorder accompanied by recent significant trauma, including physical or sexual abuse	Hospital admission for psychotherapy / counselling up to 3 days, or up to 12 outpatient psychotherapy / counselling contacts
910T	Alcohol withdrawal delirium; alcohol intoxication delirium	Hospital-based management up to 3 days leading to rehabilitation
908T	Anorexia Nervosa and Bulimia Nervosa	Hospital-based management up to 3 weeks/year or minimum of 15 outpatient contacts per year
903T	Attempted suicide, irrespective of cause	Hospital-based management up to 3 days or up to 6 outpatient contacts
184T	Brief reactive psychosis	Hospital-based management up to 3 weeks/year
910T	Delirium: Amphetamine, Cocaine, or other psychoactive substance Hospital-based management up to 3 days
902T	Major affective disorders, including unipolar and bipolar depression	Hospital-based management up to 3 weeks/year (including inpatient electro-convulsive therapy and inpatient psychotherapy) or outpatient psychotherapy of up to 15 contacts
907T	Schizophrenic and paranoid delusional disorders	Hospital-based management up to 3 weeks/year
909T	Treatable dementia	Admission for initial diagnosis; management of acute psychotic symptoms – up to 1 week

Chronic PMB conditions

Addison’s Disease
Asthma
Bipolar Mood Disorder
Bronchiectasis
Cardiac Failure
Cardiomyopathy
Chronic Renal Disease
Chronic Obstructive Pulmonary Disease
Coronary Artery Disease
Crohn’s Disease
Diabetes Insipidus
Diabetes Mellitus Types 1 & 2
Dysrhythmias
Epilepsy
Glaucoma
Haemophilia
Hyperlipidaemia
Hypertension
Hypothyroidism
Multiple Sclerosis
Parkinson’s Disease
Rheumatoid Arthritis
Schizophrenia
Systemic Lupus Erythematosus
Ulcerative Colitis