Medical Schemes Act, 1998 (Act No. 131 of 1998)

Regulations

Regulations in terms of the Medical Schemes Act

Annexures

Annexure A

Mental Illness

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CODE:

182T

DIAGNOSIS:

ABUSE OR DEPENDENCE ON PSYCHOACTIVE SUBSTANCE, INCLUDING ALCOHOL

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 WEEKS/YEAR



CODE:

901T

DIAGNOSIS:

ACUTE DELUSIONAL MOOD, ANXIETY, PERSONALITY, PERCEPTION DISORDERS AND ORGANIC MENTAL DISORDER CAUSED BY DRUGS;

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 DAYS



CODE:

910T

DIAGNOSIS:

ACUTE STRESS DISORDER ACCOMPANIED BY RECENT SIGNIFICANT TRAUMA, INCLUDING PHYSICAL OR SEXUAL ABUSE

TREATMENT:

HOSPITAL ADMISSION FOR PSYCHOTHERAPY COUNSELLING UP TO 3 DAYS, OR UP TO 12 OUTPATIENT PSYCHOTHERAPY / COUNSELLING CONTACTS



CODE:

910T

DIAGNOSIS:

ALCOHOL WITHDRAWAL DELIRIUM; ALCOHOL INTOXICATION DELIRIUM

TREATMENT:

HOSPITAL BASED MANAGEMENT UP TO 3 DAYS LEADING TO REHABILITATION



CODE:

908T

DIAGNOSIS:

ANOREXIA NERVOSA AND BULIMIA NERVOSA

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 WEEKS/YEAR OR MINIMUM OF 15 OUTPATIENT CONTACTS PER YEAR



CODE:

903T

DIAGNOSIS:

ATTEMPTED SUICIDE, IRRESPECTIVE OF CAUSE

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 DAYS OR UP TO 6 OUTPATIENT CONTACTS



CODE:

184T

DIAGNOSIS:

BRIEF REACTIVE PSYCHOSIS

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 WEEKS/YEAR



CODE:

910T

DIAGNOSIS:

DELIRIUM: AMPHETAMINE, COCAINE, OR OTHER PSYCHOACTIVE SUBSTANCE

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 DAYS



CODE:

902T

DIAGNOSIS:

MAJOR AFFECTIVE DISORDERS, INCLUDING UNIPOLAR AND BIPOLAR DEPRESSION

TREATMENT:

HOSPITAL-BASED MANAGEMENT UP TO 3 WEEKSLYEAR (INCLUDING INPATIENT ELECTRO-CONVULSIVE THERAPY AND INPATIENT PSYCHOTHERAPY) OR OUTPATIENT PSYCHOTHERAPY OF UP TO 15 CONTACTS



CODE:

907T

DIAGNOSIS:

SCHIZOPHRENIC AND PARANOID DELUSIONAL DISORDERS

TREATMENT:

HOSPITAL-BASED MEDICAL MANAGEMENT UP TO 3 WEEKS/YEAR



CODE:

909T

DIAGNOSIS:

TREATABLE DEMENTIA

TREATMENT:

ADMISSION FOR INITIAL DIAGNOSIS; MANAGEMENT OF ACUTE PSYCHOTIC SYMPTOMS - UP TO I WEEK