PMB list
Below is a list of the PMB condition treatment pairs for Brain and Nervous System. Your medical aid has to pay for the treatment, and cannot use funds from your savings, even if the treatment is given out-of-hospital.
To see the rest of the 270 PMB conditions, please see our “List of PMBs” page.
For an explanation of general treatments (example: “Medical Management”) please read our explainer.
Brain and Nervous System
| CODE | CONDITION | TREATMENT |
|---|---|---|
| 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 | Anaerobic infections – life threatening | Medical management; hyperbaric oxygen |
| 48S | 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 |
To see the rest of the 270 PMB conditions, please see our “List of PMBs” page.
How does your medial aid plan cover this benefit?
What you see above is the minimum level of cover for each condition. Medical aids can offer more benefits than the limits above.To see how your plan pays out for a condition, find your plan here, and view your plan’s full benefits.
You can also compare any two medical aid plans side by side, to see which one suits your needs best.
Remember, a medical aid can still impose conditions on how PMBs are treated. For example, the scheme can impose network service providers (DSPs), a medicine formulary or even require that you be treated in a state hospital. You can read a full explanation on how medical aids must pay for PMBs here.
