Note: We are updating 2024 benefits as they are released. Some plans show old benefits until schemes release new plans.

List of PMB conditions: Ear, Nose, Mouth and Throat

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.

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 โ€“ 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; Vincentโ€™s angina Incision and drainage; 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.


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