PMB list
Below is a list of the PMB condition treatment pairs for Skin and Breast.. 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.
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 |
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.
