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Resolution Of 16 December 2015, Of The General Civil Servants Of The State Mutual, Which Publishes Concert Signed With Dkv Seguros Y Reaseguros, Sae, For Assurance Of Health Care To The Mutual Dest...

Original Language Title: Resolución de 16 de diciembre de 2015, de la Mutualidad General de Funcionarios Civiles del Estado, por la que se publica el Concierto suscrito con DKV Seguros y Reaseguros, SAE, para el aseguramiento de la asistencia sanitaria a los mutualistas dest...

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TEXT

In application of the provisions of Articles 17.1 of the recast of the Law on Social Security of Civil Servants of the State, approved by Royal Legislative Decree 4/2000 of 23 June, and 77 of the General Regulation of Administrative Mutualism, approved by Decree 375/2003 of 28 March 2003, this General Mutuality of Civil Servants of the State (MUFACE), upon public notice, the notice of which was published in the "Official Gazette of the State" and in the Platform of Contracting of the State on October 29, 2015, has signed on December 15, 2015 with the Contracting entity, DKV Insurance and Reinsurance, S.A.E., Concerto for the insurance of health care to mutualists intended and/or residents abroad and their beneficiaries, during the years 2016 and 2017.

In order to ensure that stakeholders are aware of the content and the health care delivery regime, this Directorate-General resolves to publish the aforementioned Concerto as an annex to this resolution.

Madrid, December 16, 2015.-The Director General of the General Mutuality of Civil Servants of the State, P.S. (Royal Decree 577/1997, of April 18), the General Secretariat of the General Mutuality of Civil Servants of the State, Maria Dolores Lopez of Rica.

ANNEX

Concerto subscribed by MUFACE and DKV Seguros y Reinsurance, S.A.E., for the insurance of health care for the mutual funds intended and/or residents abroad and their beneficiaries, during the years 2016 and 2017

Index

Chapter 1. Object of the Concert and Scope.

1.1 Object of the Concert and Principal Obligations.

1.1.1 Object.

1.1.2 Entity Obligations.

1.1.3 Obligations of MUFACE.

1.2 Covered Contingencies.

1.3 Protected Collective.

1.4 Birth and Ention of Rights.

1.4.1 Birth of Rights.

1.4.2 Newborn.

1.4.3 Extinction of rights.

1.4.4 Continuity of benefits of mutualists or beneficiaries who have caused low in the Concert.

1.5 Attach to the entity.

1.5.1 Procedure.

1.5.2 High and low communication to the entity.

1.5.3 Return cards and talonaries.

1.6 Obligations of mutualists and beneficiaries.

1.6.1 Obligations with MUFACE.

1.6.2 Obligations with the entity.

Chapter 2. Service portfolio.

2.1 General provisions.

2.1.1 Definition.

2.1.2 General content.

2.1.3 Portfolio update.

2.2 Services portfolio content and specifications.

2.2.1 Structure.

2.2.2 Primary care.

2.2.3 Specialised attention and supplementary specifications.

2.2.4 Emergency care.

2.2.5 Palliative Care.

2.2.6 Rehabilitation.

2.2.7 Bucodental health/Odontostomatology.

2.2.8 Pharmacy, sanitary products, and dietetic products.

2.2.9 Health transport, evacuation and repatriation.

2.2.10 Other capabilities.

Chapter 3. Means of the entity and form of the benefit.

3.1 General provisions.

3.1.1 Overview.

3.1.2 Card.

3.1.3 Guide.

3.1.4 Information and telephone service.

3.1.5 Web page.

3.2 Assistance provided abroad.

3.2.1 Accredited branches and representatives.

3.2.2 Basic Principle.

3.2.3 Request for capabilities.

3.2.4 Models.

3.2.5 Presentation.

3.2.6 Request Direct Payment.

3.2.7 Request for Refunds.

3.3 Assistance provided on national territory.

3.3.1 Basic Principle.

3.3.2 Using entity media.

3.3.3 Additional requirements.

3.3.4 Previous entizations of the entity.

3.3.5 Using Unarranged Media.

3.3.6 Unjustified denial of assistance.

3.3.7 Vital character urgent assistance.

3.3.8 Ordinary Transport.

3.3.9 Transitional provisions.

Chapter 4. Health information and documentation.

4.1 General rules.

4.1.1 Entity Obligations.

4.1.2 Application Guarantees Data Protection.

4.2 Activity information.

4.2.1 Information system.

4.2.2 Filing data.

4.3 Health care management information.

4.3.1 Information System.

4.3.2 Filing data.

4.4 Clinical and health documentation.

4.4.1 Reporting capabilities.

4.4.2 Other reports.

Chapter 5. Legal status of the Concert.

5.1 Legal Regime of the Concert.

5.1.1 Legal framework.

5.1.2 Application health standards.

5.2 Regime of relationships based on the Concert.

5.2.1 Regime of care relationships.

5.2.2 Regime of relationships between MUFACE and entity.

5.1.3 Regime of the relationship between MUFACE and the branches or accredited representatives of the entity abroad.

5.3 Mixed Commission.

5.3.1 Composition.

5.3.2 Functions.

5.3.3 Operating system.

5.4 Procedure for claims.

5.4.1 Claims.

5.4.2 Resolution of claims.

5.4.3 Estimated claims execution procedure.

5.4.4 Reimbursement of expenses unduly assumed by MUFACE.

5.5 Economic compensations for partial default of obligations defined in the Concert and deductions for failures of availability. Procedure for their imposition.

5.5.1 Economic compensation for partial non-compliance with obligations defined in the Concert.

5.5.2 Deductions for availability failures.

5.5.3 Procedure for the imposition of financial compensation and deductions for failures of availability.

Chapter 6. Duration, economic regime and price of the Concert.

6.1 Duration of the Concert.

6.1.1 Effects of Concert.

6.1.2 Quantity Retention.

6.2 Economic Regime.

6.2.1 Economic effects and monthly payments.

6.2.2 Information about variations produced.

6.2.3 Taxes and Remedies.

6.3 Price of Concert.

6.3.1 Price of Concert.

6.3.2 Price of the Concert in the years of the Concert.

Annex 1. Portfolio of services.

Annex 2. Criteria for the availability of media in national territory by level of care.

Annex 3. Cross-border healthcare.

Annex 4. Glossary of terms.

Annex 5. Health information system.

Annex 6. Reimbursement rates.

Chapter 1

Object of the Concert and Scope

1.1 Object of the Concert and Principal Obligations.

1.1.1 In accordance with the provisions of Article 17 of the recast of the Law on Social Security of Civil Servants of the State, approved by Royal Decree of Law 4/2000 of 23 June, and in articles 85 and 86 of the General Regulation of Administrative Mutualism (hereinafter RGMA), approved by Royal Decree 375/2003 of 28 March 2003, the object of the Concert between the General Mutuality of Civil Servants of the State (hereinafter MUFACE) and the Entity signatory (hereinafter, Entity), is to ensure the provision of health care in any country of the world, including Spain, to the collective identified in clause 1.3 by means of the procedures and requirements set out in the following clauses.

1.1.2 The Entity assumes the commitment to provide healthcare to mutualists and beneficiaries through healthcare providers of accredited creditworthiness and quality of care, guaranteeing the benefits included in the Portfolio of Services set out in Chapter 2 and Annex 1 to this Agreement in accordance with the procedures, specifications and requirements contained in Chapter 3, by making available to the public health facilities or covering expenditure, by means of reimbursement or directly, including the anticipation of funds or amounts to When required by healthcare providers, account should be taken. The criteria for the availability of resources in national territory are set out in Annex

.

1.1.3 Furthermore, the Entity is required to cover cross-border healthcare, in accordance with Royal Decree 81/2014 of 7 February establishing rules to ensure cross-border healthcare, and by which the Royal Decree 1718/2010, of December 17, is amended on medical prescriptions and orders of dispensation. The exercise of the right by the beneficiaries, their scope, the conditions, requirements, procedure and fees for the reimbursement of expenses for such assistance are set out in Annexes 3 and 6.

1.1.4 For its part and to the same end, MUFACE is obliged to pay the Entity the amount per month and person provided for in clause 6.3, subject to the specifications and procedure contained therein.

1.2 Contingencies covered. The contingencies covered by this Concert are those arising from common or professional illness, injuries resulting from accidents, whatever the cause, even if it is an act of terrorism, and by pregnancy, childbirth and puerperium, as well as the preventive actions taken in the Concert.

1.3 Protected Collective. For the purposes of this Agreement and in accordance with the provisions of Chapter II of the RGMA, the collective protected by the RGMA is composed of the mutualists destined to be outside the national territory or who are outside the national territory. for a period of more than six months for other reasons relating to the civil service, and other assumptions assimilated by the rules of mutual benefit, its beneficiaries and beneficiaries in the event of death, separation, divorce or nullity of the marriage of the mutualist, to which MUFACE has attached to the Entity for the purposes of its health care. Both types of beneficiaries will be protected by this Concert as long as MUFACE has recognised them, maintain the requirements to be so and the mutualist of which they are beneficiaries.

1.4 Birth and extinction of rights to receive healthcare from the Entity.

1.4.1 Without prejudice to the following clause, the rights of mutualists and beneficiaries for the purposes of this Concert begin on the date on which they have been assigned to the Entity by the services of MUFACE, with no shortage time for any kind of assistance.

1.4.2 For the purposes mentioned above, when the mother is a mutualist or beneficiary protected by the Concert, it is presumed that the newborn is attached to the Entity during the first fifteen days from the moment of delivery. From then on, this right is conditional on the formalisation of the newborn's membership with the consequent economic effects.

1.4.3 The rights of the mutualists and beneficiaries are extinguished, in any case, on the date on which the services of MUFACE agree to their absence in the Mutual Fund or the end of their membership to the Entity for ceasing to attend the requirements or assumptions in fact that allow in each case to be protected by this Concert, without prejudice to the continuity of benefits provided for in the following clause and the economic effects for the Entity established in the clause 6.2.1.

1.4.4 When a mutualist or beneficiary causes a loss in the Entity in accordance with the provisions of the above clause, the Entity shall continue to be obliged, regardless of the economic effects provided for in clause 6.2.1 and with the the same loan content of the Concito in force, if it were covered by the date of extinction of the health effects, an assistance to a mutual or beneficiary due to a very serious illness under hospitalization, day or detention until the high of the current episode or, in any case, until it can be Ensure continuity of treatment in other media or healthcare facilities. For these purposes, a disease which carries vital risk or irreparable damage to the physical integrity of the person shall be understood as a very serious disease.

1.5 Adage to Entity.

1.5.1 Mutualists or beneficiaries with a document assimilated to that of affiliation who, due to their professional or personal circumstances, may be protected by the Concert, must request in MUFACE the discharge for themselves and their beneficiaries under the cover scheme of this Concert, following the procedure laid down for this purpose.

1.5.2 Once the condition of a mutualist or beneficiary protected by this Concert has been recognized, MUFACE will communicate to the Entity daily the users in a telematic way, depositing the information in a secure directory with access by the Entity. The same procedure shall also provide for the reporting of casualties and variations in data from mutualists and beneficiaries.

1.5.3 For their part, mutualists or beneficiaries with a document assimilated to the death affiliation of the mutualist must submit to MUFACE the health cards of the Entity or the Public Health Service of the The Autonomous Community to which they were previously attached to their health care in the national territory and those of their beneficiaries, as well as the prescriptions of MUFACE, as from the date of the effects of their attachment to the I, a signatory to this Concert, will not be able to make use of them.

1.6 Obligations of mutualists and beneficiaries.

1.6.1 Obligations against MUFACE:

Pursuant to the provisions of Article 20.2 of the RGMA, the mutualists or beneficiaries with a document assimilated to that of affiliation attached to the Entity and protected by this Concert are obliged to communicate to the services of MUFACE any modification that may result in its discharge in the Entity, as well as any of its beneficiaries, especially in the following cases:

(a) When a change of destination and/or residence of the mutualist or beneficiary is produced with document assimilated to that of affiliation with transfer to the national territory.

(b) Where in a beneficiary the circumstances justifying their membership are no longer present as such, in accordance with the applicable rules.

The lack of unjustified communication by the mutualist or beneficiary with a document assimilated to that of affiliation within one month from the production of the event causing the circumstance causing its absence in the Entity or any of its beneficiaries shall give rise, where MUFACE is aware of, to the mutualist or, where appropriate, the beneficiary with a document assimilated to that of affiliation, the costs incurred by the cover improperly received care.

1.6.2 Obligations against Entity:

Mutualists or beneficiaries with a document assimilated to that of affiliation who cease to be protected by this Concert will not be able to make use of the services offered by the Entity from the date of extinction of their rights, with the exception of the rules, which on continuity of benefits are set out in clause 1.4.4 and must return the cards or any other identifying documents of the Entity, at the time the discharge occurs.

In turn, they may be required by the Entity to proceed to be examined by the medical services of the same, provided that, pending the authorization for the coverage of an assistance or a request for reimbursement This requirement is reasonable and respects the guarantees of health confidentiality as laid down in Law 15/1999 of 13 December on the Protection of Personal Data and its implementing legislation. In case of doubt as to the reasonableness of such examination, the beneficiary may request the procedure provided for in clause 5.4 of this Concert.

Chapter 2

Service Portfolio

2.1 General provisions.

2.1.1 Healthcare to mutualists and beneficiaries of MUFACE attached to the Entity shall be provided in accordance with the Service Portfolio established in this Concert.

The Services Portfolio is the set of techniques, technologies or procedures, understanding each of the methods, Directory and resources based on scientific knowledge and experimentation, through which they are effective health benefits.

A glossary of terminological clarifications related to the contents of this Chapter is included in Annex 4.

2.1.2 The Portfolio of Services to be provided by the Entity shall comprise at least the benefits contained in the Common Portfolio of Services of the Spanish National Health System (SNS), in accordance with Spanish health regulations in force at any time, with the specificities set out in this Chapter and in Annex 1.

2.1.3 The Service Portfolio that is determined in this Chapter will be automatically updated by updating the SNS Common Service Portfolio.

When in application of Article 85 of the RGMA, it is necessary to incorporate new services, techniques or procedures into the Services Portfolio or the exclusion of existing ones that do not correspond to the Common Portfolio of Services of the SNS, and which have a relevant character, shall be made by Resolution of the General Directorate of Mutual, after hearing of the Entity, and shall proceed, where appropriate, in accordance with the provisions on modification of contracts established in the current regulations on public sector procurement.

The provisions of the preceding paragraph shall not apply to the pharmaceutical provision, which shall be governed by its own rules. It shall also not apply to services, techniques or procedures involving a minor change in existing or incorporating devices or products with minor technical modifications, except for scientific evidence and/or the impact of such changes. bioethical and social, the Directorate-General of MUFACE considers it appropriate to limit its incorporation to the Portfolio of Services for specific indications, drawing up the corresponding protocol.

2.2 Services Portfolio Content and Specifications.

2.2.1 The Services Portfolio object of this Concert is structured into the following capabilities:

A. Primary Care.

B. Specialized Care.

C. Emergency Care.

D. Preventive Programs

E. Palliative Care.

F. Rehabilitation.

G. Dental Health.

H. Pharmaceutical and dietetic products.

I. Health Transportation, Evacuation and Repatriation.

J. Other capabilities:

a. Podiology.

b. Respiratory Therapies.

c. Spell/prosthetic delivery and complementary health services.

2.2.2 Primary Care: You will understand health care by specialists in Family and Community Medicine or general practitioners, specialists in Pediatrics and nursing professionals, dentist, physiotherapist, matron and podiatrist, which will be dispensed at an outpatient, home and emergency level.

2.2.3 Specialized attention: Includes the health care, diagnostic, therapeutic and rehabilitation and palliative care, as well as those of prevention whose nature makes necessary the intervention of doctors specialists, in accordance with the relationship set out in Annex 1.

Specialized care, whether scheduled or urgent, may be provided in external consultation or in hospitalization that includes internment, medical or surgical day hospital, and home hospitalization.

The following supplementary specifications are set for these capabilities:

A. Mental Health: Includes clinical diagnosis and follow-up, drug treatment and individual, group or family psychotherapy, psychiatric illnesses.

The Entity is required to provide a maximum number of 20 sessions of psychotherapy per calendar year (short psychotherapy or focal therapy), except for cases of eating disorders, in which all sessions will be provided the psychiatrist responsible for the assistance considers necessary for the correct evolution of the case.

It will be carried out in hospitalization, external consultations and emergencies, guaranteeing in any case the necessary continuity of care.

Hospitalization, including day care, will be prolonged for as long as the psychiatrist responsible for patient care considers necessary and therefore up to hospital discharge, and will cover all acute processes. as chronic.

Psychoanalysis, psychoanalytic psychotherapy, hypnosis and outpatient narcolepsy are excluded, as well as the social internment of patients affected by some type of dementia, alcoholism or drug addiction.

B. Plastic, aesthetic, and restorative surgery: Aesthetic plastic surgery is covered, and restorative that is related to accident, disease or congenital malformation. In cases of occupational disease or accident at the service of a service, it shall include the necessary surgery in cases where, even if the lesions have been cured, there shall be deformations or mutilations resulting in changes in the physical appearance or make the patient's total recovery difficult.

C. Diagnosis and treatment of sterility. 1. General considerations. It includes the diagnosis of the sterility of the mutualist or beneficiary/to which it will be extended when appropriate to the partner and assisted reproduction techniques when the woman on whom the technique is to be performed is a mutual or benefit from MUFACE and do not have any child, previous and healthy. In case of couples, without any common, prior and healthy children.

All the techniques included in the common portfolio of services of the National Health System are included, in accordance with Law 14/2006, of 26 May, on techniques of Human Reproduction Assisted, and Order SSI/2065/2014, 31 October, amending Annexes I, II and III to Royal Decree 1030/2006 of 15 September establishing the portfolio of common services of the National Health System and the procedure for updating them, with the conditions and requirements set out in the same.

At the time of the start of the sterility study, the beneficiary must be over 18 years of age and under 40 years of age and not suffer any type of pathology in which the pregnancy may present a serious and uncontrollable risk to her. his health as for that of his possible offspring. In the case of couples, the male should be aged 18 and under 55.

Not included, among the benefits funded by assisted reproductive techniques that are performed when the sterility of any member of the partner has occurred voluntarily or over-come as a consequence. the natural physiological process of completion of the person's reproductive cycle or documented medical contraindication.

In assisted reproduction treatments, the tests to be performed in the field of such treatment to the other member of the partner will be provided by the entity of the woman's attachment to which the Assisted Human Reproduction technique. The funding of the pharmacological treatments associated with the Assisted Human Reproduction Technique to which the other member of the couple is to be submitted is excluded.

In the case of human reproduction techniques assisted with the donation of gametes and preembryos, the expenses resulting from the actions and, where appropriate, the medications required by the donors, will be carried out by the Entity to the be part of the cost of the technique used. In no case may the recipient recipient of the donation be passed on.

It will be on behalf of the Entity the coverage of the cryopreservation and maintenance of gametes and ovarian tissue for the deferred own use of beneficiaries who will undergo medical and/or surgical treatments that may affect In an important way to your fertility. The coverage period in the case of the woman will be up to the day before the 50-year-old compliance and in the case of the man until the day before the 55-year-old compliance. In addition, it shall be the responsibility of the Entity for the cryopreservation and maintenance of pre-embryos left over from authorised IVF cycles until the previous day when the woman is 50 years of age.

The coverage of assisted human reproduction techniques in women in which there is a diagnosis of sterility by gynecological pathology that prevents the achievement of a pregnancy, regardless of the existence or not of the pair.

2. Limits on the maximum number of treatment cycles and the age of the woman

Artificial Insemination

Fecundation in vitro *

Semen

Donor Semen

Own Gameths

Donated Gameos

cycles no

4

6

3

3

< 40

< 40

< 40

< 40

< 40

Centro_table_body "> <40

* Including complementary techniques. In cases of the use of cryopreserved ovocytes and ovarian tissue, the age limit will be the one established for the IVF technique with donation of gametes/preembryos. The ages are computed until the day before the woman is 38 or 40 years old, as the case may be.

The following criteria will be considered for application of the limits:

(a) The prescription of the treatment of Assisted Human Reproduction must have been performed prior to the day when the woman has fulfilled the years established as the age limit to be entitled to the funding in each one of the techniques.

b) For computation purposes, the number of cycles is independent for each technique, although the total number of cycles performed independently of the funder will be taken into account. To consider that a patient has performed a IVF cycle, it must have reached at least the egg cell recovery phase.

When there are leftover frozen preembryos from authorised IVF cycles, their transfer is part of the IVF cycle in which they were obtained and will be financed until the previous day when the woman is 50 years old, with independence from the existence of previous and healthy children.

(c) A new IVF cycle shall not be permitted where cryopretained leftover preembryos from previous cycles exist.

d) In any case, the completion of the initiated cycle is guaranteed to be covered by application of the criteria and limits in force at the time of its commencement.

e) If after the performance of a technique of assisted human reproduction and obtained a pregnancy the abortion patient may repeat a new cycle with the technique for which the pregnancy occurred, once the number has been completed maximum of established cycles and provided that the age limit is not exceeded in order to be eligible for funding in each of the techniques.

D. Transplants: You will understand transplants of all kinds, as well as bone and/or tendinous grafts. Organ procurement and transplantation shall be performed in accordance with the current health legislation of the country in which the transplant occurs, corresponding to the Entity assuming all the expenses of obtaining and transplantation of the organ or fabric.

2.2.4 Emergency Care: Emergency care is included in cases where the clinical situation requires immediate health care during the 24 hours of the day every day of the year, in the place where it occurs. the need for care and in healthcare facilities.

2.2.5 Palliative Care: Comprises comprehensive, individualized and continuous care of people with advanced disease who are not susceptible to receiving treatments for curative purposes and with a life expectancy limited, as well as the persons to whom they are linked.

2.2.6 Rehabilitation: Rehabilitation and physiotherapy treatments in patients with a recoverable functional deficit prescribed by rehabilitators or specialists responsible for the pathologies susceptible to them. treatments, even if they require the intervention of different rehabilitating professionals or techniques.

2.2.7 Bucodental health/Odontostomatology:

A. Benefits included: Prior to the prescription of an optional specialist, it will be in charge of the Entity to treat stomatological conditions in general, including any kind of extractions and cleaning of the mouth once a year or, more if necessary, prior to the optional expert's report.

In addition, for beneficiaries under 15 years of age, it includes periodic reviews that are considered accurate for the maintenance of good dental health, the application of topical fluorine and in permanent parts: Occlusal sealants, obturations, fillings or reconstructions, pulparian treatments (endodontics), tartrectomies and treatments of incisors and canines in case of disease, malformations or trauma.

For the pregnant mutualists and beneficiaries, preventive follow-up of the oral cavity with topical fluoride application is included according to the individual needs.

For patients with mental disabilities, the costs of hospitalization, operating room and anaesthetist are included for the treatment and dental benefits excluded from the coverage of the Concert.

Dental implants are included in charge for patients with cancer processes that affect the oral cavity involving loss of teeth directly related to the pathology or its treatment, and patients with congenital malformations that are in the course of anodontics.

B. Exclusions: They are excluded from the coverage of the Concert, both in terms of their cost, their placement, the fillings and the endodontics to beneficiaries in general 15 years of age or more, the dental prostheses, the osteointegrated implants (with the (i) the treatment of orthodontics and periodontics, as well as treatments for the sole aesthetic purpose and the carrying out of additional tests for the assessment and monitoring of the treatments excluded from the Services Portfolio.

However, these benefits will be included when you measure professional illness or accident in service prior to recognition by MUFACE of the right to benefits arising from such contingencies.

2.2.8 Pharmacy, medical devices and dietetic products: They shall be in charge of the Entity where there is a medical prescription in writing, any medication, effect or accessory, or complex dietoterapic product and nutrition Household enteral which is covered for the purpose of financing and with the same indications provided for in the Spanish National Health System, with the following specifications:

A. The total cost of the pharmaceutical, sanitary and dietetic products necessary for any treatment in the hospital, including those that according to the Spanish health legislation are qualified as of hospital use or Hospital diagnosis without a seal and should be dispensed through a hospital to outpatient or outpatient patients, as well as to the chemoterapics both intravenously and intravesical.

B. Growth hormone treatments will require the prior authorization of MUFACE. In order to obtain this authorization, the mutualist or beneficiary with a document assimilated to that of affiliation must submit duly completed by optional specialist the Protocol which for these purposes is included in the website of MUFACE.

C. Those treatments that have their origin in an accident in service or professional illness.

D. 70% of the cost of medicines and other medical devices included in the provision of the Spanish National Health System for dispensing through pharmacy offices.

E. In the case of medicinal products and effects and accessories subject to reduced input as provided for in paragraph 3.2 of Annex V to Royal Decree 1030/2006 of 15 September establishing the service portfolio National Health System and the procedure for updating it, as well as those prescribed for patients diagnosed with cystic fibrosis and Paget's disease in treatment with calcitonin, the level of coverage will be 90% of the cost of the product dispensed, except where the amount corresponding to the patient exceeds EUR 4,24 per package, in which case the Entity shall pay the difference between the cost and the contribution.

F. 70% of the cost of acquiring items for urinary incontinence if needed from a medical point of view, up to a maximum of 600 euros per year.

G. The total cost of complex dietoterapic products intended for persons suffering from certain congenital metabolic disorders and enteral enteral nutrition for those to whom it is not possible to meet their needs nutrition with food for ordinary consumption.

H. The total cost of the health products listed below:

1. Intrauterine devices (IUD), including intrauterine release systems (hormonal DIUs).

2. Local infusion pumps for parenteral administration of insulin and other drugs.

3. The fungible material needed for parenteral administration of insulin or other antidiabetic drugs.

4. Precise means, elements or pharmaceutical products for performing diagnostic techniques, such as sharp contrast and laxative means, or others.

5. The reactive strips for the measurement in diabetic patients of glucose, glucosuria and combined glucose/ketone bodies, as well as the glucometro, lancets and the necessary material, according to the criteria and standards established by the health administrations and scientific societies, and provided that, in the opinion of the responsible professional, they are better suited to the needs and skills of the patient.

6. The systems for administration of enteral enteral nutrition, tracheototomy cannula, laringuectomy as well as its accessories and special vesical probes when these products were duly indicated by the specialist.

2.2.9 Health transport, evacuation and repatriation.

It will be in charge of the Entity:

A. The health transport within the same country where the contingency or the need for assistance to move to the hospital or health center where the patient receives assistance or periodic treatment occurs when the pathology of the patient prevents him. travel by their own means, which is accredited by the written prescription of the optional on which the transfer is necessary.

Transport should be performed in the most appropriate way depending on the patient's physical condition and other circumstances, in the following means: ambulance, medicalized ambulance, mobile UVI, medicalized aircraft and helicopter, and aircraft.

B. Health transport, between different countries, when the patient requires an assistance covered by this Concert and the appropriate means are not available in the country where the patient is located. In this case, the Entity will take care of the expenses caused by the use of the most suitable means of transport from the country where the treatment is found in the terms of clause 3.2.2 A, except the of the third subparagraph, up to a maximum of EUR 50 000, which shall include the travel costs of a patient's companion. These benefits shall be subject to the certification of the medical need for such transport and treatment by the physician who addresses the patient and the prior approval of the Entity.

C. The health evacuation of a mutualist or beneficiary as a result of a disease or injury covered by the present Convention, at a terminal stage, duly justified by the report of the physician responsible for the assistance. This report must be submitted to the Entity for authorization and must pay the costs arising from the evacuation of the patient to Spain or the country of habitual residence, from the country where the patient has been treated, in the most appropriate to the patient's physical condition, including, if necessary, the expenses of the medical or nursing staff accompanying the patient, up to a maximum of 50,000 euros.

D. The repatriation of the body or ashes of a mutualist or beneficiary from the country where the death occurred in Spain or the country of habitual residence, which shall include the costs of transporting the remains, of a companion, embalming and coffin, up to a maximum of 10,000 euros.

2.2.10 Other capabilities:

A. Podiology: Podiological care is included for insulin-dependent diabetic patients as well as for diagnosed patients with neuropathic foot of etiology other than diabetes.

The attention of the podiatrist requires medical prescription. The maximum number of sessions per patient will be six per year.

B. Respiratory Therapies: Coverage of any of the home respiratory therapy techniques served in the National Health System is included, when the circumstances of the patient so require, including the use of the liquid oxygen, pulsioximetry, and aerosoltherapy.

C. Orthoprosthetic provision and complementary health benefits: They are included in the coverage of the Concert:

1. Surgical, therapeutic or diagnostic implants, such as medical devices designed to be implanted in whole or in part in the human body by means of a given medical act or surgical intervention, as well as the renewal of any of its accessories, including external accessories. Materials used to perform osteosynthesis techniques are included.

The monitoring studies are also included in accordance with the provisions of Order SSI/1356/2015 of 2 July, amending Annexes II, III and IV to Royal Decree 1030/2006, of 15 September, for which the establishes the common services portfolio of the National Health System and the procedure for updating it.

2. External prostheses, wheelchairs, orthotheses and special orthoprostheses, after medical prescription, with the contents and extension provided for in the specific rules of the Mutuality.

3. Supplementary health benefits. These include hearing aids, laringophones, antiesfaced mattresses, with the medical prescription, with the content and extension provided for in the specific rules of the Mutual Fund.

The glasses, contact lenses and any other prostheses intended to correct refractive defects are excluded, except when medical illness or accident is performed on an act of service to be on behalf of the Entity, prior recognition by MUFACE of the right to benefits arising from such contingencies.

Chapter 3

Means of the Entity and form of the benefit

3.1 General provisions.

3.1.1 The Entity shall provide the mutualists and beneficiaries of MUFACE with access to the benefits included in the Services Portfolio of the Concert, in accordance with Chapter 2, by means of the procedures covered by this Chapter, subject to the requirements and specifications for each type of assistance provided for in this Chapter.

3.1.2 To this end, the Entity shall provide a specific individual card for the application of this Concert by which the mutualists and beneficiaries may access the means agreed by the Entity and/or, as the case may be, accredit the right to receive healthcare in the form and conditions set out in this Concert. The card will bear the MUFACE logo on the front page and will include among the personal data the membership number that will be facilitated by the Mutuity to the Entity.

3.1.3 Furthermore, the Entity will provide the protected collective with a guide, once supervised its content by MUFACE, with the necessary information for the correct use of its services, as well as the updated relationship by country and localities of their delegations, branches or accredited representatives, provided for in clause 3.2.1.

3.1.4 The Entity will have an information and telephone assistance service in Spanish, during the 24 hours of the day, 365 days of the year, and virtual office with permanent service, to which the mutualists and beneficiaries of the Concert can be directed from any country where they reside, to obtain:

a. Information to address emergency situations, especially the care devices that mutualists and beneficiaries can use in these situations.

b. Information about the care services closest to the patient's place of residence.

c. Information on the contents of the Concert and the procedures for access to the coverage of the benefits or, where appropriate, to the reintegration.

d. Information on delegations, own branches or accredited representatives, in each locality or country.

e. Processing of any type of health benefit included in this Concert.

The lack of operability of these resources will result in the demand for the economic compensation provided for in Chapter 5.

3.1.5 Likewise, mutualists and beneficiaries will be able to access this information through the website of the Entity, in the specific section of MUFACE which, in any case, must be available in Spanish.

In addition, through this website you will be able to download and complete the different application models provided for in clause 3.2.3, as well as the other functionalities mentioned in the Concert.

The lack of operability of this resource will result in the demand for the economic compensation provided for in Chapter 5.

3.2 Assistance provided abroad.

3.2.1 The delegations, whether their own branches or accredited representatives of the Entity, will have sufficient capacity to manage all the procedures and procedures related to the benefits included in the This Concert, including the anticipation of funds or amounts to account when required by suppliers. In addition, they will provide all necessary information to mutualists and beneficiaries who need it, both in person (if possible by means of health professionals) and at a distance (telephone, fax, ordinary or electronic mail, etc.) from:

a. The loan content of the Concert and the form of access to benefits.

b. The adequacy of the existing health care centres and professionals in the country of residence or displacement to the specific needs of the mutualist or beneficiary, depending on the prior knowledge available to the entity on such healthcare providers.

c. The list of health facilities in the country of residence or movement in which the payment of the costs of assistance to the mutual societies and beneficiaries of the Concert for their use is not required, all without prejudice to their freedom of choice.

d. Aspects related to the most prevalent diseases, vaccinations, preventive measures or other relevant medical information in the geographical scope of the State of residence or displacement, by own or concerted health personnel with the Entity.

The Entity shall communicate, within a period not exceeding one month, to MUFACE and to the mutualists and beneficiaries with a document assimilated to that of affiliation, directly affected, any modification produced in the data and services of the delegations, whether they are branches of their own or by representation.

3.2.2 The coverage of healthcare that mutualists and beneficiaries attached to the Entity need to be structured on the following basic principles:

A. In general, assistance shall be received in the country of destination or residence, unless the appropriate means are not available to it.

On temporary displacements outside the country of destination or residence, except for those made to Spain (the care of which is regulated in clause 3.3, the health care that the patient needs is covered, provided that, If adequate means exist in the country of destination or residence, the reason for the displacement has not been precisely to receive medical treatment.

Subsidiary as an alternative, the mutualist or beneficiary who wishes to receive any health benefit covered by this Concert in a country other than that of residence or destination, must inform the Entity in advance Minimum five calendar days prior to posting, the intention to receive this assistance, attaching medical report and indication of the country. The entity shall be obliged to refund the costs by applying the tariffs set out in Annex 6 to this Concert or the maximum expenditure incurred if it is less than. In no case shall the transport costs be covered by the displacement of the patient or his companions.

B. The free choice of doctors and other health facilities in the country of destination or residence by the mutualists and beneficiaries with the sole limit of compliance with the requirements laid down, in general, by the rules health in the State in which the assistance is received, under the supervision which, with the same character, may be carried out by the competent health administration.

C. The relationship with healthcare providers is the responsibility of the Entity, which will assume the dialogue with them for the purpose of ensuring compliance with the provisions of the Concert, resolving all issues related to the service delivery may arise.

D. Reimbursement by the Entity of the expenses incurred by the mutualists and beneficiaries for the health benefits received, provided that they are among those contained in Chapter 2, are prescribed by a doctor or, where appropriate, other healthcare professionals and their value does not exceed the normal and usual expenses for such services and supplies in the locality where they are received.

E. The direct payment by the Entity to healthcare providers in the cases of hospitalizations and in certain treatments such as those related to Acquired Immunodeficiency Syndrome, dialysis and others. However, in order to provide better care for mutualists and beneficiaries, the Entity will seek to facilitate direct payment to healthcare centres and professionals, who support it for as many benefits as possible. in the present Concert, especially in cases of scheduled interventions, chronic treatments, or complex diagnostic tests.

3.2.3 Application for benefits: Mutualists and beneficiaries with a document equivalent to that of affiliation may apply for benefits and reimbursements to those entitled, as well as other formalities or obligations which are derived from this Concert by any of the following means:

A. Presentially, in any of the entity's delegations, be their own branches or accredited representatives.

B. By mail.

C. By fax.

D. Through the website of the Spanish Entity in the specific section of MUFACE.

The entity will have for its completion by the interested standard models of application in Spanish, specific to the application of this Concert.

Also, the Entity will have standard Spanish settlement models where the data can be entered separately from each refund request, amount paid, amount not paid and cause of refusal (if applicable).

To the same end, the Entity will have on the Spanish-language website a specific section for the applications that will allow the download of the models, their completion, as well as to annex invoices, medical reports and any other documents. It must also allow the submission, processing and resolution of the application to be carried out through the page and the applications to the effect to allow the various stages of the procedure to be recorded, as well as to allow the interested at any time to know the processing status of your request.

In cases of periodic assistance for the same process or in cases of optional or primary care facilities, the holder will accumulate the invoices up to a minimum of 200 euros or equivalent amount in another currency, for the purpose of requesting reimbursement for one time.

The application should allow you to be able to obtain for periods of time at least weekly reports on requests for refunds submitted and their status of processing at the date of the report.

3.2.4 Request for direct payment: For the assists included in clause 3.2.2.E the mutualist or beneficiary shall in advance communicate the internment or initiation of the treatment to the Entity, which will manage the corresponding authorisation and the anticipation of funds or amounts to be taken into account when required by the respective centre or health care professional. The entity shall resolve and communicate the outcome of the proceedings to the data subject within a maximum of five days.

In these cases, the Entity will pay the healthcare professional the amount invoiced over a period of time that does not exceed, in any case, 60 days. The unjustified exceedance of that period shall give rise to the requirement for the economic compensation provided for in Chapter 5.

In cases where there are regular assists in the process itself or in cases of optional or primary care, the holder may ask the entity to manage the direct payment of the cost with the supplier. generated, provided there is compliance with it. Except in the case provided for as a subsidiary in the third paragraph of clause 3.2.2 A, which shall always be in return at the request of the person concerned and provided that the prior notice provided for in that clause has been produced.

3.2.5 Request for Refunds: Refunds must be made in the official currency of the country of destination, residence or euro, within 10 working days of the date on which the Entity receives the relevant documentation, All expenses that may be incurred by the change of currency shall be borne by the Entity. The unjustified exceedance of that period shall give rise to the requirement for the economic compensation provided for in Chapter 5.

To determine the euro value of the refunds, the exchange rates in force on the day on which the payment of the invoice materializes will be taken into account, in accordance with the Bank of Spain's announcement published in the "BOE". If no official change exists for that day, the corresponding one shall be taken into account the nearest day.

3.3 Assistance provided on national territory.

3.3.1 The coverage of health care that mutualists and beneficiaries attached to the Entity require on national territory is structured on the following basic principles:

A. The institution shall make available to the mutualists and beneficiaries all the appropriate means of their own or in accordance with the terms set out in Annex 2.

The entity must have a free telephone available 24 hours a day, 365 days a year, to channel the demand for emergency and health emergencies by ensuring the accessibility and coordination of the resources available for this type of care.

B. The institution must ensure access to the means referred to in the previous paragraph, unless the means are not available at private or public level. If exceptionally the Entity does not have such concerted means, it shall be directly responsible for the expenditure incurred for the use of non-concerted means in accordance with the provisions of clause 3.3.6.

C. In order to enable the mutual and beneficial owners to use their own and concerted means in Spain, the Entity will edit, in paper format and in electronic format, (in this case accessible in the section specific to MUFACE of its website), Suppliers ' Catalogs containing the detailed relationship of the same and the information necessary for this purpose.

Suppliers catalogs, will have provincial scope, and will be adapted to the levels of care established in the Concert. Where in the province in question the Entity is not required to have services of Level IV of Specialized Care, in accordance with the criteria of Annex 3, the catalogue shall contain the means to which the Entity may have in the the territorial scope of the Autonomous Community to which the province belongs, the Reference Services shall also be registered throughout the national territory.

In general, the content of the paper catalogs will follow the following structure:

1) The cover shall bear the logo of MUFACE and that of the institution, as well as the free and unique telephone of the institution's Emergency and Emergency Coordinating Centre.

2) On the first page, and prominently, the data relating to:

− Phone of the Emergency and Emergency Coordinator Center of the Entity

− Entity Information Phone.

− Fax number or other system for authorizations.

− Address, telephones and operating hours of an office for the face-to-face care of the mutualists.

− Http address of the Entity's web page.

3) In the right margin of the header of each page, the telephone of the Emergency and Emergency Coordinating Center must be included.

4) The content of this clause 3.3.1 (except this paragraph C) and clauses 3.3.6 and 3.3.7, as well as a comprehensive list of services requiring prior authorisation of the Entity and the procedure for its get.

5) All professionals, centres and functional units must appear in relation to their identification data (first and last names) and specialty, and the address, telephone and schedule of operation.

D. Mutualists and beneficiaries may freely choose optional and centre from among those listed in the Catalogues of Entity Providers throughout the national territory.

3.3.2 Use of Entity Media: Mutualists and beneficiaries shall directly access the agreed means of the Entity included in their Provincial Supplier Catalogues with the presentation of the card identification as referred to in clause 3.1.2.

3.3.3 Additional Requirements: The Entity may require additional requirements for access to the assistance as a medical prescription or prior authorization of the Entity, provided that they are expressly stated in the Catalogs.

The Entity, through the physicians who prescribe or perform diagnostic tests or treatments that require authorization, shall duly inform the patient of this requirement. In no case may the mutualist or beneficiary be made out of the unauthorised evidence if he has not been informed prior to the need for such prior authorisation or, in the case of medical or surgical acts carried out at the time of the query, for lack of time to obtain it.

3.3.4 Prior Entitlements of the Entity: The Entity shall have the necessary organisational resources to make it easier for mutualists and beneficiaries who need it to obtain prior authorisation for the provision of the services by any of the following means:

a) Presentially, in any of the offices that consist of the Catalogs of the Entity.

b) Telefonically.

c) By fax.

d) Through the Entity's web page.

In order to avoid any delay in the access to the requested benefit, the sending of the authorization to the applicant by the Entity shall be carried out at most in 5 working days or, if not necessary, indicate the reason and, in their case, the means allocated to facilitate it on national territory, in the terms stipulated in this Concert.

The entity, in the authorization of admission to hospital or major outpatient surgery that it issues, will be responsible for informing the mutualists and beneficiaries that their health data can be treated by MUFACE for the aims, always with the recommendations and channels established by the Organic Law 15/1999, of December 13, of Protection of Personal Data and its regulations of development.

3.3.5 Use of non-concerted means: In accordance with Articles 17 of the recast of the Law on Social Security of Civil Servants of the State and 78 of the RGMA, when a mutualist or the beneficiary, by his own decision or his or her family members, uses means which are not in agreement with the Entity, must pay, without the right to reimbursement, the costs which may be incurred, except in cases of unjustified refusal of assistance and in the cases of Vital urgent assistance that is detailed and regulated in the following clauses.

3.3.6 Unjustified denial of assistance.

A. Acceptance by the Entity or, where appropriate, the statement by MUFACE that there is an unjustified refusal of assistance, does not imply acceptance or declaration, respectively, that there has been a refusal of assistance for other purposes. civil or criminal proceedings, for which, where appropriate, the beneficiary will have to go to the appropriate ordinary court.

B. To the exclusive enforcement effects of this Concert there is an unjustified denial of assistance:

1. Where the mutualist or beneficiary requests in writing to the Entity the provision of a particular health care prescribed by a physician arranged by the Entity in Spain, or by an optional outside Spain whose care has been covered by the Entity, and it does not offer it, also in writing and before the end of the fifth working day following the communication, the care solution valid at the appropriate level.

2. Where the Entity does not meet the requirements for the availability of means provided for in Annex 2 to this Agreement. In this case the mutualist or beneficiary may refer to the faculty or institutions other than the Entity that exist at the appropriate level.

3. Where a mutualist or beneficiary requests authorization from the Entity to attend an optional or non-concerted centre, upon written prescription of an individual of the Entity with exposure to the medical causes of the the need for referral to the non-concerted means and the Entity, before the end of the tenth working day following the submission of the authorisation, does not offer a valid alternative to the media.

4. When a mutual or beneficiary has come or is in a center of the Entity to receive assistance, and according to the criterion of the physician, the necessary care resources are not available or are not available. In this case, it is presumed that an unjustified denial of assistance situation occurs when the patient has been referred to a non-concerted centre from the entity's environment.

5. Where the mutualist or beneficiary is entered in an unconcluded centre because of a medical situation requiring immediate emergency attention, and the latter (or the family or third parties responsible) informs the entity within the the 48 hours after admission and does not offer a valid care solution before the end of the 48 hours following the communication, either committing to the costs incurred, or managing the transfer to a centre of the the Entity, itself or concerted, provided that the shipment is medically possible.

The application to the Entity will be made by a means that allows to be put on record (preferably through its Emergency and Emergency Coordinating Center) and will include a brief description of the facts and circumstances. in which the income has occurred.

C. Obligations of the Entity in respect of an unjustified refusal:

1. In any of the alleged unjustified refusal of assistance described, the Entity is obliged to assume the expenses arising from the assistance.

In the case referred to in point 5 of the previous letter B, if the Entity has offered a valid care solution within the time limit set, the beneficiary shall bear the costs incurred for the assistance up to your transfer to your own or concerted centre.

2. When the Entity offers its own or concerted means, the offer must be managed by the Entity, specifying in addition the name of the optional, service or center that will assume the assistance and that can carry out the diagnostic technique or prescribed therapy.

3. Where the beneficiary has come to non-agreed means as a result of a refusal of assistance due to the fact that the Entity has not provided a valid alternative care within the time limits laid down in each case, or The entity must assume, without exclusions, the expenses incurred by the care process until the discharge of the case. However, after six months from the refusal of assistance or from the date of the last authorisation, the beneficiary shall request the entity to renew the continuity of the assistance so that, before the end of the the tenth working day following the submission, the authorisation or offer a valid alternative to the media, in accordance with the specifications set out in point 2 above.

4. Where the Entity receives from the mutualist or beneficiary the communication of the assistance provided in means other than any of the circumstances provided for by unjustified refusal, it shall make appropriate representations to the supplier in order to obtain charge of the costs incurred by such assistance and that the corresponding invoice is issued to the Entity.

5. If the person concerned has paid the costs directly to the health provider, the entity shall make the reimbursement within 10 calendar days of the date on which the person concerned submits the supporting documents for the expenditure.

3.3.7 Vital character urgent assistance.

A. Concept and requirement: It is considered a situation of urgency of a vital nature in that a pathology has been produced whose nature and symptoms make foreseeable a vital risk imminent or very close, or irreparable damage to physical integrity of the person not to obtain a therapeutic action immediately.

In order for the mutualist or beneficiary to have the right to cover the costs incurred by the use of foreign media in a situation of vital urgency, the other means to which the patient is directed or transferred must be reasonably chosen, taking into account the circumstances of place and time when the pathology occurred, as well as the decision-making capacity of the patient and, where appropriate, the persons who provided the first aid.

B. Special situations of urgency: They shall be deemed to have always met the condition of urgency of a vital nature and that the assistance received in other means has also the requirement laid down in the preceding letter, the following situations special:

1. Where the MUFACE mutualists belonging to the National Police Corps require assistance in other means of injury or bodily harm suffered in the exercise of the functions of the Body or on the occasion of acts committed by persons integrated into organised and armed bands or groups.

2. Where the mutualist or beneficiary is on the public road or places and public health emergency teams (112, 061, etc.) are activated by a person other than that or his or her family members in the event that they are accompanied.

3. When the activation of public health emergency equipment is performed by the state security bodies or other non-sanitary emergency structures (firefighters, etc.).

4. When the mutualist suffers an accident at the service and is treated by the public health emergency teams at the place where it occurs.

5. Where the beneficiary resides in a centre of assisted living or in a centre for chronic and public health emergency teams are activated by the staff of the centre, or where the person resides at home, and such equipment is activated by a public financing teleassistance service, in both cases provided that the person or his/her family has communicated to the centre its membership for the purposes of its health care.

C. Scope: For the purposes of the coverage of the expenses incurred, the emergency situation of a vital nature extends from the entrance to the hospital discharge (including possible transfers to other non-concerted centers for reasons). assistance), except in the following two scenarios:

1. When the Entity, with the compliance of the medical team that is providing the assistance, offers a care alternative that allows the patient to be transferred to a proper or appropriate center and the patient or his or her family members responsible refuse to do so.

2. When the patient is referred to a second foreign center and there are no causes to prevent the continuity of treatment at a center of the Entity.

D. Communication to the Entity: The mutualist or beneficiary, or other person on its behalf, shall communicate to the Entity the assistance received with other means by any means that permits the communication to be recorded, contributing the corresponding emergency medical report, within 48 hours of the start of the assistance, unless exceptional circumstances, duly justified, have prevented them from communicating the assistance received with other means.

E. Obligations of the Entity: When the Entity receives the communication of the assistance of a beneficiary in non-concerted means, it must answer, within 48 hours after the receipt of the communication and by any (a) means that it allows to be kept on record, if it recognises the existence of the situation of vital urgency and therefore accepts payment of the costs incurred or if, on the other hand, is not deemed to have been obliged to pay for understanding that there has not been a Emergency situation of a vital nature.

In the event that the Entity recognizes the existence of the emergency situation, it must inform the health provider that it is directly responsible for the expenses incurred, in order to be issued by the entity. corresponding invoice to the Entity. If the person concerned has paid the expenses, the Entity shall make the refund within 10 calendar days of the date on which it applies for reimbursement by submitting the supporting documents for the expenses.

In the event that the Entity is not considered obligated to pay for understanding that the situation of vital urgency has not existed, it will issue, within a maximum period of seven calendar days, a report arguing and substantiating such a situation. This shall be the case and shall transfer the same to the mutualist or beneficiary and to the Delegation of MUFACE for staff abroad (hereinafter the Delegated Office.

When the person concerned has not made the communication in time and form, the Entity will refund the amount within one month from the date on which the corresponding invoice is presented and, if applicable, the supporting document fertilizer. If the Entity has not made the provision in this clause, it shall be obliged to pay directly to the healthcare provider if the person concerned requests it.

3.3.8 Without prejudice to clause 2.2.9 A, for health transport in Spain the Entity shall cover the costs for ordinary transport in the cases specified below:

A. Where the required means do not exist, so that the mutualist or beneficiary is obliged to move from the locality in which he resides, on a temporary or permanent basis, to the nearest locality where those exist.

B. Level IV Services and Reference Services located in a province other than that of residence.

C. In the case of transfers necessary to another locality other than that of residence for health care resulting from an accident in service or occupational disease.

You shall be entitled to travel expenses for accompanying travel effected, in accordance with the preceding paragraphs, by patients:

A. Under the age of 15 years and in the case of the cities of Ceuta and Melilla and island provinces, children under the age of eighteen.

B. With a degree of disability equal to or greater than 65%, duly accredited.

C. Residents in the cities of Ceuta and Melilla and the island provinces when prescribed by their responsible doctor, in which case they shall provide written prescription of the optional.

For these purposes, it is considered ordinary means of transport that is carried out by car, bus, railway, or if it comes (because it is the island provinces or cities of Ceuta and Melilla) by boat or plane. Transfers shall always be valued at their cost, in normal or tourist class, on regular bus, rail, boat or aircraft transport lines.

3.3.9 Principle of continuity of care. If during the validity of the Concert there is the absence of some concerted means, or in the case that the contracting entity is the same as for the previous Concert but has modified its Catalogs will be of application the following stipulations:

A) If the absence of any professional of the Catalogues of Services occurs, the Entity will guarantee the continuity of care with the same optional to the patients in treatment of serious pathological processes the six months following the date on which the discharge occurred, provided that the practitioner can continue the exercise of his or her profession and that he is in conformity with him.

B) If the discharge refers to a health center or hospital service, the Entity will guarantee to the patients that the continuity of treatment of the same in that center is being taken care of a certain pathological process service, for as long as the need for the service persists or until the discharge has been obtained. Such care continuity shall be carried out in any case for a maximum period of one year, provided that the Entity has a valid care alternative to treat that pathological process.

The Entity must inform each patient in writing about its right to maintain the treatment and continuity of care in the said center or service, with charge to the Entity, according to the provisions of the the above clause within a period not exceeding seven calendar days, from the date of the centre or service discharge.

3.3.10 Transitional provisions for the assistance of mutualists and beneficiaries attached to the Health Care Concert abroad as at 31 December 2015:

A. Patients who at December 31, 2015 were being treated in Spain for serious pathologies in the media arranged by the contracting entity of the Health Care Concert in the Exterior of MUFACE for the years 2012-2015 and that, by application of the stipulations of this Concert, they must pass on to receive the assistance in means arranged by the new Entity, they shall inform the Entity so that it offers in writing before the end of the fifth working day following the communication the valid care solution at the appropriate level. Throughout this period, the Entity must take care of the expenses incurred by the continuity of the patient's assistance in the means provided by the previous Entity.

B. The provisions of the preceding paragraph shall extend to maternity care when the delivery is scheduled for January or February 2015.

C. The costs arising from the assistance of patients who at 31 December 2015 were receiving it in the hospital, whether in the home, in the day or in detention, in centres not arranged by the Entity in this Concert. be assumed by the latter until the date of the discharge of the current episode or, in any case, until the continuity of treatment can be ensured in the healthcare facilities or facilities of the Entity.

3.3.11 Special provisions for assistance in certain processes to the mutualists and beneficiaries attached to the Concert during its term of office.

When the assignment to this Concert of any patient occurs during a serious and/or complex care process by which, in his or her condition as a collective protected by MUFACE, he was previously treated in the territory of the In the case of media not agreed upon by the Entity, this duty should be borne by outside media until the process is high.

CHAPTER 4

Healthcare information and documentation

4.1 General rules.

4.1.1 In order for MUFACE to have the information necessary for the assessment of the health benefits to be covered by this Concert, its planning and decision-making, the Entity will provide all the necessary information. details specified in this Chapter on the services provided to the mutualists and beneficiaries. It will also do so for those who, although not specified, during the validity of the Concert could be sued by the Ministry of Health, Social Services and Equality in the context of the development of the System Information System National of Health.

4.1.2 The Entity is obliged to comply with all the requirements laid down in Organic Law 15/1999, of December 13, of Protection of Personal Data and in its development regulations, in relation to the information and health documentation relating to the mutualists and beneficiaries of MUFACE, as well as to safeguard the exercise of the rights of the patients referred to in Article 10 of Law 14/1986 of 25 April, General of Health and Law 41/2002, of 14 November, regulator of the Autonomy of the Patient and of rights and obligations in matters of Information and Clinical Documentation, especially with regard to informed consent and respect for the prior instructions, rights established by Articles 10 and 11 of that law.

4.2 Activity information.

4.2.1 The Entity will have a system of care information that allows to know the number, type and cost of the services provided to the mutualists and beneficiaries of MUFACE and the country where the assistance, all in accordance with the format set out in Annex 5 to this Agreement.

4.2.2 The Entity will provide MUFACE with the data on the care activity of each calendar quarter through its referral, in computer support, within three months of the end of the corresponding period.

4.3 Health care management information.

4.3.1 The Entity will have a system of information about the management carried out that allows to know the number of steps taken for the application and fulfillment of the Concert, all according to the format that appears in the Annex 5 to this Agreement.

44.3.2 The Entity shall provide MUFACE with the data on the management of each calendar quarter by means of its referral, in computerised form, within three months of the end of the corresponding period.

4.4 Information about the means offered or agreed. The information of the own and concerted means offered by the Entity to provide the service shall be sent in electronic form to MUFACE annually in accordance with the requirements set out in paragraph 3 of Annex 5. The referral to MUFACE of the electronic support containing such information shall be made by the Entity before 1 December of the year preceding the year to which the information relates.

4.5 Clinical and health documentation.

4.5.1 The costs of medical reports, scans or diagnostic tests that prescribe the MUFACE mutualists for assessment, qualification, declaration or disability review shall be borne by the Entity. permanent in order for the recognition of retirement for permanent incapacity for service or permanent disability pension.

4.5.2 Furthermore, the Entity must also bear the costs of medical reports, scans or diagnostic tests that prescribe the MUFACE mutualists for the assessment, qualification, declaration or review, of the Temporary incapacity, risk during pregnancy or risk during natural lactation, for any other benefit managed by the Mutuality.

4.5.2 The entity shall be responsible for the costs incurred by the issuing of the documentation, reports or certificates on the health status of the mutualists and beneficiaries which are required by law or regulation, as well as the necessary for the management of the benefits that MUFACE manages.

4.5.3 Likewise, the Entity must also bear the costs for the issuance of the medical documentation or certification of birth, death and other ends for the Civil Registry, and other reports or certificates on the status of legal or regulatory provision for health.

CHAPTER 5

Legal Regime of the Concert

5.1 Legal Regime of the Concert.

5.1.1 This Concert is governed by:

A. The Recast Text of the Law on Social Security of Civil Servants of the State, approved by Royal Legislative Decree 4/2000, of 23 June, in particular the forecasts contained in its article 5.2, which states that the Concerts for the provision of healthcare and pharmaceutical services is the one established by this same Law and its implementing rules, those contained in Article 16 which establishes the content of health care that MUFACE must to provide to their protected mutualists and beneficiaries and in Article 17.1, which provides for assistance health may be provided by Concert with public or private entities.

B. The General Regulation of Administrative Mutualism, adopted by Royal Decree 375/2003 of 28 March 2003, in particular the provisions of Articles 85 and 86 thereof on the content and methods of coverage of healthcare provided outside the national territory to the mutualists and beneficiaries of MUFACE intended and/or resident abroad and in Articles 77 and 151.3 on the arrangements for the provision of services and their basic content for the provision of services medical care by MUFACE.

C. The Royal Legislative Decree 3/2011 of 14 November, approving the recast text of the Law on Public Sector Contracts, and its regulatory development.

5.1.2 Application health standards. With regard to the content of the health benefits included in Chapter 2, this Concert will be in accordance with its own clauses as well as, if in doubt, the content of Spanish basic health legislation and more specifically to the provisions of Law 16/2003, of 28 May, of Cohesion and Quality of the National Health System and Royal Decree 1030/2006, of 15 September, establishing the portfolio of common services of the National Health System and the procedure for updating them or the rules which could replace them, develop them or complement them.

5.2 Regime of relationships based on the Concert.

5.2.1 Regime of care relations: This Concert does not imply or cause any relationship between MUFACE and the medical means that the mutualists and beneficiaries have freely chosen to receive assistance. or that the Entity has, for that purpose, made available to them. The relationships between the Entity and such sanitary means are also alien to the Concert.

Consequently, they are also alien to the set of rights and obligations that determine the ends of the Concert and are configured as autonomous relations between the parties, those that occur between the mutualists and beneficiaries with the health means which have assisted them because it affects or relates to the care activity of those means or the operation of their facilities or for reasons affecting or relating to the scope of the professional practice of the (a) optional, under any title, to develop their activity in such centres.

These relationships shall have the nature that, in accordance with the law of the country in which the relationship has occurred, corresponds to its content and, the knowledge and decision of the questions that may arise therein, shall be within the jurisdiction of that State.

5.2.2 Regime of the relationship between MUFACE and the Entity: Issues arising in the field of the relations between MUFACE and the Entity, in order to comply with the rights and obligations that, according to Clause 1.1 constitute the object of the Concert or in the field of relations between the mutualists and beneficiaries and the Entity, in order to comply with the same care obligations contained therein, shall be of an administrative nature, in the terms of the Spanish Administrative Law and will be resolved by the organ of MUFACE that has attributed to the competition, prior to the procedure provided for in clause 5.3 of this Concert.

Against these resolutions, he will appeal to the person of the Ministry of Finance and Public Administrations. The competent court shall, where appropriate, always be the administrative dispute.

5.2.3 Regime of the relationship between MUFACE and the re-present accredited by the Entity abroad: The representation agreements that underwrite the Entity will not produce relations between MUFACE and the Representative Entity, the obligations contained in the Concert shall always be construed as being the sole responsibility of the Concerted Entity.

5.3 Mixed Commission.

5.3.1 The Joint Committee, with a joint composition, will be composed of at least two representatives of MUFACE and two of the Entity. The President shall be appointed by the Director-General of MUFACE and as Secretary shall act as an official of MUFACE.

5.3.2 The Joint Commission is committed to:

a) The monitoring, analysis and assessment of compliance with this Concert.

b) The analysis of MUFACE's initiatives on economic compensation for partial non-compliances of the Concert and on deductions for failures of availability.

(c) The knowledge of claims that may be made by the mutualists and beneficiaries with a document assimilated to that of affiliation or, where appropriate, of trade by MUFACE, according to the terms of the Concert.

For the purposes of the tasks set out in paragraphs (b) and (c) it is understood that with the intervention of the Entity it takes place for the same the fulfillment of the procedure laid down in article 84 of Law 30/1992, of 26 of November, the Legal Regime of Public Administrations and the Common Administrative Procedure.

5.3.3 The operating system of the Joint Commission shall be as set out in the following paragraphs and, where not provided for in them, the rules on the functioning of the collective bodies provided for in Law 30/1992 shall apply. November 26.

The Commission shall meet on an ordinary basis, provided that there are matters to be dealt with, in the first 15 days of each month and on an extraordinary basis, at the request of either party, provided there are matters to be dealt with do not admit delay. In the event of a failure to attend a meeting of the representatives of the Entity, it shall be understood that the entity accepts the agreements that MUFACE adopts in relation to the matters included in the agenda of the meeting.

For each session, the secretary, whose draft, with his signature, will immediately be sent to the Entity for knowledge, conformity and return. This refund, signed by the representative of the Entity, must be carried out within the maximum period of seven working days. Once signed by the representative of the same, it will be understood as approved. If there are discrepancies in the content of the minutes, they shall be settled by means of appropriate arrangements between the two parties and, in any case, at the following meeting.

5.4 Procedure for claims.

5.4.1 Mutualists and beneficiaries with a document assimilated to that of affiliation may claim from MUFACE that they agree to the origin of any action by the Entity for refusing or not to answer a request for a benefit or some other of the obligations set out in the Concert.

This administrative route is not appropriate for complaints about the relationships mentioned in clause 5.2.1. In the event of a question, the person concerned will be replied that, due to the lack of competence of MUFACE, it is not possible to resolve the merits of the complaint, indicating that it can be made, if appropriate, to the centres, in the court of the country in which the facts were produced.

In those exceptional circumstances in which the mutualist or beneficiary with a document assimilated to that of affiliation cannot lodge a claim and a billing has occurred in his or her name or in any of its beneficiaries, an assistance that the Entity may be required to reintegrate, MUFACE may automatically initiate the complaint that it deems appropriate before the Joint Commission, motivating the cause of that initiation of trade.

5.4.2 Resolution of complaints: Claims will be made in writing to the MUFACE Delegate Office for staff abroad (hereinafter the Delegate Office), accompanying as many documents as possible. same.

Received any claim, the Delegate Office, if you initially consider that there are reasons for your estimation, will immediately take the necessary steps before the Entity to obtain satisfaction, in whose case will be closed without further formalities with annotation of the solution adopted. In the event that the said procedures do not prosper, the Delegate Office shall formalize the appropriate file and forward it to the Department of Health Services, which shall include it on the agenda of the immediate meeting of the Joint Committee. The corresponding minutes will be drawn up, in which the positions of MUFACE and the Entity on the complaint raised will necessarily be established.

In any event the claim will be settled by the MUFACE General Directorate within three months from the filing of the claim, notifying the content of the claim to the Entity and to the interested party.

Against resolutions handed down by the Directorate-General of MUFACE, an appeal may be brought before the head of the Ministry of Finance and Public Administrations, in accordance with the provisions of Articles 107 to 115 of Law 30/1992, of 26 November.

5.4.3 Estimated claims execution procedure: In complaints positively resolved by the MUFACE General Directorate, the execution procedure will be as follows:

(A) The Entity shall, within one month of the notification of the decision, carry out the reimbursement of the costs claimed, on presentation, where appropriate, of the appropriate supporting documents, which shall, for that purpose and he has submitted them, shall be returned to the claimant, indicating, where appropriate, his credit.

In the case of the requested benefit authorization, the deadline will be ten days.

B) Within the period referred to, the Entity shall inform the Delegated Office which has made the payment, or that the payment has not been made because the person concerned has not submitted, has not provided the appropriate supporting documents or has not accepted the referred payment.

C) If MUFACE had not received this communication within the indicated time limit or if, after this deadline, it was aware that the payment to the person concerned would have been refused, on any occasion, the Head of the Office Delegated, without further formalities and provided that it is in force at that time in force with the Entity or out of application the provisions of clause 6.1.3, will issue certification of the adopted agreement and subsequent facts and will forward it to the Department of Economic and Financial Management of MUFACE. It shall also, without further requirements, propose the appropriate agreement to the Directorate-General and deduct the amount corresponding to the immediate monthly payment to the Entity.

In the case of administrative decisions or judgments that resolve appeals against acts of MUFACE in respect of expenses subject to this Concert, the payment of the amount in each case It will be made directly by MUFACE to the person concerned on behalf of the Entity, deducting the amount of the monthly fees to pay to it and making it easier for the document to prove that the payment has been made on its own.

5.4.4 Reimbursement of expenses unduly assumed by MUFACE: When MUFACE detects that it has assumed expenses for benefits covered in this Agreement that should have been in charge of the Entity, including the billing of Pharmacy offices, the Mutuality shall, after communication to the Entity, carry out the corresponding discount on the monthly payment of the fees to be paid to it, in accordance with the provisions of clause 6.2 of this Concert.

5.5 Economic compensations for partial default of obligations defined in the Concert and deductions for failures of availability. Procedure for their imposition.

5.5.1 Economic compensation for partial non-compliance with obligations defined in the Concert:

The Entity is required to meet the expected obligations and deadlines set out in clauses 3.1.4, 3.1.5, 3.2.4 and 3.2.5 of this Concert.

Failure to comply with any of these obligations will result in the imposition of the corresponding economic compensation on the terms that, in the following paragraphs, are established:

A. Lack of availability or operability of the information and telephone support service.

If the Entity does not have the information and telephone assistance service provided for in clause 3.1.4 or the same is not operational, the Entity will be obliged to satisfy an economic compensation of 30,000 euros for each month or fraction of the month that the non-compliance occurred.

B. Lack of availability or operability of the Entity's web page.

If the Entity does not have the web page provided for in clause 3.1.5 or the same is not operational, the Entity will be obliged to satisfy an economic compensation of 30,000 euros for each month or fraction of the month produced the non-compliance.

C. Delay in the direct payment of invoices to healthcare facilities or professionals.

In the assumptions regulated in clauses 3.2.2. E and 3.2.4 in that the Entity must directly satisfy the amount of the expenses generated to the centers or health professionals when they agree to issue the invoice to the Entity, if that does not make the payment within 60 days, will come required to pay an economic compensation of 10% of the amount invoiced if it does so within the following month, with the compensation being increased by an additional 10% for each month or fraction of the month after payment. This economic compensation is independent of any surcharges that the health care professional may impose on the Entity for the delay.

D. Delay in payment of refunds.

If the Entity has not made cash the refund to the mutualist or beneficiary with a document assimilated to that of affiliation, within 10 working days of the date on which it received the relevant documentation, in accordance with clause 3.2.5, the latter shall be required to pay an economic compensation of 10% of the amount of the reimbursement if it does so within the following month, with the compensation being increased by an additional 10% for each month or fraction of the month elapsed until your credit.

5.5.2 Deductions for failures of availability: The absence of any of the delegations of the Entity, whether their own branches or accredited representatives, is understood as a failure of availability in the localities that it offers in the outside for the subscription of this Concert. Where an availability failure occurs, the Entity shall count, from the day following that MUFACE has communicated it, the one-month time limit for its correction.

Transfer of the time of correction without the delegation being replaced in the same locality, either own branch or accredited representative, an economic deduction shall apply for each day of the transfer from the following to on the end of the correction period. The amount of the daily deduction shall be calculated as follows:

A. Where there is no other delegation of the Entity in the same country, a daily deduction shall be applied which shall be 10% of the product of the number of mutualists and beneficiaries resident in that country by the daily premium.

B. Where there is another delegation of the Entity in the same country, a daily deduction shall be applied which shall be 5% of the product of the number of mutualists and beneficiaries resident in the locality where the availability of the premium has occurred. daily.

C. The daily premium referred to in the preceding letters shall be calculated by multiplying by 12 the monthly premium set out in clauses 6.3.1 and 6.3.2 and dividing the result by 365.

5.5.3 Procedure for the imposition of financial compensation and deductions for failures of availability: In cases where a breach of the obligations set out in the clauses has been detected 3.1.4, 3.1.5, 3.2.4 and 3.2.5, in the terms described in clause 5.5.1, or a failure of availability which, in accordance with clause 5.5.2, ended the correction period has not been communicated by the Entity which has been subsated, the Department of Health benefits of MUFACE shall include the case for failure to comply or failure to availability for their study on the agenda of the immediate meeting of the Joint Commission for the Entity to present the related allegations. In the case of the case, the positions held by MUFACE and the Entity will be included in the Commission's minutes. In the event that the positions are consistent and the result thereof is that such failure or failure is considered as unproduced, it is sufficient that this end is included in the approved act to end the matter.

In case of agreement with the existence of a default or failure, or in case of disagreement of the parties in the Joint Commission it will resolve the Directorate General of MUFACE that will fix the amount of the corresponding economic compensation or deduction.

According to the terms set forth in the resolution of the MUFACE General Directorate, the following monthly payment will be made to the Entity the cost of the compensation or deduction and will be notified to the Entity that will be able to to bring an appeal before the person holding the Ministry of Finance and Public Administration, as provided for in Articles 107 to 115 of Law 30/1992, of 26 November.

When the availability failure has not been corrected at the date of the Joint Commission's conclusion, the daily deduction shall be made until the date on which the correction is communicated. the corresponding monthly discounts reporting the same to the Entity at the next session of the Joint Commission.

CHAPTER 6

Duration, economic regime and price of the Concert

6.1 Duration of the Concert.

6.1.1 The effects of this Concert shall be initiated at zero hours of the day one January 2016 and shall be extended to 24 hours on the thirtieth day of December 2017.

6.1.2 Finished the duration of the Concert if a new Concert with the Entity is not formalized for the year 2018, MUFACE will retain until thirty one of January 2018 a ten percent of the amount to pay to the Entity the month of December 2017, with the sole purpose of dealing, on behalf of the Entity, with the reimbursements of expenses that are agreed during the year 2018 under this Concert. If the estimated quantity is exhausted or refunds are agreed after the date indicated, the Entity is obliged to satisfy them directly and immediately.

6.2 Economic Regime.

6.2.1 Economic effects and monthly payments: The payment shall be made in accordance with the terms set out in Article 216 of the TRLCSP, in the firm and in favour of the contracting entity, in the form that is regulated in the following headings, upon submission of the electronic invoice through the Electronic Invoice Entry Point (FACE) and the certificate of compliance of the contract's proposer unit.

The additional provision of the HAP/492/2014 Ministerial Order of 27 March 2014 governing the functional and technical requirements of the accounting records of entities in the scope of the law 25/2013, of December 27, of impulse of the electronic invoice and creation of the accounting record of invoices in the Public Sector, determines that the invoices are issued by collecting the codes established in the directory DIR3, therefore the codification of administrative bodies in this contract is:

DIR3 Code

Body Manager (OG).

E00106104

General State Civil Officials Mutuality (MUFACE)

Accounting Office (PO).

EA0003306

Accounting Service (MUFACE)

Unit (UT).

EA0003307

Hiring Service (MUFACE).

Proposer Unit (UP).

E02660204

Health Benefits Department.

Without prejudice to birth and extinction for mutualists and beneficiaries of rights derived from the Concert in the terms provided for in clause 1.5, the high level will cause economic effects at zero hours of day one. of the month following the month in which they occur and the casualties within 24 hours of the last day of the month in which they took place.

Each monthly payment shall be the result of multiplying the amount of the monthly premium by the number of existing mutualists and beneficiaries at zero hours of the day one of the month in question and shall be made by MUFACE, by the bank transfer, within the first fifteen working days of the following month, prior to the withholding or discounts which it has made in accordance with the provisions laid down in this Convention or in the Resolution of Convocation, including economic compensation and deductions for failures of availability on the terms set out in the clause 5.5. The monthly payment for December may be anticipated, in whole or in part, in the last ten days of that month.

6.2.2 Information on the variations produced: MUFACE will communicate to the Entity the high, low and variances of mutualists and beneficiaries produced, through the most immediate possible procedure. Similarly, MUFACE will deliver, together with the settlement of each month and in the most appropriate support, the relation with the data of all the ups, downs and variations in the previous month, communicating the figure of the total collective assigned to the Entity, referred to zero hours on the first day of the month that is liquid.

The relationship may be verified by the Entity, so that, if you consider that there are differences, you can make the subsequent complaint to MUFACE, attaching the information on which the claim is based, within the time limit. maximum of three months from the monthly communication of the status of the collective and relation of incidents. After this period, without any claim, it will be understood that there is conformity on the part of the Entity, acquiring firmness the payment made, according to this collective. The complaints submitted shall be resolved by MUFACE within three months of the date of filing.

6.2.3 Taxes and Remedies: All taxes, arbitrations, fees and charges that are taxed on the acts resulting from this Concert shall be on behalf of the Entity.

In the case of health care for injuries caused or a disease caused or aggravated by accidents covered by any form of compulsory insurance, on the basis of the legislation of the country where the caused, or where the cost of the healthcare provided is to be met by public bodies or private entities in the State where the patient resides or where the fact has occurred, the Entity, without prejudice to any case of assistance, may be subrogated to the rights and actions of the mutualist or beneficiary relating to the amount of the expenditure arising from such health care, taking the necessary steps to reintegrate the costs of the health care. The mutualists or beneficiaries, for their part, shall be obliged to provide the Entity with the data necessary for this purpose.

Whenever there is a firm court judgment in which MUFACE is ordered to pay compensation, arising from direct or subsidiary liability for assistance actions included in the object of the Concert, MUFACE, without Prejudice to the execution of the judgment, the amount paid to the corresponding agreed entity shall be passed in accordance with the procedure laid down in clause 5.4.3 of this Concert.

6.3 Price of Concert. The monthly premium that MUFACE will pay to the Entity for the obligations that it corresponds to under the Concert for its entire duration, will be a maximum of 154.05 euros per month for each mutualist or beneficiary. Payments will be satisfied by application 15.106.312E.251.01, within the Agency's budgetary availabilities.

ANNEX 1

Service Portfolio

A. Preventive assists.

1. Immunizations.

• Vaccines of the children's vaccination program of the Spanish National Health System and/or the State of residence or destination.

• Vaccines of the adult vaccination program of the Spanish National Health System and/or the State of residence or destination.

• Systematic vaccines recommended by the World Health Organization 1, as well as those recommended according to the geographical area of residence or work, or for belonging to groups at risk.

• Specific vaccination campaigns established as compulsory by the State of residence or destination.

• Mandatory vaccinations for travelers who are required for entry into the country according to the International Health Regulations, provided that the reason for posting is labor.

2. Neonatal screening programs for endocrine-metabolic diseases in the basic common portfolio of the Spanish National Health System.

3. Cancer screening programs of the basic common portfolio of the Spanish National System care services.

B. Relationship of covered specialties *.

1. Medical and surgical specialties:

• Family and Community Medicine.

• Alergology.

• Pathological Anatomy.

• Anesthesiology and Resuscitation.

• Angiology and Vascular Surgery.

• Digestive System.

• Cardiology.

• Cardiovascular Surgery.

• General and Digestive Tract Surgery.

• Oral and Maxillofacial Surgery.

• Orthopaedic and Traumatology Surgery.

• Pediatric Surgery.

• Plastic, Aesthetic, and Repairing Surgery.

• Thoracic Surgery.

• Medical-Surgical and Venereology dermatology.

• Endocrinology and Nutrition.

• Clinical Pharmacology.

• Hematology and Hemotherapy.

• Physical Medicine and Rehabilitation.

• Intensive Care Medicine.

• Internal Medicine.

• Nuclear Medicine.

• Preventive Medicine and Public Health.

• Nephrology.

• Pneumonia.

• Neurosurgery.

• Clinical Neurophysiology.

• Neurology.

• Obstetrics and Gynecology.

• Ophthalmology.

• Medical Oncology.

• Radioterapic Oncology.

• Otorhinolaryngology.

• Pediatrics and their specific areas.

• Psychiatry.

• Diagnostics.

• Rheumatology.

• Urology.

2. Other:

• Clinical Analysis.

• Clinical Biochemistry.

• Microbiology and Parasitology.

• Immunology.

3. Other health professions:

• Physical Therapy.

• Psychology.

• Matron.

• Logopedia.

• Nursing.

• Odontostomatology.

• Podology.

* In any case, the equivalent specialties in care content and benefits in the official name that they have in the country of residence ..

ANNEX 2

Media availability criteria in national territory by care levels

1. General criterion. The Entity must ensure access to the means that at each level requires the Services Portfolio of this Concert in the terms specified below, unless there are no private or public means.

The definition of the care levels and the specialties required in each of them are detailed in the following points, although in application of article 85 of the RGMA, they will be updated automatically by the criteria established for the provision of health care to mutualists intended for national territory.

2. Availability of Primary Care Media.

2.1 All the municipalities will have Primary Care, which will include health care at the outpatient, home and emergency level in charge of the general practitioner or family, pediatrician, nursing graduate, matron, physiotherapist, dentist and podiatrist, according to the following criteria:

(a) The municipalities of less than 10,000 inhabitants will always have a general or family doctor and a diploma in nursing. In addition, the municipalities from 5,000 inhabitants will have a paediatrician.

b) The municipalities of more than 10,000 inhabitants will also have physiotherapists and odontostomatologists.

(c) The municipalities of more than 20,000 inhabitants, in which more than 500 MUFACE beneficiaries reside, will also have a podiatrist and a midwife, increasing the number of professionals according to the number of beneficiaries. as follows:

1) A general or family physician and a nursing graduate will be increased for each increase of 500 resident beneficiaries.

2) A pediatrician, odontostomatologist, and physical therapist will be increased for each increase of 1,000 resident beneficiaries.

3) A podiatrist and a midwife will be increased, for each increase of 2,000 resident beneficiaries.

d) The municipalities of more than 100,000 inhabitants will have Primary Care services in all postal districts or, failing that, in a border district.

2.2 Primary Emergency Care will be provided, on an ongoing basis, during the twenty-four hours of the day, through medical and nursing care on an outpatient and home basis.

2.3 If, exceptionally, the Entity does not have its own or agreed means, it must guarantee the coverage of the assistance by other private services that exist in the same municipality or, if those services do not exist, by the corresponding public services.

2.4 As an additional criterion, it will be taken into account that, in the rural areas expressly provided for in the conventions referred to in Annex 2 to this Agreement, and with the scope and content stipulated in each of them, the Health care at the outpatient, home or emergency level, in charge of the general practitioner or family, pediatrician, nursing graduate and matron may be provided by the Primary Care and Emergency Services of the Public Health Network. In any case, the beneficiaries resident in the municipalities included in the respective rural agreements, may choose to be cared for in the means available to the Entity in the nearby municipalities.

In any case, and for the assistance of this Concert, the services of Primary Care and Emergency Services of the Public Health Services are assimilated to the means of the Entity, in accordance with the provisions of the rural conventions referred to in Annex 2 to this Agreement.

2.5 In the municipalities of less than 20,000 inhabitants belonging to autonomous communities with which the collaboration agreements provided for in the previous point have not been formalized, or these only have as their object the assistance In the case of emergency health, and where the Entity does not have its own or concerted means, and there is no private means, it shall facilitate the access of the beneficiaries to the Primary Care services dependent on the relevant Community Autonomous, both for ordinary and urgent assistance, directly assuming the expenses that can be billed.

3. Definition of the Specialized Care and Service Portfolio Levels.

3.1 The Specialized Care will be dispensed in conditions of equivalence with the municipalities or groups with population from 20,000 inhabitants and 500 beneficiaries of MUFACE residents.

The various benefits included in the Portfolio of Care Services to facilitate by the Entity are structured in four levels in increasing order, in which definition is addressed to general population criteria, number of resident beneficiaries, as well as distance and time of travel to urban centres where there is a greater availability of private health resources.

3.2 Furthermore, and taking into account the above, for the purpose of optimising the availability of concerted private media, some municipalities are grouped by geographical proximity and ease of transport, as well as by concentrating a higher number of beneficiaries, in such a way that the supply of the required means at that level in any of the municipalities listed in the corresponding listings by level of Specialized Care will be considered valid.

3.3 Each Level of Specialized Care includes the means required at the lower level of care, in addition to the Primary Care services that correspond, according to the provisions of point 2 of this section. Annex.

3.4 The following descriptive tables are included in point 3.9 of this annex:

a) In tables 1, 2 and 3, the required specialties are related to each level of specialized care in outpatient or outpatient settings, hospital and hospital emergency.

b) In Table 4, the units and multidisciplinary teams are related to levels of care.

c) In Table 5, the specifications corresponding to the contents of the different specialties are related.

3.5 Level I Care.

3.5.1 The territorial framework of the Level I of the Specialized Care is that of the municipalities and groupings that with the criteria defined above are related in the following table:

Province

Cadiz.

.

Murcia.

.

Lalin.

Municipalities and Level I

A Coruña.

Cambre.

A Coruña.

Carballo.

A A Coruña.

Culleredo.

Ribeira.

Albacete.

Almansa.

Albacete.

Villarroledo.

Alicante/Alacant.

Campello/ Muttxamel.

Alicante/Alacant.

Sant Vicente de Raspeig/Sant Joan d' Alacant.

Almería.

Adra.

Barcelona.

Barcelona.

Castellar del Valles.

Barcelona.

Esparraguera/Olessa from Monserrat/Martorell.

Barcelona.

Igualada.

Barcelona.

Masnou.

Barcelona.

Sea Premia

Barcelona.

Sant Andreu de la Barca/Molins del Rei/Sant Vicenc dels Horts.

Barcelona.

Sitges.

Bizkaia.

Bizkaia.

Basauri/Sestao.

Bizkaia.

Santurzi/Portugalete.

.

Cadiz.

Cadiz.

.

San Roque.

Cantabria.

Camargo.

Castro-Urdials

Castro-Urdials.

Cantabria.

Pielagos.

Castellón/Castello.

Burriana.

Castellon/Castello.

Wave.

Castellon/Castello.

Vall d' Uixo (La)

Castellon/Castello.

Villa-Real.

.

Open.

Montilla

.

Priego of Córdoba

Gipuzkoa.

Irun/Errenteria.

Girona.

Blanes/Lloret de Mar.

Granada.

Almuñecar.

Granada.

Armilla.

Granada.

Baza.

Granada.

Loja.

Granada.

Maracena.

Guadalajara.

Huelva.

Lepe

Illes Balears.

(Mallorca Island)-Calvia.

Illes Balears.

(Isla de Mallorca)-Inca.

Illes Balears.

(Isla de Mallorca)-Llucmajor.

Illes Balears.

(Mallorca Island)-Marratxi.

Illes Balears.

(Menorca Island)-Minorca Citadel

Illes Balears.

(Menorca Island)-Mahon.

Jaen.

Alcala the Real.

Jaen.

Martos.

The Palms.

(Gran Canaria Island)-Aguimes.

The Palms.

(Gran Canaria Island)-Arucas.

Palmas.

(Gran Canaria Island)-Galdar.

Gran Canaria Island)-Ingenio

Palmas.

(Isle of Lanzarote)-Teguise.

Madrid.

/Toledo.

Madrid/Toledo.

Madrid/Toledo.

Madrid.

Madrid.

.

Jarama Paracoulos.

Madrid.

Villaviciosa Odon.

Malaga.

Coin.

Murcia.

.

Murcia.

.

Alhama de Murcia/Totana.

Murcia.

Murcia.

Navarre.

Navarra.

Navarra.

Baranain.

Pontevedra.

A Estrada.

Cangas.

Canges.

Lalin.

Marin.

Pontevedra.

Redondela.

, la.

Calahorra.

Santa Cruz de Tenerife.

(Palma Island)-Ariadne Llanos

Santa Cruz de Tenerife.

(Tenerife Island)-Candelaria.

Santa Cruz de Tenerife.

(Isla de Tenerife)-Icod de los Vinos.

Cruz de Tenerife.

(Tenerife Island)-Tacoronte.

Sevilla.

.

Sevilla.

.

Seville.

Carmona.

Seville.

Rio Coria.

Seville.

The Rinse.

Seville.

Lebrija.

Seville.

The Palacios and Villafranca.

Seville.

Mairena de Alcor.

Seville.

Mairena de Aljarafe.

Seville.

Border Moron.

Seville.

San Juan de Aznalfarache.

Seville.

Tomares.

Tarragona.

Salou/Vila-Seca.

.

Valls.

Toledo.

Ills.

Valencia/Valencia.

Valencia/Valencia.

Algemesi.

Valencia/Valencia

Valencia/Valencia.

Valencia/Valencia.

Burjassot/Paterna/Mislata.

Valencia/Valencia.

Catsheds.

Valencia/Valencia.

Cullera.

Valencia/Valencia.

Paiporta.

Valencia/Valencia.

/Valencia.

Quart de Poblet/Manises.

Valencia/Valencia.

Valencia/Valencia.

Valencia/Valencia.

Turia.

Valencia/Valencia.

Valencia/Valencia.

Torrent.

Xativa.

Valencia/Valencia.

Xirivella/Alaquas/ Aldaia.

Valladolid.

Duero Lagoon.

Valladolid.

Field Medina.

Zaragoza.

Calatayud.

3.5.2 These municipalities and groups shall have at least the means of attention specified in Table 1, which shall include health care on the basis of external or outpatient consultations, with the specifications identified in Table 5.

3.6 Level II of Specialized Care.

3.6.1 The territorial framework of the Level II of the Specialized Care is that of the municipalities and groupings that with the criteria defined above are related in the following table:

Asturias.

Castellon/Castello.

Illes Balears.

Murcia.

Province

Level II Municipalities and Pools

Urgences

A Coruña.

Oleiros.

Hellin.

Hellin.

X

Alicante/Alacant.

Alcoa/Ibi.

X

Alicante/Alacant.

Denia/Javea.

X

Alicante/Alacant.

Elche/Crevillent/Santa pola/Aspe/Novelda.

Alicante/Alacant.

Elda/Petrer/Villena.

X

Alicante/Alacant.

l' Alfas del Pi/Altea/Benidorm/Villajoyosa/Calpe.

X

Alicante/Alacant.

Orihuela.

Alicante/Alacant.

Torrevieja.

X

Almeria.

The Ejido.

Almeria.

Sea Roquettes

.

Aviles.

X

Asturias.

Asturias.

Siero.

Almendralejo/Merida.

X

Badajoz.

Don Benito/Villanueva de la Serena.

X

Barcelona.

Badalona /Santa Coloma de Gramanet/Sant Adria de Besos.

Barcelona.

Barbera del Valles/Ripollet/Cerdanyola del Valles.

Barcelona.

Castelldefels/Gava/Viladecans.

Barcelona.

Granollers/Mollet del Valles/Moncada i Reixac.

.

Hospitalet de Llobregat/Cornella de Llobregat/Sant Boi de Llobregat.

.

Manresa.

Barcelona.

Mataró/Vilassar de Mar.

Barcelona.

Sabadell.

X

Barcelona.

Sant Cugat del Valles/Terrassa/Rubi.

Barcelona.

Sant Feliu de Llobregat/Sant Joan Despi/El Prat de Llobregat /Llobregat Esplugues.

Barcelona.

Vic/Manlleu.

X

Barcelona.

Barcelona.

X

X

Barcelona/Tarragona.

Vilanova i la Geltru/ The Vendrell (Tarragona).

X

Bizkaia.

Leioa/Getxo.

.

Aranda of Duero.

X

Burgos.

Miranda de Ebro.

X

Caceres.

Plasence.

X

Cadiz.

Border/Royal Port Chiclana.

.

Jerez de la Frontera/El Puerto de Santa Maria/Sanlúcar de Barrameda/Arcos de The Border.

Cantabria.

Torrelavega.

Benicar/Vinos.

X

Real City.

San Juan Alcazar.

X

Real City.

X

X

Ciudad Real.

Tomelloso.

X

City.

Valdepees.

X

Córdoba.

Lucena/Puente Genil.

X

Girona.

Figueres.

Girona.

Olot.

X

Granada.

X

Ibiza Island)-Eivissa/Santa Eulalia de Rio/Sant Josep de Sa Talaia/Sant Antoni de Portmany.

X

Illes Balears.

(Mallorca Island)-Manacor.

X

Jaen.

Andujar.

X

Jaen.

X

Jaen.

Ubeda.

X

The Palms.

(Island of Fuerteventura)-Port of the Rosary.

X

The Palms.

(Gran Canaria Island)-Saint Lucia of Tirajana/San Bartolomé de Tirajana.

X

Palmas.

(Gran Canaria Island)-Telde.

Lanzarote Island)-Arrecife.

X

.

Ponferrada.

X

.

Alcala de Henares/ Ardoz Torrejon.

X

Madrid.

X

Madrid.

The King/Rivas-Vaciamadrid Argand_table_izq"> Arganda.

Madrid.

Colmenar Viejo/ Three Chants.

Madrid.

Coslada/San Fernando de Henares.

Madrid.

Fuenlabradada/Leganes.

X

Madrid.

Galpower/ Villlalba/Torrelodones Collado.

Madrid.

Getafe/Parla.

X

Madrid.

Madrid.

Pinto/Valdemoro

Madrid.

Madrid.

Madrid.

.

Malaga.

Malaga.

the Tower.

Malaga.

Antequera.

X

Malaga.

Malaga.

Marbella/Fuengirola/Mijas.

Malaga.

Ronda.

X

Malaga.

Torremolinos/ Benalmadena.

Málaga.

Vélez-Málaga/Rincón de la Victoria.

Cieza/Molina de Segura/The Towers Towers.

 

Murcia.

Lorca.

X

Murcia/alicante.

San Javier/San Pedro de Pinatar/Pilar de la Horadada.

Murcia.

Yecla.

X

Navarra.

Tudela.

X

Pontevedra.

Villagarcia of Arousa.

Santa Cruz de Tenerife.

(Tenerife Island)-Arona/Adeje/Granadilla de Abona.

X

Santa Cruz de Tenerife.

(Isle of Tenerife)-La Orotava/Puerto de la Cruz/Los Realejos.

Cruz de Tenerife.

(Tenerife Island)-San Cristobal de la Laguna.

Seville.

Two Sisters/Alcala de Guadaira.

Seville.

Ecija.

X

Seville.

Utrera.

.

Amposa/Tortosa.

X

.

Reus/Cambrils.

Toledo.

Queen's Talavera.

X

Valencia/Valencia.

Alzira/Carcaixent.

X

Valencia/Valencia.

Gandia/Oliva.

X

Valencia/Valencia.

Ontinyent.

X

Valencia/Valencia.

Sagunto.

3.6.2 These municipalities and groups shall have at least the means of attention specified in Tables 1 and 3, which shall include health care in the form of external or outpatient consultations; and in addition to hospital emergencies in those municipalities expressly mentioned in the table above. The entity shall also assume, where appropriate, the corresponding hospital income or stays that may be derived from these hospital emergencies. In all cases the assistance shall be provided taking into account the specifications set out in Table 5.

3.6.3 Notwithstanding the above, if the Entity does not have a hospital center arranged in any municipality or group of this Level II in which there is a private hospital, it is required to provide in this center (including all the specialties available in the same) health care, in the form of external consultations and hospitalisation, to beneficiaries resident in that municipality or group, as well as emergency assistance hospital to any beneficiary of the Concert. For the purposes of this Concert, these private hospitals are assimilated to the means of the Entity.

3.6.4 In the case of concerted private centres, the Entity must have in the hospital emergency room of physicians of physical presence for the specialties mentioned in Table 3. However, if the guard is located, the availability of the specialists must be guaranteed, once they are required by the emergency room doctor, as soon as possible according to the patient's pathology and clinical condition, not more than in any case within 30 minutes.

3.7 Level III of Specialized Care.

3.7.1 The territorial framework of the Level III of Specialized Care is the province, so all the capitals of the province and cities of Ceuta and Melilla will have the means established for this level. The following table lists, in addition to the provincial capitals and the cities of Ceuta and Melilla, the municipalities and clusters that correspond to this level of specialized care.

Province

Basin.

Huesca.

.

Madrid.

Segovia.

Municipalities and Tier III

A Coruña.

Ferrol/Naron.

A Coruña.

Santiago de Compostela/Ames.

Almeria.

Almeria

Vitoria-Gasteiz.

Asturias.

Gijon

Avila.

Avila.

.

Burgos.

Caceres.

Caceres.

.

Algeciras/La Linea de la Concepción/Los Barrios.

.

Cadiz/San Fernando.

Castellón/Castello.

Castellón de la Plana/Almazora.

Ceuta.

Ceuta.

Actual City.

.

Cuenca

Basin.

Basin.

Gipuzkoa.

San Sebastian.

Girona.

Gerona/ Salt.

Guadalajara.

Huelva.

Huelva.

Huesca.

Jaen.

Jaen.

Leon.

Leon/San Andres de Rabanedo.

Lleread.

Lugo.

Lugo.

Madrid.

Boadilla del Monte/Las Rozas/Majadahonda.

Pozuelo Alarcon.

.

Murcia.

Cartagena

Ourense.

Ourense.

Palence.

Palence.

Pontevedra.

Pontevedra.

Salamanca.

Salamanca.

Segovia.

Soria.

Soria.

.

Tarragona.

Teruel.

Teruel.

Toledo.

Toledo.

.

Zamora.

3.7.2 These municipalities and groups shall have at least the means of attention specified in Tables 1, 2, 3 and 4, which shall include health care in the form of external or outpatient consultations, hospitalization, hospital emergency and multidisciplinary units, with the specifications mentioned in Table 5.

3.7.3 The Entity must have in the hospital emergency room of physicians of physical presence for the specialties mentioned in Table 3. However, if the guard is located, the availability of the specialists must be guaranteed, once they are required by the emergency room doctor, as soon as possible according to the patient's pathology and clinical condition, not more than in any case within 30 minutes.

3.7.4 In case of hospitalization the offer of the Entity will be considered valid when the hospital offered is located in another municipality, provided that the hospital is at a distance less than 30 minutes from the urban core, or from the farthest in the case of the clusters of municipalities and in that municipality, the availability of the hospital is not to be demanded.

3.8 Level IV of Specialized Care.

3.8.1 The territorial framework of Level IV is the Autonomous Community, so at least one municipality in each Autonomous Community will have the means established for this level. The following table lists the municipalities that correspond to the Level IV of the Specialized Care.

Autonomous Community

Province

Level IV

Andalusia.

Córdoba.

Córdoba.

Granada.

Granada.

Malaga.

.

Seville.

Aragon.

Zaragoza.

Zaragoza.

Asturias.

Asturias.

Oviedo

Canary Islands.

Las Palmas.

Las Palmas de Gran Canaria.

Santa Cruz de Tenerife.

Cantabria.

Cantabria.

Santander.

Castilla la Mancha.

Albacete.

Albacete.

lion.

Valladolid.

Valladolid.

Catalonia.

Barcelona.

Barcelona.

Extremadura.

Badajoz.

Galicia.

A Coruña.

A Coruña.

Pontevedra.

Vigo.

Illes Balears.

Illes Balears.

Palma de Mallorca.

rioja.

La Rioja.

Logon.

C. of Madrid.

Madrid.

Madrid.

Region of Murcia.

Murcia.

.

.

Navarra.

Basque Country

Bilbao

. Valencia.

Valencia.

Valencia.

Alicante.

Alicante.

3.8.2 All the municipalities included in the table above shall have at least the means of attention specified in Tables 1, 2, 3 and 4, which shall include health care in the form of external consultations or ambulatory, inpatient, hospital emergency and multidisciplinary units, with the specifications mentioned in Table 5.

In the municipalities of Madrid and Barcelona, the availability of all Level IV Services will always be guaranteed and at least one Hospital with teaching accreditation for the Specialized Medical Training.

3.8.3 On an exceptional basis, in the absence of the own or concerted means of some of the specialties in the related municipalities, MUFACE may consider a valid offer, for these purposes, if such means are available in another locality in the Autonomous Community to which the municipality concerned belongs. In the case of a single-provincial autonomous community, the offer shall be valid in another province bordering on if the Autonomous Community does not have adequate private means.

3.8.4 The Entity must have in the hospital emergency room of physicians of physical presence for the specialties mentioned in Table 3. However, if the guard is located, the availability of the specialists must be guaranteed, once they are required by the emergency room doctor, as soon as possible according to the patient's pathology and clinical condition, which may not be in any case greater than 30 minutes.

3.8.5 In case of hospitalization the offer of the Entity will be considered valid when the hospital offered is situated in another municipality, provided that it is a distance less than 30 minutes from the urban core, and in that municipality the availability of hospital is not required, in turn.

3.9 Descriptive tables of media availability according to type of care and levels of Attention:

A) Table 1. Specialties in outpatient or outpatient settings.

Endocrinology and Nutrition.

Queries/Outpatients

Level I

Level II

Level III

Level IV

Alergology.

Analysis.

Angiology and Vascular surgery.

digestive appliance.

Cardiology.

Cardiovascular Surgery.

General Surgery and Digits.

Maxillofacial Surgery.

Surgery Orthopaedic and Traumatology.

Surgery.

Plastic and Repairing Surgery.

Toracica Surgery.

 

Medicosurgical Dermatology.

Hospital Pharmacy.

Gynecology and Obstetrics.

Assisted H. Reproduction.

Hematology and Hemotherapy.

Medicine and Rehabilitation.

Internal Medicine.

 

Nuclear Medicine.

Neurosurgery.

Neurophysiology.

Neurology.

 

ophthalmology.

Oncology.

Radioterapic Oncology.

 

Otorhinolaryngology.

Psychiatry.

Psychology.

 

Radiodiagnostic.

Sunshade ">

Urology.

B) Table 2. Specialties in hospital.

Hospital

Hematology

Nephrology

Psychiatry

Reumatology

Sunshade ">

Level III

Level IV

Analysis Clinicians

Pathology Anatomy

 

Anesthesia and Resuscitation /URPA

Angiology and Vascular Surgery

 

Biochemistry

Cardiology

Surgery

Surgery and Digestive Apparatus

Orthopaedic Surgery and Traumatology

Surgery

Plastic and Repairing Surgery

Dermatology Medicosurgical

Endocrinology and Nutrition

Pharmacy

Gynecology and Obstetrics

Hemotherapy

Microbiology and Parasitology

Medicine/ICU

Medicine and Rehabilitation

Medicine

Nephrology

Neurosurgery

Neurology

ophthalmology

Medical Oncology

Radioterapic Oncology

Otorhinolaryngology

 

Urology

C) Table 3. Specialties in hospital emergencies.

Maxillofacial.

Radiodiagnostics.

Urgences

Level II

Level III

Level IV

Analysis.

 

Anesthesia and Reanimation/URPA.

Angiology and Vascular Surgery.

Digestive Device.

Surgery.

Surgery and Digits.

Orthopaedic and Traumatology Surgery.

Surgery.

Gynecology and Obstetrics.

Hematology and hemotherapy.

Medicine.

Nephrology.

Neurosurgery.

Neurology.

ophthalmology.

Otorhinolaryngology.

Psychiatry.

D) Table 4. Multi-disciplinary units/teams/Genetic Council.

Units/Teams

Level III

Level IV

Palliative Care.

CP Support Teams.

CP Unit.

Unit.

Unit of Ictus.

Infectious Unit.

Genetic Council.

E) Table 5. Specifications by craft.

Specialty

Ablation/cardioversion

Nephrology

Specifications

Level I

Level II

Level III

Level IV

Analysis.

Genetics/Cytogenetics.

Immunology.

Digestive Apparatus.

Copy.

capsule.

Cardiology.

Electrophysiology Cardiaca/ pacemaker.

Implantable defibrillator.

Gynecology and obstetrics.

Gynecological Ecography.

Prenatal Diagnostic.

-risk obstetrics.

Hematology

Hospital of day.

Medicine

Radioisotopos/.

Gammagrafia.

PET-TC.

Hemodialysis and peritoneal dialysis.

Neurophysiology.

Potentials evoked.

unit.

medical

Hospital of day.

 

Otorhinolaryngology

Vestibular Rehabilitation.

Sunshade ">

Ecography.

 

Mamography.

 

RNM.

Densitometry.

interventional.

 

Rehabilitation

Physical Therapy General.

Logopedia.

Rehabilitation.

 

floor rehabilitation.

Urology.

Litotricia.

Laser.

3.10 Reference Services. Reference services are considered to be those for the attention of pathologies requiring high professional specialization or high technological complexity, or when the number of cases to be treated is not high and it may be advisable to concentration of diagnostic and therapeutic resources. The Reference Services shall have as a geographical and population framework the whole of the national territory.

3.10.1 Generally, the pathologies, techniques, technologies or diagnostic or therapeutic procedures that may be treated in the Reference Services shall be those designated by the Committee of the Designation of Centers, SNS services and reference units, which are published by resolutions of the Ministry of Health, Social Services and Equality. In such cases, the Entity will provide access to these centers located in the Autonomous Community of residence or, if not there, in the Autonomous Community bordering closer to the beneficiary's residence.

3.10.2 In addition to the above mentioned above, the following therapeutic services, techniques and procedures shall be considered as reference within the Portfolio of Specialized Care Services:

a) Complex Cancer Treatments:

1) Surgery with the curative intent of esophageal cancer.

2) Surgery with curative intent of pancreatic cancer.

3) Combined oncology surgery of the pelvic organs.

4) Radio-guided surgery.

5) Surgery of liver metastases.

6) Central and extracranial nervous system radiosurgery.

b) Transplantation of organs, tissues, and cells.

c) Brain Damage Unit.

d) Medular Injured Unit.

e) Large Burns Unit.

f) Thoracic Surgery:

1) Videothoracoscopy diagnostic and therapeutic.

2) Palliative Endoscopic Treatments in lung cancer and tracheobronchial tumors.

3) Diaphragmatic Neurostimulators.

4) tracheal and bronchial protesis.

3.10.3 The Entity will offer at least three alternatives, of which at least one must be located in the Autonomous Community of residence of the beneficiary or, if not there, in the Autonomous Community bordering on close to the beneficiary's residence. Where the alternatives offered are differentiated only by the ownership of the centre, the one that corresponds to a private health centre shall be prioritised.

4. Additional conditions for the Insular territory.

4.1 In addition to the above mentioned at each level for the corresponding municipalities or groupings mentioned in point 3, the additional special conditions for the islands of the Balearic and Canary Islands will be the following:

a) The population of each island and the number of resident beneficiaries have been taken as a reference.

(b) In non-capitalistic islands, the Entity shall ensure the hospital emergency services established in Level II of Specialized Assistance.

4.2 According to the special conditions set out in the previous point, the following tables relate the islands of each archipelago with the level and modality of the Specialized Attention that each corresponds to.

Illes Balears

Island

Specialized Attention Level

External Queries

Hospitalization (*)

Hospital

Mallorca.

Level IV.

X

X

X

Eivissa.

Level II.

X

X

X

Minorca.

Level II.

X

X

X

Formentera.

X

Canary Islands

The Palm.

Island

Specialized Attention Level

External Queries

Hospitalization (*)

Hospital

Gran Canaria.

Level IV.

X

X

X

.

Level II.

X

X

X

Fuerteventura.

Level II.

X

X

X

X

Tenerife.

Level IV.

X

X

X

Level II.

X

X

X

The Gomera.

X

The Iron.

X

(*) The specialties in hospitalization in the Level II of the Specialized Care are the following: Clinical Analysis, Pathological Anatomy, Anesthesia Resuscitation/UrPA, Digestive System, Biochemistry, Cardiology, Surgery General and Digestive System, Orthopedic Surgery and Traumatology, Pharmacy, Gynecology and Obstetrics, Hemotherapy, Physical Medicine and Rehabilitation, Internal Medicine, Ophthalmology, Otorhinolaryngology, Pediatrics and Radiodiagnosis.

4.3 The provisions of paragraph 3.6.3. of this Annex shall apply to the islands to which the level II of the Specialized Attention corresponds to the islands referred to in point 3.6.3, unless any of its municipalities are listed related to the table listed in point 3.6.1, corresponding to that same level of care.

4.4 The Entity shall in all cases assume the costs of interisland travel for assistance to Level III specialties, unless it has a concerted means to provide such assistance on the island.

4.5 In case of non-existence of the means required on each island, the Entity will guarantee assistance on the nearest island that has the same, and must assume the travel expenses.

4.6 The Section IV, if it is not available in the corresponding Autonomous Community, will be provided in the one that is closest to the time of travel, and the entity will assume the offset.

ANNEX 3

Cross-border Healthcare.

In accordance with the provisions of clause 1.1.3, the Entity is obliged to cover the cross-border healthcare of its protected collective, in accordance with Royal Decree 81/2014 of 7 February, for which it is establish rules for ensuring cross-border healthcare, and amending Royal Decree 1718/2010 of 17 December 2010 on medical prescriptions and dispensing orders. The exercise of the right by the beneficiaries, their scope, the conditions, requirements and procedure for the reimbursement of expenses for such assistance are set out in this Annex.

cross-border healthcare is the one received when the beneficiary decides to go to health services located in another EU Member State. Therefore, it does not include the temporary stay cases where, for oversold medical reasons, the beneficiary has received health care, the coverage of which is provided through the coordination mechanisms with the institutions of the rest of member states.

Cross-border healthcare does not include expenses related to healthcare provision.

1. General rules.

1.1 Content. The cross-border healthcare in charge of the Entity includes the health benefits that form the Common Portfolio of SNS Services and whose coverage corresponds to the Entity in accordance with the provisions of Chapter 2 of the Concert.

Those benefits expressly mentioned by Royal Decree 81/2014 of 7 February 2014 laying down rules to ensure cross-border healthcare are excluded, such as:

(a) Services in the field of long-term care, the purpose of which is to help those who require assistance when performing routine and daily tasks.

b) The allocation of organs and access to organs for transplantation purposes.

(c) Public vaccination programmes against infectious diseases, which have the sole purpose of protecting the health of the population in the Spanish territory and which are subject to specific planning and implementation, without prejudice to those relating to cooperation between Spain and the other Member States in the field of the European Union.

In no case will the expenses arising from healthcare provided on national territory be reimbursed by means other than those allocated by MUFACE to the beneficiary through this Concert.

In the case of treatments listed in paragraph 2.1 of this Annex, prior authorisation shall be required in accordance with the procedure laid down in point 2.2.

1.2 Mode. The method of coverage shall be through the reimbursement of expenses by applying the tariffs included in Annex 6, without exceeding the actual cost of the assistance actually provided, and with the limits, terms, conditions and requirements which are specified in this Annex.

1.3 Subjective scope. The expenditure covered by the institution shall be the expenditure incurred by the cross-border health care provided by the mutualists and the family members or assimilated persons who are recognised as beneficiaries and the newborn in question. the terms of clause 1.3.2.

1.4 Other obligations of the Entity. The means of the Entity shall facilitate the access of beneficiaries seeking cross-border healthcare to their medical records or, at least, to a copy thereof.

Regardless of the right to reimbursement of expenses arising from cross-border healthcare, where necessary, the Entity will facilitate the subsequent monitoring of the beneficiary through the corresponding services, under the same conditions as if the assistance had been carried out by means of the Entity.

2. Health benefits subject to prior authorisation and procedure for obtaining them.

2.1 The following benefits will be subject to prior authorization of the Entity:

a) Any type of health care that involves the patient having to stay in the hospital at least one night.

b) Those techniques, technologies or procedures included in the common portfolio of SNS services that have been selected on the basis of the requirement for the use of highly specialised medical procedures or equipment, to the need for care for patients with complex problems, or at high economic cost:

− positron emission tomography (PET), and combined with CT (PET-TC) and SPECT.

− Assisted human reproduction.

− Dialysis.

− Outpatient surgery requiring the use of a surgical implant.

− Treatment with radiotherapy.

− pharmacological or biological products, the monthly amount of which is greater than EUR 1,500.

− Radiosurgery.

− Genetic analyses, oriented to the diagnosis of complex cases, including prenatal and pre-implantation diagnosis, presymptomatic and carrier genetic analysis, pharmacogenetic and pharmacogenomic analysis.

− Treatment of disabilities that require for correction or improvement: Electric wheel sils, upper limb prosthesis except partial hand prostheses, lower limb prosthesis except partial prostheses standing, hearing aids and bitutors.

− Attention to pathologies and performing procedures listed in Annex 2 as Reference Services.

This relationship should be adjusted, where appropriate, to the common criteria that the SNS Interterritorial Council will establish.

2.2 The application for authorisation shall be submitted to the Entity which, within a maximum of seven working days, must authorise the benefit requested or, if not applicable, indicate the motive and, where appropriate, the means allocated to it. to facilitate it on national territory, in the terms stipulated in the Concert.

The response of the Entity must be made in writing or by any other means that permits to be placed on the record and with an indication of the right of the person concerned to lodge a complaint with the Mutuality.

In the event that the authorization is denied, on the same date of communication to the data subject, the Entity must submit the complete file to the Department of Health Services with a supporting report.

When the Entity has issued the appropriate authorization, and immediate complications are produced that require other assistance that is included within those requiring prior authorization, they will be understood All care benefits derived from the same process are authorized.

3.3 The authorisation may be refused in the cases and for the reasons expressly mentioned in Article 17 of Royal Decree 81/2014, cited above, including when health care can be provided on national territory, in the terms stipulated in the Concert, within a period that is medically justifiable.

If the refusal is not made to include the assigned means, or if the reply does not occur within the time limit set out in point 2.2, it is understood that the assistance of the beneficiary cannot be carried out within a period of time. justifiable.

3.4 In the event of a complaint by the person concerned to MUFACE, because the Entity has refused the authorization, it will be resolved by the MUFACE General Directorate, on a proposal from the Department of Health Services, within the maximum period of Forty-five working days, from the date of entry of the application into the Entity, suspending the calculation of the period from the day following the date of refusal of the Entity until the day when the claim of the person concerned has The entry into the Mutuality is inclusive.

3. Procedure for the reimbursement of expenses for cross-border healthcare.

3.1 The procedure will be initiated at the request of the data subject. However, it may be initiated on its own initiative by MUFACE, where the person concerned has submitted a request for reimbursement of expenditure abroad and in the case of the case, which is considered to be the subject of cross-border health care. If the Entity considers this to be a benefit received due to the need for temporary stays, it will send to the corresponding MUFACE Provincial Service the complete file for study and resolution as appropriate.

3.2 The request for reimbursement shall be submitted by the person concerned to the Entity, within a maximum period of three months from the date of payment of the assistance received, accompanied by the original invoice, in which they appear in a form details of the various care concepts carried out, and of the accreditation of their credit, as well as a copy of the medical prescription or clinical report showing the health care provided, indicating the diagnostic procedures and primary and secondary therapeutics performed.

In the treatments listed in point 2.1 of this Annex, reference to the existence of prior authorisation shall be required.

3.3 The application and other documentation, once the necessary checks have been carried out, including if the default of the application or lack of the documentation is necessary, the Entity will proceed to the reimbursement of the costs to the person concerned in accordance with the tariffs in Annex 6, within a maximum of one month.

Within that same period, if the Entity considers that the reimbursement, in whole or in part, does not proceed, it shall inform the person concerned in writing or by any other means which permits to be put on record, indicating the reason for refusal and the the right to claim for mutual benefit.

In the event of a refusal, on the same date of communication to the data subject, the Entity shall forward the complete file to the Department of Health Services with a supporting report.

3.4 The person concerned may make the corresponding complaint to MUFACE in case the Entity does not proceed within the time limit laid down in the point before the reimbursement of the expenses or is refused, as well as in the case of disconformity with the application of the tariffs. For the processing and resolution of the complaint, the procedure provided for in clause 5.4 shall be followed, corresponding to the knowledge and study of the complaint, as provided for in clause 5.3.2, to the Joint Committee. This complaint will be resolved by the MUFACE Directorate-General within the maximum period of three months.

ANNEX 4

Terms Glossary

• By "hospital" or "hospital facility" means the legally authorised health facilities intended for the treatment of patients in detention. No hospitals are considered for the purposes of this Concert, the hotels, nursing homes, homes for convalescing, residences of elderly people or institutions dedicated mainly to the internment and/or treatment of drug addicts or alcoholics.

• In-hospital care includes all basic hotel services inherent in hospitalization, with an individual room with bath or shower and a companion bed.

• The expenses covered may not exceed the average rate, per accommodation and maintenance in private room, of the hospital where the assistance was received. The expenses incurred by personal services of a non-medical nature that may have been received by the patient or companion during a hospital stay covered by the Concert are excluded.

• In Annex 5 of the Health Information System, patients will be understood to be the number of different people assisted in each declared quarter.

ANNEX 5

Healthcare information system

1. Activity information.

1.1 Number of assists and patients cared for abroad and in Spain:

1.1.1 Number of monthly assists abroad.

Year:

Quarter:

Month

Euro amount

Number of assists

Patients

 

1.1.2 Number of monthly assists in Spain

Year:

Quarter:

Month

Euro amount

Number of assists

Patients

 

1.2 Country-by-country data:

1.2.1 Number of assists per country.

Year:

Quarter:

Country

Euro amount

Total assists

Refund

Direct Payment

Amount

Denomination of the country in alphabetical order (including Spain).

 

1.3 Data broken down by type of assistance:

1.3.1 Type of healthcare abroad

Year:

Quarter:

Podology.

Type

Patients serviced

Amount in Euros

Total number of assists

Average

attendance.

: external queries.

Specialized: hospitalization.

stations.

and pharmaceuticals.

Evacuation and Repatriation.

1.3.2 Type of healthcare in Spain

Year:

Quarter:

Podology.

Type

Patients serviced

Amount in Euros

Total number of assists

Average

attendance.

: external queries.

Specialized: hospitalization.

stations.

and pharmaceuticals.

of day.

1.4 Data broken down by craft:

1.4 Specialty Assistants

Year:

Quarter:

Anesthesia and Resuscitation.

Nephrology.

Radioterapic Oncology.

Euro Amount

Number of Assists

Number of

General/Family Medicine.

Alergology.

Analysis.

Pathology Anatomy.

Angiology and Vascular Surgery.

digestive appliance.

.

Cardiovascular Surgery.

and Digestive Surgery.

Oral and Maxillofacial Surgery.

Orthopaedic and Traumatology Surgery.

Surgery.

, Aesthetic, and Repairing Surgery.

Endocrinology and Nutrition.

Estomatology.

hematologica.and Hemotherapy.

Medicine and Rehabilitation.

Intensive Medicine.

Medicine.

Nuclear Medicine.

Preventive Medicine.

and Parasitology.

Neumology.

Neurosurgery.

Neurophysiology.

Ophthalmology.

Oncology.

Psychiatry.

Radiodiagnostics.

Reumatology.

2. Information on the management of health benefits.

2.1 Health Care Requests Abroad:

2.1.1 Request type.

Quarter:

authorization.

Type

Number.

Resolved

Time resolution (days)

Estimated

Disestimated

Pending number

days

days

Reintegrated.

Payment.

2.1.2 Form of presentation.

Quarter:

Number

Average resolution time (days)

Web.

Presential.

Valija.

Fax.

2.2 Applications for Health Care in Spain:

2.2.1 request type

Quarter:

authorization.

Type

Number.

Resolved

Time resolution (days)

Estimated

Disestimated

Pending number

days

days

Payment

2.2.2 Form of presentation.

Quarter:

Number

Average resolution time (days)

Web.

Presential.

Valija.

Fax.

3. Information about the means offered by the Entity.

The information of the own and concerted means offered by the Entity to provide the service will be sent in electronic form to MUFACE annually in accordance with the requirements defined below.

The information to be sent by the Entity to MUFACE consists of four tables:

1. Data from delegations by country.

2. Data from clinics and hospitals in Spain.

3. Data from hospitals and health centers abroad.

4. Data from healthcare professionals in Spain.

The data will be sent to MUFACE in four files, in XLS format with the following denominations:

Name

Description

delegationName.xls

Contains all the information about the delegations by countries (branches or accredited representatives) of the entity.

national_hospitalName.xls

Contains all information about own or concerted private hospitals and hospitals of the entity in Spain

information about hospitals and own or concerted health centers of the entity abroad

professionalityName.xls

Contains all information about the entity's own or concerted professionals in Spain.

Both the order and the name of the columns must be respected, so that the Excel files sent to MUFACE must match the number of columns and the name of the columns. The cell format of all the columns of the Excel files to be sent must be "Text" type to avoid automatic deletion of the "0" to the left in numeric fields, such as hospital or country codes.

In all cases, there must be a first row with the identifiers of the Excel columns, and then all rows with the corresponding data.

The format of the Excel files must have an extension ". xls". Excel files with a different extension will not be valid, for example: ". xlsx". That is, all Excel files must be saved in "Excel book 97-2003".

3.1 Table of Country Delegations. It contains the general information data of the Delegations of the Entity in each Country. A row shall be completed for each Delegation of the Entity.

Length

Description

5

5

Code of the country where the entity's delegation is located

Text of the location where the delegation is located

responsable name

50

Person name

50

First last name

the person Delegation

responsable

50

Second last name of the contact person in the Delegation

branch

1

Indicate whether you have a branch of your own or not. Possible values S/N.

Accredited Representative

1

Indicate if you have a representative accredited. Possible values S/N.

150

Postal address of the Entity delegation.

delegation_phone

15

Entity delegation phone.

Emergency Telephony

15

Emergency phone and resource coordination

Fax

15

The Fax Number of the Entity's delegation.

E_box

60

Delegation Email

3.2 Table of clinics and hospitals in Spain. It contains the information of all hospitals and clinics (with internment) private or agreed by the Entity in Spain. One row shall be completed for each hospital or clinic.

Length

Description

Hospital

6

Code according to the National Hospital Catalog

150

150

Cif_nif

9

CIF/NIF center

Province

2

Province Code.

4

Local_table_to_izq"> Township INE Code

Beds Number

4

Indicate the number of beds installed

Nivel_ AE

1

Specialized care level, as shown in Annex 2 of the Concert.

Services

1

Indicate whether you have an emergency service or not. Possible values S/N.

type

5

Hospital address type of path.

name address

150

Hospital address path name.

Address number of path

3

Hospital Address Number of via.

Locality

150

Locality of the Hospital.

Postcode

5

Postal code.

9

9

The_table_table_izq"> Phone Contact.

E_box

60

Mail Address Clinic or Hospital electronics

3.3 Table of hospitals and health centers abroad. It contains the information of all hospitals and private health centers owned or arranged by the Entity outside Spain. One row shall be completed for each hospital or clinic.

Length

Description

150

5

5

country

Locality

50

Text of the city where the hospital center is located.

1

Indicate whether you have an emergency service or not. Possible values S/N.

150

Address of the Clinic or Hospital.

Telephone

15

Contact phone.

15

fax The_table_table_izq"> Hospital or Health Center fax number.

E_box

60

Hospital or Health Center email address.

3.4 Table of healthcare professionals in Spain. It contains the information of all healthcare professionals associated with the Entity in Spain. A row shall be completed for each professional.

Length

Description

NIF

9

NIF.

name 1

50

First Last

50

Last

Name

50

Name.

Collegiate

9

Collegiate

Province

2

Province code.

4

INE municipality code

2

Code of WTO specialties

Specialist

75

Enter the literal name of the craft.

activity

1

Professional Activity

CIF Clinic _ center

9

CIF Center

150

150

150

5

Address in Spain type of path

150

150

_table_table_izq"> Address Path

Number

3

Address number of

Locality

150

Locality

5

5

The_table_table_izq"> Postal Code.

50

Mail Address

Telefono_phone

9

Phone contact

ANNEX 6

Refund Rates

Healthcare

45

minor.

Query Succession.

Stay in Service Hospitalization medical.

Rates (euros)

1. Healthcare in primary care

1.a Healthcare in the center

query.

First medical query without additional testing.

69

Succession Query medical without additional testing.

34

First medical consultation with complementary tests.

Succession Query with Complementary Tests.

46

First Medical Query with Nursing without Complementary Tests.

84

succession query with nursing without additional testing.

46

First query medical with nursing and complementary testing.

103

succession consultation with nursing and complementary testing.

59

Query dentistry.

63

Query.

21

Query with Complex Care.

29

Matron query.

45

45

90

1.b Home Assistance

Medical Query.

First Medical Query without Complementary Tests.

98

Succession Query without Complementary Evidence.

44

First medical query with complementary tests.

121

Medical Succession Query with Complementary Tests.

medical query with nursing without additional testing.

97

Medical Succession Query with Nursing without Complementary Tests.

53

First Medical Query with Nursing and complementary tests.

124

Medical Succession Query with Nursing and Complementary Tests.

64

Query.

query with basic care.

60

Nursing Query with Complex Care.

93

2. Emergency Health Care

Urgency.

141

Outpatient Urgency.

237

Urgency.

General Urgency.

383

Paediatric Urge.

308

urgency Gyna-obstetrical.

293

trauma urgency.

393

Hospital Urgency that requires observation in box/day of stay and busy bed.

331

3. Health Care in Specialty Care

3.a External Queries

Queries.

First Query.

-resolution query.

235

pediatric.

First query.

191

306

306

306

 

First query.

119

Succession query.

-resolution query.

146

Queries.

First query.

101

Succession Query.

60

High-resolution query.

162

3.b Hospitalization

Hospitalization of day.

86

86

Geriatric Hospitalization.

Hospitalization onco-hematologic.

908

Infective Hospitalization.

472

Other hospitalizations.

259

Hospitalization.

209

hospital stays.

Stance in psychiatric service hospitalization.

234

234

234

234

234

234

234

234

557

service hospitalization.

1095

and neonatological service hospitalization.

740

UVI/ICU status.

in Neonatal UVI/ICU.

858

UVI/ICU Stay.

3082

Stay in adult UVI/ICU.

1486

3.c Outpatient surgery

 

Outpatient minor surgery.

Hospital Surgery.

252

Surgery hospital.

722

Echo.

118

118

.

218

240

138

138

124

124

124

124

RX echo intraoperative.

373

373

240

240

240

214

151

108

43

43

43

43

43

43

43

145

906

143

41

41

bronchodilation.

626

626

88

Laparoscopy with or without a biopsy.

165

110

epicutaneas (by session) (multiple).

360

Amniocentesis.

Amniocentesis control ecographic.

112

Otorhinolaryngology

638

MM.II Arteriography.

(via) AX/BRAG.

Arteriography.

738

395

Doppler MM. II.

adrenal.

258

20

Ecocardiogram/study and report.

376

EEC with sleep deprivation.

264

Other segmental distonies-session.

976

Session oesophageal dilatation.

Rehabilitation (per session

103

inactivated.

20

20

20

20

leucitarians.

34

117

14

Typical HLA low resolution class I/ (A or B or C).

115

Clonal Reordering copper DNA.

190

cell count.

63

63

15

14

14

14

94

76

complete.

and therapeutic procedures

Rates (euros)

94

94

94

Angiography.

898

Shoulder Arthrography

421

Cistography.

257

Cistouretrography with string (uplink).

431

-kerh Colangiography.

276

CT arthro-tac.

303

130

303

303

CT simulations.

130

CTPH + drain + stent (others).

535

CTPH + external bile drain.

849

Defecography.

321

gastroduodenal Study (E.G.D.).

200

Eco colecist . By trocar (percutaneous aspiration).

479

Eco with liver biopsy.

259

Doppler Echo.

255

doppler Echo.

118

118

Neck Ecography.

118

Soft Parts Ecopgraphy.

118

218

118

Ecography. Drainage abcesses.

1.039

Ecotography. Pleural puncture.

144

Ecography. Cystic Sclerosis.

Ecography. Paaf.trioids and (echo-led fine needle aspiration).

287

endoanal-endorrectal Ecography.

335

240

Enteroclisis.

549

Esofagogram.

321

Scan.

21

Fistulography.

355

Mamography.

110

Mamography galactography.

190

138

Mamograph P.A.A.F. with sterotaxia.

373

percutaneous biopsy with mammotomo directed by esteroxia.

520

206

206

206

206

206

206

206

206

340

164

164

RX CT abdomen

pelvis.

343

RX CT narrow tac.

310

RX CT biopsy by aspiration (BAP).

722

RX CT lumbar column c/c.

256

RX CT body integer.

343

RX CT liver s/c.

275

RX CT kidney s/c and c/c.

343

CT chest adrenal liver.

343

RX CT chest s/c.

149

RX CT chest and abdomen.

RX echo alco. Paratiroids.

RX eco alcoho. Splenic plexus.

240

94

94

124

doppler echo.

124

RX echo doppler.

108

doppler RX.

112

RX echo

137

echo thoracocentesis chest.

115

373

RX stereotaxia screening.

127

RX Mamography breast specimen.

340

RX paaf screening mom.

431

RX screening mom.

137

Transrectal RX prostate.

95

Scanner CT hip.

240

CT scanner.

343

Scanner CT dorsal column.

243

Scanner CT lumbar column.

144

Scanner CT skull with contrast.

240

Scanner CT skull stereotaxia.

324

Scanner CT skull without contrast.

Scanner CT neck.

240

Scanner CT liver dynamic.

275

Scanner CT hygado-pancreas.

343

Scanner CT larynx.

240

257

257

Scanner CT scans with contrast.

Scanner CT breast.

144

Scanner CT breasts with contrast.

244

Scanner CT chair turca/axial.

260

Scanner CT turca/coronal chair.

253

adrenal CT scanner.

268

Scanner CT contrast chest.

271

240

Scanner CT abdomen.

288

Scanner CT Contrast.

271

Scanner CT C.A.I. cysternography.

287

Scanner CT C.A.I. coronal.

240

Scanner CT. Cervical column.

359

Siallography (digestive).

352

intestinal transit.

378

Uretrography.

439

intravenous Urography.

338

Video fluoroscopy.

321

Pielography.

bone density.

90

bone density.

175

Densitometry triple.

216

RX.eco-paaf (pun. With asp. Ag. Fina)

287

PAAF.

57

Conventional Radiology.

31

101

Studies in contrast.

85

functional studies with RM.

586

RMN study simple.

374

RMN double study.

569

RMN study triple.

764

Plus NMR anesthesia.

156

RMN contrast plus.

128

214

vascular TAC (angio TAC).

201

anesthesia supplement.

153

contrast supplement.

151

Medicine- Oncology

Angiogammafia.

92

587

587

hemodynamic study with isotopes.

251

glomerular filtering.

108 resolution.

597

abdominal Meckel's diverticulum.

159

Gammagrafia.

377

Gammagrafia.

296

Splenic Gammagrafia.

61

Liver Gammagrafia.

105

148

148

bone.

174

pulmonary perfusion

175

617

testicular Gammagrafia.

85

thyroid Gammagrafia.

185

bile.

148

salivar glands.

85

Hematies marked.

244

713

Tracing with iodine -131-i.

180

Tracing with mibi.

354

gastro flow.

140

Renogram.

43

120

Treatment with 131-i.

603

total, cellular, and plasma.

180

marked Leucocytes.

436

IBZM.

894

906

143

Respiratory-Pneumonia

pleural biopsy.

capillary alveolus diffusion.

488

41

92

Gasometry.

49

Mantoux.

36

72

185

185

185

Interstitial Broncoscopy.

375

Broncoscopy enf

Infectious.

Broncoscopy.

260

Sweat Test.

65

Test for exercise.

104

metacoline test.

139

Polisomnography.

290

Gastrointestinal Surgery

Anoscopies.

80

blind liver (echo liver biopsy).

164

Biopsies (liver, kidney, bone, thoracocentesis, etc.) With ultrasound.

363

Biopsies (liver, kidney, bone, thoracocentesis, etc.) With TAC.

530

Biliary drainage placement.

884

Unique esophageal Dilatations with Port-Port.

729

Extraneous foreign body.

1.1.894

308

Manometry rectal.

135

Paracentesis.

438

Phmetry.

290

165

165

165

165

165

165

165

Urology- scans and surgery

163

163

274

110

110

161

58

58

211

maxillofacial surgery

Spell-Spell.

41

Siallography.

139

Intermaxillary Lock.

666

360

Quistectomy.

646

Gynecology-Obstetrics

148

450

Corial biopsy.

77

29

43

43

43

43

43

43

43

43

43

43

194

36

10

112

Histerosonography.

139

Microlegrate (biopsy Endometrial)

230

119

119

119

119

119

119

119

119

80

Audiometry.

189

Laryngoscopy.

123

vestibular tests.

204

Otoemissions.

195

Interventional Vascular Radiology

Diagnostic Procedures.

Therapeutic Procedures.

1,733

abdominal angiography (Dynamic Angiographies).

neck angiography.

236

Angiinography malformation.

237

Angidinography MM.SS. (MM.II.).

416

varicocele angiography.

237

2.315

Lung Angiography.

2.315

653

Digital renal Angiography.

509

Angiography.

1.241

abdominal.

660

member Arteriography.

627

Top member standard arteriography.

627

638

528

630

MM.II Arteriography. (femoral) trans.

575

abdominal selective arteriography.

715

Carotid selective Arteriography.

Arteriography via venous.

723

908

Change Nephrostomy catheter.

380

Cavography.

747

Transparenitohepatic Colangiography.

774

Control of fibrinolysis.

618

Biliary-stent drain control.

488

nephrostomy Control.

376

Control shunt porto cava.

1,021

Dacriocystography.

3.308

1,435

1,435

1,776

1,776

Doppler.

>1.202

219

Doppler MM.SS.

668

and venous studies

155

810

doppler MM.II.

1.252

doppler color doppler.

354

Hypertension diagnostic study.

1.289

Bleeding diagnostic study.

1.069

753

462

462

462

MM.SS Flebography.

642

member Flegrams.

520

630

nephrectomy catheter recolocation.

435

Hickman Catheter Repair.

513

Reposition catheter.

383

Biliary drainage reposition.

533

Withdrawal catheter reservoir.

268

Tunelized central venous catheter removal.

188

Gastrostomy catheter removal.

339

Withdrawal Nephrostomy Catheter.

388

Biology.

94

Grals. Micol and anaer.

14

Hemocultures.

13

20

10

20

Urocrops, coproc, and paras.

5

Virology.

43

Ergometry (stress test).

177

Holter.

108

376

Eco transesophageal.

208

Electrocardiogram.

21

electro0physioligia (EEF) study.

892

Neurophysiology

Electroencephalogram /simple.

130

320

Pathology Study of sleep.

385

Electroencephalogram with quantification.

236

EMG electromyography.

155

315

315

315

194

Treatment with botulinum toxin (includes drug)

Cervical Distonia-session.

1,577

264

607

825

botulinum toxin injection.

Anatomy pathological

Citology.

83

biopsy.

183

biopsy Transjugular liver.

156

Preoperative biopsy.

115

218

biopsy (for minor surgical piece).

140

electron microscopic.

Immunofluorescency-study.

274

Autopsia/necropia.

2,714

tests

Campimetry.

Nistagmogram.

257

Treatment

anesthesia.

272

Locking trigger points.

129

Load and/or preload pump.

129

Subcutaneous plus analgesia with anaesthetist presence.

161

treatment.

378

pain unit.

176

584

584

584

Gastroscopy.

224

Gastroscopy.

therapeutic astroscopy.

105

Ecoendoscopy.

Colonoscopy.

263

diagnostic and therapeutic colonoscopy.

140

Long Diagnostic and Therapeutic Colonoscopy.

239

976

976

976

709

Lasertherapy

Treatment Outpatient regimen.

114

retina repair.

352

Lasertherapy in congenital vascular malformations.

18

Hemotherapy and transfusion directory and services

Blood Components:

blood to transfuse.

95

CPD-adenine blood.

110

140

140

Concentric of filtered hematies.

140

Filtered platelet pool.

350

Apheresis Platelet Concentrate.

400

Unactivated platelet pool.

344

Concentric of frozen platelets.

450

buffy-coat drive.

15

fresh plasma inactivated with methylene blue.

50

fresh Plasma in IGA.

70

.

108

Filtering.

53

Irradiation.

27

erythrocyte FenoType.

32

Fenotype Platelet.

120

Freezing.

137

Immunohematology Analytics:

 

ABO Group and RH.

14

Study of Irregular Antibodies for Transfusion.

35

Fenotype RH.

20

Fenotype (serology).

80

200

200

200

200

200

200

200

200

200

53

Hemolytic anemia study autoimmune.

113

Study Antiplatelet Antibodies.

126

Study of anti-leukocyte antibodies.

126

of platelet antigens.

105

105

Infectious disease analytics;

Determining anti-HIV antibodies.

12

anti-HCV antibodies.

Determination of AG HBS.

11

-HIV Confirmatorium (BLOT).

57

65

31

NAT for HCV.

30

117

117

34

Anticore.

14

Anti s.

15

Anti e.

15

14

14

Reagenic test for syphilis.

9

confirmatory test for syphilis TPHA.

18

T Antibodies cruzi.

20

Antibodies.

20

Molecular Biology Analytics Tests:

resolution I/ class resolution (A + B + C).

48

resolution class II lower resolution (DRB1 + DBR3/4/ 5).

138

HLA low resolution class II (DRB1 + DBR3/4/5 + DQB1))

125

HLA Class II Resolution (DQA1 + DQB1).

65

HLA high class I (A + B + C) resolution.

275

HLA high resolution class II (DRB1 + DBR3/4/5 + DQB1).

280

HLA high resolution by allelic string (A or B or C or DRB1 or 3/4/5 or DQB1).

143

Lymphocytic cross-testing.

20

125

125

34

Quantifying CD-34 cells.

55

chromosomal hibration (FISH).

88

Cycle.

115

74

Clonal reordering over RNA.

108

Automatic Sequencing of PCR products or clones.

190

Send blood samples from bone marrow donors/DNA cord units.

65

Determination of residual disease.

176

Count Leukocytes absolute

17

diagnostic tests:

Elastometry.

211

of pharmacological levels in blood.

106

Procedures infectious diseases:

: bacteriological, mycological,.

21

Identification microorganisms.

63

Test of resistance.

63

63

79

Other immunological studies.

21

- Hematology (for each determination)

323

14

Hematology tests.

4

series tests.

89

string tests.

73

urgency tests.

7

Fenobarbital.

15

hidantomy.

15

15

15

11

11

Clinical analysis tests, hormone determinations, and allergies.

analysis tests, biochemistry determinations.

1

Clinical analysis tests, manual determinations, and lipids.

2

analysis tests, determinations proteins.

17

Clinical Analysis Tests, Orine determinations.

2

Benzodiacepines.

6

52

52

Cocaine and metabolites.

5

Diazepam.

14

14

117

Helicobacter pylori breath test.

54

122

Basic Analysisof Central Analys"> Basic Analytics

Analytics (blood count, biochemistry, and urine).

15

15

29

76

Hepatitis B.

235

Hepatitis C.

119

HIV.

119

biochemical profile.

141

Unit.

20

Test alcoholemia.

72

Urine Abuse Drug Detection.

59

Analytics Confirmation.

141

Query Brachytherapy.

447

Schedules successive.

Radiotherapy only query.

RT radical level IV.

3,453

7,500

24

Rehabilitation-rehabilitation

283

Therapeutic Procedures.

Aterotomy (hemodynamics)

1,064

Fibrinolysis by pass.

6.925

6.714 intravascular.

7.600

1777

Procedures

Rates (euros)

Chemotherapy

chemotherapy session (separate drug cost).

151

Cancer Chemotherapy Session.

511

hematologic chemotherapy session.

765

Application of BR

High-breast interstitial (BOOST).

712

Braquit application. Cervix and e. Not operated.

815

Braquit application. Endom. Y c. Operated.

858

ophthalmic Brachytherapy.

8.475

12.172

Brachytherapy in other locations.

827

224

Session.

1.117

600

600

3,600

8,700

Therapy

Therapy (full treatment).

2.645

134

palliative radiation therapy level I.

833

Complex palliative radiation therapy level II.

1,753

RT level III adjuvant.

3.099

7,500

24

24

24

24

-neurological session.

22

Session neurologic.

34

session.

78

Electrotherapy Session with Shock Waves.

163

Colloquological Session.

125

Biofeedback Session.

23

Genetic

carotype.

210

Amniotic liquid Cariotypes.

334

351

351

351

marrow Cariotypes.

257

Lig Protocol. Amniotic (culture and biochemistry).

556

medicine

Shunt.

7,873

accelerator session.

43

spect with general anesthesia.

510

positrons (PET-TAC).

1.143

body PET.

1,012

803

interventional vascular Radiology

stereotaxic radiosurgery for brain tumors and neuralgia trigemino.

7,653

stereotaxic radiation of arteriovenous malformations.

9.450

procedures.

807

1,331

Angiography

2.315

Angioplasty.

6.605

Angioplasty MM.II. Distal.

2.169

Humeral MMSS angioplasty.

2,603

angioplasty.

1,410

1.410

Angioplasty therapeutics.

5,684

6.344

4,771

arteriography.

893

biopsy.

916

711

Change Nephrostomy catheter.

380

Cavography.

747

Transparenitohepatic Colangiography.

774

Hickman catheter placement.

930

infusion catheter placement.

632

1,064

Placement cava via femoral.

2,618

Tear Stent Placement.

3.372

Hickman catheter control.

418

354

354

fibrinolysis.

618

Drain control

488

Gastrostomy Control.

395

1.021

Dacunocystography.

3.308

Biliary Dilatation.

1.273

esophagus Dilatation peptic.

1,776

/External Biliary Drillage.

810

Embolization. A.V.C. Malformation

2,440

aneurysm Embolization.

16,733

bronchial Embolization.

1,916

Carotid Embolization.

>2.266

spermatic Embolization.

1,161

Splenic Embolization.

1,744

2.224

2.224

2.224

2.682

2.682

stent or peripheral vein.

2,668

prosthesis.

3.450

mmi arterial stent.

2,916

3.033

2,086

2.894

2.086

2.086

2.086

of Hypertension Study.

1.289

bleeding diagnostic study.

1.069

Study hemodynamic prentg (portal hypertension).

1,064

hemodynamic study.

462

Extraction cava filter.

1,515

arterial Fibrinolysis.

>1,954

1,997

Fibrinolysis.

3,770

899

462

462

462

Nefrostomy.

1.206

venous trace.

630

Shunt port cava.

6.925

6.925

1,614

Embolization hypogastric artery.

2,490

aorta stent.

2,698

2.092

2.092

Intent shunt port cava.

3.279

Control Embolization digestive tract (indent).

1.348

Embolization to. Pulmonary.

1,917

Angiop.ater.fistula arterioven.

2.332

Tumor Embolization.

1,648

Extraneous body extraneous RXVI.

1,703

Valvuloplasty.

Coronariography + ACTP.

3.309

Coronariography + ACTP + atherectomy.

6.321

Coronariography + ACTP + atherectomy + stent.

9.834

Coronariography + ACTP + stent.

Heart

Valves cardiac with catheterization.

16,785

valves without catheterization.

13.307

cardiovascular procedures with cc.

10.675

7,600

thoracic Surgery

Toracotomy.

5,421

Eteotomy.

1,960

Toracoscopy + talcage.

553

Toracot. Axillary resection bulla.

1,268

pleural drainage.

237

358

358

358

358

Hemotherapy and transfusion directory and services

Criopreservation hematopoietic progenitor cells.

350

genetic diagnostics.

475

Cie-9

5.271

5.271

09.82

10.42

11.52

12.64

16.09

18.39

19.6

20.95

23.11

23.19

25.2

27.43

27.62

27.7

26.21

12.775

2.152

39.95

652

49

58.45

59.8

61.4

62.1

63.6

64.0

67.33

70.51

70.55

70.77

147

76.6

78.54

80.27

801

801

80.74

80.82

883

888

1.808

83.11

83.44

83.5

83.99

83.99

87.82

Description of procedures

Rates (euros)

Non-classified procedures and interventions elsewhere

00.50

Resync Therapy (pacemaker).

14.224

0.6

ACTP or AITP or ACETP.

00.6

ACTP + atherectomy

5.271

00.6

ACTP + atherectomy + stent.

00.6

ACTP + STENT or AITP or ACETP.

5,773

5,773

0.6

Aterectomy, cava filters.

3.066

0.61

Angioplasties, Embolizations, Central venous accesses, and Intravascular foreign body extractions.

2,618

System operations nervous

01.13

Stereotactic brain biopsy.

1,331

01.14

Brain biopsy.

154

01.24

Craneotomy.

1.377

01.24

Craneotomy fossa fossa.

2.56

03.01

Extraction Foreign body of the spinal canal.

1,473

03.09

Other exploration and decompression of the spinal duct.

3.024

03.09

Hemilaminectomy.

761

03.09

625

03.09

cervical Laminectomy.

1,432

04.07

Other cranial nerve evulsions or evulsions without cc.

1,078

04.43

Carpal tunnel release.

693

04.44

Tarsal tunnel release.

983

04.49

Other decompression or lysis Peripheral nerve or ganglion adhesion.

700

04.92

Deployment complete system neurostimulation.

721

 

Endocrine system operations

06

Thyroid Procedures.

1,500

06

Parathyroid procedures.

1,100

06.3

Partial Tiroidectomy.

1.346

06.4

Total Thyroidectomy.

1,617

06.7

06.7

854

06.81

Total Parathyroidectomy.

1,475

06.89

Other parathyroidectomy.

1,475

08

08

08

Table_table_izq"> Extraceocular procedures except edad> 17.

804

08

Extracular Procedures except Orbit Age <18.

601

08.20

Removing eyelid injury, N. E. O. M.

341

08.21

Scalment Scission.

303

08.22

Excision of another minor eyelid injury.

341

08.32

Repair of front muscle blepharoptosis with facial suspension.

1.061

08.33

Repair of blepharoptosis by resection or advance of elevator or aponeurosis muscle.

1.061

08.36

Repair of blepharoptosis by other techniques.

340

08.38

1.061

08.4

08.4

08.4

08.4

entropion or ectropion.

261

08.44

Entropion or ectropion repair with eyelid reconstruction.

846

08.49

Other entropion or ectropion repair.

786

08.59

Another neom eyelid position adjustment.

1.061

08.61

Rebuilding with flap or skin graft.

08.64

08.64

Rebuilding of eyelid with tarsoconjunctival flap.

1.205

08.89

Another eyelid repair.

786

09.2

Injury gland injury tear.

244

09.81

Dacriocistorinostomy (DCR).

939

786

10.31

Injury or injury termination connective tissue.

616

Conjuntivoplasty.

10.41

10.41

616

616

10.42

10.42

Body_table_izq"> Backend rebuild with free graft.

616

10.44

Other free graft to the conjunctiva.

704

10.99

Another operation on ncoc conjunctiva.

616

11

intraocular procedures except retina, iris, and crystalline.

1.024

11.39

Another pterigion split/pterigion excision.

412

Cornea postoperative wound dehiscence repair.

704

11.99

Other operation on ncoc cornea.

616

12

Primary Procedures on iris.

873

12.53

Goniotomy with goniopuntura.

832

12.59

Other facilitation of intraocular circulation.

832

1.356

12.65

Other scleral fistulization with iridectomy.

1.356

12.79

Other glaucoma procedures.

789

13

Crystalline procedures with or without vitrectomy.

988

Crystalline Extracapsular Extraction, line extraction technique.

967

Crystalline Extracapsular Extraction, Simple Aspiration Technique, and Simple Irrigation.

967

967

967

13.19

Other Intracapsular Crystalline Extraction.

967

13.41

Facoemulsification and aspiration of cataract/cataract/prosthetic lens insertion.

977

13.59

Other extraction Crystalline extracapsular.

821

13.64

Secondary membrane dissection (after cataract).

693

13.66

Secondary membrane mechanical fragmentation (after cataract).

784

13.69

Other cataract/cataract extraction/prosthetic lens insertion.

809

13.71

Waterfalls/lens insertion prosthetic.

821

13.72

Secondary insertion of intraocular lens prosthesis.

967

13.90

Operation over crystalline, unclassified under another concept.

967

13.91

Intraocular telescopic prosthesis implantation.

967

14

1.140

14.22

Injury Destruction coriorretinal by cryotherapy.

967

14.24

Coriorretinal injury destruction by laser photocoagulation.

967

14.52

Other retinal detachment repair with cryotherapy.

335

14.27

Coriorretinal Injury Destruction by Deployment radiation source.

967

14.41

Scleral indentation with implantation.

1,300

14.49

Other scleral indentation.

1,300

14.6

Extraction surgically implanted material, rear segment eye.

967

14.71

Extraction of vitreous body, previous access.

848

14.72

Other extraction of the vitreous body.

848

14.73

Mechanical Vitrectomy by previous access.

848

14.74

Other mechanical vitrectomy.

1,085

14.75

Substitute Injection vitreous (including pharmacology).

307

14.79

Other operations on the vitreous body.

1,600

14.9

Other operations on retina, choroids, and rear camera.

1,085

15.3

Operations s/two or more extraocular muscles c/temporary detachment balloon, one or both eyes.

1,085

Other operations s/two or more muscles extraocular, one or both eyes.

1,046

15.7

Repair of muscle injury extraocular.

1,046

15.9

Other operations on extra-eye muscles and tendons/strabismus/operations on extra-eye muscles.

810

16

Orbit Procedures.

1,650

16.0

Orbit and balloon operations.

Other orbitotomy.

1.220

16.89

Other balloon or orbit injury repair.

1.220

16.92

Orbit injury termination.

Ear Operations

18.21

Preatrial sinus termination.

1,047

18.29

Retroatrial cyst and cyst removal.

Other excision of the ncoc external ear.

721

Prominent headphone surgical correction.

1,046

18.79

Other plastic repair external ear.

847

18.9

Other operations on the external ear.

721

19.1

Stapetectomy.

662

19.3

Other operations on the chain osticular.

1.154

19.4

Miringoplasty.

1.154

Review of timpanoplasty.

1.154

20.01

Miringotomy with tube insertion 606/ miringoplasty. Transtimpanic drain.

20.01

Miringotomy with edad> 17 tube insertion.

1,007

20.01

Miringotomy with pipe insert age <18.

604

20.09

Other miringotomy 606/miringoplasty. Transtimpanic drain.

20.51

Ear injury termination.

742

20.7

InCision, excision, and internal ear destruction.

742

Electromagnetic Hearing Prothesis.

1.013

20.96

1,031

Operations on the nose, mouth, and pharynx

21.30

Nasal Polypectomy with biopsy.

398

21.32

nasal polypectomy with biopsy.

398

21.5

Resection submucosa of the nasal septum.

818

21.6

Turbinectomy.

387

21.61

536

21.69

Other turbinectomy.

536

21.87

Other rhinoplasty.

1.062

21.88

Another septoplasty/nasal septoplasty/septoplasty.

773

22.9

Other operations on sinuses (paranasals).

709

23.1

Removing dental cordons/surgical removal, with sedation.

23.11

23.11

144

Other Tooth/canine surgical removal included.

286

23.73

Apicectomy.

143

24

Trast. Dental and mouth except extractions and age repositions <18.

1.137

24.2

550

24.3

Other gum operations.

24.4

maxillary Injury Scission, of tooth origin.

25.1

550

550

550

550

550

Partial table_izq"> Glosectomy.

550

25.91

Lingual Frenotomy.

550

25.92

26.0

InCision glands or salivate pipe.

290

26.29

Other salivary gland injury excision.

821

26.30

Sialoadenectomy, N. E. O. M.

619

26.31

Partial Sialoadenectomy.

821

26.99

salivar gland procedures except sialoadenectomy.

694

27

miscellaneous procedures on ear, nose, mouth, and throat.

1.171

27

Other ear, nose, mouth, and throat diagnostics age > 17.

1.548

27

Other surgical procedures on hearing, nose, mouth, and throat.

1,682

27.31

Local termination or injury destruction or bone palate tissue.

550

27.4

Mouth Procedures without cc.

979

27.41

Frenectomy labial.

341

27.42

Wide lip injury termination.

798

Another split of injury or lip fabric.

550

27.49

Other Mouth excision.

550

27.54

Cracked lip repair.

868

868

27.64

implant insert Palate.

893

27.69

Other palate plastic repair.

550

Partial Ressection palate. Uvuloplasty.

398

27.92

Incision of buccal cavity, structure not specified.

977

28.0

InCision and Amygdala Drainage and periamigliin structures.

853

28.2

Amigdelectomy without adenoidectomy.

541

28.3

Amigdectomy with adenoidectomy.

574

28.6

562

562

28.99

Other operations on tonsils and adenoids (with laser).

539

28.99

Proceed. S. tonsils and adenoids except tonsillectomy and/or adenoidectomy alone, edad> 17.

828

28.99

Proceed. S. tonsils and adenoids except tonsillectomy and/or adenoidectomy only, age <18.

675

28.99

Proceed. S. Amigdalas and adenoids except tonsilectomiaa and/or adenoidectomy alone, edad> 17.

831

28.99

Proceed. S. tonsils and adenoids except tonsillectomy and/or adenoidectomy only, age <18.

713

29.2

1,415

26.21

26.21

Drain_table_body (abscess).

360

26.29

Quistectomy.

646

29.39

Other excision or resection of injury or fabric of the pharynx.

29.52

branchial slit fistula closure.

1,099

26.99

Parotidectomy.

934

Respiratory apparatus operations

30.09

Other excision or destruction of injury or larynx/excision tissue or lesion resection or larynx tissue.

612

30.22

Vocal Cordectomy.

1.013

31.3

Other larynx or trachea incision.

1,000

31.42

Laryngoscopy and other tracheostomy.

463

Other non-cc respiratory apparatus surgical procedures.

3.155

31.69

Airway Prosthesis Placement

3.012

31.7

Placement Tracheobronchial prosthesis.

2.217

33

biopsy (pneumology).

302

Operations on the cardiovascular apparatus

35.20

Rec. Mitro-aortic valve.

12.770

35.22

Aortic valve replacement.

35.24

Spare mitral valve replacement.

12.775

36.03

Endarterectomy carotid.

1,441

36.10

By coronary aortic pass.

37.23

Trast. Circulatory except iam, with undiagnosed catheterization.

1,150

37.24

biopsy endomyocardial.

1,456

37.33

Heart Ablation.

5.206

37.34

Arrhythmia Ablation with Browser.

9.225

37.80

implant. Pacemaker card. Perm. No iam, f. Heart, shock, desfib. Or subt. Generator.

5,905

37.85

Replacing any type of camera device single, unspecified rate sensitive.

3.401

37.86

Replacing any type of pacemaker with apar. Single camera, sensitive rhythm.

3.401

37.87

Replacing any type of pacemaker with Double camera device.

4,846

37.89

Heart pacemaker review except generator replacement.

3,400

37.89

Review of generator replacement cardiac pacemakers.

4.158

38.5

38.5

973

38.50

Ligature and removal of v. Varicosas site not specified.

837

38.59

38.59

38.59

Table_table_der" >1.043

38.69

Other lower member vein excision.

1.017

38.89

Other surgical occlusion of lower limb veins.

1,017

38.95

Venous catheterization for kidney dialysis.

661

39

Other surgical procedures for circulatory apparatus.

1.215

39

Diagnostic hemodynamic procedures.

2,420

39

Therapeutic hemodynamic procedures.

4.460

39

904

904

39.27

Arteriovenostomy for renal dialysis/arteriovenos/favi fistula.

907

39.29

By pass femoro popliteal.

1,675

39.42

Review of arteriovenous bypass for renal dialysis.

917

39.43

Extraction of arteriovenous deviation for renal dialysis.

39.5

vessel repair.

2.152

39.53

fistula repair arteriovenous.

1.492

39.59

Other vessel operations: arterioplasty and others.

2.152

39.92

Sclerosing agent injection into vein.

Hemodialysis on patient/month outpatient regimen.

3,610

39.95

Operations on the blood and lymphatic system

40.21

Deep cervical lymph node rescission.

1,009

40.23

Axillary lymph node rescission.

1,009

40.29

Simple rescission of another lymphatic structure/simple removal of another structure lymphatic.

438

40.3

Regional Lymph Node termination.

Operations on the digestive system

42.81

Prosthesis Placement of the digestive tract.

1.255

42.92

Unique esophageal dilatations with port-port.

729

43

percutaneous Ostomies. Enteral feeding nasoeyunal probe.

1,610

43.1

Gastrostomy.

700

43.11

Endoscopic gastrostomy Probe.

540

44.13

Gastroscopy without a biopsy.

100

44.14

Gastroscopy with biopsy + anatomopathological report.

150

44.39

Gastroenterostomy (proced.integral.c.bariatric).

4,042

44.66

Proc. To create competition to esfinter esof ./gastr.

1,515

44.66

Gastroplicature endoscopic.

2,715

45.23

Biopsy without biopsy.

190

45.25

Colonostomy with biopsy + anatomopathological report.

240

45.42

Endoscopic Polypectomy of the large intestine.

243

45.7g

laparoscopic colectomy.

2,917

45.79

Other coarse and other partial bowel excision not specified.

4,901

48.35

Local injury or rectal tissue termination.

789

48.5

Previous resection of rectum.

48.6

652

652

48.6

Sigmoidectomy + hysterectomy.

3.359

48.7

Repair of rectum.

789

Year and enterostomy procedures without cc.

682

49.11

anal Fistulotomy.

789

49.12

anal Fistulectomy.

49.3

49.3

Local removal or removal (destruction) of another injury or tissue of the year (anal fissure/physurectomy anal)

500

49.39

Other local excision or destruction of injury or anal tissue.

789

49.45

hemorrhoid ligation.

789

49.46

Hemorrhoids/hemorrhoids/hemorroidectomy.

764

49.59

844

844

49.6

Year's Eve.

591

49.79

Another anal sphincter repair.

591

49.92

Insert or implant

753

49.99

Another operation on ncoc year.

591

50.11

Liver biopsy.

567

50.11

Liver biopsy percutaneous.

1,629

50.13

Transjugular liver biopsy.

3.394

50.94

Liver Embolization for therapeutic substance (alcoholization).

3.162

50.99

Diagnostic and therapeutic hepatic catheterization.

51.10

51.10

51.10

51.10

761

51.2

Colecystectomy + votomy + gastroenterostomy.

2.255

51.22

1.337

51.23

laparoscopic cholecystectomy.

1,337

51.23

laparoscopic laparoscopic cholecystectomy. Bile duct without cc.

1,523

51.36

Biliary drainage placement/ choledocoenterostomy.

1.591

51.86

Colocation-pancreatic prosthesis placement.

3.012

51.88

Perpercutaneous Extraction of biliopancreatic calculations.

1,024

52.41

2,830

53

hernia procedures except inguinal and femoral edad> 17 with cc.

1.391

53

hernia procedures except inguinal and femoral edad> 17 without cc.

901

53

procedures on inguinal hernia and femoral edad> 17 with cc.

1.169

53

procedures on inguinal and femoral hernia edad> 17 without cc.

767

53

hernia procedures age <18.

845

53.0

Unilateral repair of inguinal hernia.

844

53.1

Bilateral Repair inguinal hernia.

1,020

53.2

Unilateral repair of crural hernia.

724

53.3

Bilateral hernia repair.

905

53.4

910

53.49

Hernia Repair umbilical.

740

53.5

Repair of another hernia from the anterior abdominal wall without grafting not prostheses.

910

53.51

Incisional Hernia Repair (eventration).

878

53.6

Repair of another hernia from the anterior abdominal wall with graft or prosthesis.

1,092

54

other surgical procedures on digestive system without cc.

1,455

54.3

Scission or elimin. Injury or abdominal wall tissue or wombl.

54.11

Exploratory Laparotomy.

839

54.19

Other laparotomy.

727

54.21

Laparoscopy.

773

54.21

More colostomy Exploratory Laparoscopy.

998

54.92

Extraction of foreign body from the peritoneal cavity.

916

54.93

Creation of skin-peritoneal fistula.

916

Urinary apparatus operations

55.01

percutaneous Nepholytomy.

340

55.23

biopsy renal.

568

55.5

Nephrectomy.

1,031

55.9

other surgical procedures on kidney and urinary tract.

1,535

56.0

Extraction obtruc transurethral. Ureter and renal pelvis.

1,049

56.0

percutaneous extraction of urinary calculations.

3.012

56.3

Diagnostic procedures in ureter.

898

57.18

Another suprapubic cystotomy.

952

57.19

Another cystotomy.

756

57.4

R. T. U. bladder.

753

57.49

Other excision or transurethral destruction of injury or tissue bladder.

1.123

57.6

Partial Cistectomy.

1,630

57.85

Cistouretroplasty and bladder neck repair.

1,630

57.99

Other operation on the ncoc bladder.

952

57.99

minor bladder procedures without cc.

1,049

58.0

Uretrotomy.

756

58.1

58.2

Diagnostic Procedures on urethra.

477

58.2

procedures on urethra, edad> 17 without cc.

727

58.2

procedures on urethra, age <18.

655

58.3

Scision or destruction of tissue or urethral injury.

869

Hipospadias or epispadias repair.

936

58.49

Repair of hipospadias or epispadias.

1,021

58.49

Uretroplasty.

58.5

895

895

895

895

58.93

Artificial urinary sphincter (AUS) implantation.

952

59.6

Parauthral suspension.

1,630

59.79

Other repair of ncoc effort urinary continence.

1.079

ureteral catheter placement.

477

59.8

Double catheter placement j.

929

59.8

Double catheter removal j.

Operations on male genital organs

60.11

Prostate biopsy.

60.11

60.11

ecodirected prostate biopsy with immunohistochemistry.

60.11

60.11

ecodirected prostate biopsy without immunohistochemistry.

60.2

60.2

60.2

Prostry_table_body_body"> Prostate transurethral resection.

1,075

60.3

818

60.3

60.3

60.3

60.3

60.3

839

839

839

839

Centro_table_body " > 60.4

Retropubic prostatectomy.

1,580

60.62

Perineal prostatectomy (concerted supra).

1.164

60.69

Cistoprost + linfoaden + briker.

3.148

61.2

Termination of hydrocele (vaginal gown).

607

61.4

61.4

333

62.1

Procedures on testicle, non-malign process ed> 17.

1.157

62.1

testicle procedures, non-malign process age <18.

62.2

62.2

924

924

62.3

Orquiectomy unilateral.

1,088

62.5

Orchidopexia.

799

62.42

Remaining testicle removal.

953

63.1

Varicocele and hydrocele Termination of Spermatic cord.

652

63.2

Eepididym cyst rescission.

682

63.3

Other injury or spermatic and epididym cord tissue.

924

348

63.82

Deferential Pipeline Rebuild surgically divided.

953

63.92

Epiditomy.

615

64

1.061

Circumcision.

64.0

Circumcision ed> 17.

780

64.0

64.49

Other penis repair with plastic surgery.

682

64.93

Release of penis adhesions.

64.98

Other operations on the penis.

474

64.9

Other proc.surgical of masc. Exc. For malignancy.

729

Operations on female genital organs

65/71

proc. Female genital apparatus reconstruction.

1.021

65.01

laparoscopic Ooforotomy.

535

65.25

Other local excision or ovarian laparoscopic destruction.

839

65.29

Other local excision or Ovary Destruction.

788

65.31

930

930

Other unilateral oophorectomy.

930

65.41

laparoscopic unilateral Salpingoofectomy.

930

65.49

Other unilateral salpingooforectomy.

930

65.53

Extirpation laparoscopic of both ovaries in one act.

1.293

65.61

Extitration of ovaries and tubes in a surgical act.

861

65.63

laparoscopic removal of both ovaries and tubes in the same act.

1.293

65.81

laparoscopic release of ovary adhesions and Fallopian tubes.

1,424

65.91

Exexial mass cytology.

80

66.21

Bilateral Fallopian Tubes and Endoscopic Crushing.

66.2

66.2

833

66.22

Ligature and bilateral endoscopic section of fallopian tubes.

66.29

Other destruction or bilateral endoscopic fallopian tube occlusion.

768

66.3

tubal interruption by laparoscopy and laparotomy.

898

66.32

676

676

66.39

Other bilateral destruction or occlusion of fallopian tubes.

734

66.51

Extirpation of both fallopian tubes in the same operative time.

66.63

bilateral partial Salpingectomy.

682

682

66.69

Other partial salpingectomy.

682

67.2

Cervical Conization.

880

67.32

Destruction of Cauterization Cervical Injury.

654

Destruction of Cervical Injury by cryosurgery.

654

68.1

955

68.1

Operational Laparoscopy

68.1

964

68.1

Surgical Laparoscopy fiv.

1,739

68.12

930

930

68,12

Diagnostic Histeroscopy ambulatory.

705

68.12

1.171

68.19

68.2

Termination or destruction of injury or uterus tissue.

861

68.21

endometrial sinews section.

930

68.22

InCision or cleavage of congenital septum of utero.

930

68.23

668

68.29

Other cleavage or destruction of uterine uterus/myomectomy injury.

884

68.49

Total abdominal hysterectomy.

1,607

68.59

Vaginal hysterectomy.

proc. About utero and anejos by ca.in situ and non-malignant process without cc.

1.137

69.0

Dilatation and Uterine Leg.

69.02

Dilatation and bequeath after delivery or abortion.

681

69.09

Other dilation and bequeath.

670

69.09

Dilatation and bequeath, conization and radio-implant by malignant neoplasm.

1.355

69.09

Dilatation and bequeathing, conization except for malignancy.

642

69.29

Other uterus repair and support structures.

1,323

69.52

Post-partum egrad.

463

69.92

Donor artificial insemination.

923

69.92

Artificial spouse insemination.

1,140

70.33

Scision or destruction of vagina injury.

654

70.50

Cystocele and rectocele repair.

641

Cistocele Repair.

641

70.52

Rectocale Repair.

622

70.53

Cystocele and rectocele repair with graft or prosthesis.

789

70.54

Cystocele repair with graft or prosthesis.

789

Rectocele repair with graft or prosthesis.

789

Suspension and Fixing vaginal.

789

70.78

Suspension and vaginal fixation with graft or prosthesis.

789

70.79

Vagina colpoperineoplasty/repair.

634

70.8

vaginal dome blitteration.

789

70/71

Procedures on vagina, cervix, and vulva.

1.121

71.2

Bartholin gladula operations.

539

71.3

Other local excision or destruction of vulva and perineum.

589

71.23

bartholin gland marsupialization (cyst).

789

71.24

Scission or other destruction of bartholin (cyst) gland.

789

71.62

Bilateral vulvectomy.

935

obstetric procedures

Parto_table_to_izq"> Parto with forceps.

1.199

73

Induction to childbirth.

760

73.51

1.199

73.59

Normal stop.

1.199

1.199

73.59

1.199

74.0

Caesarea.

1.199

74.3

ectopic pregnancy.

819

75

Pregnancy volunteer (I.V.E.).

444

290

12.1 -14 sem.

500

14.1 -16 sem.

570

16.1 -18 sem.

700

975

975

20.1 -22 sem.

1,200

75.1

Amniocentesis controlled by ultrasound or corial biopsy.

75.33

75.33

147

75.33

Umbilical extraction + conservation.

1,688

Procedures on the appliance musculoskeletal

76.2

Local termination or destruction of bone injuries facial.

76.39

Submaxilectomy.

623

Other facial bone repair/orthognathic surgery.

2.027

76.63

Mandibular Osteotomy.

1,584

76.66

maxillary Osteotomy.

1,284

76.69

Rebuild bone and soft parts.

2,790

76.69

Rebuild soft parts.

961

76.7

Open reduction.

1.013

76.7

Dissection neck 1st.

1,052

76.7

Dissection neck 2nd.

1.055

76.7

neck 3º dissection.

1.110

76.76

Reduction Jaw fracture open.

1.016

76.9

Bone and Joint Operations facials.

869

76.97

Removing facial bone internal fixation device.

838

76.99

666

666

77.1

Another unsplit bone incision.

606

77.14

Other incision bone-free carpianos and metacarpal bone.

868

77.20

Wedge Osteotomy.

1,737

77.23

77.23

1,195

1,195

77.25

Osteotomy in cuna-femur.

1,737

77.27

77.27

737

1,737

77.28

Osteotomy in cuna-arsianos and metatarsians.

813

77.29

813

813

77.33

Radio and Cubite Osteoarthrotomy.

960

77.34

Carpianos and metacarpianos Osteoarthrotomy.

831

77.35

1,737

1,737

77.36

Rotula Osteoarthrotomy.

1.243

77.37

tibia and fibula Osteoarthrotomy.

1,737

77.38

Osteoartrotomy of Tassians and Metatarsians.

861

77.4

Bone biopsies.

77.51

Bursect.with soft tissue correction and osteotomy of the 1st metatarsal/soft tissue correction bunionectomy.

723

77.54

Hallux-valgus Scission /excision or correction of hallux valgus-unil.

796

77.56

Toe repair in hammer.

733

77.57

Garra toe repair.

733

77.58

Other spin-off, merge, and repair of toes.

724

77.59

643

77.6

Local Injury or Fabric Scission bone.

606

77.65

Local injury or femur bone tissue termination.

1,073

77.68

Local injury or tissue tissue or Tatar bones and metatarsal bones.

957

77.69

Local injury or tissue other ncoc bone.

1.227

77.7

Bone Scission for grafting.

606

77.81

Shoulder subachromial decompression.

1.560

77.83

Partial Ostectomy-radio and cubit.

813

77.84

Partial Ostectomy-carpianos and metacarpianos.

813

77.85

Partial Ostectomy-femur.

813

77.86

Partial Ostectomy-kneecap.

1.243

77.87

77.87

Other tibia and fibula.

1,737

77.88

Partial Ostectomy-Tassians and Metatarsians.

813

78.0

Other bone/graft operations unspecified site.

813

proc. Lower and humerus exc. Hip, foot, femur edad> 17 without cc.

1.397

foot procedures.

1,412

proc. Shoulder, elbow or forearm, exc. Joint greater proc.greater than cc.

1,849

78.35

elongation procedures extremities-femur.

1,737

78.37

Limb Elongation Procedures-lukewarm and perone.

1,737

78.40

Other repair or plastic operations on the bone (pseudoarthrosis repair). Falanges (foot-hand).

813

78.41

Other repair or plastic operations on the bone (pseudoarthrosis repair). Scapula, collarbone, and chest [ribs and sternum].

1,737

78.42

Other repair or plastic operations on the bone (pseudoarthrosis repair). Humerus.

1,737

78.43

Other repair or plastic operations on the bone (repair pseudoarthrosis). Radio and Cubite.

813

78.44

Other repair or plastic operations on the bone (pseudoarthrosis repair). Carpianos and metacarpianos.

813

Proc. greater on thumb or joint, or other proc.s.hand or wrist with cc.

1.294

Proc. On hand or wrist, except proc.majors s.articulation without cc.

1.013

78.45

Other repair or plastic operations on the bone (pseudoarthrosis repair). Femur.

1,737

78.46

Other repair or plastic operations on the bone (repair pseudoarthrosis). Kneecap.

1,737

78.47

Other repair or plastic operations on the bone (repair pseudoarthrosis). Tibia and perone.

1,737

78.48

Other repair or plastic operations on the bone (pseudoarthrosis repair). Tarsianos and metatarsians.

813

78.49

Other repair or plastic operations on the bone (pseudoarthrosis repair). Pelvic bones-vertebrae.

1,737

78.52

Internal bone fixation (humerus).

1,737

78.53

Internal bone setting (radio and cubit).

813

Internal bone setting (carpianos and metacarpianos).

813

78.55

Internal bone setting (femur).

1,737

78.56

Internal fix bone (kneecap).

1,737

78.57

Internal bone setting (tibia and perone).

1,737

78.58

Internal bone setting (Tassians and metatarsians).

813

78.6

Extraction of osteosynthesis material.

643

78.60

78.60

78.60

78.61

Extraction devices implanted in scapula. Collarbone and thorax (ribs and sternum)/emo minor.

598

78.62

Extraction of material of osteosynthesis-humerus (emo major).

643

78.63

Extraction of osteosynthesis material -radius and cubit (emo minor).

284

78.64

Extraction of osteosynthesis-carpianos and metacarpianos (emo minor) material.

284

78.65

Extraction device implanted femur/extraction of osteosynthesis-femur material (emo major).

786

78.66

Extraction of osteosynthesis-kneel (emo minor) material.

284

78.67

Extraction of osteosynthesis-tibia and perone material (emo major).

643

78.68

Extraction of osteosynthesis-Tassians and metatarsal material (emo minor).

78.69

Extraction internal fixing devices in column.

851

79

79

1,025

79.01

Reduced Fracture Fracture

884

79.02

Reduced fracture and radio fracture reduction.

655

79.03

Closed carpal or metacarpal fracture reduction.

607

79.04

Reduction Fault fracture closed.

607

79.05

Reduced femur fracture reduction/ Femur osteosynthesis with orthofix.

1,327

79.05

Osteosynthesis hip with t. Howse.

3.271

79.06

Reduced Lukewarm Fracture and Perone/Lukewarm Osteosynthesis with orthofix.

1.056

79.12

Closed fracture reduction with internal fixation on radio and cubit.

1,195

79,12

Osteos. Radio Head.

1,752

79.13

Closed fracture with internal fixation on carpal and metacarpal.

868

79.14

Closed fracture reduction with internal fixation on

868

79.21

Reduced humerus open fracture.

1,761

79.21

Osteos. Acromy-clavicular.

1,477

79.22

Reduced fracture and radio open fracture.

813

79.23

Reduced carpal or metacarpal open fracture.

813

79.24

Reduction Open Fracture Reduction.

813

79.25

Reduction femur open fracture.

1,737

79.25

Osteos. From femur with kuntscher.

874

79.25

Osteos. Cad. With c. Render.

1,449

79.26

Osteos. Tibia with kuntscher.

1.496

79.26

Osteos. Tibial plateau.

903

79.36

Reducc. Open fracture of tibia and fibula with fixac. Internal.

1,737

79.71

Closed reduction of Shoulder luxation.

655

79.75

Closed hip luxation reduction.

1.287

79.76

Closed knee dislocation reduction.

79.78

Closed foot and toe luxation reduction.

516

79.81

Open Shoulder Dislocation reduction.

1,449

79.85

Reduced hip luxation reduction.

1,737

79.86

Open knee-luxation reduction.

1,737

79.87

Osteos. Ankle.

1,335

80.0

Local and Disp Removal. Internal hip and femur fixation.

1,589

80.0

Local termination and extraction of internal fixation device except hip and femur, without c.

1.522

80.2

Artroscopy.

1.303

80.21

Shoulder arthroscopy.

1.295

80.22

971

823

Doll Artroscopy

971

1.108

80.24

691

80.25

Artroscopy hip.

1.156

80.26

Knee arthroscopy.

1.222

1.108

828

Footer and toe Artroscopy standing.

516

80.29

Artroscopy of other specified sites.

1.142

80.4

1.119

848

1.119

1.119

1.119 Body_table_table_izq"> Capsule Division, Foot Joint Ligament, or Cartilage Division, and toes.

1.295

851

Intervertebral Disk Excision.

3.024

80.52

Intervertebral quimionucleolysis.

2.359

80.54

Fibrous ring repair with graft or prosthesis.

3.024

80.59

Another fibrous ring repair.

3.024

80.6

80.6

Knee semilunar cartilage/knee-length excision.

801

801

801

801

80.72

Sinovectomy elbow.

925

80.73

Doll Sinovectomy.

933

Hand finger and hand Sinovectomy.

743

80.75

Hip Sinovectomy.

801

80.76

Knee Sinovectomy

911

80.77

ankle Sinovectomy.

911

88078

Sinovectomy (foot and toes).

516

881

Total termination or destruction of joint (shoulder) injury.

516

Total termination or destruction of joint (elbow) injury.

516

Total termination or destruction of joint (wrist) injury.

516

80.84

Total termination or destruction of joint (hand and finger) injury.

516

8885

Total termination or destruction of joint (hip) injury.

801

886

Total termination or destruction of joint (knee

injury

801

887

Total termination or destruction of joint (ankle) injury.

516

Total termination or destruction of joint injury (foot and toes).

516

81.00

3.322

81.01

Artrodesis a-o.

1.155

81.02

Caspar cervical column fix.

1,437

81.11

Artrodesis and foot and ankle arthroresis.

1,650

81.12

Triple ankle arthrodesis.

1,830

81.13

Subastragalin Artrodesis.

1.226

81.15

Tarsometarsal Fusion.

1.119

81.16

Artrodesis metatarsal-phalangica.

1.155

81.17

Another foot merge.

1.119

81.18

Subastragalin joint arthroereisis.

1.155

81.2

2.448

2.448

81.21

hip arthrodesis.

1,658

81.22

Knee arthrodesis.

1,623

81.23

Shoulder arthrodesis.

981

81.25

81.25

1.144

1.144

81.26

Artrodesis carpometacarpiana.

1.144

81.27

Artrodesis metacarpophalangica.

1.144

81.28

868

868

81.29

Artrodesis of other specified joints.

1.119

81.44

1.261

1.261

81.45

Other cross-ligaments repair.

1,458

81.47

Other knee repair.

1,458

Non-cc knee procedures.

1.466

81.49

Other ankle repair.

1.259

81.51

Prot. Total autobloq. Cad.

1.587

81.51

Total hip replacement (prosthesis not included).

4,098

81.52

Partial hip replacement (prosthesis not included).

4.098

81.52

Riddstone Operation (ext. Femur head) (femur head resection).

1.548

81.53

Hip Prosthesis Replacement (prosthetic not included).

4,098

81.53

Spare and head replacement.

1,614

procedures on back and neck exc. Spinal fusion without cc.

3.508

81.54

Total knee replacement (prosthesis not included)

4,098

81.54

Prot. Total rotating rod.

1,661

81.54

Prot. Total rod tack.

1,382

81.55

Knee Prosthesis Replacement Replacement (prosthetic not included)

4.098

81.57

Foot And Finger Joint Replacement (prosthesis not included)

1.571

81.7

Hand, finger, and wrist arthroplasty (prosthetic not included).

1.571

81.71

81.71

1,808

81.72

Artroplasty of metacarpophalangica joints and interphalangica without implant.

1.074

81.74

Carpocarpiana joint arthroplasty and teacarpophalangica with implant.

1,808

81.75

Carpocarpiana joint arthroplasty and metacarpophalangica without implant.

1.074

81.80

Total shoulder replacement (prosthetic not included).

4,098

81.81

Partial shoulder replacement (prosthesis not included).

4,098

81.82

Shoulder/repair frequent dislocation repair Shoulder relapsing dislocation.

1,627

81.83

Other shoulder repair.

1.203

81.84

Elbow Arthroplasty (prosthesis not included).

4.098

81.85

Another elbow repair (prosthetic not included)

1,449

81.93

1.195

81.95

Capsule or Ligament Suture of another lower extremity.

516

81.96

Other articulation repair.

516

82.01

Hand tendon sheath scan.

508

82.11

Hand Tenotomy (plasty risartrosis).

979

82.12

Hand Fasciotomy.

508

82.21

Extermination of hand tendon/ganglionectomy sheath injury.

441

82.22

Hand muscle injury excision.

333

82.29

Scission of another hand soft tissue injury.

568

82.31

Hand Bursectomy.

508

82.33

Other hand tendonectomy.

508

82.35

Other hand/release fasciectomy dupuytrain.

737

82.39

Other soft tissue excision.

568

82.4

Muscle, tendon and hand fascia suture.

1,008

82.8

Hand plastic operations.

1,008

82.91

Hand-to-trigger stick-to-toe-stick.

516

83.0

Incis. From musc., tendon, fascia and sinovi bag. (except for hand).

83.1

Division of muscle, tendon, and fascia.

Aquitletenotomy.

918

83.12

Hip Adductor Tenotomy.

767

83.13

Other Tenotomy.

641

83.14

Fasciotomy.

918

83.21

musculoskeletal and connective tissue system biopsies.

2.026

83.29

Other musculoskeletal and connective tissue system diagnostics.

83.39

83.39

Other soft tissue/(baker cyst).

568

Another fasciectomy.

544

83.49

Other Fabric Split soft.

508

soft tissue procedures without cc.

987

569

569

83.63

Bushing Repair rotators.

1,570

83.64

tendon suture.

801

83.65

Other muscle suture or fascia.

83.76

Other Transposition of Tendon.

801

83.81

tendon graft.

1.207

83.83

1.207

83.85

Other change in muscle length or tendon.

663

83.87

Other muscle/ligaments disorders.

508

83.88

Release of the carpal tunnel /repair tendinous hand.

516

83.89

Other plastic operations on fascia.

783

83.9

Other surgical s.musculoskeletal and t.connective without cc.

1.288

83.91

Muscle, tendon, fascia, and synovial attachment lysis.

605

Other operations on muscle, tendon, fascia, and synovial bag.

783

Other plastic operations on fascia.

508

81.0

Amputations top member.

1,752

84.01

Amputation and hand finger disarticulation.

702

84.02

Amputation and thumb disarticulation.

799

84.1

Lower member amputation.

1,752

84.11

Footing.

793

84.17

Amputation above the knee.

1,752

84.3

amputation stump review.

709

Operations on the tegumentary appliance

85.11

Arpon-led breast biopsy.

204

85.11

Esteroxia-directed breast biopsy.

605

85.12

Breast biopsy and local excision by non-malignant process.

843

85.19

Proc. About breast by non-malignant process except biopsy and local excision.

1,433

85.21

Scission local injury to the breast injury minor.

537

85.22

Breast quadrant resection.

836

85.24

Ectopic breast tissue rescission.

836

85.25

nipple Scission.

836

85.31

Reduction Mamoplasty unilateral.

1.355

85.32

Bilateral reduction mammoplasty.

1,831

85.41

Mastectomy.

1.103

85.42

Total Mastectomy bilateral.

1,623

85.53

Unilateral breast implant.

1,100

85.54

Breast implant bilateral.

1,688

85.6

Mastopexia.

1,078

85.7

Total Mom Rebuild.

2,529

85.70

Reconstruction and graft.

468

85.81

Scission and direct suture.

85.82

85.84

Colgajo on the breast.

85.84

917

85.84

Microsurgical Colgajo.

2.353

85.84

Plastia with flap.

712

85.85

Mio-cutaneous Colgajo.

85.87

pawn repair or rebuild.

1.033

85.89

Scision and plasty with 1st flap.

371

85.89

Surgical debridement.

838

85.91

Breast Aspiration.

1,078

85.93

Breast implant review.

1,100

85.94

Removing breast implant.

684

85.95

Breast tissue expander insert.

1.016

85.96

Fabric expander extraction mammary.

917

85.99

Another operation on mama ncoc.

585

86.0

Lower skin disorders without cc.

963

86.1

Other procedures on skin, subcutaneous, and breast without cc.

1,160

86.04

Other incision with skin and tissue drainage subcutaneous.

567

86.05

Incision with foreign body or skin device removal and subcutaneous tissue.

153

86.06

Fully implantable infuser pump insert.

996

86.07

Fully implantable vascular access device insert.

725

86.2

Extirpation or destruction of skin and tissue injury or tissue subcutaneous (lipomas).

317

86.21

Scision of cyst or pilonidal breast.

664

86.23

Removing one, bed, or fold one.

153

86.24

Quimicosurgery for skin.

783

86.26

Stub Ligure supernumerary finger/finger.

700

86.3

Other local removal or injury destruction or skin tissue and subcutaneous tissue.

153

86.4

Radical cutaneous malignant injury termination.

517

86.60

Free skin graft.

539

86.62

Other skin grafting by hand.

1,195

86.70

Pask and hang grafts. Plastic surgery.

1,332

86.83

Size reduction plastic operation/ lipectomy.

1,660

86.84

Skin-linked scar or contracture relaxation skin plasty.

948

86.85

Correction of syndactylia.

903

86.89

Other skin and subcutaneous tissue repair and reconstruction.

539

Misceleal Diagnostic and Therapeutic Procedures

Histerosalpingography.

112

89.17

Polisomnography.

695

89.50

Subcutaneous holter implantation.

93.26

release of joint adhesions.

516

96.23

anal sphincter dilatation.

500

98.0

Extraction of foreign sleep in tube digestive.

1,889

98.14

Extraction of foreign body tractraconchial.

1,960

98.52

Extracorporeal renal Litotricia.

1.143

Treatment hyperbaric chamber.

2,429

Endoscopic capsule.

976

Histerosonography.

139

epidural anesthesia.

Attention threat premat care.

374

Fecundation in vitro.

3,448

Intracytoplasmic Sperm Injection (ICSI).

Microinjection

1,140

1,140

Transfer of frozen.

1,140

Other haematological and haematopoietic organ surgical proc.

. Bad difer. With another procedure.

2,200

surgical with diag. From other contact with health services.

1.083