Healthcare services requiring prior authorisation

Transcription

1 Annex 2 Healthcare requiring prior authorisation This list does not include organ transplants and does also not apply to long-term care and the primary purpose of which is to support people in need of assistance in carrying out routine, everyday tasks as they fall outside the scope of the Cross Border Directive. The service/s for which prior authorisation is required must form part of the National Health Care Package offered locally. This list may from time to time be updated or modified. System Radiology Services Radiofrequency Services Radiotherapy Services Cardiac Services Vascular Services Respiratory and Thoracic Services requiring prior authorisation Angiography CT Scan Angioplasty CT diagnostic & therapeutic radiology Magnet Resonance Imaging Nuclear Medicine Radiologically guided interventions Radiofrequency Ablation Radiotherapy Services Cardiac valve and septa surgery Cardiac vessel/s surgery Other specialised cardiac surgery that may require overnight stay. Adult specialist cardiac Cardiac Angiogram and Angioplasty. Paediatric cardiac Vascular surgery that may require an overnight hospital stay. Other specialised vascular Thoracic Surgery Service requiring Specialist respiratory for Adult specialist respiratory 1

2 Nervous System Central and peripheral specialised nervous system surgery. Spinal surgery service requiring overnight stay Spinal cord injury Specialist Neurology Services. Neuropsychiatry Services involving mental health Ear Services Digestive system Dermatology Pain management Gynaecological and Obstetric Services Specialist eating disorders Adult specialist mental health Paediatric specialist mental health Alcohol, Drug and Gambling Addiction Bone anchored hearing aid Cochlear implantation Specialist ear and procedures that may require Digestive system and procedures that may require Specialist gastroenterology, hepatology and nutritional support Specialist liver disease Specialist for complex gastrointestinal, liver, biliary and pancreatic diseases. Highly specialised dermatology and allergy Highly specialised pain management Gynaecological procedures and requiring Obstetric procedures and that may require Normal vaginal delivery and other forms of assisted delivery. Specialist gynaecological and obstetric Fetal medicine 2

3 Infectious Diseases Services for persons with infectious diseases. Specialist for persons infected with HIV. Plastic Surgery Cleft lip and palate repair Craniofacial procedures and Plastic surgery Burns Services Haematology, Lymphatic and Immunology Specialist burn care Haematology and Lymphatic system and surgery that may require Specialist haemoglobinopathy Specialist haematology Specialist immunology for patients with deficient immune systems. Severe combined immunodeficiency and related disorders Specialist for haemophilia, thalassemia and other related bleeding disorders. Breast Surgery Procedures to breast that may require Male Genital Organs Procedures on male genital organs that may require Musculoskeletal/Orthopaedic system Nose, mouth, other facial and throat Procedures and on musculoskeletal system that may require Specialist orthopaedic Services and procedures to nose, mouth, other facial and throat that may require Specialist to nose, mouth, other facial and throat. 3

4 Genetic Specialist genetic Dental Specialist dentistry for Dentistry that may require Cancer Specialist cancer Chemotherapy/hormone therapy/antibody therapy Renal and Urology Procedures and on renal and urinary system that may require Specialist renal and urology and procedures for children and young persons. Adult specialist renal and urology Ophthalmic Ophthalmic procedures and that may require Adult and paediatric specialist ophthalmology Intensive care Intensive care Rehabilitation Rehabilitation Specialist rehabilitation for patients with complex needs. Rheumatology Specialist rheumatology for Adult specialist rheumatology Orthotics and Prosthetics Specialised Orthotic and Prosthetic 4

5 Other specialist Endocrine Specialist for children with special needs. Endocrine procedures and that may require Specialist endocrinology Specialist metabolic disorder Highly specialised diabetic Specialist morbid obesity Trauma Palliative care Major trauma Trauma rehabilitation Palliative care requiring Hyperbaric oxygen treatment Hyperbaric oxygen treatment Rare Diseases Services required by persons with rare conditions (rare conditions as defined by ORPHANET website). General Surgery Surgery for persons who may require Neonatal care Endoscopy Specialist neonatal care Endoscopy 5