SchemeBook / Covered conditions

Find a PMB condition or minimum treatment

Search the Diagnosis Treatment Pair (DTP) directory by condition, DTP code or minimum treatment, or browse by clinical category. This is a SchemeBook guide to the CMS PMB source set — not a quote, diagnosis or individual benefit decision.

Prescribed Minimum Benefits

266 DTP records currently indexed

The Council for Medical Schemes describes a limited set of 271 medical conditions defined through Diagnosis Treatment Pairs. SchemeBook currently indexes 266 parsed DTP records from the current CMS source material. The remaining difference is being reconciled before SchemeBook describes the catalogue as complete.

A DTP links a diagnosis to a minimum treatment entitlement. It does not by itself tell you which provider to use, what a provider will charge, whether authorisation is required, or the exact amount your option will pay.

Endocrine, Metabolic And Nutritional

13 matching indexed records

← All clinical categories

DTP code	Condition	Minimum treatment
236K	Iron deficiency; vitamin and other nutritional deficiencies – life-threatening	Medical management
30K	Benign neoplasm of islets of Langerhans	Excision of tumour; medical management
31K	Hypoglycemic coma; hyperglycemia; diabetic ketoacidosis	Medical management
331K	Acute thyroiditis	Medical management
447K	Disorders of parathyroid gland; benign neoplasm of parathyroid gland	Medical and surgical management
61K	Congenital hypothyroidism	Medical management
901K	Life-threatening congenital abnormalities of carbohydrate, lipid, protein and amino acid metabolism	Medical management
902K	Disorder of adrenal secretion NOS	Medical management; adrenalectomy
903K	Life-threatening disorders of fluid and electrolyte balance, NOS	Medical management
904K	Hyper and hypothyroidism with life-threatening complications or requiring surgery	Medical management Surgery
950K	Cancer of endocrine system, excluding thyroid - treatable	Medical and surgical management, which includes chemotherapy and radiation therapy
951K	Benign and malignant tumours of pituitary gland with/without hypersecretion syndromes	Medical and surgical management; radiation therapy
952K	Cancer of thyroid - treatable; carcinoid syndrome	Medical and surgical management, which includes chemotherapy and radiation therapy

Using this with SchemeBook

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Start with a general healthcare service or procedure concept if you do not know the DTP code.

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Choose your medical scheme and see what SchemeBook can verify from the available source layer.

Authoritative source

Council for Medical Schemes — Prescribed Minimum Benefits ↗ · CMS PMB conditions list ↗

Annexure A to the Medical Schemes Act regulations is the legal source. CMS notes that its coded PMB conditions list is a guideline and the regulatory condition definition prevails if there is a conflict.