| TN0659 CRYPTOCOCCAL MENINGITIS | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
| ALTERED SENSORIUM / FEVER | CBC / CLINICAL PHOTO / CRYPTOCOCCAL ANTIGEN DETECTION | TOTAL BED DAYS | 20 | |||
| BEDS IN ICU | ||||||
| DAYS UNDER VENTILATOR SUPPORT | ||||||
| INVESTIGATIONS | csf study - india ink staining and culture | 30 | ||||
| general work up including HIV | mandatory | |||||
| antigen detection | mandatory | |||||
| CT scan brain | ||||||
| TREATMENT | supportive medicines | 50 | ||||
| antifungal - amphotericin B | mandatory | |||||