TN0702a PERITONEAL DIALYSIS
PREAUTH		CLAIMS
MIN. CLINICAL SYMPTOMS	MIN. REQUIRED	CRITERIA	DETAILS	% breakup amount - claims	POINTS AWARDED	SPECIAL MENTION
Fever / abdominal pain	CLINICAL PHOTO / RFT / USG kub	TOTAL BED DAYS	7
		BEDS IN ICU	1
		DAYS UNDER VENTILATOR SUPPORT
		INVESTIGATIONS	GENERAL WORK UP			Serum electrolytes, BUN, creatinine, lactate dehydrogenase (LDH), creatine phosphokinase (CPK), and liver function tests:
		TREATMENT	INCLUDES PROCEDURAL COST ALSO