TN 0376 IMMUNODEFICIENCY
PREAUTHCLAIMS
MIN. CLINICAL SYMPTOMSMIN. REQUIREDCRITERIADETAILS% breakup amount - claimsWEIGHTAGE(%) IN CLAIMS AMOUNTSPECIAL MENTION
RECURRENT INFECTONS, FAILURE TO THRIVECLINICAL PHOTO, CBC, CXR,TOTAL BED DAYS> 520  
  DAYS IN ICU   discretion of treating doctor
  DAYS UNDER VENTILATOR SUPPORT    
  INVESTIGATIONSGENERAL WORK UP30 includes cbc and cxr
   IMMUNOGLOBULIN ASSAY MANDATORYada enzyme levels , iga levels , complement levels .
   BLOOD/URINE CULTURE   
       
       
       
  TREATMENTSUPPORTIVE CARE50 PACKAGE NAME TO BE REVISED TO BE MORE SPECIFIC
    IMMUNOGLOBULIN INFUSION MANDATORY 
   TREATMENT OF INFECTIONS