TN0691 ACUTE MI REQUIRING IABP PUMP | ||||||
---|---|---|---|---|---|---|
PREAUTH | CLAIMS | |||||
MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
CHEST PAIN +/_ VOMITING | ECG / CLINICAL PHOTO / ECHO | TOTAL BED DAYS | 20 | |||
BEDS IN ICU | ||||||
DAYS UNDER VENTILATOR SUPPORT | ||||||
INVESTIGATIONS | ECG Changes | 30 | mandatory | |||
Cardiac Enzymes | ||||||
echo | mandatory | |||||
TREATMENT | IABP | 50 | mandatory | |||
Thrombolysis / LMWH & Others | ||||||
angiogram | mandatory | |||||
other supportive medicines |