TN0692 REFRACTORY CARDIAC FAILURE |
PREAUTH | CLAIMS |
MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
BREATHLESSNESS +/- ANASARCA ,EDEMA, PREVIOUS TREATMENT HISTORY FOR CARDIAC FAILURE | XRAY CHEST / ECHO / ECG / CLINICAL PHOTO / PREVIOUS ECHO REPORT | TOTAL BED DAYS | | 20 | | |
| | BEDS IN ICU | | | | |
| | DAYS UNDER VENTILATOR SUPPORT | | | | INCLUDES NON INVASIVE VENTILLATION |
| | INVESTIGATIONS | General Work UP + ECG | 30 | mandatory | |
| | | CXR | | mandatory | |
| | | ECHO | | mandatory | |
| | TREATMENT | digoxin / lasix / aldosterone antagonist | 50 | mandatory | PACKAGE IS NOT FOR CORRECTABLE CAUSE OF CARDIAC FAILURE |
| | | ionotrophs | | mandatory | |
| | | | | | |
| | | IABP / DIALYSIS / SUPPORTIVE THERAPY | | SEPERATE PACKAGE | |