| TN0719 PEMPHIGUS/PEMPHIGOID | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
| BLISTERS, MUCOSAL LESIONS: FLACCID SKIN IN PEMPHIGUS VULGARIS | CLINICAL PHOTO | TOTAL BED DAYS | 20 | |||
| DAYS IN ICU | ||||||
| INVESTIGATIONS | GENERAL WORK UP | 30 | ||||
| SKIN BIOPSY + HP FROM BLISTER'S EDGE | mandatory | |||||
| IF STUDIES/TZANCK SMEAR | ||||||
| TREATMENT | STEROIDS - PULSE THERAPY | 50 | mandatory | |||
| IMMUNOSUPPRESANTS | ||||||
| IV IMMUNOGLOBULINS | ||||||
| ANTIBIOTICS AND SUPPORTIVE CARE | ||||||