TN 0392 SEVERE BRONCHIOLITITS/SEVERE BRONCHOPNEUMONIA/SEVERE ASPIRATION PNEUMONIA (NON VENTILATED) |
PREAUTH | CLAIMS |
MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % breakup amount - claims | WEIGHTAGE(%) IN CLAIMS AMOUNT | SPECIAL MENTION |
RESP. DISTRESS, INTERCOSTAL RECESSION, SUBCOSTAL RECESSION, FEVER, COUGH, REFUSAL TO FEED, SEIZURE+- | CLINICAL PHOTO, CBC, CXR | TOTAL BED DAYS | > 5 | 20 | | |
| | DAYS IN ICU | | | | discretion of treating doctor |
| | DAYS UNDER VENTILATOR SUPPORT | | | | |
| | INVESTIGATIONS | GENERAL WORK UP + ECG + ELECTROLYTES | 30 | | |
| | | CXR | | mandatory | |
| | | Rpt CXR | | | |
| | | ABG | | | |
| | | sputum collection c/s | | | |
| | | | | | |
| | TREATMENT | SUPPORTIVE CARE | 50 | | |
| | | IV ANTIBIOTICS | | mandatory | |
| | | NEBULISATION/OXYGEN THERAPY | | mandatory | |