| TN 0393 SEVERE BRONCHIOLITITS/SEVERE BRONCHOPNEUMONIA/SEVERE ASPIRATION PNEUMONIA (VENTILATED) | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MINIMUM CLINICAL REQUIREMENTS | 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, SaO2 | 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 | |||||
| ABG | mandatory | |||||
| RPT CXR | mandatory | |||||
| sputum collection c/s | ||||||
| TREATMENT | SUPPORTIVE CARE | 50 | includes nebulisation / IV fluids/ oxygen | |||
| IV ANTIBIOTICS | mandatory | |||||
| VENTILATORY CARE | mandatory | |||||