TN0722 SLE | ||||||
---|---|---|---|---|---|---|
PREAUTH | CLAIMS | |||||
MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
MALAR RASH , JOINT PAIN | CLINICAL PHOTO, ANA | TOTAL BED DAYS | 20 | |||
BEDS IN ICU | ||||||
INVESTIGATIONS | GENERAL WORK UP | 30 | mandatory | Includes LFT / RFT / ECHO / CXR | ||
SEROLOGY | mandatory | ANA , ANCA , Anti dS DNA, | ||||
RELEVANT INVESTIGATIONS PERTAINING TO SYSTEM AFFECTED | ||||||
IMAGING | CHEST CT | |||||
TREATMENT | STEROIDS / IMMUNOSUPPRESSION / | 50 | mandatory | |||
SUPPORTIVE CARE |