TN0723 SLE WITH SEPSIS | ||||||
---|---|---|---|---|---|---|
PREAUTH | CLAIMS | |||||
MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
SLE RASH , FEVER , ALTERED SENSORIUM | CLINICAL PHOTO, ANA, ECHO, RFT, CBC | TOTAL BED DAYS | 20 | |||
BEDS IN ICU | ||||||
DAYS UNDER VENTILATOR SUPPORT | INCLUDES NIV | |||||
INVESTIGATIONS | GENERAL WORK UP | 30 | mandatory | Includes LFT / RFT / ECHO / CXR | ||
CULTURES | mandatory | |||||
SEROLOGY | mandatory | |||||
IMAGING | ||||||
TREATMENT | STEROIDS / IMMUNOSUPPRESSION / | 50 | mandatory | |||
ANTIBIOTICS | mandatory | |||||
SUPPORTIVE CARE |