TN0726 VASCULITIS |
PREAUTH | CLAIMS |
MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % BREAKUP AMOUNT - CLAIMS | POINTS AWARDED | SPECIAL MENTION |
VARYING PRESENTATION - CONSTITUTIONAL SYMPTOMS - FEVER, WEIGHT LOSS, FATIGUE, ORGAN SPECIFIC SYMPTOMS - CNS - HEADACHE, SEIZURES/ RENAL - HEMATURIA / PULMONARY - BREATHLESSNESS | CLINICAL PHOTO, SEROLOGY - ANA, ANCA POSITIVITY | TOTAL BED DAYS | | 20 | | |
| | BEDS IN ICU | | | | |
| | INVESTIGATIONS | GENERAL WORK UP | 30 | | CXR |
| | | SEROLOGY - AUTOANTIBODIES | | mandatory | |
| | | BIOPSY - HPE | | | |
| | | INFECTIOUS WORK UP | | | |
| | | THROMBOPHILIA WORK UP | | mandatory | APTT, LUPUS ANTICOAGULANT, ANTICARDIOLIPIN ANTIBODY, ANTI BETA2 MICROGLOBULIN ANTIBODY, PROTEIN C, PROTEIN S, ANTI THROMBIN 3 LEVELS. - ANY TWO INV. IS MANDATORY |
| | | IMAGING | | | CT or MRI ANGIOGRAPHY |
| | TREATMENT | STEROIDS / IMMUNOSUPPRESION / I.V IG | 50 | mandatory | |
| | | SUPPORTIVE CARE | | | |