| TN 0391 Term Baby, Septic Shock, Ventilated, Hyperbilirubinemia,with or without Renal Failure | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % breakup score - claims | WEIGHTAGE(%) IN CLAIMS AMOUNT | SPECIAL MENTION |
| LETHARGY, HYPO/HYPERTHERMIA, JAUNDICE+-, SEIZURES+- | CLINICAL PHOTO, CBC, CXR ,ANTHROPOMETRICAL DATA | TOTAL BED DAYS | > 5 | 20 | ||
| DAYS IN ICU | discretion of treating doctor | |||||
| DAYS UNDER VENTILATOR SUPPORT | ||||||
| INVESTIGATIONS | GENERAL WORK UP + LFT + RFT + S.BILIRUBIN + BLOOD G&T + S.CALCIUM + CXR | 30 | MANDATORY | |||
| BLOOD +/- Other CULTURE | MANDATORY | |||||
| ABG | MANDATORY | |||||
| COAGULATION STUDY | ||||||
| CSF STUDY | ||||||
| CRP | MANDATORY | |||||
| ECHO, Micro ESR | ||||||
| TREATMENT | SUPPORTIVE CARE | 50 | ||||
| ANTIBIOTICS +/- AEDS | MANDATORY | |||||
| PHOTOTHERAPY SOS | ||||||
| EXCHANGE TRANSFUSION SOS | ||||||
| MECHANICAL VENTILLATION | MANDATORY | |||||