TN0707 OPTIC NEURITIS
PREAUTH		CLAIMS
MIN. CLINICAL SYMPTOMS	MIN. REQUIRED	CRITERIA	DETAILS	% breakup amount - claims	POINTS AWARDED	SPECIAL MENTION
VISUAL SYMPTOMS - BLURRING OF VISION WITH RETRO ORBITAL PAIN	CLINICAL PHOTO, FUNDUS EXAMINATION REPORT, VISUAL EVOKED POTENTIAL REPORT	TOTAL BED DAYS		20
		BEDS IN ICU
		INVESTIGATIONS	GENERAL WORK UP	30	mandatory	INCLUDING FUNDUS EXAMINATION AND OPHTHALMOLOGIST REVIEW - visual field evaluation
			VISUAL EVOKED POTENTIAL		mandatory
			OTHER RELEVANT INVESTIGATION			HbA1c, LIPID PROFILE,
			MRI BRAIN - TO r/o MULTIPLE SCLEROSIS
		TREATMENT	STEROIDS	50	mandatory	I.V METHYLPREDNISOLONE
			OTHER RELEVANT TREATMENT