| TN0717 FUNGAL MENINGITIS ( MINIMUM 20 DAYS IN ICU ) | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % breakup amount - claims | POINTS AWARDED | SPECIAL MENTION |
| CNS SYMPTOMS LIKE ALTERED SENSORIUM, SEIZURES | CLINICAL PHOTO, CT SCAN BRAIN, LP - CSF STUDY | 20 | ||||
| BEDS IN ICU | ||||||
| DAYS UNDER VENTILATOR SUPPORT | ||||||
| INVESTIGATIONS | GENERAL WORK UP | 30 | ||||
| CSF STUDY | mandatory | INCLUDING KOH MOUNT | ||||
| CT SCAN BRAIN ( PLAIN ) | mandatory | |||||
| MRI BRAIN | ||||||
| OTHER RELEVANT INVESTIGATIONS | ||||||
| TREATMENT | I.V. ANTIFUNGALS | 50 | mandatory | |||
| SUPPORTIVE CARE | mandatory | I.V fluids / oxygen / etc. | ||||
| MECHANICAL VENTILLATION | ||||||