|
SERIAL NUMBER
|
Procedure
|
1st Qtr
|
Per Qtr (for next 3 Qtrs)
|
Requirements while submitting for follow-up Preauth
|
Requirements while submitting for follow-up Claims
|
|
76
|
FP0076 : Acute Severe Asthma with (Ventilated)
|
1,600
|
800
|
Previous Discharge Summary
|
Clinical Evaluation, Relevant Investigations, PFT
|
|
80
|
FP0080 : Status Epilepticus
|
1,600
|
800
|
Previous Discharge Summary
|
Clinical Evaluation, EEG, LFT-M, drug Level
|
|
81
|
FP0081 : Intra Cranial bleed
|
2,000
|
1,000
|
Previous Discharge Summary
|
Clinical Evaluation, Investigations On Case To Case Basis
|
|
86
|
FP0086 : Neuro Tuberculosis
|
2,000
|
1,500
|
Previous Discharge Summary
|
Clinical Evaluation, CBC,LFT,CSF Analysis,EEG
|
|
