| TN0896 CHRONIC HEPATITIS C | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % breakup amount - claims | POINTS AWARDED | SPECIAL MENTION |
| ABDOMINAL PAIN, JAUNDICE, FATIGUE | CLINICAL PHOTO, USG REPORT, VIRAL MARKERS,VIRAL LOAD. | TOTAL BED DAYS | 5 | 5 | ||
| DAYS IN ICU | 0 | |||||
| DAYS UNDER VENTILATOR SUPPORT | 0 | |||||
| INVESTIGATIONS | GENERAL WORK UP +LFT + RFT | 5 | ||||
| HBV PROFILE INCLUDING VIRAL LOAD | 10 | |||||
| USG ABD | ||||||
| COAGULATION PROFILE | ||||||
| TREATMENT | PEG - INTERFERON | 60 | 6 MONTHS TREATMENT SHOULD BE GIVEN | |||
| ORAL ANTIVIRAL DRUGS | 20 | |||||
| SUPPORTIVE CARE | ||||||