| TN 0378 HEMOPHAGOCYTIC LYMPHOHSITIOCYTOSIS | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % breakup score - claims | WEIGHTAGE(%) IN CLAIMS AMOUNT | SPECIAL MENTION |
| LAP, JAUNDICE+-, HEPATOSPLENOMEGALY | CLINICAL PHOTO, CBC, CXR, LFT | TOTAL BED DAYS | > 5 | 20 | ||
| DAYS IN ICU | discretion of treating doctor | |||||
| DAYS UNDER VENTILATOR SUPPORT | ||||||
| INVESTIGATIONS | GENERAL WORK UP | 30 | LFT / RFT | |||
| CBC, LFT, RFT, FERRITIN | MANDATORY | |||||
| CT ABDOMEN/ | ||||||
| CXR, | ||||||
| USG ABDOMEN | MANDATORY | |||||
| TREATMENT | SUPPORTIVE CARE | 50 | MANDATORY | |||
| IMMUNOSUPPRESSANTS | MANDATORY | |||||
| IMMUNOGLOBULIN THERAPY | ||||||