TN 0381 NEONATAL CHOLESTASIS
PREAUTH		CLAIMS
MIN. SYMPTOMS	MIN. REQUIRED	CRITERIA	DETAILS	% breakup amount - claims	WEIGHTAGE(%) IN CLAIMS AMOUNT	SPECIAL MENTION
JAUNDICE, PALE STOOLS	CLINICAL PHOTO, LFT, CBC,USG ABDOMEN	TOTAL BED DAYS	> 5	20
		DAYS IN ICU				discretion of treating doctor
		DAYS UNDER VENTILATOR SUPPORT
		INVESTIGATIONS	GENERAL WORK UP	30
			LFT, RFT, CBC
			USG ABDOMEN		MANDATORY
			CT ABDOMEN
			repeat LFT / RFT and CBC		MANDATORY
			HIDA Scan
		TREATMENT	SUPPORTIVE CARE	50
			PED. SURGEON'S OPINION and treatment		MANDATORY	includes antibiotics and other relevant treatment