TN 0384 THALASSEMIA MAJOR REQUIRING CHELATION THERAPY
PREAUTH		CLAIMS
MIN. SYMPTOMS	MIN. REQUIRED	CRITERIA	DETAILS	% breakup amount - claims	WEIGHTAGE(%) IN CLAIMS AMOUNT	SPECIAL MENTION
HEPATOSPLENOMEGALY, ANEMIA	CLINICAL PHOTO, CBC, PERIPHERAL SMEAR	TOTAL BED DAYS	> 5	20
		DAYS IN ICU				discretion of treating doctor
		DAYS UNDER VENTILATOR SUPPORT
		INVESTIGATIONS	GENERAL WORK UP	30		including ECG / CXR / USG ABDOMEN / routine blood investigations / cbc
			Hb ELECTROPHORESIS		MANDATORY
			Serum Transferrin, Ferritin, Fe Binding Capacity;		MANDATORY
			Repeat blood investigations / Xray skull
			Peripheral Blood Smear		MANDATORY
			Urine urobilin & Urobilogen; Hematocrit; Serum Bilirubin
		TREATMENT	SUPPORTIVE CARE	50
			BLOOD/PRBC TRANSFUSION		MANDATORY
			CHELATION THERAPY		MANDATORY	DEFARASIROX
			BONE MARROW TRANSPLANTATION		separate package available
			SPLENECTOMY IN SEVERE CASES		separate package available