GASTRIC VARICES
PREAUTH		CLAIMS
MIN. CLINICAL SYMPTOMS	MIN. REQUIRED	CRITERIA	DETAILS	% breakup amount - claims	POINTS AWARDED	SPECIAL MENTION
Epigastric discomfort / hematemesis / malena	USG abdomen - evidence of portal hypertension / CLINICAL PHOTO /	TOTAL BED DAYS		20
		BEDS IN ICU
		DAYS UNDER VENTILATOR SUPPORT
		INVESTIGATIONS	GENERAL WORK UP	30		INCLUDES LFT / PT / PLATELET COUNT
			Endoscopy		mandatory
			coagulation profile
			usg abdomen		mandatory
		TREATMENT	PROTON PUMP INHIBITORS	50	mandatory	INSUFFICIENT PACKAGE RATE
			TREATMENT TO REDUCE PORTAL PRESSURE
			ENDOSCOPIC INTERVENTION