| OESOPHAGEAL FISTULA | ||||||
|---|---|---|---|---|---|---|
| PREAUTH | CLAIMS | |||||
| MIN. CLINICAL SYMPTOMS | MIN. REQUIRED | CRITERIA | DETAILS | % breakup amount - claims | POINTS AWARDED | SPECIAL MENTION |
| HISTORY OF ASPIRATION, DIFFICULTY IN SWALLOWING, | CXR, ECHO | TOTAL BED DAYS | 20 | |||
| BEDS IN ICU | ||||||
| DAYS UNDER VENTILATOR SUPPORT | ||||||
| INVESTIGATIONS | GENERAL WORK UP | 30 | MANDATORY | ELECTROLYTES, RFT,CBC | ||
| Endoscopy | ||||||
| ECHO | ||||||
| CXR | MANDATORY | |||||
| USG KUB | ||||||
| TREATMENT | FISTULA CORRECTION | 50 | MANDATORY | |||
| supportive MEDICINES | ||||||
| FLUID MANAGEMENT | MANDATORY | |||||