2018 Clinical Revisions
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1 InterQual Guidelines for Surgery and Procedures Performed in the Inpatient Setting 2018 Clinical Revisions Review and Incorporation of Recent Medical Literature Change Healthcare is committed to keeping the InterQual product suite current and accurate. Criteria are continually reviewed and updated, with new editions of every product released annually. Change Healthcare's staff of physicians, nurses, other licensed healthcare professionals, and its extensive array of primary care and specialty consultants participate in ongoing criteria revision as new medical information emerges. Each annual release of the criteria reflects a thorough review of new medical literature, society guidelines, current practice standards, and incorporation of consultant and user feedback. Customer Hub The Customer Hub ( provides interactive support, answers to commonly asked questions and links to other resources. For a user ID and password, contact your Customer Hub site administrator or MHScustomerhub@mckesson.com Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 1
2 Revisions CARDIOTHORACIC Transcatheter Aortic Valve Replacement (TAVR) Subclavian Transcatheter Aortic Valve Replacement These types of Transcatheter Aortic Valve Replacement (TAVR) surgeries can be performed in the inpatient Transaortic Transcatheter Aortic Valve Replacement Transapical Transcatheter Aortic Valve Replacement Transcartotid Transcatheter Aortic Valve Replacement Transfemoral Transcatheter Aortic Valve Replacement GENERAL Appendectomy Gangrenous Appendicitis Suppurative Appendicitis Gangrenous Appendicitis and Suppurative Appendicitis are now addressed in this GENERAL Bariatric or Metabolic Surgery Changed from Bariatric Surgery Bariatric surgery, in addition to metabolic surgery, is now addressed in this HAND, PLASTIC & RECONSTRUCTIVE Breast Reconstruction: Flap Breast Reconstruction with Autologous Fat Grafting These types of breast reconstruction surgeries can be performed in the inpatient Gluteal Flap (GAP Free Flap) Gracilis Free Flap Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 2
3 Latissimus Dorsi Muscle Flap Oncoplastic Reconstruction Profunda Perforator Flap Rubens Flap Superficial Inferior Epigastric Artery (SIEA) Flap Superficial or Deep Inferior Epigastric Perforator (SIEP/DIEP) Flap Transverse Rectus Abdominis Myocutaneous (TRAM) Flap Bone Augmentation, Mandible Bone Augmentation, Mandible is now addressed in this Autologous Iliac Crest Donor Site Bone Augmentation, Maxilla Bone Augmentation, Maxilla is now addressed in this Autologous Iliac Crest Donor Site Sinusotomy, Frontal: Open Sinusotomy, Frontal: Open is now addressed in this Tonsillectomy Changed from Suspected Tonsillar Malignancy to Tonsillar Malignancy Tonsillar malignancy is now addressed in this Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 3
4 ORTHOPEDIC LOWER EXTREMITY Total Joint Replacement (TJR), Knee with asterisk: Avascular Necrosis (Osteonerosis), Tibial Plateau or Femoral Condyle* Due to variations in practice, these procedures can be performed in the inpatient or outpatient Osteoarthritis or Post-Traumatic Arthritis* ORTHOPEDIC LOWER EXTREMITY Unicondylar Knee Replacement Added asterisk: Unicondylar Knee Replacement* Due to variations in practice, this procedure can be performed in the inpatient or outpatient setting Adenoidectomy (Pediatric) Changed indication from Obstructive Sleep Apnea Syndrome (OSAS) to Obstructive Sleep Apnea Syndrome (OSAS) or Obstructive Sleep-Disordered Breathing Obstructive sleep apnea syndrome (OSAS), as well as obstructive sleep-disordered breathing, is now addressed in this Removed: Symptomatic adenoid hypertrophy* Appendectomy Gangrenous appendicitis Suppurative appendicitis Gangrenous Appendicitis and Suppurative Appendicitis are now addressed in this Bariatric or Metabolic Surgery (Adolescent) Changed from Bariatric Surgery Bariatric surgery, in addition to metabolic surgery, are now addressed in this Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 4
5 Bariatric Surgery (Revisional) (Adolescent) Revision of gastroduodenal anastomosis with reconstruction Revision of gastrojejunal anastomosis with reconstruction Electroconvulsive Therapy (ECT), (Adolescent)* Added with asterisk Electroconvulsive Therapy (ECT), (Adolescent) is now addressed in this Due to variations in practice, these procedures can be performed in the inpatient or outpatient Hyperbaric Oxygen Therapy* Added with asterisk Hyperbaric Oxygen Therapy is now addressed in this Due to variations in practice, these procedures can be performed in the inpatient or outpatient Thyroidectomy, Partial or Total Radical Neck Dissection Sternal Split Transthroacic Tonsillectomy (Pediatric) Changed indication from Obstructive Sleep Apnea Syndrome (OSAS) to Obstructive Sleep Apnea Syndrome (OSAS) or Obstructive Sleep-Disordered Breathing Obstructive sleep apnea syndrome (OSAS), as well as obstructive sleep-disordered breathing, is now addressed in this Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 5
6 SPECIALIZED PROCEDURES Ablative Therapy, Liver, Open Cryoablation, Liver, Open Microwave Ablation, Liver, Open Radiofrequency Ablation (RFA), Liver, Open SPECIALIZED PROCEDURES Electroconvulsive Therapy (ECT)* with asterisk Electroconvulsive Therapy (ECT) is now addressed in this Due to variations in practice, these procedures can be performed in the inpatient or outpatient SPECIALIZED PROCEDURES Hyperbaric Oxygen Therapy* with asterisk Hyperbaric Oxygen Therapy is now addressed in this Due to variations in practice, these procedures can be performed in the inpatient or outpatient UROLOGY Nephrectomy, Partial Nephrectomy, Radical Nephrectomy, Simple s content and are performed in the inpatient VASCULAR Endovascular Intervention, Peripheral Artery Peripheral Artery Thrombolysis Peripheral Artery Thrombolysis is now addressed in this Added asterisk: Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 6
7 Planned Anticoagulation* Renal Failure* Due to variations in practice, these procedures can be performed in the inpatient or outpatient VASCULAR Thrombolysis, Deep Vein Thrombosis (DVT) This procedure is performed in the inpatient Catheter-Directed Thrombolysis (CDT) Pharmacomechanical Catheter- Directed Thrombolysis (PCDT) Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 7
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