InterQual Level of Care 2018 Index Long-Term Acute Care (LTAC) Criteria The Index is an alphabetical listing of conditions and/or diagnoses designed to guide the user to the criteria subset where a specific condition or diagnosis may be found. The actual criteria may be worded differently from that of the listed condition or diagnosis. Index Words by Subset Subset MEDICALLY COMPLEX ABSCESS AIDS BACTEREMIA BONE MARROW COMPLICATIONS BOWEL, NONFUNCTIONING BRAIN ABSCESS BUN, ELEVATED (METABOLIC DISTURBANCE) CACHEXIA CANCER CARDIAC DISEASE CARDIAC DYSFUNCTION CARDIAC SURGERY CARDIOMYOPATHY CHEMOTHERAPY RELATED COMPLICATION Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 1
MEDICALLY COMPLEX (cont d) CHRONIC RENAL DISEASE CHRONIC RENAL INSUFFIENCY CIRRHOSIS CNS INFECTION CNS INJURY COAGULOPATHY COLITIS, ULCERATIVE COMPLEX MEDICAL CONDITIONCORONARY ARTERY BYPASS GRAFT (CABG) CREATININE, ELEVATED (METABOLIC DISTURBANCE) CROHN'S DISEASE CYTOMEGALOVIRUS DEHYDRATION DIALYSIS DVT DYSPNEA ENCEPHALITIS END STAGE DISEASE ENDOCARDITIS FAILED OUTPATIENT MANAGEMENT FUNGAL INFECTION GASTROINTESTINAL CONDITION / ILLNESS GUILLAIN BARRE HEART DISEASE, CONGENITAL / ACQUIRED HEART FAILURE HEMATOLOGIC CONDITION HIV HIV ABSCESS HYPERCALCEMIA, MALIGNANCY RELATED Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 2
MEDICALLY COMPLEX (cont d) HYPERTENSION, UNCONTROLLED / LABILE HYPERVISCOSITY, MALIGNANCY RELATED INADEQUATE ORAL INTAKE INFECTION, BRAIN INFECTION, FUNGAL INFECTION, LIVER INFECTION, OPPORTUNISTIC INFECTION, PROTOZOAL INFECTION, RENAL INFECTION, SYSTEMIC INFLAMMATORY BOWEL DISEASE INTRAABDOMINAL ABSCESS INTRACTABLE PAIN JOINT INFECTION LABILE HYPERTENSION LIVER ABSCESSLIVER FAILURE / INSUFFICIENCY MALIGNANCY COMPLICATION MALIGNANT DISEASE MALNUTRITION MENINGITIS METABOLIC DISEASE METASTATIC DISEASE MICRO BACTERIA MULTIPLE TRAUMA NECROTIZING PANCREATITIS NEUTROPENIA OPPORTUNISTIC INFECTION ORGAN FAILURE ORGAN INFECTION Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 3
MEDICALLY COMPLEX (cont d) OSTEOMYELITIS PERICARDIAL EFFUSION PERITONITIS PNEUMONIA POST CARDIAC SURGERY POST-TRANSPLANT PRE-TRANSPLANT PROTOZOAL INFECTION PULMONARY INFILTRATE PYELONEPHRITIS REHABILITATION RENAL ABSCESS RENAL DISEASE, CHRONIC RENAL FAILURE RENAL INSUFFICIENCY SEPSIS SEPTIC SHOCK SOLID ORGAN TRANSPLANT SURGICAL WOUND INFECTION SYSTEMIC / ORGAN INFECTION THROMBOEMBOLISM TOXOPLASMOSIS TRANSPLANT COMPLICATIONS TRANSPLANT REJECTION TRANSPLANT, BONE MARROW / STEM CELL TRANSPLANT, HEART TRANSPLANT, LIVER TRANSPLANT, LUNG TRANSPLANT, PANCREAS Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 4
MEDICALLY COMPLEX (cont d) TRANSPLANT, RENAL ULCERATIVE COLITIS UNCONTROLLED HYPERTENSION WEGENER'S GRANULOMATOSIS RESPIRATORY COMPLEX ADULT RESPIRATORY DISTRESS SYNDROME AIDS AIRWAY BURNS AMYOTROPHIC LATERAL SCLEROSIS (ALS) ARDS ARNOLD-CHIARI MALFORMATION ASPIRATION INJURY ASTHMA BURN, INHALATION BURNS, AIRWAY CHEST TUBE CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CHRONIC RESPIRATORY DISEASE COMPLICATIONS OF PNEUMONIA DYSPNEA EFFUSION, PLEURAL EMPHYSEMA EMPYEMA FAILED OUTPATIENT MANAGEMENT FUNGAL INFECTION HIV HYPERTENSION, PULMONARY Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 5
RESPIRATORY COMPLEX (cont d) HYPOXIA INTERSTITIAL LUNG DISEASE NG TRANSPLANT NIPPV TRIAL PHRENIC NERVE PARALYSIS PLEURAL EFFUSION PNEUMOCYSTIS CARNII PNEUMONIA COMPLICATIONS POLIO PRE-OP OPTIMIZATION PULMONARY FIBROTIC DISEASE PULMONARY HYPERTENSION PULMONARY INFILTRATE RESPIRATORY DISTRESS SYNDROME RESPIRATORY FAILURE THORACIC WALL DEFORMITIES THORACOPLASTY TRACHEOMALACIA TRACHEOSTOMY VENTILATOR DEPENDENT VENTILATOR MANAGEMENT VENTILATOR WEANING ADULT RESPIRATORY DISTRESS SYNDROME AIRWAY BURNS AMYOTROPHIC LATERAL SCLEROSIS (ALS) ARDS ARNOLD-CHIARI MALFORMATION Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 6
VENTILATOR WEANING (cont d) ASPIRATION INJURY ASTHMA BURN, INHALATION BURNS, AIRWAY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) CHRONIC RESPIRATORY FAILURE COMPLICATIONS OF PNEUMONIA CONGENITAL HEART DISEASE CYSTIC FIBROSIS FLAIL CHEST GULLAIN-BARRE INTERSTITIAL LUNG DISEASE LUNG TRANSPLANT MYASTHENIA GRAVIS MYELOMENINGOCELE NERVE PARALYSIS, PHRENIC NIPPV TRIAL PENETRATING CHEST WOUND PLEURAL EFFUSION PNEUMONIA PNEUMOTHORAX, TENSION POLIO PULMONARY FIBROTIC DISEASE PULMONARY INFILTRATE, PNEUMONIA RESPIRATORY DISTRESS SYNDROME RIB FRACTURES, MULTIPLE SPINAL CORD INJURY / TUMOR Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 7
VENTILATOR WEANING (cont d) TENSION PNEUMOTHORAX VENTILATOR WEANING KYPHOSCOLIOSIS LUNG TRANSPLANT MULTIPLE RIB FRACTURE MUSCULAR DYSTROPHY NIPPV TRIAL PLEURAL EFFUSION POLIO PULMONARY FIBROTIC DISEASE RESPIRATORY DISTRESS SYNDROME THORACIC WALL DEFORMITIES THORACOPLASTY TRACHEOMALACIA TRACHEOSTOMY VENTILATOR DEPENDENT WOUND/SKIN ABSCESS AIDS AMPUTATION AMPUTATION, FOOT / FOREFOOT AMPUTATION, ONE LIMB BEHCET'S SYNDROME BELOW THE KNEE AMPUTATION (BKA) BURN, FULL THICKNESS BURN, PARTIAL THICKNESS BURN, SUBDERMAL Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 8
WOUND/SKIN (cont d) BURNS BURNS, 2ND / 3RD DEGREE CELLULITIS CHEST WOUND, PENETRATING DEBRIDEMENT, INSTRUMENTAL / SERIAL SHARP DERMATOMYOSITIS FAILED OUTPATIENT MANAGEMENT FISTULA FLAPS, SKIN FUNGAL INFECTION GANGRENE GRAFTS, SKIN HIV IMPAIRED SKIN INTEGRITY INFECTION, BACTERIAL INFECTION, FUNGAL INFECTION, PROTOZOAL INFECTION, WOUND MICRO BACTERIA NECROSIS NECROTIZING FASCIITIS OPEN WOUND OPPORTUNISTIC INFECTION OSTEOMYELITIS OSTOMY PENETRATING WOUND PERIPHERAL VASCULAR ULCER Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 9
WOUND/SKIN (cont d) PRESSURE ULCER RECALCITRANT WOUND SJOGREN'S SYNDROME SKIN FLAP SKIN GRAFT SKIN LOSS STAB WOUND STAGE III / IV PRESSURE ULCER SURGICAL WOUND SURGICAL WOUND INFECTION SYSTEMIC / ORGAN INFECTION TRAUMATIC WOUND ULCER, PRESSURE ULCERATION ULCERS, VENOUS STASIS VENUS STASIS ULCER WEGENER'S GRANULOMATOSIS WOUND / SKIN CONDITION WOUND DEHISCENCE WOUND, GUN SHOT WOUND, INFECTION WOUND, PENETRATING WOUND, STAB WOUND, SURGICAL WOUND, TRAUMATIC WOUND, VENUS STASIS ULCER Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 10