InterQual Level of Care 2018 Index Rehabilitation Criteria Index Words by Subset 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. Subset BURNS ADL IMPAIRMENT BURN, DEEP PARTIAL THICKNESS BURN, FIRST DEGREE BURN, FULL THICKNESS BURN, INHALATION BURN, SECOND DEGREE BURN, SUBDERMAL BURN, THIRD DEGREE BURNS DYSPNEA ELECTRICAL INJURY FIRE FIRST DEGREE BURN FROST BITE, SEVERE Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 1
BURNS (cont d) FULL THICKNESS SKIN LOSS / INVOLVEMENT FUNCTIONAL IMPAIRMENT INFECTION INFECTION, SKIN INHALATION INJURY MOBILITY IMPAIRMENT PARTIAL THICKNESS SKIN LOSS PRESSURE GARMENTS RADIATION REHABILITATION RESPIRATORY IMPAIRMENT SCAR SECOND DEGREE BURN SKIN SKIN CARE SPLINTING SPASTICITY STEVENS JOHNSON SYNDROME SUBDERMAL INVOLVEMENT SUBDERMAL LOSS SURGERY, BURNS THERMAL INJURY THIRD DEGREE BURN TOXIC EPIDERMAL NECROLYSIS (TEN) TRACHEOSTOMY VENTILATOR ASSISTED VENTILATOR DEPENDENT Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 2
BURNS (cont d) VENTILATOR WEANING WOUND WOUND CARE PAIN CNS / TBI ABI ACQUIRED BRAIN INJURY (ABI) ADL IMPAIRMENT ANOXIC BRAIN INJURY BLADDER MANAGEMENT BOWEL MANAGEMENT BRAIN ABSCESS BRAIN ANEURYSM BRAIN INJURY BRAIN INJURY, ANOXIC BRAIN INJURY, CHEMICAL BRAIN INJURY, TRAUMATIC BRAIN TUMOR CEREBRAL VASCULAR ACCIDENT (CVA) CNS NEOPLASM COGNITIVE IMPAIRMENT CNS INFECTION COGNITIVE LEVEL COGNITIVE SCALE CVA, EMBOLIC, HEMORRHAGIC DYSARTHRIA DYSPHAGIA FUNCTIONAL IMPAIRMENT Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 3
CNS / TBI (cont d) GLASGOW COMA SCALE (GCS) GUILLAIN-BARRE SYNDROME (GBS) HEAD INJURY HEMORRHAGE, INTRACRANIAL HEMORRHAGE, SUBARACHNOID HEMORRHAGE, SUBDURAL INTRACRANIAL HEMORRHAGE (ICH) LANGUAGE IMPAIRMENT LEVEL OF COGNITIVE FUNCTIONING (LOCF) MOBILITY IMPAIRMENT NEOPLASM NEUROLOGICAL DEFICIT NEUROMUSCULAR DEGENERATIVE NEUROMUSCULAR DISORDER NEUROMUSCULAR PROGRESSIVE PAIN PAIN MANAGEMENT PROGRESSIVE CNS DISORDER RANCHO LEVEL 3 RANCHO LEVEL 4, EVOLVING RANCHO LEVEL 5, EVOLVING RANCHO LEVEL 6, EVOLVING RANCHO LOS AMIGOS REHABILITATION SKIN CARE SPASM SPASTICITY Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 4
CNS / TBI (cont d) SPEECH DISORDER SPEECH IMPAIRMENT SPLINTING STROKE SUBARACHNOID HEMORRHAGE (SAH) SUBDURAL BLEED SUBDURAL HEMORRHAGE SURGERY, CRANIOTOMY SWALLOWING IMPAIRMENT TBI TRAUMATIC BRAIN INJURY MEDICALLY INTENSIVE ADL IMPAIRMENT BRAIN TUMOR CABG CAD CANCER CANCER, BONE CANCER, BRAIN CANCER, LUNG CANCER, SPINE CARDIAC ARREST, HISTORY OF CARDIAC DISEASE / EVENT CARDIAC REHAB PROGRAM CARDIAC SURGERY CEREBRAL PALSY CHF Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 5
MEDICALLY INTENSIVE (cont d) CHRONIC PAIN MANAGEMENT CHRONIC PULMONARY DISEASE CNS, PROGRESSIVE COGNITIVE IMPAIRMENT CONGENITAL DEFORMITY COPD CORONARY ARTERY BYPASS GRAFT, POST (CABG) DEGENERATIVE NEUROMUSCULAR DISORDER EMPHYSEMA FAILED OUTPATIENT MANAGEMENT FUNCTIONAL IMPAIRMENT HEART TRANSPLANT INJURY, MAJOR / MULTIPLE TRAUMA ISCHEMIC HEART DISEASE LANGUAGE IMPAIRMENT MAJOR TRAUMA MALIGNANT DISEASE METASTATIC DISEASE MYOCARDIAL INFARCTION (MI) MOBIILITY IMPAIRMENT MOTOR IMPAIRMENT MULTIPLE SCLEROSIS MULTIPLE TRAUMA MYASTHENIA GRAVIS MYOPATHY NEUROMUSCULAR DISORDER, DEGENERATIVE NEUROMUSCULAR DISORDER, PROGRESSIVE Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 6
MEDICALLY INTENSIVE (cont d) PAIN MANAGEMENT, CHRONIC PAIN, UNCONTROLLED PARAPARESIS PARAPLEGIA PARKINSON'S DISEASE POLYARTERITIS NODOSA PROGRESSIVE CNS DISORDER PROGRESSIVE NEUROMUSCULAR DISORDER REHABILITATION RESPIRATORY IMPAIRMENT SPEECH IMPAIRMENT SPINAL BIFIDA SPINAL MUSCULAR ATROPHY SURGERY, CARDIOVASCULAR SURGERY, NEUROLOGICAL SWALLOWING IMPAIRMENT SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) TRAUMA, MAJOR TRAUMA, MULTIPLE UNCONTROLLED PAIN VENTILATOR ASSISTED VENTILATOR DEPENDENT VENTILATOR MANAGEMENT VENTILATOR WEANING ORTHOPEDIC / AMPUTATION ABOVE THE KNEE AMPUTATION (AKA) ADL IMPAIRMENT Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 7
ORTHOPEDIC / AMPUTATION (cont d) AMPUTATION, MULTIPLE LIMBS AMPUTATION, POST SURGICAL, ONE LIMB AMPUTATION, TRAUMATIC ARTHRITIS, RHEUMATOID / OSTEO ARTHROPLASTY, MULTIPLE JOINTS ARTHROPLASTY, ONE JOINT & ACTIVE COMORBIDITY BELOW THE KNEE AMPUTATION (BKA) FRACTURE WITH STABILIZATION FRACTURE, BILATERAL WITH IMMOBILITY FRACTURE, UPPER EXTREMITY FRACTURE, UPPER EXTREMITY AND LOWER EXTREMITY FRACTURE FRACTURE, UPPER EXTREMITY AND PELVIC FRACTURE FRACTURES, MULTIPLE FUNCTIONAL IMPAIRMENT HEMIPELVECTOMY HIP FRACTURE HIP TRAUMA INFLAMMATORY JOINT DISEASE INJURY, MAJOR TRAUMA INJURY, MULTIPLE TRAUMA JOINT MUSCLE ATROPHY JOINT REPLACEMENT, MULTIPLE JOINTS JOINT REPLACEMENT, ONE JOINT & ACTIVE COMORBIDITY MAJOR JOINT REPLACEMENT, MULTIPLE JOINTS MAJOR JOINT REPLACEMENT, ONE JOINT & ACTIVE COMORBIDITY MAJOR TRAUMA MOBILITY IMPAIRMENT Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 8
ORTHOPEDIC / AMPUTATION (cont d) MOTOR IMPAIRMENT MULTIPLE TRAUMA OSTEOARTHRITIS POLYARTICULAR REHEUMATOID ARTHRITIS PSORIATIC ARTHRITIS SERONEGATIVE ARTHROPATHIES SURGERY, AMPUTATION SURGERY, ARTHROPLASTY TOTAL HIP REPLACEMENT TRAUMA, AMPUTATION TRAUMA, MAJOR TRAUMA, MULTIPLE PEDIATRIC REHABILITATION ABOVE THE KNEE AMPUTATION (AKA) ABSCESS, BRAIN ABSCESS, SPINAL ACUTE HOSPITALIZATION EXTENDED BY COMPLICATION ADL IMPAIRMENT AMPUTATION, MULTIPLE LIMBS AMPUTATION, POST SURGICAL, ONE LIMB AMPUTATION, TRAUMATIC ANOXIC BRAIN INJURY ARTHROPLASTY, MULTIPLE JOINTS ARTHROPLASTY, ONE JOINT & ACTIVE COMORBIDITY BELOW THE KNEE AMPUTATION (BKA) BRAIN ANEURYSM BRAIN INJURY, ANOXIC Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 9
PEDIATRIC REHABILITATION (cont d) BRAIN INJURY, CHEMICAL BRAIN INJURY, TRAUMATIC BRAIN TUMOR BURN, DEEP PARTIAL THICKNESS BURN, FULL THICKNESS BURN, INHALATION BURN, SUBDERMAL BURNS CANCER CANCER, BONE CANCER, BRAIN CANCER, LUNG CANCER, SPINE CNS NEOPLASM CNS, PROGRESSIVE COGNITIVE IMPAIRMENT COMPRESSION INJURY CRANIOTOMY, POST CVA DEGENERATIVE NEUROMUSCULAR DISORDER ENCEPHALITIS FEEDING IMPAIRMENT FRACTURE WITH STABILIZATION FRACTURE, UPPER EXTREMITY AND PELVIC / LOWER EXTREMITY FRACTURE(S) FRACTURES, MULTIPLE FROST BITE, SEVERE Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 10
PEDIATRIC REHABILITATION (cont d) FULL THICKNESS SKIN LOSS / INVOLVEMENT FUNCTIONAL IMPAIRMENT GUILLAIN-BARRE HEAD INJURY HEMIPARESIS HEMIPLEGIA HIP FRACTURE HIP TRAUMA MOTOR IMPAIRMENT MULTIPLE TRAUMA MUSCULAR DYSTROPHY INFECTIOUS DISEASE, CEREBRAL INFECTIOUS DISEASE, SPINAL INHALATION INJURY INJURY, MAJOR TRAUMA INJURY, MULTIPLE TRAUMA INJURY, SPINAL CORD INTERSTITIAL LUNG DISEASE INTRACRANIAL HEMORRHAGE JOINT REPLACEMENT, MULTIPLE JOINTS JOINT REPLACEMENT, ONE JOINT & ACTIVE COMORBIDITY LANGUAGE IMPAIRMENT MAJOR JOINT REPLACEMENT, MULTIPLE JOINTS MAJOR JOINT REPLACEMENT, ONE JOINT & ACTIVE COMORBIDITY MALIGNANT DISEASE MENINGITIS METASTATIC DISEASE Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 11
PEDIATRIC REHABILITATION (cont d) MOBILITY IMPAIRMENT NEOPLASM, CNS NEUROMUSCULAR DISORDER, DEGENERATIVE NEUROMUSCULAR DISORDER, PROGRESSIVE NEUROSURGERY, SPINAL PARALYSIS PARAPARESIS PARAPLEGIA PARTIAL THICKNESS SKIN LOSS PROGRESSIVE NEUROMUSCULAR DISORDER PROGRESSIVE CNS DISORDER QUADRIPLEGIA RANCHO LEVEL 3 RANCHO LEVEL 4, EVOLVING RANCHO LEVEL 5, EVOLVING RANCHO LEVEL 6, EVOLVING REHABILITATION RESPIRATORY IMPAIRMENT SKIN GRAFT SKIN LOSS, FULL THICKNESS SKIN LOSS, PARTIAL THICKNESS SKIN SUBDERMAL INVOLVEMENT SKIN SUBDERMAL LOSS SPEECH IMPAIRMENT SPINAL ABSCESS SPINAL CORD INJURY SPINAL NEUROSURGERY Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 12
PEDIATRIC REHABILITATION (cont d) STROKE SURGERY, AMPUTATION SURGERY, ARTHROPLASTY SURGERY, BURNS SURGERY, CRANIOTOMY SURGERY, NEUROLOGICAL SURGERY, SPINAL SWALLOWING IMPAIRMENT TBI TOTAL HIP REPLACEMENT TOXIC EPIDERMAL NECROLYSIS (TEN) TRACHEOSTOMY, POSTBROWN-SEQUARD'S SYNDROME TRANSVERSE MYELITIS TRAUMA, AMPUTATION TRAUMA, MAJOR TRAUMA, MULTIPLE TRAUMATIC BRAIN INJURY TUMOR, SPINAL CORD VENTILATOR ASSISTED VENTILATOR DEPENDENT VENTILATOR WEANING NEURODEGENERATIVE DETERIORATION PARESIS SPINAL CORD INJURY ABSCESS, SPINAL ADL IMPAIRMENT BROWN-SEQUARD'S SYNDROME CANCER, SPINE Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 13
SPINAL CORD INJURY (cont d) COMPRESSION INJURY FRACTURE, SPINAL FUNCTIONAL IMPAIRMENT INFECTIOUS DISEASE, SPINAL INJURY, SPINAL CORD MOBILITY IMPAIRMENT MOTOR IMPAIRMENT NEOPLASM, SPINAL CORD NEUROSURGERY, SPINAL OSTEOMYELITIS, VERTEBRAL PARALYSIS PARAPARESIS PARAPLEGIA QUADRIPLEGIA REHABILITATION RESPIRATORY IMPAIRMENT SPINAL ABSCESS SPINAL CORD INJURY SPINAL CORD NEOPLASM SPINAL FRACTURE SPINAL FUSION SPINAL NEUROSURGERY SPINAL TUMOR SPONDYLOSIS SURGERY, NEUROLOGICAL SURGERY, SPINAL TRANSVERSE MYELITIS Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 14
SPINAL CORD INJURY (cont d) TUMOR, SPINAL CORD VERTEBRAL OSTEOMYELITIS SUBACUTE REHABILITATION ABOVE THE KNEE AMPUTATION (AKA) ABSCESS, SPINAL ACUTE HOSPITALIZATION EXTENDED BY COMPLICATION ADL IMPAIRMENT AIDS AMPUTATION, MULTIPLE LIMBS AMPUTATION, POST SURGICAL, ONE LIMB AMPUTATION, TRAUMATIC AMYOTROPHIC LATERAL SCLEROSIS (ALS) ANOXIC BRAIN INJURY ARTHROPLASTY, ONE JOINT & ACTIVE COMORBIDITY BELOW THE KNEE AMPUTATION (BKA) BONE MARROW TRANSPLANT (BMT) / STEM CELL TRANSPLANT (SCT) BRAIN ANEURYSM BRAIN INJURY BRAIN INJURY, ANOXIC BRAIN INJURY, CHEMICAL BRAIN INJURY, TRAUMATIC BRAIN TUMOR CABG CANCER CANCER, BONE CANCER, BRAIN CANCER, LUNG Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 15
SUBACUTE REHABILITATION (cont d) CANCER, SPINE CARDIAC ARREST, HISTORY OF CARDIAC DISEASE / EVENT CARDIAC REHAB PROGRAM CARDIOMYOPATHY CHF CHRONIC DISEASE, MULTIPLE CHRONIC PAIN MANAGEMENT CHRONIC PULMONARY DISEASE CNS NEOPLASM CNS, PROGRESSIVE COGNITIVE IMPAIRMENT COMPROMISED PHYSICAL FUNCTION COPD CORONARY ARTERY BYPASS GRAFT, POST (CABG) CRANIOTOMY, POST CVA DECONDITIONING DEGENERATIVE NEUROMUSCULAR DISORDER DIABETIC POLYNEUROPATHY EMPHYSEMA ENDURANCE COMPROMISED FAILED OUTPATIENT MANAGEMENT FRACTURE, HIP & ACTIVE COMORBIDITY FRACTURES, MULTIPLE FUNCTIONAL IMPAIRMENT HEAD INJURY Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 16
SUBACUTE REHABILITATION (cont d) HEART FAILURE HEART TRANSPLANT, POST HEART VALVE REPLACEMENT, POST HEMIPLEGIA / PARESIS HIP FRACTURE HIP TRAUMA HIV HUNTINGTON'S CHOREA INFLAMMATORY JOINT DISEASE INTERSTITIAL LUNG DISEASE INTRACRANIAL HEMORRHAGE ISCHEMIC HEART DISEASE / ISCHEMIA JOINT REPLACEMENT, MULTIPLE JOINTS JOINT REPLACEMENT, ONE JOINT & ACTIVE COMORBIDITY LANGUAGE IMPAIRMENT LIVER TRANSPLANT LUNG TRANSPLANT MAJOR JOINT REPLACEMENT, MULTIPLE JOINTS MAJOR JOINT REPLACEMENT, ONE JOINT & ACTIVE COMORBIDITY MALIGNANT DISEASE METASTATIC DISEASE MOBILITY IMPAIRMENT MULTIPLE SCLEROSIS MYOCARDIAL INFARCTION, POST MI NEOPLASM, CNS NEURODEGENERATIVE DETERIORATION NEUROMUSCULAR DISORDER Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 17
SUBACUTE REHABILITATION (cont d) NEUROMUSCULAR DISORDER, DEGENERATIVE OR PROGRESSIVE PAIN MANAGEMENT, CHRONIC PAIN, UNCONTROLLED PARAPLEGIA / PARAPARESIS PARKINSON'S DISEASE POLYNEUROPATHY POST CRANIAL SURGERY POST MECHANICAL VENTILATION POST TRANSPLANT, BONE MARROW POST TRANSPLANT, HEART POST TRANSPLANT, LIVER POST TRANSPLANT, LUNG POST TRANSPLANT, RENAL PROGRESSIVE / DEGENERATIVE PROGRESSIVE CNS DISORDER RANCHO LEVEL 3 REHABILITATION RENAL TRANSPLANT RESPIRATORY IMPAIRMENT SPASM SPASTICITY SPEECH IMPAIRMENT STROKE STUMP CARE SURGERY, AMPUTATION SURGERY, ARTHROPLASTY SURGERY, CARDIOVASCULAR Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 18
SUBACUTE REHABILITATION (cont d) SURGERY, CRANIOTOMY SWALLOWING IMPAIRMENT TBI TOTAL HIP REPLACEMENT TRANSPLANT, POST TRAUMA, AMPUTATION TRAUMATIC BRAIN INJURY UNCONTROLLED PAIN VENTILATOR DEPENDENT VENTILATOR DEPENDENT / ASSISTED VENTILATOR MANAGEMENT VENTILATOR WEANING Copyright 2018 Change Healthcare LLC and/or one of its subsidiaries. All Rights Reserved. Produced in Cork, Ireland. 19