What physicians and case managers should know
Physicians and case managers may not be aware that Medicare requires that only 60% of acute patients have a CMS-13 diagnosis, which are:
- Active polyarticular rheumatoid arthritis
- Amputation
- Brain injury/brain tumor
- Burns
- Congenital deformity
- Hip fracture
- Hip/knee replacement
- BMI>50
- Bilateral joins (both sides at same time)
- 85 years or older
- Major multiple trauma
- Multiple fracture
- Neurological disorders (not an all-inclusive list)
- Multiple sclerosis
- Motor neuron disease
- Encephalopathy
- Critical illness myopathy/polyneuropathy
- Guillain Barré
- ALS
- Parkinson's disease
- Late effects polio
- Friedreich's ataxia
- Osteoarthritis or degenerative joint disease
- Two or more weight-bearing joints
- Spinal cord impairment
- Stroke
- Systemic vasculidities with joint inflammation
40% of the other rehabilitation diagnoses and conditions that doctors and case managers should consider for rehabilitation:
- Temporal arthritis
- Polymyalgia
- PMR
- Lupus
- Rheumatica
- Gouty arthritis
- Abdominal aortic aneurysm
- Coronary artery bypass graft (CABG)
- Cancer
- Cardiac conditions
- Congestive heart failure (CHF)
- Debility
- Joint replacement
- Laminectomy
- Myocardial infarction (MI)
- Neuropathy
- Orthopedic injuries
- Pneumonia
- Peripheral vascular disease (PVD)
- Respiratory failure
- Wound care
- Conditions affecting mobility, activities of daily living (ADL's), swallowing or cognition/thinking abilities
- Late effects from previous neurological injury or illness, i.e. brain injury, stroke or spinal cord injury
- Other conditions or complications
- Supporting doctor, nursing and therapy documentation
- Patient's level of independence before illness or injury
To refer your patient to a HealthSouth hospital, contact the Admissions Department at a
HealthSouth hospital near you .