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2014 INTERQUAL GUIDELINES

Acute Care: Non Acute Care Definition

Evidence-Based Criteria/Guidelines | Utilization
InterQual Criteria Our four criteria suites provide comprehensive coverage for medical and behavioral health across all levels of care as well as ambulatory care planning. With an outstanding track record, widespread adoption, and continual enhancement, InterQual Criteria are the standard for evidence-based clinical decision support.Location: 3055 Lebanon Pike Ste 1000, Nashville, 37214, TNLogin · Interqual Level of Care Criteria · Criteria Powered by InterQual · Interqual Education
InterQual Clinical Revisions - Johns Hopkins Hospital
InterQual® Guidelines for Surgery and Procedures Performed in the Inpatient Setting. The following new procedures are appropriate for the inpatient setting based on InterQual® Procedures Criteria: General - Thyroidectomy, Partial or Total. Radical Neck Dissection; Sternal Split; Transthoracic; Neurologic & Spine - Decompression +/- Fusion, Cervical
InterQual® Level of Care Criteria | Change Healthcare
InterQual® Level of Care Criteria help healthcare organizations assess the safest and most clinically appropriate care level for more than 95% of reasons for admission. The condition-specific format presents evidence-based interventions that are specific to the condition and help to Location: 3055 Lebanon Pike Ste 1000, Nashville, 37214, TN[PDF]
2018 InterQual guidelines - provcommihealth
2018 InterQual® guidelines . Below is a summary of the changes included in the April 2018 InterQual Criteria release that AmeriHealth New Jersey will begin using on August 20, 2018. Acute Level of Care updates . New subsets were added for both the adult and pediatric criteria as follows:[PDF]
HOSPITAL IN PATIENT VS. OBSERVATION GUIDELINES
Milliman or Interqual Criteria (standard recognized guidelines) to help determine if a patient will meet inpatient or observation status and can advise the physician Nurse case managers and social workers work with nursing, patients, ancillary staff, and physicians to ensure that the patient has[PDF]
InterQual Actionable Evidence-Based Criteria Portfolio
1. Internal analysis based on 2008 HCPCS data. InterQual Care Planning Criteria InterQual Care Planning Criteria help to identify when imaging studies, procedures, molecular diagnostics, durable medical equipment, specialty referral consultations and specialty pharmaceuticals are medically appropriate based on the evidence.[PDF]
Inpatient Admission and Medical Review Criteria
Inpatient Admission and Medical Review Criteria . The 2-Midnight Rule . January 14th 2014 . 1:30-3:00 PM[PDF]
2019 MAGELLAN CLINICAL GUIDELINES MEDICAL NECESSITY
Guidelines for Clinical Review Determination Preamble Magellan is committed to the philosophy of supporting safe and effective treatment for patients. The medical necessity criteria that follow are guidelines for the provision of diagnostic imaging. These criteria are designed to guide both providers and reviewers to the most appropriate
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