Acute Care Inpatient Guidelines

 More than 350 guidelines that contain acute care inpatient review criteria with MS-DRG and APR-DRG Length of Stay data.

 Evidence-based, with comprehensive reference links.

 Provides utilization management and claims departments with essential information to assist in medically-necessary benefit determinations.

 Includes a section entirely devoted to Managing Unplanned Readmissions, which includes issues, innovative programs, resources and strategies needed to manage CMS targeted readmission diagnoses and avoid financial penalties.

 Detailed review criteria by MS-DRG focus on medical necessity and appropriateness of care.

 Search guidelines by DRG, CPT/HCPCS, ICD-9 or keyword.

Guidelines

  • Pre Stem Cell and Organ Transplantation
  • MDC1 Diseases and Disorders of the Nervous System
  • MDC2 Diseases and Disorders of the Eye
  • MDC3 Diseases and Disorders of the Ear, Nose, Mouth and Throat
  • MDC4 Diseases and Disorders of the Respiratory System
  • MDC5 Diseases and Disorders of the Circulatory System
  • MDC6 Diseases and Disorders of the Digestive System
  • MDC7 Diseases and Disorders of the Hepatobilliary System and Pancreas
  • MDC8 Diseases and Disorders of the Musculoskeletal System and Connective Tissues
  • MDC9 Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast
  • MDC10 Diseases and Disorders of the Endocrine, Nutritional and Metabolic Diseases and Disorders
  • MDC11 Diseases and Disorders of the Kidney and Urinary Tract; Dialysis
  • MDC12 Diseases and Disorders of the Male Reproductive System
  • MDC13 Diseases and Disorders of the Female Reproductive System
  • MDC14 Diseases and Disorders of Pregnancy, Childbirth and Puerpium
  • MDC15 Diseases and Disorders of Neonates (Perinatal Period)
  • MDC16 Diseases and Disorders of the Blood and Blood Forming Organs and Immunological Disorders
  • MDC17 Diseases and Disorders of Myeloproliferative DDs (Poorly Differentiated Neoplasms)
  • MDC18 Diseases and Disorders of the Infectious and Parasitic Diseases
  • MDC19 Diseases and Disorders of the Mental Diseases and Disorders
  • MDC20 Diseases and Disorders of the Alcohol/Drug Use or Induced Mental Disorders
  • MDC21 Diseases and Disorders of the Injuries, Poison and Toxic Effect of Drugs
  • MDC22 Diseases and Disorders - Burns
  • MDC23 Factors Influencing Health Status
  • MDC24 Multiple Significant Trauma
  • MDC25 Human Immunodeficiency Virus Infection
  • INP Addenda
  • INP Inpatient References and Resources
  • INP Length of Stay, DRG, Second Opinions, Never Events and Preventable Adverse Events
  • INP Unplanned Readmissions: Management Strategies