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McKesson Health Solutions, an independent company, has made significant
changes to the InterQual Level of Care Criteria for 2016.
Beginning in August 2016, the Clinical Services – Utilization
Management department at Independence (formerly known as Care Management and
Coordination) will use the 2016 InterQual Level of Care criteria for review of
acute inpatient, acute rehabilitation, skilled nursing facility, and long-term
acute care admissions. In addition, we will transition to the 2016 home care
guidelines. Changes include:
- InterQual Acute Adult Level of Care criteria:
- - General Medical. Updates were made to inpatient chemotherapy
administration.
- - Sepsis and Septic Shock. Criteria were updated based on the
current evidence, including the recently published Third
International Consensus Definitions for Sepsis and Septic
Shock.
- - Sickle Cell Crisis. Criteria were updated based on the new
National Heart, Lung, and Blood Institute guidelines.
- InterQual Acute Pediatric criteria:
- - General Medical. Updates were made to inpatient chemotherapy
administration.
- - Hyperbilirubinemia. Criteria were revised to align more closely
with American Academy of Pediatrics guidelines.
- InterQual Post-Acute Care criteria: Updates were made to the
Subacute/Skilled Nursing Facility, Long Term Acute Care, and Acute
Rehabilitation products.
For detailed information on the 2016 InterQual guidelines, please visit the
McKesson Health Solutions
website.]