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13 diagnoses that fall into the 75% rule??



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Old Nov 06, 2006, 06:30 AM
Registered User
Join Date: Aug 2004
13 diagnoses that fall into the 75% rule??

I've got a quick question. Does anyone know specifically which 13 diagnoses medicare will count towards the 75%? Can't seem to find them. Thanks! Sue

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Old Jan 01, 2007, 04:05 PM
Registered User
Join Date: Dec 2006
Re: 13 diagnoses that fall into the 75% rule??

I'm new on this board and I saw your question. I have looked all over the web to find specifics. You would think someone would post these where we could tell exactly who meets criteria:
1. stroke
2. brain dysfunction- traumatic and nontraumatic (brain injury)
3. spinal cord dysfunction- traumatic and nontraumatic (spinal cord injury)
4. neurological conditions- (MS, motor neuron dz, polyneuropathy, muscular dystrophy, parkinsons)
5. amputation
6. active polyarticular RA, psoriatic arthritis, and seronegative arthritis
7. major multiple trauma
8. systemic vasculidities with joint inflammation
9 OA or DJD- must be in 2 or more wt bearing joints (elbow shoulder hips)
10. Joint replacement plus BMI>50, >85 yr, or bilateral replacement
11. burns
12. congenital deformity
13. femur fracture- i think it has to be the head, not shaft of proximal end

hope this helps

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13 diagnoses that fall into the 75% rule??

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