13 diagnoses that fall into the 75% rule??

  1. 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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    About Wellness RN

    Joined: Aug '04; Posts: 24


  3. by   nurseliason
    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