Apparently did not obtain appropriate laboratory tests and/or imaging studies. This category is used for failure to order diagnostic (laboratory C09 and/or imaging) studies that are deemed appropriate for the patient's condition. Apparently did not develop and initiate appropriate discharge, and/or rehabilitation plans. This category is used for a lack of arrangements or plans for conditions continuing to require treatment C10 and/or monitoring prior to or following discharge; failure to develop a plan that reflects an appropriate transition of care; failure to identify additional needed resources; failure to provide appropriate teaching; failure to transmit pertinent information. Apparently did not demonstrate that the patient was ready for discharge. This category is used for failure to assure that the patient is C11 stable enough for discharge to the setting into which the patient is being discharged. Apparently did not provide appropriate personnel and/or resources. This category is used for lack of sufficient staff to handle patient load; C12 lack of credentialed staff for provision of offered services; equipment unavailable to carry out treatment plan. Apparently did not order appropriate specialty consultation. This category is used for those cases in which a specialty consultation that would have been necessary to adequately assess and treat the patient C13 was not ordered. If there is a distinct clinical management concern over and above failure to order the consultation, cite that category as well, even if it is C03. Apparently specialty consultation process was not completed in a timely manner. This category is used when a specialty consultation is not ordered in a timely manner or is not completed in a timely manner. If the C14 only issue is the delay, do not additionally cite C03. If there is a distinct clinical management concern over and above the delay in ordering or completing the consultation, cite that category as well, even if it is C03.
C09 Apparently did not obtain appropriate laboratory tests and/or imaging studies. This category is used for failure to order diagnostic (laboratory and/or imaging) studies that are deemed appropriate for the patient's condition. C10 Apparently did not develop and initiate appropriate discharge, and/or rehabilitation plans. This category is used for a lack of arrangements or plans for conditions continuing to require treatment and/or monitoring prior to or following discharge; failure to develop a plan that reflects an appropriate transition of care; failure to identify additional needed resources; failure to provide appropriate teaching; failure to transmit pertinent information. C11 Apparently did not demonstrate that the patient was ready for discharge. This category is used for failure to assure that the patient is stable enough for discharge to the setting into which the patient is being discharged. C12 Apparently did not provide appropriate personnel and/or resources. This category is used for lack of sufficient staff to handle patient load; lack of credentialed staff for provision of offered services; equipment unavailable to carry out treatment plan. C13 Apparently did not order appropriate specialty consultation. This category is used for those cases in which a specialty consultation that would have been necessary to adequately assess and treat the patient was not ordered. If there is a distinct clinical management concern over and above failure to order the consultation, cite that category as well, even if it is C03. C14 Apparently specialty consultation process was not completed in a timely manner. This category is used when a specialty consultation is not ordered in a timely manner or is not completed in a timely manner. If the only issue is the delay, do not additionally cite C03. If there is a distinct clinical management concern over and above the delay in ordering or completing the consultation, cite that category as well, even if it is C03.
ProviderManual.docx