Active Medical Conditions During Lookback Period Checklist

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Active Medical Conditions During Lookback Period Checklist

Medicare

  1. Reimbursement and Billing Purposes: Medicare and other insurance providers require documentation of active medical conditions during a specific lookback period to ensure appropriate reimbursement for the care provided.

  2. Care Planning: Understanding past medical conditions helps in planning and providing comprehensive care. It ensures that current care plans consider any ongoing or previous medical issues that might affect the patient's health status or treatment.

  3. Risk Assessment: Certain conditions, such as pressure ulcers, infections, or respiratory failures, can be indicators of underlying health risks or ongoing health issues. Knowing their presence during the lookback period allows healthcare providers to assess ongoing risks and implement preventive measures.

  4. Treatment Monitoring: For chronic conditions like COPD, DM, or Parkinson's, knowing if these conditions were active in the past aids in tracking the effectiveness of treatments, medications, and interventions over time.

  5. Quality of Care Evaluation: Assessing the presence of certain conditions, like pressure ulcers, pneumonia, or infections, during the lookback period helps in evaluating the quality of care provided previously and determining if improvements or changes in care plans are necessary.

  6. Medication Management: Conditions like DM requiring insulin injections or certain infections needing IV medications signify ongoing treatments. Knowing their status during the lookback period ensures proper medication management and continuity of care.

 

  1. Burns: Recent burns or healing burn wounds.
  2. Cerebral Palsy: History or ongoing management of cerebral palsy.
  3. Chemotherapy: Recent or ongoing chemotherapy treatments.
  4. Comatose: Episodes of being comatose or having a reduced level of consciousness.
  5. COPD and SHOB (Shortness of Breath): Chronic obstructive pulmonary disease or instances of severe shortness of breath.
  6. Dialysis: Requirement for dialysis treatments.
  7. DM and Insulin Injections/Order Changes: Diabetes mellitus management with insulin injections or changes in insulin orders.
  8. Feeding Tubes: Utilization of feeding tubes for nutritional support.
  9. Fever, Pneumonia, Vomiting, Weight Loss: Instances of fever, pneumonia, vomiting, weight loss, or use of feeding tubes due to illness.
  10. Food Infection: History of food-related infections or foodborne illnesses.
  11. IV Meds: Administration of intravenous medications.
  12. Multiple Sclerosis: History or ongoing management of multiple sclerosis.
  13. Oxygen Therapy: Requirement for oxygen therapy.
  14. Parkinson's: History or ongoing management of Parkinson's disease.
  15. Pneumonia: Past or ongoing episodes of pneumonia.
  16. Pressure Ulcers with Treatments: Presence of pressure ulcers and associated treatments.
  17. Quadriplegia: Paralysis affecting all four limbs.
  18. Radiation: History or ongoing radiation therapy.
  19. Respiratory Failure and Oxygen: Instances of respiratory failure requiring oxygen support.
  20. Septicemia: Episodes of sepsis or systemic infection.
  21. Surgical Wounds: Recent or healing surgical wounds.
  22. Therapy Services: Utilization of therapy services (e.g., physical therapy, occupational therapy).
  23. Tracheostomy: Presence of a tracheostomy tube for breathing support.
  24. Transfusions: History of blood transfusions.
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Medicare Skilled Care
Medicare Eligibility Requirements
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Medicare
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