Attachment H 2023-1 CE Protocols with Possible Additions.pdf

Highlight

Link to what to do with significant abnormal findings?

Highlight and ER visits as well as what precipitated the attack, if known

History of how frequently using inhaler and/or supplemental oxygen and how often are they getting refills of prescription inhaler? Complete list of current medications and frequency of use must be included

Note should be made regarding SOB during exam, while tying shoes, dressing, etc. Also note if able to walk 50 feet at normal pace with/without SOB

Should they contact provider for approval to order? see above.

Include frequency of PND and level of orthopnea (sleeps with 2 pillows? sleeps in recliner?)

Does claimant use Nitroglycerin? If so, how many times per month and is it always following activity or is it also at rest?

If part of complaint, include number of stools per day and medication used and frequency of medication use.

Must include complete physical exam to include abdominal exam noting pain/rigidity, any organomegaly, hemorrhoids, or occult blood (Do we want to include that?)

??? Must have BMP within 12 months in record, add: Hx of blood transfusion)

Include all medications currently used and recent (12 months) BMP and HgA1C must be in chart.

link to signifcant new findings>?

Romberg test and results should be noted in exam

Note if positive or negative and note any inconsistencies/hesitancies in exam

Medication use and frequency including any steroid boosts or immunotherapy agents

??? link to significant medical finding on exam

Note if positive or negative and note any inconsistencies/hesitancies in exam

Medication use and frequency including any steroid boosts or immunotherapy agents link to significant finding including onset of symptoms, frequency (Continuous/daily/weekly and time duration of symptoms. If symptoms interfere with ADLs, which ADLs and if constant or intermittent should be noted.

Current use of medications must be noted.

Include OTC medications used, herbal, cannibis, etc ??

Please do MSE, not MMSE

Do we want MMPI for anxiety/depression/personality disorders/?

We are missing pages 32 and 33 here

Should we comment on biopsies authorized/not authorized?

What time limit? Someplace else states not within 3 months of infection requiring treatment

Are we still looking for Bruce Protocol or do we need nuclear stress test?

HgA1C ??

Hemocult ??

Would it be helpful to make this into a check list (done/not done) with a signature line and send these with the claimant to the exam ?

Where is Exhibit 5??