Injury Eligibility
Neck and Back s/s with 6 months of chiro
Yes
How would you capture an ER visit for a neck/back sprain strain?
Examination of Musculoskeletal System- GP or ER visit - neck or back pain 8E0KXY.GP
Clear policy limit cases
No
How would you capture an ortho visit for a neck/back sprain strain?
Examination of Musculoskeletal System- Treating specialist consultation - neck or back pain 8E0KXY.TS
Neck sprain with an ER visit and 4 PCP visits
No (do not enter if incurred treatment < 45 days from the date of loss)
How would you capture an exacerbation to a prior injury to the spine?
Capture the sprain/strain injury. Consider the accepted treatment period, given the potential prolonged recovery.
Shoulder tear with surgical recommendation
Yes
When would it be appropriate to capture "Headaches" as a complication in LNAV?
If they are persistent and documented
Major leg scar with soft tissue injuries
No
How would you capture a partial left shoulder tear with a surgical recommendation? (Minor, Moderate, Severe)
Severe