How to Refer a Patient

How to refer a patient

What physicians and case managers should know

Physicians and case managers may not be aware that Medicare requires that only 60% of acute patients have a CMS-13 diagnosis, which are:

  • Active polyarticular rheumatoid arthritis
  • Amputation
  • Brain injury/brain tumor
  • Burns
  • Congenital deformity
  • Hip fracture
  • Hip/knee replacement
  • BMI>50
  • Bilateral joins (both sides at same time)
  • 85 years or older
  • Major multiple trauma
  • Multiple fracture
  • Neurological disorders (not an all-inclusive list)
  • Multiple sclerosis
  • Motor neuron disease
  • Encephalopathy
  • Critical illness myopathy/polyneuropathy
  • Guillain Barré
  • ALS
  • Parkinson’s disease
  • Late effects polio
  • Friedreich’s ataxia
  • Osteoarthritis or degenerative joint disease
  • Two or more weight-bearing joints
  • Spinal cord impairment
  • Stroke
  • Systemic vasculidities with joint inflammation

40% of the other rehabilitation diagnoses and conditions doctors and case managers should consider for rehabilitation:

  • Temporal arteritis
  • Polymyalgia
  • PMR
  • Lupus
  • Rheumatica
  • Gouty arthritis
  • Abdominal aortic aneurysm
  • Coronary artery bypass graft (CABG) 
  • Cancer
  • Cardiac conditions
  • Congestive heart failure (CHF)
  • Debility
  • Joint replacement
  • Laminectomy
  • Myocardial infarction (MI)
  • Neuropathy
  • Orthopedic injuries
  • Pneumonia
  • Peripheral vascular disease (PVD)
  • Respiratory failure
  • Wound care
  • Conditions affecting mobility, activities of daily living (ADL’s), swallowing or cognition/thinking abilities
  • Late effects from previous neurological injury or illness, i.e. brain injury, stroke or spinal cord injury
  • Other conditions or complications
  • Supporting doctor, nursing and therapy documentation
  • Patient’s level of independence before illness or injury

Contact Us

To make a referral or for more information, contact our admissions department at 305 259-6494 or luis.aguiar@healthsouth.com . You will be put in contact with one of our rehabilitation liaisons to perform a pre-admission screening and coordinate transfer to our hospital.

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