Policy Manual sample

MDT Home Health Care Agency, Inc. 1Patient has pathogens cultured from purulent exudate obtained from the conjunctiva or contiguous tissues, such as eyelid, cornea, meibomian glands, or lacrimal glands. 2Patient has pain or redness of conjunctiva or around eye. EYE-Eye, other than conjunctivitis An infection of the eye, other than conjunctivitis, must meet at least 1 of the following criteria: 1Patient has organisms cultured from anterior or posterior chamber or vitreous fluid. 2Patient has at least 2 of the following signs or symptoms with no other recognized cause: eye pain, visual disturbance, or hypopyon EAR-Ear mastoid Ear and mastoid infections must meet at least 1 of the following criteria: Otitis externa must meet at least 1 of the following criteria: 1Patient has pathogens cultured from purulent drainage from ear canal. 2Patient has at least 1 of the following signs or symptoms with no other recognized cause: fever (.38 o C), pain, redness, or drainage from ear canal and organisms seen on Gram’s stain of purulent drainage. Otitis media must meet at least 1 of the following criteria: Patient has organisms cultured from fluid from middle ear obtained by tympanocentesis or at surgical operation. Patient has at least 2 of the following signs or symptoms with no other recognized cause: fever (.38 o C), pain in the eardrum, inflammation, retraction or decreased mobility of eardrum, or fluid behind eardrum. Otitis interna must meet at least 1 of the following criteria: 1Patient has organisms cultured from fluid from inner ear obtained at surgical operation. 2Patient has a physician diagnosis of inner ear infection. ORAL-Oral cavity (mouth, tongue, or gums) Oral cavity infections must meet at least 1 of the following criteria: 1Patient has organisms cultured from purulent material from tissues of oral cavity. 2Patient has an abscess or other evidence of oral cavity infection seen on direct examination, during a surgical operation, or during a histopathologic examination. 3Patient has at least 1 of the following signs or symptoms with no other recognized cause: abscess, ulceration, or raised white patches on inflamed mucosa, or plaques on oral mucosa SINU-Sinusitis Sinusitis must meet at least 1 of the following criteria: 1Patient has organisms cultured from purulent material obtained from sinus cavity. 2Patient has at least 1 of the following signs or symptoms with no other recognized cause: fever (.38 o C), pain or tenderness over the involved sinus, headache, purulent exudate, or nasal obstruction. UR-Upper respiratory tract, pharyngitis, laryngitis, epiglottitis Upper respiratory tract infections must meet at least 1 of the following criteria: 1. Patient has at least 2 of the following signs or symptoms with no other recognized cause: fever (.38 o C), erythema of pharynx, sore throat, cough, hoarseness, or purulent exudate in throat Home Health Agency Nursing Care & Procedures K-143