ࡱ> Y[X` bjbjss .8,T?Xjh!d"?>?>?>?>?>?$YAhCnb?###b?w?$$$# ,?0?r<6/D$/D,=/D=h""#$#2#"""b?b?$ """?####$ ( ( ICD-9 Code: 836.0 Narrative: Tear Medial Meniscus, Knee Other Names: Torn knee cartilage Ohio Specific Disability Outcomes: 30th Percentile 50th Percentile All Claims including Surgical Cases 39 74 Menisectomy 45 65  HYPERLINK "../ALL%20USERS/MEDICAL%20DEFINITIONS.doc" \l "MEDDTEARMDMENISCUS" MEDD RTW Best Practices: Condition SeveritySurgical Procedure HYPERLINK "../ALL%20USERS/RTW%20and%20Job%20Modifications/Knee%20Restrictions%20and%20Modifications.xls" Sedentary Work:  < 10 lbs HYPERLINK "../ALL%20USERS/RTW%20and%20Job%20Modifications/Knee%20Restrictions%20and%20Modifications.xls" Clerical/Light Work: < 20 lbs HYPERLINK "../ALL%20USERS/RTW%20and%20Job%20Modifications/Knee%20Restrictions%20and%20Modifications.xls" Manual Work:< 50 lbs HYPERLINK "../ALL%20USERS/RTW%20and%20Job%20Modifications/Knee%20Restrictions%20and%20Modifications.xls" Heavy Duty Work: > 50 lbsNone0-2 days21 days HYPERLINK "../ALL%20USERS/MEDICAL%20DEFINITIONS.doc" \l "Arthroscopic" Arthroscopy14 days(21 days)42 days(42 days) HYPERLINK "../ALL%20USERS/MEDICAL%20DEFINITIONS.doc" \l "Arthrotomy" Arthrotomy28 days56 days84 days Description: Injury with tear of the cartilage in the knee due to trauma or result of trauma on degenerative changes. Commonly has pain, swelling, pain on weight bearing, and locking of knee. BWC Required Diagnostics: MRI to support diagnosis. Common Treatment Procedures (CPT Codes): MRI (73721) Arthroscopic Partial or Complete  HYPERLINK "../ALL%20USERS/MEDICAL%20DEFINITIONS.doc" \l "Menisectomy" Menisectomy (Usually outpatient) (29881,29882) Post-Surgical  HYPERLINK "http://orthoinfo.aaos.org/booklet/view_report.cfm?thread_id=15&topcategory=knee" Physical Therapy Physical Therapy Guidelines: May have 10 visits pre-surgery (Presumptive Authorization) Ten visits post-surgical Additional Visits based on Clinical Progress Common Surgical Procedures: Arthroscopic Partial or Complete Menisectomy Arthrotomy less common Early Case Management: 14 days Essential Case Management: 30 days Common Restrictions: Restrictions lessen (less restrictive) with improvement of symptoms. Sedentary: Standing limited to 5-10 min/hr; walking only on a smooth surface using crutches with limited pressure on the foot;no walking on an irregular surface; no climbing stairs; no climbing ladders or hill climbing requiring frequent knee flexion; no activities requiring balance; no applying strength against bent knee (squatting, kneeling, crouching, stooping, pedaling, etc.); elevate leg half of time; may need immobilization; limited weight bearing. Medium: Standing not more than 50 min/hr; walking on a smooth surface up to 1,200 ft/hr carrying up to 25 lbs; walking on an irregular surface up to 900 ft/hr carrying up to 25 lbs; climbing stairs up to 8 flights/hr carrying up to 40 lbs; climbing ladders up to 50 rungs/hr carrying up to 25 lbs; activities requiring balance up to 45 min/hr (if able to work with two hands without assistance for balance); applying strength against bent knee (pedaling, squatting, kneeling, etc.) up to 60 times/hr; may need brace for uneven ground or ladders. Common Case Management Issues: Early (Commonly performed as part of Knee Sprain/strain with lost time) Clinical Status Planned Treatment If Surgery, what about post-surgical therapy/rehab Work Restrictions and whether Restricted Duty Work Available (Sit-down) Additional Services Necessary Diagnostic or Consultation Follow-up (Manage from date of surgery) Clinical Status/Surgical Results Identify any reason failing to improve as expected. Why Unable to Return to Work Address any Barriers If not progressing as expected Identify any reason for failing to improve as expected Any need for diagnostic studies/consults Any need for ergonomic analysis/job modifications Address any barriers Additional Allowances Consider IME (prefer orthopedist)  8;<I]^դpbQH?h,]5CJaJh@5CJaJ hn7hn75B*CJaJphhW5B*CJaJph hn7h@5B*CJaJph#hn7h,]5B*CJH*aJph hn7h,]5B*CJaJph+hn7h,]56B*CJOJQJaJph h<6h,]h<6h,]5hn7h&5CJaJhn7h,]5CJaJhn7hf(+5CJaJhf(+5CJaJh ,5CJaJ<]^J K L ` s   ! $Ifgd<6p@&^p`gd,] p^p`gd,]@&gd,] p^p`gdf(+B C D H I J K L     z { |  򾵩ugSg&jhGh!5CJUaJhGh<60J5CJaJ&jhGh!5CJUaJhG5CJaJjhG5CJUaJh<65CJaJhn7hn75CJaJh ,5CJaJh,]5CJaJhGhG0J5CJaJ&jhGh!5CJUaJhG5CJaJjhG5CJUaJ    ! "      % . 7 @ C D ޾ǜqhhǜTq&jh!h!5CJUaJhk925CJaJh!h<60J5CJaJ&jmh!h!5CJUaJh!5CJaJjh!5CJUaJ&jhGh!5CJUaJhG5CJaJh<65CJaJhGh<60J5CJaJjhG5CJUaJ&jhGh!5CJUaJ :1111 $Ifgd<6kd!$$IflֈqZ <,"(P t08)44 la  1kd$$IflֈqZ <,"(P t08)44 la $Ifgd<6 % / 7 A B 1kdF$$IflֈqZ <,"(P t08)44 la $Ifgd<6B C $Ifgd<6 :1111 $Ifgd<6kd$$IflֈqZ <,"(P t08)44 la { 1//kdg $$IflֈqZ <,"(P t08)44 la $Ifgd<6 z { OPQ\]r Z[tuپٲپٲynbh)(Dh)(D5CJaJh)(Dh)(DCJaJ#j h!h!CJUaJh!h)(D0JCJaJ#j h!h!CJUaJh!CJaJjh!CJUaJh(CJaJh)(Dh ,CJaJh ,CJaJh)(DCJaJh)(D5CJaJh ,5CJaJh ,h ,5CJaJ%{ |  [u$%Hgdfgd)(D & F & Fgd)(D & F & Fgd)(D & Fgd)(D & F & Fgd)(D@&gd,]$%@BGHIpqx7jǼ۴ۏۇ|pdh ,h ,5CJaJh ,h)(D5CJaJhYh)(DCJaJh0}CJaJh+yCJaJhi&hf5CJaJhfB*phhf5CJaJh<6CJaJhKh)(DCJaJhk92CJaJhKh)(D5CJaJh)(DCJaJh)(D5CJaJh ,5CJaJh<6h ,CJaJq RSp7L & Fgd)(D & Fgd)(Dgd)(D & Fgd)(D & Fgd)(D & Fgd)(D@&gd,]gdf & FgdfLbgd)(D & Fgd)(D,1h/ =!"#$% DyK  yK J../ALL USERS/MEDICAL DEFINITIONS.docMEDDTEARMDMENISCUSDyK yK ../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xlsDyK yK ../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xlsDyK yK ../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xlsDyK yK ../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xls$$If!vh5555P55#v#v#v#vP#v:Vl t8)5555P5$$If!vh5555P55#v#v#v#vP#v:Vl t8)5555P5DyK  yK J../ALL USERS/MEDICAL DEFINITIONS.doc Arthroscopic$$If!vh5555P55#v#v#v#vP#v:Vl t8)5555P5DyK  yK J../ALL USERS/MEDICAL DEFINITIONS.doc Arthrotomy$$If!vh5555P55#v#v#v#vP#v:Vl t8)5555P5$$If!vh5555P55#v#v#v#vP#v:Vl t8)5555P5DyK  yK J../ALL USERS/MEDICAL DEFINITIONS.doc MenisectomyDyK yK http://orthoinfo.aaos.org/booklet/view_report.cfm?thread_id=15&topcategory=knee@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List j@j  , Table Grid7:V06U@6 & Hyperlink >*B*phFVF GFollowedHyperlink >*B* phZY@"Z ,] Document Map-D M CJOJQJ^JaJ8<]^JKL`s!%/7ABC{| [u$%Hq  R Sp7Lb000<00^0^0^00000L 0L 0L 0L 0L0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L 0L0L0L0L0L0 0 0 000 0 0 0000 0 000000 0 000 0  0  0  0  0  0 0  0  0  0  0  0 0  0  0  0  0  0  0  0 0 0 <]^JL`s!%/7ABC{| [u$%Hq  R Sp7Lb000 0 00I00 0 0 0 00 0 0 0 0 0 0 0 00 0 0 0 0 0 00 0 0 0 0 0 00 0 0 0 0 0 00000000 0m 0m 0m0m0 0 0 0000 0` 0`0`0000 0 000 0Q  0p Q  0p Q  0 Q  0p Q  0p Q 0Q  0Q  0Q  0Q  0Q  0Q 0Q  0Q  0BQ  0BQ  0BQ  0BQ  0BQ  0BQ 0Q 0Q     B { L CH{!CP\XXXXXXXXX _Hlt110651581 _Hlt110651582 _Hlt130286987 _Hlt130288712 _Hlt130288713 _Hlt130288716 _Hlt130288736 _Hlt130288737 _Hlt130288738 _Hlt130289032 _Hlt130289029 _Hlt130289030 _Hlt130289031 _Hlt130289043 _Hlt130286965 _Hlt130286966 _Hlt130286967 _Hlt130286968 _Hlt130286969 _Hlt130286970 _Hlt130286982 _Hlt130288708 _Hlt130288709 _Hlt130289034 _Hlt130289038 _Hlt130289039 _Hlt130289041 _Hlt110651110 _Hlt110651111 _Hlt110651878 _Hlt110651879++8GG@@@@@@@@@ @ @ @ @ @@@@@@@@@@@@@@@@@@,,8HH9Dl49~4^^bb9*urn:schemas-microsoft-com:office:smarttagsState9*urn:schemas-microsoft-com:office:smarttagsplace  NR" & 33< [uI : p7gX2xB,b30|Խ,VR."Ud:hePnq:q{t0 ;~ͬh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohpp^p`OJQJo(hHh@ @ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJQJo(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohPP^P`OJQJo(hHPnb30q{g"UdxB,;~,VR                                                                        @2f(+ ,;,k92<6)(DWmpGf&0}+yn7(,]!`s!%/7ABC@\4\@{@@UnknownGz Times New Roman5Symbol3& z Arial3z Times5& z!Tahoma?5 z Courier New;Wingdings"hFfQ5 Q5 $24d 2QHX)? ,2 ICD-9 Code:Gregory M. Jewella71410,        Oh+'0  < H T`hpx ICD-9 Code:Gregory M. Jewell Normal.dota714108Microsoft Office Word@ա@e@lSQ5 ՜.+,D՜.+,8 hp|  BWC  ICD-9 Code: Title 8@ _PID_HLINKSA6tdPhttp://orthoinfo.aaos.org/booklet/view_report.cfm?thread_id=15&topcategory=knee+q5%../ALL USERS/MEDICAL DEFINITIONS.doc Menisectomys&%../ALL USERS/MEDICAL DEFINITIONS.doc Arthrotomy@%../ALL USERS/MEDICAL DEFINITIONS.doc Arthroscopic)x O../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xls+)x O../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xls+)xO../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xls+)xO../ALL USERS/RTW and Job Modifications/Knee Restrictions and Modifications.xls+y+%../ALL USERS/MEDICAL DEFINITIONS.docMEDDTEARMDMENISCUS  !"#$&'()*+,-./0123456789:;<=>?@ABCDEFGIJKLMNOQRSTUVWZRoot Entry F5lS\Data 1Table%[DWordDocument.8SummaryInformation(HDocumentSummaryInformation8PCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q