IRR Testing for Physicians using CMS Criteria
The patient has made a diligent effort to achieve healthy body weight
The patient has failed to maintain a healthy weight despite adequate participation in a structured dietary program
A structured dietary program is overseen by a: o Physician (MD or DO). o Registered dietician (RD). o Board certified specialist in pediatric nutrition (CSP). o Board certified specialist in renal nutrition (CSR). o Fellow of the American Dietetic Association (FADA)
All of the above
Approve
Deny
Approve
Deny
Basal cell carcinomas in anatomic locations where they are prone to recur
Squamous cell carcinomas in anatomic locations where they are prone to recur
Any malignant melanoma
All of the above
True
False
Approve
Denied
Patient has type I or type II diabetes and has a lower extremity wound that is due to diabetes
Patient has a wound classified as Wagner grade III or higher
Patient has received standard wound care as described in NCD 20.29 for 30 days
All of the above
True
False
Assessment of vascular status and correction of any vascular problems if possible
Optimizing nutritional status
Optimizing glucose control
All of the above
Approve
Deny
Approve
Deny
Approve
Deny
Approve
Deny
Approve
Deny
Approve
Deny