InterQual 2014 release raises the bar for evidence-based clinical content at the point of care

We are pleased to announce the availability of the InterQual^® 2014 and CareEnhance^® Review Manager Enterprise 13.0 releases. We greatly appreciate your business, and continually strive to ensure the quality of the products and services we provide to you and your organization. Over the course of the past year, we have made a concerted effort to hear from as many of you as we can about how our products are helping you, and about how our products can be enhanced. We value your feedback, and rely upon it to help shape the future of InterQual. We are committed to addressing your input, suggestions and concerns.

Enhanced and Expanded Criteria

All InterQual Criteria with associated ICD-9 codes were updated to support ICD-10 compliance.

InterQual Acute Criteria continued refinement and evidence-based updating of "condition-specific" content, which included breaking out general subsets, streamlining episode days, and building out robust responder criteria to simplify the content, enhance navigation and improve usability.  Nursery Criteria added level IV nursery and greater specificity around severity and interventions.  Antepartum/Postpartum has four new subsets.

InterQual Outpatient Rehabilitation and Chiropractic Criteria have a new Cardiac Rehabilitation subset and a new subset on maintenance therapy to address Medicare policy updates related to the Jimmo v.Sebelius settlement and help improve patient outcomes.

InterQual Home Care Criteria have a new subset on maintenance therapy to address Medicare policy updates related to the Jimmo v. Sebelius settlement and help improve patient outcomes.

InterQual Behavioral Health Criteria have been updated based upon the American Psychiatric Association’s DSM-5™ manual and new medical literature.  Applied Behavior Analysis (ABA) criteria subsets for autism spectrum disorders were added to Child Psychiatry.

InterQual Procedures Criteria have two new subsets, Bariatric Surgery (Adolescent) and Skin Substitute Graft, to support evidence-based decision-making regarding the medical necessity of these increasingly common procedures. 

InterQual Imaging Criteria have added many new indications to existing subsets based on current medical literature.  The adolescent age group has been expanded for the Imaging, Pelvis subset.

InterQual Durable Medical Equipment Criteria have been updated to reflect current medical literature, and 5 new pieces of equipment have been added.  The Senior module underwent updates to maintain alignment with Centers for Medicare & Medicaid national and local coverage determinations.

InterQual Specialty Rx Criteria were expanded by twelve new non-oncology drugs and four new oncology drugs since the InterQual 2013 release to further support evidence-based decision-making regarding the appropriate use of drugs and biologics in patients.  In addition to many updates based on the latest evidence, criteria related to off-label indications were updated in accordance with the NCCN Compendium^®.

InterQual Molecular Diagnostics Criteria have added 25 new tests, as well as evidence-based criteria updates, to keep organizations current on a rapidly growing field.  The criteria now cover over 680 molecular and genetic tests.

SIM plus™ has four new retrospective monitoring subsets, Bariatric Surgery (Pediatric), Colpopexy, Radiofrequency Ablation (RFA), Liver and Transarterial Chemoembolization (TACE), Liver, to help organizations assess the appropriateness of additional surgical and nonsurgical invasive procedures.

Technology Enhancements

InterQual Mobile, the first mobile version of our InterQual content, is now available at no additional cost. Payers and providers can get anytime, anywhere access to InterQual Level of Care Criteria and InterQual Behavioral Health Criteria via iOS or Android smartphones or tablets. InterQual Mobile’s tap-and-go menus help speed clinical documentation and medical necessity administration with roaming access to evidence-based decision support wherever and whenever it’s needed.

CareEnhance Review Manager Enterprise was updated to fully support ICD-10 codes and now includes print-book-on-demand functionality, which allows printing of whole criteria sets. Its Review Transmission feature can send outcome information, link a continued stay with an initial admission request and check member eligibility prior to submitting an authorization request.

InterQual Content Customization Tool was enhanced to allow for better management of citations, easier incorporation of clinical revisions and improved usability.  The tool now has medical spell check functionality and additional clinical revisions default templates.

To speed up client access to our software, criteria and software enhancements will be available via download on McKesson Download Central (DLC), a secure website that uses a state-of-the-art method for distributing software and product updates.

Do you want to learn more about InterQual? Contact us at 800.782.1334 or MHS@mckesson.com to request more information.