Tier 1
Qualifying Comorbidities: Rare, critical conditions
Presence of ANY ONE Tier 1 qualifying comorbidity (e.g., renal dialysis, tracheostomy, vocal cord paralysis) assigns Tier 1, regardless of other conditions.
Tier 2
Qualifying Comorbidities: Dysphagia, infections
Presence of ANY ONE Tier 2 qualifying comorbidity (e.g., dysphagia, C. diff, pseudomonas) assigns Tier 2, regardless of other conditions.
Tier 3
Qualifying Comorbidities: Diabetes, obesity, heart/kidney disease
Presence of ANY ONE Tier 3 qualifying comorbidity (e.g., diabetes with complications, morbid obesity, CHF, acute kidney failure) assigns Tier 3.
01 - Stroke (CVA)
Tier 1 (Rare - 5%)
Young, healthy stroke patient with no pre-existing conditions. Very uncommon in IRF population.
Example: 45-year-old with isolated ischemic stroke, no other medical history
Tier 2 (Common - 40%)
Stroke patient with 1-2 comorbidities such as hypertension or diabetes.
Example: Stroke + Hypertension + Type 2 Diabetes
Tier 3 (Most Common - 55%)
Stroke patient with 3+ comorbidities. This is the MOST COMMON tier for stroke patients.
Example: Stroke + HTN + DM + CHF + AFib
Common Comorbidities in Stroke Patients:
- • Hypertension (HTN)
- • Type 2 Diabetes Mellitus
- • Atrial Fibrillation (AFib)
- • Congestive Heart Failure (CHF)
- • Hyperlipidemia
- • Chronic Kidney Disease (CKD)
- • COPD
- • Obesity (BMI ≥40)
Most Commonly Tier 1:
- • Traumatic Brain Injury (young patients)
- • Traumatic Spinal Cord Injury (young patients)
- • Major Multiple Trauma (no brain/spinal)
- • Joint Replacement (healthy patients)
Most Commonly Tier 2:
- • Neurological Disorders
- • Joint Replacement (typical patients)
- • Other Orthopedic
- • Osteoarthritis
- • Guillain-Barré
- • Burns
Most Commonly Tier 3:
- • Stroke (CVA)
- • Amputation Lower Extremity
- • Cardiac
- • Pulmonary
- • Fracture Lower Extremity (elderly)
Important Reminder:
These are TYPICAL patterns based on common patient presentations. Always assign the tier based on the ACTUAL number of documented comorbidities for each individual patient, not on diagnosis category alone. A young stroke patient with no comorbidities would be Tier 1, while an elderly joint replacement patient with diabetes, CHF, and COPD would be Tier 3.