TN 5 (12-04)

DI 22510.043 Pediatric CE Report Content Guidelines – Hematological Disorders

A. Policy - General

Specific requirements exist in addition to all general pediatric guidelines in DI 22510.035.

B. Policy - History

The history should include:

  • Fatigue/anorexia;

  • Headache;

  • Pain;

  • Weight loss/gain;

  • Edema;

  • Jaundice;

  • Bleeding - ecchymoses;

  • Transfusions (RBCs, platelets) – frequency;

  • Infusions (plasma factors) – frequency; and

  • Infections.

C. Policy - Physical exam

The physical exam should include:

  • Jaundice;

  • Abnormal bleeding;

  • Liver and spleen size;

  • Size and distribution of lymph nodes; and

  • Abdominal masses.

D. Policy - Laboratory testing

Laboratory testing should include:

  • CBC;

  • Serial hemoglobin measurements (at least 3) over a 12 month period, if available; and,

  • Chest x-ray.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0422510043
DI 22510.043 - Pediatric CE Report Content Guidelines - Hematological Disorders - 05/15/2015
Batch run: 05/15/2015
Rev:05/15/2015