SECTION 3.8008. Continued Stay Criteria for Inpatient (Hospital or 24-hour Residential) Detoxification Services

(a) Eligibility for continued stay for inpatient (hospital or 24-hour residential) detoxification services shall be based on the patient meeting at least one of the criteria in paragraphs (1)-(3) of this subsection.

(1) Chemical substance withdrawal complication. The patient must meet the criteria in one of the subparagraphs (A)-(C) of this paragraph, as follows:

(A) incomplete medically stable withdrawal from alcohol/drugs, as evidenced by documentation of:

(i) unstable vital signs;

(ii) continued disorientation;

(iii) abnormal laboratory findings related to chemical dependency;

(B) continued cognitive deficit related to withdrawal with the deficit affecting the patient's ability to recognize alcohol/drug use as a problem; or

(C) laboratory finding which, in the judgment of a physician, indicate that a drug has not sufficiently cleared the patient's system.

(2) Major medical complications. Documentation must indicate that a medical condition or disorder (e.g., diabetes mellitus, uncontrolled) continues to present a health risk and is actively being treated.

(3) Major psychiatric complication. The patient must meet the criteria in subparagraph (A) or (B) of this paragraph, as follows:

(A) documentation that a DSM III-R AXIS I psychiatric condition or disorder, which, in combination with alcohol/drug use, continues to present a major health risk, is actively being treated; or

(B) documentation that severe neurological and/or psychological symptoms have not been satisfactorily reduced but are actively being treated.

(b) The criteria in subsection (a)(1)-(3) of this section shall be considered in determining utilization review points referred to in §3.8010 of this title (relating to Recommended Length of Stay for Inpatient (Hospital or 24-hour Residential) Detoxification Services).

Source Note: The provisions of this §3.8008 adopted to be effective August 28, 1991, 16 TexReg 4403