Cognitive Rehabilitation

Cognitive Rehabilitation Last Review Date: March 11, 2016 Number: MG.MM.ME.58 Medical Guideline Disclaimer Property of EmblemHealth. All rights rese...
Author: Earl Harmon
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Cognitive Rehabilitation Last Review Date: March 11, 2016

Number: MG.MM.ME.58

Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth the clinical evidence that the patient meets the criteria for the treatment or surgical procedure. Without this documentation and information, EmblemHealth will not be able to properly review the request for prior authorization. The clinical review criteria expressed below reflects how EmblemHealth determines whether certain services or supplies are medically necessary. EmblemHealth established the clinical review criteria based upon a review of currently available clinical information (including clinical outcome studies in the peer-reviewed published medical literature, regulatory status of the technology, evidence-based guidelines of public health and health research agencies, evidence-based guidelines and positions of leading national health professional organizations, views of physicians practicing in relevant clinical areas, and other relevant factors). EmblemHealth expressly reserves the right to revise these conclusions as clinical information changes, and welcomes further relevant information. Each benefit program defines which services are covered. The conclusion that a particular service or supply is medically necessary does not constitute a representation or warranty that this service or supply is covered and/or paid for by EmblemHealth, as some programs exclude coverage for services or supplies that EmblemHealth considers medically necessary. If there is a discrepancy between this guideline and a member's benefits program, the benefits program will govern. In addition, coverage may be mandated by applicable legal requirements of a state, the Federal Government or the Centers for Medicare & Medicaid Services (CMS) for Medicare and Medicaid members. All coding and web site links are accurate at time of publication. EmblemHealth Services Company LLC, (“EmblemHealth”) has adopted the herein policy in providing management, administrative and other services to HIP Health Plan of New York, HIP Insurance Company of New York, Group Health Incorporated and GHI HMO Select, related to health benefit plans offered by these entities. All of the aforementioned entities are affiliated companies under common control of EmblemHealth Inc.

Definitions Cognitive function

The ability to selectively focus on information, obtain knowledge, and properly apply knowledge; the conscious intellectual activity of knowing, thinking, learning, judging, reasoning and remembering.

Cognitive deficits

Impacts to attention, language, memory, reasoning, executive functions, problem solving, and visual processing.

Cognitive rehabilitation therapy

Cognitive rehabilitation, which may be provided in the inpatient or outpatient setting, offers retraining in the ability to think, use judgment and make decisions. The focus is on correcting deficits in memory, concentration and attention, perception, learning, planning, sequencing, and judgment. The goals of treatment are to enhance the person's capacity to process and interpret information and to improve functional ability. There are two basic approaches to cognitive rehabilitation:  Restorative — where intellectual deficits are bolstered by various repetitive exercises  Compensatory — where adaptive devices and strategies and modification of the environment are used to restore functioning despite ongoing deficits. These two techniques can be used in combination and can be components of a comprehensive multidisciplinary rehabilitation program that involves other forms of remediation and psychosocial therapy. A single strategy program can target either an isolated cognitive function or multiple functions concurrently. Note: Cognitive rehabilitation should not be confused with cognitive behavior therapy. Cognitive behavior therapy (also known as cognitive therapy) is a form of psychotherapy that emphasizes the role of thought patterns in moods and behaviors.

Traumatic brain injury (TBI)

Damage to the brain caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain. Most instances of traumatic brain injury are the result of motor vehicle accidents, violence, sports injuries and falls.

Related Medical Guidelines Neuropsychological Testing

Cognitive Rehabilitation Last review: March 11, 2016 Page 2 of 16

Guideline EmblemHealth considers cognitive rehabilitation therapy (as an adjunct to multidisciplinary rehabilitation [e.g., physical, occupational or speech therapy]) to be medically necessary for significantly impaired cognitive function secondary to aneurysm, brain tumors, traumatic brain injury (TBI), brain injury due to cerebrovascular accident (CVA [stroke]), brain injury due to systemic toxin or metabolic derangement1, or HIV-associated neurocognitive impairment when the all of the following criteria are met: 1. Onset of injury/clinical condition within ≤ 6 months of service request 2. Member was active and responsive to verbal or visual stimuli prior to service request and has an ability to follow commands and process and retain information 3. Member has been evaluated by a neuropsychiatrist or neuropsychologist2 4. Member has completed neuropsychological testing (NPT) and results demonstrate applicability to treatment-planning and implementation of rehabilitation strategies 5. Expectation of significant cognitive improvement; i.e.: a. Mental and physical condition prior to injury indicates significant potential for improvement b. Member is able to actively participate in therapy [e.g., not in a vegetative state, receiving custodial, etc.) 6. Symptoms cannot be attributed to: a. direct effects of a substance b. be better explained by active and poorly controlled symptoms of psychiatric illness in the setting of lack of treatment (such as distractibility due to internal stimuli due to untreated psychosis or poor concentration secondary to severe untreated depressive illness). Psychiatric symptoms should be assessed and appropriately clinically managed prior or concurrently with cognitive rehabilitation therapy for the original traumatic brain injury. Note: When the injury is one affecting the central nervous system, concomitant cognitive and physical issues may exist. When physical rehabilitation needs no longer exist, the cognitive issues may be addressed either as part of a formal cognitive rehabilitation program, or if there are continuing speech therapy or occupational therapy needs, with the continuation of these services.

Care Plan Documentation Cognitive rehabilitation may be performed by an occupational therapist, physical therapist, speech/language pathologist, neuropsychologist or physician. A written Care Plan, which includes all of the following components, must be submitted to the plan upon request: 1. Diagnosis and date of onset of the condition 2. Reasonable time-frame estimate for when goals are achievable 1

Examples of systemic toxin brain injury include resolving hepatic encephalopathy, resolving uremic encephalopathy, etc. 2 While EmblemHealth requires a neuropsychiatrist or neuropsychologist to perform the evaluation for cognitive rehabilitation therapy, the performance of NPT may be completed by any of following types of providers (as commensurate with NYS licensure): Developmental-behavioral/neurodevelopmental specialist, psychiatrist (MD or DO), clinical psychologist (CP), clinical social worker (CSW), psychiatric nurse practitioner (NP), clinical nurse specialist (CNS) and physician assistant (PA).

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3. 4. 5. 6.

Specification of long and short-term goals that are quantitative and objective Cognitive therapy evaluation (completed by neuropsychiatrist or neuropsychologist) Frequency and duration of treatment Specific cognitive rehabilitation therapy techniques to be utilized

The Care Plan should be ongoing and updated commensurate with the member’s change in condition. Re-evaluation should occur regularly (typically on a monthly basis) and document goalprogression. (Substantiating documentation should link cognitive therapy to the goal-achievements specified in the Care Plan) Utilization Rehabilitation for visuo-spatial deficits generally entails 20 1-hour sessions delivered over the course of 4 weeks. For language and communication deficits, patients usually receive 8 hours of weekly therapy, beginning at 4 weeks post-onset and continuing up to 48 weeks post-onset. Courses of cognitive rehabilitation substantially longer than these durations will be case-by-case reviewed. Limitations/Exclusions 1. Cognitive rehabilitation therapy is not considered medically necessary when: a. Performed as a stand-alone program b. Measurable improvement within a reasonable and predictable period of time is not thought to be achievable c. Member is not making progress toward treatment goals, has reached a plateau or is regressing (demonstrated by the lack of measurable progress towards set goals for at least 1 week) and there is no reasonable expectation of progress despite treatment planning changes d. Member fails to comply with the treatment program, or attendance in therapies is insufficient, to the extent that treatment is not beneficial 2. Cognitive rehabilitation therapy is not considered medically necessary for indications other than those listed above due to insufficient evidence of therapeutic value (including, but not limited to: Epilepsy/seizure disorders, Down syndrome, mental retardation, cerebral palsy [CP], dementia [e.g., Alzheimer’s disease, Parkinson’s disease], cognitive decline in multiple sclerosis [MS] and chronic obstructive pulmonary disease [COPD], Wernicke encephalopathy and behavioral/psychiatric disorders such as attention-deficit/hyperactivity disorder [ADD/ADHD], depression, schizophrenia, social phobia, substance abuse disorders and pervasive developmental disorders [including autism]). 3. Presence of acute and ongoing substance use resulting in fluctuating level of consciousness. 4. The following treatment modalities are not considered medically necessary due to insufficient evidence of therapeutic value: a. Coma stimulation (aka "Responsiveness Program" [cognitive remediation of comatose persons]), coma arousal program/therapy, sensory stimulation and multi-sensory stimulation programs b. Sensory integration therapy (performed to enhance sensory processing and promote adaptive responses to environmental demands) is regarded as investigational, but may be covered for Medicare members only. Per Local Coverage Determination (LCD): Outpatient Physical and Occupational Therapy Services (L33631), services may be medically necessary for acquired sensory problems resulting from head trauma, illness,

Cognitive Rehabilitation Last review: March 11, 2016 Page 4 of 16

or acute neurologic events including CVA. They are not appropriate for patients with progressive neurological conditions without potential for functional adaptation. Therapy is not considered a cure for sensory integrative impairments, but is used to facilitate the development of the nervous system’s ability to process sensory input differently. Further, according to the LCD, utilization of this service should be infrequent for Medicare patients. 5. The following services, frequently associated with cognitive rehabilitation programs, are not considered medically necessary as they are not considered primarily medical in nature: a. Vocational rehabilitation b. Structured adult education c. Community re-entry programs d. Behavioral training e. Driving training f.

Compensatory devices such as memory books, date books, electronic paging systems or computer-assisted training

g. Employment counseling h. Work hardening i.

Cognitive therapy provided to improve academic performance

j.

Music, recreation and/or art therapy

k. Intelligence testing (IQ testing) l.

Community-based, non-medical services such as clubhouses for socialization, day programs and social skill development programs, supported living programs and independent living centers, and supported employment programs

Applicable Procedure Codes 97532

Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes

Applicable Diagnosis Codes B20

Human immunodeficiency virus [HIV] disease

C71.1

Malignant neoplasm of frontal lobe

C71.2

Malignant neoplasm of temporal lobe

C71.3

Malignant neoplasm of parietal lobe

C71.4

Malignant neoplasm of parietal lobe

C71.5

Malignant neoplasm of cerebral ventricle

C71.6

Malignant neoplasm of cerebellum

C71.7

Malignant neoplasm of brain stem

C71.8

Malignant neoplasm of overlapping sites of brain

C71.9

Malignant neoplasm of brain, unspecified

C79.31

Secondary malignant neoplasm of brain

C79.32

Secondary malignant neoplasm of cerebral meninges

D33.0

Benign neoplasm of brain, supratentorial

D33.1

Benign neoplasm of brain, infratentorial

Cognitive Rehabilitation Last review: March 11, 2016 Page 5 of 16

D33.2

Benign neoplasm of brain, unspecified

D33.3

Benign neoplasm of cranial nerves

D43.0

Neoplasm of uncertain behavior of brain, supratentorial

D43.1

Neoplasm of uncertain behavior of brain, infratentorial

D43.2

Neoplasm of uncertain behavior of brain, unspecified

D43.3

Neoplasm of uncertain behavior of cranial nerves

F07.81

Postconcussional syndrome

G45.0

Vertebro-basilar artery syndrome

G45.1

Carotid artery syndrome (hemispheric)

G45.2

Multiple and bilateral precerebral artery syndromes

G45.3

Amaurosis fugax

G45.4

Transient global amnesia

G45.8

Other transient cerebral ischemic attacks and related syndromes

G45.9

Transient cerebral ischemic attack, unspecified

G46.0

Middle cerebral artery syndrome

G46.1

Anterior cerebral artery syndrome

G46.2

Posterior cerebral artery syndrome

G46.3

Brain stem stroke syndrome

G46.4

Cerebellar stroke syndrome

G46.5

Pure motor lacunar syndrome

G46.6

Pure sensory lacunar syndrome

G46.7

Other lacunar syndromes

G46.8

Other vascular syndromes of brain in cerebrovascular diseases

G92

Toxic encephalopathy

G93.0

Cerebral cysts

G93.1

Anoxic brain damage, not elsewhere classified

G93.2

Benign intracranial hypertension

G93.40

Encephalopathy, unspecified

G93.41

Metabolic encephalopathy

G93.49

Other encephalopathy

G93.5

Compression of brain

G93.6

Cerebral edema

G93.7

Reye's syndrome

G93.81

Temporal sclerosis

G93.89

Other specified disorders of brain

G93.9

Disorder of brain, unspecified

G94

Other disorders of brain in diseases classified elsewhere

G97.31

I60.00

Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating a nervous system procedure Intraoperative hemorrhage and hematoma of a nervous system organ or structure complicating other procedure Nontraumatic subarachnoid hemorrhage from unspecified carotid siphon and bifurcation

I60.01

Nontraumatic subarachnoid hemorrhage from right carotid siphon and bifurcation

I60.02

Nontraumatic subarachnoid hemorrhage from left carotid siphon and bifurcation

I60.10

Nontraumatic subarachnoid hemorrhage from unspecified middle cerebral artery

G97.32

Cognitive Rehabilitation Last review: March 11, 2016 Page 6 of 16

I60.11

Nontraumatic subarachnoid hemorrhage from right middle cerebral artery

I60.12

Nontraumatic subarachnoid hemorrhage from left middle cerebral artery

I60.20

Nontraumatic subarachnoid hemorrhage from unspecified anterior communicating artery

I60.21

Nontraumatic subarachnoid hemorrhage from right anterior communicating artery

I60.22

Nontraumatic subarachnoid hemorrhage from left anterior communicating artery

I60.30

Nontraumatic subarachnoid hemorrhage from unspecified posterior communicating artery

I60.31

Nontraumatic subarachnoid hemorrhage from right posterior communicating artery

I60.32

Nontraumatic subarachnoid hemorrhage from left posterior communicating artery

I60.4

Nontraumatic subarachnoid hemorrhage from basilar artery

I60.50

Nontraumatic subarachnoid hemorrhage from unspecified vertebral artery

I60.51

Nontraumatic subarachnoid hemorrhage from right vertebral artery

I60.52

Nontraumatic subarachnoid hemorrhage from left vertebral artery

I60.6

Nontraumatic subarachnoid hemorrhage from other intracranial arteries

I60.7

Nontraumatic subarachnoid hemorrhage from unspecified intracranial artery

I60.8

Other nontraumatic subarachnoid hemorrhage

I60.9

Nontraumatic subarachnoid hemorrhage, unspecified

I61.0

Nontraumatic intracerebral hemorrhage in hemisphere, subcortical

I61.1

Nontraumatic intracerebral hemorrhage in hemisphere, cortical

I61.2

Nontraumatic intracerebral hemorrhage in hemisphere, unspecified

I61.3

Nontraumatic intracerebral hemorrhage in brain stem

I61.4

Nontraumatic intracerebral hemorrhage in cerebellum

I61.5

Nontraumatic intracerebral hemorrhage, intraventricular

I61.6

Nontraumatic intracerebral hemorrhage, multiple localized

I61.8

Other nontraumatic intracerebral hemorrhage

I61.9

Nontraumatic intracerebral hemorrhage, unspecified

I62.00

Nontraumatic subdural hemorrhage, unspecified

I62.01

Nontraumatic acute subdural hemorrhage

I62.02

Nontraumatic subacute subdural hemorrhage

I62.03

Nontraumatic chronic subdural hemorrhage

I62.1

Nontraumatic extradural hemorrhage

I62.9

Nontraumatic intracranial hemorrhage, unspecified

I63.00

Cerebral infarction due to thrombosis of unspecified precerebral artery

I63.011

Cerebral infarction due to thrombosis of right vertebral artery

I63.012

Cerebral infarction due to thrombosis of left vertebral artery

I63.019

Cerebral infarction due to thrombosis of unspecified vertebral artery

I63.02

Cerebral infarction due to thrombosis of basilar artery

I63.031

Cerebral infarction due to thrombosis of right carotid artery

I63.032

Cerebral infarction due to thrombosis of left carotid artery

I63.039

Cerebral infarction due to thrombosis of unspecified carotid artery

I63.09

Cerebral infarction due to thrombosis of other precerebral artery

I63.10

Cerebral infarction due to embolism of unspecified precerebral artery

I63.111

Cerebral infarction due to embolism of right vertebral artery

I63.112

Cerebral infarction due to embolism of left vertebral artery

I63.119

Cerebral infarction due to embolism of unspecified vertebral artery

Cognitive Rehabilitation Last review: March 11, 2016 Page 7 of 16

I63.12

Cerebral infarction due to embolism of basilar artery

I63.131

Cerebral infarction due to embolism of right carotid artery

I63.132

Cerebral infarction due to embolism of left carotid artery

I63.139

Cerebral infarction due to embolism of unspecified carotid artery

I63.19

Cerebral infarction due to embolism of other precerebral artery

I63.20

Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries

I63.211

Cerebral infarction due to unspecified occlusion or stenosis of right vertebral arteries

I63.212

Cerebral infarction due to unspecified occlusion or stenosis of left vertebral arteries

I63.219

Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral arteries

I63.22

Cerebral infarction due to unspecified occlusion or stenosis of basilar arteries

I63.231

Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries

I63.232

Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries

I63.239

Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid arteries

I63.29

Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries

I63.30

Cerebral infarction due to thrombosis of unspecified cerebral artery

I63.311

Cerebral infarction due to thrombosis of right middle cerebral artery

I63.312

Cerebral infarction due to thrombosis of left middle cerebral artery

I63.319

Cerebral infarction due to thrombosis of unspecified middle cerebral artery

I63.321

Cerebral infarction due to thrombosis of right anterior cerebral artery

I63.322

Cerebral infarction due to thrombosis of left anterior cerebral artery

I63.329

Cerebral infarction due to thrombosis of unspecified anterior cerebral artery

I63.331

Cerebral infarction due to thrombosis of right posterior cerebral artery

I63.332

Cerebral infarction due to thrombosis of left posterior cerebral artery

I63.339

Cerebral infarction due to thrombosis of unspecified posterior cerebral artery

I63.341

Cerebral infarction due to thrombosis of right cerebellar artery

I63.342

Cerebral infarction due to thrombosis of left cerebellar artery

I63.349

Cerebral infarction due to thrombosis of unspecified cerebellar artery

I63.39

Cerebral infarction due to thrombosis of other cerebral artery

I63.40

Cerebral infarction due to embolism of unspecified cerebral artery

I63.411

Cerebral infarction due to embolism of right middle cerebral artery

I63.412

Cerebral infarction due to embolism of left middle cerebral artery

I63.419

Cerebral infarction due to embolism of unspecified middle cerebral artery

I63.421

Cerebral infarction due to embolism of right anterior cerebral artery

I63.422

Cerebral infarction due to embolism of left anterior cerebral artery

I63.429

Cerebral infarction due to embolism of unspecified anterior cerebral artery

I63.431

Cerebral infarction due to embolism of right posterior cerebral artery

I63.432

Cerebral infarction due to embolism of left posterior cerebral artery

I63.439

Cerebral infarction due to embolism of unspecified posterior cerebral artery

I63.441

Cerebral infarction due to embolism of right cerebellar artery

I63.442

Cerebral infarction due to embolism of left cerebellar artery

I63.449

Cerebral infarction due to embolism of unspecified cerebellar artery

I63.49

Cerebral infarction due to embolism of other cerebral artery

I63.50

Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery

I63.511

Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery

Cognitive Rehabilitation Last review: March 11, 2016 Page 8 of 16

I63.512

Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery

I63.519

Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery

I63.521

Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery

I63.522

Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery

I63.529

Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery

I63.531

Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery

I63.532

Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery

I63.539

Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery

I63.541

Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery

I63.542

Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery

I63.549

Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery

I63.59

Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery

I63.6

Cerebral infarction due to cerebral venous thrombosis, nonpyogenic

I63.8

Other cerebral infarction

I63.9

Cerebral infarction, unspecified

I67.0

Dissection of cerebral arteries, nonruptured

I67.1

Cerebral aneurysm, nonruptured

I67.2

Cerebral atherosclerosis

I67.3

Progressive vascular leukoencephalopathy

I67.4

Hypertensive encephalopathy

I67.5

Moyamoya disease

I67.82

Cerebral ischemia

I67.83

Posterior reversible encephalopathy syndrome

I67.841

Reversible cerebrovascular vasoconstriction syndrome

I69.00

Unspecified sequelae of nontraumatic subarachnoid hemorrhage

I69.01

Cognitive deficits following nontraumatic subarachnoid hemorrhage

I69.020

Aphasia following nontraumatic subarachnoid hemorrhage

I69.021

Dysphasia following nontraumatic subarachnoid hemorrhage

I69.022

Dysarthria following nontraumatic subarachnoid hemorrhage

I69.023

Fluency disorder following nontraumatic subarachnoid hemorrhage

I69.028

Other speech and language deficits following nontraumatic subarachnoid hemorrhage

I69.098

Other sequelae following nontraumatic subarachnoid hemorrhage

I69.10

Unspecified sequelae of nontraumatic intracerebral hemorrhage

I69.11

Cognitive deficits following nontraumatic intracerebral hemorrhage

I69.120

Aphasia following nontraumatic intracerebral hemorrhage

I69.121

Dysphasia following nontraumatic intracerebral hemorrhage

I69.122

Dysarthria following nontraumatic intracerebral hemorrhage

I69.123

Fluency disorder following nontraumatic intracerebral hemorrhage

I69.128

Other speech and language deficits following nontraumatic intracerebral hemorrhage

I69.198

Other sequelae of nontraumatic intracerebral hemorrhage

I69.20

Unspecified sequelae of other nontraumatic intracranial hemorrhage

I69.21

Cognitive deficits following other nontraumatic intracranial hemorrhage

I69.220

Aphasia following other nontraumatic intracranial hemorrhage

I69.221

Dysphasia following other nontraumatic intracranial hemorrhage

Cognitive Rehabilitation Last review: March 11, 2016 Page 9 of 16

I69.222

Dysarthria following other nontraumatic intracranial hemorrhage

I69.223

Fluency disorder following other nontraumatic intracranial hemorrhage

I69.228

Other speech and language deficits following other nontraumatic intracranial hemorrhage

I69.298

Other sequelae of other nontraumatic intracranial hemorrhage

I69.30

Unspecified sequelae of cerebral infarction

I69.31

Cognitive deficits following cerebral infarction

I69.320

Aphasia following cerebral infarction

I69.321

Dysphasia following cerebral infarction

I69.322

Dysarthria following cerebral infarction

I69.323

Fluency disorder following cerebral infarction

I69.328

Other speech and language deficits following cerebral infarction

I69.398

Other sequelae of cerebral infarction

I69.80

Unspecified sequelae of other cerebrovascular disease

I69.81

Cognitive deficits following other cerebrovascular disease

I69.820

Aphasia following other cerebrovascular disease

I69.821

Dysphasia following other cerebrovascular disease

I69.822

Dysarthria following other cerebrovascular disease

I69.823

Fluency disorder following other cerebrovascular disease

I69.828

Other speech and language deficits following other cerebrovascular disease

I69.898

Other sequelae of other cerebrovascular disease

I69.90

Unspecified sequelae of unspecified cerebrovascular disease

I69.91

Cognitive deficits following unspecified cerebrovascular disease

I69.920

Aphasia following unspecified cerebrovascular disease

I69.921

Dysphasia following unspecified cerebrovascular disease

I69.922

Dysarthria following unspecified cerebrovascular disease

I69.923

Fluency disorder following unspecified cerebrovascular disease

I69.928

Other speech and language deficits following unspecified cerebrovascular disease

I69.998

Other sequelae following unspecified cerebrovascular disease

I97.810

Intraoperative cerebrovascular infarction during cardiac surgery

I97.811

Intraoperative cerebrovascular infarction during other surgery

I97.820

Postprocedural cerebrovascular infarction during cardiac surgery

I97.821

Postprocedural cerebrovascular infarction during other surgery

S02.0XXS

Fracture of vault of skull, sequela

S02.10XS

Unspecified fracture of base of skull, sequela

S02.110S

Type I occipital condyle fracture, sequela

S02.111S

Type II occipital condyle fracture, sequela

S02.112S

Type III occipital condyle fracture, sequela

S02.113S

Unspecified occipital condyle fracture, sequela

S02.118S

Other fracture of occiput, sequela

S02.119S

Unspecified fracture of occiput, sequela

S06.0X0S

Concussion without loss of consciousness, sequela

S06.0X1S

Concussion with loss of consciousness of 30 minutes or less, sequela

S06.0X2S

Concussion with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.0X3S

Concussion with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

Cognitive Rehabilitation Last review: March 11, 2016 Page 10 of 16

S06.0X4S

Concussion with loss of consciousness of 6 hours to 24 hours, sequela

S06.0X5S

S06.0X9S

Concussion with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Concussion with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Concussion with loss of consciousness of unspecified duration, sequela

S06.1X0S

Traumatic cerebral edema without loss of consciousness, sequela

S06.1X1S

Traumatic cerebral edema with loss of consciousness of 30 minutes or less, sequela

S06.1X2S

Traumatic cerebral edema with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.1X3S

Traumatic cerebral edema with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.1X4S

Traumatic cerebral edema with loss of consciousness of 6 hours to 24 hours, sequela

S06.1X5S

S06.1X9S

Traumatic cerebral edema with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Traumatic cerebral edema with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Traumatic cerebral edema with loss of consciousness of unspecified duration, sequela

S06.2X0S

Diffuse traumatic brain injury without loss of consciousness, sequela

S06.2X1S

Diffuse traumatic brain injury with loss of consciousness of 30 minutes or less, sequela

S06.2X2S

Diffuse traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.2X3S

Diffuse traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.2X4S

Diffuse traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.2X5S

S06.2X9S

Diffuse traumatic brain injury with loss of consciousness greater than 24 hours with return to pre-existing conscious levels, sequela Diffuse traumatic brain injury with loss of consciousness greater than 24 hours without return to preexisting conscious level with patient surviving, sequela Diffuse traumatic brain injury with loss of consciousness of unspecified duration, sequela

S06.300S

Unspecified focal traumatic brain injury without loss of consciousness, sequela

S06.301S

Unspecified focal traumatic brain injury with loss of consciousness of 30 minutes or less, sequela

S06.302S

Unspecified focal traumatic brain injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.303S

Unspecified focal traumatic brain injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.304S

Unspecified focal traumatic brain injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.305S

S06.309S

Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours with return to preexisting conscious level, sequela Unspecified focal traumatic brain injury with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Unspecified focal traumatic brain injury with loss of consciousness of unspecified duration, sequela

S06.310S

Contusion and laceration of right cerebrum without loss of consciousness, sequela

S06.311S

Contusion and laceration of right cerebrum with loss of consciousness of 30 minutes or less, sequela

S06.312S

Contusion and laceration of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.313S

Contusion and laceration of right cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Contusion and laceration of right cerebrum with loss of consciousness of 6 hours to 24 hours, sequela

S06.0X6S

S06.1X6S

S06.2X6S

S06.306S

S06.314S S06.315S

S06.319S

Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Contusion and laceration of right cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Contusion and laceration of right cerebrum with loss of consciousness of unspecified duration, sequela

S06.320S

Contusion and laceration of left cerebrum without loss of consciousness, sequela

S06.321S

Contusion and laceration of left cerebrum with loss of consciousness of 30 minutes or less, sequela

S06.316S

Cognitive Rehabilitation Last review: March 11, 2016 Page 11 of 16

S06.322S

Contusion and laceration of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.323S

Contusion and laceration of left cerebrum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Contusion and laceration of left cerebrum with loss of consciousness of 6 hours to 24 hours, sequela

S06.324S S06.325S

S06.329S

Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Contusion and laceration of left cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Contusion and laceration of left cerebrum with loss of consciousness of unspecified duration, sequela

S06.330S

Contusion and laceration of cerebrum, unspecified, without loss of consciousness, sequela

S06.331S

S06.340S

Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, sequela Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, sequela Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Contusion and laceration of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, sequela Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Contusion and laceration of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Contusion and laceration of cerebrum, unspecified, with loss of consciousness of unspecified duration, sequela Traumatic hemorrhage of right cerebrum without loss of consciousness, sequela

S06.341S

Traumatic hemorrhage of right cerebrum with loss of consciousness of 30 minutes or less, sequela

S06.342S

Traumatic hemorrhage of right cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.343S

Traumatic hemorrhage of right cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela Traumatic hemorrhage of right cerebrum with loss of consciousness of 6 hours to 24 hours, sequela

S06.326S

S06.332S S06.333S S06.334S S06.335S S06.336S S06.339S

S06.344S S06.345S

S06.349S

Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Traumatic hemorrhage of right cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Traumatic hemorrhage of right cerebrum with loss of consciousness of unspecified duration, sequela

S06.350S

Traumatic hemorrhage of left cerebrum without loss of consciousness, sequela

S06.351S

Traumatic hemorrhage of left cerebrum with loss of consciousness of 30 minutes or less, sequela

S06.352S

Traumatic hemorrhage of left cerebrum with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.353S

Traumatic hemorrhage of left cerebrum with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela Traumatic hemorrhage of left cerebrum with loss of consciousness of 6 hours to 24 hours, sequela

S06.346S

S06.354S S06.355S

S06.359S

Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Traumatic hemorrhage of left cerebrum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Traumatic hemorrhage of left cerebrum with loss of consciousness of unspecified duration, sequela

S06.360S

Traumatic hemorrhage of cerebrum, unspecified, without loss of consciousness, sequela

S06.361S

Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 30 minutes or less, sequela

S06.362S

Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 31 minutes to 59 minutes, sequela Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 1 hours to 5 hours 59 minutes, sequela

S06.356S

S06.363S

Cognitive Rehabilitation Last review: March 11, 2016 Page 12 of 16

S06.364S

Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of 6 hours to 24 hours, sequela

S06.365S

Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Traumatic hemorrhage of cerebrum, unspecified, with loss of consciousness of unspecified duration, sequela Contusion, laceration, and hemorrhage of cerebellum without loss of consciousness, sequela

S06.366S S06.369S S06.370S S06.371S S06.372S S06.373S S06.374S S06.375S S06.376S S06.379S S06.380S S06.381S

Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 30 minutes or less, sequela Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 31 minutes to 59 minutes, sequela Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of 6 hours to 24 hours, sequela Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Contusion, laceration, and hemorrhage of cerebellum with loss of consciousness of unspecified duration, sequela Contusion, laceration, and hemorrhage of brainstem without loss of consciousness, sequela

S06.4X0S

Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 30 minutes or less, sequela Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 31 minutes to 59 minutes, sequela Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of 6 hours to 24 hours, sequela Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Contusion, laceration, and hemorrhage of brainstem with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Contusion, laceration, and hemorrhage of brainstem with loss of consciousness of unspecified duration, sequela Epidural hemorrhage without loss of consciousness, sequela

S06.4X1S

Epidural hemorrhage with loss of consciousness of 30 minutes or less, sequela

S06.4X2S

Epidural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.4X3S

Epidural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.4X4S

Epidural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela

S06.4X5S

S06.4X9S

Epidural hemorrhage with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Epidural hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Epidural hemorrhage with loss of consciousness of unspecified duration, sequela

S06.5X0S

Traumatic subdural hemorrhage without loss of consciousness, sequela

S06.5X1S

Traumatic subdural hemorrhage with loss of consciousness of 30 minutes or less, sequela

S06.5X2S

Traumatic subdural hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.5X3S

Traumatic subdural hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.5X4S

Traumatic subdural hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela

S06.382S S06.383S S06.384S S06.385S S06.386S S06.389S

S06.4X6S

Cognitive Rehabilitation Last review: March 11, 2016 Page 13 of 16

S06.5X5S

S06.5X9S

Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours with return to preexisting conscious level, sequela Traumatic subdural hemorrhage with loss of consciousness greater than 24 hours without return to preexisting conscious level with patient surviving, sequela Traumatic subdural hemorrhage with loss of consciousness of unspecified duration, sequela

S06.6X0S

Traumatic subarachnoid hemorrhage without loss of consciousness, sequela

S06.6X1S

Traumatic subarachnoid hemorrhage with loss of consciousness of 30 minutes or less, sequela

S06.6X2S

Traumatic subarachnoid hemorrhage with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.6X3S

Traumatic subarachnoid hemorrhage with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.6X4S

Traumatic subarachnoid hemorrhage with loss of consciousness of 6 hours to 24 hours, sequela

S06.6X5S

Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours with return to preexisting conscious level, sequela Traumatic subarachnoid hemorrhage with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Traumatic subarachnoid hemorrhage with loss of consciousness of unspecified duration, sequela

S06.5X6S

S06.6X6S S06.6X9S S06.810S

S06.890S

Injury of right internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Injury of right internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified without loss of consciousness, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 30 minutes or less, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 31 minutes to 59 minutes, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of 6 hours to 24 hours, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness greater than 24 hours without return to pre-existing conscious level with patient surviving, sequela Injury of left internal carotid artery, intracranial portion, not elsewhere classified with loss of consciousness of unspecified duration, sequela Other specified intracranial injury without loss of consciousness, sequela

S06.891S

Other specified intracranial injury with loss of consciousness of 30 minutes or less, sequela

S06.892S

Other specified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.893S

Other specified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.894S

Other specified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.811S S06.812S S06.813S S06.814S S06.815S S06.816S

S06.819S S06.820S S06.821S S06.822S S06.823S S06.824S S06.825S S06.826S S06.829S

Cognitive Rehabilitation Last review: March 11, 2016 Page 14 of 16

S06.895S

S06.899S

Other specified intracranial injury with loss of consciousness greater than 24 hours with return to preexisting conscious level, sequela Other specified intracranial injury with loss of consciousness greater than 24 hours without return to preexisting conscious level with patient surviving, sequela Other specified intracranial injury with loss of consciousness of unspecified duration, sequela

S06.9X0S

Unspecified intracranial injury without loss of consciousness, sequela

S06.9X1S

Unspecified intracranial injury with loss of consciousness of 30 minutes or less, sequela

S06.9X2S

Unspecified intracranial injury with loss of consciousness of 31 minutes to 59 minutes, sequela

S06.9X3S

Unspecified intracranial injury with loss of consciousness of 1 hour to 5 hours 59 minutes, sequela

S06.9X4S

Unspecified intracranial injury with loss of consciousness of 6 hours to 24 hours, sequela

S06.9X5S

Unspecified intracranial injury with loss of consciousness greater than 24 hours with return to pre-existing conscious level, sequela Unspecified intracranial injury with loss of consciousness greater than 24 hours without return to preexisting conscious level with patient surviving, sequela Unspecified intracranial injury with loss of consciousness of unspecified duration, sequela

S06.896S

S06.9X6S S06.9X9S

References Abikoff H. Cognitive training in ADHD children: Less to it than meets the eye. J Learn Disabil. 1991;24:205-209. Agency for Healthcare Policy and Research (AHCPR). Rehabilitation for traumatic brain injury. AHCPR Evidence Report/Technology Assessment No.2. February 1999. http://www.ncbi.nlm.nih.gov/books/NBK11865/. Accessed January 28, 2016. Agency for Healthcare Research and Quality (AHRQ). Rehabilitation for traumatic brain injury in children and adolescents. Evidence Report/Technology Assessment No. 2. September 1999. http://www.ncbi.nlm.nih.gov/books/NBK11898/. Accessed January 28, 2016. Amato MP, Portaccio E, Zipoli V. Are there protective treatments for cognitive decline in MS? J Neurol Sci. 2006;245(12):183-186. American Academy of Neurology. Assessment: Neuropsychological testing of adults. Considerations for neurologists. Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 1996;47(2):592-599. American Academy of Neurology. Practice Parameters: Assessment and management of patients in the persistent vegetative state (Summary Statement). Report of the quality Standards Subcommittee of the American Academy of Neurology. 1995. Reaffirmed Jul 2006. https://www.aan.com/guidelines/home/getguidelinecontent/83. Accessed January 28, 2016. Bahar-Fuchs A, Clare L, Woods B. Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer's or vascular type: A review. Alzheimers Res Ther. 2013;5(4):35. BlueCross BlueShield Association (BCBSA), Technology Evaluation Center (TEC). Cognitive rehabilitation for traumatic brain injury in adults. TEC Assessment Program. Chicago IL: BCBSA; 2002;17(20). BlueCross BlueShield Association (BCBSA), Technology Evaluation Center (TEC). Cognitive rehabilitation for traumatic brain injury in adults. TEC Assessment Program. Chicago, IL: BCBSA; May 2008; 23(3). Boccellari A, Zeifert P. Management of neurobehavioral impairment in HIV-1 infection. Psychiatry Clin North Am. 1994;17:183-203. Bourgeois MS. Effects of memory aids on the dyadic conversations of individuals with dementia. J Appl Behav Anal. 1993;26:77-87. Bowen A, Hazelton C, Pollock A, Lincoln NB. Cognitive rehabilitation for spatial neglect following stroke. Cochrane Database Syst Rev. 2013;7:CD003586. Bowen A, Lincoln NB, Dewey M. Cognitive rehabilitation for spatial neglect following stroke. Cochrane Database Syst Rev. 2007;(2):CD003586. Brissart H, Daniel F, Morele E, et al. Cognitive rehabilitation in multiple sclerosis: A review of the literature. Rev Neurol (Paris). 2011;167(4):280-290.

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Carney N, Chestnut RM, Maynard H, et al. Effect of cognitive rehabilitation on outcomes for persons with traumatic brain injury: A systematic review. J Head Trauma Rehabil. 1999;14(3):277-307. Centers for Disease Control and Prevention (CDC). Injury Prevention & Control: Traumatic Brain Injury. Updated March 2015. http://www.cdc.gov/traumaticbraininjury/. Accessed January 29, 2016. Chung CS, Pollock A, Campbell T, et al. Cognitive rehabilitation for executive dysfunction in adults with stroke or other adult non-progressive acquired brain damage. Cochrane Database Syst Rev. 2013;4:CD008391. Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: Recommendations for clinical practice. Arch Phys Med Rehabil. 2000;81(12):1596-1615. Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: Updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil. 2005;86(8):1681-1692. Cicerone KD, Langenbahn DM, et al. Evidence-based cognitive rehabilitation: Updated review of the literature from 2003 through 2008. Arch Phys Med Rehabil. 2011;92(4):519-530. Clare L, Woods RT, Moniz Cook ED, et al. Cognitive rehabilitation and cognitive training for early-stage Alzheimer's disease and vascular dementia. Cochrane Database Syst Rev. 2003;(4):CD003260. Eack S, HogartyG, ChoR, et al. Cognitive enhancement therapy protects against gray matter loss in early schizophrenia: Results from a two-year randomized controlled trial. Arch Gen Psychiatry. 2010;67(7):674-682. Farina E, Raglio A, Giovagnoli AR. Cognitive rehabilitation in epilepsy: An evidence-based review. Epilepsy Res. 2015;109C:210-218. Gard DE, Fisher M, Garrett C, et al. Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Schizophr Res. 2009;115(1):74-81. Georgiopoulos M, Katsakiori P, Kefalopoulou Z, et al. Vegetative state and minimally conscious state: A review of the therapeutic interventions. Stereotact Funct Neurosurg. 2010;88(4):199-207. Golisz K. Occupational therapy practice guidelines for adults with traumatic brain injury. Bethesda, MD: American Occupational Therapy Association (AOTA); 2009. Granholm E, McQuaid JR, McClure FS, et al. A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. Am J Psychiatry. 2005;162(3):520-529. Guina FD, Cosic T, Kracon L, et al. Sensorimotor stimulation of comatose patients. Acta Med Croatica. 1997;51(2):101103. Hayes Medical Technology Directory. Cognitive Rehabilitation for Traumatic Brain Injury. Apr 2, 2008. Updated June 17, 2014. Hayes RL, McGrath JJ. Cognitive rehabilitation for people with schizophrenia and related conditions. Cochrane Database Syst Rev. 2000;(3):CD000968. Hosobuchi Y, Yingling C. The treatment of prolonged coma with neurostimulation. Adv Neurol. 1993;63:247-251. Incalzi RA, Corsonello A, Trojano L, et al. Cognitive training is ineffective in hypoxemic COPD: A six-month randomized controlled trial. Rejuvenation Res. 2008;11(1):239-250. Jak AJ, Seelye AM, Jurick SM. Crosswords to computers: A critical review of popular approaches to cognitive enhancement. Neuropsychol Rev. 2013;23(1):13-26. Johnson DA, Roethig-Johnston K, Richards D. Biochemical and physiological parameters of recovery in acute severe head injury: Responses to multisensory stimulation. Brain Inj. 1993;7(6):491-499. Lainhart JE, Piven J. Diagnosis, treatment, and neurobiology of autism in children. Curr Opin Ped. 1995;7:392-400. Lee SS, Powell NJ, Esdaile S. A functional model of cognitive rehabilitation in occupational therapy. Can J Occup Ther. 2001;68(1):41-50. Levin HS. Cognitive function outcomes after traumatic brain injury. Curr Opin Neurol. 1998;11(6):643-646. Lincoln NB, Gladman JR, Berman P, et al. Functional recovery of community stroke patients. Disabil Rehabil. 2000;22(3):135-139. Lincoln NB, Majid MJ, Weyman N. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database Syst Rev. 2000;(4):CD002842. Loetscher T, Lincoln NB. Cognitive rehabilitation for attention deficits following stroke. Cochrane Database Syst Rev. 2013;5:CD002842.

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Lombardi F, Taricco M, De Tanti A, et al. Sensory stimulation for brain injured individuals in coma or vegetative state. Cochrane Database Syst Rev. 2002;(2):CD001427. Mazaux JM, Richer E. Rehabilitation after traumatic brain injury in adults. Disabil Rehabil. 1998;20(12):435-447. McDonald BC, Flashman LA, Saykin AJ. Executive dysfunction following traumatic brain injury: Neural substrates and treatment strategies. NeuroRehabilitation. 2002;17(4):333-344. Mehlhorn J, Freytag A, Schmidt K, et al. Rehabilitation interventions for postintensive care syndrome: a systematic review. Crit Care Med 2014; 42:1263. Mikkelsen ME, Netzer G, Iwashyna T. Post-intensive care syndrome (PICS). UpToDate. December 17, 2014. Nair RD, Lincoln NB. Cognitive rehabilitation for memory deficits following stroke. Cochrane Database Syst Rev. 2007;(3):CD002293. Namerow, NS. Cognitive and behavioral aspects of brain-injury rehabilitation. Neurol Clin. 1987;5(4):569-583. National Academy of Neuropsychology (NAN). Cognitive rehabilitation. Official Statement of the National Academy of Neuropsychology. NAN Position Papers. Denver, CO: NAN; May 2002. https://www.nanonline.org/docs/PAIC/PDFs/NANPositionCogRehab.pdf. Accessed January 28, 2016. National Government Services. Local Coverage Determination (LCD): Outpatient Physical and Occupational Therapy Services (L33631). October 2015. https://www.cms.gov/medicare-coverage-database/details/lcddetails.aspx?LCDId=33631&ContrId=300&ver=9&ContrVer=1&CntrctrSelected=300*1&Cntrctr=300&name=National+Go vernment+Services%2c+Inc.+%28National+Government+Services%2c+Inc.+%2813202%2c+A+and+B+and+HHH+MAC%2c +J+-+K%29%29&LCntrctr=300*1&DocType=Active&bc=AgACAAIAAAAAAA%3d%3d&. Accessed January 28, 2016. National Institute of Neurological Disorders and Stroke (NINDS). Disorders. Coma and persistent vegetative state. Bethesda, MD: National Institutes of Health (NIH); updated September 18, 2012. http://www.ninds.nih.gov/disorders/coma/coma.htm. Accessed January 28, 2016. National Institutes of Health (NIH). Rehabilitation of persons with traumatic brain injury. NIH Consens Statement 1998 https://consensus.nih.gov/1998/1998traumaticbraininjury109html.htm. Accessed January 26, 2016. O'Brien AR, Chiaravalloti N, Goverover Y, Deluca J. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: A review of the literature. Arch Phys Med Rehabil. 2008;89(4):761-769. Pennington L, Goldbart J, Marshall J. Speech and language therapy to improve the communication skills of children with cerebral palsy. Cochrane Database Syst Rev. 2003;(3):CD003466. Prigatano GP, Wong JL. Cognitive and affective improvement in brain dysfunctional patients who achieve inpatient rehabilitation goals. Arch Phys Med Rehabil. 1999;80(1):77-84. Specialty matched clinical peer review. Suslow T, Schonauer K, Arolt V. Attention training in the cognitive rehabilitation of schizophrenic patients: A review of efficacies studies. Acta Psychiatr Scand. 2001;103(1):15-23. Suslow T, Schonauer K, Arolt V. Attention training in the cognitive rehabilitation of schizophrenic patients: A review of efficacy studies. Acta Psychiatr Scand. 2001;103(1):15-23. Thomas PW, Thomas S, Hillier C, et al. Psychological interventions for multiple sclerosis. Cochrane Database Syst Rev. 2006;(1):CD004431. Thompson AJ. Neurorehabilitation in multiple sclerosis: Foundations, facts and fiction. Curr Opin Neurol. 2005;18(3):267271. Titov N, Andrews G, Schwencke G, et al. Randomized controlled trial of Internet cognitive behavioural treatment for social phobia with and without motivational enhancement strategies. Aust N Z J Psychiatry. 2010;44(10):938-945. Zorowitz RD, Gross E, Polinski DM. The stroke survivor. Disabil Rehabil. 2002;24(13):666-679.

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