InterQual is described as?

• A. A billing code set for Medicare Part B
• B. A pharmacy management system
• C. A clinical decision support tool that determines when and how a patient progresses through the continuum, organizes resources, and uses objective evidence-based criteria
• D. A patient satisfaction survey

Answer: (C)

InterQual is a clinical decision support tool that uses objective, evidence-based criteria to guide care decisions. It helps determine when a patient should be admitted or moved through the care continuum, how resources are allocated, and what level of care is appropriate. By standardizing utilization decisions across settings, it supports clinicians and payers in justifying care decisions with documented, evidence-based standards. It is not a billing code set, a pharmacy management system, or a patient satisfaction survey.