Unconsciousness distinguishes the first day from later missed days; recovery from insanity during Ramadan carries a different make-up rule; menstruation and nifās prevent a valid fast and require later make-up; and relevant mid-day recovery or arrival brings abstention for the remaining hours.
A reliable method is to identify the cause, timing, and validity of the fasting intention, then determine qaḍāʾ and imsāk separately.