FY 2018 WISEWOMAN / Wise Choices Procedure Code Reference Chart

Transcription

1 99203 Office or other outpatient visit for the evaluation and management of a new patient, a detailed history; a detailed examination; and medical decision making of low complexity. Usually the presenting problem(s) are of moderate. Physicians typically spend Office or other outpatient visit for the evaluation and management of a new patient, a comprehensive history; a comprehensive examination; and medical decision making of moderate complexity. Usually the presenting problem(s) are of moderate to high. Physicians typically spend Initial comprehensive preventive medicine evaluation and management of an individual /risk factor reduction interventions, and the ordering of appropriate immunizations(s), laboratory/diagnostic procedures, new patient; years Initial comprehensive preventive medicine evaluation and management of an individual /risk factor reduction interventions, and the ordering of appropriate immunizations(s), laboratory/diagnostic procedures, new patient; years Initial comprehensive preventive medicine evaluation and management of an individual /risk factor reduction interventions, and the ordering of appropriate immunizations(s), laboratory/diagnostic procedures, new patient; 65 years and over Straightforward problem of moderate Detailed history and P/E needed high glucose, or high blood pressure ( Alert or Emergency values) Complex problem of moderate to high Comprehensive history and P/E needed high glucose, and high blood pressure New patient between the ages of 18 and 39 New patient between the ages of 40 and 64 New patient age 65 and older FY18 1

2 99201 Office or other outpatient visit for the evaluation and management of a new patient, a problem focused history; a problem focused examination; and Usually, the presenting problems are self limited or minor. Physicians typically spend Office or other outpatient visit for the evaluation and management of a new patient, an expanded problem focused history; an expanded problem focused examination; and Usually, the presenting problem(s) are of low to moderate. Physicians typically spend Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: an expanded problem focused history; an expanded problem focused examination; medical decision making of low complexity. Counseling and coordination of care with other providers or agencies are provided Usually, the presenting problem(s) are of low to moderate. Physicians typically spend Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: Minor problem Problem focused history and P/E needed and treatment of borderline cholesterol. Straightforward problem of low/moderate Problem focused history and P/E needed high glucose, or high blood pressure (not Alert values) Straightforward problem of low/moderate Problem focused history and P/E needed high glucose, or high blood pressure Complex problem of moderate to high FY18 2

3 a detailed history; a detailed examination; medical decision making of moderate complexity. Usually the presenting problem(s) are of moderate to high. Physicians typically spend Periodic comprehensive preventive medicine reevaluation and management of an counseling/anticipatory /risk factor reduction interventions, and the ordering of appropriate immunization(s), laboratory/diagnostic procedures, established patient; years Periodic comprehensive preventive medicine reevaluation and management of an counseling/anticipatory /risk factor reduction interventions, and the ordering of appropriate immunization(s), laboratory/diagnostic procedures, established patient; years Periodic comprehensive preventive medicine reevaluation and management of an counseling/anticipatory /risk factor reduction interventions, and the ordering of appropriate immunization(s), laboratory/diagnostic procedures, established patient; 65 years and over Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services Office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three components: a problem focused history; Comprehensive history and P/E needed high glucose, and high blood pressure Established patient between the ages of Established patient between the ages of Established patient age 65 and older and treatment of borderline cholesterol. Minor problem FY18 3

4 FY 2018 a problem focused examination; Usually, the presenting problem(s) are self limited or minor. Physicians typically spend Lipid panel. This panel must include the following: Cholesterol, serum, total Lipoprotein, direct measurement, high density cholesterol (HDL Cholesterol) Triglycerides QW Lipid panel. This panel must include the following: Cholesterol, serum, total Lipoprotein, direct measurement, high density cholesterol (HDL Cholesterol) Triglycerides (CLIA waived) high glucose, or high blood pressure (not Alert values) Lipid panel (TC, HDL, triglycerides) Lipid panel (TC, HDL, triglycerides) Test performed with Cholestech Collection of venous blood by venipuncture Venipuncture Glucose; quantitative, blood (except reagent strip) Plasma Glucose QW Glucose; quantitative, blood (except reagent strip) (CLIA waived) Plasma Glucose Test performed with Cholestech Hemoglobin; glycosylated (A1C) Hemoglobin A1C QW Hemoglobin; glycosylated (A1C) (CLIA waived) Hemoglobin A1C Performed with DCA or Cholestech GDX Unlisted preventive and medicine service Alert value case management Unlisted cardiovascular service or procedure Hypertension case management T1023 Screening to determine the appropriateness of an individual for participation in a New WISEWOMAN recruited specified program FY18 4

5 S5190 Wellness assessment, performed by a non physician Client is not ready to change: Make f/u call in 1 2 months S0315 Disease management program, initial assessment and initiation Client initiates medication adherence S0340 Lifestyle modification program for management of CVD 1st stage Client participated in 1 st health coaching session or Lifestyle Program encounter S0341 Lifestyle modification program for management of CVD 2 nd or 3 rd stage Client participates in two health coaching sessions after health coaching or LSP is complete S0342 Lifestyle modification program for management of CVD final stage Client completes health coaching or Lifestyle Program S0316 Disease management program, follow up/reassessment Outcome evaluation contact completed S T Patient education not otherwise listed non physician provider Preventive behavior change, intensive program of prevention of diabetes using a standardized diabetes prevention program curriculum, provided to individuals in a group setting, minimum 60 minutes, per day Client exhibits positive changes on outcome evaluation contact Client attends a Diabetes Prevention Program session FY18 5