Workload Capture and Coding Keeping it Simple! National Education Blitz March 2011 Sharon Castle, Pharm.D., BCPS Chief, Pharmacy Service Ralph H. Johnson.

Workload Capture and Coding

Keeping it Simple! National Education Blitz

March 2011

Sharon Castle, Pharm.D., BCPSChief, Pharmacy Service

Ralph H. Johnson VA Medical CenterCharleston, South Carolina

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History

Workload/Billing Workgroup formed in 2007 to improve documentation of pharmacist encounters Lori Golterman, Jan Carmichael, Sharon Castle

Milestones Decision to use Patient Care Encounter system to

document outpatient and inpatient workload (PCE, not event capture)

160 (clinical pharmacy stop code) approved for use as a primary stop code

Expanded the definition of encounter to include items such as NF reviews, non face to face workload

Major improvements Nationally with pharmacist documentation

Future

National group expanded to gain further expertise

3 Categories Workload capture documentation

Continue national education Alpha codes specific to pharmacy

Reports Corporate Data Warehouse reports

National Directive Draft in review by group

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Progress ReportsFacility Specific

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Progress Reports 160 Primary or Secondary/Pharmacy Unique5

VISN Station Station NameClinic Encounters -

160 Primary or Secondary

Clinic Encounters - 160 Primary or

Secondary / Pharmacy Unique

Pharmacy Uniques

Complexity

8 516 Bay Pines, FL 201,735 2.4699 81,678 1a18 678 Tucson, AZ 75,024 1.8685 40,152 1a18 504 Amarillo, TX 34,555 1.6186 21,349 221 654 Reno, NV 34,959 1.4305 24,439 223 636A6 Central Iowa HCS 30,368 1.1777 25,785 27 534 Charleston, SC 36,818 0.9170 40,152 1c7 679 Tuscaloosa, AL 11,460 0.9076 12,627 323 568 VA Black Hills HCS, SD 15,487 0.9055 17,103 320 692 White City, OR 11,571 0.8798 13,152 39 581 Huntington, WV 22,405 0.8658 25,877 219 575 Grand Junction, CO 8,626 0.8622 10,005 216 586 Jackson, MS 32,219 0.8237 39,115 1b4 540 Clarksburg, WV 14,928 0.8072 18,493 210 539 Cincinnati, OH 22,723 0.7652 29,696 1b20 668 Spokane, WA 15,492 0.7323 21,154 310 538 Chillicothe, OH 12,797 0.7222 17,720 33 632 Northport, NY 19,394 0.7077 27,406 210 541 Cleveland, OH 54,399 0.6672 81,536 1a11 655 Saginaw, MI 15,975 0.6520 24,501 3

Don’t Miss the BoatWhat do you need to know to succeed?6

Pharmacy Workload Capture Key Elements7

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Key References

Patient Care Data Capture VHA Directive 2009-002, January 23, 2009

Copayment for Outpatient Care VHA Directive 2009-012, March 5, 2009

DSS Outpatient Identifiers VHA Directive 2008-069, October 27, 2008 All DSS Identifier references are located on the DSS

Identifiers web page http://vaww.dss.med.va.gov/programdocs/pd_oident.asp Website updated annually: 2011 References – Reference B

(October 1, 2010) DSS Pharmacy Workload Collection Document

http://vaww.dss.med.va.gov/programdocs/pd_clinictop.asp 2008 Telephone Encounter Definitions

Document available on SharePoint Home Based Primary Care Program

VHA Handbook 1141.01, January 31, 2007

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Patient Encounters

Patient Care Data Capture, VHA Directive 2009-002 An encounter is a professional contact between a

patient and a practitioner vested with responsibility for diagnosing, evaluating, and treating the patient’s condition

Encounters occur in both the outpatient and inpatient setting

Why document workload? Legal and professional obligations Encourage consistency throughout VA Clinical

Pharmacy Services to ensure count credit for clinical pharmacist services

Advance profession

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Count versus Non Count

Count refers to activity that meets the definition of an encounter (PCDC VHA Directive 2009-002)

Count activity requires (3 ’s): A corresponding progress note in CPRS Documentation must include medical history Documentation must include clinical decision making

VA PBM goal to increase count workload A face to face visit is NOT required for count

Non-Count activity can be tracked for DSS workload purposes; however, is not transmitted to NPCD in Austin

Will only transmit to DSS for workload if done through a noncount clinic/will not transmit if “historical” checked.

This presentation will not review noncount workload capture for DSS Please review the 2009 presentations on the PBM website under workload

and billing process for more information on documenting noncount workload.

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Count versus NonCount Examples*Facility specific based on intervention and documentation!

Pharmacy Intervention Count* NonCount

Pharmacist Outpatient Clinics X

Telephone Clinic (med management) X

Nonformulary Consult X (Formal consult or business rule required + progress note by pharmacist with documenting count activity)

Telephone calls from patients asking questions (medication been mailed, prescription refills, etc)

X

Inpatient consults (pharmacokinetics, anticoagulation, etc)

X (Formal consult or business rule/policy for pharmacy to follow + progress note by pharmacist documenting count activity)

Pharmacy Interventions (CrCl adjustments, drug-drug interactions)

X

Drug Information Question X

Education Classes X (despite not always meeting 3 below)

*Count = 1. Medical history taken 2. Clinical decision making 3. Documentation in medical record

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Stop Codes (DSS Identifiers)

Primary Stop Codes (DSS Identifiers) 160 – Clinical Pharmacy

Use for all clinics except telephone and HBPC 147 – Telephone clinics (Required to use as primary) 324 – PACT telephone clinics (Required to use for PACT)

Must use 324/323 in FY11 (New PACT codes in FY12) 176 – HBPC Clinical Pharmacist (Required to use as

primary) 178 – HBPC telephone (Required to use as primary)

Not pharmacy specific Secondary Stop Codes (DSS Identifiers)

Further defines where pharmacy services takes place Provides standard reference workload accounting Discretion left to local Medical Center; however,

specificity allows national tracking of pharmacist services Certain areas may require deviation from this

guidance for special funding or performance measure tracking

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Stop Codes (DSS Identifiers)

Selection of Stop Codes/DSS Identifiers http://vaww.dss.med.va.gov/programdocs/pd_oident.asp FY11 Summary of Active DSS Identifiers (Reference B on

website) Midyear changes/updates (For example, 348, PC Shared Medical

Appointment) Provides detail on each stop code/identifier

Use of stop code in the primary, secondary or both Definition provided for each stop code

Mental Health Example - Definitions provide clarity 502 – Mental Health Clinic Individual

Definition: Individual evaluation, consultation and/or treatment by clinical staff trained in mental health diseases

Pharmacist can use as a secondary stop 509 – Psychiatry – Individual

Definition: Use by psychiatrist only when care is not delivered in an interdisciplinary setting

Pharmacist cannot use as a secondary stop (psychiatrist only)

DSS Active IdentifiersReference B

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Common Secondary Stop Codes

323 – Primary care 317 – Anticoagulation 160 – Clinical Pharmacy

Will be used in secondary position when a primary stop other than 160 is required Telephone, HBPC (see previous slides)

306 – Diabetes 309 – Hypertension 318 – Geriatric Clinic 130 – Emergency Department 697 – Chart consult

Allows intervention to be count but not charge a copay Must have a formal consult

Chart ConsultNon-Face to Face Visits

Use for all non-face to face visits that meet the definition of count

Requires a formal consult from the provider/team or a policy/business rule at the Medical Center that automatically consults pharmacy for that particular situation

Use 697 stop code in the secondary position 697 – “Chart Consult” (160/697) Avoids copay (did not see patient face to face)

Examples: Pharmacist completing nonformulary requests Pharmacist automatically manages all

aminoglycoside dosing

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Stop Codes

Clinic Stop Code Credit Stop Code

Warfarin Clinic (Face to Face) 160 317 (Anticoag)

Warfarin Clinic (Telephone) 147 160

Hypertension Clinic 160 309 (Hypertension)

Diabetes Clinic 160 306 (Diabetes)

Epogen (Anemia) Clinic 160 308 (Hematology)

HBPC Warfarin Clinic 176 317

HBPC Warfarin Telephone 178 160

Infectious Disease Clinic 160 310

Geriatric Clinic 160 318

Geriatric Evaluation and Management

160 319 (Geriatric Specialist)

Alpha Codes

4 letter alpha code Provides further granularity by clinic Limited pharmacy specific codes available Most major areas will be covered in FY12 DSS must enter alpha codes in the DSS side of

VISTA The fileman field is called Clinic and Stop Codes Field is not visible to us as part of the clinic profile Please work with your local DSS staff for addition

of alpha codes Example: Inpatient Pharmacokinetics Clinic 160/697,

PKPH

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Alpha Codes AvailableFull List Available On DSS Website

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CDPHCardiac Disease Pharmacist PDCC Pulmonary Disease CC Team

CGPHCoag Management Pharmacist PDPH

Pulmonary Disease Pharmacist

DEPH Dementia Pharmacist PHRM Clinical PharmacyDIAB Diabetes Education PLPH Palliative PharmacistDMCC Diabetes Mellitus CC Team PNPH Pain Management Pharmacist

DMPHDiabetes Mellitus Pharmacist RHPH Rehabilitation Pharmacist

HTCC Hypertension CC Team SCPH SCI Pharmacist

HTPH Hypertension Pharmacist SSFUStop Smoke Follow-up – Individual Patient

IDCCInfectious Disease CC Team WCPH Wound Care Pharmacist

IDPHInfectious Disease Pharmacist SSGD

Stop Smoking Group Double Provider

MHCC Mental Health CC Team SPGPSingle Provider – Group of Patients

MHPH Mental Health Pharmacist SATPSubstance Abuse Treatment Program

MMPHMultiple Co-Morbidities Pharmacist CHOL

Cholesterol Education - Double Provider

Alpha CodesAdditions as of DSS Patch ECX*3*133 (6/30/2011)20

CDED Cardiac Disease Education (CHF, etc) NSPH Nutritional Support Pharmacist

CRRC Cardiovascular Risk Reduction Pharmacist NUCL Nuclear Medicine Pharmacist

CCPH Critical Care Pharmacist ONCO Oncology Pharmacist

DRPH Dermatology Pharmacist OPTH Ophthalmology Pharmacist

EDPH Emergency Department Pharmacist SPCH Specialty Care Pharmacist

ESPH ESA Pharmacist SUPH Surgery/Anesthesia/OR Pharmacist

HEPC Hepatitis C Pharmacist PACP Patient Aligned Care Team Pharmacist

HIVD HIV Pharmacist PACT Patient Aligned Care Team

IMPH Internal Medicine Pharmacist PGEN Pharmacogenomics Pharmacist

MTMP Medication Therapy Management Pharmacist PKPH Pharmacokinetics Pharmacist

MREC Medication Reconciliation Pharmacist PTPH Polytrauma Pharmacist

NEUR Neurology Pharmacist RHUM Rheumatology Pharmacist

NFPA Non-Formulary/Prior Approval Pharmacist WMPH Women's Health Pharmacist

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Copay

Copay For Outpatient Medical Care Directive 2009-012

Attachment B – Defines copay tiers for stop code 160 stop code – Basic copay = $15 147 stop code – No copay (telephone clinics)

Why is this important? Efforts to increase count credit for clinical

pharmacy services may result in copay 160 Stop Code generates a $15 copay If they have another visit that day, only 1 copay is

charged It is inappropriate to choose stop codes based

on your desire to charge or not charge a copay

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The Big PictureIs the intervention count?

Option 1: Set-up clinic as non-countOption 2: Link to count clinic (if one exists) but check historical box on encounter *Example of #2: To document “noncount” interventions in a warfarin clinic set up with a 160/317 stop code Will not require a second noncount clinic but not DSS workload credit.

No

Yes

Seen in clinic?

Yes

Clinic is set-up with appropriate stop codes. 160 stop code will generate $15.00 copay when encounter completed

If formal consult or business rule/policy: Option 1: To gain count credit, a separate clinic will need to be created with a secondary stop of 697 to avoid a copay

Option 2: Can be seen in clinic without 697 as secondary stop but must be marked historical to avoid a copay, results in no count credit

Count? (3 ’s required)Medical history taken? Clinical decision making? Documented?

No Copay

*Ideal to allow capture as count*Should be used if a high volume of interventions fall into this category*Maximize count/no copay!

*Lost count workload*Less desirable*Should only be used in low volume scenarios where you do not mind losing count credit

No

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Copay ScenarioCount with copay

Pharmacist sees patient in hypertension clinic Clinic set-up: 160 primary/309

secondary Progress note entered History and clinical decision making

documented Count (3 ’s) Basic copay charged for 160 stop code

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Copay ScenarioCount without copay based on clinic set-up

Pharmacist reviews patient history and documentation to ensure appropriate lab work is completed, correct dosing, and provides recommendations to the provider or fulfills the recommendations themselves Clinic set-up: 160 primary/697 secondary Progress note entered History and clinical decision making documented

Count (3 ’s) Basic copay not charged (697 secondary stop)

Requires consult or business rule/policy to use 697 May need two clinics, one count and one count with 697

secondary Anemia (EPO) clinic with pharmacist seeing patient in clinic (160/308) Anemia (EPO) clinic with pharmacist completing review as above

(160/697) Allows you to obtain count workload without charging a copay

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Medication Therapy Management

Use New MTM Codes for all face- to-face pharmacist visits 99605—MTM service(s) provided by a pharmacist to an

individual patient during a face-to-face encounter that involve an assessment and intervention if provided; used to code the initial 15 minutes of an initial encounter with a new MTM patient

99606—Initial 15 minutes with an established patient 99607—Each additional 15 minutes of an initial or subsequent

MTM encounter; list separately in addition to code for primary service and in conjunction with 99605 or 99606

RVUs established by some insurances but not consistent

Currently billing institutional/facility fee $141 (if multiple visits that day, only 1 fee billed) Future goal: Establish payment structures for MTM within

contracts Nationally (CBO responsibility)

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MTM Codes Inpatient/Chart Consults Inpatient

Q: Can we use these new MTM CPT codes for inpatient services? A: The new CPT codes were designed to be applicable for all

pharmacy practice environments and circumstances. The answer depends on whether payers include inpatient pharmacist services in their spectrum of covered benefits and whether the pharmacist is an employee of the institution or a private practitioner. If a payer recognizes inpatient pharmacist services as a separate billable service, the pharmacist should be able to use these codes and get reimbursed as per the agreement with the payer.

VA bills one fee for inpatient services, rolling ancillary services into one DRG; billing of the MTM codes for inpatient is therefore, irrelevant. However, it is very important to set up clinics to capture workload.

Chart Consults (Pharmacist Encounter – Not Face to Face) Stop code 697 in the secondary position Use MTM CPT codes Mark clinic nonbillable in MCCR package to avoid coding/billing staff

seeing this as a face to face, billable clinic (see slide 30) It is no longer recommended to use 99090/99091.

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Clinic-Based Telephone Care

VHA Directive 2009-002 Patient Care Encounters defines telephone encounter: A telephone contact between a practitioner and a patient is

only considered an encounter (count) if the telephone contact is documented and that documentation includes the appropriate elements of a face-to-face encounter, namely history and medical decision-making.

Telephone encounters must be associated with a telephone clinic that is assigned one of the DSS telephone three-digit identifiers. Telephone encounters are to be designated as non-billable and are count clinics.

Most clinic-based pharmacist telephone care are encounters and therefore should be “count” clinics with documentation in the chart and workload sent to Austin Encounter is a professional contact between a patient and a

practitioner vested with responsibility for diagnosing, evaluating, and treating the patient’s condition.

As always, certain type of telephone ‘visits’ do not count and will be documented as either a historical visit or as a note addendum. Examples: Appointment reminder, Follow-up after visit, Lab

test results received day after the visit

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CPT CodesNon Physician Services - Telephone 98966 Telephone assessment and management

service provided by a qualified non-physician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous seven days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion

98967 11-20 minutes of medical discussion 98968 21-30 minutes of medical discussion

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CPT CodesChart Consult

Interpretation of Data Stored in a Computer Encounter that collects and reviews data

with documentation 99090 0-29 minutes 99091 30 or more minutes

Use for encounters (count workload) that you have a secondary stop of 697. Example: Non-formulary reviews

Consult with facility compliance staff on utilization

Secure Messaging Primary stop code: 160 / Secondary stop code: 719 CPT Code: 98969 (online assessment and management)

The service being reported with this code cannot be a continuation of a service that was provided within the previous seven days.

There is ONE option for directly saving secure messages from the SM application as TIU notes. A single location of “Other” is the default location and this location creates a “historical” note. Workload cannot be captured utilizing a “historical” note. All notes saved directly from the secure messaging system to CPRS are saved as a historical note.

Workload Credit: For the limited number of messages that meet the criteria for an online evaluation, the author may utilize the copy and paste functionality to copy a secure message, in its entirety, from the SM application to create a note that is associated with a count, non-billable clinic specifically set up to capture secure messages. The clinic must utilize the secondary stop code 719 to ensure all first and third party billing is suppressed and to allow for accurate capture of information. All notes that are copied and pasted from the SM application are mapped to the standard note title “My HealtheVet (MHV) Dialog Note.”

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Billable/Nonbillable Option

Option available in MCCR package Work closely with billing staff to ensure

billable clinics are marked billable Not all facilities are aware that institutional

fees can be billed for pharmacy clinics Generic recommendations

Face to face – mark billable Non Face to Face – mark nonbillable

Mark clinic nonbillable to avoid coding staff misinterpreting a note and thinking it is a face to face, billable clinic

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Clinic Nonbillable - VISTA

Select MCCR System Definition Menu Option: FLTP   Flag Stop Codes/Clinics for Third Party

          Flag Stop Codes and Clinics for Third Party Billing===============================================================================

FOR THIRD PARTY BILLING, THIS OPTION IS USED TO SET UP:

1. INDIVIDUAL OR A GROUP OF STOP CODES OR CLINICS AS:

   a. NON-BILLABLE OR BILLABLE.

      A Stop/Clinic is assumed billable until it is flagged as non-billable.

   b. IGNORED BY THE AUTO BILLER.  Stops the auto biller from creating

      bills for specified billable Stops/Clinics.

2. ALL CLINICS TO BE:

   a. IGNORED BY THE AUTO BILLER.  Stops the auto biller from creating bills

      for ALL clinics.  Should only be used if the outpatient auto biller

      is on but only a small number of Clinics should be auto billed.

   b. BILLED BY THE AUTO BILLER.  Resets all Clinics to be auto billed.

Use of this option will have an immediate effect on your billing operations

so you should have your work pre-planned before using this option.

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Clinic Nonbillable – VISTA (cont.) Select one of the following:

           S         STOP CODES

          C         CLINICS

          A         ALL CLINICS

Enter your choice: CLINICS

 You may now enter the clinics that you wish to flag.  Please note

all clinics that you select will be assigned the same effective

date and billable status and auto bill status.

Select CLINIC: DERMATOLOGY-TELEPHONE

Next CLINIC:

Is this clinic Non-Billable for Third Party Billing? YES

Please enter the date this should become effective: 010108  (JAN 01, 2008)

 DERMATOLOGY-TELEPHONE

Effective Jan 01, 2008 the above clinics will be Non-billable

and will NOT have bills created by the Third Party auto biller.

Is this correct, is it okay to proceed and file these entries? YES

 Filing these CLINIC entries...  . done

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Where to Begin?

Document high volume clinical activities at your site Count or noncount for each activity

Clinic set-up Check stop codes of current clinics Set-up clinics for high volume activities that do not

have a clinic currently (inpatient!) Select appropriate CPT codes for the clinics

Develop policies/business rules for activities that do not require consult

Educate staff – encounters, how to document Listen for issues/concerns from staff

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Questions to Ask Yourself

Are my current stop codes correct? Do face to face visit clinics have 160 in the

primary? If 160 isn’t the primary, why? (telephone, hbpc, other)

If cannot be in primary, is it in the secondary?

Are nonface to face, nontelephone visits, 160 primary and 697 secondary (to avoid copay)?

Is everything being documented in these clinics truly count (history taken, clinical decision, documented)?

Are we using the appropriate CPT codes? Should no longer be using 99211 Face to face – use MTM codes!

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Questions to Ask Yourself Are my face to face clinics marked billable

in the MCCF package? Does my billing/coding staff know they can bill

institutional fees for these pharmacy visits? Are the nonface to face visits marked

nonbillable? What are we doing that is “count”

workload that we aren’t documenting? Clinics NFs Inpatient (med rec, kinetics, anticoagulation,

etc)

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Clinic Set-Up37

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Questions?

Count? (3 ’s required)1. Medical history taken? 2. Clinical decision making? 3. Documented?

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Screen Captures: Inpatient Encounters

It is imperative that the location be changed to the appropriate location (inpatient clinic) for inpatient notes

*Disclaimer: Facility variation may occur

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Inpatient Encounter Example

The following slides are the steps to complete an encounter for an inpatient interaction

It is imperative that the location be changed to the appropriate location (inpatient clinic) for inpatient notes

41Click on the location box directly next to the patient data box, found in the upper left corner of the screen. ***For INPATIENT NOTES, the location MUST be changed FIRST in order for productivity/workload to be credited to the clinic.

Location block

42

Click on “Clinic Appointments” if appointment exists and select it to link the note to existing appointment.

43

If no appointment exists, click on NEW VISIT, enter name of clinic (location) and time of appointment (encounter).

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Click on NEW NOTE, enter name of note title you wish to use. ****If there is a consult associated with visit, choose “CONSULT” title to close consult at same time note is written. With active

consults, an additional dialog box will appear at bottom of Progress Note Properties box.

This is the area that consults will appear, if applicable

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Write note as you normally would.

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Click “Action, Sign Note Now”. For NON-COUNT clinics, you will NOT be prompted for encounter data. Sign note. You MUST click encounter button after signing note.

***COUNT CLINICS: Encounter data MUST be entered before SIGNING note.

Click ACTION

Sign Note Now

Click encounter button after note is signed

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Click encounter button and enter encounter data as usual. Be sure to answer service connected and rated disabilities questions, visit type and/or procedure and diagnosis code

to satisfy encounter. This will provide DSS with workload.

Clinical Video Telehealthhttp://vaww.telehealth.va.gov/telehealth/index.asp48

Clinical Video Telehealth

Two clinic appointments must be made for these visits: One appointment at the patient site with the

following secondary DSS Identifiers (stop code): Patient site (originating site) = 690

One appointment at the provider site. The clinic setups will have the following secondary DSS Identifiers (stop codes): Provider site (distant site) – same station number

= 692 (#1 above) Provider site (distant site) – different station

number = 693 (situations #2 and #3)

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Care Coordination/Home Telehealth Program growth, frequent changes Detailed guidance on documentation coming out

soon http://vaww.telehealth.va.gov/telehealth/index.asp

Coding requires CCHT codes in primary and secondary position Common primary stop codes

674, 683, 685, 686

Common secondary stop codes 179, 371, 684

Due to lack of pharmacy specific codes, excellent place to use alpha codes

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Care Coordination/Home Telehealth*Work with local billing staff for appropriate codes! Patient Site: Use the CPT/HCPCS (Healthcare Common Procedure

Coding System) code Q3014, which stands for the Telehealth Originating Site Facility Fee. The thinking is this nominal fee supports the facility (equipment, power, heating, cooling, lighting) providing the patient a place to access care via telehealth. This is the only code that is appropriate for the patient site. For activities performed by clinical staff at the patient site, (e.g., blood pressure, weight, temperature) a separate face to face clinic visit should be set up for documentation. Questions regarding eligibility, Agent Orange and ionizing radiation, need to be answered to complete checkout.

Provider site: Use the appropriate CPT code as if the procedure/service was performed face-to-face, but use the realtime telehealth modifier. For example, 97112-GT where CPT 97112 designates "Neuromuscular Re-Education" and HCPCS modifier code GT designates "Realtime" or "Interactive" telehealth.

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CCHT Stop Code PairsExamples

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CCHT SCREENING TCor

CCHT SCREENING PHONEor

CCHT SCREENING PH

686

CCHT TECH EDUCATION 674 685

CCHT Tech Education

Note

CCHT Tech Education Template

This document contains patient education, skill validation and installation for technology on all CCHT patients.

NOTE: ALWAYS attached to the coding pair 674/685 (Non-Count)Use as often as needed when re-educating the patient on technology, changing or troubleshooting technology or adding new peripheral devices.Training/Education on technology only.

CCHT INTERVENTION 686 684CCHT

Intervention Note

CCHT Intervention Template

This progress note contains information about all interventions generated from symptoms, behavior and knowledge data gathered from daily monitoring by a non-video messaging device.

NOTE: Use ONLY to document patient encounters in response to alerts from vendor data- not to be used as generic note, and not to be used with VIDEO visit.

CCHT MONTHLY MONITOR-X 683 685CCHT

Monthly Monitor Note

CCHT Monthly Monitor

Template

This progress note contains information about the monthly monitoring of patients assigned non-video messaging devices.

NOTE: Document using this note title once each calendar month on EVERY messaging patient regardless of other patient interactions during the month. Not to be used for patients on video technology that does not have messaging functionality.

CCHT VIDEO VISIT 685 179CCHT Video Visit Note

CCHT Video Visit

Template

This document contains information about any visit over a video device (tele-Monitor/ Videophone) that meets required criteria for secondary Stop Code xxx179

NOTE: Must meet certain documentation requirements of replicating a face-to-face visit or it can’t be coded as 179

371CCHT

Screening Consult

CCHT Screening Consult

Template

This consult document is used to document initial evaluation for enrollment WHETHER OR NOT the patient is actually enrolled.

NOTE: Use to close consult