LOUISE SLACK
Networker
Hello fellow auditors.
I have always been easily confused on how to count/quantify the # of diagnoses or Treatment Options.
Especially when considering what I can allow for the provider.
If a new problem arises due to medication do you count it as a new problem with or without additional workup.? Then if the provider treats/manages that medication complication does the provider get credit for it on every visit where it is re-evaluated?
for example:
The oncologist is treating a cancer patient.
During treatment the patient developes constipation, decreased apetite and a skin fungal infection. The Oncologist manges each of the problems with OTC and or RX. then reasses the problems at each recheck.
If the patient is still recieveing chemo and cancer is still present I give them 2 points for the established problem, I consider this worsening until we have evidence the chancer has gone into remission. ( I know carriers deny using a point system but lets face it thats all we have)
Then one point for each of the complications of chemo if stable/improved which most of them are.
So for this example we are looking at 5 points/options for problems to the examining physician. Agree?
I really need your expert opinoins.
Thank You
Louise
I have always been easily confused on how to count/quantify the # of diagnoses or Treatment Options.
Especially when considering what I can allow for the provider.
If a new problem arises due to medication do you count it as a new problem with or without additional workup.? Then if the provider treats/manages that medication complication does the provider get credit for it on every visit where it is re-evaluated?
for example:
The oncologist is treating a cancer patient.
During treatment the patient developes constipation, decreased apetite and a skin fungal infection. The Oncologist manges each of the problems with OTC and or RX. then reasses the problems at each recheck.
If the patient is still recieveing chemo and cancer is still present I give them 2 points for the established problem, I consider this worsening until we have evidence the chancer has gone into remission. ( I know carriers deny using a point system but lets face it thats all we have)
Then one point for each of the complications of chemo if stable/improved which most of them are.
So for this example we are looking at 5 points/options for problems to the examining physician. Agree?
I really need your expert opinoins.
Thank You
Louise