Emerging Coding Implications for Pharmacist Integration in New Care Delivery Systems
February 17, 2021 11:00am MT
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The purposes of this Webinar is to provide the AAPC coding community with an overview of pharmacists’ patient care roles and responsibilities in evolving healthcare delivery systems, and to discuss the health reporting and billing implications of pharmacist integration in fee-for-service and value-based financing.
You Will Learn To:
* Describe the evolution of pharmacists’ patient care responsibilities from dispensing medications to assuming responsibilities for patients’ drug therapy outcomes using the National Library of Medicine’s - Pharmacy Practice Activity Classification taxonomy.
* Understand health reporting nomenclature for pharmacists’ professional services assigned in Current Procedural Terminology as Medication Therapy Management Services.
* Discuss challenges and success in coding pharmacists’ patient care services, and in obtaining reimbursement for these services.
1) Overview of pharmacists’ evolving professional responsibilities described in the four domains of, Ensuring Appropriate Therapy and Outcomes, Dispensing Medications and Devices, Health Promotion and Disease Prevention, and Health Systems Management as codified in the National Library of Medicine’s - Pharmacy Practice Activity Classification system at: https://www.nlm.nih.gov/research/umls/sourcereleasedocs/current/PPAC/index.html
2) Historical review of pharmacists’ professional services from the clinical pharmacist movement in hospitals (1960’s) to contemporary practice models in which pharmacists assume responsibility for patients’ medication use outcomes through collaborative drug therapy management authority in a variety of practice settings.
3) Summary of literature on the clinical, economic, and humanistic outcomes of pharmacist integration in high performing healthcare delivery and financing systems.
4) Description of the service using official health reporting nomenclature of CPT -Medication Therapy Management Services, including development of a profession-wide consensus on the pharmacists’ patient care process.
5) Overview of pharmacists’ clinical documentation, access to electronic health records, development of eCare Plan standards, and alignment with SNOMED-CT architecture.
6) Review of national and state reimbursement requirements for pharmacists’ professional services in both government and commercial payer programs.
About The Author
Dr. Isetts' field of expertise is in the scholarship of caring, specifically studying the outcomes of medication therapy management services provided in integrated, team-based care settings. Research interests focus on the exchange of electronic health information to redesign the nation's medication use system. Also served as Co-Investigator on a three-year National Library of Medicine HIT grant titled, "Semantic Relatedness for Active Medication Safety and Outcomes," and served as a Health Policy Fellow at the Centers for Medicare and Medicaid Innovations in Washington, D.C.
-Alternate CPT Representative for Pharmacy (Pharmacy HIT Collaborative), American Medical Association, Current Procedural Terminology Advisory Panel
-Chairman, Workgroup 1-CPT Coding, Pharmacy Health Information Technology Collaborative
-Member, CMS Part D MTM Program Technical Expert Panel
-Member, Pharmacy Quality Alliance – University of Minnesota Representative
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