Documentation
True or False
Cannabis Dependence risk adjusts.
What is TRUE?
Cannabis Dependence is a newly added diagnosis to the risk adjustment model. If it is not a prescribed medication, the DSM-V criteria does not apply and the diagnosis can be made clinically.
This is the time frame for action on the Osteoporosis Management in Women with a Fracture measure.
What is 6 months from date of fracture?
This measure is reported using the information documented on the last visit of the measurement year.
What is the Controlled BP?
For the Two HbA1c Tests measure, the tests must be more than this far apart.
What is 14 days?
Disorders of this type have been added to the HCC model for 2018 dates of service.
What are Personality Disorders and Drug/Alcohol Use Disorders?
This documentation should be included in when using the diagnosis of Alcohol Dependence.
What is recommendation to drug or alcohol treatment program?
True or False: A diabetic with a HbA1c of 8.9% meets the Part C Stars Comprehensive Diabetes Care A1c Measure.
What is TRUE?
In the Star rating model, the HbA1c must be below 9%
If your patient needs Colorectal Cancer Screening, the nurse should do this while reviewing aftercare instructions.
What is give the patient a Fit Kit AND explain the process of collection AND incentive for completion?
For the Cervical Cancer Screening measure, women in this age range are in the measure.
What is 24-64 every measurement year or two years prior?
Documentation of Morbid Obesity on a patient with a BMI of 38.5 requires this.
What is the co-morbid condition?
DOUBLE JEOPARDY
Documentation of this diagnosis meets criteria for the Diabetes Care-Nephropathy measure, ADDITIONALLY, this lab can also be done to meet the measure.
What is CKD?
What is Urine for Microalbumin?
True or False:
If a senior has a blood pressure reading of 140/88 at intake, then it is repeated at the end of the visit and the reading is 138/92, then they are compliant for the Controlling Blood Pressure measure.
What is TRUE?
Name four of the tests that are standard protocol for completion at every SW.
What are Spirometry, EKG, CKR, Depression Screening, Senior Lab Panel, QuantaFlo, NCV, ADL, Fall Risk, Pain Scale?
DOUBLE JEOPARDY!
Name four Core HEDIS Measures for the Medi-Cal line of business.
LT Rx, CCS, CIS, CDC, Prenatal and Postpartum Care, WCV, CBP?
Name three of the many HOS measures.
What are Addressing Risk of Urinary Incontinence, Monitoring Physical Activity, Improving Physical Activity, Improving Mental/Emotional Health, Reducing Fall Risk, Getting a Flu Shot?
Under the DSM-V Criteria, this number of maladaptive patterns must be present and documented to report the diagnosis of Drug Dependence.
DOUBLE JEOPARDY! Name that many of them.
What is 2?
This is the age range for the Colo-rectal Cancer Screening Star measure.
What is 50-75?
The measure for Long Term Medications (ACE/ARBS and Diuretics) requires we complete these labs annually.
Serum Potassium and Creatinine?
True or False: BMI is a measure for every single line of business at HDMG.
What is TRUE?
This particular diagnosis needs to be specified when documenting Diabetes with Other Specified Manifestations.
What is the Specified Manifestation?
Name three acute diagnosis that providers should avoid documenting in the outpatient setting.
What are CVA/Stroke/Infarct, Cerebral Occulsion/Stenosis, Acute Respiratory Failure, Coronary Occlusion/MI, Unstable Angina, Sepsis, Established Compression Fx without any worsening?
True or False:
HDMG is currently rated 5 Stars on both 3x weighted Part C Star measures.
What is FALSE?
We are not longer at 5 stars on A1c, but need 68 more to get there.
Name three of the four incentives Sr. HMO members are eligible for from HDMG in 2018.
What are SWV gift card, BCS gift card, BCS sports bra, FIT Kit gift card?
This is what the term 'HOS' stands for.
What is Health Outcome Survey?
DOUBLE JEOPARDY!
Multiple Choice:
This risk-adjusting diagnosis was brought back into the HCC model for 2018 dates of service and has this RAF weighting.
0.168, 0.68, 0.068
What is 0.068 ?