Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with
CPT4 code
Name of the Procedure:
Advance Care Planning; Explanation and Discussion of Advance Directives (Standard Forms)
Summary
Advance care planning involves a face-to-face discussion between a patient and a healthcare professional about future healthcare preferences. This includes the completion of advance directives, which are legal documents that outline a patient's wishes in case they become unable to make their own medical decisions.
Purpose
Advance care planning addresses the need for patients to have their healthcare preferences documented and respected. The goal is to ensure that patients receive the type of medical care they desire, guided by their values and personal wishes.
Indications
- Chronic or terminal illness
- Comorbidities in elderly patients
- High-risk surgical or medical procedures
- Desire for autonomy in medical decision-making
- Legal and family considerations
Preparation
- No specific preparation is typically required.
- Patients may be asked to think about their healthcare preferences and wishes beforehand.
- It can be helpful for patients to discuss their thoughts with family members prior to the appointment.
Procedure Description
- Introduction: The healthcare professional introduces the purpose of advance care planning.
- Discussion: The patient and healthcare professional discuss the patient’s values, goals, and preferences regarding future medical treatment, including life-sustaining measures.
- Explanation of Forms: The healthcare professional explains advance directive forms, which may include living wills and durable power of attorney for healthcare.
- Completion of Forms: The healthcare professional assists the patient in completing the forms if they wish to do so.
- Review and Documentation: The forms are reviewed and documented in the patient’s medical record.
Duration
The procedure typically takes about 30 minutes.
Setting
This discussion can take place in various settings, including:
- Outpatient clinic
- Hospital
- Long-term care facility
- Patient's home
Personnel
- Physician
- Nurse Practitioner (NP) or Physician Assistant (PA)
- Social Worker or another qualified healthcare professional
Risks and Complications
Advance care planning itself poses no physical risks. However, patients may experience emotional or psychological discomfort when discussing end-of-life care.
Benefits
- Ensures patient’s healthcare preferences are known and respected
- Reduces stress and uncertainty for family members and caregivers
- Improves patient autonomy
- Facilitates clear communication between patients and healthcare providers
Recovery
- No physical recovery is required.
- Patients may need time to process emotional aspects of the discussion.
Alternatives
- Informal discussions with family members without formal documentation
- Online tools and resources for creating advance directives independently
- Legal consultations for personalized advance directive documents
Patient Experience
Patients may feel a mix of relief and discomfort during the discussion. It is a time to reflect deeply on personal values and wishes regarding one’s healthcare future. Comfort measures include creating a supportive environment and, if needed, offering follow-up visits for further discussion.