Name of the Procedure:

Skilled Nursing Services by a Registered Nurse (RN) for Management and Evaluation of the Plan of Care; Each 15 Minutes (HCPCS Code: G0162)

Summary

This service involves a registered nurse (RN) visiting a patient's home to manage and evaluate their plan of care. The RN ensures that any essential non-skilled care is effectively delivered according to the patient's needs and underlying medical conditions.

Purpose

The procedure addresses the need for professional oversight in the home healthcare setting, especially for patients with complex medical conditions or complications. The goal is to ensure that the prescribed non-skilled care achieves its desired health outcomes efficiently and safely in the patient's home environment.

Indications

• Chronic disease management (e.g., diabetes, heart failure)
• Post-surgical recovery
• Patients with multiple comorbidities
• Situations where non-skilled care needs professional evaluation to be effective
• High-risk patients requiring frequent monitoring

Preparation

• No specific pre-procedure instructions are usually required.
• The patient should maintain an up-to-date medication list.
• Any recent medical reports or test results should be available for the RN.

Procedure Description

1. Initial Assessment: The RN assesses the patient’s overall health status and current plan of care.
2. Plan Review: The RN evaluates and updates the care plan as needed, ensuring it aligns with the patient's current condition.
3. Implementation Oversight: The RN oversees the implementation of non-skilled care activities (e.g., wound care, medication management) by family members or caregivers.
4. Education: The RN educates the patient and caregivers on best practices and necessary adjustments.
5. Documentation: All findings and care plan modifications are documented accurately.

Tools:

• Medical records
• Standard nursing equipment (e.g., blood pressure cuff, stethoscope)

Duration

This service is billed in 15-minute increments, with the total duration depending on the patient's needs.

Setting

Performed in the patient's home.

Personnel

• Registered Nurse (RN)

Risks and Complications

• Very low-risk procedure
• Potential for miscommunication or misunderstanding of instructions, which the RN mitigates with thorough education and follow-up.

Benefits

• Improved management of chronic and acute conditions in the home
• Enhanced patient and caregiver understanding of care plans
• Better health outcomes through timely intervention and adjustments

Recovery

• No recovery period required as this is a non-invasive service.
• Follow-up visits are scheduled as necessary based on the patient’s condition.

Alternatives

• In-hospital care: More intensive and more costly.
  • Pros: Immediate access to a broader range of medical services.
  • Cons: More disruptive to the patient's life and more expensive.
• Outpatient clinic visits:
  • Pros: Professional care in a clinical setting.
  • Cons: More travel and less convenience for the patient.

Patient Experience

• The patient can expect a respectful and professional visit from the RN.
• The RN will provide comfort measures and pain management strategies if applicable.
• Patients often feel more secure and supported in managing their health at home with professional guidance.

This comprehensive guide aims to offer a detailed yet accessible overview of the HCPCS procedure G0162, ensuring patients and caregivers understand the scope and importance of skilled nursing services in home-based care.