Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)
HCPCS code
Name of the Procedure:
Comprehensive Assessment and Care Planning for Chronic Care Management (CCM) Services (G0506)
Summary
This procedure involves a detailed evaluation and strategic care planning for patients who require ongoing management of chronic conditions. It is performed in addition to the primary monthly care management services.
Purpose
Coping with chronic health issues such as diabetes, heart disease, or arthritis can be challenging. The goal of this procedure is to create a personalized care plan that addresses the unique health needs of each patient to improve their overall quality of life and manage chronic conditions more effectively.
Indications
The procedure is indicated for patients with multiple chronic conditions that last a year or more and require continuous medical attention. It is particularly beneficial for those experiencing symptoms such as frequent hospital visits, difficulty managing medications, or complex care needs.
Preparation
Patients may need to provide a comprehensive medical history and list of current medications before the assessment. Specific instructions on fasting or medication adjustments will be communicated by the healthcare provider.
Procedure Description
- Initial Consultation: The healthcare professional will review the patient's medical history, current conditions, medications, and lifestyle.
- Evaluation: Conduct necessary diagnostic tests or assessments to thoroughly understand the patient's health status.
- Care Plan Development: Based on the evaluation, the healthcare team will develop a personalized care plan that includes medication management, lifestyle adjustments, appointment scheduling, and monitoring strategies.
- Discussion: The care plan is discussed with the patient and their family to ensure understanding and adherence.
Tools/Equipment: Electronic Health Records (EHR) system, diagnostic tools such as blood pressure monitors or glucose meters.
Anesthesia/Sedation: Not required.
Duration
The comprehensive assessment and care planning typically take 45 to 60 minutes.
Setting
The procedure is usually performed in an outpatient setting, such as a primary care clinic or a specialized chronic care management clinic.
Personnel
- Primary Care Physician (PCP)
- Nurse Practitioner (NP) or Physician Assistant (PA)
- Chronic Care Coordinator
- Medical Assistants
Risks and Complications
This is a non-invasive procedure with minimal risks. However, there might be a risk of incomplete information leading to an ineffective care plan.
Benefits
Patients can expect a well-coordinated, individualized care plan aimed at better managing their chronic conditions, which can lead to fewer emergency visits, better symptom control, and an improved quality of life. Benefits are often realized within a few weeks of implementing the care plan.
Recovery
There is no recovery period required as the procedure itself is evaluative and planning-based. Patients are advised to adhere to the care plan and attend follow-up appointments as scheduled.
Alternatives
- Self-Management: Patients manage symptoms and medication independently with occasional check-ups.
- Traditional Care: Regular doctor visits without a structured chronic care management program.
Pros of CCM: Personalized, continuous care, better health outcomes.
Cons of Alternatives: Potential for missed symptoms, less structured care.
Patient Experience
During the assessment, patients will have detailed discussions with healthcare providers about their health history and current issues. Post-assessment, they may feel more informed and empowered about managing their conditions. Pain is generally not an issue, and comfort measures include ensuring patient understanding and addressing any concerns or questions they might have.