Name of the Procedure:

Qualified Nonphysician Qualified Healthcare Professional Assessment Service (HCPCS G2063)

Summary

This procedure involves an assessment service provided by a qualified non-physician healthcare professional for an established patient. It includes clinical evaluation and decision-making for up to seven days, cumulative time during which totals 21 minutes or more.

Purpose

This service is intended to manage and assess ongoing health issues in established patients. The goal is to monitor health status, adjust treatments if necessary, and provide additional guidance for disease management over a specified timeframe.

Indications

• Chronic disease management (e.g., diabetes, hypertension)
• Post-surgical follow-up
• Ongoing assessment of a diagnosed condition
• Situations requiring continuous monitoring and adjustment of care plans

Preparation

• No specific preparation is usually required.
• Patients should have their medical records up-to-date.
• Patients may need to provide a list of current medications and any recent changes in their health status.

Procedure Description

1. Initial Contact: The procedure begins when the patient first contacts the qualified healthcare professional.
2. Assessment: The healthcare professional conducts a detailed assessment, which may include reviewing medical history, current symptoms, and treatment goals.
3. Documentation: All interactions and evaluations over the cumulative 7-day period are documented.
4. Decision Making: The healthcare professional recommends adjustments to treatment plans as needed, based on the clinical data collected.

Tools and Equipment

• Medical records
• Telemedicine platforms (if virtual)
• Diagnostic tools (e.g., blood pressure monitors, glucose meters)

Anesthesia or Sedation

• Not applicable for this procedure.

Duration

The service encompasses cumulative time of 21 minutes or more over a period of up to seven days.

Setting

• Outpatient clinics
• Telemedicine platforms
• Community health settings

Personnel

• Qualified non-physician healthcare professionals (e.g., nurse practitioners, physician assistants)

Risks and Complications

• Minimal risks are associated since it primarily involves clinical assessment and decision-making.
• Misinterpretation of symptoms if communication is not clear.
• Potential for delayed intervention if significant changes in health status are not promptly conveyed by the patient.

Benefits

• Continuous monitoring and management can lead to better health outcomes.
• Early detection and intervention for complications.
• Personalized care based on ongoing evaluation.

Recovery

• No physical recovery is needed.
• Patients should follow any updated treatment or care plans as advised.

Alternatives

• Traditional in-person visits to a physician.
• Self-management with periodic in-person check-ups.
• Emergency care for acute symptoms.

Pros and Cons of Alternatives

• In-person Visits: More comprehensive but might be less convenient for ongoing assessments.
• Self-management: Greater autonomy but may lack professional oversight.
• Emergency Care: Necessary for acute situations but not ideal for chronic management.

Patient Experience

• Patients should feel comfortable discussing their ongoing health concerns.
• They might experience a convenient, timely, and continuous oversight of their health.
• Pain is not expected as part of the procedure.
• Assurance and clarity in managing their conditions through professional support.