Patients 66 years of age and older with at least one claim/encounter for frailty during the measurement period and a dispensed medication for dementia during the measurement period or the year prior to the measurement period
HCPCS code
Name of the Procedure:
- Common Name: Dementia Management in Frail Elderly Patients
- Medical Term: HCPCS Code G2115
Summary
This procedure involves the identification and management of patients aged 66 and older who have shown evidence of frailty and have been prescribed medication for dementia within a certain timeframe. It includes tracking health encounters and ensuring patients receive appropriate dementia care.
Purpose
- Medical Conditions/Problems Addressed: Frailty and dementia in elderly patients.
- Goals/Outcomes: To ensure comprehensive care for elderly patients who are frail and have dementia, ensuring they receive necessary medications and monitoring their health status to prevent complications.
Indications
- Symptoms/Conditions: Evidence of frailty (such as reduced physical strength, mobility issues) and diagnosis of dementia.
- Patient Criteria: Patients aged 66 years and older with at least one documented claim or encounter indicating frailty and a prescription for dementia medication.
Preparation
- Pre-Procedure Instructions: No specific fasting or pre-procedure preparation instructions.
- Diagnostic Tests/Assessments: Medical history review, physical examination, and cognitive assessments to confirm dementia and evaluate frailty.
Procedure Description
The process includes:
- Initial Assessment: Reviewing patient's medical records for evidence of frailty and dementia.
- Medication Review: Verifying the prescription and dispensing of dementia medication in the last year or during the current measurement period.
- Follow-Up Plan: Establishing an ongoing care plan which may include regular follow-ups, medication management, and physical therapy or supportive services for frailty.
- Tools/Equipment: Patient medical records, cognitive assessment tools.
- Anesthesia/Sedation: Not applicable.
Duration
- The assessment and management plan formulation can vary but typically takes 30 minutes to an hour per patient visit.
Setting
- Performed in outpatient clinics, general practice offices, or specialized geriatric care centers.
Personnel
- Healthcare Professionals: General practitioners, geriatricians, nurse practitioners, pharmacists, and potentially social workers.
Risks and Complications
- Risks: Misinterpretation of symptoms, medication side effects.
- Complications: Potential for polypharmacy issues, increased risk of falls due to frailty.
Benefits
- Expected Benefits: Improved management of both frailty and dementia, leading to enhanced quality of life and potentially slowed progression of dementia symptoms.
- Realization Time: Benefits can be seen in the short-term with improved daily function, and long-term with slowed disease progression.
Recovery
- Post-Procedure Care: Regular follow-up appointments, adherence to medication regimen, incorporation of recommended lifestyle changes such as physical exercise.
- Recovery Time: Continuous management, no specific recovery time as this is an ongoing care approach.
Alternatives
- Other Treatment Options: Non-pharmacologic interventions like cognitive therapies, lifestyle modifications, physical rehabilitation.
- Pros and Cons: Alternatives may be less invasive but may not be as effective in managing advanced symptoms of dementia.
Patient Experience
- During Procedure: Patients may undergo cognitive and physical assessments, which can be mentally and physically tiring.
- After Procedure: Patients should experience comprehensive care support, improved symptom management. Pain is generally not a concern, but comfort measures include supportive social services and counseling if needed.