Patients age 66 or older in institutional special needs plans (snp) or residing in long-term care with pos code 32, 33, 34, 54 or 56 for more than 90 days during the measurement period
HCPCS code
Name of the Procedure:
Institutional Special Needs Plan Assessment and Long-term Care Evaluation (HCPCS Code G9910)
Summary
The Institutional Special Needs Plan Assessment (G9910) evaluates patients aged 66 or older living in long-term care facilities or involved in special needs plans for more than 90 days. This assessment helps ensure that their healthcare needs are met comprehensively and continuously.
Purpose
The assessment aims to monitor and manage chronic conditions, prevent potential health complications, and optimize overall health and quality of life. It ensures coordinated, patient-centered care for elderly individuals in long-term care settings.
Indications
- Older adults (age 66 or older) who are in Institutional Special Needs Plans (SNP).
- Residents of long-term care facilities with a stay of more than 90 days.
- Patients living in settings with place of service (POS) codes 32, 33, 34, 54, or 56.
Preparation
- Patients should gather their medical history and current medication list.
- Routine diagnostic tests may be required to assess the patient's current health status.
Procedure Description
- Comprehensive Health Assessment: Includes a review of medical history, current medications, and existing health conditions.
- Physical Examination: A thorough physical check-up conducted by healthcare professionals.
- Coordination of Care: Development of a personalized care plan in coordination with a multidisciplinary healthcare team.
- Continuous Monitoring: Regular follow-ups and updates to the care plan based on the patient's health status.
Tools, Equipment, or Technology
- Patient records and medical history.
- Diagnostic tools for blood tests, imaging, etc.
- Digital health records system for coordinating care.
Anesthesia or Sedation
- Not applicable for this procedure.
Duration
The assessment typically takes 1-2 hours, and the care planning and coordination may take additional time as needed.
Setting
The procedure is performed in long-term care facilities such as nursing homes, skilled nursing facilities, or specialized care institutions.
Personnel
- Primary Care Physician
- Nurses
- Geriatric Specialists
- Social Workers
- Pharmacists
Risks and Complications
- Minimal risks associated; largely involves review and coordination of existing care.
- Possible miscommunication or oversight in patient history, mitigated by thorough reviews and cross-checks.
Benefits
- Improved management of chronic conditions.
- Enhanced quality of life through tailored healthcare.
- Reduction in hospital readmissions and emergency visits.
- Coordinated care ensures comprehensive treatment of all health issues.
Recovery
- Immediate recovery ensues as the procedure is non-invasive.
- Follow-up appointments and care plan updates as necessary.
Alternatives
- Routine check-ups with multiple specialists (not coordinated in a single plan).
- Home-based care programs or remote monitoring services.
- Benefits of the SNP and long-term care assessments include coordinated care leading to better patient outcomes.
Patient Experience
- Expect routine check-ups and discussions regarding health status.
- Emphasis on comfort; no invasive procedures involved.
- Continuous support from a multidisciplinary healthcare team ensures patient comfort and quality care.