Clinical Decision-Making NU671.Unit 2 Discussion New Patient Encounter. Due 11-8-2. 800w.4 references.

Home>Homework Answsers>Nursing homework help2 years ago08.11.202320Report issuefiles (1)ClinicalDecision-MakingNU671.Unit2NewPatientEncounter.Due11-8-2.800w.4references..docxClinicalDecision-MakingNU671.Unit2NewPatientEncounter.Due11-8-2.800w.4references..docxClinical Decision-Making NU671. Unit 2New Patient Encounter. Due 11-8-2. 800w.4 references.Initial ResponseInstructions:Consider the following questions in your initial discussion post:· Review the SOAP note accessed through this link.  For purposes of the assignment, the patient is a ‘new patient’ in the practice.·New Patient SOAP NoteDownload New Patient SOAP NoteDownload New Patient SOAP NoteInitial PostUse your lecture materials to determine what CPT E&M Code to utilize for this ‘new patient’ encounter.You may choose to assign the code based on the anticipated/guestimate amount of time the provider would spend with the patient in the encounter or you may choose to utilize the Medical Decision Making (MDM) approach. If you choose the MDM include the following information in your discussion:1. the level of history taking achieved – identify the history elements present2. the type of exam performed – identify the number of systems and bulleted points in the note3. the level of medical complexity encompassed – include # of points for a) diagnoses/management options, b) amount/complexity of data reviewed, and c) level of risk for complications, morbidity, mortalityPlease be sure to validate your opinions and ideas with citations and references in APA format.SOAP notes provided by the instructor for this assignmentChief Complaint:“I don’t know how much longer I can go on like this. I’ve been down in the dumps for years and it isn’t getting any better.”History of Present Illness:75-year-old white male present to clinic with above complaint. Lost his first, the “love of his life” wife 19 years ago. Remarried 2 years after her death and states he probably married again too soon reporting his current wife is difficult. He describes an instance, when he was at work, the second wife would not let his son, daughter-in-law and new grandbaby into his house to visit until he got home from work. The second wife also insisted that he no longer visit with his deceased wife’s family telling him ‘when you married me, you divorced that whole family’. Conversations with his wife about his concerns resulted in only short-term changes in her approaches and behaviors. Now his wife insists they sell the house he has lived in for 46 years. He reports that his memory and ability to make simple decisions have been deteriorating significantly over the last several months. His wife suggested he probably has Alzheimer’s and should go see his primary care provider about his memory issues. He reports that he engages with modest exercise daily, eats well but is waking up numerous times at night and is usually “up for good” by 5am. He blames his disrupted sleep pattern on his feeling of fatigue starting around 9am. He reports all these circumstances as contributing to his increased depression and his desire to “give up the fight”.PMH:reports usual childhood illnesses inclusive of measles, mumps and chickenpoxtraumatic injury, likely secondary to ‘blast’ effect, sustained during the bombing of Pearl Harbor where he was stationed as a cook; he suffered a hearing loss for six months after the bombing and was diagnosed at 54 with a rare eyes disorder resulting in poor peripheral vision that is thought to be secondary to this traumaFamily Hx:Father died at 67 secondary to colon cancer; mother died at 24 secondary to influenza during an epidemic (he was 2 years old at that time)No know family history of depression or other mental illnessSocial Hx:HS graduate, married to HS sweetheart for 27 years then widowedCurrent marriage of 17 yearsRetired after 25-year banking careerAttends Catholic mass regularlyDrinks 1-2 beers several times a week, denies episode of intoxication; never smoked or used illicit drugsDrinks hot tea, reporting coffee causes too much GI distressNever driven a motor vehicle secondary to poor peripheral visionROS:Denies HA, body aches, dizziness, fainting spells, tinnitus, ear pain, ear discharge, nasal congestion, diarrhea, constipation, change in appetite skin abnormalities, or genitourinary symptomsDenies periods of extreme irritability or elation associated with periods of sadness; denies feeling more depressed during the winter months than other seasonsReports fatigued most of the time, often feels stiffness in his neck and shouldersDenies homicidal ideations, hallucinations, paranoia or delusionsReports suicidal thoughts, has a 22-caliber rifle at home and has considered using to end his lifeSIGECAPS:Reports – poor sleep maintenance, loss of pleasure, he feels as though he remarried too soon, he is experiencing fatigue, he is experiencing memory disturbances, eating well, no problems maintaining exercise regimen, is having suicidal ideationsMedications:No routine medicationsAllergies:NonePhysical Examination:Constitutional – BP 118/73, P 83, RR 16, T 98.8, Ht 71 in, Wt 174 lbs, BMI 24Integument – skin, hair and nails unremarkableHEENT – PERRLA, EOMs intact, nares patent without discharge noted, TMs gray and shiny bilateral, numerous silver amalgams notedNeck – supple without adenopathy, no thyromegalyLungs – CTAHeart – RRR without murmur/gallopAbdomen – soft, non-distended, active bowel sounds, non-tender, no organomegalyGenitalia/Rectum – deferredMusculoskeletal – no gross abnormalities or major limitations of ROM notedNeurologic – CNs II-XII intact, finger-to-nose test negative, DTRs 2+ and equal bilateral, sensory capacity intact upper and lower extremities intact bilateralMental status – PHQ 9 score is 19Diagnostics – Na 138 meq/L, K 4.2 meq/L, Cl 102 meq/L, HCO3 27 meq/L, Bun 11 mg/dL, Cr 0.9 mg/dL, fasting Glu 106 mg/dL, Ca 9.5 mg/dL, Mg 1.8 mg/dL, AST 34 IU/L, ALT 42 IU/L, GGT 38 IU/L, Alb 4.4 g/dL,TSH 2.8, Vit B12 98 pg/mL, Folic acid 333 ng/mL, PSA 4.9 ng/mL, Hgb 14.3 g/dL, HCT 41.4 %Urine dipstick – 5.8 pH, SG 1.016, all other parameters negativeAssessment:1. F32.1 Major depressive disorder, single episode, moderate2. R45.851 Suicidal ideations/thoughts3. R73.03 Prediabetes4. E53.9 Vitamin B deficiencyPlan:1. Major depressive disordera. Diagnostic – noneb. Therapeutic – citalopram 20mg take 1 by mouth daily dispense #30 with 2 refillsc. Educational – effects of citalopram may not be fully evident for up to 3 or 4 weeks; if you note fatigue exacerbated from the citalopram take it at bedtime; RTC in 1 month for follow upd. Consultation/Collaboration – none2. Suicidal ideations/thoughtsa. Diagnostic – noneb. Therapeutic – same as diagnosis #1c. Educational – same as diagnosis #1; educate on the potential negative impact of his current intake of beer – educate on how to safely reduce this consumption and to avoid abrupt cessation; educate on need to remove the 22-caliber rifle from his home; provide information on suicide hot linesd. Consultation/Collaboration – referral for counseling3. Prediabetesa. Diagnostic – noneb. Therapeutic – nonec. Educational – nutrition education aimed at making dietary lifestyle choices of low glycemic index foods (<55 GI) that aid in development and maintenance of stable insulin and glucose levelsd. Consultation/Collaboration – none4. Vitamin B deficiencya. Diagnostic – noneb. Therapeutic – hydroxocobalamin 1000 mcg IM during this OV; start on 2mg oral B-12 daily; recheck Vitamin B-12 level in 2 to 3 monthsc. Educational – nutrition education on foods high in B-12d. Consultation/Collaboration – noneSample assignmentsNew Patient EncounterSOAP Note ReviewThis type of note is used in medical or psychological sectors by professionals whileworking with clients or patients. In the note provided, the patient presents a persistent rash as thechief complaint .The rash was first in the chest but has recently spread to the arms, and it is notitchy and painful. He has had Hypoglycemia in 2010 and an allergy to NKDA. He has nofrequent medications and occasionally uses OTC NSAIDS if he has minor pain .The new patientis married and smokes a packet per day, six-pack beer daily, and denies any chemical drugs use.His history indicates his father and mother, are deceased due to cardiac issues. His paternalgrandmother had Cardiac died at 78, and his grandfather also had a Stroke. His maternalgrandmother had diabetes type 2 and is 75. The review of systems reveals that has no issues withthe targeted aspects.His physical examination indicates a weight of 197, height 74.5 in, BMI 25.05 bloodpressure 130/86, and temperature at 98.9 PR 70 RR 18. The patient is alert and hashyperpigmented muscles on both arms. The head, eyes, ears, nose, and throat (HEENT)examination show normality in every aspect .The chest cavity, GU, lungs, abdomen, and otherdiagnostics do not indicate any abnormalities. He is diagnosed with Tinea Versicolor at B36.0and alcohol abuse at F10.10. His treatment plan involves Tinea versicolor Therapeutics in whichhe is to apply Ketoconazole 2% external shampoo on the affected skin for three days. The patientis enlightened about using the medication as prescribed and asked to report if the symptomspersist or worsen. The are no diagnostics for alcohol abuse, but he was educated on the risks oftaking alcohol while on medication and its effects on the liver and advised not to quit coldTurkey.Selection of CPT E&M CodeThe CPT E&M code to utilize in this scenario is 99201 since the encounter is with a newpatient and is likely to take 45 minutes (Babac, et al., 2019).This code is best since it covers theentire patient history and examination and moderates the medical decision-making process(Cohen, et al., 2020).Various diagnoses will be undertaken, and management options and thecomplexity of data involved is moderate, and the risk of complications is medium.This study source was downloaded by 100000769192234 from CourseHero.com on 11-07-2023 10:51:09 GMT -06:00https://www.ReferencesBabac, A., Von Friedrichs, V., Litzkendorf, S., Zeidler, J., Damm, K., & Graf von derSchulenburg, J. (2019). Integrating patient perspectives in medical decision-making: Aqualitative interview study examining potentials within the rare disease informationexchange process in practice. BMC Medical Informatics and DecisionMaking, 19(1). https://doi.org/10.1186/s12911-019-0911-zCohen, B. H., Busis, N. A., Villanueva, R., & Ciccarelli, L. (2020). Evaluation and ManagementCodes for Outpatient Neurology Services in 2021: Changes to 99202-99215. Continuum:Lifelong Learning in Neurology, 26(6), 1686-1697.This study source was downloaded by 100000769192234 from CourseHero.com on 11-07-2023 10:51:09 GMT -06:00https://www.coursehero.com/file/104575109/NEW-PATIENT-ENCOUNTERdocx/Powered byNew Patient EncounterThe comprehensive assessment and examination of patients with mental disorders differgreatly from the comprehensive assessment and examination of patients who are suffering fromphysical disorders. Mentally ill patients require extensive evaluation, detection of severity ofsymptoms, in-depth analysis of thought process, ideologies and perceptions. The implementationof tools, interview questions and evaluation of results are time consuming. All these componentsdemand adequate time investment of psychiatrist and if the patient is new then the analysis andevaluation takes more time as compared to those patients who came with established complains.Considering these facts, the CPT E&M code for this new patient is 99205. The provided readingresources for this module also indicated that the total time spent with a new patient should be 60to 74+ and therefore the designated code should be 99205. I have not selected other codesassociated with new patient encounter (that is, 99202, 99203 and 99204) because the presentedcase study is a complicated case that requires evaluation of depressive symptoms, their severityand severity of suicidal thoughts and ideation (Melnyk, 2020).The patient also reported that he desires to “give up the fight” which indicates that hepossesses thought processes related to suicides as he mentioned the presence of 22-caliber rifle athome and shared his feelings to end his life by using that rifle. Furthermore, patient is alsosuffering from physical disorders like prediabetes, sleep issues, fatigue and loss of appetite. Allof these symptoms indicate that the patient requires extensive evaluation and monitoring.Although, he is a new patient but the follow visits would also require the implementation of code99204 in order to continuously monitor improvement in symptoms and progress of disorder andtreatment. If the follow up visits for this patient requires implementation of 99204 code then it ismandatory to implement the code of 99205 to his first visit (Modrek, Hamad & Cullen, 2015).ReferencesMelnyk, B. M. (2020). Reducing healthcare costs for mental health hospitalizations with theevidence-based COPE program for child and adolescent depression and anxiety: A costanalysis.Journal of Pediatric Health Care,34(2), 117-121.Modrek, S., Hamad, R., & Cullen, M. R. (2015). Psychological well-being during the greatrecession: Changes in mental health care utilization in an occupational cohort.AmericanJournal of Public Health,105(2), 304-310.Response 1Hello Brittney,Each year, in the United States, healthcare insurers process over 5 billion claims forpayment. To ensure that healthcare data are captured accurately and consistently and that healthclaims are processed properly for Medicare, Medicaid, and other health programs, a standardizedcoding system for medical services and procedures is essential. The Current ProceduralTerminology (CPT) system, developed by the American Medical Association (AMA), is used forjust these purposes. The AMA system provides a standard language and numerical codingmethodology to accurately communicate across many stakeholders, including patients, themedical, surgical, diagnostic, and therapeutic services provided. The CPT descriptiveterminology and associated code numbers provide the most widely accepted medicalnomenclature used to report medical procedures and services for processing claims, conductingresearch, evaluating healthcare utilization, and developing medical guidelines and other forms ofhealthcare documentation (Pelech & Hayford, 2019).ReferencePelech, D., & Hayford, T. (2019). Medicare advantage and commercial prices for mental healthservices.Health Affairs,38(2), 262-267.Response 2Hello Lorilee,The Current Procedural Terminology (CPT) code set describes tests, evaluations,treatments, and other medical procedures used in the spectrum of healthcare. The set containsover 8,000 codes and is published and updated annually by the American Medical Association. Itwas created to track healthcare trends and issues as well to use in the claims submission process.The codes communicate to payers what procedures should need to be reimbursed for as aprovider. The codes related to mental health (codes 90785-90899) are found in the Psychiatrysection of the CPT code set and cover services provided by medical professionals, such aspsychiatrists, as well as services that can be delivered by non-medical professionals such aslicensed clinical psychologists, licensed professional counselors, licensed marriage and familytherapists, and licensed clinical social workers (Powell, Torous, Firth & Kaufman, 2020).ReferencePowell, A. C., Torous, J. B., Firth, J., & Kaufman, K. R. (2020). Generating value with mentalhealth apps.BJPsych Open,6(2).ClinicalDecision-MakingNU671.Unit2NewPatientEncounter.Due11-8-2.800w.4references..docxClinical Decision-Making NU671. Unit 2New Patient Encounter. Due 11-8-2. 800w.4 references.Initial ResponseInstructions:Consider the following questions in your initial discussion post:· Review the SOAP note accessed through this link.  For purposes of the assignment, the patient is a ‘new patient’ in the practice.·New Patient SOAP NoteDownload New Patient SOAP NoteDownload New Patient SOAP NoteInitial PostUse your lecture materials to determine what CPT E&M Code to utilize for this ‘new patient’ encounter.You may choose to assign the code based on the anticipated/guestimate amount of time the provider would spend with the patient in the encounter or you may choose to utilize the Medical Decision Making (MDM) approach. If you choose the MDM include the following information in your discussion:1. the level of history taking achieved – identify the history elements present2. the type of exam performed – identify the number of systems and bulleted points in the note3. the level of medical complexity encompassed – include # of points for a) diagnoses/management options, b) amount/complexity of data reviewed, and c) level of risk for complications, morbidity, mortalityPlease be sure to validate your opinions and ideas with citations and references in APA format.SOAP notes provided by the instructor for this assignmentChief Complaint:“I don’t know how much longer I can go on like this. I’ve been down in the dumps for years and it isn’t getting any better.”History of Present Illness:75-year-old white male present to clinic with above complaint. Lost his first, the “love of his life” wife 19 years ago. Remarried 2 years after her death and states he probably married again too soon reporting his current wife is difficult. He describes an instance, when he was at work, the second wife would not let his son, daughter-in-law and new grandbaby into his house to visit until he got home from work. The second wife also insisted that he no longer visit with his deceased wife’s family telling him ‘when you married me, you divorced that whole family’. Conversations with his wife about his concerns resulted in only short-term changes in her approaches and behaviors. Now his wife insists they sell the house he has lived in for 46 years. He reports that his memory and ability to make simple decisions have been deteriorating significantly over the last several months. His wife suggested he probably has Alzheimer’s and should go see his primary care provider about his memory issues. He reports that he engages with modest exercise daily, eats well but is waking up numerous times at night and is usually “up for good” by 5am. He blames his disrupted sleep pattern on his feeling of fatigue starting around 9am. He reports all these circumstances as contributing to his increased depression and his desire to “give up the fight”.PMH:reports usual childhood illnesses inclusive of measles, mumps and chickenpoxtraumatic injury, likely secondary to ‘blast’ effect, sustained during the bombing of Pearl Harbor where he was stationed as a cook; he suffered a hearing loss for six months after the bombing and was diagnosed at 54 with a rare eyes disorder resulting in poor peripheral vision that is thought to be secondary to this traumaFamily Hx:Father died at 67 secondary to colon cancer; mother died at 24 secondary to influenza during an epidemic (he was 2 years old at that time)No know family history of depression or other mental illnessSocial Hx:HS graduate, married to HS sweetheart for 27 years then widowedCurrent marriage of 17 yearsRetired after 25-year banking careerAttends Catholic mass regularlyDrinks 1-2 beers several times a week, denies episode of intoxication; never smoked or used illicit drugsDrinks hot tea, reporting coffee causes too much GI distressNever driven a motor vehicle secondary to poor peripheral visionROS:Denies HA, body aches, dizziness, fainting spells, tinnitus, ear pain, ear discharge, nasal congestion, diarrhea, constipation, change in appetite skin abnormalities, or genitourinary symptomsDenies periods of extreme irritability or elation associated with periods of sadness; denies feeling more depressed during the winter months than other seasonsReports fatigued most of the time, often feels stiffness in his neck and shouldersDenies homicidal ideations, hallucinations, paranoia or delusionsReports suicidal thoughts, has a 22-caliber rifle at home and has considered using to end his lifeSIGECAPS:Reports - poor sleep maintenance, loss of pleasure, he feels as though he remarried too soon, he is experiencing fatigue, he is experiencing memory disturbances, eating well, no problems maintaining exercise regimen, is having suicidal ideationsMedications:No routine medicationsAllergies:NonePhysical Examination:Constitutional – BP 118/73, P 83, RR 16, T 98.8, Ht 71 in, Wt 174 lbs, BMI 24Integument – skin, hair and nails unremarkableHEENT – PERRLA, EOMs intact, nares patent without discharge noted, TMs gray and shiny bilateral, numerous silver amalgams notedNeck – supple without adenopathy, no thyromegalyLungs – CTAHeart – RRR without murmur/gallopAbdomen – soft, non-distended, active bowel sounds, non-tender, no organomegalyGenitalia/Rectum – deferredMusculoskeletal – no gross abnormalities or major limitations of ROM notedNeurologic – CNs II-XII intact, finger-to-nose test negative, DTRs 2+ and equal bilateral, sensory capacity intact upper and lower extremities intact bilateralMental status – PHQ 9 score is 19Diagnostics – Na 138 meq/L, K 4.2 meq/L, Cl 102 meq/L, HCO3 27 meq/L, Bun 11 mg/dL, Cr 0.9 mg/dL, fasting Glu 106 mg/dL, Ca 9.5 mg/dL, Mg 1.8 mg/dL, AST 34 IU/L, ALT 42 IU/L, GGT 38 IU/L, Alb 4.4 g/dL,TSH 2.8, Vit B12 98 pg/mL, Folic acid 333 ng/mL, PSA 4.9 ng/mL, Hgb 14.3 g/dL, HCT 41.4 %Urine dipstick – 5.8 pH, SG 1.016, all other parameters negativeAssessment:1. F32.1 Major depressive disorder, single episode, moderate2. R45.851 Suicidal ideations/thoughts3. R73.03 Prediabetes4. E53.9 Vitamin B deficiencyPlan:1. Major depressive disordera. Diagnostic – noneb. Therapeutic – citalopram 20mg take 1 by mouth daily dispense #30 with 2 refillsc. Educational – effects of citalopram may not be fully evident for up to 3 or 4 weeks; if you note fatigue exacerbated from the citalopram take it at bedtime; RTC in 1 month for follow upd. Consultation/Collaboration – none2. Suicidal ideations/thoughtsa. Diagnostic – noneb. Therapeutic – same as diagnosis #1c. Educational – same as diagnosis #1; educate on the potential negative impact of his current intake of beer – educate on how to safely reduce this consumption and to avoid abrupt cessation; educate on need to remove the 22-caliber rifle from his home; provide information on suicide hot linesd. Consultation/Collaboration – referral for counseling3. Prediabetesa. Diagnostic – noneb. Therapeutic – nonec. Educational – nutrition education aimed at making dietary lifestyle choices of low glycemic index foods (<55 GI) that aid in development and maintenance of stable insulin and glucose levelsd. Consultation/Collaboration – none4. Vitamin B deficiencya. Diagnostic – noneb. Therapeutic – hydroxocobalamin 1000 mcg IM during this OV; start on 2mg oral B-12 daily; recheck Vitamin B-12 level in 2 to 3 monthsc. Educational – nutrition education on foods high in B-12d. Consultation/Collaboration – noneSample assignmentsNew Patient EncounterSOAP Note ReviewThis type of note is used in medical or psychological sectors by professionals whileworking with clients or patients. In the note provided, the patient presents a persistent rash as thechief complaint .The rash was first in the chest but has recently spread to the arms, and it is notitchy and painful. He has had Hypoglycemia in 2010 and an allergy to NKDA. He has nofrequent medications and occasionally uses OTC NSAIDS if he has minor pain .The new patientis married and smokes a packet per day, six-pack beer daily, and denies any chemical drugs use.His history indicates his father and mother, are deceased due to cardiac issues. His paternalgrandmother had Cardiac died at 78, and his grandfather also had a Stroke. His maternalgrandmother had diabetes type 2 and is 75. The review of systems reveals that has no issues withthe targeted aspects.His physical examination indicates a weight of 197, height 74.5 in, BMI 25.05 bloodpressure 130/86, and temperature at 98.9 PR 70 RR 18. The patient is alert and hashyperpigmented muscles on both arms. The head, eyes, ears, nose, and throat (HEENT)examination show normality in every aspect .The chest cavity, GU, lungs, abdomen, and otherdiagnostics do not indicate any abnormalities. He is diagnosed with Tinea Versicolor at B36.0and alcohol abuse at F10.10. His treatment plan involves Tinea versicolor Therapeutics in whichhe is to apply Ketoconazole 2% external shampoo on the affected skin for three days. The patientis enlightened about using the medication as prescribed and asked to report if the symptomspersist or worsen. The are no diagnostics for alcohol abuse, but he was educated on the risks oftaking alcohol while on medication and its effects on the liver and advised not to quit coldTurkey.Selection of CPT E&M CodeThe CPT E&M code to utilize in this scenario is 99201 since the encounter is with a newpatient and is likely to take 45 minutes (Babac, et al., 2019).This code is best since it covers theentire patient history and examination and moderates the medical decision-making process(Cohen, et al., 2020).Various diagnoses will be undertaken, and management options and thecomplexity of data involved is moderate, and the risk of complications is medium.This study source was downloaded by 100000769192234 from CourseHero.com on 11-07-2023 10:51:09 GMT -06:00https://www.ReferencesBabac, A., Von Friedrichs, V., Litzkendorf, S., Zeidler, J., Damm, K., & Graf von derSchulenburg, J. (2019). Integrating patient perspectives in medical decision-making: Aqualitative interview study examining potentials within the rare disease informationexchange process in practice. BMC Medical Informatics and DecisionMaking, 19(1). https://doi.org/10.1186/s12911-019-0911-zCohen, B. H., Busis, N. A., Villanueva, R., & Ciccarelli, L. (2020). Evaluation and ManagementCodes for Outpatient Neurology Services in 2021: Changes to 99202-99215. Continuum:Lifelong Learning in Neurology, 26(6), 1686-1697.This study source was downloaded by 100000769192234 from CourseHero.com on 11-07-2023 10:51:09 GMT -06:00https://www.coursehero.com/file/104575109/NEW-PATIENT-ENCOUNTERdocx/Powered byNew Patient EncounterThe comprehensive assessment and examination of patients with mental disorders differgreatly from the comprehensive assessment and examination of patients who are suffering fromphysical disorders. Mentally ill patients require extensive evaluation, detection of severity ofsymptoms, in-depth analysis of thought process, ideologies and perceptions. The implementationof tools, interview questions and evaluation of results are time consuming. All these componentsdemand adequate time investment of psychiatrist and if the patient is new then the analysis andevaluation takes more time as compared to those patients who came with established complains.Considering these facts, the CPT E&M code for this new patient is 99205. The provided readingresources for this module also indicated that the total time spent with a new patient should be 60to 74+ and therefore the designated code should be 99205. I have not selected other codesassociated with new patient encounter (that is, 99202, 99203 and 99204) because the presentedcase study is a complicated case that requires evaluation of depressive symptoms, their severityand severity of suicidal thoughts and ideation (Melnyk, 2020).The patient also reported that he desires to “give up the fight” which indicates that hepossesses thought processes related to suicides as he mentioned the presence of 22-caliber rifle athome and shared his feelings to end his life by using that rifle. Furthermore, patient is alsosuffering from physical disorders like prediabetes, sleep issues, fatigue and loss of appetite. Allof these symptoms indicate that the patient requires extensive evaluation and monitoring.Although, he is a new patient but the follow visits would also require the implementation of code99204 in order to continuously monitor improvement in symptoms and progress of disorder andtreatment. If the follow up visits for this patient requires implementation of 99204 code then it ismandatory to implement the code of 99205 to his first visit (Modrek, Hamad & Cullen, 2015).ReferencesMelnyk, B. M. (2020). Reducing healthcare costs for mental health hospitalizations with theevidence-based COPE program for child and adolescent depression and anxiety: A costanalysis.Journal of Pediatric Health Care,34(2), 117-121.Modrek, S., Hamad, R., & Cullen, M. R. (2015). Psychological well-being during the greatrecession: Changes in mental health care utilization in an occupational cohort.AmericanJournal of Public Health,105(2), 304-310.Response 1Hello Brittney,Each year, in the United States, healthcare insurers process over 5 billion claims forpayment. To ensure that healthcare data are captured accurately and consistently and that healthclaims are processed properly for Medicare, Medicaid, and other health programs, a standardizedcoding system for medical services and procedures is essential. The Current ProceduralTerminology (CPT) system, developed by the American Medical Association (AMA), is used forjust these purposes. The AMA system provides a standard language and numerical codingmethodology to accurately communicate across many stakeholders, including patients, themedical, surgical, diagnostic, and therapeutic services provided. The CPT descriptiveterminology and associated code numbers provide the most widely accepted medicalnomenclature used to report medical procedures and services for processing claims, conductingresearch, evaluating healthcare utilization, and developing medical guidelines and other forms ofhealthcare documentation (Pelech & Hayford, 2019).ReferencePelech, D., & Hayford, T. (2019). Medicare advantage and commercial prices for mental healthservices.Health Affairs,38(2), 262-267.Response 2Hello Lorilee,The Current Procedural Terminology (CPT) code set describes tests, evaluations,treatments, and other medical procedures used in the spectrum of healthcare. The set containsover 8,000 codes and is published and updated annually by the American Medical Association. Itwas created to track healthcare trends and issues as well to use in the claims submission process.The codes communicate to payers what procedures should need to be reimbursed for as aprovider. The codes related to mental health (codes 90785-90899) are found in the Psychiatrysection of the CPT code set and cover services provided by medical professionals, such aspsychiatrists, as well as services that can be delivered by non-medical professionals such aslicensed clinical psychologists, licensed professional counselors, licensed marriage and familytherapists, and licensed clinical social workers (Powell, Torous, Firth & Kaufman, 2020).ReferencePowell, A. C., Torous, J. B., Firth, J., & Kaufman, K. R. (2020). Generating value with mentalhealth apps.BJPsych Open,6(2).Bids(77)Miss DeannaDr. Ellen RMMISS HILLARY A+abdul_rehman_Emily ClareProf Double RDoctor.NamiraProWritingGuruYoung NyanyaJahky BSheryl HoganDr. Adeline ZoeDr M. MichelleAshley Elliesherry proffTutor Cyrus KenWIZARD_KIMgrA+de plusPremiumPROF_ALISTERShow All Bidsother Questions(10)History For Academic research proPPS SamplingdeletedHCS 325 Effective Communication Paper Week 6EssayUnit 5 Response NeededDue 9pm Central TimeWeek 1 Assignment Post Your Introductionarticle dqhttps://www.coursehero.com/file/15230336/training-assignmentdocx/

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