Wed. May 8th, 2024

Medical Economics had this very uninteresting article recently called Advance care planning coding: answers to common questions. Why mention it to you on a DPC site? Well, I just wanted to highlight what you are missing out on by leaving the FFS system.

 Practitioners are advised to consult their Medicare Administrative Contractors (MACs) regarding documentation requirements. While CMS has not issued specific requirements, it has suggested the following as examples of appropriate documentation:

– an account of the discussion with the beneficiary (or family members and/or surrogate) regarding the voluntary nature of the encounter;

– documentation indicating the explanation of advance directives (along with completion of those forms, when performed);

– who was present; and

Got it? But wait, there are more questions they go over:

  • Can I report code 99497 for advance care planning (ACP) when the time of service is 20 minutes rather than the 30 minutes listed in the code descriptor?
  • Can ACP codes be billed on the same date as an annual wellness visit (G0438 or G0439)?
  • Can the ACP codes be used with other Evaluation and Management (E/M) codes?

There are at least ten more questions in the article. Each one makes you care less and less about this whole process.

Now, imagine not having to do any of this crap? You would do the advance care planning because it is right for the patient and not to make third parties happy.

This is direct primary care.

102110cookie-checkThings You Will Never Have to Care About Again if You Do Direct Primary Care
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By Douglas Farrago, MD

Douglas Farrago MD is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Douglas Farrago, MD received his Bachelor of Science from the University of Virginia in 1987, his Masters of Education degree in the area of Exercise Science from the University of Houston in 1990, and his Medical Degree from the University of Texas at Houston in 1994. His residency training occurred way up north at the Eastern Maine Medical Center in Bangor, Maine. In his final year, he was elected Chief Resident by his peers. Dr. Farrago has practiced family medicine for twenty-three years, first in Auburn, Maine and now in Forest, Virginia. He founded Forest Direct Primary Care in 2014, which quickly filled in 18 months. Dr. Farrago still blogs every day on his website Authenticmedicine.com and lectures worldwide about the present crisis in our healthcare system and the effect it has on the doctor-patient relationship. Dr. Farrago’s has written three books on direct primary care: The Official Guide to Starting Your Own Direct Primary Care Practice, The Direct Primary Care Doctor’s Daily Motivational Journal and Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) are all best sellers in this genre. He is a leading expert in direct primary care model and lectures medical students, residents, and doctors on how to start their own DPC practice. He retired from clinical medicine in October, 2020.

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