patient care pathway
TRANSCRIPT
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PATIENT CARE
PATHWAY
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TABLE OF CONTENTS
Contents lntroduction ..... ........... ...... ............ ...... ............ ........... ...... ............ ...... ............ ...... ........... ............ ...... ............ . 4
Part 1 ..... ............ ........... ...... ............ ...... ............ ...... ........... ............ ...... ............ ...... ........... ....... ..... ...... ............ . 5
I. Admission ........... ............ ...... ............ ...... ..... ...... ............ ...... ............ ...... ............ ........... ...... ............ . 6
II. First Admission Consult .... ............ ........... ...... ............ ...... ............ ...... ........... ............ ...... ............ . 6
Ill. Second Consult - one week after the first consult .... ............ ...... ..... ....... ........... ...... ............ . 6
IV. First six weeks .... ............ ...... ..... ....... ........... ...... ............ ...... ............ ........... ...... ............ ...... ........... .. 7
V. Ongoing care ...... ............ ...... ..... ....... ........... ...... ............ ...... ............ ........... ...... ............ ...... ............ . 7
VI. Table of proactive care ....... ............ ...... ..... ....... ........... ...... ............ ...... ............ ........... ...... ............ . 8
VII. Summary of annual proactive Patient Care Pathway ............ ...... ............ ...... ........... ............ . 9
Part 2 ..... ............ ...... ............ ...... ........... ............ ...... ............ ...... ..... ....... ........... ...... ............ ...... ............ .......... 10
RACF attendance items ...... ..... ...... ............ ...... ............ ........... ...... ............ ...... ............ ...... ........... ........... 11
I. In hours attendances .......... ............ ...... ............ ...... ..... ...... ............ ...... ............ ...... ............ .......... 11
II. After-hours Services ..... ...... ............ ...... ............ ........... ...... ............ ...... ............ ................. ........... 12
Chronic disease management. ....... ........... ...... ............ ...... ........... ............ ...... ............ ...... ............ ...... .... 15
I. Care plan contributions ...... ........... ...... ............ ...... ........... ............ ...... ............ ...... ............ ...... .... 15
II. Comprehensive medical assessments (CMA) ............. ...... ..... ...... ............ ...... ............ ...... .... 16
Ill. GenWise CMA template ...... ...... ........... ............ ...... ............ ...... ..... ....... ........... ...... ............ ...... .... 17
IV. Medication management .... ...... ............ ...... ............ ........... ...... ............ ...... ........... ............ ...... .... 18
V. GP multidisciplinary case conferences .. ..... ...... ............ ...... ............ ........... ...... ............ ...... .... 19
VI. Common procedural items ....... ..... ...... ............ ...... ............ ........... ...... ............ ...... ............ ...... .... 20
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Part 1 A step-by-step care pathway for patients residing in Residential Aged Care
Facilities
Part 2 A desktop guide to frequently used MBS item
numbers in Residential Aged Care Facilities
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Introduction GenWise is dedicated to supporting health professionals deliver quality care to residents in Aged Care Facilit ies. Patients in Aged Care Facilit ies are some of the most vulnerable members of the community. A high proportion have chronic, complex conditions and co-morbidities. Co-ordinating their care in a timely and effective manner can be challenging.
It is essential to hold in mind that the priority of this guide, and of our work in Residential Aged Care Facilities, is our patients and their care. Holding that humanity at front of mind, when delving into details of process and MBS Item numbers, can be challenging and will be highlighted through-out this guide.
The MBS provides rebates for providing important elements in the provision of quality care for patients residing in aged care facilities. They can provide a template for planned activities which have been shown to significantly improve patient outcomes.
There are increased opportunities for improving quality of care for residents by all members of the multidisciplinary team. Australian Government initiatives provide for general practit ioners to carry out comprehensive medical assessments and contribute to residents' care plans. There is also provision for residential medication management reviews, and referrals to allied health and dental services. Advance care planning and access to new models for end of life care are also included; stressing the importance of the involvement of the resident, their family, and residential aged care facility staff. This guide encourages collaboration between health professionals and provides suggestions for implementing systematic care involving you as the GP, residents, residential aged care facility staff, families and other carers.
The case for integration across the sector is now stronger than ever before, with a necessary focus on better coordinated management of chronic and complex conditions in a strengthened primary healthcare sector. This guide supports integrated models of care that include general practice and other private providers.
Regulatory bodies will use your cl inical notes to determine the care you provide. Your cl inical notes must be a true account of the consultation and also record any communication you have with family members or other health professionals. Regulatory bodies will conclude that if it is not in the patient cl inical notes then it did not happen. Your cl inical notes must satisfy AHPRA requirements and the MBS Item requirements. AHPRA requirements for medical records is contained in Section 8.4 of Good Medical Practice: a code of conduct for doctors in Australia, available here: https://www.medicalboard.qov.au/codes-guidelines-policies/code-ofconduct.aspx.
For a comprehensive explanation of each MBS Item Number, please refer to the Medicare Benefits Schedule online at www.mbsonline.gov.au
Dr Troye Wallett Dr Umberto Russo
Clinical Manager - Gen Wise Health Chief Medical Officer- 24-7 Healthcare
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Part 1
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A step-by-step care pathway for patients residing in residential aged care
facilities
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Annual Patient Care Pathway
I. Admission
Change is stressful and when a patient moves into a RACF, they will be overwhelmed and stressed. The level of stress will depend on the patient. Accordingly, when you meet them for the first time it is best to move slowly and spread out assessments in the fi rst few weeks. The added benefit of this is that you get to know the patient over t ime which builds rapport.
II. First Admission Consult
In this consult, the priority is to get a brief medical history from the patient, their family or the paperwork that comes with them. The RACF will need the drug chart completed. It is an opportunity to review the patient's medications and consider ongoing care.
Actions:
1. Introduce yourself to the patient. 2. Get a medical history. 3. Ask the patient if there are any medical problems they would like addressed. 4. Fill in the drug chart from information from the patient or their paperwork. 5. Arrange a review in a week to complete CMA and the CP. 6. Arrange a Case Conference with the family.
MBS Billing item:
1. Attendance Item based on time: 90035 (level B) or 90043 (Level C) or 90051 (Level D).
Ill. Second Consult - one week after the first consult
With this consult the focus is on proactive care and planning. Address the patient to discuss their ongoing care and address any issues that have arisen. It is during this consult that you should spend time with the patient and gather the information for the CMA. Completing the CMA after the Family meeting is advised as there will be information gathered in the conference that is necessary for the CMA. See later for a guide on completing the CMA. Review the RACF Care Plan and prepare your Contribution.
Actions: • Address any issues that have arisen. • Start the CMA. • Do the CP. • Refer to the pharmacist for RMMR.
MBS Billing item: • Attendance item if appropriate: 90035 (level B) or 90043 (Level C) or 90051 (Level D). • Care Plan: 731
(Note. If the consult is only about gathering information for the CMA and the CP, an attendance item will be inappropriate.)
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IV. First six weeks
Case Conferences are incredibly valuable as it allows the team to discuss continuing and best care. Involving the family is vital for communication and their confidence. In the Case Conference discuss best care, review the medications and discuss advanced care directives. (see later for a guide on ACDs).
Having spent t ime with the patient and then following with the case conference will give all the information needed to complete the CMA.
MBS Billing Items: • Case Conference depending on t ime: 747, 750, 758. • CMA depending on time: 701, 703, 705, 707
V. Ongoing care
Ongoing care can be thought of as proactive and reactive. Reactive care is responding to requests from the patient or the RACF staff. It will be to manage acute issues as they arise and can be subdivided into urgent, acute and subacute issues.
Proactive care involves regular scheduled consultations for each resident. This may be monthly to 3 monthly depending on the care needs of the resident. The table below provides a guide to residents with high needs and moderate needs.
High Needs Moderate Needs
Dementia Mood diagnosis
BPSD Involved family member
3 or more systems diagnosis Early dementia
Very involved family with demands Frequent falls
Polypharmacy of more than 6 meds Unstable medical condit ion
3 problems in moderate needs
On an opiate
On an antipsychotic
Proactive care is preventative care in action. It is tailored to the patient and includes assessments and management of chronic diseases. Some proactive care will be disease related, i.e. diabetes management, and some with be relevant to all patients over 80 years old.
Activities conducted as part of the proactive care of a patient is highlighted on the CMA and scheduled into the annual care plan for the patient.
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VI. Table of proactive care
The table below outlines proactive activit ies which can be allocated to your scheduled revues throughout the year. High needs patients may need to be seen monthly or even fortnightly. Moderate needs patients may need to be seen monthly. Low needs patients may need to be seen only 3 monthly.
[resource: https://www.aihw.qov.au/reports/hospitals/hospital-care-for-patients-aged-85-and-over-201 4/contents/summarv/for-what-conditions-did-patients-aged-85-and-over-receive-carel
Proactive activity Further information
Frailty and Falls Includes Wt review
Mood GOS
BPSD review NLP
Cognitive review RUDAS, MMSE
Diabetic review 3 monthly or 6 monthly. Based on recommendations.
Metabolic review Blood test, done annually. Anemia is a cause of hospital admission.
Cardiovascular BP, risk factors, exercise
Pulmonary Pulmonary Function Test
Medication Review Medication reviews done 24 weekly or 6 monthly. Triggered by drug chart.
Influenza and Planned for March/April when the vaccines become available Pneumovacc
Quality of Life Scored and assessed.
Pain assessment Monthly if on opiate or 6 monthly.
Advanced Care Annual check Directive
These proactive activities are important in the context of the leading causes of total burden among those aged 75 and over as outlined in the table below. It would be useful to target one of the activities listed in the table above each month as part of scheduled care.
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VII . s ummary o f annua f proac 1ve pf a1en tC are
Action MBS Items What the doctor does summary applicable*
On Drug chart Attendance Item Introduces themselves to admission depend ng on t me the patient.
Heath summary taken Reviews the medications
90035 - Leve B and does the drug chart. 90043 - Leve C
1 week after Contr but on to 731 Receives prepared Care admission Care Pan Plan or completes
themselves
Famy Case conference Attends and documents meet ng/case Item based on t me the CC. conference 747, 750, 758
CMA CMA Item Receives prepared CMA
Within first depend ng on t me from RN or completes
6weeks taken themselves
701, 703, 705, 707
RMMR 903 Doctor does pharm referral and reviews the RMMR.
Regu ar rev ew Attendance Item Attends monthly of ACF pat ent depend ng on t me schedules consult for
Monthly wth add tona taken preventative care, visits spec f c focus assisted by RN
each month on 90035 - Leve B an annua zed 90043 - Leve C pan
3 monthly Contr but on to 731 Reviews care plan and Care Pan finalises
24Weekly Med cat on Attendance consu t Reviews medication, revew drug charts and scripts
Annually CMA 701, 703, 705, 707 Reviews CMA and finalises
Case 747, 750, 758 Arranged by RN with conference doctor
Every 2 RMMR 903 Reviews and replies to years RMMR.
*MBS App cab e Items see Charts be ow for more deta on MBS Items •• RN ava ab ty may vary from state to state
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p th a way
What GW Reception What GW nurse does does**
Obta ns pat ent f es, Update patent up oads to system and notes. Contact nks pat ent GW PCP tam y about
(and RN f ava ab e) GenWse.
GW sets up rem nders Start Care Pan and every 3 months. Books CMA. the pat ent onto appo ntment st ReferRMMR
Ass sts n schedu ng Arrange t me for CC w th RN and Doctor case conference
Hands over CMA to doctor.
Sets rem nder for CMA annua y
Sets up a reca s
Books n the regu ar ldentf es schedu ed month y preventat ve care appo ntments for su tab e for pat ent. preventat ve care Creates
preventat ve care p an and focus for each month
Prepares doctor care pan
GW sets up rem nders
Prepares doctor CMA
Ind cated by pat ent compexty
Arranges referra for RMMR
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Part 2
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A desktop guide to frequently used MBS item
numbers in residential aged care facilities
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RACF attendance items
The RACF attendance Items can be split into in-hours attendance items, after-hours attendance items and Bulk bill incentive items.
I. In hours attendances
MBS Attendance Items are to be used for any attendance where patients are directly addressed within an aged care facility. MBS attendance items are based on clinically relevant time (except Level A consults) and content. The MBS rebate is dependent on the number of patients seen at the same location on the same occasion. The following two tables summarise attendance items by type and benefits.
Standard RACF Consultations-in hours
Level A - 90021 Level B - 90035 Level C - 90043 Level D - 90051
Obvious and Consultation lasting less Consultation lasting at Consultation lasting at straightforward cases than 20 minutes for least 20 minutes for cases least 40 minutes for cases
and this should be cases that are not in relation to one or more in relation to one or more reflected in the obvious or health related issues. health related issues.
practitioner's records. In straightforward in The medical practitioner The medical practitioner this context, the relation to one or more may undertake all or some may undertake all or some
practitioner should health related issues. of the tasks set out in the of the tasks set out in the undertake the The medical practitioner item descriptor as clinically item descriptor as cl inically
necessary examination may undertake all or relevant, and this should relevant, and this should of the affected part if some of the tasks set be reflected in the be reflected in the
required, and note the out in the item practitioner's record. practitioner's record. action taken (less than descriptor as clinically
5 minutes). relevant, and this should be reflected in the
practit ioner's record.
Medicare pays a Flag Fall amount when you visit an Age Care Facility. When you bi ll your first pat ient
at a facility add 90001 to your billing. For example, if you see a patient and bi ll for a level B, you would bill 90035 for t he level Band 90001 for the Flag Fall.
Other useful information
Patients with a OVA Gold card attract OVA rebates. The rebate for Veterans Affairs patients is 15% higher than the equivalent rebate from Medicare. The item numbers used are the same as those for Medicare - only the benefit payable differs. Veteran's Affairs also provides a travel allowance; they will pay 76 cents per kilometre (km) after the first km's travelled. When updating your billing it is important to state the km's travelled, which is km's travelled from your base to the site and back. If more than one patient is being seen at the site, then this is only claimable on the fi rst patient.
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II. After-hours Services The following table provides a summary of MBS Items for after-hours services.
Urgent after-hours attendances
1. These items can only be used for the first patient, if more than one patient is seen on the one occasion, standard (non- urgent) after hours items apply.
2. The urgent after-hours items can only be used where the patient has a medical condition that requires urgent assessment, which could not be delayed until the next in-hours period.
3. The request for attendance MUST be made during the after-hours period and the attendance must be during the same after hours period as the request.
MBS Attendance Period Item Payment
No
Urgent attendance - after hours
Mon- Fri Sat Sun & Pub
7 - Sam or 7 - Sam or Holidays
5S5 $129.SO 6 - 11pm 12noon -
7am - 11pm
11pm
Urgent attendance - unsociable hours
Mon- Fri Sat Sun & Pub
11pm - Holidays 11 599 $153.00
?am 11 pm - pm - ?am ?am
Sat Mon- Fri
Before Sam Sun & Pub
Before Sam or after
Holidays All or after 6pm
12pm day
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Non urgent after-hours attendances
As for in-hours, Levels A to D apply. The only difference is the MBS Item used, the fee derived and the time these items can be claimed.
Time of attendance MBS Item Fee Notes
Mon - Fri Before Sam or after 6pm Level A· 5010 75.70 For multiple patients seen at the 1 location
Level B • 5028 95.70 on the same occasion
Sat • Before Sam or after 12pm Level C • 5049 130.65 see table below.
Level D • 5067 164.45 Sun & Pub Holidays All day
When multiple patients are seen at the same location on the same occasion, the following table provides a summary of item numbers and fees:
ACF Visit Item Numbers
Level A LevelB Level C LevelD
Item No. Rebate Item No. Rebate Item No. Rebate Item No. Rebate
5010/1 $75.70 5028/1 $95.70 5049/1 $130.65 5067/1 $164.45 5010/2 $52.35 5028/2 $72.35 5049/2 $107.30 5067/2 $141 .10 5010/3 $44.55 5028/3 $64.55 5049/3 $99.50 5067/3 $133.30 5010/4 $40.65 5028/4 $60.65 5049/4 $95.60 5067/4 $129.40 5010/5 $38.35 5028/5 $58.35 5049/5 $93.30 5067/5 $127.10 5010/6 $36.80 5028/6 $56.80 5049/6 $91 .75 5067/6 $125.55 5010/7 $32.30 5028/7 $52.30 5049/7 $87.25 506717 $121 .05
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Bulk bill incentives
Bulk bill incentive items can be rendered in addition to Medicare consultation items and a summary of their use is provided in the table below:
Bulk Bill Incentives
Management of bulk billed services Provision of unreferred services
Medical Services MBS Item 10990; MBS Item 10991 (Eligible areas); MBS Item 10992 (After
Service type hours) Diagnostic Imaging
MBS Item 64990; MBS Item 64991 (Eligible area) Pathology Services
MBS Item 74990; MBS Item 74991 (Eligible area)
Eligibility Criteria For all clients under the age of 16 or for Commonwealth concession card
Ensure patient I client holders who are not admitted patients of a day hospital or day care facility, and eligibility provided from a practice location in either any or an eligible area. Refer to
the Medicare Benefits Scheme website for a comprehensive list of eligible areas.
Service requirements The service must be bulk billed and then the bulk billing incentive item can be
claimed in conjunction with it. The bulk billing incentive must also be bulk billed.
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Chronic disease management
I. Care plan contributions
Care plans are a helpful reminder for recurring actions such as 3 monthly blood tests or weight checks. The important difference to office Care Plans (item 721 or 732) is that the RACF Care Plan is billed 731 and is a contribution to a care plan. The significance of this is that you can bill a 731 and a consult on the same day. You also do not need to see the patient but do need to view the Residential Aged Care Facility care plan.
The other major difference is that you cannot bill a team care arrangement or a review (item 732) for RACF patients.
The template for Care Plans is on Best Practice. It is called Care Plan RACF.
Medicare requirement for a GP contribution to an RACF care plan (RACF care plan)
1. The resident has at least one chronic medical condition. 2. Ongoing management by at least 3 collaborating health care providers who offer a different service. You
are one of them. The RN will be another and there is always going to be an OT, podiatrist or physio involved.
Doing a RACF care plan for the first time
1 . Open the patient records 2. Check that the Past History in the patient tree is up to date. 3. Click on Correspondence Out in the tree on the left and select Care Plan RACF. 4. If this is the first time you have used templates see the GenWise Info Sheet called Using Templates for
help setting up your templates. 5. The template that comes up will seem very empty. But will have a table to fill in. We have set up
keyboard Auto-fills to populate the care plans. See the list of diagnoses and the shortcuts at the end of this instruction sheet. Type the shortcut into a box and it will fill it in. Do this for every diagnosis.
6. Print the document by clicking on the Printer icon at the top right. 7. Remember to bill 731. 8. Set a reminder on your to-do app to repeat the Care plan in 3 months.
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Three month reviews
1. Reviews can be done every 3 months. To review the care plan, select the Care Plan document in the Correspondence Out tab and cl ick Edit.
2. Change the date to today's date. Review any actions.
3. Update your to-do list to remind you do repeat the Care Plan in 3 months
Initial care plan completed by ACF. Then we provide regular contributions to the care plan
Chronic Disease Management
Item Name $ Description I Recommended Frequency
GP contribution to, or review of, a multidisciplinary care GP contribution to, or plan prepared by RACF, at the request of the facil ity, for
Review of, patients with a chronic or terminal condition and complex Multidisciplinary Care needs requiring ongoing care from a team including the
731 Plan prepared by RACF $70.40 GP and at least 2 other health or care providers. Not more than once every 3 months.
II. Comprehensive medical assessments (CMA)
CMAs are an integral part of working in Residential Aged Care Facilities. CMAs are different to 75-year-old health checks in that there are fewer criteria and it allows far more autonomy. Your CMAs can be modified to collect the information that is important to you and your patient.
CMA criteria 1. Obtain and record patient consent 2. Take a patient history 3. Review medical conditions 4. Review physical, psychological and social function 5. Initiating interventions and referrals as indicated 6. Providing a comprehensive preventive health care management plan for the patient
The CMA must include 1. A written summary of the CMA 2. A list of diagnoses and medical problems 3. Providing a copy of the summary to the residential aged care facility 4. Offering the resident a copy of the summary
If you fill in all the sections of the Gen Wise CMA template you will have met the criteria.
Considerations 1. The information collected in CMAs can be adjusted as you like. Some doctors focus on Quality of Life
questions, others frailty and others cognition etc. 2. The time that you spend on a CMA is cost effective compared to billing a consult. ($4.48 per minute for
60mins versus $3.71 if you spend 10mins and bill a level B.) 3. The rapport that is gained when doing CMAs is invaluable. 4. It is worth doing CMAs that take 30mins. The dollar per minute billing rate is still excellent billing a 30min
CMA. ($4.60 per minute)
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Ill. GenWise CMA template
The GenWise CMA template is called CMA Best. See our Using Templates guide to find out how to add it to your favourites. It is designed to guide your CMA and you will be able to adjust it to your needs.
If you have a CMA template that you would prefer to use, feel free to add it to Best Practice (instruction sheet on Using Templates will advise how to do this) or send it to us and we will do it for you.
CMA/Health Assessments
Item Name $ Description I Recommended Frequency
701 Brief Health Assessment $59.35 Lasting no more than 30 minutes
703 Standard Health $137.90
> 30-44 minutes - see MBS for complexity of Assessment care requirements
705 Long Health Assessment $190.30 > 45 - < 60 minutes - see MBS for complexity of care requirements
707 Prolonged Health $268.80
> 60 minutes - see MBS for complexity of Assessment care requirements
Aboriginal and Torres Strait
715 Islander Health Assessment
$212.25 Not t imed
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IV. Medication management
Medication reviews are an important part of patient care. The review is not only good for the patients but is good for learning. The pharmacist is normally contracted by the RACF and so you will not be able to choose your own. It is recommended that every resident gets a RMMR on admission and annually if there are significant changes to the condition of the patient or the medications that they are taking change.
Requirements
1. Consent from the patient. 2. Collaborate with pharmacist providing CMA or clinical information. A referral letter is often adequate. 3. If changes are recommended in the RMMR, there should be a conversation with the pharmacist. This can
be face to face or by telephone. 4. Post review discussion NOT necessary when: no recommended changes, minor changes, issues require
a case conference. 5. Document findings, strategies, actions of implementation and follow up, develop or review medication
plan. 6. Finalise plan with patient - offer copy of plan 5. Copy of the plan in notes 6. Discuss plan with nursing staff
RM MRS
During the CMA get consent for the RMMR. Refer the patient to the Pharmacist using the normal referral template. Give the RACF nursing staff your referral to forward to the Pharmacist.
Upon getting the RMMR, use the RMMR Reply template to document your comments on the RMMR. (This fills the documentation and the Medicare criteria.)
Add any recurring actions from the RMMR to the patients Care Plan i.e. check renal functions or digoxin levels. Advise the patient and the faci lity nurse of any changes.
Most commonly the changes are minor and you will not need to discuss them with the pharmacist. However, if the changes are major, call them or arrange a case conference.
It is important to discuss any changes or comments by the Pharmacist with the patient.
Medication Management
Item Name $ Description I Recommended Frequency
For permanent residents of Residential Aged Residential Medication Care Facilities who are at risk of medication Management Review
$106.00 related misadventure. Performed in collaboration
903 (RMMR) with the resident's pharmacist. Once every 12 months.
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V. GP multidisciplinary case conferences
Case Conferences are an incredibly useful tool. In Residential Aged Care Facilities there are always teams of health care professionals looking after the residents. Getting them all in one room prevents miscommunication, wasted time repeating yourself and leads to more effective care.
Type fam1 in Best Practice to see the keyboard shortcut. The shortcut includes all the criteria and so fill it out and you will have met all the criteria.
When to perform case conferences
Family meetings
Ask the RN to coordinate a time with the family and yourself. The participants can be the RACF nurse, a carer or co-ordinator, physio and yourself. Basically, anyone from the Facility that cares for the patient. Family members do not count towards the 3 participants.
Standard case conference
Use a case conference anytime such as when your patient's condition changes or becomes complex. Involve the physio, podiatrist, pharmacist, RN or cl inical nurse as your other providers. A case conference needs some planning as there are consent and documentation criteria to fi ll.
Patient eligibility
1. Have a chronic medical condition for 6 months or terminal 2. Require ongoing care from multidisciplinary team
MBS requirements for claiming a case conference
1. Explain, consent and record patient's agreement. 2. Three health professionals must be attending the meeting including the GP. 3. Recorded date and time started and ended. 4. Record the names of the participants. 5. Offer the patient a summary of the case conference. 6. Provide this summary to other team members. 7. Discuss the outcomes of the conference w ith the patient and the patient's carer. 8. Document all matters discussed and put a copy of this in the patient's medical record.
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Case Conferences
Item Name MBS Fee Description I Recommended Frequency
15 - 20 m nutes. GP organ ses and coord nates case Organ se and coord nate a case conference n RACF, commun ty, or on d scharge. For
conference $70.65 patents w th a chron c or term na cond ton and 735 comp ex, mu t d sc p nary care needs.
20 - 40 m nutes. GP organ ses and coord nates case Organ se and coord nate a case
$120.95 conference n RACF, commun ty, or on d scharge. For
conference pat ents w th a chron c or term na cond t on and 739 comp ex, mu t d sc p nary care needs.
> 40 m nutes. GP organ ses and coord nates case
Organ se and coord nate a case $201.65 conference n RACF, commun ty, or on d scharge. For pat ents w th a chron c or term na cond ton and
743 conference comp ex, mu t d sc p nary care needs.
15 - 20 m nutes. GP part c pates n a case conference
Part c pate n a case conference $51.90 n RACF, commun ty, or on d scharge. For patents w th
747 a chron c or term na cond t on and comp ex, mu t d sc p nary care needs.
30 - 40 m nutes. GP part c pates n a case conference
Part c pate n a case conference $89.00 n RACF, commun ty, or on d scharge. For patents w th a chron c or term na cond t on and comp ex,
750 mu t d sc p nary care needs.
Part c pate n a case conference > 40 m nutes. GP part c pates n a case conference n RACF, commun ty, or on d scharge. For patents w th
758 $148.20 a chron c or term na cond t on and comp ex, mu t d sc p nary care needs.
Benefit Suturin other than face and neck
30026 $44.40 30029 $76.50 30038 $76.50
Suturin on face or neck 30032 $70.15 30045 $99.95
Removal of forei n bod 30061 Su erficial $20.00 30064 Subcutaneous re incision or suture $93.45
Miscellaneous 11506 $20.55 36800 $23.50 30219 lncision/draina e of small abcess $23.25
~GENWISE 20