Reporting Month/Year: November 2024
Patient Information
Full Name: John Doe
Date of Birth (DOB): 01/15/1950
Medical Record (MR) #: 123456789
Type of Residence: Home
Chronic Conditions (2 or more required for eligibility)
- Hypertension (ICD-10: I10) – The patient has stage 2 hypertension with a blood pressure consistently above 140/90 mmHg. Clinical indicators include elevated systolic and diastolic readings.
- Management plan includes Lisinopril 20 mg daily, low-sodium diet, regular blood pressure monitoring, and bi-weekly telehealth check-ins.
- Type 2 Diabetes Mellitus (ICD-10: E11.9) – The patient has poorly controlled diabetes with an HbA1c of 8.5%. Clinical indicators include elevated blood glucose levels and neuropathy.
- Management plan includes Metformin 500 mg twice daily, dietary modifications, regular blood glucose monitoring, and monthly endocrinologist consultations.
Other Medical Conditions
- Hyperlipidemia – The patient has elevated cholesterol levels impacting cardiovascular health.
- Management strategy includes Atorvastatin 10 mg daily, dietary changes, and quarterly lipid panel tests.
- Osteoarthritis – The patient experiences joint pain and stiffness, affecting mobility.
- Management strategy includes physical therapy, NSAIDs as needed, and referral to an orthopedic specialist.
Other Needs (Social and Access to Care)
- Transportation Needs: Relies on community services for medical appointments.
- Social Support System: Supported by family and local senior center resources.
- Nutritional Needs: Requires low-sodium and low-sugar diet; referred to a dietitian.
- Psychosocial and Mental Health Needs: Mild depression managed with counseling and support groups.
- Functional Limitations: Requires assistance with ADLs due to joint pain.
Physician or Qualified Health Professional (QHP) Responsible for CCM
Primary Physician/QHP: Dr. Emily Carter, MD
Date Initial Plan of Care Developed: 10/01/2024
Date Plan of Care Provided to Patient/Caregiver: 10/05/2024
Consent Documentation
- Verbal or Written Consent Obtained: Yes
- Date of Consent: 10/01/2024
- Consent Notes: Patient expressed concerns about medication costs, discussed potential financial assistance.
Care Plan Components
- Assessment of Patient’s Medical, Functional, and Psychosocial Needs: Comprehensive review of chronic conditions, mobility issues, and mental health status.
- Preventive Care Needs Addressed: Annual flu vaccination and diabetic foot exam performed.
- Medication Reconciliation and Self-Management Plan: Current medications reviewed, patient instructed on adherence and lifestyle modifications.
- Care Coordination and Communication:
- Coordination with Dr. Smith, Endocrinologist, for diabetes management.
- Referral to Senior Center for social support services.
Care Transition Management
- Hospital or Facility Discharges in the Past 30 Days: No
- Recent Emergency Department Visits: No
- Follow-up Actions Required: Continue regular monitoring and scheduled appointments.
- Continuity of Care Documents Shared: Yes
Chronic Care Management Activities and Time Documentation
Date: 11/01/2024
- Activity: Medication review and patient education on lifestyle changes.
- Time Start and Stop: 09:00 AM - 09:30 AM
- Total Time: 30 minutes
- Documentation Reference: EHR Note
- Signature: Nurse Jane Smith, RN
Date: 11/15/2024
- Activity: Care coordination with endocrinologist and dietitian.
- Time Start and Stop: 10:00 AM - 10:45 AM
- Total Time: 45 minutes
- Documentation Reference: Call Notes
- Signature: Nurse Jane Smith, RN
Date: 11/29/2024
- Activity: Follow-up on patient’s adherence to care plan and psychosocial support.
- Time Start and Stop: 11:00 AM - 11:30 AM
- Total Time: 30 minutes
- Documentation Reference: EHR Note
- Signature: Nurse Jane Smith, RN
Total CCM Time for Month: 105 minutes
Billing Codes and Documentation
- 99487 – Complex Chronic Care Management (CCCM), at least 60 minutes of clinical staff time
- 99489 – Additional 30 minutes of CCCM (Enter number of units: 1)
- 99490 – Standard Chronic Care Management (CCM), at least 20 minutes of clinical staff time
- 99439 – Additional 20 minutes of CCM (Up to 2 units)
- 99491 – CCM, at least 30 minutes of physician time
- 99X21 – Additional 30 minutes of physician time
- 99X22 – Principal Care Management (PCM), at least 30 minutes of physician time
Supervising Physician or QHP Signature
Dr. Emily Carter, MD
Date: 11/30/2024