Production & Coding Forms

1HCC Review

Encounter Summary

( Results: 17 ) show all

Serivce Date
04/22/2015

Clinic
Superior Primary Care

Physician
Dr. Darren Dunn

Encounter	POS	CPT	CPT Description	Modifiers	Diagnosis
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1

( Total HCCs: 1 )

Renal Failure

Most Recent HCC Capture

Serivce Date
11/12/2014

Diagnosis
v75.0

Physician
Dr. June Landers

Diagnosis Description
BMI 50.0 - 59.9 Adult

HCC Information

Description

Review Results (Disposition)

Recommended Action

Recommended Code Change

Account Routing

Notes

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2Quality Measures

Technical Physicain

Encounter Summary

( Results: 9 ) show all

Serivce Date
04/22/2015

Clinic
Superior Primary Care

Physician
Dr. Darren Dunn

Encounter	POS	CPT	CPT Description	Modifiers	Diagnosis
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1
1238282761	11	37224	PTA femoral / popliteal	88, 14, 27	895.1

( Total HCCs: 1 )

Body Mass Index (BMI)

Eligibility

Measure Type
HEDIS/ACO/STAR

Eligible Measures
The percentage of members 18-74 years of age who had an outpatient visit and wholse body mass index (BMI) was documented during the within the last 2 year.

Description

Review Results (Disposition)

Recommended Action

Recommended Code Change

Account Routing

Notes

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3Hospital Acquired Conditions (HAC)

Encounter Summary

( Results: 2 )

Encounter	Date of Service	Principal DX	Principal PX	LOS	DRG	Admission Source
1238282761	02/14/2015	DX Here	PX Here	LOS Here	DRG Here	Admission Source Here
1238282761	02/14/2015	DX Here	PX Here	LOS Here	DRG Here	Admission Source Here

( Total HCCs: 1 )

Surgical Site Infection

HAC Details

HAC Diagnosis
519.2

Associated Procedure
36.10

Surgical Site Infection
Orthopedic

POA Status
Y, N, U, W

Description

Review Results (Disposition)

Recommended Action

Recommended Code Change

Account Routing

Notes

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4Mortality Review

Encounter Summary

( Results: 2 )

Encounter	Date of Service	Principal DX	Principal PX	LOS	DRG	Admission Source
1238282761	02/14/2015	DX Here	PX Here	LOS Here	DRG Here	Admission Source Here
1238282761	02/14/2015	DX Here	PX Here	LOS Here	DRG Here	Admission Source Here

( Total HCCs: 1 )

Pneumonia

Capture Comorbities

Capture Date
01/01/2014

CC Category
95

Description
Stroke

Description

Review Results (Disposition)

Recommended Action

Recommended Code Change

Account Routing

Notes

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Action	whiteNumberBox	Note	Activity	Call User
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Patient Engagement	Susan Peterson
Busy Signal	04/25/2015 - 10:23 AM	N/A	Documentation & Coding	Susan Peterson
Left Voicemail	04/21/2015 - 11:05 AM	No answer. Left message.	Patient Engagement	Jared Allen
Guarantor Requests Call Back	03/27/2015 - 3:02 PM	Spoke with Jonathan, however something came up and the call needed to be disconnected	Patient Engagement	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Documentation & Coding	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Patient Engagement	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Patient Engagement	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Patient Engagement	Susan Peterson
Busy Signal	04/25/2015 - 10:23 AM	N/A	Documentation & Coding	Susan Peterson
Left Voicemail	04/21/2015 - 11:05 AM	No answer. Left message.	Patient Engagement	Jared Allen
Guarantor Requests Call Back	03/27/2015 - 3:02 PM	Spoke with Jonathan, however something came up and the call needed to be disconnected	Patient Engagement	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Documentation & Coding	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Patient Engagement	Susan Peterson
No answer, left message with person	04/27/2015 - 9:02 AM	Jonathan was not home. A message was left with his sister.	Patient Engagement	Susan Peterson

Clinic / Department	Physician	Reason	Date	Time	Date Scheduled
Quest Diagnostics	—	Mammogram	04/15/2015	9:00 AM	03/10/2015
St. Michael's Medical	Dr. Smith	Wellness	02/10/2015	11:00 AM	01/15/2015