Wiki G0538 Documentation Requirements?

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kknope

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Hello everyone!

I was wondering if anyone had information on the documentation requirements surrounding G0538? We are trying to streamline our information to the providers regarding this and want to make sure we aren't missing any ways to make it easier to consolidate the tool output.
 
KKnope
Ahh just read that must be internist or cardio provider and monthly billed. The risk management services code, G0538, would be reimbursable on patients found to have intermediate, medium or high risk for cardiovascular disease as determined by the ASCVD risk assessment and would include medication management, blood pressure management, cholesterol management and smoking cessation.
I hope helped you
Lady T
 
Thank you both! I was looking more for guidance on whether or not certain criteria is required in addition to the usual physician documents. For instance do we know if a screenshot or print out of the tool is required to be in the patient's chart, or is the physician stating that they used the tool and listing the resulting score and plan enough?

Both of your answers provided more information on the code itself and I appreciate the help :)
 
kknope said:
Thank you both! I was looking more for guidance on whether or not certain criteria is required in addition to the usual physician documents. For instance do we know if a screenshot or print out of the tool is required to be in the patient's chart, or is the physician stating that they used the tool and listing the resulting score and plan enough?

Both of your answers provided more information on the code itself and I appreciate the help :)
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I think it would be best practice like other tools for 96160, 96161, etc. where you should have the report and tool scanned in with the results and not just stated in the note. I think it depends on the payer probably in what they would accept. It might be enough to state it in the note and have the score/plan in the note.
 
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