# High Risk



## Jagadish (Aug 7, 2009)

"drug therapy requiring intensive monitoring for toxicity" gives high risk in risk table. 

If the physician is managing epilepsy in an office f/u visit with anti epileptic drugs (or) does pain management with drugs like opiate agonists (or) manages multiple conditions with multiple prescription drugs; can we take risk as high? because in all of the above examples physician should monitor very closely for any drug toxicity.


----------



## Karolina (Aug 10, 2009)

If the potential risk is above and beyond common prescription drugs I would say yes. It is also high risk if the provider documents that there will be some form of monitoring for toxicity at certain specified intervals, e.g., check lfts every week. I also think that patients on clinical trials for new meds are high risk - because the drug is still in the testing stage.


----------



## FTessaBartels (Aug 10, 2009)

*My opinion*

To me, the key is "*intensive* monitoring."  In my opinion, this means the kind of monitoring done in a hospital or while the patient is IN the office. 

For example: you give an injection of morphine to a patient with a severe migraine, and monitor the patient *in the office *suite for the next 2 hours before you allow the patient to be driven home. 

Or - chemotherapy drugs given via port in the oncology clinic. 

Heck - Tylenol is toxic to the liver ... but I don't think most people would classify that as a high-risk drug therapy.

Just my opinion. Hope that helps.

F Tessa Bartels, CPC, CEMC


----------



## Karolina (Aug 12, 2009)

This is what I mean by toxicity above and beyond the common Rx. All meds are toxic at some level, but some require monitoring - others don't so much. I'm not sure the monitoring is limited to right then in the office. Some meds work slower but might cause trouble if not detected soon and the patient may have to get labs checked on a regular basis while on the drug. Those I would include, especially if the documentation states that there is close monitoring due to the prescribed medication.


----------



## Karolina (Aug 12, 2009)

Also, some medications might be more toxic to patient A than to patient B, so with the proper documentation it might differ from patient to patient.


----------

