Home Health & Hospice Week

Stable patients have care planning needs too.

Anewly revised LCD from Palmetto GBA may remind you of diabetic patients’ blood glucose testing requirements, but you shouldn’t focus only on patients with the highest testing requirements. Quarterly-testing patients certainly need diabetes interventions. But even stable patients should have diabetes addressed in the care plan, maintains Julianne Haydel with Haydel Consulting Services.

For example: “The lowered frequency of A1Cs only applies to stable diabetics with no changes to their treatment, but these patients also need eye exams, assessment for depression and emergency teaching for hypoglycemia,” Haydel urges on her blog. “Even if they have been a diabetic for ten years and have been stable for almost as long, make sure they know which medications might cause lactic acidosis and to notify the agency when their activity changes to prevent hypoglycemia.”

“All of these interventions take very little time and can easily be included in care plans when the primary diagnosis is something else,” Haydel says. “If we don’t take advantage of ensuring that diabetes is addressed completely when it is not a crisis, the costs — both human and economic — to treat complications will be significantly higher.”

Result: “The hope is that the patient will have fewer adverse consequences requiring emergency room treatment and decrease the probability of other complications of diabetes,” notes Lisa Selman-Holman with Selman-Holman & Associates and CoDR — Coding Done Right in Denton, Texas.