Wiki G0545 Infectious Disease

[kmcintire@widc.biz]

Medicare's new add on code G0545 for infectious disease specialists. I'd love to hear thoughts on what documentation requirements will be needed to justify using this code.

 

[tarachatham]

This code is very similar to G2211. No additional documentation other than what is documented in the MDM for the infectious disease diagnosis of the E&M service. THe Final RUle does give this:

1. Disease Transmission Risk Assessment and Mitigation​

• Developing, following, and supervising specialized, individualized infection control protocols for an individual patient based on their diagnosis and risks in order to reduce risk of disease transmission.
• Coordinating with human resources regarding infection prevention and control measures to enable healthcare facility staff to safely care for patient.
• Counseling patients, family members and caregivers regarding infection prevention.
• Managing infection prevention and treatment protocols associated with transitions of care for complex patients.

2. Public Health Investigation, Analysis, and Testing​

• In-depth patient chart review that entails going back farther in time and assessing the complete breadth of all health care interactions, with higher-level synthesis for complex diagnoses.
• Communicating with the clinical microbiology lab and directly reviewing specimens.
• Coordinating specialized diagnostic evaluations (for example, identifying and facilitating diagnostic laboratory tests only available at specialized laboratories, the state health department, and/or the Centers for Disease Control & Prevention).
• Coordinating with Federal, State and local public health agencies and laboratories to assist with contact tracing, obtaining specimens for specialized testing, and/or identifying prior testing and treatment for communicable diseases in other jurisdictions.

3. Complex Antimicrobial Therapy Counseling & Treatment​

• Counseling patients, family members, and caregivers regarding antimicrobial stewardship and resistance for the patient.
• 
  Engaging in complex medical decision-making associated with antimicrobial prescribing including considerations such as antimicrobial resistance patterns, emergence of new variants/strains, recent antibiotic exposure, interactions/complications from comorbidities including concurrent infections, public health considerations to minimize development of antimicrobial resistance, and emerging and re-emerging infections.

 

[TThivierge]

KMC,
I d probably use that with pts have ongoing infectious ds. problems like dx codes of B20, respiratory ds like J01, pneumonia, Covid U09, or contagious skin infections or Sepsis or ongoing sex disease . I imagine use it the first visit as new patient or when lab results confirm the ds.
I hope helped you
Lady T