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Plan:
|
|
|
Problem:
|
Plan:
|
|
Comment:
|
|
|
Problem:
|
Plan:
|
|
Comment:
|
|
|
Problem:
|
Plan:
|
|
Comment:
|
|
|
Problem:
|
Plan:
|
|
Comment:
|
|
|
Problem:
|
Plan:
|
|
Comment:
|
|
|
Monitor:
|
|
|
Lab(s):
|
|
|
Behavior(s):
|
|
|
Coordinate care with:
• • •
|
other
|
|
Pt understands risks and benefits of treatment options
|
|
|
Therapy:
|
|
|
Therapy type:
• • •
|
other
|
|
Focus:
• • •
|
other
|
|
>50% Time spent on counseling or coordination of care
|
|
|
Focus:
• • •
|
other
|
|
Labs:
• • •
|
Lab Comments
|
|
Other:
|
|
|
Radiology:
• • •
|
Radiology Comments
|
|
Other Referrals:
|
|
|
Education:
• • •
|
Education Comments
|
|
Diet:
• • •
|
Diet Comments
|
|
General Instructions:
• • •
|
General Instruction Comments
|
|
CPT Coding
|
|
|
EM Code
|
Therapy or Psychoed Code
|
