Improve diagnosis management in notes, patients’ master list and claims
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Dana Dabransky
Currently the diagnosis portion of someone’s chart is very clunky and rigid. I would like the following:
- When I choose diagnoses for a particular visit to have a list of prior diagnoses the patient has been given in PQ and to be able to select/check which of those diagnoses I want associated with that visit. And then add any new diagnoses if applicable. This eliminates redundant diagnosis codes in the patient’s “master” diagnosis list.
- To rearrange the order of the diagnoses within the visit note. Right now you can only do this by rearranging the full list of diagnoses under the patient’s diagnosis tab in their chart. Some visits the focus is going to be more on a particular issue vs another, which can vary per visit (or practitioner), and should be reflected in the order of the diagnoses.
- The claim that is created from a particular visit ONLY pull diagnosis codes that have been associated with that specific visit. Currently ALL of a patient’s diagnoses populate into a claim, which means lots of editing claims and possible errors if a code remains on a claim that is not pertinent to the visit.
As a solo practitioner who sees people with a combination of multiple chronic conditions with a peppering of acute issues I am having serious limitations with they way diagnoses are managed in PQ, I can’t imagine how challenging this is for multidisciplinary clinic.
These existing feature requests in PQ touches on some of my asks, but not all:
- https://practiceq.canny.io/feature-requests/p/diagnosis
- https://practiceq.canny.io/feature-requests/p/show-active-diagnoses-when-adding-new-ones
- https://practiceq.canny.io/feature-requests/p/uncheckcheck-all-button-for-dxs
The above (#3) request addresses my issue with all the dx codes populating in a claim. I think my suggestion solves this issue an ideal way because no codes would need to be deleted if it pulled the codes from the visit note.
Tyson Edwards
We had to put this behind a permission so if you don't see it today, check the Roles under More > Team > Roles.
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Kim Schemahorn
I just did some test notes and I think this is going to be WAY better. Thank you so much for pushing this through.
Tyson Edwards
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Hello, we have made some 'Current Diagnosis' question type updates to provide some flexibility when managing diagnosis from visit to visit as the focus of the visit can change. Please review and provide any feedback.
Thank you!
- You can now edit the diagnosis for a visit from the Current Diagnosis question type.
- This will allow you to remove, add and arrange Diagnosis Codes.
- These updates would only apply to that visit / note
- These updates would follow through to the claim or superbill for notes linked to appts.
- Still working on #1 on this feature request
Updated Article:
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Ryne Evans
Tyson Edwards: Hi Tyson, I think that there still needs to be the ability to add directly into the client profile. I can foresee when practices are switching EHRs especially with a large # of clients, the tedious process of having to create a note to just enter a diagnosis would be...well tedious. Can this be kept as "in progress" until this feature is added?
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Dana Dabransky
Tyson Edwards: thank you!!
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Dana Dabransky
Ryne Evans: agreed, being able to add diagnoses to the master/problem list directly in the patient profile is a great suggestion!
Tyson Edwards
What other stuff can we do (besides preventing duplicates) on the Clients Diagnosis tab that would help for mutli-practitioners?
Would it be more helpful to filter by the practitioner that assigned them or the session date or the date is was assigned?
Maybe could list them by Session Date and Service?
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Rachel Achatz
Tyson Edwards: It would be great if the "current diagnosis" box in notes would contain 4 separate "drop down" boxes that were connected to the diagnosis codes we've already uploaded. With any session note we would be able to change the diagnosis which would remove the previous one that was in that dropdown. I can visually see it in my head, but I'm not sure that I'm explaining it well.
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Kim Schemahorn
For the note I would like to see something like the 1st attached picture. I can see that this patient has multiple diagnosis but only the checked ones are being addressed during this (vision therapy) visit.
For the diagnosis tab, they could be laid out similar to the second image. This way I do not have a bunch of the same diagnosis that I have to keep removing or adding end dates too and the active diagnosis for that specific visit is easy to see.
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Erin Klender
Tyson Edwards- The first white picture with the checkboxes is exactly what I need.
-There would be a spot where you could check the boxes of whatever diagnoses were pertinent to that visit and leave unchecked whatever no longer applies.
-AND the ability to prioritize which one shows up first on the note as many claims get rejected if say an R or Z code shows up as the first diagnosis.
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Francesca Pascale
Kim Schemahorn: You are right. This is how it should be. Has this been done yet? Is there a way to make this work?
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Kim Schemahorn
Francesca Pascale: No. Generally, I just clean up diagnosis codes every couple of months instead. We only have two providers at our facility though and it's still pretty tedious. I can't imagine the amount of time it would take for big facilities to clean up the codes.
Tyson Edwards
Merged in a post:
Uncheck/Check all Button for DXs
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Kim Schemahorn
It would be very helpful to have a check/uncheck all button for the diagnosis codes when creating a claim or superbill. Some of our patients are seen by multiple providers and have a fairly big diagnosis list that isn't always relevant to each visit. Having to uncheck so many dxs gets exhausting. Thanks!
Tyson Edwards
The only codes that should display would be the codes from the appointment note correct?
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Cary Shore
Tyson Edwards: it’s really difficult to adjust diagnoses in a follow up note. You can’t delete an existing diagnosis, only add to it. Can we make it much easier to remove diagnoses from an existing note?
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Kim Schemahorn
Tyson Edwards: I think if the focus was on Dana's request it would ultimately fix this issue but yes the active codes from that specific visits should be the only ones on the claim.
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Jill O'Brien
Tyson Edwards: in a daily note the codes from past visits show up and you can't easily remove those codes if that issue no longer pertains to that visit...
Tyson Edwards
Merged in a post:
Diagnosis
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Delia Sewell
It would be helpful while being able to pull diagnosis lists for patients into new encounters to be able to "x" out the ones that don't apply to the current visit. Diagnosis codes can change from visit to visit and I find myself having to manually enter them as I can't edit the master diagnosis list that populates.
Dr. Zachary Causey
I also think that having the ability to pull over dx codes from the last note would be great, even if you have a pop up asking if you would like to use the last visit dx codes: yes or no. This would help as we use the same dx codes for an entire care plan unless there is a new complaint or exacerbation.
Tyson Edwards
Hi Dana, it would really help me to see your workflow here. Would you mind if I schedule a meeting so we can discuss?
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Dana Dabransky
Tyson Edwards: Yes please that would be great. I would be thrilled if this part of PQ could be enhanced :)
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Kim Schemahorn
Yes yes yes! This is making my job a thousand times harder as we occasionally have patients that see 4 different providers and several of them are using different codes. I have some patient charts with enormous dx lists. It's insane!
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