u/RoarOfTheWorlds

One episode left. Do you think he’ll get his Pope interview?

It’s THE thing he’s been holding out for and I can’t imagine it should be that difficult given how big the show is. Granted I fully expect he’ll get to interview him at some point in the future, but I really would love this for Colbert.

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u/RoarOfTheWorlds — 2 days ago
▲ 57 r/videos

Limmy Show’s “I Wanna Be There” - moderately difficult to understand given their heavy accents but absolutely phenomenal nonetheless

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u/RoarOfTheWorlds — 3 days ago

I want to start doing Cognitive Assessments to bill for 99483 but I feel like I'll miss something important and get burned in an audit. Does anyone here successfully/confidently do them?

OpenEvidence gave me the following requirements and they seem simple but something about it just feels like I am missing something important:

Required elements (all must be documented): [3]

  1. Cognition-focused evaluation — history and examination
  2. Medical decision-making — must support moderate or high complexity
  3. Functional assessment — ADLs/IADLs (can use standardized tool)
  4. Standardized dementia staging — e.g., Clinical Dementia Rating (CDR), FAST, GDS
  5. Medication reconciliation and review
  6. Neuropsychiatric and behavioral symptoms evaluation
  7. Safety evaluation — driving, wandering, firearms, fall risk
  8. Caregiver identification and assessment — caregiver needs, burden
  9. Advance care plan review — or initiation of ACP discussion
  10. Written care plan creation — must be shared with patient/caregiver with education and support
  11. Independent historian — required (i.e., a caregiver/informant must be present or contacted)

Practical tips for making this feasible:

  • Have the MA administer the standardized tools (Mini-Cog/MoCA, ADL checklist, dementia staging scale, safety checklist, caregiver burden screen) before the physician enters — this can take 15–20 min of staff time
  • The physician then performs the cognition-focused H&P, reviews results, creates the care plan, and discusses with patient/caregiver — roughly 30 min of physician face-to-face time
  • The work can be split across multiple visits but cannot be billed until all elements are complete
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u/RoarOfTheWorlds — 9 days ago

Applying to a clinic with a culture of five days a week, but I’m really trying to push them towards letting me do four days with one full admin day. What are some good arguments I can make to convince them?

I feel like I’m pretty strong with billing and I pull in a good number of patients per day, I just know that five days a week gets really exhausting and honestly it’s so much easier for me to handle the four days on when I know I’ve got three days off.

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u/RoarOfTheWorlds — 14 days ago