Q/A: How Do I Release a Patient from PI When They Still Have Problems?

by  Wyn Staheli, Director of Research
August 10th, 2018

Question

Once a PI patient is released with symptoms, or without symptoms, and a prognosis of likely exacerbations with a future medical estimation of $1500 over then next 2 years, how am I supposed to release them from care when they still have ongoing needs?

Answer

We have discussed this with several different experts. The consensus is that the patient should not be released from the PI case until BOTH of the following have occurred:

  1. the ortho/neuro exam is normal or has stabilized AND
  2. outcome assessments show no significant measurable and functional change after 3 exams over varying times. This one, known as a trial withdrawal of care, is commonly overlooked by chiropractors

If the patient shows no measurable and functional change and they don't worsen without treatment, they should either be released from care or referred out. During the trial withdrawal of care, the patient should be instructed to gradually and carefully increase their activity level to what is was before the injury. It is essential to know if they will be fine without ongoing care. If their situation worsens after not seeing you for a week (or two or three), then you should continue treating, based on their exam findings and outcome assessments.

At some point, though, if they are still having issues, it becomes necessary to stop and say that we tried a withdrawal of care and explain to the PI payer that the patient is unable to go without treatment for more than x days/weeks/months. That becomes the supporting rationale to explain the need for ongoing care and at what cost. When persistent injury symptoms remain, it is an indication that an impairment rating is appropriate.

Documenting their condition as "static" might be a wise thing to do (if applicable, of course), so as to help validate that the patient has not officially returned to pre-injury status or MMI.

Q/A: How Do I Release a Patient from PI When They Still Have Problems?. (2018, August 10). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/q-a-how-do-i-release-a-patient-from-pi-when-they-still-have-problems-34539.html

© InnoviHealth Systems Inc

Article Tags  (click on a tag to see related articles)


Publish this Article on your Website, Blog or Newsletter

This article is available for publishing on websites, blogs, and newsletters. The article must be published in its entirety - all links must be active. If you would like to publish this article, please contact us and let us know where you will be publishing it. The easiest way to get the text of the article is to highlight and copy. Or use your browser's "View Source" option to capture the HTML formatted code.

If you would like a specific article written on a medical coding and billing topic, please Contact Us.


contact

innoviHealth Systems, Inc.
62 East 300 North
Spanish Fork, UT 84660
Phone: 801-770-4203 (9-5 Mountain)
Email:
free demo
request yours today
pricing
for any budget
sign IN
welcome back!