Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma &...
-
Upload
terry-cooks -
Category
Documents
-
view
213 -
download
0
Transcript of Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma &...
![Page 1: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/1.jpg)
Provider Respiratory Inservice
![Page 2: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/2.jpg)
2
Welcome
![Page 3: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/3.jpg)
Opening Remarks
3
We will cover:• Definition of Asthma & COPD• Evidence based guidelines for diagnosis,
evaluation, and management of asthma • Evidence based guidelines for diagnosis,
evaluation, and management of adult with COPD • Coding • BC/BS services available to assist your practices
![Page 4: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/4.jpg)
4
What is Asthma?
• Obstructive lung disease with characteristics of:– Airway obstruction; reversible in most patients– Chronic airway inflammation (eosinophils)– Increased airway responsiveness
• Onset of symptoms can occur at any age
![Page 5: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/5.jpg)
Asthma
• 34 million people in the U.S. currently diagnosed with asthma
• 7.1 million children are diagnosed with asthma
• 1.3 million visits to hospital outpatient departments with asthma as a primary diagnosis
• Asthma costs exceed $30 billion/year• Asthma in the U.S. is growing every year
5 U.S Department of Health and Human Resources Center for CDC: 12/2012
![Page 6: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/6.jpg)
6
What is COPD?
• A common, preventable, and treatable disease:– Characterized by persistent airflow limitation
• Usually progressive– Associated with an enhanced chronic
inflammatory response in the airways and the lung to noxious particles or gases.
– Exacerbations and comorbidities contribute to the overall severity in individual patients.
![Page 7: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/7.jpg)
COPD
• 16 million U.S. adults have been diagnosed with COPD
• 15 million or more U.S. adults have COPD that have not been diagnosed
• 4th leading cause of death in the U.S.• Annual direct & indirect COPD Medical
Costs $42.6 billion
7 U.S Department of Health and Human Resources Center for CDC: 2007
![Page 8: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/8.jpg)
8
Differential Diagnosis
* Onset early in life (often childhood).
* Symptoms vary from day to day.
SUGGESTIVE FEATURES
* Onset in mid-life.
* Symptoms slowly progressive.
* Largely irreversible airflow limitation.
COPDSUGGESTIVE FEATURES
Asthma
* Symptoms at night/early morning.
* Allergy, rhinitis, and/or eczema also present.
* Family history of asthma.
* Largely reversible airflow limitation.
* Long smoking history.
* Dyspnea during exercise.
![Page 9: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/9.jpg)
Asthma vs. COPD
• Spirometry is required pre- and post- bronchodilator to help differentiate between Asthma and COPD– Asthma = Reversibility– COPD = No/partial reversibility
• Chest Xray – to order or not?• Vaccinate for flu and pneumonia
9
![Page 10: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/10.jpg)
Case Study
• 45 year old female presents to the office with complaints of shortness of breath and wheezing. She has a history of asthma.
10
![Page 11: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/11.jpg)
History – Questions to ask• Symptoms (wheezing, dyspnea, cough)• Timing and Frequency• Triggers
– Work environment: dust, fumes, chemicals– Home environment: heating, mold, pets, dust,
roaches, cigarette/cigar smoke– Exercise– Upper Respiratory Infections
• Medications – inhalers, steroids and other medications
• Smoking history• Family history
11
![Page 12: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/12.jpg)
Findings
• Smoker – 1 ppd X 10 years, quit age 30• SOB and wheezing – daily• Uses albuterol inhaler 1x per day• Wakes at least 1 night per week with a
cough• Becomes SOB with exercise• Works at Chevy plant Monday – Friday • 2 courses of oral systemic corticosteroids
last 6 months
12
![Page 13: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/13.jpg)
Spirometry
13
![Page 14: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/14.jpg)
Asthma Spirometry Results
14
![Page 15: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/15.jpg)
15
Asthma Spirometry Results
Predicted Actual Predicted % Actual Predicted %
FEV1 (L) 3.11 2.21 71 2.49 80 13%
FVC (L) 3.88 3.33 86 3.53 91 6%
FEV1/FVC % 83 66 71
% Change
Pre Bronchodilator
Post Bronchodilator
![Page 16: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/16.jpg)
16
Guidelines
http://www.nhlbi.nih.gov/guidelines/asthma/asthma_qrg.pdf
![Page 17: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/17.jpg)
Classifying Asthma Severity
• According to EPR-3 guidelines, the member is classified as having moderate persistent asthma
• Diagnosis = moderate persistent asthma– Next - therapy
17
![Page 18: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/18.jpg)
18
![Page 19: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/19.jpg)
19
Step approach – medications
![Page 20: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/20.jpg)
Asthma Medications
Quick-Relief medication:• SABA (Short-Acting Beta Agonists)
Controller medications:• ICS (Inhaled Corticosteroids)
• LABA (Long-Acting Beta Agonists)
• LABA/ICS Combinations• LEUKOTRIENE MODIFIERS• Miscellaneous (theophylline, cromolyn)
20
![Page 21: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/21.jpg)
Next Steps
Education:• Review Medications• Review inhaler technique + compliance at
each visit• Reducing exposure to triggers• Review asthma action plan each follow-up
visit• Smoking cessation assistance• Vaccinate for flu and pneumonia
21
![Page 22: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/22.jpg)
Asthma Action Plan
22
![Page 23: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/23.jpg)
Follow-up: 2-6 weeks after initial visit
23
• ACT test – patient completes• Assess level of symptom control with
current medication regime• Medication compliance and technique• Step up or step down, according to signs
and symptoms• Patient education• Referral to pulmonologist or allergist, if
needed• Review and update Asthma action plan• Encourage compliance
![Page 24: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/24.jpg)
24
Asthma Control Test
4
4
5
4
4
21
![Page 25: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/25.jpg)
Case study follow-up• ACT test – review • SOB 1X in 3 weeks• No nighttime awakening• No SOB while exercising• Use albuterol inhaler 1X in 3 weeks• Repeat spirometry showed FEV1 > 80%
predicted• Next follow up appointment in 1-6 months• Well controlled• Consider step down if well controlled for
at least 3 months25
![Page 26: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/26.jpg)
26
Follow-up
![Page 27: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/27.jpg)
Case Study
• 45 year old female presents to the office with complaints of shortness of breath and wheezing.
27
![Page 28: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/28.jpg)
History – Questions to ask
• Symptoms (SOB, cough, wheezing, phlegm production, color, amount)
• Timing and Frequency• Smoking history• Medications – inhalers, steroids, other
medications • Family history
28
![Page 29: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/29.jpg)
Findings
• Smoker 2ppd since age 20• Dyspnea and wheezing• Uses albuterol inhaler 1x per day• Experiences cough and some dyspnea with
exercise• Productive cough with white sputum• Works at Chevy plant Monday – Friday • Has been treated with 2 courses of
Prednisone in the past 6 months
29
![Page 30: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/30.jpg)
Is this COPD?
Spirometry MUST be performed!Within 180 days from initial diagnosis
• Pulse oximetry – to do or not?• Chest Xray – to do or not?
30
![Page 31: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/31.jpg)
31
COPD Spirometry Results
![Page 32: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/32.jpg)
32
COPD Spirometry Results
Predicted Actual Predicted % Actual Predicted %
FEV1 (L) 3.11 1.87 60 1.94 62 4%
FVC (L) 3.88 3.1 80 3.15 81 2%
FEV1/FVC % 83 60 62
% Change
Pre Bronchodilator
Post Bronchodilator
![Page 33: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/33.jpg)
COPD Medications
• SABA (Short-Acting Beta Agonists)
• ICS (Inhaled Corticosteroids)
• LABA (Long-Acting Beta Agonists)
• LABA/ICS Combinations• Anticholinergics• Miscellaneous (theophylline, roflumilast, combivent)
33
![Page 34: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/34.jpg)
Medications for Asthma & COPD• Pharmacy Formulary
34
Type ofMedication
Commercial/Child Health Plus/Healthy New York
Medicaid/Family Health Plus Medicare
SABA ProAir HFAProventil HFA
ProAir HFAVentolin HFA
ProAir HFAXopenex HFA
LABA Foradil, Serevent Diskus
Serevent Diskus Arcapta, Foradil, Perforomist, Severent Diskus
ICS Asmanex, Flovent Diskus/HFA, Pulmicort, QVAR
Alvesco, Flovent Diskus HFA, Pulmicort Flexhaler, QVAR
Alvesco, Asmanex, Flovent Diskus/HFA, QVAR
LABA/ICS combos
Advair, Symbicort Advair, Symbicort Advair, Dulera, Symbicort
Anticholinergics Spiriva, Atrovent Spiriva, Atrovent Spiriva, Atrovent
Miscellaneous Combivent, montelukast, zafirlukast
Combivent, montelukast, zafirlukast
Combivent, Daliresp, montelukast, zafirlukast
* Included medications are tier 1 (generics) and tier 2 (brands) for commercial/HNY/CHP. *Included medications are covered for Medicaid on generic or brand tier. *Included medications are tier 2 (non-preferred generic) and tier 3 (preferred brand) for Medicare
![Page 35: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/35.jpg)
Next Steps
• Review medications• Review inhaler technique & compliance at
each visit• Review care plan each follow up visit• Smoking cessation assistance• Vaccinate for flu and pneumonia
35
![Page 36: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/36.jpg)
Follow up
• Follow up Q 6 months or sooner if hospitalized or in ED for COPD
• Review symptoms at each visit• Review Medications• Spirometry every year
36
![Page 37: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/37.jpg)
37
Asthma Codes
Description ICD-9-CM Diagnosis
Extrinisic (allergic) asthma 493.0
Intrinsic (non-allergic) asthma 493.1
Asthma + COPD 493.2
Asthma unspecified 493.9
Status asthmaticus Add "1" as fifth digit to 493.0 or 493.1 or 493.2 or 493.9
Asthma exacerbation Add "2" as fifth digit to 493.0 or 493.1 or 493.2 or 493.9
Exercise induced asthma 493.81
Cough variant asthma 493.82
Codes Identifying Asthma
Asthma
![Page 38: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/38.jpg)
38
493.02
![Page 39: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/39.jpg)
39
COPD Codes
Note: chronic bronchitis involves a persistent cough with sputum production for at least 3 months in at least 2 consecutive years
Description ICD-9-CM Diagnosis
Chronic bronchitis - simple (catarrhal, "smoker's cough) 491.0
Chronic bronchitis - mucopurulent 491.1
Emphysema 492.8
Chronic bronchitis + emhysema 491.20
COPD with acute exacerbation 491.21
COPD with acute bronchitis 491.22
COPD nonspecific 496
COPDCodes Identifying COPD
![Page 40: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/40.jpg)
40
Smoking Cessation Codes
Description CPT
for 3-10 minutes of counseling 99406
for over 10 minutes of counseling 99407
Smoking Cessation
* If a modifier is used on the smoking cessation code, documentation must support both of the criteria for the E&M code and the smoking cessation code.
![Page 41: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/41.jpg)
41
Pulse Oximetry & Spirometry Testing Codes
Description CPTNon-invasive ear or pulse oximetry for oxygen saturation; single determination
94760
Multiple determinations 94761
Description CPT
Spirometry 94010
Spirometry pre and post bronchodilator administration 94060
Spirometry Testing
Pulse Oximetry
![Page 42: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/42.jpg)
42
Flu and Pneumococcal Vaccine Codes
Description CPTInfluenza virus, preservative free, intramuscular administration 3 years of age and older
90656
Influenza virus, intramuscular administration 3 years of age and older
90658
Influenza virus, nasal administration 90660
Description CPT
Adult pneumoccoccal vaccine (23-valent polysaccharide) 90732
Flu Vaccine Codes
Adult Pneumococcal Vaccine
![Page 43: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/43.jpg)
43
Administration Codes
Description CPTIM administration 1st component through age 18 with counseling
90460
Each additional component through age 18 with counseling 90461
Immunization administration all ages without counseling 90471
Immunization administration-each additional all ages without counseling
90472
Immunization oral/nasal administration all ages without counseling
90473
Immunization oral/nasal administration-additional all ages without counseling
90474
Admin Codes
![Page 44: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/44.jpg)
How we can help you
• One on one health coaching with a registered nurse available to assist our BCBS members– Educate about disease process– Medication management– Address gaps in care– Coordinate services– Reinforce treatment plan
44
![Page 45: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/45.jpg)
How we can help you
• We also have a team of social workers, dieticians and outreach workers
• Community classes:– Smoking cessation– Nutrition– Weight management– Exercise programs– Stress management
45
www.bcbswny.com
![Page 46: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/46.jpg)
How to access DM/CM services
• Fax referral form to 716-887-7913
• Phone – call 1-877-878-8785, option 2
• Member self referral online at
DM = “Disease mangement”CM = “Case management”
46
www.bcbswny.com
![Page 47: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/47.jpg)
47
Questions
![Page 48: Provider Respiratory Inservice. 2 Welcome Opening Remarks 3 We will cover: Definition of Asthma & COPD Evidence based guidelines for diagnosis, evaluation,](https://reader037.fdocuments.net/reader037/viewer/2022110304/551c0fdc5503469e4f8b535f/html5/thumbnails/48.jpg)
Thank You!