About

• The last date asthma was discussed as a well visit ("last_well_asthma") - Dx code #2-4 on a well visit
• The last date asthma was discussed at a sick visit ("last visit") - Dx code #1 on a sick visit
• Last plan - this is the plan part for the note (per the sick visit noted above)
• Severity of asthma in the Problem List - if this is blank, then you:
  • Don't have asthma in the problem list
  • Have asthma but don't have it coded J45.x in the ICD area
  • Don't have it coded with a severity
  • Some combo of the above
• The last date the albuterol Rx was prescribed ("last Rx")
  
  

A sample image of this SQL report run in the Database Viewer is shown below:

Report Usage Ideas

• Make telemedicine visits for all patients who you haven't seen in 3 months and check their inhaler technique online - 94664 - this can be done virtually and it can be done by a provider or by nonclinician support staff. NHLBI 3rd edition recommends you check technique at every visit.
• Make telemedicine visits for patients.
  • Ask them to complete the ACT - you can bill 96160 for this and then discuss management online as part of a telemedicine visit.
• Kids who have asthma and 1 other chronic condition - your support staff can bill 99490 if they spend 20 minutes in a calendar month working on an Asthma Action Plan, phoning in prescriptions, helping them locate a spacer, then send the written plan to the family electronically (a portal message to the family bullet pointing what was done is great for this!)
• Providers who haven't cleaned up their charts in a while/coded their problem lists/kept up with their problem lists need to do that for more streamlined recalls.

SQL Code: Firebird

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select r.patno, staffname, fname, lname, birthdat, last_well_asthma, last_visit, cast(mdm_plan as char(30000)) as last_plan, severity as pl_severity,  last_rx, next_appt from register r
left outer join (select patno, max(date1) as last_visit from enc_note where dxcode like 'J45%' group by patno)
e on e.patno = r.patno
left outer join (select patno, max(date1) as last_well_asthma from physical where (dxcd2 like 'J45%' or dxcd3 like 'J45%' or dxcd4 like 'J45%')  group by patno) w on w.patno = r.patno
inner join
(select patno, max(date1) as last_Rx from medications  where
( lower(prescrib) like '%albuterol%' or
lower(prescrib) like '%ventolin%' or lower(prescrib) like '%proventil%' or lower(prescrib) like
'%proair%'  )
and purpose not like '%reference%'
and date1 >= cast('today' as date) - 365  group by patno) m on m.patno = r.patno
left outer join (select patno, icd_1, severity from chartnotes where problem_list = 'Y' and icd_1 like 'J45%') p on p.patno = r.patno
left outer join (select patno, date1, mdm_plan from enc_note) e2 on e2.patno = r.patno and e2.date1 = e.last_visit
left outer join (select patno, min(appt_date) as next_appt from schedule where appt_date > cast('today' as date) and( visit_status is null or visit_status not in ('Cancelled','Canceled','No Show','No Show*')) group by patno) s on s.patno = r.patno
left outer join staff1 on staff1.staffid = r.addr_id
where status_pat = 'ACTIVE' and lname <> 'TESTPATIENT'
and next_appt is null

SQL Code: MySQL

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select r.patno, staffname, fname, lname, birthdat, last_well_asthma, last_visit, mdm_plan as last_plan, severity as pl_severity,  last_rx, next_appt from register r
left outer join (select patno, max(date1) as last_visit from enc_note where dxcode like 'J45%' group by patno)
 e on e.patno = r.patno
left outer join (select patno, max(date1) as last_well_asthma from physical where (dxcd2 like 'J45%' or dxcd3 like 'J45%' or dxcd4 like 'J45%')  group by patno) w on w.patno = r.patno

inner join

 (select patno, max(date1) as last_Rx from medications  where
 ( lower(prescrib) like '%albuterol%' or
 lower(prescrib) like '%ventolin%' or lower(prescrib) like '%proventil%' or lower(prescrib) like
 '%proair%'  ) 
and purpose not like '%reference%'
and  datediff(curdate(),date1) <= 365  group by patno) m on m.patno = r.patno
left outer join (select patno, icd_1, severity from chartnotes where problem_list = 'Y' and icd_1 like 'J45%') p on p.patno = r.patno
left outer join (select patno, date1, mdm_plan from enc_note) e2 on e2.patno = r.patno and e2.date1 = e.last_visit
left outer join (select patno, min(appt_date) as next_appt from schedule where appt_date > cast('today' as date) and( visit_status is null or visit_status not in ('Cancelled','Canceled','No Show','No Show*')) group by patno) s on s.patno = r.patno
left outer join staff1 on staff1.staffid = r.addr_id
where status_pat = 'ACTIVE' and lname <> 'TESTPATIENT'
and next_appt is null