“717”
DELETE THE LINES IN BLUE – THEY ARE A REMINDER TO YOU ABOUT BILLING
AND COMPLIANCE
Item 717 is claimed alone unless in combination with a
clinically indicated item 23 etc - annotated "not related to the health check"
Health check for people aged 45 to 49 and who have an
identified chronic disease risk factor.
Consent to health check explained and permission obtained.
SNAPF Risk factors
Smoking, nutrition, alcohol, physical activity and Family History
Elevated BP, cholesterol or BMI
Investigations
Fasting lipids, E/LFT's
Insure
Pap
Mammogram
Assessment
"insure"
INSURE test discussed, implications of +ve & -ve
test discussed, no test 100%.
Explained cost & method. Kit given
"cdm"
Benefits and procedures of a management plan considered,
explained and agreed.
Goals, needs and actions discussed.
Other providers mutually chosen and contacted, and
permission to share relevant information obtained.
Items –
721 Plan 725 Review
723 Coordination 727 Review
Treatment/services to be provided by collaborating
providers
Review of targets agreed to
BELOW IS AN EXAMPLE OF MY 717 TEMPLATE INACTIOIN
OPEN THE LETTER WRITER AND GO TO THE TEMPLATE CALLED 717
OPEN THE TEMPLATE
A Medical Centre
SA, 5999
Phone 8000000 Fax 8999999
Staying Healthy - 17/11/2006
Mrs L McSample
7
Somewhere St
Inasuburb SA 5999
Today's Notes
Progress notes for L M
Thursday November 16 2006 12:59:55
Dr. Terry Rose
Examination:
General:
BP(Sitting): 100/80
Weight: 70kg
Height: 166cm
BMI: 25.4
Smoking assessment changed: 16/11/2006
Smoker: smoker
Strong FH heart disease (mother and grandmother)
Cholesterol not checked for 3 years
SNAPF Risk factors
Smoking, nutrition, alcohol, physical activity and Family History
Elevated BP, cholesterol or BMI
Investigations
Fasting lipids, E/LFT's
Insure
Pap
Mammogram
Assessment:
Generally healthy,
check iron
minimal alcohol
Pathology requested: Lipids/HDL; E/LFT's; TFT's; FBE; ESR; - 12 hours water only
Letter Created - re. 717.
Letter Printed - re. 717.
Relevant Investigations:
Performed:
29/11/2003
Test
name: GENERAL CHEMISTRY
GRIBBLES
PATHOLOGY
GENERAL
CHEMISTRY SPECIMEN:
SERUM
Sodium
137 mmol/L (136 - 146)
Calcium 2.50 mmol/L (2.10 -
2.55)
Potassium 4.7 mmol/L (3.5 - 5.2) Phosphate 1.25 mmol/L (0.75 - 1.45)
Chloride
103 mmol/L (98 - 109)
T.Protein 75 g/L (60 - 82)
Bicarb.
25 mmol/L (20 - 33) Albumin 48
g/L (35 - 50)
Urea
4.3 mmol/L (2.5 - 8.0)
Alk.Phos 73 U/L (30 - 120)
Creat.
0.06 mmol/L (0.05 - 0.11)
Bilirubin 8 umol/L (< 25)
Urate
0.22 mmol/L (0.15 - 0.45
GGTP 24 U/L (< 50)
Glucose
3.5 mmol/L (see below)
AST 18 U/L (< 41)
ALT 16 U/L (< 51)
LD 175 U/L (50 - 280)
* Cholesterol 5.7 mmol/L (Ideal<5.5)
Elevated cholesterol, suggest full lipid
profile on a fasting sample.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Suggested Programme:
SNAPF Risk
factors
Smoking, Nutrition, Alcohol, Physical activity and Family
History
Elevated
BP, cholesterol or BMI
Smoking is the
single biggest reversible cause of major suffering in this country.
Some steps
toward becoming an ex-smoker and improving your health include:
Write down
the reasons why you may continue to smoke in a diary.
On one
page of the diary, write down the reasons why you would continue to smoke.
Reasons
may include “to relax” or “it helps me get through the day”
On another
page write down the reasons why you would become an ex-smoker.
Reasons may
include “the kids want me to stop” or “I feel awful in the mornings”
Keep these
pages and check them once a month to see if they still reflect how you feel.
Have a
good look for the triggers that encourage smoking and record them.
Once you
have recognised and acknowledged these triggers, you can challenge them.
Set a quit
date – in consultation with your loved ones if that is appropriate - and give
it a go.
You can
succeed, and the benefits are tremendous.
Dietary
guidelines for Australian adults
• Enjoy a
wide variety of nutritious foods
– eat
plenty of vegetables and fruits
– eat
plenty of cereals (rice, pasta, noodles) preferably wholegrain
– include
lean meat, fish, poultry
– include
milks, yoghurts, cheeses. Reduced fat varieties should be
chosen
where possible
• Drink
plenty of water – at least 2 litres a day
And take
care to:
– limit
saturated fat and moderate total fat intake
– choose
food low in salt
– limit
your alcohol intake if you choose to drink
– consume only
moderate amounts of sugars and foods containing added sugars
You should
eat at least 2 portions of fruit a day - examples of 2 portions of fruit:
2 medium
sized fruit such as apples, bananas or oranges
2 cups of
fruit salad
1 cup of
fruit juice
You should
eat at least 5 portions of vegetables a day – examples of a single portion of
vegetables are:
1 cup of
salad vegetables
1/2 cup
cooked vegetables (75 g)
1 medium
potato
A move to
a lower glycaemic index vegetable will help with weight loss.
Details of
sample serves can be found at the Australian Guide to
Healthy
Eating website (www.health.gov.au/pubhlth/strateg/food/guide/materials.htm).
Weight reduction can be achieved in a
variety of ways, eg. reduced fat (particularly saturated fat), carbohydrate,
protein or alcohol intake and smaller portion size. Any changes must be
maintainable in the long term.
Fad diets are not recommended for long term
weight loss.
If your
body mass index (BMI) is over 25, you
should consider reducing your weight by 5% over the next 6 months.
This
amount is achievable and will have a significant benefit in terms of your risks
as well as how you feel. At a BMI closer to the ideal, you will have less load
on your joints, be able to move more freely, and will have more energy.
Men and
women differ in their tolerance of alcohol. As a safe guide, men should limit their alcohol
intake to less than 28 standard drinks per week, while women should limit their
intake to 14 standard drinks per week.
This is
bearing in mind that a standard drink of standard beer is 285 mls and a wine is
100 mls.
You will
need to check the sizes of your glasses.
We
recommend 30 minutes of moderate exercise,
such as walking, on most days of the week.
The duration
is more important than the intensity.
If the
exercise causes a slight but noticeable increase in your breathing rate or in
your heart rate or makes you perspire slightly, then it is adequate.
PREVENTIVE
HEALTH
"Insure" screen for bowel cancer
every year. This test is very specific for human blood, as well as being quite
sensitive.
A negative test is good news, but does not
totally exclude a bowel tumour.
A positive test indicates bleeding from
somewhere and this can include bleeding form a tooth, the stomach and also from
a polyp in the bowel.
So a positive test is an indicator for
follow up, and is not diagnostic of a tumour.
......................................................................................................................
TEMPLATE FOR ITEM
717 HANDOUT FOR
MEDICAL DIRECTOR
A Medical Centre
SA
Phone 800000 Fax
8999999
Staying Healthy -
<<Miscellaneous:Date>>
<<Patient Demographics:Full Name>>
<<Patient Demographics:Full Address>>
Today's Notes
<<Summary:Progress Note (Current)>>
<<Clinical Details:Measurements>>
<<Clinical Details:Measurements>>
<<Clinical Details:History List>>
Current Medications:
<<Clinical Details:Medication List>>
Relevant Investigations:
<<Summary:Investigation
Results (Selected)>>
Suggested Programme:
SNAPF Risk
factors
Smoking, Nutrition, Alcohol, Physical activity and Family
History
Elevated
BP, cholesterol or BMI
Smoking is the
single biggest reversible cause of major suffering in this country.
Some steps
toward becoming an ex-smoker and improving your health include:
Write down
the reasons why you may continue to smoke in a diary.
On one
page of the diary, write down the reasons why you would continue to smoke.
Reasons
may include “to relax” or “it helps me get through the day”
On another
page write down the reasons why you would become an ex-smoker.
Reasons may
include “the kids want me to stop” or “I feel awful in the mornings”
Keep these
pages and check them once a month to see if they still reflect how you feel.
Have a
good look for the triggers that encourage smoking and record them.
Once you
have recognised and acknowledged these triggers, you can challenge them.
Set a quit
date – in consultation with your loved ones if that is appropriate - and give
it a go.
You can
succeed, and the benefits are tremendous.
Dietary
guidelines for Australian adults
• Enjoy a
wide variety of nutritious foods
– eat
plenty of vegetables and fruits
– eat
plenty of cereals (rice, pasta, noodles) preferably wholegrain
– include
lean meat, fish, poultry
– include
milks, yoghurts, cheeses. Reduced fat varieties should be
chosen
where possible
• Drink
plenty of water – at least 2 litres a day
And take
care to:
– limit
saturated fat and moderate total fat intake
– choose
food low in salt
– limit
your alcohol intake if you choose to drink
– consume only
moderate amounts of sugars and foods containing added sugars
You should
eat at least 2 portions of fruit a day - examples of 2 portions of fruit:
2 medium
sized fruit such as apples, bananas or oranges
2 cups of
fruit salad
1 cup of
fruit juice
You should
eat at least 5 portions of vegetables a day – examples of a single portion of
vegetables are:
1 cup of
salad vegetables
1/2 cup
cooked vegetables (75 g)
1 medium
potato
A move to
a lower glycaemic index vegetable will help with weight loss.
Details of
sample serves can be found at the Australian Guide to
Healthy
Eating website (www.health.gov.au/pubhlth/strateg/food/guide/materials.htm).
Weight reduction can be achieved in a
variety of ways, eg. reduced fat (particularly saturated fat), carbohydrate,
protein or alcohol intake and smaller portion size. Any changes must be
maintainable in the long term.
Fad diets are not recommended for long term
weight loss.
If your
body mass index (BMI) is over 25, you
should consider reducing your weight by 5% over the next 6 months.
This
amount is achievable and will have a significant benefit in terms of your risks
as well as how you feel. At a BMI closer to the ideal, you will have less load
on your joints, be able to move more freely, and will have more energy.
Men and
women differ in their tolerance of alcohol. As a safe guide, men should limit their alcohol
intake to less than 28 standard drinks per week, while women should limit their
intake to 14 standard drinks per week.
This is
bearing in mind that a standard drink of standard beer is 285 mls and a wine is
100 mls.
You will
need to check the sizes of your glasses.
We
recommend 30 minutes of moderate exercise,
such as walking, on most days of the week.
The duration
is more important than the intensity.
If the
exercise causes a slight but noticeable increase in your breathing rate or in
your heart rate or makes you perspire slightly, then it is adequate.
PREVENTIVE
HEALTH
"Insure" screen for bowel cancer
every year. This test is very specific for human blood, as well as being quite
sensitive.
A negative test is good news, but does not
totally exclude a bowel tumour.
A positive test indicates bleeding from
somewhere and this can include bleeding form a tooth, the stomach and also from
a polyp in the bowel.
So a positive test is an indicator for
follow up, and is not diagnostic of a tumour.
......................................................................................................................