Physician’s Home Page



ONCOCHART? TRAININGPHYSICIANSTable of Contents TOC \o "1-3" \h \z \t "Chapter Title,1" Physician’s Home Page PAGEREF _Toc383508315 \h 3Physician Documentation PAGEREF _Toc383508316 \h 4Staging PAGEREF _Toc383508317 \h 4Physician’s Home Page: CALENDAR PAGEREF _Toc383508318 \h 4Physician’s Initial Evaluation (History & Physical) PAGEREF _Toc383508319 \h 4Clinical Treatment Planning (77261, 77262, 77263) PAGEREF _Toc383508320 \h 5Performed Prior to Treatment Start PAGEREF _Toc383508321 \h 5Weekly Progress Notes (WPN) - Physician PAGEREF _Toc383508322 \h 5Weekly Treatment Management 77427 PAGEREF _Toc383508323 \h 6End of Treatment PAGEREF _Toc383508324 \h 6Physician Follow-Up Note PAGEREF _Toc383508325 \h 6Special Treatment Procedures 77470 PAGEREF _Toc383508326 \h 6Treatment Related Procedures Performed by Other Staff Members PAGEREF _Toc383508327 \h 6HYPERLINK \l "_Toc383508328"Treatment Planning CT (Computed tomography guidance for placement of radiation therapy fields) 77014 PAGEREF _Toc383508328 \h 6Simulation 77280, 77285, 77290 PAGEREF _Toc383508329 \h 6Immobilization Devices 77332, 77333, 77334 PAGEREF _Toc383508330 \h 7Blocks 77332, 77333, 77334 PAGEREF _Toc383508331 \h 7IMRT MLC Block 77334 PAGEREF _Toc383508332 \h 7Other Treatment Devices 77332, 77333, 77334 PAGEREF _Toc383508333 \h 7Basic Dosimetry 77300 PAGEREF _Toc383508334 \h 8Isodose Plan 77305, 77310, 77315 PAGEREF _Toc383508335 \h 83-D Dosimetry 77295 PAGEREF _Toc383508336 \h 8IMRT Dosimetry (77301) PAGEREF _Toc383508337 \h 8Block Check Simulation 77280 PAGEREF _Toc383508338 \h 9CT Guidance Daily (77014) PAGEREF _Toc383508339 \h 9Stereoscopic X-ray Guidance (77421) PAGEREF _Toc383508340 \h 9Ultrasound Localization PAGEREF _Toc383508341 \h 9Micro Dosimetry 77331 PAGEREF _Toc383508342 \h 9Special Physics Report 77370 PAGEREF _Toc383508343 \h 9Respiratory Motion Simulation +77293 PAGEREF _Toc383508344 \h 9PHYSICIAN’S HOME PAGE: Physician Orders PAGEREF _Toc383508345 \h 10PHYSICIAN’S HOME PAGE: ePrescribe PAGEREF _Toc383508346 \h 10Physician Quality Reporting System PAGEREF _Toc383508347 \h 11PHYSICIANSThe Physician’s Home Page XE "Physician’s Home Page:PHP" (PHP) is where ONCOCHART? physicians will spend the bulk of their time. From this screen, they are able to work with all of their active patients inside a very intuitive interface. To get to the PHP, press the Phys. Home Page button on the main ONCOCHART? screen. Physician’s Home Page XE "Physician’s Home Page:PHP" Here is a brief explanation of information contained in some of the pertinent columns:TX Today - If the patient is scheduled for a treatment today, the appointment time is shown using military-type notation. For example, 3:00 pm will appear as "15:00".Appt Today - If the patient is scheduled for an appointment with the physician today, the appointment time is shown using military-type notation. For example, 3:00 pm will appear as "15:00".Patient Name - This is the full name of the patient.ICD-9 - The diagnosis code for the patient's current course of treatment.Diagnosis - A description of the ICD-9 diagnosis code.PN's Needed - This number reflects the number of Progress Notes that the physician is behind (based on one note per 5 treatments).Last PN Date - In the case of a patient undergoing treatment, this is the last date of a Progress Note. If the patient has not yet started treatment, this field will be blank.Total Dose Planned - This is the total dose planned for the course of treatment.Click Physician’s Home Page XE "Physician’s Home Page:PHP" Icon, or Select Physician’s Home Page XE "Physician’s Home Page:PHP" from Home Pages menu.The list will populate with your Active Status patients assigned to you as the treating physician.The menu at the bottom offers several shortcuts to view and create documentation for your patient.The patient list is color coded: White background: Active patient that has not started Treatment.Green background: Active patient under Treatment that is caught up on Weekly Progress Notes.Yellow background: Active patient under Treatment that is due one Weekly Progress Note XE "Weekly Progress Note" .Red background: Active patient under Treatment that is due two or more Weekly Progress Notes.Physician DocumentationStagingAfter opening Physician Home Page, double click on a patient.Click Clinical XE "Clinical" .Select Staging Walk through the steps and Save at the end.The options you select during Staging XE "Staging" determine the following:Diagnosis related questions appearing in the Initial Evaluation XE "Initial Evaluation" , Weekly Progress Notes and Follow-Up.***All of the following instructions stem from the Physicians Home Page and using the Calendar (or Click Clinical and then Calendar)Physician’s Home Page: CALENDARPhysician’s Initial Evaluation XE "Initial Evaluation" (History & Physical) Select a Patient by highlighting him/her.Click Calendar XE "Calendar" .Click EM (Evaluation & Management).Click & Drag Initial Evaluation (INI) to a date on the Calendar XE "Calendar" .Select Billing XE "Billing" or Narrative XE "Narrative" (If your center is set up to allow both).Step through the tabs; answering as many questions as appropriate. It is important to document as completely as possible on all sections of the Narrative XE "Narrative" . Answers from the Initial Nursing Assessment & ONCOintake appear in your note – you can Edit the answers. Note: If you began your note prior to the Initial Nurse Assessment or ONCOintake, the answers will not appear in your note.Click on MDM Pt. Type.The required question Coordination of Care directs the program to score the Narrative XE "Narrative" from the correct group of CPT Codes. If the patient has Medicare, only 99201 – 99025 will be used. If the patient is non-Medicare, the codes below will be used. New Patient, Consultation Request 99241-99245.Consultation, New Problem, Previous Therapy 99241-99245.New Patient Consultation Request, Inpatient 99251-99255.Consult, New Problem, Previous TX, Inpatient 99251-99255.Established Patient, New Problem 99201-99205.Direct Request for Treatment 99201-99205.Self-Referral 99201-99205.Click Save for later review or click Save & Record to lock the document, sign your name and send the charge to Billing XE "Billing" . Note: The scoring of the level of E&M is based on your answers.Clinical XE "Clinical" Treatment Planning XE "Treatment Planning" (77261, 77262, 77263) Performed Prior to Treatment StartFrom the Calendar, click Clinical XE "Clinical" Treatment Plan.Select the appropriate Plan (Conventional, IMRT XE "IMRT" , Brachy, etc.).Click & Drag the plan to a date on the Calendar XE "Calendar" .Select Billing XE "Billing" or Narrative XE "Narrative" (If your center is set up to allow both).If you have any previously completed Treatment Plans saved as a template, you can select one to fill in many of the needed answers. Step through the tabs; answering as many questions as appropriate.Click Save for later review or click Save & Record to lock the document, sign your name and send the correct level of charge to Billing XE "Billing" .You can save this plan as a template for use in future plans if you desire. Weekly Progress Notes (WPN) - PhysicianFrom the Calendar, click EM.Click & Drag Weekly Progress Note XE "Weekly Progress Note" (WPN) to a date on the Calendar XE "Calendar" .Step through the tabs; answering as many questions as appropriate.On your first WPN, many answers will carry over from your Initial Evaluation XE "Initial Evaluation" . On subsequent WPN’s, most answers will carry over from your previous WPN.You can delete or change any carry over answers.Most answers in your final WPN will carry over to your first Follow-Up Note XE "Follow-Up Note" . Weekly Treatment Management 77427Weekly Treatment Management CPT is sent to the Billing XE "Billing" Log when you have completed a Weekly Progress Note XE "Weekly Progress Note" for every 5 Treatments. End of Treatment XE "End of Treatment" When treatment is completed and the final Weekly Progress Note XE "Weekly Progress Note" has been completed as the last day of therapy:From the Calendar, click EM or select from your Favorites.Click & Drag Clinical End of Treatment to the last treatment date on the Calendar XE "Calendar" . Select Create Narrative XE "Narrative" , or send to Billing XE "Billing" if you have that option. Step through the tabs; answer the questions that apply to that patient.As in all forms, once the End of Treatment XE "End of Treatment" Summary has been Saved and Recorded, the note is locked and is no longer editable.This is not a billable event but is necessary to close out the patient’s course of therapy. Physician Follow-Up Note XE "Follow-Up Note" From the Calendar, XE "Physician Procedures" Click EM or select from your Favorites list.Click & Drag Follow-Up Exam to a date on the Calendar XE "Calendar" .Select Billing XE "Billing" or Narrative XE "Narrative" .Step through the tabs; answering as many questions as appropriate.On your first Follow-Up Exam note XE "Follow-Up Note" , many answers will carry over from your last Progress Note.On subsequent Follow-Up Exams, most answers will carry over from your previous Follow-Up Exams XE "Follow-Up Note" .If a Nursing Follow-Up was performed, those answers will carry over to your note. You can delete or change any carry over answers.Follow-Up Exam notes are a billable event. The correct CPT Code is selected based on your answers to the questions. Special Treatment Procedures 77470 From the Calendar, click Special Treatment Procedure.Answer the questions on the appropriate tab(s) (Chemo, Previous XRT, etc.).Click Save to Edit later or click Save and Record to send 77470 to Billing XE "Billing" .Treatment Related Procedures Performed by Other Staff MembersTreatment Planning XE "Treatment Planning" CT (Computed tomography guidance for placement of radiation therapy fields) 77014From the Calendar, click & Drag CT Treatment Planning XE "Treatment Planning" (technical charge only) to a date on the Calendar XE "Calendar" .Simulation XE "Simulation" 77280, 77285, 77290From the Calendar, click Simulations.Click & Drag type of Simulation XE "Simulation" to the Calendar XE "Calendar" . (CT, 3-D, Block Check, Conventional, Clinical XE "Clinical" , Brachy)Answer the questions on the tabs that relate to that patient’s case.*If you answer the question on the Summary tab, you do not need to answer any other questions and will generate a short generic Narrative XE "Narrative" , Billing 77280.** The more questions answered, the more complete the documentation will be. Complexity billed is based on answers selected on the question located under the Technical Factors and the Medical Necessity tabs. Immobilization Devices 77332, 77333, 77334From the Calendar, click Treatment Devices\Basic Dosimetry.Click & Drag Immobilization Device XE "Immobilization Device" to a date on the Calendar XE "Calendar" .Select Billing XE "Billing" or Narrative XE "Narrative" .Type in the Number of Devices.The Narrative XE "Narrative" form will appear with the number of tabs corresponding to the number you typed in for Number of Devices. Answer the questions.Click Save and Send to Billing XE "Billing" – this sends the correct level of CPT Code to the Billing Log. Blocks 77332, 77333, 77334From the Calendar, click Treatment Devices\Basic Dosimetry.Click & Drag the Treatment Device XE "Treatment Device" to a date on the Calendar XE "Calendar" . Select Billing XE "Billing" or Narrative XE "Narrative" . Type in the number of blocks.The Narrative XE "Narrative" form will appear with the number of tabs corresponding to the number you typed for blocks. Click Condensed to provide only the Port and Description.Selecting the Condensed button negates the necessity to answer questions under any other button. This will bill the correct level Treatment Device XE "Treatment Device" and one Basic Dosimetry XE "Dosimetry" . Click Expanded to answer detailed questions.These questions select the correct level of block charge.Answering the Basic Dosimetry XE "Dosimetry" question will send CPT Code 77300 to Billing XE "Billing" .Answering any of the Additional Dosimetry XE "Dosimetry" questions will send CPT Code 77300 to Billing XE "Billing" in addition to the code sent for the Dosimetry question. Answering the Dosimetry XE "Dosimetry" & Additional Dosimetry questions negates the need to do a Dosimetry Narrative XE "Narrative" for these blocks. Click Save and Send to Billing XE "Billing" – this sends the correct CPT Codes to the Billing Log.IMRT XE "IMRT" MLC Block 77334From the Calendar, click Treatment Devices.Click & Drag IMRT XE "IMRT" MLC Block to a date on the Calendar XE "Calendar" . Answer the question(s). Click Save and Send to Billing XE "Billing" – this sends the CPT Code to the Billing Log.Other Treatment Devices 77332, 77333, 77334From the Calendar, click Treatment Devices.Click & Drag the Treatment Device XE "Treatment Device" to a date on the Calendar XE "Calendar" . Select Billing XE "Billing" or Narrative XE "Narrative" .Type in the number of Devices.The Narrative XE "Narrative" form will appear with the number of tabs corresponding to the number you typed in for Number of Devices. Answer the questions. The answers determine the complexity of the Device. Click Save and Send To Billing XE "Billing" – this sends the CPT Code to the Billing Log.Basic Dosimetry XE "Dosimetry" 77300If you answered the Dosimetry XE "Dosimetry" or Summary questions under Treatment Devices, it is not necessary to do a separate Basic Dosimetry Narrative XE "Narrative" , which would send another 77300 to Billing XE "Billing" . If you have not answered the Dosimetry XE "Dosimetry" questions under Treatment Devices, or need to bill additional Dosimetry charges, proceed as follows: Click Clinical XE "Clinical" .Click Calendar XE "Calendar" . Click Basic Dosimetry XE "Dosimetry" (MU Efficiency Index) to a date on the Calendar XE "Calendar" .Select Billing XE "Billing" or Narrative XE "Narrative" .Type in the number of Dosimetries.The Narrative XE "Narrative" form will appear with the number of tabs corresponding to the number typed for number of Dosimetries. Answer the questions.Click Save and Send to Billing XE "Billing" – this sends the 77300 CPT Code to the Billing Log, for each Dosimetry XE "Dosimetry" Recorded. Isodose Plan 77305, 77310, 77315From the Calendar, click Isodose Plan.Select Conventional Isodose or Brachy Isodose.Step through the tabs; answer the questions that apply to that patient.Your answers will determine the complexity of the plan and select the correct CPT Code for Billing XE "Billing" . 3-D XE "Simulation" Dosimetr XE "Dosimetry" y 77295From the Calendar, click Simulation.Click & Drag 3-D to the Calendar XE "Calendar" . Answer the questions on the tabs that relate to that patient’s case.Note: If you answer the question on the Summary tab, a short generic Narrative XE "Narrative" will be created and you do not need to answer any other questions. Remember, the more questions you answer the better the quality of your documentation. IMRT XE "IMRT" Dosimetry XE "Dosimetry" (77301)The Physician must complete the Clinical XE "Clinical" Treatment Plan for IMRT XE "IMRT" or Tomotherapy and the plan must include at least one Critical Dose Point for this button to be active. Click & Drag IMRT XE "IMRT" Dosimetry XE "Dosimetry" to a date on the Calendar XE "Calendar" .Select Billing XE "Billing" or Narrative XE "Narrative" .It is strongly recommended that you select Narrative XE "Narrative" .Select the area of treatment (Head & Neck, Prostate, etc.).Step through the tabs; answer the questions that apply to that patient.Click Save and Send to Billing XE "Billing" . This will send the CPT Code 77301 to Billing.Block Check Simulation XE "Simulation" 77280Some centers will have Block Check Simulations XE "Block Check Simulations" enter automatically when the Linac detects the proper sequence of Ports to deliver a Block Check Sim. The physician must Verify and Record this event for Billing XE "Billing" . If your center is not pulling Block Check Simulation XE "Simulation" information from the treatment machine, follow these steps. From the Calendar, click Simulation.Click & Drag Block Check to the Calendar XE "Calendar" .Answer the questions on the tabs that relate to that patient’s case.CT Guidance Daily (77014) From the Calendar, click & drag CT Guidance Daily to a date on the Calendar XE "Calendar" . Step through the tabs; answer the questions that apply to that patient. You must enter data in all Shift questions to record procedure.Some of these answers cascade to the next procedure. Stereoscopic X-ray Guidance (77421)From the Calendar, click & drag Stereoscopic X-ray Guidance to a date on the Calendar XE "Calendar" . Step through the tabs; answer the questions that apply to that patient. You must enter data in all Shift questions to record procedure.Some of these answers cascade to the next procedure. Ultrasound Localization XE "Ultrasound" From the Calendar, click Ultrasound Localization XE "Ultrasound" .Click & drag the appropriate Ultrasound XE "Ultrasound" type to a date on the Calendar XE "Calendar" . Step through the tabs; answer the questions that apply to that patient.Micro Dosimetry XE "Dosimetry" 77331From the Calendar, Drag & Drop MicroDosimetry XE "Dosimetry" to a date on the Calendar XE "Calendar" . Type in the number of MicroDosimetry procedures performed. Send to Billing XE "Billing" or create a Narrative XE "Narrative" .Step through the tabs; answer the questions that apply to that patient.Special Physics Report 77370 – may occur at any point during Treatment at Physician’s requestFrom the Calendar, click Special Physics Consult.Drag & Drop Special Physics type to a date on the Calendar XE "Calendar" . Step through the tabs; answer the questions that apply to that patient.Technical charge is sent to Billing XE "Billing" .Generally only one allowed per course of therapy. Respiratory Motion Simulation +77293 - Add-on code used in conjunction with 77295 or 773011. From the Calendar, click on Respiratory Motion Simulation.2. Drag & Drop Respiratory Motion Simulation type to a date on the Calendar.3. Step through the tabs; answer the questions that are clinically appropriate.PHYSICIAN’S HOME PAGE: Physician OrdersIn the Physicians Home Page, Click the Physician Order XE "Physician Order" icon.Select the patient by clicking Select Patient.Click on Create New Order.Select the procedure from the menu tree on the left.Enter as much information as needed for that procedure. Instructions to the facility.Reason for the procedure.Date you need the procedure performed by.Desired location.Any specifications.Add any special remarks.Select the person(s) to whom you want to send the order.Click Save – this “freezes” the order until it is noted.PHYSICIAN’S HOME PAGE: ePrescribe XE "ePrescribe" Click ePrescribe XE "ePrescribe" .Add patient Allergies XE "Allergies" .Select Common Allergies XE "Allergies" from the dropdown or add Common Allergy Type.Click Done with Allergies XE "Allergies" .Add patient pharmacy.Fill in the zip code and state, and then click Find.Any pharmacy with (E) next to the name is an electronically prescribed pharmacy. Click the pharmacy name to add to patient chart.Add patient prescription.Type all or part of the name of the medication and click Find.Select desired medication from the list.Fill out Sig Code information, quantity, refills etc…Click Continue. Verify that your script is correct.You can add your prescription to your favorite list for quick access in future.Click OK to finalize adding a prescription.Select prescription you want to transmit. Type your signature password and click send. (For schedule medications, they can’t be electronically sent but can be entered into the system for documentation).Add patient outside medication.Click the Manage Meds hyperlink.Type all or part of the name of the medication and click Find.Select desired medication from the list.Change provider to Select One.Type in comments who prescribed the medication and click Continue.For a detailed report of medication prescribed by outside physicians, click PBM Hx hyperlink, obtain new data and select the medication you want to add to the outside list.Close ePrescribe XE "ePrescribe" tab and medications will populate your patient’s ONCOCHART? records.Physician Quality Reporting SystemPhysician Quality Reporting System (PQRS XE "PQRS" )Appears in the INI, WPN, and Follow-Ups.CMS program to collect patient data.Physician received payment for submitting data.Set Medicare as Government Insurance.Select Administration.Click General Maintenance.Click Billing XE "Billing" .Click Insurance Companies.Select Medicare.Click Edit.Check the Government Insurance box.Click OK.When a patient with Medicare is selected and meets any diagnosis requirements, appropriate PQRS XE "PQRS" questions will be available. INDEX INDEX \e "" \h "A" \c "1" \z "1033" AAllergies8BBilling3, 4, 5, 6, 7, 8, 9Block Check Simulations7CCalendar3, 4, 5, 6, 7, 8Clinical2, 3, 5, 6, 7DDosimetry5, 6, 7EEnd of Treatment4ePrescribe8, 9FFollow-Up Note4IImmobilization Device5IMRT3, 6, 7Initial Evaluation2, 3, 4NNarrative3, 4, 5, 6, 7PPhysician Order8Physician Procedures4Physician’s Home PagePHP1, 2PQRS9SSimulation5, 6, 7Staging2TTreatment Device5, 6Treatment Planning3, 5UUltrasound7WWeekly Progress Note2, 4 ................
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