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Advance Care Planning

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Advance care planning (ACP) refers to how patients make decisions about care they will receive if they can no longer speak for themselves.

  • Several methods address uncertainty of goals...

TREATMENT

  • ACP discussions are often complicated by various emotional, cultural, and medical factors. It is important to engage in these conversations with sensitivity about the patient’s frame of refe...

ONGOING CARE

Reimbursement: The Centers for Medicare & Medicaid Services has reimbursed physicians for ACP discussions since 2015. 
  • The current CPT codes are 99497 for the first 30 minutes of discu...

REFERENCES

1
1 Advance directive forms by state. http://www.aarp.org/home-family/caregiving/free-printable-advance-directives/. Accessed November 21, 2017.
2
2 Spoelhof GD, Elliott B. Implementing advanc...

ADDITIONAL READING

CODES

ICD10

  • Z71.89 Other specified counseling

  • Z51.5 Encounter for palliative care

  • Z66 Do not resuscitate

ICD10

  • V68.89 Encounters for other specified administrative purpose

  • V66.7 Encounter for palliative car...

CLINICAL PEARLS

  • ACP is important and underutilized.

  • The primary barriers to discussing advanced directives in the primary care setting from the patient perspective include lack of knowledge, fear of bu...

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