99509

With the new cardinal care contract risk stratification, many of our members are now receiving one face to face contact per year. We have concerns with the frequency of routine visits being specific to medical needs. There are many situations that can lead to a need for adjustments to the plan of care such as changes in support system changes and health related social needs that may not otherwise be identified short of the providers routine visits. 

S5116

Where should the outcome of a work hour verification be appropriately documented and billed when additional education for the EOR is identified as necessary, but the S5116 code is limited to use only when the EOR explicitly requests education?

Specifically, if education is required based on findings during verification (rather than by request), what is the correct mechanism for capturing both the intervention and associated staff time to ensure compliance and accurate documentation?