Diabetes physicians’ offices

The referral form also includes check boxes for the physician to mark the appropriate ICD-9-CM codes. For diabetes education, he includes the common ICD-9 codes 250.00 (i.e., uncomplicated type 2 diabetes, controlled), 250.02 (i.e., uncomplicated type 2 diabetes, uncontrolled), and an Other field with room for the physician to add a more specific code (Buck and Lockyear, 2007). For the hyperlipidemia component, he has also included the common codes used to describe these conditions. Within the referral form is the statement of medical necessity and contact information for the physician and patients to reach the pharmacy to make appointments. Although Dr. Brouchard likes the form that he has created, he plans on revising the form based on his experience and input from the physicians office after a few months of use. He wants to make sure that the referral form is as easy to use as possible and that it contains most of the information he needs to submit claims successfully. 

Portable meters for measurement of blood glucose concentrations are used in three major settings (a) in acute and chronic care facilities (at the patient s bedside and in clinics or hospitals) (b) in physicians offices and (c) by patients at home, work, and school. The last, self-monitoring of blood glucose (SMBG), used by approximately 1 miUion diabetic patients, is performed in the United States at least once a day by 40% and 26% of individuals with type 1 and 2 diabetes, respectively. The worldwide market for SMBG is 2.7 billion per year, with annual growth estimated at 10% to 12%. ... 

Decreased doses. A patient with diabetes had been receiving 80 mg prednisone daily for several months. After an office visit, the physician decided to decrease the daily dose by 5 mg, from 80 to 75 mg, and wrote the order, Decrease prednisone—75 mg. The order was misinterpreted as meaning 80 mg minus 75 mg and was transcribed as, Prednisone 5 mg PO daily. As a result, a 5-mg dose was given, and the unintentional sudden large decrease in dosage caused the patient to collapse. Decrease prednisone by 5 mg daily is clearer, but the safest way to write the order is, Decrease prednisone by 5 mg daily. New dose is 75 mg daily. ... 

Pharmacists can assist e physician by assessing clinical outcomes of diabetes, hypertension, thyroid disorders, and lipids, and making recommendations to the physician about the potential need for adjustments in medications. Pharmacists can also educate individuals and groups of the physician s patients on diabetes within the office setting. 

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