What are your percentage of level 3, level 2 and level 1 progress notes

[bananas85]

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For hospitalist rounders, can you give me a break down of your level 3s and level 2s.

I want to compare it to the culture at my place where it seems most people are billing 80-90 % level 3.

I am currently in an admitting shift, trying to switch to rounding shift, and trying to calculate the average RVUs

 

[gutonc]

For hospitalist rounders, can you give me a break down of your level 3s and level 2s.

I want to compare it to the culture at my place where it seems most people are billing 80-90 % level 3.

I am currently in an admitting shift, trying to switch to rounding shift, and trying to calculate the average RVUs

If you're doing anything more than babysitting them until ortho can do their ORIF, it's a level 3.

 

[rokshana]

If you're doing anything more than babysitting them until ortho can do their ORIF, it's a level 3.

And the day after you bill a level 1 is the day a pt should be discharged.

 

[jm192]

If you're doing anything more than babysitting them until ortho can do their ORIF, it's a level 3.

Is this really how you look at it? Asking for my own education, not criticizing or questioning your judgement

I started in August and am still figuring it out. Our director said that he thought it should be mostly two's, and that some of the guys always billing 3's would eventually get audited or something to that effect.

Even then, patients are sick, and I probably run 60-70% 3's--but wonder if it should be more.

 

[Doc_Mcstuffins]

Is this really how you look at it? Asking for my own education, not criticizing or questioning your judgement

I started in August and am still figuring it out. Our director said that he thought it should be mostly two's, and that some of the guys always billing 3's would eventually get audited or something to that effect.

Even then, patients are sick, and I probably run 60-70% 3's--but wonder if it should be more.

I think actual numbers I’ve heard from a couple years back were national average: 5% Level 1, 55% Level 2, 40% Level 3. Now could some level 2 be billed at higher level due to better documentation - most certainly.

 

[DrSnips]

Virtually any patient you are actively managing for anything can be a level 3. My dementia patients awaiting placement are level 2s. I am not familiar with this level 1 you speak of.

 

[InvestingDoc]

According to my billing software:

71% level three

28% level two

1% level one

I only bill level one on inpatient hospice where I'm not making any changes, just focusing on comfort. As you can see, this is not the majority of my patients.

 

[jdh71]

Is this really how you look at it? Asking for my own education, not criticizing or questioning your judgement

I started in August and am still figuring it out. Our director said that he thought it should be mostly two's, and that some of the guys always billing 3's would eventually get audited or something to that effect.

Even then, patients are sick, and I probably run 60-70% 3's--but wonder if it should be more.

Well. It's nonsense. You need TWO of three areas. Put in the labs, review the images yourself, note you talked to the consultant. Have all the stupid HPI stuff there plus the rest of the history that any decent EMR will blow into your note now and it's a level 3 after you've assessed all the crap every single patient has that is sick enough for an admit.

Take a class and quit losing out on RVUs. Hospitalists work hard enough the way it is. It doesn't take much longer to put the stuff that a level three note needs.

 

[jdh71]

The really challenging notes to sometime get are the level 5 returns in the clinic.

 

[gutonc]

The really challenging notes to sometime get are the level 5 returns in the clinic.

Not really.

1. Cancer X - Continue Treatment Y
2. Pancytopenia - Due to Y. Continue to monitor, transfuse for whatever makes you feel like you're not killing people.
3. Chemo induced SE 1 - Supportive treatment X, Consider dose reduction
4. Chemo induced SE 2 - Supportive treatment Y, Consider dose reduction

All I did there was see a routine chemo f/u in 5 minutes with the usual complaints that my triage RN documented 3x/day over the past 2 weeks.

99215...BOOM!!!

 

[jdh71]

Not really.

1. Cancer X - Continue Treatment Y
2. Pancytopenia - Due to Y. Continue to monitor, transfuse for whatever makes you feel like you're not killing people.
3. Chemo induced SE 1 - Supportive treatment X, Consider dose reduction
4. Chemo induced SE 2 - Supportive treatment Y, Consider dose reduction

All I did there was see a routine chemo f/u in 5 minutes with the usual complaints that my triage RN documented 3x/day over the past 2 weeks.

99215...BOOM!!!

Quit giving people hope and poison at the same time???

 

[gutonc]

Quit giving people hope and poison at the same time???

Hope+Poison =99215

 

[aafisahar]

only a resident, but looking at what a level 3 progress note is is basically a well written note in residency.

 

[jm192]

Well. It's nonsense. You need TWO of three areas. Put in the labs, review the images yourself, note you talked to the consultant. Have all the stupid HPI stuff there plus the rest of the history that any decent EMR will blow into your note now and it's a level 3 after you've assessed all the crap every single patient has that is sick enough for an admit.

Take a class and quit losing out on RVUs. Hospitalists work hard enough the way it is. It doesn't take much longer to put the stuff that a level three note needs.

Any suggested sites or resources? Thanks

 

[PlutoBoy]

Any suggested sites or resources? Thanks

www.emuniversity.com