The CPT rules for the use of problem-oriented E/M office visit codes changed significantly on January 1, 2021. Since then, office visits are coded based on levels of medical decision-making or “total time” and the prior rules for using the “three key components” no longer apply. Consequently, Family PACT E/M coding policies were updated in February 2021, as well as the publication of a new policy on coding and billing for counselor services.

Learning Objectives:

  1. List at least six activities that can be counted in the “total time” of a visit when computing E/M level
  2. List each of the 3 elements used in medical decision-making, and give examples of each
  3. Describe the Family PACT policy for coding for a clinician visit and counselor services on the same date of service

Presenter:

  • Michael Policar, MD, MPH

Resources:

STD Expert Hour Webinar – Disseminated Gonococcal Infection (DGI)

February 23, 2021

The California Department of Public Health (CDPH) has received increasing reports of disseminated gonococcal infection (DGI), a severe complication of untreated gonorrhea. Dr. Laura Quilter and Dr. Eric Tang discuss DGI epidemiology, clinical presentation, and management, and review California’s recent DGI investigation and what clinicians can do to help.

Drs. Quilter and Tang cover the following learning objectives for this webinar:

  1. Describe the epidemiology of uncomplicated gonorrhea and DGI
  2. Recognize the clinical manifestations of DGI and increase clinical suspicion for DGI in patients with joint pain
  3. Demonstrate how to diagnose, manage, and treat DGI
  4. Report all laboratory-confirmed and clinically-suspected cases of DGI to public health
  5. Prioritize routine screening, testing, and treatment of STDs among high-risk patients

STD Clinical Update Webinar – Maternal & Congenital Syphilis Update for CA Prenatal Care Providers

Syphilis among women and congenital syphilis are on the rise in California. Congenital syphilis is preventable with prompt detection and treatment during syphilis. Dr. Eric Tang of the California Department of Public Health (CDPH) and California Prevention Training Center (CAPTC) discusses prenatal care provider knowledge in management of maternal and congenital syphilis for pregnant patients.

Dr. Tang covers the following learning objectives for this webinar:

  1. Describe California’s CS epidemiology
  2. Recognize the clinical manifestations of CS
  3. Discuss CS diagnosis, evaluation, and management
  4. Report all laboratory-confirmed and clinically-suspected cases of CS to public health

STD Expert Hour Webinar – Understanding the Concerning Rise in Maternal and Congenital Syphilis in Hawaii

Oct 13, 2020

The California Prevention Training Center (CAPTC) and the STI/HIV Prevention Program at the Hawaiʻi Department of Health’s (HIDOH) Harm Reduction Services Branch present this webinar for healthcare providers and community service providers who work with communities that face cultural, economic, and language barriers to obtaining good prenatal and neonatal care.

This webinar will address the increasing rate of syphilis cases within Hawaii, with a special focus on maternal syphilis and congenital syphilis. Learners will gain an understanding of the local epidemiology of syphilis as well as the important role the Hawaii Department of Health performs in syphilis case follow-up and investigation. An overview of the pathophysiology of syphilis with its varied clinical manifestations will be discussed. Content will include the importance of staging, stage-based treatment as well as best practices for diagnosis and follow-up.

Providing Family PACT Services During COVID-19 Part 2: Understanding Benefit Changes

September 17, 2020

The ongoing COVID-19 public health emergency has caused a shift from providing exclusively in-person services to a combination of remote and in-person visits, referred to as “hybrid visits”. This webinar will provide an update of how Family PACT services (client encounters) have changed since March, 2020.

The following topics are covered in detail:

  • Medi-Cal/Family PACT policy for telephonic-only remote visits.
  • A series of case studies including contraceptive visits, evaluation of genital tract infections, well person visits, and a colposcopy visit, with an emphasis on coding and billing Family PACT.

Presenters:

Resources

STD Expert Hour Webinar – Delivering Sexual Health Services in the Time of COVID-19

August 13, 2020

The coronavirus (COVID-19) is impacting the delivery of sexual health services in California and throughout the United States. Dr. Ina Park and Dr. Rosalyn Plotzker provide an overview of recent CDC recommendations for STD diagnosis and treatment when in-person exams and visits are limited. They also discuss best practices for the use of telehealth and home-testing for STD care and PrEP management.

Drs. Park and Plotzker cover the following learning objectives for this webinar:

  1. Share implementation strategies for self-collected testing to minimize clinician exposure to COVID-19 when seeing clients for STD-related symptoms
  2. Identify changes to recommended syndromic treatment of urethritis, including treatment for gonorrhea and chlamydia
  3. Describe management recommendations for patients with genital ulcer disease
  4. Discuss HIV PrEP telehealth management approaches to ensure continuation of PrEP use for clients who are unable to get care in a clinic setting during and after the COVID-19 public health emergency

Implementing the 2019 ASCCP Risk-Based Management Guidelines for Abnormal Cervical Cancer Screening Tests in Your Practice

July 23, 2020

The long-awaited new ASCCP Management Guideline App is now available, as well as the print version of the 2019 Guidelines. The new guidelines are streamlined for ease of use and can be significantly more individualized than the 2012 guidance by integrating information about an individual’s previous screening test and biopsy results, and personal factors such as age and immunosuppression. The guidelines now provide recommended follow up for all 3 available cervical screening strategies.

The following topics are covered in detail:

  • The rationale used in developing the Guidelines
  • How various abnormalities should be managed
  • Interactive demonstrations of how to use the app
  • Specific considerations for the application of Family PACT benefits, including coding and billing

Learning objectives: At the end of this session, the learner will be able to:

  1. Describe the risk-based paradigm for managing abnormal cervical cancer screening test results.
  2. Explain how risk-thresholds guide the clinical actions of immediate treatment, colposcopy, and short-interval follow up.
  3. Demonstrate use of the ASCCP app to apply the new guidelines to patient care.

Presenters:

Resources

STD Expert Hour Webinar – Genital Dermatology 101

June 1, 2020

Dr. Kenneth Katz covers the following learning objectives for this webinar:

  1. Differentiate between genital skin diseases
  2. Formulate differential diagnoses for genital skin disease
  3. Identify genital skin diseases that warrant referral to specialty care

Providing Family PACT Services During COVID-19 Part 1: Clinical Considerations

May 8, 2020

Since March 2020, most providers of family planning services in California have shifted patient care from in-person visits to remote visits. This webinar will be conducted in a “frequently asked questions” format, focusing on the adaptations that clinicians should make in order to successfully provide family planning care remotely during the public health emergency and afterward.

The following topics are covered in detail:

  • Subjects will include the role of blood pressure measurement before prescribing combined hormonal contraception
  • The use of injectable birth control subcutaneous depot medroxyprogesterone acetate (DMPA-SQ)
  • Syndromic treatment of sexually transmitted infections
  • Pregnancy testing without a clinic visit.
  • Recently enacted Family PACT and Medi-Cal policies regarding telehealth visits and remote enrollment of clients into the Family PACT program.

Presenters:

Resources

Clinical Practice Alert: Cervical Cancer Screening and Emergency Contraception

March 24, 2020

This webinar features two new Family PACT Clinical Practice Alerts.

Cervical Cancer Screening

Topics in this portion of the webinar will include benefits through Family PACT that have been expanded to include high-risk HPV-alone screening, use of this test, alternative cervical cancer screening options, and new guidelines regarding cervical cancer screening for females who are HIV positive or who are immunocompromised.

Emergency Contraception

Topics in this portion of the webinar will include the relationship between body weight and emergency contraception failure rates, when oral contraceptives can be started with females who have used ulipristal acetate, options for accessing emergency contraceptive pills and the use of the copper IUD as emergency contraception.

Presenters:

Resources: