Welcome, Providers!

In an effort to positively impact the health and wellness of our members, Fidelis Care recently sent providers a listing of patients who are non-compliant with their asthma medications.  Please be on the lookout for these letters to help us ensure these patients are receiving appropriate care for their conditions. 

Helpful Hints for Treating Asthma:

• Review your patient’s asthma self-management at each visits.  If your patient doesn’t have an Asthma Action Plan, help create one.  If the patient does have a plan, you may need to adjust the plan based on the patient’s behavior. 

• Check Asthma Medications: If your patient is over utilizing their quick relief medication, please follow up to see if the patient is using the controller medication consistently and correctly.  Switching the patient to a different controller medication may help address the issue.

• Educate patient on reducing asthma triggers.  Many asthma triggers are environmental.  Assessing the patient’s asthma incidents and instructing them to eliminate triggers from their home.

• Connect patients with asthma resources.   New York State offers programs to help people with asthma reduce asthma triggers in their homes and neighborhoods.

Best Practices: 

• Develop asthma action plans with patients and educate on reduction of asthma triggers. An Asthma Action Plan is a written document that gives clear instructions about how to treat the condition and how to respond quickly to an asthma attack. Having a clear asthma action plan could save a life. A printable sample is available at www.health.ny.gov/publications/4850.pdf. 

• Increase asthma medication adherence by:

• Providing education regarding the difference between a rescue inhaler versus a long-term controller.

• Creating patient-centered interactions by listening and incorporating patient’s opinions into the Asthma Action Plan.

• Prioritize patients with a low asthma medication ratio (e.g., less than 0.5).

Coding Tips:

• Avoid coding asthma if the diagnosis is for an asthma-like symptom (e.g., wheezing during viral upper respiratory infection and acute bronchitis is not “asthma”).

• Code for any diagnoses on the exclusion list on an annual basis. This includes emphysema, COPD, obstructive chronic bronchitis, chronic respiratory conditions due to fumes/vapors, cystic fibrosis, and acute respiratory failure.

For additional information please reference our AMR Tip Sheet.