QUESTION: Should I Document Medications on Progress Notes?I have heard from others, who consider themselves Medicare documentation experts, that it is unnecessary to document anything about psychiatric medication compliance and effectiveness. They advise against it as it is the prescriber's job, not … [Read more...] about Should I Document Medications on Progress Notes?
How to Document Prognosis for Mental Health
Medicare just added Prognosis to its list of documentation requirements. UGH! One more thing to think about and document. But how?What Is a Prognosis?Prognosis refers to making an educated guess about the expected outcome of treatment. Based on the medical model, it’s a prediction of a client’s … [Read more...] about How to Document Prognosis for Mental Health