This module maps to the four Medicare skilled-nursing categories. Document the one(s) that apply this visit in coverage language.
Observation and assessment
Recognizing anaphylaxis and the reactions that precede it, verifying reaction-readiness, and treating a single fever in immunosuppression as an emergency require the knowledge and judgment of a licensed nurse. Reaction and infection surveillance are the core of observation and assessment for this domain.
Teaching and training
Teaching the anaphylaxis action plan and auto-injector technique, allergen avoidance, infection precautions, and immunosuppressant management — to patient and caregiver competence with return demonstration — is skilled teaching and training and is the dominant skilled service for at-risk patients.
Management and evaluation of the plan of care
Evaluating whether reaction-readiness and immune status are adequate and coordinating epinephrine replacement, immunosuppressant changes, infection treatment, or vaccine planning when they are not is skilled management and evaluation of the plan of care.
Skilled procedures
Skilled procedures in this domain include epinephrine administration and reaction management per order; the assessment, readiness verification, and surveillance are the skilled service.
