6 month diet
So my Therapist who is a MD has been seeing me for over 2 years and said she has been monitoring me on my diet and can pull up 6 months of documents. I started dieting this year before I really looked into wls. My question is the papers she gave me to give my center looks like this. Will this work for my insurance company??
Referring Provider
(Doctors name) MD
Diagnoses
Obesity - Primary 278.00
ADHD (attention deficit hyperactivity disorder) 314.01
Depression 311
Ordered Medications
Disp Refills Start End
(meds)50mg Oral 30 Cap 0 2/19/2013
capsule
Take 1 Cap by mouth daily early morning for 30 days - Oral
Discontinued Medications
Reason for Discontinue
Reorder
Oral capsule
Visit Disposition
Disposition
Return in about 1 months (around 3/19/2013)
Vitals – Last Recorded
BP Pulse Ht Wt BMI Breastfeeding?
160/74 89 5’6” (1.676 m) 285 lb 2.4 oz (129.341 kg) 46.0kg/m2 No
Pain Information
No pain information on file
Not recorded
Reviewed On 2/19/2013 By
Allergies as of 2/19/2013
Allergen Noted Type Reactions
Penicillins 02/19/2013 Topical Rash
Progress Notes
doctor, MD at 2/19/2013 2:31 PM
Status: Signed
MD: doctor name MD
DATE: 2/19/2013
Length of appointment: 30 minutes
Subjective:
Visit 1 out of 6
My name is a 24 y.o female who presents for
Chief Complaint
Patient presents with
- ADHD
- Obesity
CURRENT ISSUES:
She is on a 1200 calorie /day diet using weighing and portion control and using a nutrition diet plan. Discussed no fried foods, sodas, and very low sugar.
Patient has joined Gym with trainer doing Cardio for 30 mins to 1hour a day for 2days a week.
She is dealing with coping with food when stressed or bored. Advised her to take a walk to some other form of activity instead of eating.
Patient starting a 6 MSD for bariatric surgery.
Issuing MED for ADHD and weight loss
Patient understands risks and benefits of the medication
Patient Active Problem List
Diagnosis Dates Noted
- Obesity 02/19/2013
- Depression 02/19/2013
- ADHD (attention deficit hyperactivity disorder) 02/19/2013
Allergies
Allergen Reactions
- Penicillins Rash
Current Outpatient Prescriptions
Medication Sig Dispense Refill
- MED Take 1 Cap by mouth daily 30 Cap 0
50 mg Oral capsule early morning for 30 days.
No current facility-administered medications for this visit.
No past surgical history on file.
No past medical history on file.
No family history on file.
History
I did block out doc name my name and meds but u get the point
Looks good to me. She might need to do a summary of the last 6 months that includes diagnoses and the diet/exercise plan. Also, that she/he 'recommends gastric weight loss surgery'. That's just as important as all the other stuff...the recommendation itself. But to be sure...you should check with your insurance provider.
on 8/2/13 1:01 am
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It looks good. According to insurance an it seems to be with all of the ones that require the 3- 6 month diets, as long as it is within a year of the surgery requested, the diet monitoring must consist of what type of diet that your pcp recommends and if you have gained any weight or lost any. This must be consecutive for 180 days, 6 months there can be no interruption in paperwork. So if this is 6 months consecutive and done by your primary care physician then you are good.
