Include specifiers and modifiers of diagnoses to Diagnosis section of assessment
It would be helpful to have additional fields in the diagnosis section so that we can include specifiers and modifiers of diagnoses as required by the DSM 5. This field could also be used to note if the diagnosis is provisional or a rule/out diagnosis. Thank you!
App Type
TheraNest App
ADMIN RESPONSE
Aug 23, 2024
Added an editable description field to diagnosis codes. This will allow users to add specifiers or any other information relevant to client diagnoses.
I am a therapist and office administrator at the agency I work for. It has come to my attention, in my own cases as well as in questions I have received from other providers at the agency, that the loss of ability to edit diagnoses (i.e. adding specifiers such as "r/o", "by history", "per client report", etc.) is problematic. Clinically, it is very often relevant and most accurate to include diagnoses with these types of specifiers on a client's assessment. Making the diagnoses editable or creating a field associated with each individual diagnosis to include these would be best for the fidelity of our documentation.
In the Initial assessment & Diagnosis codes-classification of the diagnosis, can resolved and preliminary diagnosis be added to the drop down box under classification?
The new Diagnostic Classifications that rolled out on 09/07/23 are EXCELLENT. The options of primary, secondary, etc. are a welcome addition. Is there any chance we can add "Rule out" to those options? And unlike primary, secondary, etc., one could have multiple rule out options.
Thanks!
it's important to have the modifiers especially in substance use disorders whether they are Active, Early Remission, or Sustained Remission - why did you take the ability to even make rule-outs?
TheraNest just got rid of the ability to list diagnoses as rule outs. A greater majority of our diagnoses are rule outs, so this greatly impacts us. We do psychological and neuropsychological testing, so at the intake the diagnoses are often not known- that's why they are referred for testing. So the diagnoses are listed as rule outs instead until testing is performed to confirm the diagnoses. We now no longer have the ability to do this, which impacts our practice. TheraNest just suddenly got rid of this function, and doesn't offer an alternate to continue allowing this to be an option in any way.
If I free text a rule out, it is added to the superbill as if it is just diagnosed and that feels misleading to the client and to the insurance company they are submitting to.
Please add more features/ modifiers to diagnoses, so that we can specify when diagnoses are Rule-Outs, and we can see when a diagnosis was ruled-in, added, etc.
Please remove retroactive application of new diagnoses to older progress notes (a "date added" notation would also be helpful). This is extremely important, both clinically, and so that our notes and diagnoses are accurate and comply with requirements.
Yes, in addition, I need to be able to add a primary diagnosis and show what are the secondary ones. In this format, is hard to be able to do this. This is very important when you bill for Medicaid, for example.
It would be great to have this as an option on the list of diagnosis and not have it generate into the treatment plan (as we are only looking to rule it out at this point).
