Common use of PROBLEM LIST Clause in Contracts

PROBLEM LIST. 20.4.1 Contractor will create and maintain a Problem List for each client served under this Agreement. The problem list is a list of symptoms, conditions, diagnoses, and/or risk factors identified through assessment, psychiatric diagnostic evaluation, crisis encounters, or other types of service encounters. 20.4.2 Contractor must document a problem list that adheres to industry standards utilizing at minimum SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®️) U.S. Edition, March 2021 Release, and ICD-10-CM 2023. 20.4.3 A problem identified during a service encounter may be addressed by the service provider (within their scope of practice) during that service encounter and subsequently added to the problem list. 20.4.4 The problem list shall be updated on an ongoing basis to reflect the current presentation of the client. 20.4.5 The problem list shall include, but is not limited to the following: 20.4.5.1 Diagnoses identified by a provider acting within their scope of practice, if any. Diagnosis-specific specifiers from the current DSM shall be included with the diagnosis, when applicable. 20.4.5.2 Current International Classification of Diseases (ICD) Clinical Modification (CM) codes. 20.4.5.3 Problems identified by a provider acting within their scope of practice, if any. 20.4.5.4 Problems identified by the client and/or significant support person, if any. 20.4.5.5 The name and title of the provider that identified, added, or removed the problem, and the date the problem was identified, added, or removed. 20.4.6 A problem identified during a service encounter (e.g., crisis intervention encounter) may be addressed by the service provider (within their scope of practice) during that service encounter, and subsequently added to the problem list. 20.4.7 The problem list shall be updated on an ongoing basis to reflect the current presentation of the member. Providers, within their scopes of practice, shall add to, amend, or resolve problems from the problem list when there is a relevant change to a member’s condition. DHCS does not require the problem list to be updated within a specific timeframe or have a requirement about how frequently the problem list should be updated after a problem has initially been added. However, providers shall update the problem list within a reasonable time and in accordance with generally accepted standards of practice. 20.4.8 For members that were receiving services prior to July 1, 2022 (the date that problem list requirements first took effect), a problem list is not required to be created retroactively. However, a problem list should be started when the member receives a subsequent DMC-ODS service after July 1, 2022.

PROBLEM LIST. 20.4.1 19.4.1 Contractor will create and maintain a Problem List for each client served under this Agreement. The problem list is a list of symptoms, conditions, diagnoses, and/or risk factors identified through assessment, psychiatric diagnostic evaluation, crisis encounters, or other types of service encounters. 20.4.2 19.4.2 Contractor must document a problem list that adheres to industry standards utilizing at minimum SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®️) U.S. Edition, March 2021 Release, and ICD-10-CM 2023. 20.4.3 19.4.3 A problem identified during a service encounter may be addressed by the service provider (within their scope of practice) during that service encounter and subsequently added to the problem list. 20.4.4 19.4.4 The problem list shall be updated on an ongoing basis to reflect the current presentation of the client. 20.4.5 19.4.5 The problem list shall include, but is not limited to the following: 20.4.5.1 19.4.5.1 Diagnoses identified by a provider acting within their scope of practice, if any. Diagnosis-specific specifiers from the current DSM shall be included with the diagnosis, when applicable. 20.4.5.2 19.4.5.2 Current International Classification of Diseases (ICD) Clinical Modification (CM) codes. 20.4.5.3 19.4.5.3 Problems identified by a provider acting within their scope of practice, if any. 20.4.5.4 19.4.5.4 Problems identified by the client and/or significant support person, if any. 20.4.5.5 19.4.5.5 The name and title of the provider that identified, added, or removed the problem, and the date the problem was identified, added, or removed. 20.4.6 19.4.6 A problem identified during a service encounter (e.g., crisis intervention encounter) may be addressed by the service provider (within their scope of practice) during that service encounter, and subsequently added to the problem list. 20.4.7 19.4.7 The problem list shall be updated on an ongoing basis to reflect the current presentation of the member. Providers, within their scopes of practice, shall add to, amend, or resolve problems from the problem list when there is a relevant change to a member’s condition. DHCS does not require the problem list to be updated within a specific timeframe or have a requirement about how frequently the problem list should be updated after a problem has initially been added. However, providers shall update the problem list within a reasonable time and in accordance with generally accepted standards of practice. 20.4.8 19.4.8 For members that were receiving services prior to July 1, 2022 (the date that problem list requirements first took effect), a problem list is not required to be created retroactively. However, a problem list should be started when the member receives a subsequent DMC-ODS service after July 1, 2022.