OUTPATIENT COGNITIVE ASSESSMENT – WHAT YOU DID NOT KNOW YOU DID NOT KNOW!

Abstract

This practical session will be packed with clinical pearls regarding the diagnostic assessment of the neurocognitive disorders (NCD) with a focus on history taking and office screening, neuropsychological testing, and coding and billing. Attendees will learn about history taking for each of the six cognitive domains. Multimodality office screening tests will be disassembled and reassembled by cognitive domains. Tips will be provided regarding incorporating supplemental tests, indications for performing qualitative analyses and using alternative scoring schemes in order to greatly enhance the diagnostic yield of office screening tests. Office screening for cognitive symptoms that are included in the diagnostic criteria of the NCD but not usually covered by common tests, such as the apraxias, agnosias, surface dyslexia and apraxia of speech, will be discussed. Select neuropsychiatric symptoms have a role in supporting a diagnosis of NCD and will be described with examples. Next, attendees will learn to synthesize information obtained from history and office screening to make an informed clinical diagnoses of some common NCD. Office screening has limitations and it is important to know when to refer patient out for more detailed testing. The place of neuropsychological testing in diagnosing the NCD will be covered in some detail. A neuropsychologist is an expert in brain and behavior relationships, assessment of cognitive functioning, and interventions to promote daily functioning. Attendees will learn about the role of a neuropsychologist in an interdisciplinary outpatient memory disorder clinic in assisting with diagnosis and treatment planning. Additionally, attendees will learn about the role of a neuropsychologist in providing cognitive training and behavioral interventions for the patients and diagnosis-specific education and support for the care partners. Clinicians also need to be well compensated for their efforts, and an in-depth discussion of the current state of coding and billing for such a diagnostic work-up will follow. If attendees did not know that clinicians can use additional codes for office screening of the NCD, this session will help them figure out the best way to do that. By the conclusion of the session, all participants will have learned some new time-efficient and cost-effective strategies to score and augment common office screening tests in order to make more accurate clinical diagnoses of the NCD in the office, regardless of their prior expertise in this area. At least 20 minutes will be set aside for a robust Q&A session at the end.