NYSCRI Psychiatric Evaluation Update (NYPEU)

Form Details

• Form Properties
  1. Form Title: NYSCRI Psychiatric Evaluation Update
  2. Start from an Existing Form - Yes, if there is a previous version signed and locked.
  3. Copyrighted Form - No
  4. Billable Progress Note - No
  5. Have multiple versions open at same time - No
  6. Open Blank on new version - No
• Required Fields - Yes
• Lookup Tables - None
• Pre-Fill Logic - Yes
  1. Organization Name will prefill from Setup Program/Billing Defaults Company Info Tab.
  2. Program Name will prefill from the Program the patient enrolled in.
  3. Diagnoses on Axis Tab will prefill from diagnosis listed in ICD 10 Diagnosis Table (Administration ICD 10/DSM 5) or most recent signed and locked Diagnosis form/tab.
• Fill to Logic - Yes
  1. Diagnosis tab will fill any new Diagnosis or Assessment forms and the read-only Diagnosis tab in Patient Details.
  2. Needs identified will fill the Goal/Needs section of a Treatment Plan.
• Signatures
  1. Individual’s Signature
     • Sig type: Patient
  2. Guardian’s Signature
     • Sig type: Any
  3. Physician/NPP Signature
     • Credential required to sign: Physician, NP, MD.
     • Title will fill title entered in user setup.
     • Signature required.
     • Route To functionality is available.
  4. Supervisor Signature
     • Credential required to sign: Supervisor.
     • Title will fill from title entered in user setup.
     • Defaults to N/A checked.
     • Signature required.
     • Route To functionality is available.

Brief History Tab

• The Organization Name will prefill from the Program/Billing Defaults/Company Information tab.
• The Program Name will prefill from the Program the patient is enrolled in.
• Selecting the box for Refer to Attached Mental Status Evaluation will grey out the narrative text box and the Danger to section.
• Selecting Denied any Danger to Self/Others will grey out the Self and Others options.

See Program/Billing Defaults, Programs.

Diagnosis Tab

• You must select a Primary diagnosis.

• ICD 10 Diagnosis Code - Will pull from diagnosis listed in ICD 10 Diagnosis table (Administration ICD10/DSM5) or most recent previously completed diagnosis form/tab.
• Specifier - Set up Specifier Lookup table (Specifiers ICD10) in Lookup Manager (see Lookup Manager).

Child/Adolescent Tab

• All questions in the Child/Adolescent tab will grey out if the patient is under the age of 18.

Assessed Needs Tab

• Selecting No Additional Recommendations Clinically Indicated will grey out the Prioritized Assessed Needs fields.
• Selecting None under Individual Declined/Deferred/Referred Rationale(s) will grey out the 1, 2 and 3 text fields.

Signatures Tab

1. Signature Type Credentials
   • Individual’s Signature
     • Sig type: Patient
   • Guardian’s Signature
     • Sig type: Any
   • Physician/NPP Signature
     • Credential required to sign: Physician, NP, MD.
     • Title will fill title entered in user setup.
     • Signature required.
     • Route To functionality is available.
   • Supervisor Signature
     • Credential required to sign: Supervisor.
     • Title will fill from title entered in user setup.
     • Defaults to N/A checked.
     • Signature required.
     • Route To functionality is available.