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The long-awaited 2021 CDC Sexually Transmitted Infections Treatment Guidelines were published in MMWR on July 22, 2021. This webinar will focus on significant changes from the 2015 CDC STD Treatment Guidelines, including updated guidelines for the screening, diagnosis and treatment of gonorrhea, chlamydia, syphilis, pelvic inflammatory disease, genital herpes, Mycoplasma genitalium, and vaginal trichomoniasis. To assist health care providers in obtaining a sexual history, the updated “Five P’s” approach will be reviewed. In addition, current Family PACT benefits for each type of sexually transmitted infection discussed in the program will be explained.
Learning Objectives:
List 3 examples of sexual history questions for each the “Five P’s” of sexual history taking
Explain why the treatment guidelines for both chlamydia and gonorrhea genital tract infections were updated in the 2021 Guidelines
List the indications for obtaining chlamydia and gonorrhea samples from the anus and the oropharynx
Describe the consequences of Mycoplasma genitalium genital infection in males and females
List 2 updates in the 2021 Guidelines regarding vaginal trichomoniasis
The ongoing COVID-19 public health emergency has caused a shift from providing exclusively in-person services to a combination of remote and in-person visits, referred to as “hybrid visits”. This webinar will provide an update of how Family PACT services (client encounters) have changed since March, 2020, focusing on the Medi-Cal/Family PACT policy for telephonic-only remote visits. A series of case studies will be presented including contraceptive visits, evaluation of genital tract infections, well person visits, and a colposcopy visit, with an emphasis on coding and billing Family PACT. There will be ample time for you to ask questions about both clinical issues and Family PACT coding and billing policies.
Speaker:
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
The long-awaited new ASCCP Management Guideline App is now available, as well as the print version of the 2019 Guidelines. The new guidelines are streamlined for ease of use and can be significantly more individualized than the 2012 guidance by integrating information about an individual’s previous screening test and biopsy results, and personal factors such as age and immunosuppression. The guidelines now provide recommended follow up for all 3 available cervical screening strategies. This webinar will briefly explain the rationale used in developing the Guidelines, discuss how various abnormalities should be managed, and provide interactive demonstrations of how to use the app. In addition, specific considerations for the application of Family PACT benefits, including coding and billing, will be discussed. Learning objectives: At the end of this session, the learner will be able to:
Learning Objectives:
Describe the risk-based paradigm for managing abnormal cervical cancer screening test results.
Explain how risk-thresholds guide the clinical actions of immediate treatment, colposcopy, and short-interval follow up.
Demonstrate use of the ASCCP app to apply the new guidelines to patient care.
Since March 2020, most providers of family planning services in California have shifted patient care from in-person visits to remote visits. This webinar will be conducted in a “frequently asked questions” format, focusing on the adaptations that clinicians should make in order to successfully provide family planning care remotely during the public health emergency and afterward.
Subjects will include the role of blood pressure measurement before prescribing combined hormonal contraception, the use of injectable birth control subcutaneous depot medroxyprogesterone acetate (DMPA-SQ), syndromic treatment of sexually transmitted infections, pregnancy testing without a clinic visit and others. Recently enacted Family PACT and Medi-Cal policies regarding telehealth visits and remote enrollment of clients into the Family PACT program will be discussed. Ample time will be available for the audience to submit questions and to share information about the adaptations that you have been implementing at your clinic.
Speakers:
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
Jennifer Karlin, MD, PhD Assistant Professor & Associate Director Course Director for Pre-Clerkship Intersession, Health Systems Science Pillar Department of Family & Community Medicine UC Davis School of Medicine
The CPT rules for the use of problem-oriented E/M office visit codes changed significantly on January 1, 2021. Since then, office visits are coded based on levels of medical decision-making or “total time” and the prior rules for using the “three key components” no longer apply. Consequently, Family PACT E/M coding policies were updated in February 2021, as well as the publication of a new policy on coding and billing for counselor services.
Learning Objectives:
List at least six activities that can be counted in the “total time” of a visit when computing E/M level
List each of the 3 elements used in medical decision-making, and give examples of each
Describe the Family PACT policy for coding for a clinician visit and counselor services on the same date of service
Speaker:
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
This webinar features two new Family PACT Clinical Practice Alerts.
Cervical Cancer Screening
Topics in this portion of the webinar will include benefits through Family PACT that have been expanded to include high-risk HPV-alone screening, use of this test, alternative cervical cancer screening options, and new guidelines regarding cervical cancer screening for females who are HIV positive or who are immunocompromised.
Emergency Contraception
Topics in this portion of the webinar will include the relationship between body weight and emergency contraception failure rates, when oral contraceptives can be started with females who have used ulipristal acetate, options for accessing emergency contraceptive pills and the use of the copper IUD as emergency contraception.
Presenters will also address your clinical questions, as well as your questions about Family PACT benefits related to these topics.
Speakers:
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
Nicole Economou, MD Complex Family Planning Specialist at UC Davis School of Medicine
Rates of sexually-transmitted diseases (STDs) such as chlamydia trachomatis (CT) and gonorrhea (GC) have reached an all-time high. In the U.S., California leads the nation in reported cases of these STDs. Because persons with CT and GC are often asymptomatic, screening is essential for the early detection and treatment that can prevent reproductive complications including pelvic inflammatory disease (PID), tubal infertility, ectopic pregnancy, and chronic pelvic pain in females and epididymitis in males. Join us for a webinar to learn about current clinical guidelines for routine and targeted screening, treatment, follow-up, and prevention of CT and GC.
Learning Objectives:
Understand current guidelines for screening for CT and GC among sexually active people
List the indications for anorectal and oropharyngeal CT/GC screening
Explain when test-of-cure is indicated
Identify the proper ICD-10 codes for lab requests and billing information
Speakers:
Ina Park, MD, MS Co-author of the CDC STI Treatment Guidelines, 2021
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
Patients often experience varying levels of pain or discomfort from procedures performed during family planning visits. The purpose of this webinar is to provide clinicians with evidence-based tips, tricks, and strategies on how to prevent and minimize pain during family planning procedures.
The webinar focuses on the most commonly performed family planning procedures such as: IUD insertion/removal, implant insertion/removal, colposcopy, biopsy, and vulvar biopsy. Less common procedures for non-gynecologists such as LEEP, cryo, and procedures not covered by the Family PACT Program are not discussed.
Learning Objectives:
Three components and factors associated with procedure pain and strategies to alleviate discomfort
Four examples of trauma-informed care practices for family planning clients
Three examples of ways to use patient-centered language during pelvic exams
Considerations for administering and providing the appropriate level of local anesthetic
The purpose of the webinar is to provide clinicians who are doing IUD placements with advanced skills to prevent and manage the uncommon complications that can occur with the placement and use of IUDs. It consists of case studies that detail the management of difficult IUD placements owing to cervical stenoisis, morbid obesity, and vasovagal syncope. Management of IUD complications, including uterine perforation, tenaculum site injuries, and post-IUD placement infection will be discussed. The work-up and management of the patient with a “missing” IUD string, including variants of malpositioned IUDs and intrauterine pregnancy with an IUD in place, are explained as well.
Learning Objectives:
Maneuvers that can be performed to improve the likelihood of successful placement in morbidly obese patients
Techniques to avert vaso-vagal episodes and 4 sequential steps in the management of a vaso-vagal syncope
The most common predisposing factors for uterine perforation with IUD placement
Causes of a “missing” IUD string and how each is managed
Management of post-IUD placement pelvic inflammatory disease
Speaker:
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
The contents of the well-woman visit have changed significantly in the past decade, such that many screening tests are performed in modified age groups and at different screening intervals. This webinar will review the well-woman health screening recommendations published by the California Department of Public Health (CDPH), U.S. Preventive Services Task Force (USPSTF), American College of Obstetrics and Gynecology (ACOG) and other national organizations.
Learning Objectives:
Reproductive goals counseling
Use of newer cervical cancer screening technologies
Utility of screening clinical breast exams and screening pelvic exams
Coding for well-woman visits
Speaker:
Michael Policar, MD, MPH Professor Emeritus, UCSF Senior Medical Advisor, CAPTC and California OFP Clinical Fellow, NFPRHA
