COPD APCM Compliance & Audit Readiness Checklist

Confirm the patient has two or more chronic conditions expected to last 12 months, such as COPD and Heart Failure.

Record verbal or written consent in the EHR, explaining cost-sharing and the ability to terminate at any time.

Ensure the medical record contains spirometry results (FEV1/FVC < 0.70) to support the COPD diagnosis.

Implement an AI-driven or live-agent after-hours system to address urgent respiratory symptoms and prevent ER visits.

Document the time spent by the provider or clinical staff creating the comprehensive COPD management plan.

Check patient-specific coverage for G-codes to ensure reimbursement and minimize patient billing surprises.

Log the monthly review of the COPD Action Plan, specifically tracking patient understanding of 'Green, Yellow, Red' zones.

Record monthly status updates and specific counseling provided for patients still using tobacco or nicotine products.

Use AI call interactions to verify patient inhaler use and document corrective education for audit readiness.

Ensure the care plan specifies flow rates, saturation targets, and DME provider contact information.

Document referrals to or participation in pulmonary rehab programs as part of the holistic care strategy.

Revise the care plan immediately following any hospital discharge or acute exacerbation event for compliance.

Maintain a timestamped log of at least 20 minutes of non-face-to-face time per calendar month.

Integrate structured data from automated symptom monitoring calls directly into the patient's medical record.

Document current status for influenza, pneumonia, and COVID-19 vaccines to meet quality performance metrics.

Log reconciliation of all medications, including rescue and maintenance inhalers, after every transition of care.

Document annual PHQ-9 or GAD-7 screenings, as these are common comorbidities that impact COPD outcomes.

Maintain logs of communications with oxygen suppliers regarding tank refills and equipment maintenance.