Visit planning materials
These visit planning materials will help improve the ease of documenting a patient
visit for adult spinal pain (neck or low back pain). You may want these documents
on your spinal pain patients’ charts. Click on the title to link to the document:
- Adult Spine Pain Guideline on one page
- Historical red flags/exam red flags
- Lumbar Spine X-ray Indications and Spine Imaging Guideline
- Patient History form - to be filled out by patient before a provider visit
- Adult Spine Pain Exam form – for quick documentation
- Follow-up Spine Assessment Visit
- Adult Spine Pain Standing Orders form – shows prompted treatment guideline
- Patient education handouts:
- Home Exercise Program for Neck Pain
- Home Exercise Program for Low Back Pain
- Treating Your Spinal Pain
- How Your Provider Will Manage Your Spinal Pain
- Diagnostic Imaging Tests for Spinal Pain
- Your First Clinic Visit for Spinal Pain
- Treating Acute Disc Herniations
Special notes about the contents:
- The Patient History form asks for all the information needed for a 99204 or 99214 visit.
- The exam form and standing orders sheet are rapid ways to document a visit completely.
Please feel free to give any feedback about improving the accuracy and ease of
use of the contents of the visit planning packet. Email your feedback to Kathy
Popp at kathleen.popp@allina.com.