--- id: visit-wizard-ehr-overview title: Visit Wizard overview module: visit-wizard-ehr audience: [clinician] roles: [clinician, medical_director] type: concept estimated_minutes: 6 last_reviewed: 2026-06-29 app_route: /facility/{facility_uuid}/visit-wizard-v2-page related: - visit-wizard-ehr-start-a-visit - visit-wizard-ehr-how-the-wizard-opens - visit-wizard-ehr-note-honesty-guardrails - visit-wizard-ehr-wound-assessment - visit-wizard-ehr-lcd-navigator - visit-wizard-ehr-wound-cockpit - visit-wizard-ehr-work-offline - visit-wizard-ehr-sign-off - visit-wizard-ehr-medication-dosespot tags: [visit-wizard, EHR, LCD, Medicare, autosave, AI-drafting, ABI] --- # Visit Wizard overview The Visit Wizard is Medipyxis's step-by-step wound care documentation flow. It guides clinicians through **17 sections** — from consent to provider attestation — supporting documentation completeness, real-time LCD compliance, and clean billing-code generation before a note is signed. ![Visit Wizard section navigator and patient header](../../assets/visit-wizard/03_visit_wizard_overview.png) *The Visit Wizard section navigator. Completed sections display a checkmark, and the active section is highlighted.* --- ## How the Visit Wizard fits into the workflow The Visit Wizard opens from the **Fleet Calendar** (tap the appointment, then **Start Visit**), from the **Wound Cockpit**, or from the Patient Chart's Appointment Management card. All three surfaces call the same resolver, so a live draft is resumed by identifier no matter which surface you came from. When opened, the wizard locks to the selected patient, wound, and date of service. See [How the Visit Wizard opens](./how-the-wizard-opens.md) for the route-on-arrival behavior. The Visit Wizard route is `/facility/{facility_uuid}/visit-wizard-v2-page`. Fleet Calendar uses **specialty routing**: **Start Visit** sends primary-care patients to the Primary Care Cockpit and wound-care patients into the Visit Wizard. --- ## How the Visit Wizard is structured The Visit Wizard uses **17 sections** that mirror the structure auditors expect. Notable behaviors: - **Continuous autosave** — each field is saved as you complete it (per-field debounced save plus a safety-net heartbeat), so drafts survive network drops and device switches. There is no separate offline mode in the web app. - **Warn-and-proceed** — sections that used to hard-block on incomplete fields now surface a **soft warning** and let you continue, recording a review flag rather than stopping documentation. (One exception: if the service date does not match the appointment date, a soft-block prompt at close-out asks for a reason.) - **Clinical history carry-forward** — comorbidities, allergies, prior treatments, and historic measurements pre-populate from the prior visit; a **Pull from History** action can bring forward documented sections on demand. - **LCD Navigator ambient badge** — real-time Medicare compliance status, always visible at the top. See [LCD Navigator](./lcd-navigator.md). - **ABI documentation for compression** — the wizard flags a compression order that lacks a documented ankle-brachial index. - **AI-assisted drafting** — generate section text from structured data, with guardrails and a one-time AI Disclaimer acknowledgment. - **Medical Necessity Statement** — auto-generated narrative tied to LCD requirements. - **Deterministic CPT autocode** with **AI fallback** when the deterministic engine returns zero rows; **Pull Codes** can auto-populate billing codes from the documentation. - **LCD audit on save** — every save runs a compliance audit that updates the ambient badge. --- ## The 17 sections | # | Section | Key fields / notes | |---|---|---| | 1 | **Consent & Attestation** | HIPAA notice, telehealth consent toggle, patient e-signature. | | 2 | **Patient Context / Demographics** | Reason for visit, visit type, allergies. Insurance is shown here; the **secondary payer is read-only** — edit insurance on the **Insurance** tab. | | 3 | **Review of Systems** | Body-system checklist; carries forward from prior visit. | | 4 | **Objective Assessment** | Vitals: **BP**, **HR**, **Temp**, **SpO₂**, **Respirations**, **Weight**, **Height**, **BMI**. | | 5 | **Comorbidities / Risk Factors** | DM, PAD, CVI, CHF, lymphedema, smoking status. Feeds the billing engine and stage-aware ICD-10 resolver. | | 6 | **Functional Status & ADLs** | Ambulation, ADL independence, fall risk. | | 7 | **Wound Assessment** | Etiology, staging, dimensions, tissue percentages, anatomical location, exudate, pain, infection signs, photo upload. Each wound carries a **Treating / Monitoring** status. See [Wound Assessment](./wound-assessment.md). | | 8 | **Previous Treatment** | Prior interventions (offloading, compression, debridement history, prior grafts). | | 9 | **Treatment / Intervention** | Debridement type, dressing selection, ultrasonic therapy (MIST / Arobella), AI-assisted draft available. | | 10 | **Care Plan** | Goals, frequency, next-visit interval, plan-of-care dates. | | 11 | **Procedures & Supplies** | Graft SKU + UIN, wastage calculation, **Generate Procedure Note**, auto-mapped to billing codes. | | 12 | **Orders & DME** | Clinical orders and DME. DME is a vendor-fulfilled order — there is **no product picker** here; clinicians order and the item is fulfilled downstream. | | 13 | **Medication Management** | Medications and **DoseSpot** e-prescribing (pharmacy selection and prescription handled in the DoseSpot modal). | | 14 | **Billing** | Deterministic CPT autocode with AI fallback, E/M level, modifiers, POS code, **Medical Necessity Statement**. Billing lines can be dragged to reorder. | | 15 | **Patient Education** | Handout selection and teach-back. | | 16 | **LCD Audit & Review** | LCD Navigator final review — see [LCD Navigator](./lcd-navigator.md). | | 17 | **Provider Attestation** | ESIGN/UETA/CMS/HIPAA attestation and **Sign & Lock**. See [Sign Off](./sign-off.md). | --- ## Autosave and drafts The Visit Wizard saves continuously — each field is written as you complete it, with a safety-net heartbeat — so you rarely need to save manually. Draft visits appear on the **Fleet Calendar** with a draft status and can be resumed on any device. --- ## Clinical history carry-forward When you open a follow-up visit, the wizard pre-populates from the prior visit: Review of Systems, Comorbidities, Allergies, Previous treatments, Historic measurements (used to compute % area change), and the care plan. A **Pull from History** action lets you bring specific sections forward on demand, with a preview before applying. Always review pre-populated values — carry-forward is a starting point, not a substitute for re-assessment. --- ## LCD Navigator (ambient) The LCD ambient badge is visible at the top of every section and refreshes on every save: - **Green** — all checks pass. - **Amber** — at least one item needs clinician action. - **Red** — a flagged item; resolve it before **Sign & Lock**. Click the badge to open **Dojo tiles** with intervention guidance and the **copy bank** of pre-written compliance statements for NPWT, Compression, and Offloading. Full guide: [LCD Navigator](./lcd-navigator.md). --- ## AI-assisted drafting Several sections expose an **AI-assisted draft** button. The model drafts a clinical narrative from the structured data you have entered. You must read the draft, edit anything inaccurate, and acknowledge the **AI Disclaimer** the first time you use AI drafting in a visit. Anything left in an AI draft becomes part of your signed note — review carefully before attestation. Progress notes are generated with zero-fabrication safeguards: only clinician-documented supplies, plans, and findings appear. --- ## Procedures & Supplies The Procedures & Supplies section records what was done and what was used. From this section you can add procedures, enter graft SKUs/UINs and quantities (wastage is calculated automatically), and click **Generate Procedure Note**. Inventory is deducted and a **tissue log** entry is written on save; anything documented here flows into the billing codes engine. --- ## Provider Attestation and Sign & Lock The final section captures the rendering provider's electronic signature under the ESIGN Act, UETA, CMS, and HIPAA disclosure standards. Complete the visit with **Sign & Lock**; a **Go to Billing** prompt then appears. After sign-off, the note is locked and changes require an **Addendum** with a documented reason. See [Sign Off](./sign-off.md). CMS requires that the rendering provider be physically present at the place of service for in-person procedure codes. The encounter record is part of the audit trail and may be requested during a Medicare audit. --- ## Offline documentation The web Visit Wizard is online-only and saves continuously to the server; there is no Work Offline toggle. See [Document a visit offline](./work-offline.md) for what this means for field visits. --- ## Related modules - [Wound Cockpit](./wound-cockpit.md) — the canonical wound screen and between-visit hub. - [How the Visit Wizard opens](./how-the-wizard-opens.md) — route-on-arrival: draft resume, fresh start, and signed-note protection. - [Note honesty guardrails](./note-honesty-guardrails.md) — what the renderer will and will not add to your signed note. - [LCD Navigator](./lcd-navigator.md) — ambient compliance badge, Dojo tiles, and copy bank. - [Sign Off](./sign-off.md) — provider attestation, addenda, and audit log. - [Document a visit offline](./work-offline.md) — how offline field visits are handled. ## Related Auto-rendered from `related:` in frontmatter.