Posts tagged ‘physical therapy’

August 16, 2012

Open Door Forum transcripts now available

There was a delay on the blog post regarding the recent Medicare Open Door Forums … the post didn’t publish until after the forums had happened!
No problem. Transcripts and audio are now available.

From the August 9, 2012 Medicare Fee-For-Service Recovery Auditor Prepayment Review Demonstration Special Open Door Forum.

From the August 7, 2012 Manual Medical Review of Therapy Claims Special Open Door Forum.

September 19, 2011

Read up on PT assessment exceptions

CMS has answered issues with single therapy visits …

Question: Can you please clarify this for me? If we are only doing physical therapy (PT) and the 30-day re-evaluation not only falls on the 12 visit and on a Friday and then come Monday is the 13 visit, do I have to send out the PT for another re-evaluation? We are concerned that a 30-day reassessment conducted on the 12th PT visit in single therapy cases will not suffice to meet the 13th therapy visit assessment. If it doesn’t meet requirements, there would be a large financial impact based on non-coverage of subsequent PT visits.

CMS Response: You are correct that for a single therapy case, the therapist must do the reassessment visit exactly on the 13th and 19th visits, unless the rural or documented circumstances outside the control of the therapist exceptions apply as stated in 42 CFR 409.44(C)(2)(i)(C). If neither exception applies, the PT would need to do the reassessment on the 13th visit as required by the regulations.

April 11, 2011

PT scope of practice is probably larger than you think

I often hear from clinicians frustrated that PTs won’t do this or that … maybe for good reasons, and maybe not. And I hear from PTs who just don’t know what their scope of work should be.

If you want to know the PT scope of practice, just go to the Benefit Policy Manual. In Chapter 7 you will find the General Principles Governing Reasonable and Necessary Physical Therapy, Speech-Language Pathology Services, and Occupational Therapy sections in 40.2.1-40.2.4.3 of the Benefit Policy Manual.

CMS provides examples of the type of work in the scope of practice, including assessment, wound care, teaching, and other issues.

April 5, 2011

Episode dictates restart of therapy counts

Question: Does the therapy count start over if a patient is admitted to the hospital? Since new therapy evaluations are completed after the post-hospital visit (resumption of care), would a new count begin at this point?
Lisa says:This has to do with the number of therapy visits per episode. The count does not start over after a hospitalization unless you’re in a new episode.
January 23, 2011

What happens in Vegas, you take to your agency

Last chance for the Coding and Regulatory Symposium!

All of the coding and regulatory education that you learn at the Coding and Regulatory Symposium is too good to keep in Vegas! Attend the class this week, then bring back all kinds of information to share with coders, clinicians, billers, and administrators.

This conference is put on by Selman-Holman Associates. Take a look at just part of the agenda:.

  • April 2011 changes and how they impact your coding and operations
  • Wound care coding: Debridements aren’t surgical wounds, pressure ulcers never go away in coding, but they might in OASIS, and do you use aftercare of surgery (V58.xx) and wound dressing codes (V58.3x) together? These are just some of the confusing topics we’ll clear up.
  • The money follows proper coding. Really. Code by patient acuity and services, and the money will come. Learn the proper way to code and prioritize your codes.
  • HIPAA 5010 Compliance: Have you checked your checklist of where your agency should be in preparation for the changes?
  • Interactive coding both days! Sharpen your coding and OASIS interaction skills.
  • V57: Evil code or often-used friend? It should be a need-to-use code that has many guidelines surrounding its use … learn them and never worry about coding therapy again. Plus: learn the regulatory and billing issues behind it.
  • Documentation! Support your coding and appeal downcoding.

2 days of education for $385! And you’re in Las Vegas!
We’ll see you Jan. 27 and 28!