eval codes Flashcards

1
Q

red flags

A

signs of serious pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

orange flags

A

could be psychiatric symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

yellow flags

A

beliefs appraisal and judgements; emotional responses, pain behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

blue flags

A

perceptions about the rltp b/w work and health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

black flags

A

system or contextual obstacles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is an activity limitation

A

difficulties or restrictions of an individual executing a specific task

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a participation restriction?

A

difficulties or restrictions on an individual in societal aspects of functioning or in life situations
ex. work, domestic life, school, community activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Examining systems eqn

A

body systems examined + body areas examined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

the ‘other’ system category

A

level of consciousness, cognition, learning preferences, expected emotional behavior or response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

the body systems

A

musculoskeletal, neuromuscular, cardiovascular, integumentary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

does taking vital signs fall under a certain system?

A

no, its not really something we examination.. its a screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

body areas

A

Head/neck, trunk, UE, LE

you will always look at 1 body area so anything more than that you add body area to the systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When you give the final eval code you always give the highest complexity code. (T/F)

A

False, always give the lowest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 4 names of the CPT codes

A

low complexity, moderate complexity, high complexity, re-evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

example of an unstable/unpredictable pt

A

amputee with non-healing wounds, history or frequent falls, unexplained dizziness with activity, decreased cognition, unpredictable behavior and unstable medical history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

example of patient with evolving stability

A

musculoskeletal problem that has prolonged recovery, pregnancy, recent CVA with slow progression of return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

who developed the CPT codes and has copyright

A

the AMA- American Medical Association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when were PT eval codes first used

A

1998

19
Q

the new CPT codes were introduced in ___ of ___

A

January of 2017

20
Q

has the CMS adopted the 3 tiered structure for payment?

A

no.. they currently only pay one rate for a PT evaluation

21
Q

personal factors of the pt influence..

A

influence how the disability is experienced by the individual
ex. age, sex, social background, education, profession, past/current experience

22
Q

environmental factors

A

physical, social and attitudinal environment in which they live

23
Q

in order for personal factors and environmental factors to be considered they must ____

A

influence the plan of care

24
Q

a stable clinical presentation

A

patient’s condition has not changed, remained constant, straight-forward, uncomplicated

25
Q

Low complexity in history/limitations

A

no personal factors or comorbidities

26
Q

Moderate complexity in history/limitations

A

1-2 personal factors of comorbidities

27
Q

High complexity in history/limitations

A

3+ personal factors or comorbidities

28
Q

Low complexity in examination (body parts and systems)

A

adresses 1-2 examination elements

29
Q

Moderate complexity in examination (body parts and systems)

A

adresses 3 examination elements

30
Q

High complexity in examination (body parts and systems)

A

Addresses 4 + examination elements

31
Q

Low complexity clinical presentation

A

stable

32
Q

Moderate complexity clinical presentation

A

evolving

33
Q

High complexity clinical presentation

A

unstable/unpredictable

34
Q

Examination aspect consists of

A

tests and measures

35
Q

Your documentation is your

A

PROTECTION

36
Q

the US healthcare system uses ___ for disease codes.

A

ICD-10

37
Q

Typical Insurance

A

blue cross, cigna, humana, united healthcare

38
Q

non-traditional

A

case, work comp, personal injury, auto (other person’s insurance)

39
Q

Medicare Documentation guidelines

A

most comprehensive, typically adopted by other insurance carriers, APTA has worked with medicare to establish these guidelines for defensible documentation

40
Q

functional G codes

A

added in 2014
must be completed/repeated on the 1st and 10th visit until discharge
was repealed when PT was accepted into MIPS program

41
Q

MIPS/APMS and what its goal is

A

Merit Based Incentive Payment Program
Alternative Payment Model
Goal: collect data and pay for performance

42
Q

ultimate goal of electronic medical records

A

one unified medical record

43
Q

Threats to electronic medical records

A

data security, encryption, passwords, protection of protected health information