Final Flashcards
Time setting determined by third-party payer
Medical setting
Time period not as limited. Therapy continues while student attends school
Educational setting
What are the three discharge requirements in the educational setting
– Goals met
– 21 years old
– Ed goals become med problem
Qualifications for PT in the school system
– Has difficulty moving in school
– Cannot ambulate independently
– Has balance problems
What is considered maintenance therapy
– No progress shown
– Goals met
– Received allowable amount of service covered by payer
What are the most common types of telephone communication
– Verbal referrals
– Info from pt
– Inquiries about pt’s medical condition
What is the difference between The medical setting and educational setting
Time period tx is allowed
What is required when documenting a TO/VO
– date – name – Name of PCP – Details of referral – name of person taking TO
A legal procedure to ensure that a patient knows all of the risks and costs involved in treatment
Informed consent
What three components must occur for informed consent
– pt is aware of risks
– Voluntary
– Competence
What does IEP consent include
– Services provided
– Time limit
– Frequency of treatment
When should you file an incident report
– Something out of the ordinary
– An accident
– Unusual routine or procedural
What is the purpose of incident reports
Risk management in legal protection
What is included in an incident report
Dash name and address
– Objective description
– Identification of witnesses
True/false: document incident in chart, but do not document a report was filed
True
When patient refuses treatment PTA should:
– Determine reason
– Educate patient
– Document refusal-notify PT
What is included in documenting treatment refusals
– Statement of refusal
– Reason for refusal
– PTAs response
– Statement about notifying PT
Describes procedures/treatment provided. Created by AMA
CPT codes
Based on total time actually spent in the delivery of the service. Require constant patient contact
Time – based codes
8-22 min per unit
2 units= 23-37 min
8 minute rule
Untimed, unattended codes. Require supervision of clinician.
97010-97028. 97150. 97001-97002
Service-based codes
Can only be billed once per treatment session
Service based codes
When a procedure or modality is not paid as distinct and separate
Bundling
Ex. Hot/cold packs
Alphanumeric codes based on CPT codes. Uses numbers and letters. Created by CMS
HCPCS codes
Created by WHO. Up to seven characters. First character Alpha second is numeric
ICD-10 codes
Two digit codes added to CPT anD HCPCS codes that provide additional information about billed procedure
Modifiers
Requirement for reporting on Medicare beneficiaries’ function and condition
G-Codes
Attended service requiring one on one patient contact. Most time based codes. 15 min increments billing
Constant service
Unattended service requiring supervision by clinician. Supervised modalities. Only one unit
Supervised services
One clinician treating one patient
Individual
Two clinicians treating one patient at the same time. Cannot double bill
Co-treatment/team therapy
One therapist treating two patients for different activities
Concurrent
Involves 2-4 pts being treated at the same time. Medicare a can only bill 25%
Group therapy
Standardized assessment tool of health status
MDS
Time period when patient is assessed for MDS reporting and RUG level
Assessment period
Last day of MDS seven day
ARD
Classifies patients in LTC facilities based on care required
RUG levels
RUG Ultra high Very high High Medium Low
720 500 325 150 45
Minimum # min for daily tx=
Minimum RUG min/# of tx sessions per week
