Final Flashcards

1
Q

Time setting determined by third-party payer

A

Medical setting

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2
Q

Time period not as limited. Therapy continues while student attends school

A

Educational setting

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3
Q

What are the three discharge requirements in the educational setting

A

– Goals met
– 21 years old
– Ed goals become med problem

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4
Q

Qualifications for PT in the school system

A

– Has difficulty moving in school
– Cannot ambulate independently
– Has balance problems

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5
Q

What is considered maintenance therapy

A

– No progress shown
– Goals met
– Received allowable amount of service covered by payer

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6
Q

What are the most common types of telephone communication

A

– Verbal referrals
– Info from pt
– Inquiries about pt’s medical condition

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7
Q

What is the difference between The medical setting and educational setting

A

Time period tx is allowed

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8
Q

What is required when documenting a TO/VO

A
– date
– name
– Name of PCP
– Details of referral 
– name of person taking TO
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9
Q

A legal procedure to ensure that a patient knows all of the risks and costs involved in treatment

A

Informed consent

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10
Q

What three components must occur for informed consent

A

– pt is aware of risks
– Voluntary
– Competence

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11
Q

What does IEP consent include

A

– Services provided
– Time limit
– Frequency of treatment

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12
Q

When should you file an incident report

A

– Something out of the ordinary
– An accident
– Unusual routine or procedural

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13
Q

What is the purpose of incident reports

A

Risk management in legal protection

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14
Q

What is included in an incident report

A

Dash name and address
– Objective description
– Identification of witnesses

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15
Q

True/false: document incident in chart, but do not document a report was filed

A

True

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16
Q

When patient refuses treatment PTA should:

A

– Determine reason
– Educate patient
– Document refusal-notify PT

17
Q

What is included in documenting treatment refusals

A

– Statement of refusal
– Reason for refusal
– PTAs response
– Statement about notifying PT

18
Q

Describes procedures/treatment provided. Created by AMA

A

CPT codes

19
Q

Based on total time actually spent in the delivery of the service. Require constant patient contact

A

Time – based codes

20
Q

8-22 min per unit

2 units= 23-37 min

A

8 minute rule

21
Q

Untimed, unattended codes. Require supervision of clinician.

97010-97028. 97150. 97001-97002

A

Service-based codes

22
Q

Can only be billed once per treatment session

A

Service based codes

23
Q

When a procedure or modality is not paid as distinct and separate

A

Bundling

Ex. Hot/cold packs

24
Q

Alphanumeric codes based on CPT codes. Uses numbers and letters. Created by CMS

A

HCPCS codes

25
Q

Created by WHO. Up to seven characters. First character Alpha second is numeric

A

ICD-10 codes

26
Q

Two digit codes added to CPT anD HCPCS codes that provide additional information about billed procedure

A

Modifiers

27
Q

Requirement for reporting on Medicare beneficiaries’ function and condition

A

G-Codes

28
Q

Attended service requiring one on one patient contact. Most time based codes. 15 min increments billing

A

Constant service

29
Q

Unattended service requiring supervision by clinician. Supervised modalities. Only one unit

A

Supervised services

30
Q

One clinician treating one patient

A

Individual

31
Q

Two clinicians treating one patient at the same time. Cannot double bill

A

Co-treatment/team therapy

32
Q

One therapist treating two patients for different activities

A

Concurrent

33
Q

Involves 2-4 pts being treated at the same time. Medicare a can only bill 25%

A

Group therapy

34
Q

Standardized assessment tool of health status

A

MDS

35
Q

Time period when patient is assessed for MDS reporting and RUG level

A

Assessment period

36
Q

Last day of MDS seven day

A

ARD

37
Q

Classifies patients in LTC facilities based on care required

A

RUG levels

38
Q
RUG 
Ultra high
Very high
High
Medium
Low
A
720
500
325
150
45
39
Q

Minimum # min for daily tx=

A

Minimum RUG min/# of tx sessions per week