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Final Flashcards

1
Q

code for therapeutic activities (transfers, bed mobility, lifting carrying)

A

code 97530

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2
Q

code for gait training

A

code 97116

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3
Q

code for neuro-muscular reeducation

A

code 97112

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4
Q

therapeutic exercise

A

code 97110

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5
Q

Functional outcomes report

A

focuses on patient’s ability to perform meaningful functional activities rather than isolated impairments

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6
Q

problem-oriented medical record

A

the clinician describes a patient’s problem list, subjective and objective data, overall impression, the treatment provided, and the plan for each problem

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7
Q

narrative notes

A

the clinician describes the patient encounter with pertinent information provided in paragraph format

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8
Q

what is included in the subjective portion of a SOAP note?

A

anything the pt. says

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9
Q

what is included in the objective portion of a SOAP note?

A

objective data; results of systems review, interventions provided and billed (including codes), tests and measures

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10
Q

systems review

A

cardiovascular system, integumentary system, musculoskeletal system, etc.

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11
Q

what is included in the assessment portion of a SOAP note?

A

clinical judgement, problem solving, determining PT diagnosis, prognosis, and POC

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12
Q

what is included in the plan portion of a SOAP note?

A

plans for next session(s); plan for reassessment, reevaluation, or discharge

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13
Q

code for manual therapy

A

code 97140

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14
Q

what is included in an initial evaluation?

A

(1) evaluation
(2) diagnosis
(3) prognosis
(4) intervention
(5) outcomes

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15
Q

C-modifiers

A 
CH - 0% impaired
CI - <20%
CJ - 20-40%
CK - 40-60%
CL - 60-80%
CM - 80-99%
CN - 100%
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16
Q

what codes are used for diagnosis?

A

ICD-10 codes

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17
Q

what codes are used to determine how sick the patient is, and how much better you’re going to get the patient?

A

G-Codes

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18
Q

what codes are used to determine what you’re going to do to help the patient?

A

CPT codes

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19
Q

what does medicare part A cover? (4)

A

(1) hospitals
(2) SNF
(3) home health
(4) hospice

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20
Q

how is a hospital reimbursed?

A

DRG (Diagnosis related groups) - meaning, you’re paid for a set amount of time regardless of how long the treatment takes

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21
Q

how is a SNF reimbursed?

A

RUG (resource utilization group) - amount of services provided

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22
Q

Ultra High RUG

A

720 minutes, 5 days, 2 disciplines

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23
Q

Very High RUG

A

500 min, 5 days

24
Q

High RUG

A

325 min, 5 days

25
Q

Medium RUG

A

150 min, 3 days

26
Q

Low RUG

A

45 min, 3 days

27
Q

how is hospice reimbursed?

A

daily rate

28
Q

how is home health reimbursed?

A

episode of care, based on severity

29
Q

what is the minimum amount of treatment time in a SNF to count?

A

15 minutes

30
Q

do you include the evaluation in the MDS assessment?

31
Q

what does medicare part B include?

A

(1) OP (primarily)

(2) LTC

32
Q

what are CPT codes?

A

Current Procedural codes; TIME BASED

33
Q

what is the time required to bill for time based codes?

A

at least 8 minutes

34
Q

billing for 1 unit

A

8-22 minutes

35
Q

billing for 2 units

A

23-37 minutes

36
Q

billing for 3 units

A

38-52 minutes

37
Q

billing for 4 units

A

53-67 minutes

38
Q

billing for 5 units

A

68-82 minutes

39
Q

CCI

A

National Correct Coding Initiative

40
Q

what is the therapy cap on medicare part B

41
Q

CCI modifier indicators

A

0 - billing these two different codes together on the same day is NOT ALLOWED
1 - billing these two different codes together on the same day is ALLOWED

42
Q

CCI Edit - XE

A

XE - separate encounter

43
Q

CCI Edit - XS

A

XS - separate structure

44
Q

CCI Edit - XP

A

XP - separate practitioner

45
Q

CCI Edit - XU

A

XU - unusual (non-overlapping service)

46
Q

If the column I and column II codes are billed to the same patient in different 15-minute intervals, what modifier would be used?

47
Q

when is functional reporting required?

A

(1) evaluation (re-eval)
(2) once EVERY 10 DAYS
(3) discharge

48
Q

G-codes are only used for what?

A

Medicare Part B

49
Q

G-codes for Mobility

A

G8978 - current status
G8979 - projected goal status
G8980 - D/C status

50
Q

G-codes for Changing and Maintaining Body Position

A

G8981 - current status
G8982 - projected goal status
G8983 - D/C status

51
Q

G-codes for Moving & Handling Objects

A

G8984 - current status
G8985 - projected goal status
G8986 - D/C status

52
Q

how would you complete functional reporting?

A

combine G-code with C-Modifier
examples:
Time of Evaluation

G8978-CL (Mobility, Current Status Max A)
G8979-CJ (Goal for Mobility, become Min A)

53
Q

what is clinical impression?

A

listing problems that contribute to functional deficits noted in reason for referral

54
Q

what is the ICF model?

A

International Classification of Functioning, Disability and Health - language that describes how people function in their daily lives rather than focusing exclusively on their medical or disease‐specific diagnosis

55
Q

what are the components of the ICF model? (8)

A

(1) body functions
(2) body structures
(3) impairments
(4) activity
(5) participation
(6) activity limitations
(7) participation restrictions
(8) environmental factors

56
Q

LEARN Model

A 
Listen
Elicit
Assess
Recommend
Negotiate

PTP I (3 decks)

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