July 14, 2011

What Should We Do When Our Outpatient Is Picked Up By HHA For Nursing Needs?

Medicare Mentor

Question: I work for a company who does Home Health and Part B patients in a senior apartment complex and have recently been having issues/concerns with pts we are seeing under Part B being referred to Home Health. For example: We were seeing a patient under Part B when they were referred to Home Health for “behavioral issues”. How can we justify seeing her under Home Health when for the past 2 wks she has been in outpatient therapy? There hasn’t been a change in functional mobility. We are concerned that if …
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July 9, 2011

What is Medicare’s Minimum Requirements For HHA Therapy Evaluations?

Medicare Mentor

Question: I am looking for information on Medicare guidelines for therapy (PT, OT, ST) documentation. Ideally, I need to find Medicare’s minimum required documentation for therapy evaluations and not start of care requirements. I would appreciate any/all resources you recommend and thank you in advance for any help/consideration you may afford me. Answer: Welcome to Medicare Mentor HHA! I hope I can be of help to you and anyone else who has questions about navigating the world of Medicare Home Health. The answer to your question is based on rules …
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July 1, 2011

Can A PTA Do Modalities?

Medicare Mentor

Question: I had a question regarding Medicare and supervision. I know there are a lot of questions about this subject but everything you read is different. I employ a PT and PTA. We do several types of modalities, ultrasound, muscle stimulation, heat, ice, etc. If both the PT and PTA are in the office treating patients does the PT have to literally turn on every modality, push every button of every machine that the PTA does? Can the PTA (after being instructed by pt) do ultrasound on their own? My …
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June 3, 2011

When We Do A Discharge On A Friday, Do We Get 2 Extra Days Of Therapy Payment?

Medicare Mentor

Question: Do you know what requirements must be met to define the frequency of therapy services that are provided in a SNF? This could have an impact on the End of Therapy OMRA date. For example, if a patient discharges on Friday–If the facility is a 5 day a week therapy facility, the EOT OMRA can be done on Monday following the Friday discharge, thereby allowing the facility to capture two additional Rehab RUG days (Saturday and Sunday). If the facility is a 7 day a week therapy facility, using …
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May 27, 2011

Why Are Some Companies Not Allowing 2 Disciplines On The Same Day Under Part B?

Medicare Mentor

Question: It has been brought to my attention from an employee of mine that some companies are changing the way they treat Part B. The company has put forth an implementation that a patient cannot have 2 disciplines treat a patient on the same day. They are stating that this is a Medicare ruling- and I cannot find clarification to support this. So, they are having PT treat 3x per week and on opposite days OT sees 2X/week. Answer:What the company is doing is maximizing their reimbursement by not providing …
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May 20, 2011

How long is a Dr’s order good for if the patient comes back with the same condition?

Medicare Mentor

Question: I attended your seminar a few months ago and have a question, as there is a difference of opinion with our other therapists who also attended. How long is the Dr’s orders for PT valid…if the patient comes back with the same condition- 3-4 months later, under part B: e.g- we saw this patient for low back pain. Dr’s orders were dated 1/12/11…now the patient on returned-5/4/11…can we use the same order (dated 1/12/11) Answer:The referral is valid until you perform the evaluation and send the POT to the …
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May 6, 2011

Do we have to make up missed visits when patient not seen on a holiday?

Medicare Mentor

Question: : I am a PT who has staff working at a Veterans Home. We have 5 times per week patients who we will not see on Thanksgiving because of the Holiday. The facility frowns upon us treating patients on the weekends and most patients also do not want to be bothered on Holidays. So, in the past we have not seen patients if it is a Holiday and document, “patient not seen due to the Holiday”. So, they are seen 4 times these weeks vs. 5 times. I wanted …
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April 24, 2011

My company is using my Medicare number to bill for other therapists when I’m not there, is that OK?

Medicare Mentor

Question: I attended a course of yours and have been trying to figure a few things out. I’m hoping you can help me in particular with a topic that came up today. I work in an outpatient clinic at an orthopedic surgeon’s office. Am I correct that my Medicare provider number used for billing is the same number I would use regardless of what office I work at? It doesn’t vary for each location I work? At our office, it seems that the main therapists have all their information and …
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March 28, 2011

Do we need a new MDs when OT stops and PT starts?

Medicare Mentor

Question: Here I am again with a situation. We have a resident where we combined SOT and 30-Day MDS. It was occupational therapy who worked with the resident first as the orthopedic surgeon cleared him to do UE exercise and ADL training for feeding skills. We got a RUGS level of RMC. Now OT has discontinued and PT will take over. Because of the resident’s medical condition and behavior problems he can only handle one therapy at a time. We recently received an order for PT. We will be providing …
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Can anyone treat a patient in their home?

Medicare Mentor

Question: I took your course last October in Buena Park. I have a question. Can anyone treat a Medicare patient at home if they are unable to walk 30 feet or drive? Is there any other criteria I need to know about. Please include your phone number. I just may subscribe to your information. I need to close my office and am thinking of going to people’s homes. Answer: Any patient can be treated in their own home, they do not have to be homebound (if they were, they could …
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