One thing I would suggest is to check with your FI and with any LMRP or
LCD's that exist for PT, OT, and ST - if any. One FI may look for different
specifics than another. However, Medicare medical review only requires an
order from the physician to evaluate and treat and a plan of care signed by
the physician. The clarification order is used by most to get the therapy
orders on the chart and to show physician supervision while the plan of
treatment is out being signed by the physician (which in some cases takes a
while to receive back). The discipline, frequency, duration and modalities
are part of what is required for the plan of care and as such are placed on
the clarification telephone order after the evaluation is complete. We do
not put specific minutes on the order nor has this been required by the FI's
with which I have worked. If your FI does not require it, then I would not
be that specific since there can be daily variances.

-----Original Message-----
From: Carol Corbett [mailto:[EMAIL PROTECTED]
Sent: Wednesday, January 14, 2004 12:15 PM
To: [EMAIL PROTECTED]
Subject: 


Our therapy department had been told by corporate consultant that we had to
write a clarification order for therapies once the initial eval was done.
On admission or shortly thereafter, our doctor writes an order for initial
evaluation and treatment.  Then, after eval.,  therapy asks for order to
specifiy treatment such as "PT 45-60 minutes 5-7 times per week for 14
days."  Recently therapy was told by another consultant that there was no
need for clarification order.  After reading the e-mail from Rena that
states section T is to be projected based on doctor's order, it would seem
that we would still need the clarification order.  Section T in RAI manual
doesn't really specify how detailed the therapy orders must be.  Do we need
to write a specific clarification order?
 
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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
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Be sure to visit the AANAC website. Accurate answers to your
         questions posted to NAC News and FAQs.
    For more info visit us at http://www.aanac.org
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