Re: therapy orders

Wed, 14 Jan 2004 21:01:31 -0800

I just checked out the June 1999 Medicare Memo, and I still have questions. It doesn't address the practice of the hospital having a discharge form called the ECTS (Extended Care Transfer Summary) with an area in which the physician can check boxes in front of PT and/or OT eval and then another place to check if he wants to order PT 5x/wk x 5wks for gait, balance, strengthening, etc. and OT 5x/wk x 5 wks for ADLs, home management, etc. It essentially is saying the physician knows the eval is going to show the need for therapy, and these are the usual reasons. The therapists still send to the physician for signature the details of the eval and the specifics for that rehab patient, but they don't wait for the clarification orders in these cases. If this isn't kosher please don't tattle to UGS, just give us a chance to fix the system. Our city of 45,000 has one hospital, and this has been the practice for some time. I would hope they are doing this with good authority.
Sally

Theresa A Lang wrote:

If you have UGS as an FI- check out the June 1999 Medicare Memo about
therapy orders in a SNF. Eval and treat orders are considered eval orders
only

www.ugsmedicare.com

Theresa Lang
Specialized Medical Services, Inc


-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Christine Kroll
Sent: Wednesday, January 14, 2004 3:50 PM
To: '[EMAIL PROTECTED]'
Subject: RE:


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
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Be sure to visit the AANAC website. Accurate answers to your
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   For more info visit us at http://www.aanac.org
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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
     "Committed to the Assessment Professional"
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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/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
     "Committed to the Assessment Professional"
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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