Hello Jimmie:

I've had to do a bit of researching to back up my statements. However, I
do  NOT  find  any evidence to support them. Perhaps I spoke to hastily.
Although,  just because it's not specifically denied, does not mean that
it's covered.

I  anticipate  that  socialization  is  billed  using  the  Community/Work
Integration Procedure Code. I've provided copy of our LMRP for Community
Integration. See if you can decipher what it's saying.

quote> Community/Work Reintegration Training (CPT Code 97537):

quote> Community  reintegration  is  performed in conjunction with other
quote> therapeutic  procedures  such as gait training and selfcare/ home
quote> management training.

quote>  The payment for community reintegration training is bundled into
quote> the  payment  for those other services. Therefore, these services
quote> are not separately reimbursable by Florida Medicare.

My primary concern is with the client and not with the billing, although
billing is an issue. I met again with the client to explain that I could
not  have  speech  as  my  primary goal. I explained that we can address
speech  as part of our therapy as it relates to mobility, socialization,
etc.  She  again  denied  wanting to address other issues and reiterated
that her primary concern is her speech.

I advised her that I would try to locate a SLP in the area that might be
willing to come to the ALF.

One  last  thing  that  I  want  to  add.  In doing my 'research', I did
discover that Florida's Intermediary will cover motivation as follows:

quote> When an individual's motivational needs are related to a specific
quote> diagnosed  psychiatric  illness,  the meeting of such needs would
quote> require  an  individualized  therapeutic program. An occupational
quote> therapy program would be considered reasonable and necessary.


===============<Original Message>===============

On 3/22/2005, Jimmie Arceneaux <[EMAIL PROTECTED]> said:


JA> Ron,

JA> I am reviewing the outpatient OT LMRP for my geographical area
JA> and I do not note any wording that states Medicare doesn't pay for
JA> "socialization."  Could you tell me where you are referencing that
JA> statement?  Is it something particular to you intermediary in
JA> Florida?

JA> I would code this case 438.0 late effects of CVA - cognitive
JA> deficits, 438.12 late effects CVA - dysphasia, 438.89 other late
JA> effects of CVA and possibly either 438.84 ataxia or 438.85 vertigo
JA> (both related to late effects CVA) depending on if you will
JA> concurrently address the balance issues.  The CPT codes utilized
JA> would most assuredly be 97532 cognitive skills development, 97530
JA> therapeutic activities, 97537 community reintegration training and
JA> possible 97112 neuromuscular re-ed if you work on the balance as
JA> well. 


JA> I don't see any problem with noting a skilled intervention in
JA> the scenario you noted and as long as you treat within the scope of
JA> OT practice and don't attempt to be a pseudo speech pathologist, you
JA> should be able to meet the basic guidelines for covered OT practice.
JA> It would depend on what types of intervention you are prepared to
JA> provide.  Medicare does not reimburse for diversional activities or
JA> activities to improve motivation and this is quoted from my LMRP as
JA> noted above.

JA> Jimmie



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