Hey Jimmie: I do not mean this to be sarcastic, but there is an imaginary line where treatment becomes non-medically necessary. There are literally thousands of things that we can do as therapists that are outside the realm of medically necessity. For example, if I had a stroke and couldn't go fishing, should Medicare pay an OT to teach me how to go get in my car, drive to the boat ramp, unload my boat, go fishing, clean fish. And what about going hunting, should Medicare pay for an OT to teach me how to hunt. This can go on and on, forever.
ALL interventions for which Medicare pays must be medically necessary. IMO, gardening is not medically necessary. I don't see anything that you quote that clearly indicates Medicare will pay for gardening, hunting, fishing, rock climbing, tree scaling, windsurfing, 4-wheeling, skydiving, etc. Maybe I'm wrong Jimmie, I don't know! ===========> Original Message Follows .... On4/15/2005, Jimmie Arceneaux, <[EMAIL PROTECTED]> said: > Again, I disagree! > Case and point from the Palmetto LMRP for home health OT: > "Occupational Therapists utilize clinical history, observation, > interview, standardized testing and assessment of activities of daily > living skills, work skills, and leisure skills to characterize > individuals impairments, functional limitations and to design an > individualized plan of treatments to assist in improving or restoring > function." In the same LMRP, under treatment approaches it includes, > "instrumental activities of daily living (IADL)training. The LMRP for > Home Health Psychiatric care states "selecting and teaching task > oriented therapeutic activities designed to restore and increase > cognitive abilities and functional participation....", and "planning, > implementing and supervising therapeutic tasks and activities designed > to restore sensory-integrative function..." From the outpatient OT > LMRP, "Occupational therapy is based on purposeful, goal directed > activity (occupation)." The definition of the CPT code 97530 is > therapeutic activities, direct (one-on-one) patient contact by the > provider (use of dynamic activities to improve functional > performance.) The definition of CPT codes 97537 Community/Work > reintegration training is (eg shopping, transportation, money > management, avocational activities...." > Jimmie > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] > Behalf Of Ron Carson > Sent: Thursday, April 14, 2005 8:24 PM > To: Joan Riches > Subject: Re[2]: [OTlist] Home Health Question > Yeah, I have no problem with that! I'm a big time vegetable gardener. > My point is that insurance will not pay for someone to learn gardening. > Don't plants have testosterone??? > R ===========>> Original Message Follows .... > On4/14/2005, Joan Riches, <[EMAIL PROTECTED]> said: >> Ron - like Suzanne I'm not in the US but in my book gardening is an >> IADL as well as a meaningful occupation for many people - particularly >> post menopausal women who benefit immensely from the plant estrogens >> although they may not realise that is a big reason why they love their >> gardens so. >> Joan Riches > -- > Unsubscribe? > [EMAIL PROTECTED] > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > Archive? > www.mail-archive.com/[email protected] > Help? > [EMAIL PROTECTED] > *** NOTICE--The attached communication contains privileged and > confidential information. If you are not the intended recipient, DO > NOT read, copy, or disseminate this communication. Non-intended > recipients are hereby placed on notice that any unauthorized > disclosure, duplication, distribution, or taking of any action in > reliance on the contents of these materials is expressly prohibited. > If you have received this communication in error, please delete this > information in its entirety and contact the Amedisys Privacy Hotline > at 1-866-518-6684. Also, please immediately notify the sender via > e-mail that you have received this communication in error. *** > -- > Unsubscribe? > [EMAIL PROTECTED] > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > Archive? > www.mail-archive.com/[email protected] > Help? > [EMAIL PROTECTED] -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
