Dang, this is a pretty good explanation of how I've seen many, many OT's practice over the years! SAD, but true!
If you disagree with something that in your fiscal intermediary's documents, call them. They may change it. I had a problem where my intermediary didn't cover OT evaluations in ALF. I called them, they reviewed my suggestions and made corrections. It was very simple and surprisingly effective. Of course, this is a CMS issue but your FI may be able to help! Let us know how it turns out! Ron ----- Original Message ----- From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> Sent: Tuesday, July 12, 2005 To: [email protected] <[email protected]> Subj: [OTlist] Medicare Benefit Policy 230.2 Practice of Occupational Therapy dbo> I am in the process of trying to determine why the FI denied services for dbo> OT, PT & Speech. The comment was "usage guidelines not met". So I went to dbo> the most recent CMS Pub 100-02 Medicare Benefit Policy Transmittal 34. dbo> This transmittal is effective June 6, 2005. dbo> I was totally surprised to read the examples regarding the practice of dbo> Occupational Therapy: dbo> The selection and teaching of task-oriented therapeutic activities dbo> designed to restore physical function; e.g. use of woodworking dbo> activities on an inclined table to restore shoulder, elbow and wrist dbo> range of motion lost as a result of burns; dbo> Teaching a patient with a hip fracture/hip replacement techniques of dbo> standing tolerance and balance to enable the patient to perform such dbo> functional activities as dressing and homemaking tasks. dbo> Then it went on to state that a qualified occupational therapist is defined dbo> as "eligible for the National Registration Examination of the American dbo> Occupational Therapy Association". dbo> Several questions came to mind after reading this and sharing this dbo> information with a fellow OT. How old is the definition of our services dbo> use by Medicare? Do the FI's really base their decision on these dbo> descriptors? Am I the only one who thinks these examples are out dated and dbo> the eligible for exam is incorrect? dbo> Dudi Wittwer, O.T.R. dbo> Manager, Rehab Services dbo> Bay Area Hospital dbo> 1775 Thompson Road dbo> Coos Bay, Oregon 97420 dbo> [EMAIL PROTECTED] dbo> (541) 269-8003 -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
