I have never seen anything in Medicare regs stating that two disciplines can NOT share a similar diagnosis. It is the goals that are the primary indicator of duplicity, not the diagnosis.
Ron ----- Original Message ----- From: Cim Viken <[EMAIL PROTECTED]> Sent: Friday, October 05, 2007 To: [email protected] <[email protected]> Subj: [OTlist] reply: duplication of services CV> To clarify previous post, examples of Primary Medical diagnosis code are CV> 714.0 rheumatoid arthritis, 438 Late effects of CVA, CV> Examples of "treatment (or therapy) diagnosis code" are 719.7 Difficulty in CV> walking, 438.81 apraxia, 728.87 muscle weakness. I work in hospital setting CV> where coder enter the diagnoses from our evaluations. CV> CV> The definitions of these are quoted from Rick Gawenda, PT course "Outpatient CV> Therapy CPT coding billing and documentation for Rehabilitation CV> Reimbursement." CV> Primary medical diagnosis: this item indicates the medical DX that has CV> related in the therapy disorder and which is most closely related to the CV> current plan of care for therapy. If more than one diagnosis is treated CV> concurrently, the provider enters the diagnosis that represents the most CV> intensive services (over 50 percent of the rehabilitation effort. CV> CV> Treatment diagnosis: This item indicates the DX for which rehabilitative CV> services were furnished. For example, while CVA may be the primary medical CV> DS hemiplegia might be the PT/OT treatment DX. CV> CV> CV> I guess the bottom line is I have a PT claiming OT and PT can't treat some CV> of same diagnoses. Examples are MS, muscle weakness, Lumbar stenosis, CV> My argument is PT and OT have different scope of practices. PT works on CV> exercises and mobility. OT treats occupational performance. Sometimes it's CV> ok for OT and PT to work with the same patient depending of the complexity CV> of diagnosis and overall patient's problem list/goals. (I also am stressing CV> the word sometimes) In other words, this PT claims he can treat them all CV> and he is more qualified. CV> CV> So what are your experiences or opinions? CV> Thank you. CV> CV> Cimberly Viken, OTR/L CV> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
