This patient is on home health and her primary OT diagnosis is dementia. She had NO fine motor issues, in fact her skill with a crotchet needle was quite amazing. What I posted is the entire D/C note.
The question of reimbursement is interesting. I'm unsure what Medicare might say if they audited my record. Your questions prompted me to look at this patient's goals and I clearly see there is inconsistency between the goal and the d/c note. That itself, is enough for Medicare to deny payment. I'm disappointed with myself because I did not document a good case for my intervention. This is one of those cases where I feel that OT services were of great benefit to this patient's health, but that insurance could care less. Ron -- Ron Carson MHS, OT ----- Original Message ----- From: Diane Randall <[EMAIL PROTECTED]> Sent: Friday, December 05, 2008 To: [email protected] <[email protected]> Subj: [OTlist] A "Whopper" of a D/C Note! DR> OK Ron, I am confused. can you really write notes like that? I was told to DR> never put the actual intervention into a note.....especially "crochet". This DR> sounds like a note from a mental health clinic. It is not Phys Dis, is it? DR> Did she have some sort of fine motor issue? The note would certainly not DR> indicate this...I mean... how could this possibly be billable..at all...even DR> if you reworded it? Is renewing an interest in "occupation" billable? Was DR> there more to the note? Confused -as-usual-student-in-training Diane DR> -----Original Message----- DR> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] DR> Behalf Of Ron Carson DR> Sent: Thursday, December 04, 2008 19:00 DR> To: [email protected] DR> Subject: [OTlist] A "Whopper" of a D/C Note! DR> Check out this D/C note. Can you imagine what a doctor will say *IF* DR> they ever read this note.... DR> "At evaluation, the patient was devoid of any meaningful or productive DR> occupation (activity). As such, the primary role of OT was DR> facilitating the patient to re-initiate her interest in the occupation DR> of crocheting. At d/c, the patient showed interest and spontaneously DR> participated in her previous occupation. Her husband was educated on DR> the benefit of keeping the patient appropriately engaged in this DR> occupation." DR> You know, being an OT is at time wonderful. In one day, I was seeing a DR> patient to facilitate her engagement in crocheting and facilitating DR> another patient to stand from her wheelchair. The diversity of our DR> profession never ceases to amaze me!!! DR> OT - The (O)ther (T)herapy <smile> DR> Ron DR> -- DR> Options? DR> www.otnow.com/mailman/options/otlist_otnow.com DR> Archive? DR> www.mail-archive.com/[email protected] DR> -- DR> Options? DR> www.otnow.com/mailman/options/otlist_otnow.com DR> Archive? DR> www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
