This is all very interesting to me. I was warned that Medicare (prob most
insurance) needs to see medical terminology and goals in notes or they will
just deny because most outside our profession do not understand the
therapeutic benefit of everyday interventions beyond the typical obvious
ADL's of dressing, toileting, bathing etc. For instance

1. "folding towels" would be "activity designed to increase bilateral
coordination, sequencing and problem solving skills"
2. "pennies in theraputty" would be "activity designed to increase fine
motor strength, pip/dip flexion/extension etc etc"
3. "crossword puzzles" would be "cognitive training activities"

The wonderful thing in OT is that we can really do almost anything we want
and make it therapeutic. What you did Ron was obviously therapeutic but
under appreciated in the medical community. I would think that if I ever ran
into that situation, I would just either not put it in the note at all
(because I am assuming that she had other goals that you worked on) and do
exactly what you did or reword it so that there would be no question that
services were necessary. Hmmm.... Such as "Pt participated in familiar fine
motor activities to increase cognitive processing skills, facilitate
long-term memory, and increase social occupation skills." "Family was
educated on the important of maintaining brain function by encouraging the
pt to participate in cognitive activities after discharge. As a result of
this intervention, the pt has shown significant improvement in.........."

I was also warned not to put the word "maintained" in an initial note( I am
guessing a D/C note is oK). Medicare in particular wants to see progress.
Dementia patients are hard. Medicare is looking for that plateau moment when
there isn't anymore significant progress and OT can no longer be justified.

Not sure I am on the right track. I just think there is nothing worse for
those of us in OT than to know that someone was denied payment because of
wording issues. Ron, you clearly see your patients as real people with
emotional/social needs and not just a "case".



-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Behalf Of Ron Carson
Sent: Saturday, December 06, 2008 03:46
To: Diane Randall
Subject: Re: [OTlist] A "Whopper" of a D/C Note!


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]



--
Options?
www.otnow.com/mailman/options/otlist_otnow.com

Archive?
www.mail-archive.com/[email protected]

Reply via email to