There is a newer version of this book. You are viewing the first edition of this title. Check out the second edition for more up to date information. On August 8, 2011, the Centers for Medicare & Medicaid Services released the final ruling and commentary for the new implementation of the MDS changes set to take effect on Oct. 1, 2011. The Reimbursable Therapy Minutes will be the deciding factor in determining whether a Change of Therapy (COT) OMRA (Other Medicare Required Assessment) will be required, if at all. Most of our skilled nursing facilities are using some type of tracking tool for managing the prospective payment system minutes. Some are computerized, while others are still using paper forms. The Change of Therapy (COT) observation week must be scheduled exactly seven days following the previous MDS or observation week. If there has been a change in RUG category, then a Change of Therapy (COT) OMRA must be done and the reimbursement will drop or increase to the new RUG until another change occurs. CMS decided to assume all SNFs should offer seven-day rehab options, so facilities that traditionally offered Monday through Friday services will face immense challenges with the new Change of Therapy (COT) OMRAs. This book has been updated to discuss the new MDS assessment schedule, the allocation of group therapy minutes, the revised student supervision provisions, the End of Therapy (EOT) Other Medicare Required Assessment (OMRA) and new resumption items, and the new PPS assessment- Change of Therapy (COT) OMRA (Other Medicare Required Assessment). The long term care industry has anticipated the new MDS 3.0. RUG IV coding requires the therapist to specifically account for the time captured during the look back period. This book could help occupational therapists, physical therapists and speech therapists understand Medicare standards for subacute care programs to be compliant with Medicare MDS 3.0 standards and state regulations. Documenting and billing strategies are also discussed in this book to attain maximum reimbursement. A list of commonly used ICD-9 codes is also provided. Appropriate billing and documentation should be present in the medical record. Medicare is increasingly reviewing therapy claims to ensure that the therapy provided required the skills of a therapist. The Mandated program, Recovery Audit Contractions, recovered 1 billion dollars during their 3 year demonstration project. This book covers establishing medical necessity, refusing to care for a resident, restraints, safety, creating incident reports, supervising assistive personnel and resident privacy. Coding and billing for subacute and long term care settings are also encompassed in this book, along with denial and appeal management, regulatory guidelines for insurers and improving cash flow with denial management strategies. Proper coding and documentation ensures that facilities will keep their money upon a post payment medical record audit.

On October 1, 2014 the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Also, the Middle Class Tax Relief and Jobs Creation Act of 2012 (MCTRJCA; Section 3005(g)) published at http: //www.gpo.gov/fdsys/pkg/CRPT-112hrpt399/pdf/CRPT-112hrpt399.pdf states that "The Secretary of Health and Human Services shall implement, beginning on January 1, 2013, a claims-based data collection strategy that is designed to assist in reforming the Medicare payment system for outpatient therapy services subject to the limitations of section 1833(g) of the Social Security Act (42 U.S.C. 1395l(g)). Such strategy shall be designed to provide for the collection of data on resident function during the course of therapy services in order to better understand resident condition and outcomes." This reporting and collection system requires claims for therapy services to include non-payable G-codes and related modifiers. These non-payable G-codes and severity/complexity modifiers provide information about the beneficiary's functional status at the outset of the therapy episode of care, at specified points during treatment, and at the time of discharge. These G-codes and related modifiers are required on specified claims for outpatient therapy services-not just those over the therapy caps. This book can help occupational therapists, physical therapists, and speech therapists understand Medicare standards for subacute care programs that aim to be compliant with Medicare MDS 3.0 standards and state regulations. Documenting and billing strategies are also discussed in this book. This book has been updated to discuss the new MDS assessment schedule, distinct days of therapy, co-treatment, the allocation of group therapy minutes, the revised student supervision provisions, the EOT (End of Therapy) OMRA (Other Medicare Required Assessment) and new resumption items, and the new PPS assessment-COT (Change of Therapy) OMRA. Appropriate billing and documentation should be present in the medical record. Medicare is increasingly reviewing therapy claims to ensure that the therapy provided did require the skills of a therapist. This book discusses establishing medical necessity, refusing to care for a resident, restraints, safety, creating incident reports, supervising assistive personnel, and resident privacy. Coding and billing for subacute and long-term care settings are also covered in this book, along with denial and appeal management, regulatory guidelines for insurers, and improving cash flow with denial management strategies. Proper coding and documentation ensures that facilities will keep their money upon a post-payment medical record audit. The information provided here in no way represents a guarantee of payment. Benefits for all claims will be based on the resident's eligibility, provisions of the law, and regulations and instructions from the Centers for Medicare & Medicaid Services (CMS). It is the responsibility of each provider or practitioner submitting claims to become familiar with Medicare coverage and its requirements.

Proper wrist and hand function is integral to nearly all daily life functions. An injury whether due to repetitive stress, disease or soft tissue damage makes work, sports, household, or leisure activities both stressful and painful. The care of the hand and upper extremities has long been a challenge to physicians and therapists and in order to restore function and mobility it is paramount to have a thorough knowledge of the anatomy and biomechanics of the wrist and hand. This relational understanding allows the therapist or clinician to grasp the intricate balance of the mechanics of the hand and wrist and to suggest appropriate strategies for functional improvement. Such a framework lends itself to designing treatment plans that increase patient lifestyle satisfaction while improving clinical outcomes. This course will cover the fundamental principles for evaluation and functional progression treatment of the wrist and hand. The architectural framework of the wrist and hand will be presented as the basis for treatment interventions designed to improve function. Improving patient outcomes will be facilitated through increasing your knowledge of the delicate and complex anatomy and kinesiology of the wrist and hand. Recurrent hand and wrist conditions including Carpal Tunnel Syndrome, DeQuervain's Tenosynovitis, Complex Regional Pain Syndrome and their treatment will be presented through actual case studies.

This book summarizes the effectiveness of several therapeutic modalities in the treatment of neurologic and musculoskeletal disabilities and the challenges faced by the health practitioners in selecting the most appropriate treatment. Numerous guidelines recommend therapeutic modalities for the management of musculoskeletal conditions. However, specific recommendations are lacking concerning which adjunct modalities to employ. This book will discuss current evidence-based clinical practice guidelines have been developed in the treatment of neurologic and musculoskeletal conditions. Clinicians use a variety of modalities to reduce pain improve mobility and treat neuromusculoskeletal injuries and disabilities. Examples of therapeutic modalities include: hot-packs, cold-packs, whirlpools, TENS (Transcutaneous Electrical Nerve Stimulation), ultrasound, traction, electrical stimulation, and joint and spine mobilization/manipulation that can help strengthen, relax, and heal muscles and expedite recovery in the orthopedic setting. Specific recommendations are lacking concerning which adjunct modalities to use. This review will summarize the effectiveness of several therapeutic modalities in the treatment of neurologic and musculoskeletal disabilities and the challenges faced by the health practitioner in selecting the most appropriate treatment.

The primary goal of this course is to provide you with a step-by-step guide to build your very own practice from scratch. As such, this course is dedicated to helping you put up your very own health facility where you can readily offer your professional therapeutic services to the people in your area. From beginning to end, its content will give you step-by-step guidelines. If you put your heart and mind to the task, then you will surely succeed in establishing your own health facility. Topics such as choosing the right business structure, defining your specialty, and determining if your business would be viable are written for quick and easy comprehension while conveying numerous applicable instructions and related guidelines. Surely, this book will be helpful once you decide to found your very own healthcare establishment. Take advantage of this book's guidance and instructions, and make your dreams of owning your own healthcare facility a reality

Proprioceptive training is integral to nearly all daily life functions. An injury, whether due to repetitive stress, disease or soft tissue damage, affects proprioception. Proprioception affects work, sports, household and leisure activities, and therefore, it is paramount to have a thorough knowledge of the current research on proprioceptive training. Such a framework lends itself to designing treatment plans that increase patient lifestyle satisfaction while improving clinical outcomes. This course will cover the fundamental principles of proprioception. The book will present the architectural framework of proprioception as the basis for treatment interventions designed to improve function. Improving patient outcomes will be facilitated through by increasing your knowledge of the different treatment techniques to improve proprioception. Several effective strategies will be examined for the young population, juvenile rheumatoid arthritis patients, Parkinson's patients, Alzheimer's patients, and many more...