Documentation to Support Medical Necessity: Evaluations and Reevaluations
Section: Private Practice Section
Session Code: PP-2A-4296
Date: Friday, January 25, 2019
Time: 8:00 AM - 10:00 AM
Location: Marriott Marquis
Room: Independence Salon FGH

Speaker(s):   Rick Gawenda, PT

Session Type: Educational Sessions
Session Level: Intermediate

Physical therapy services continue to be on the audit radar for various Medicare administrative contractors and private insurance carriers' medical review entities. This session will review the necessary components of documentation for the initial evaluation and reevaluation that will help you document the key points in supporting medical necessity and the skilled nature of physical therapy services. The speaker will address the importance of the subjective intake in the initial evaluation and plan of care requirements for Medicare and private insurance carriers. Attendees will learn how to write function-based goals based on the patient's current functional status compared to their previous level of function. The presenter also will discuss the certification and recertification process for outpatient therapy services under the Medicare Part B program.

Learning Objectives: Upon completion of this course, you will be able to:

1. Describe and implement the necessary components of an initial evaluation to support the need for skilled physical therapy services.

2. Identify the 4 questions a goal should answer to be able to write appropriate function-based goals.

3. Identify when a reevaluation is appropriate to perform on a patient and bill to an insurance carrier.

4. Explain the certification and recertification process for Medicare Part B therapy services.

CEU: 0.2

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