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CarePoint Therapy Management Blog

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ICD-10 Conversion Tools

  
  
  
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Common Therapy Medical & Treatment Diagnoses

ICD-9 codes are being expanded from 17,000 currently to more than 140,000 ICD-10 codes.  Our clinical staff has developed complete ICD-10 medical and treatment diagnoses tables specifically for therapists at skilled nursing facilities.  In addition, we have developed “crosswalk” tools that focus specifically on those medical and treatment diagnoses used most frequently by therapists.  This information was obtained from scores of skilled nursing facilities over the last year.

New Speech Therapy Evaluation Codes: Effective January 1, 2014

  
  
  
New CPT Codes - Speech therapy Evaluation codes

The CPT code 92506 (Evaluation of speech, language, voice, and communication) will be deleted on January 1, 2014 and replaced with four new, more specific evaluation codes related to language, speech sound production, voice and resonance, and fluency disorders.

CMS Compliance Update: Reporting Co-treatments & Distinct Calendar Days

  
  
  
Daily Note - record co treatments - therapy documentation standards

Therapists must document and report co-treatment activity for Medicare Part A patients beginning on October 1, 2013.  When two therapists from different disciplines treat one patient at the same time with different treatments, both disciplines may record the full treatment session with that patient.  All policies regarding mode, modalities, and student supervision must be followed as well as all other federal, state, practice, and facility policies.  

Creating Therapy Discharge Summaries: A Time Saving Shortcut for Therapists!

  
  
  

A contract therapy client in Ohio asked the following question …"What documents do you suggest be completed upon discharge?  We love the Goals Summary but you have to do a Progress Report to get the up-to-date status upon discharge.  We also have to complete the Discharge Summary.  The Discharge Summary cannot stand alone as it does not meet the LCD/NCD guidelines without a roll-up of progress towards goals.  It's a lot of work to make sure we are compliant.  Can you recommend any shortcuts to reduce the amount of time needed to create these documents?" 

Therapy Treatment Day Properly Defined: Don’t Miss Available RUG’s Levels!

  
  
  
Activity Edit Listing - Medicare Part A

A contract therapy client in Boston asked the following question … CarePoint included only 3 days of PT treatments in one patient’s RUG’s level calculation even though 4 days of PT treatments were provided.  Only 10 minutes of PT treatment were provided on one of those 4 days.  Treatments greater than 8 minutes are counted as one unit but I am not sure if this has anything to do with why only 3 days of PT treatment were included in the RUG’s level calculation.  Please explain why this is happening?  I want to make sure that all future RUG’s levels calculations are correct in CarePoint.

Functional Limitation G Codes: Should Therapists Assign 59 or KX Modifiers?

  
  
  
Functional Limitations - G Code - g codes - KX modifier - 59 modifier

A contract therapy client in New York asked the following question …  “If a patient exceeds the Medicare Part B therapy cap, is it CMS’s expectation that a KX modifier should be assigned to G codes as well?  I know we need to assign KX modifiers to the entire month’s billing regardless of when the actual therapy cap was exceeded during that month. However, according to CMS KX modifiers are not needed for the G codes?  Can you point me to the documentation that supports this?”

Therapy Alert: CMS Clarification of RUG’s Level Medium “Distinct Calendar Days”

  
  
  
CMS RUGS Levels - RUG Level Medium - CMS Clarification

Reporting Distinct Calendar Days of Therapy …  In the May 6, 2013 Federal Register page 26465, CMS clarifies that the Rehab Medium was always intended to be 5 distinct calendar days.  As set forth in the 2010 final rule (74 FR 40389), to be classified into the Medium Rehab category under RUG III or RUG IV, the resident must receive 5 days any combination of 3 rehabilitation disciplines.  The CMS clarification in the May 2013 Federal Register and July 2013 Final Rule is as follows …

Therapy Alert: G Code Correction for the Motor Speech Projected Goal

  
  
  
Medicare learning Network - MLN - G Code

A contract therapy client in Ohio writes …  In reviewing the Medicare Learning Network (“MLN”) Matters revised, the G code for Motor Speech Projected Goal doesn't match the G code listed in CarePoint for that goal. Can you clarify if G9186 as listed in the MLN memorandum or G9157 as listed in CarePoint is the correct code?  I am looking at the most recent MLN memorandum and want our CPT code table in CarePoint to be accurate.

CMS Guidelines for Co-signing a Physical Therapy Assistant’s Documentation

  
  
  
Physical Therapy Assistant Supervision

A visitor to our web site asked the following question …  “Is it appropriate for the supervising physical therapist to co-sign a physical therapy assistant's (PTA’s) daily physical therapy treatment charges which have been posted when the supervising physical therapist has no physical means of ensuring that such treatment charges were actually done by the PTA?  I am being asked to do this in my current work place.”

Processing Skip Days In CarePoint: Scheduled & Unscheduled ARD’s

  
  
  
Treatment Minutes - RUGS Level - Skip Days - Therapy

A therapy manager sent us a COT OMRA Management Report to review.  The 7 day observation date was displayed in error because of the misapplication of a skip day.  There is a simple way to prevent this type of error from occurring in the future.

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