100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Previously searched by you
Previously searched by you
logo
OTD 417 Exam 2 Information: Part 1 Questions With Solutions R354,32   Add to cart
Quickly navigate to
Preview
  2.  
  3. OTD
  4.  
  5. OTD

Exam (elaborations)

OTD 417 Exam 2 Information: Part 1 Questions With Solutions
 5 views  0 purchase
  • Course
  • OTD
  • Institution
  • OTD

OTD 417 Exam 2 Information: Part 1 Questions With Solutions Coverage based criteria for Medicare - need based service - established plan of care - care of physician - physician certification need based service - reasonable and necessary in terms of type, amount, frequency and duration - ...

[Show more]

Preview 3 out of 17  pages

Document information

  • October 19, 2024
  • 17
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • questions with solutions
  • otd 417 exam 2 information part 1

Written for

  • OTD
  • OTD

Seller

avatar-seller
UpperClass

Reviews received

Content preview

OTD 417 Exam 2 Information: Part 1
Questions With Solutions

Coverage based criteria for Medicare - need based service


- established plan of care

- care of physician

- physician certification




need based service - reasonable and necessary in terms of type, amount, frequency and

duration

- level of complexity and sophistication only safely and effectively performed by or under

supervision of qualified therapist




Medical necessity - reasonable to achieve desired level of relief/functional improvement


- necessary to reduce risk of deterioration or suffering if left untreated

- requires skills of licensed therapist




Jimmo vs. Sebelius - no new regulations- clarified existing


- not dependent on potential improvement but need

- homebound coverage, not bed confined

, OTD 417 Exam 2 Information: Part 1
Questions With Solutions
- skilled services to maintain, prevent or slow deterioration

- reimbursement for establishment of maintenance

- does not apply to IRF's or comprehensive outpatient rehabilitation facilities




What Medicare will not pay for/common claim denials - non-skilled


- extending to educate

- missing certification

- too many units

- no minutes

- activities to promote wellness

- missing/incomplete POC

- missing/incomplete progress notes




Plan of care - established before treatment begins


- signature and professional identity

- date

- may render billable services on date established

- certified by physician/NPP

, OTD 417 Exam 2 Information: Part 1
Questions With Solutions
- individualized- services directly related

- evaluation and treatment may occur on same day

- appropriate to begin treatment once established

- significant changes




Progress notes - therapist must complete at least every 10th visit


- provide evaluation of goals

- report any changes to POC

- must be developed by therapist (NOT OTA)

- dates for recertification do not effect

- sent to physician for recertification




Services furnished by a therapy assistant - therapist needs to apply patient modifiers to

claims for all OP services

- assistance provided at least 10% of service independently from therapist

- activate a 15% payment reduction




Medicare payment thresholds for 2020 - permitted to exceed with KX modifier

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through EFT, credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying this summary from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller UpperClass. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy this summary for R354,32. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

83662 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy summaries for 14 years now

Start selling
R354,32
  • (0)
  Buy now