Description

The Physical Therapy manual lists the basic guidelines that are used to determine if physical therapy services qualify for reimbursement. The principles of positive expectation, reasonable and necessary service, skilled service and functional progress are discussed, defined, and explained with detailed examples. The necessary components of evaluations, monthly progress reports and daily progress notes are listed. Patient selection criteria is also discussed. Readers are reminded of what Medicare reviewers look for throughout the manual. (Edited by: Thomas J. Slominski, MA.)

Written to help healthcare practitioners:

• Identify appropriate patients for evaluation and/or treatment
• Understand how to document such requirements as medical necessity and skilled service (two areas often cited as reason for denial)
• Identify documentation that would not comply with current medicare documentation requirements
• Understand how to document lack of progress and still be reimbursed
• Understand how to document need for ongoing therapy
• Understand what reviewers look for in documentation

• Eligibility, Part A, Part B Issues
• Covered/Non-Covered Services
• General Reimbursement Guidelines
• Treatment Forms (700 - 701)
• Appeals Process Strategies
• Daily Note Issues
• Monthly/Weekly Progress Notes
• Examples of Documentation that Would Comply with Medicare Reimbursement Criteria
• Patient Selection and Documentation Issues for Patients with Managed Care
• Long Term/Short Term Goals
• Acute and Progressive Disorders
• When to Implement and How to Document Functional Maintenance Programs

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Guidelines Manual: PT Edition. 

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Target Audience

Ideal reference manual for PTs in private practice, directors of rehab, and others who bill Medicare for PT services. 

Author

Thomas J. Slominski, MA, CCC-SLP, is a Speech-Language Pathologist who has been in private practice since 1972. Mr. Slominski is a nationally recognized expert regarding third-party documentation issues. For the past 15 years he has presented documentation seminars to SLPs and other healthcare professionals. Of the over 8,000 participants who have attended Mr. Slominski's seminars, 96% said they would recommend his seminar to a colleague. Also, Mr. Slominski is the author of Medicare Guidelines Explained for the SLP and editor of two other Medicare documentation manuals: Medicare Guidelines Explained for the PT and Medicare Guidelines Explained for the OT.

Teri Nishimoto-Vance, PT, GCS, has focused on rehabilitation of the older adult for the past 20 years. She holds the Geriatric Specialist Certification from the American Board of Physical Therapy Specialties. Teri has worked in several healthcare settings including skilled nursing, home health and outpatient clinics, and worked as a staff clinician, lead therapist and director of rehabilitation services.  She has lectured and published on a variety of subjects including group therapy, the geriatric amputee, and Medicare documentation. Teri has also been an adjunct professor with the Physical Therapy Program at Pacific University in Oregon.  Currently, she is the lead physical therapist at Adventist Health Physical Therapy in Sandy, Oregon where she lives with her husband and two children.