Maximizing documentation Do's and Don'ts GG codes Reimbursement Appeals
100
What is tips for evaluation/POC
Link objective/scores to functional performance
100
What is DO
Define distinct value of OT
100
What is GG code 2
setup assistance
100
What is types of reimbursement
Medicare/Medicaid/3rd party
100
What is Medical Necessity
Skilled Rehabilitative services provided by clinicians that are safe and effective
200
What is Need for documentation
Documentation must effectively communicate the need and rationale for OT services
200
What is DO
Write legibly and timely
200
What is GG code 3
Supervsion/touch assist
200
What is the bipartisan budget act
Therapy Caps/max medicare will pay for therapy services ie PT/speech and OT ($2,110 for PT/Speech and $2110 for OT)
200
What is the beneficiary
this person receives the notice of coverage or denial of services
300
What is ABC's
Accuracy, brevity, clarity
300
What is DO
specific areas of improvement
300
What is GG code 4
partial/moderate assist
300
What is Medicare
65 and older/renal failure/other illnesses/ -65 with certain disabillities, government funded "beneficiary" this is title XIX
300
What is 120 days
The amount of time a provider or client has to appeal a denial in writing
400
What are COTA responsibilities
Intervention Plan
Daily tx notes
Progress report (OTR signs off)
400
What is DONT
don't kitchen sink it
400
What is GG code 5
substantial/max assist
400
What is Medicaid
Managed by states and based off income "recipient"
400
What is both A and B
Appeals process is the same for these two parts
500
What is DONT
don't establish too many goals
500
What is GG code 6
Dependent/Total assist
500
What is PPS and PDPM
Prospective Payment System
Patient Driven Payment Model
500
What is reason for denial
Not properly filling out a form, not submitting in a timely manner, service is seen as experimental






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