Guest guest Posted March 29, 2012 Report Share Posted March 29, 2012 Does anyone know if there is a problem if a patient is shared between a OT and a PT for a diagnosis like lymphedema or lateral epicondylitis? If both do their own plan of care and get a physician prescription for PT and one for OT/physician signs off on both their plan of cares; is it a problem that the patient goes back and forth between the two therapists (i.e. sees the PT 2x/week and the OT 1x/week for pretty much the same treatment)? The main reason this happens is due to part-time staff and getting patients in if they need more than 2x/week, especially with specialized treatment like lymphedema. I can't find anything under medicare and I am wondering if it would be an issue with using the PT and OT " bank " toward the caps as they draw from different " banks/limits " ? Thanks for any input, a Hull, PT Cadence Health Manager of Rehabilitation Services Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2012 Report Share Posted March 29, 2012 As I am sure you know, this is done frequently in SNF; however, you said one thing that sounds like a red flag. PT and OT should have different goals and treatment methods. I realize that may be difficult for lymphedema if the goal is reduce swelling and not sure how that would be handled. Approach therapy from the core principals of each profession and how they view patient treatment when possible. Just a few thoughts, and not a legal or billing answer which is what you really need. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of a Hull Sent: Thursday, March 29, 2012 8:26 PM To: PTManager Subject: PT/OT evaluation Does anyone know if there is a problem if a patient is shared between a OT and a PT for a diagnosis like lymphedema or lateral epicondylitis? If both do their own plan of care and get a physician prescription for PT and one for OT/physician signs off on both their plan of cares; is it a problem that the patient goes back and forth between the two therapists (i.e. sees the PT 2x/week and the OT 1x/week for pretty much the same treatment)? The main reason this happens is due to part-time staff and getting patients in if they need more than 2x/week, especially with specialized treatment like lymphedema. I can't find anything under medicare and I am wondering if it would be an issue with using the PT and OT " bank " toward the caps as they draw from different " banks/limits " ? Thanks for any input, a Hull, PT Cadence Health Manager of Rehabilitation Services Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 29, 2012 Report Share Posted March 29, 2012 As I am sure you know, this is done frequently in SNF; however, you said one thing that sounds like a red flag. PT and OT should have different goals and treatment methods. I realize that may be difficult for lymphedema if the goal is reduce swelling and not sure how that would be handled. Approach therapy from the core principals of each profession and how they view patient treatment when possible. Just a few thoughts, and not a legal or billing answer which is what you really need. Steve Passmore PT, MS Healthy Recruiting Tools spass@... Phone: Fax: " What We Did For You Yesterday Is History. What Can We Do For You Today " Recruiting Tools: Cold Calls ~ List Enhancement ~ Direct Mailers ~ Card Design ~ Recruiting Software From: PTManager [mailto:PTManager ] On Behalf Of a Hull Sent: Thursday, March 29, 2012 8:26 PM To: PTManager Subject: PT/OT evaluation Does anyone know if there is a problem if a patient is shared between a OT and a PT for a diagnosis like lymphedema or lateral epicondylitis? If both do their own plan of care and get a physician prescription for PT and one for OT/physician signs off on both their plan of cares; is it a problem that the patient goes back and forth between the two therapists (i.e. sees the PT 2x/week and the OT 1x/week for pretty much the same treatment)? The main reason this happens is due to part-time staff and getting patients in if they need more than 2x/week, especially with specialized treatment like lymphedema. I can't find anything under medicare and I am wondering if it would be an issue with using the PT and OT " bank " toward the caps as they draw from different " banks/limits " ? Thanks for any input, a Hull, PT Cadence Health Manager of Rehabilitation Services Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2012 Report Share Posted March 30, 2012 Insurance companies, including the Medicare program, typically do not knowingly reimburse for a patient to switch back and forth between PT and OT due to staffing issues within your organization. This would be considered duplicate services. Why should an insurance company pay for 2 evaluations for the same DX simply because of staffing issues? It's a different thing if a patient required both PT and OT for the same DX and the disciplines were working towards different goals. Even with that said, there are insurance companies that do not reimburse for PT and OT on the same day for either the same DX and/or billing the same CPT codes on the same day. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. www.gawendaseminars.com Follow Gawenda Seminars & Consulting, Inc on Facebook Register for the February 22, 2012 audio conference: " Using Risk Assessment to Establish and Implement a Monitoring & Auditing Program " at https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1872 Subject: PT/OT evaluation To: PTManager Date: Thursday, March 29, 2012, 9:25 PM  Does anyone know if there is a problem if a patient is shared between a OT and a PT for a diagnosis like lymphedema or lateral epicondylitis?  If both do their own plan of care and get a physician prescription for PT and one for OT/physician signs off on both their plan of cares; is it a problem that the patient goes back and forth between the two therapists (i.e. sees the PT 2x/week and the OT 1x/week for pretty much the same treatment)?  The main reason this happens is due to part-time staff and getting patients in if they need more than 2x/week, especially with specialized treatment like lymphedema.  I can't find anything under medicare and I am wondering if it would be an issue with using the PT and OT " bank " toward the caps as they draw from different " banks/limits " ?  Thanks for any input, a Hull, PT Cadence Health Manager of Rehabilitation Services Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 30, 2012 Report Share Posted March 30, 2012 Insurance companies, including the Medicare program, typically do not knowingly reimburse for a patient to switch back and forth between PT and OT due to staffing issues within your organization. This would be considered duplicate services. Why should an insurance company pay for 2 evaluations for the same DX simply because of staffing issues? It's a different thing if a patient required both PT and OT for the same DX and the disciplines were working towards different goals. Even with that said, there are insurance companies that do not reimburse for PT and OT on the same day for either the same DX and/or billing the same CPT codes on the same day. Rick Gawenda, PT President Gawenda Seminars & Consulting, Inc. www.gawendaseminars.com Follow Gawenda Seminars & Consulting, Inc on Facebook Register for the February 22, 2012 audio conference: " Using Risk Assessment to Establish and Implement a Monitoring & Auditing Program " at https://www.showmyevent.com/events/viewEventDetails.aspx?EventID=1872 Subject: PT/OT evaluation To: PTManager Date: Thursday, March 29, 2012, 9:25 PM  Does anyone know if there is a problem if a patient is shared between a OT and a PT for a diagnosis like lymphedema or lateral epicondylitis?  If both do their own plan of care and get a physician prescription for PT and one for OT/physician signs off on both their plan of cares; is it a problem that the patient goes back and forth between the two therapists (i.e. sees the PT 2x/week and the OT 1x/week for pretty much the same treatment)?  The main reason this happens is due to part-time staff and getting patients in if they need more than 2x/week, especially with specialized treatment like lymphedema.  I can't find anything under medicare and I am wondering if it would be an issue with using the PT and OT " bank " toward the caps as they draw from different " banks/limits " ?  Thanks for any input, a Hull, PT Cadence Health Manager of Rehabilitation Services Quote Link to comment Share on other sites More sharing options...
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