Ron thanks for all the good information you have given me. This helps a lot. Juan Turcios
On 6/10/09, Ron Carson <rdcar...@otnow.com> wrote: > > Lots of good questions. I'll answer to the best of my ability: > > JT> I read somewhere that we needed some type of credentials > > At one time, Medicare was going to require that all w/c evals be > done only by people holding an ATP credential. This never came > to fruition, so no special credential is currently required. > > JT> NMy second question is how do you bill medicare for this? > > I bill Medicare under the CPT code 97542 <W/C Management>. This > is a timed codes so billing in accordance with all time code > requirements, e.g. 7-minute rule, face to face, etc. > > There is no specific time allowed for the eval. Each eval is > different and requires a different time. Usually, 30 minutes to > an hour is what is required. Higher level evals take longer! > > Do not bill under OT eval, as this is NOT appropriate. An OT > eval is used to generate a plan of care and you will not be > doing that. > > JT> Do we need a doctors order to do this evaluation? > > Medicare does NOT require doctor's orders for any therapy. The > requirement is that the patient be under the care of a doctor. > This requirement is met when a doctor signs your w/c evaluation. > > You may obtain an order if desired and/or required by your > state, but it's NOT required by Medicare. But, the patient MUST > be under a doctor's care. You will need the MD's information for > billing purposes. > > For the record, I do NOT write a separate letter of justification. That > information is contained in my evaluation. > > Hope this helps. > > Ron > > ~~~ > Ron Carson MHS, OT > www.OTnow.com > > > ----- Original Message ----- > From: Juan Turcios <jcd...@gmail.com> > Sent: Wednesday, June 10, 2009 > To: OTlist@otnow.com <OTlist@otnow.com> > Subj: [OTlist] W/C evals > > JT> Hello all, I have more medicare questions for you. Are there any > JT> requirements that we (OT's) must have to perform w/c evaluations? I > read > JT> somewhere that we needed some type of credentials. When I use to do the > JT> evals (more than 8yrs ago) I remember that I spent about 45-60 minutes > doing > JT> the measurements and about an hour writing the letter of justification. > My > JT> second question is how do you bill medicare for this? and what is the > JT> billable time allotted for these type of evaluations? Do we get the > hour > JT> only and bill under OT evaluation. Do we need a doctors order to do > this > JT> evaluation? or we can do the evaluation without the other, but we need > JT> it for w/c training? Thanks again Juan Turcios > JT> -- > JT> Options? > JT> www.otnow.com/mailman/options/otlist_otnow.com > > JT> Archive? > JT> www.mail-archive.com/otlist@otnow.com > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
