Outpatient PT Eval for wheelchair

We have a client receiving 1 visit monthly for catheter change, LUPA. He needs an eval by PT for the wheelchair company to make adjustments to his chair and use exclusively a local rehab center's outpatient therapist. How should this be handled? Any suggestions? The client's wife wanted me to discharge him then readmit him after the PT eval. My thoughts are to subcontract the PT at the rehab center. Will Medicare pay for this? New problem for us. Thanks in advance for any assistance you can give. Jan

Jan Fulfs, RN, BSN, President
American Home Health
1660 N. Farnsworth Ave., Suite #3
Aurora, IL 60505
Phone: 630.236.3501
Fax: 630.236.3505
Jan.fulfs@ahhc-1.com

Comments

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    As I see it, you have a few options:

    1. As a PT, your PT or OT should be able to do this evaluation with
    the vendor. No vendor should have exclusive rights to an outpatient center.
    Sounds to me like this maybe a little of an inducement set up. I would get
    a referral for the W/C eval for my staff and tell the vendor that your staff
    is very capable under their Practice Act to complete this. Suggest that the
    vendor can come and speak with your staff as an in-service to ensure that
    the Letter of Medical Necessity contains the proper wording. Depending on
    the state, therapists cannot write these anymore.

    2. You can hire this therapist as a PRN and bill it for you. The
    therapist would have to complete your Compliance/Orientation Program which
    will be a high cost.

    3. Discharge patient and Readmit.

    I would start with number 1.

    Lisa

    Lisa Ann Socha, PT, MBA

    Compliance Officer

    585 Southlake Blvd, Suite B

    Richmond, VA 23236

    (804) 897-9056

    Fax: (804) 897-1099


    We have a client receiving 1 visit monthly for catheter change, LUPA. He
    needs an eval by PT for the wheelchair company to make adjustments to his
    chair and use exclusively a local rehab center's outpatient therapist. How
    should this be handled? Any suggestions? The client's wife wanted me to
    discharge him then readmit him after the PT eval. My thoughts are to
    subcontract the PT at the rehab center. Will Medicare pay for this? New
    problem for us. Thanks in advance for any assistance you can give. Jan



    Jan Fulfs, RN, BSN, President

    American Home Health

    1660 N. Farnsworth Ave., Suite #3

    Aurora, IL 60505

    Phone: 630.236.3501

    Fax: 630.236.3505

    Jan.fulfs@ahhc-1.com









  • a lot of times the DME company does not submit claim for this which would mean no billing interference part B vs part A etc. I would first find out if anyone is billing for the PT eval for wc fitting and go from there, may be making something out of it that does not need to be. Otherwise suggestions above all good
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