Learning “Opptie” #3

6 thoughts on “Learning “Opptie” #3”

1. Describe a scenario with a Medicare Part A patient where co-treatment might be clinically indicated. – There are times when it is beneficial to the patient for the therapists to co-treat. Most of these cases, in my experience, have been for safety. Patients suffering from CVA’s may require co-treament for safety during balance training, transfer training and many other therapuetic activities.

   Be sure to include the therapist or therapist assistants discipline(s), the total treatment time and how each discipline would record minutes. – CPT codes are used for billing the services of one therapist or therapy assistant. The therapist cannot bill for his/her services and those of another therapist or a therapy assistant, when both provide the same or different services, at the same time, to the same patient(s). Where a physical and occupational therapist both provide services to one patient at the same time, only one therapist can bill for the entire service or the PT and OT can divide the service units. For example, a PT and an OT work together for 30 minutes with one patient on transfer activities. The PT and OT could each bill one unit of 97530. Alternatively, the 2 units of 97530 could be billed by either the PT or the OT, but not both.
   Similarly, if two therapy assistants provide services to the same patient at the same time, only the service of one therapy assistant can be billed by the supervising therapist or the service units can be split between the two therapy assistants and billed by the supervising therapist(s).

   Have you ever participated in a co-treatment session with a patient? – Yes, many times. Patients challenged with decreased trunk control may benefit from co-treatment during ADL’s at EOB. While the OT challenges the patient with dressing tasks, the PT may be behind the patient assisting and training with balance techniques. This is just a small example of some of the many ways to effectivly and properly setup a co-treatment session.

   1. Hi, Tim. It’s great to have you back in the game again today! Thank you so much for your enthusiastic participation in our Learning “Oppties” program! Your response is complete correct for a Medicare Part B patient, but you may be missing a recording of minutes opportunity with Medicare Part A! The RAI Manual for MDS 3.0, v1.07, Chapter 3, Section O states that CO-Treatment minutes for a Medicare Part A patient should be recorded using the following rule: When two clinicians, each from a different discipline, treat one resident at the same time (with different treatments), BOTH DISCIPLINES MAY CODE THE SESSION IN FULL! This year’s final rule allowed for both disciplines to each capture their time spent in diffierent services provided through a co-treatment. Please make note of this opportunity and share it with your team mates at Premier Care. I look forward to your continued involvement! Enjoy your weekend. Deb Bielek, Therapy Resource

2. 600 pound resident working on supine to sit and sitting balance with PT, while OT works on upper extremity dressing. Total treatment time 30 min. Each discipline 15 minutes. Rarely do co-treatments.

   1. Hi, Ron. Thank you so much for participating in our Learning “OPPTIES” program! Your example of this resident is a good one, as it illustrates a perfect scenario for providing therapy with a co-treatment. I like how you describe different treatments being provided by each therapist. Despite the great example, you are actually MISSING A GREAT OPPORTUNITY! According to the RAI Manual for MDS 3.0, v1.07, Chapter 3, Section O, Co-Treatment minutes for a Medicare Part A patient should be recorded using the following rule:When two clinicians, each from a different discipline, treat one resident at the same time (with different treatments), BOTH DISCIPLINES MAY CODE THE SESSION IN FULL! So, Ron, in your example, the PT and the OT could each bill 30 minutes, even though 30 was the total treatment time. This, of course, is provided that they were each present and engaged for the entire 30 minutes. Ron, thank you so much for participating and I look forward to seeing your involvement in the future. Enjoy your weekend and don’t forget to check in for tomorrow’s learning “oppties”. Deb Bielek, Therapy Resource

3. COTA and PTA co-treated patient secondary to poor activity tolerance and sitting balance. While patient worked with COTA PTA would assist in sitting balance or rest LE. When PTA working with patient COTA would assist in sitting balance or have patient rest UE. Patient also limited the amount of time she was willing to participate and this way we were able to get her activ and out of bed.

   1. Bonnie,

      Thank you so much for participating in our Learning “Oppties” program. Your answer is right on target with the requirements to be able to record the minutes in full for each discipline on the MDS under the rules for co-treatment. You indicated each discipline is working on a different aspect of skilled intervention. GREAT RESPONSE! You are also our first participant outside of our organization and for that, you will win an Opptie Prize. Please send your mailing address to me at dbielek@ensigngroup.net so that we may forward your prize. Thank you, again, for participating, Bonnie and we hope to hear from you again. Deb Bielek, Therapy Resource

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