Relias LLC is an approved provider of continuing education courses by the American Occupational Therapy Association. The assignment of AOTA CEUs does not imply endorsement of specific course content, products, or clinical procedures by AOTA.
Section 1: Introduction A. About This Course B. Learning Objectives Section 2: Medicare Rules and Regulations A. Medicare Programs B. Medicare Manuals C. Coverage Determinations D. Medicare Coverage Specific Rules E. Review F. Summary Section 3: Covered OT Services A. Key Terms B. Covered Therapy Services C. Reasonable and Necessary D. What is Reasonable? E. What is Necessary? F. Establishing Medical Necessity G. Rehabilitative Therapy H. Maintenance Therapy I. Therapy Delivery Options J. Review K. Summary Section 4: Medicare Therapy Documentation Requirements A. Evaluations B. Diagnoses C. Certification of the Plan of Care D. Functional Goal Setting at a Glance E. Progress Notes F. Treatment Notes G. Discharge Summaries H. Tips for Documenting Skills I. Clear Communication through Documentation J. Review K. Summary Section 5: Functional G-Codes A. Functional G-Codes B. G-Code Severity Modifier C. Reporting Requirements D. G-Code Reporting Example – Onset of Therapy E. Review F. Summary Section 6: Conclusion A. Summary B. Course Contributors C. Resources D. References E. Congratulations!
Ronald Orth, RN, CMAC, CHC obtained a nursing degree from Milwaukee Area Technical College in 1985 and a B. A. in Health Care Administration from Concordia University in 1996. Mr. Orth possesses over 30 years of nursing experience with over 20 of those in the Skilled Nursing industry. Mr. Orth has extensive experience in teaching Medicare regulations to healthcare providers both in the US and internationally. Mr. Orth is currently the Post-acute Care Curriculum Designer and is certified in Healthcare Compliance through the Compliance Certification Board (CCB). Ron has also successfully completed the Infection Control Officer training through the AHCA and is an AHIMA approved ICD-10-CM trainer. Disclosure: Ron Orth RN, CHC, CMAC, AHIMA-Approved ICD-10-CM Trainer has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.Expert Reviewer: Rhonda Gaudreau, MA, OTR
Rhonda Gaudreau, MA, OTR. Rhonda holds a Bachelor’s degree from Vassar College and a Master’s degree in Occupational Therapy from New York University, where she also received a Fellowship in Rehabilitation Technology. She was an adjunct faculty member for several years at New York University and Dominican College in New York. Rhonda is co-owner of Theracore Management Group LLC a company that specializes in the management of therapy services and consulting for long term care facilities to enhance their operational and clinical outcomes and to improve their regulatory compliance. Disclosure: Rhonda Gaudreau, MA, OTR has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.