NOTE: the below article is no longer valid.
Here is the CMS requirement for therapy evaluations as of 2021:
Therapy re-evaluations are covered if the documentation shows significant change in the patient's condition that supports the need to perform a formal re-evaluation of the patient's status. When a patient exhibits a demonstrable change in physical functional ability, a re-evaluation is covered to reestablish appropriate treatment goals and interventions.
The Visits / Assessments screen will guide the therapist with knowing when the 13th/19th/30th therapy reassessment visits are due. We’ll walk through some of the new features starting at the top of the screen.
When a therapist logs into Barnestorm their default display on the Visits / Assessments screen will be the Display Only Therapy bullet. This option will show additional information related to all therapy visit types. Other disciplines can select this display options as well.
Admitted = The patients admit date.
Future Vx = Any future visits that are scheduled (from the Schedule screen). This will be empty if your agency does not use the Schedule feature.
Cert = The current or most recent certification period. This date is based on the most recent 485 created.
Cert Visits = The number of chargeable visits for the current certification period. The total only reflects chargeable visits for the Cert time frame shown.
Disc = The therapy disciplines involved with this patient.
Last Eval = The last date the therapy evaluation / reassessment visit was done. The first visit from the therapist will be considered the first eval. See Setting the Codes Up below for how the system selects the reassessment visits.
Days = The number of days since the last evaluation / reassessment (first therapy visit, 13th,19th, 30th)
D/C = No means the therapist is still active. Yes means the therapist has been discharged. Barnestorm will look for a discharge visit from that discipline. See Setting the Codes Up below for how the system selects the discharge visits.
If the patient is due for a 13/19/30 reassessment then a button will appear at the top of the screen with a red warning message. You will click this button to start the appropriate reassessment visit. Once you start the assessment special notes will be added to the Comments section;Therapy Visit #, Last therapy eval (the initial assessment or the last reassessment), the number of days since the last eval, and the number of future scheduled visit, if any are scheduled.If you do not want all or select pieces of this information to show upon the assessment then you can delete the text.
## = The column header ## will count the number of therapy visits that have been completed. If a reassessment visit is due but was not created with a reassessment visit code then the number will show up as ** (Not Covered) instead. The ** will continue to show until a valid visit code is used for reassessment. The visit count will only go towards chargeable visits – non charge will not be included and will show up as NC under this column. When the 30th day is approaching, these visit count numbers will turn yellow as a warning and then red when the 30th day is close.
13/19? = This will show which reassessment number took place for each therapy. If **MISS** shows up then a reassessment was missed and that visit is considered not covered (NC).
The bottom of this screen will show any future scheduled visits. This works like the My Schedule feature from the Select Patient screen. You can select a scheduled visit and click on Start Visit to go directly to the start of the Assessment screen. Any details about the visit that was entered on the schedule will be filled in on the Assessment for you (Assessment Type, Payer, Job Code, Visit Status, Comments).
Setting the Codes Up
There are two ways you can setup the visit codes to be identified as a reassessment visit or a discharge visit. You can use the Global Settings to mark a visit code for the reassessment or the discharge visits for therapy. Go to Barnestorm Office > Codes >Security > Global Settings > Billing. Change number 1303 and 1304 to the appropriate visit status code(s).
If the global settings 1303 and 1304 are left blank, Barnestorm will scan the text in the visit status code description for the exact words: EVAL or ASSESS for the reassessment visit. It will look for the word DISCH for the disciplines discharge assessment.
There are a lot of different timing rules. We recommend reviewing the following article on all the details. http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/downloads/therapy_questions_and_answers.pdf
.jpg)