POC
What does POC stand for?
What is plan of care?
What are timed therapy treatment minutes?
What are direct, one-on-one patient qualified professional/auxiliary personnel contact, and by definition cannot be billed when performed in a supervised manner?
When must a progress report be completed by a therapist?
What is by the 10th visit or within 30 days?
The documentation is for physical therapy but the services billed were for occupational therapy, what do you do?
What is deny the claim as it is the wrong type of services?
When would a therapist use the KX modifier?
What is when they have therapy services provided above the therapy 'cap' threshold?
What three parts must be included in the POC?
What are diagnoses, long term goals, and type/amount/frequency/duration?
What are untimed therapy treatment minutes?
What are when a therapy treatment modality or procedure is not defined in the AMA CPT Manual by a specific time frame.
When must a re-certification be completed by a therapist?
What is when the date of service has ended on the original POC?
The documentation provided is for Mr. Smith when the claim states it is for Mrs. Fitzgerald, what do you do?
Who can provide services when billing the KX modifier?
What is a skilled therapist or qualified individual, not an aide?
When should the POC be signed by the referring provider?
What is in 30 days?
How many units of services for 51 minutes would be billed by a therapist?
What are 3 units of service?
What must treatment notes have in them?
What are: total timed and untimed minutes and correct coding, signed credentials of the provider, treatment modalities/interventions.
The documentation provided has what appears to be a written in date of 9/1/2019 when the billed services are for 3/12/2020, what do you do?
What is deny the claim as the date of service is incorrect?
Is the KX modifier appropriate to use for a beneficiary that wants to have conditioning to prepare them for a tennis tournament?
What is no, the KX modifier cannot be used simply for conditioning or exercise?
There is a delay in the POC signature by the physician, what is acceptable, if present, for this delay?
What is tracking/attempts made/fax attempts made for obtaining the signature?
13 minutes of TE, 32 minutes of MT, and 8 minutes of neuro-reeducation were billed, what is the total minutes billed and total units of service billed?
What is 53 minutes total, 1 unit of TE, 2 units of MT, and 1 unit of neuro re-education will be billed?
Does the therapist have to write a discharge note?
What is no?
The referring provider/physician/NPP can be the one to write a provider discharge note. The therapist can write a progress note based on the provider discharge note.
When the GA modifier is billed what do you need to ensure is provided and accurately?
What is the advanced beneficiary notice or ABN?
Is the KX modifier commonly used by therapists?
What is no, the KX modifier should not be used frequently and most conditions can be helped within the therapy cap threshold?
The POC is missing the date of service, what do you do?
What is deny the claim (GBB06 part B denial or GAI11 part A denial)?
What is the CPT code to TE (therapeutic exercise)?
What is 97110?
If a therapist changes the POC (goals added or changed, interventions changed, ect..) does the therapist need to submit for provider signature?
What is yes, the referring provider must sign any POC or re-certification with changes to be made?
You are doing well, you get a free 500 points!
I cannot think of another question for this category
The patient is making progress but the claim shows repetitive exercises and limited information as to why the KX modifier needs to be used, what should you do?
What is deny the claim as the therapy provided is repetitive and is not showing complexity or need of a skilled therapist?