BRRR coding corner
Briefings on Outpatient Rehab: Reimbursement and Regulations, September 1, 2009
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A: The certification period is valid for the duration of the POC established by the therapist or 90 days from the initial evaluation and treatment date, whichever is less, and signed and dated by the physician.
For example, if a therapist establishes a POC at three times per week for six weeks and the POC is signed and dated by the physician, the POC is valid for six weeks (18 visits) or 90 days from the start of therapy, whichever occurs first. If the 18th visit occurs on day 40 and the patient requires continued therapy services, an updated POC (recertification) would be required. The therapist should establish the duration of the POC based on the initial evaluation, including the patient’s prior and current level of function and anticipated outcome. If you are unsure whether the patient will require five or six weeks of therapy, my recommendation would be to certify for six weeks. If the patient finishes therapy prior to six weeks, no harm is done. If the patient requires the additional week, you are covered under the initial POC and do not need to recertify.
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