Re: OT w/c PIP Ultrasound denial

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In response to the "newly discovered" workers compensation requirement 436-009-0050: Chart notes must clearly indicate the time treatment begins and the time treatment ends for the day, I will soon be marketing and selling a sophisticated medical device called a "Chiropractic Clinical Measurement Device." Price will be $1,000.00 (please see below if interested). (:-)

Re: PIP Ultrasound denial

Minga, , and all -

The issue is not what is required under the administrative rules formed by OBCE, but those of the Workers' Compensation Division as to clinical documentation.

At the moment I cannot find the section in question. I have seen it, but a brief search on the Oregon Administrative Rules portion of the Secretary of State's WEB page struck out. Thus, I am working from memory. Between 5 and 10 years ago, WCD rules made a change and required specific information within the chart notes of patients being treated for work injuries. My best recall was a requirement to document the time of the patient encounter - office time, such as 2:30PM to 3:10PM. For physical medicine procedures they were requiring the duration of the therapy. However, there was some "gray" language that could be interpreted as requiring start and stop times, but it was rather weak wording.

I will try to locate the language, but it may be a few days, it not longer. The office computer has been temperamental with the Internet, and I have to fight my daughter for the "beast" at home. Her homework requirement usually trumps my random surfing. Any willing surfers can also tax their brain power. I have not scene the section in question online. My recall has it in the maroon colored book of Work Comp rules and fees, but I cannot be any more specific. My first encounter with the section was definitely pre-high speed Internet.

I know that after I saw the section I changed my charting on Work Comp cases to reflect the office time in and out, as well as the duration of any treatment. could the issue be the lack of office times, and not therapy?

Tom Freedland

In a message dated 12/12/2007 6:07:47 P.M. Pacific Standard Time, AboWomanaol writes:

All,

Ok this is one we've encountered at the board with specific insurance co filing a complaint against a DC (denial of payment) for something similar. I can't honestly remember if it was ultrasound or EMS. The board sent a letter back informing them that we do not require stop and start times to be recorded. We do support the need to record Time spent providing the therapy 8, 10,12 minutes etc, Data of specific machine use (dial settings) never leave that out!, date of treatment, signature of provider, and of course clinically justified reasoning to use the therapy. Neither WSCC or the OBCE requires start and stop time. The only reason I can see for an insurance company to require this is if you have made a specific agreement (signed and specified) as a provider to do this. Please, Vern correct me if I'm wrong, but the OBCE supported the DC in this and said we would not call it a violation to omit start and stop times.

Minga Guerrero DC

ps SInce I am unable to copy listserv messages or questions without permission, this is not an official OBCE response. It's only my personal opinion of observations. This note has not gone to the OBCE for official approval.

In a message dated 12/12/2007 2:19:44 P.M. Pacific Standard Time, dkollardcaol writes:

Has anyone else been denied payment on WC (not SAIF) for ultrasound treatment that doesn't state the time the treatment was started and stopped in the SOAP notes? I include the length of treatment (ie.. 10 min.) but not the actual times the treatment occurs, but according to them this is not enough!! They quoted the Oregon Fee schedule as their source, but I haven't checked. Any insight would be helpful!!! thanks KollarHillsboro OR

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