Eli's Rehab Report

Question: Is it OK to re-evaluate a patient or perform a progress note at the sixth visit and then again at the 12th visit, as long as we do this within the recertification or certification period? If we wait until the 10-visit mark, we could lose out on a week's worth of time with the patient if we have to do a recertification at that point. Any suggestions?

Alabama Subscriber

Answer: CMS policy says you must write a progress report once every 10 visits or once every certification interval -- whichever comes first. But there's nothing saying you can't write progress reports more often. Say you marked your progress report period after six visits (e.g., between the dates of April 2 and April 12); then, the patient returns for five more treatments between April 14 and April 22, after which you write another progress report. That's OK.

As for waiting until the 10-visit mark, if you write the progress report and know that the patient is going to need therapy beyond the certification interval, you can use that progress report as an updated plan of care. Then you can send that to the patient's physician for his signature, and he can sign it ahead of time. Just include on that last page "recertification from xx to xx" with a spot for the physician's signature and date, and that can cover up to 90 calendar days.