Medicare Severity Modifier for MI, Supervision, CGA, or Min A (1-19%)

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question
If a patient is Independent with physical assistance, what is the equivalent Medicare Severity Modifier?
answer
Definition of independent, no physical, no cognitive, can perform task safely without the use of an assistive device. Independent= CH, 0 percent impaired
question
If a patient is MI, Supervision, CGA, or Min A (1-19%), what is the Medicare Severity Modifier?
answer
Mod I - Patient requires extra time and/or assistive device Supervision-Supervision by one person for safe & effective task performance (% verbal or visual cues are provided) CGA- High probability of patient needing assistance, helper should have hands on the patient Min A-Patient requires no more than 25% physical assist to safely complete the task. The medicare severity modifier is CI, 1-19% impaired.
question
If a patient is Min A (20-25%) or Mod A (26%-39%), What is the Medicare Severity Modifier?
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Min A- patient requires no more than 25% physical assistance to safely complete the task. Mod A- patient requires 26-50% percent assistance to safely complete the task The Medicare severity modifier is CJ, 20-39% impaired
question
If a patient is is Mod A (40-50%) or Max A (51% -59%), What is the Medicare Severity Modifier?
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Mod A- Patient requires 26-50% percent assistance to safely complete the task. Max A- Patient requires 51-75% physical assist to safely complete the task The Medicare Severity Modifier is CK 40-59% impaired
question
Documentation of information used in functional reporting is required at each time functional reporting is required.
answer
1) Outset of a therapy episode of care 2) At least once every 10 treatment days 3) When the evaluative procedure is furnished and billed 4) At the time of discharge from the therapy episode of care. 5) At a time when reporting of a particular functional limitation is ended (and further therapy is necessary) 6) At the time reporting is begun on a different functional limitation.
question
The clinician documents on the applicable dates of service, the specific non-payable G-codes and severity modifiers used in the required reporting of the beneficiary's functional limitation on the claim for services, including how the modifier selection was made-such as where the therapist
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1) uses a single functional assessment tool 2) uses more than one functional assessment tool/measurement instrument to determine the severity of the modifier used or 3) uses clinical judgement to determine the severity of the modifier
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Which other outcome measures can be used to covert to Medicare Severity Modifiers?
answer
1. Modified Ashworth Scale (tone) 2. Berg Balance (Balance) 3. Tinetti (Balance and ambulation) 4. Timed Up and Go 5. FIM (total score) 6. FIM (individual score) 7. Dynamic Gait index 8. Functional Gait assessment 9. Wisconsin Gait Scale
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