Effective Documentation for Physical Therapy Professionals
Eric Shamus,Debra Stern

ISBN: 0071400656,
Division: Open University Press,
Price: £26.99,
Pub Date: JAN-04,

Pages: 384
Edition: 01
Format: Paperback

Availability: In Stock

Description

Comprehensive textbook for the documentation course required in all Physical Therapy programs. Covers every aspect of documentation including reimbursement and billing, coding, legal issues, PT and PTA communication, as well as utilization review and quality assurance. Includes a bonus pocket book with sample documentation forms and checklists.
Features

  • Uses current APTA terminology and all pertinent professional association regulations
  • Includes all aspects of documentation including reimbursement and billing, coding, legal issues, PT-PT and PT-PTA communication, and utilization review/quality assurance.
  • Sample documentation content, forms, exercises and questions are provided as appropriate
  • Provides examples of "documentation by exception" for accurate documentation
  • Provides initial examination and evaluation criteria with emphasis on objectivity and function
  • Provides guidance on goals writing including impairment-based vs. functional
  • Includes documentation aspects of supervising PTAs and Aides
  • Includes SOAP guidelines and examples as well as standardized forms and assessment tools
    		•
    Author Biography

  • Eric Shamus
    Eric Shamus PhD PT CSCS and Debra Stern DBA, PT are at Nova Southwestern University in Ft. Lauderdale FL.

    • Table of Contents


    1. Introduction, Purpose and General Rules for Health Management (Medical Record Keeping)
    2. Record Organization and General Principles
    3. Application of Models for Organization and Guidelines for Content
    4. Component Requirements
    5. Coding and Documentation
    6. Standardized Forms and Content
    7. Legal Issues in the Medical Record
    8. MDS Purpose and Components
    9. Medicare and Non-Medicare Content Principles
    10. Pediatric Documentation
    11. The Electronic Medical Record or Computerized Patient Record
    12. Utilization Review and Utilization Management
    References
    Appendices



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