Functional Assessments
Denise Fletcher
Description
Collection
Title:
Functional Assessments
Creator:
Denise Fletcher
Date:
11/30/2000
Text:
I am working with several clients who are having Medicare claims denied for
lack of a formal functional clinical assessment. A review of the
supplier's files clearly indicates that an assessment was done and the
patients assigned a functional level (usually K2 or K3) but the supplier
does not have a formal form where it documents the assessment. I have not
been able to locate any information which provides guidance on what must be
included in an assessment and the criteria for placing an individual at a
particular functional level. I have located the general descriptions of the
functional levels, as published in the Medicare manuals. My question is how
do others address this issue? What specific activities/actions/abilities
must be evaluated and documented? And just how specific does the
documentation have to be? Are others documenting the number of feet or
yards walked, the number of stairs climbed, the time to do these activities,
etc??
As an additional denial reason, the carrier is stating that descriptions of
ADLs and the specific tasks involved (for example, patient uses public
transportation to go into town to do household's grocery shopping and
patient goes out to dance at a club every weekend) are not good enough to
constitute an assessment of the patient's functional level.
I would appreciate any guidance, citations, forms or other materials that
are being used in the industry to document the placement of an individual at
a particular level.
Denise M. Fletcher
Brown & Fortunato
P.O. Box 9418
Amarillo, Texas 79105
(806) 345-6318
(806) 345-6364 Fax
<Email Address Redacted>
lack of a formal functional clinical assessment. A review of the
supplier's files clearly indicates that an assessment was done and the
patients assigned a functional level (usually K2 or K3) but the supplier
does not have a formal form where it documents the assessment. I have not
been able to locate any information which provides guidance on what must be
included in an assessment and the criteria for placing an individual at a
particular functional level. I have located the general descriptions of the
functional levels, as published in the Medicare manuals. My question is how
do others address this issue? What specific activities/actions/abilities
must be evaluated and documented? And just how specific does the
documentation have to be? Are others documenting the number of feet or
yards walked, the number of stairs climbed, the time to do these activities,
etc??
As an additional denial reason, the carrier is stating that descriptions of
ADLs and the specific tasks involved (for example, patient uses public
transportation to go into town to do household's grocery shopping and
patient goes out to dance at a club every weekend) are not good enough to
constitute an assessment of the patient's functional level.
I would appreciate any guidance, citations, forms or other materials that
are being used in the industry to document the placement of an individual at
a particular level.
Denise M. Fletcher
Brown & Fortunato
P.O. Box 9418
Amarillo, Texas 79105
(806) 345-6318
(806) 345-6364 Fax
<Email Address Redacted>
Citation
Denise Fletcher, “Functional Assessments,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/215303.
