Harmony Healthcare International (HHI) Blog

Duplication of Services

Duplication of Services
 
Often, Harmony chart audits evidence potential duplication of therapy services under Medical Review Guidelines set by CMS. Duplicate therapy when provided between disciplines of physical therapy, occupational therapy, and speech therapy is not considered medically appropriate and necessary and is at high risk for denial. Occupational therapy services provided should be distinct from physical therapy. Setting the same goal as physical therapy and labeling the activity "functional" can be perceived as a duplication of service.
 
In occupational therapy, the primary concern is developing, improving or restoring the highest level of performance in those functional activities required by the patient's living environment. Thus, the primary focus of treatment should be on the activities the patient needs to be able to do in their environment.
 
Factors in the environment (temporal, physical, social and cultural) that can affect function
Functional activities
ADLs
Home Living Skills
Underlying abilities that contribute to performance of functional activities

Topics: CMS

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