Occupational Performance deficit and problem (*please note, you may not duplicate an area of occupation or client factor from any of the other problem statements):

Occupational Performance deficit and problem (*please note, you may not duplicate an area of occupation or client factor from any of the other problem statements):

Patient performs _______________ (occupation) with _______________ (level of assist) secondary to ______________ (client factor) (2 points).

Treatment Method 1 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 1 (no more then 3 sentences) (1 point):

Treatment Method 2 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 2 (no more then 3 sentences) (1 point):

STG (2 points):

LTG (2 points):

Occupational Performance deficit and problem (*please note, you may not duplicate an area of occupation or client factor from any of the other problem statements):

Patient performs _______________ (occupation) with _______________ (level of assist) secondary to ______________ (client factor) (2 points).

Treatment Method 1 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 1 (no more then 3 sentences) (1 point):

Treatment Method 2 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 2 (no more then 3 sentences) (1 point):

STG (2 points):

LTG (2 points):

Occupational Performance deficit and problem (*please note, you may not duplicate an area of occupation or client factor from any of the other problem statements):

Patient performs _______________ (occupation) with _______________ (level of assist) secondary to ______________ (client factor) (2 points).

Treatment Method 1 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 1 (no more then 3 sentences) (1 point):

Treatment Method 2 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 2 (no more then 3 sentences) (1 point):

STG (2 points):

LTG (2 points):

Occupational Performance deficit and problem (*please note, you may not duplicate an area of occupation or client factor from any of the other problem statements):

Patient performs _______________ (occupation) with _______________ (level of assist) secondary to ______________ (client factor) (2 points).

Treatment Method 1 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 1 (no more then 3 sentences) (1 point):

Treatment Method 2 (no more then 3 sentences-methods may not be repeated) (2 points):

Rationale 2 (no more then 3 sentences) (1 point):

STG (2 points):

LTG (2 points):

Treatment Session:

Treatment Session (limited to 3 pages-double-spaced, please note only 3 pages will be reviewed, anything over the 3rd page will not be reviewed, therefore please be sure to be succinct, yet provide the required information within the 3 page limit):

STG (s) being addressed:

CPT Code(s) utilized (identify the amount of time you are billing under each, ie. Ther act (97530): 15, Self care (97535): 30 and Ther ex (97110): 15):

Session (Separate out by billing code if applicable, ie. If providing 15 min. of ther act, 30 of self-care and 15 ther ex. These codes should be specified at the beginning of each being described):

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The post Occupational Performance deficit and problem (*please note, you may not duplicate an area of occupation or client factor from any of the other problem statements): appeared first on My Nursing Papers.

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