|
TREATMENT PLAN
|
|
|
Treatment Plan Status
|
|
|
Patient Treatment Plan
|
|
|
Goals
|
|
|
Spinal Complaint #1 - Short Term Goals
• • •
|
Spinal Complaint #1 - Long Term Goals
• • •
|
|
Extremity Complaint #1 - Short Term Goals
• • •
|
Extremity Complaint #1 - Long Term Goals
• • •
|
|
E/M CODES
|
|
|
|
No Exam was performed today
|
|
Initial Exam performed today
|
Re-Exam performed today
|
|
|
Review of Findings (Day 2)
|
|
99202 (Eval and notes 15-29 mins)
|
99212 (Eval and notes 10-19 mins)
|
|
99203 (Eval and notes 30-44 mins)
|
99213 (Eval and notes 20-29 mins)
|
|
99204 (Eval and notes 45-59 mins)
|
99212 - 2nd Day ROF
|
|
|
99213 - 2nd Day ROF
|
|
DIAGNOSTIC CODES
|
|
|
|
No X-Rays were performed today
|
|
|
Cervical X-rays
|
|
72040 (2-3 Views)
|
72050 (4-5 Views)
|
|
|
Thoracic X-Rays
|
|
72070 (2 Views)
|
72072 (3 Views)
|
|
|
Lumbar X-Rays
|
|
72100 (2-3 Views)
|
72110 (4+ Views)
|
|
|
Upper Extremity X-Rays
|
|
73020 Shoulder 1 View
|
73030 Shoulder 2+ Views
|
|
73070 Elbow 2+Views
|
73100 Wrist 2 Views
|
|
73120 Hand 2 Views
|
73140 Finger(s) 2 views
|
|
|
Lower Extremity X-Rays
|
|
73500 Hip (Unilateral) 1 View
|
73510 Hip (Unilateral) 2 Views
|
|
73560 Knee 1-2 Views
|
73562 Knee 3 Views
|
|
73600 Ankle 2 Views
|
73610 Ankle 3+ Views
|
|
73620 Foot 2 Views
|
73630 Foot 3+ Views
|
|
DME's PROVIDED
|
|
|
|
No DME's were provided today
|
|
Vive Arm Sling
|
Vive Cervical Collar
|
|
Vive Wrist Brace
|
Vive Lumbar Support
|
|
Vive Knee Brace
|
Vive XL Lumbar Support
|
|
Vive Ankle Brace
|
5x18 Ice Pack
|
|
Biofreeze
|
9x12 Ice Pack
|
|
Electrodes
|
Mohey Box (At-Home Therapy)
|
|
LidoPro Patch
|
|
|
LEVEL OF ADJUSTMENT PERFORMED
|
|
|
|
No adjustment performed today
|
|
|
98940 (1-2 Regions)
|
|
|
98941 (3-4 Regions)
|
|
|
98942 (5 Regions)
|
|
|
98943 (Extremity)
|
|
THERAPIES PROVIDED
|
|
|
|
No Therapies provided today
|
|
97110 Therapeutic Exercise 1 Unit
|
97110 Therapeutic Exercise 2 Units
|
|
97530 Therapeutic Activities 1 Unit
|
97530 Therapeutic Activities 2 Units
|
|
97112 Neuromuscular Re-Education 1 Unit
|
97112 Neuromuscular Re-Education 2 Units
|
|
97140 Manual Therapy 1 Unit
|
97140 Manual Therapy 2 Units
|
|
97535 Self-Home Management
|
98960 Patient Education
|
|
97035 Ultrasound
|
97012 Mechanical Traction
|
|
G0283 Electrical Stimulation 1 Unit
|
97010 Hot / Cold Therapy
|
|
|
KT Tape
|
|
|
29240 Strapping of Shoulder
|
|
|
29260 Strapping of Elbow or Wrist
|
|
|
29280 Strapping of Hand or Finger
|
|
|
29520 Strapping of Hip
|
|
|
29530 Strapping of Knee
|
|
|
29540 Strapping of Ankle or Foot
|
|
ADDITIONAL COMMENTS
|
|
|
Insert any additional comments here...
|
|
