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Get Physical Therapy Initial Evaluation Template
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How to fill out the Physical Therapy Initial Evaluation Template online
Filling out the Physical Therapy Initial Evaluation Template online can streamline the process of documenting the initial evaluation of a patient. This guide will provide you with clear and supportive steps to help you complete the form accurately and efficiently.
Follow the steps to effectively fill out the Physical Therapy Initial Evaluation Template online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the member's name in the designated field. This is essential for identifying the individual receiving therapy.
- Fill in the member's date of birth (DOB). This information helps confirm the patient's identity.
- Provide the member ID number. This number connects the evaluation to the patient’s health plan.
- Input the diagnosis code (ICD) to categorize the condition being treated.
- Document the facility name along with the facility ID number. It is essential to specify where the evaluation is taking place.
- Enter the facility's contact phone number and fax number for communication purposes.
- Indicate the number of visits requested in the appropriate field based on the treatment plan.
- State the frequency of physical therapy visits to determine the schedule of appointments.
- Record the initial treatment date and the estimated discharge date to track the treatment timeline.
- Fill out the section on current clinical status, which includes pain intensity and various functional abilities using the provided scale.
- Complete the comments section, providing any additional notes that may assist in the evaluation.
- Review and verify all entered data for accuracy and completeness before finalizing the form.
- Lastly, save changes, download, print, or share the form as needed.
Complete your documents online to ensure accurate and efficient processing.
The specific codes for a physical therapy initial evaluation are CPT codes 97161, 97162, or 97163. These codes categorize the evaluation based on the complexity and time invested. Implementing a physical therapy initial evaluation template provides an organized way to document and assign the correct code, ensuring proper billing and effective treatment planning.
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