Chapter DHS 107

DHS 107.16(1)(b) (b) Evaluations. Covered evaluations, the results of which shall be set out in a written report to accompany the test chart or form in the recipient’s medical record, are the following:

DHS 107.16(1)(b)1. 1. Stress test;

DHS 107.16(1)(b)2. 2. Orthotic check-out;

DHS 107.16(1)(b)3. 3. Prosthetic check-out;

DHS 107.16(1)(b)4. 4. Functional evaluation;

DHS 107.16(1)(b)5. 5. Manual muscle test;

DHS 107.16(1)(b)6. 6. Isokinetic evaluation;

DHS 107.16(1)(b)7. 7. Range-of-motion measure;

DHS 107.16(1)(b)8. 8. Length measurement;

DHS 107.16(1)(b)9. 9. Electrical testing:

DHS 107.16(1)(b)9.a. a. Nerve conduction velocity;

DHS 107.16(1)(b)9.b. b. Strength duration curve — chronaxie;

DHS 107.16(1)(b)9.c. c. Reaction of degeneration;

DHS 107.16(1)(b)9.d. d. Jolly test (twitch tetanus); and

DHS 107.16(1)(b)9.e. e. “H” test;

DHS 107.16(1)(b)10. 10. Respiratory assessment;

DHS 107.16(1)(b)11. 11. Sensory evaluation;

DHS 107.16(1)(b)12. 12. Cortical integration evaluation;

DHS 107.16(1)(b)13. 13. Reflex testing;

DHS 107.16(1)(b)14. 14. Coordination evaluation;

DHS 107.16(1)(b)15. 15. Posture analysis;

DHS 107.16(1)(b)16. 16. Gait analysis;

DHS 107.16(1)(b)17. 17. Crutch fitting;

DHS 107.16(1)(b)18. 18. Cane fitting;

DHS 107.16(1)(b)19. 19. Walker fitting;

DHS 107.16(1)(b)20. 20. Splint fitting;

DHS 107.16(1)(b)21. 21. Corrective shoe fitting or orthopedic shoe fitting;

DHS 107.16(1)(b)22. 22. Brace fitting assessment;

DHS 107.16(1)(b)23. 23. Chronic-obstructive pulmonary disease evaluation;

DHS 107.16(1)(b)24. 24. Hand evaluation;

DHS 107.16(1)(b)25. 25. Skin temperature measurement;

DHS 107.16(1)(b)26. 26. Oscillometric test;

DHS 107.16(1)(b)27. 27. Doppler peripheral-vascular evaluation;

DHS 107.16(1)(b)28. 28. Developmental evaluation:

DHS 107.16(1)(b)28.a. a. Millani-Comparetti evaluation;

DHS 107.16(1)(b)28.b. b. Denver developmental;

DHS 107.16(1)(b)28.c. c. Ayres;

DHS 107.16(1)(b)28.d. d. Gessell;

DHS 107.16(1)(b)28.e. e. Kephart and Roach;

DHS 107.16(1)(b)28.f. f. Bazelton scale;

DHS 107.16(1)(b)28.g. g. Bailey scale; and

DHS 107.16(1)(b)28.h. h. Lincoln Osteretsky motion development scale;

DHS 107.16(1)(b)29. 29. Neuro-muscular evaluation;

DHS 107.16(1)(b)30. 30. Wheelchair fitting — evaluation, prescription, modification, adaptation;

DHS 107.16(1)(b)31. 31. Jobst measurement;

DHS 107.16(1)(b)32. 32. Jobst fitting;

DHS 107.16(1)(b)33. 33. Perceptual evaluation;

DHS 107.16(1)(b)34. 34. Pulse volume recording;

DHS 107.16(1)(b)35. 35. Physical capacities testing;

DHS 107.16(1)(b)36. 36. Home evaluation;

DHS 107.16(1)(b)37. 37. Garment fitting;

DHS 107.16(1)(b)38. 38. Pain; and

DHS 107.16(1)(b)39. 39. Arthrokinematic.

DHS 107.16(1)(c) (c) Modalities. Covered modalities are the following:

DHS 107.16(1)(c)1. 1. Hydrotherapy:

DHS 107.16(1)(c)1.a. a. Hubbard tank, unsupervised; and

DHS 107.16(1)(c)1.b. b. Whirlpool;

DHS 107.16(1)(c)2. 2. Electrotherapy:

DHS 107.16(1)(c)2.a. a. Biofeedback; and

DHS 107.16(1)(c)2.b. b. Electrical stimulation — transcutaneous nerve stimulation, medcolator;

DHS 107.16(1)(c)3. 3. Exercise therapy:

DHS 107.16(1)(c)3.a. a. Finger ladder;

DHS 107.16(1)(c)3.b. b. Overhead pulley;

DHS 107.16(1)(c)3.c. c. Restorator;

DHS 107.16(1)(c)3.d. d. Shoulder wheel;

DHS 107.16(1)(c)3.e. e. Stationary bicycle;

DHS 107.16(1)(c)3.f. f. Wall weights;

DHS 107.16(1)(c)3.g. g. Wand exercises;

DHS 107.16(1)(c)3.h. h. Static stretch;

DHS 107.16(1)(c)3.i. i. Elgin table;

DHS 107.16(1)(c)3.j. j. N-k table;

DHS 107.16(1)(c)3.k. k. Resisted exercise;

DHS 107.16(1)(c)3.L. L. Progressive resistive exercise;

DHS 107.16(1)(c)3.m. m. Weighted exercise;

DHS 107.16(1)(c)3.n. n. Orthotron;

DHS 107.16(1)(c)3.o. o. Kinetron;

DHS 107.16(1)(c)3.p. p. Cybex;

DHS 107.16(1)(c)3.q. q. Skate or powder board;

DHS 107.16(1)(c)3.r. r. Sling suspension modalities; and

DHS 107.16(1)(c)3.s. s. Standing table;

DHS 107.16(1)(c)4. 4. Mechanical apparatus:

DHS 107.16(1)(c)4.a. a. Cervical and lumbar traction; and

DHS 107.16(1)(c)4.b. b. Vasoneumatic pressure treatment;

DHS 107.16(1)(c)5. 5. Thermal therapy:

DHS 107.16(1)(c)5.a. a. Baker;

DHS 107.16(1)(c)5.b. b. Cryotherapy — ice immersion or cold packs;

DHS 107.16(1)(c)5.c. c. Diathermy;

DHS 107.16(1)(c)5.d. d. Hot pack — hydrocollator pack;

DHS 107.16(1)(c)5.e. e. Infra-red;