DHS 107.17(1)(g)3. 3. Edema control; and

DHS 107.17(1)(g)4. 4. Positioning;

DHS 107.17(1)(h) (h) Therapeutic adaptions, as follows:

DHS 107.17(1)(h)1. 1. Orthotics/splinting;

DHS 107.17(1)(h)2. 2. Prosthetics;

DHS 107.17(1)(h)3. 3. Assistive/adaptive equipment; and

DHS 107.17(1)(h)4. 4. Environmental adaptations;

DHS 107.17(1)(i) (i) Environmental planning; and

DHS 107.17(1)(j) (j) Evaluations or re-evaluations. Covered evaluations, the results of which shall be set out in a written report attached to the test chart or form in the recipient’s medical record, are the following:

DHS 107.17(1)(j)1. 1. Motor skills:

DHS 107.17(1)(j)1.a. a. Range-of-motion;

DHS 107.17(1)(j)1.b. b. Gross muscle test;

DHS 107.17(1)(j)1.c. c. Manual muscle test;

DHS 107.17(1)(j)1.d. d. Coordination evaluation;

DHS 107.17(1)(j)1.e. e. Nine hole peg test;

DHS 107.17(1)(j)1.f. f. Purdue pegboard test;

DHS 107.17(1)(j)1.g. g. Strength evaluation;

DHS 107.17(1)(j)1.h. h. Head-trunk balance evaluation;

DHS 107.17(1)(j)1.i. i. Standing balance — endurance;

DHS 107.17(1)(j)1.j. j. Sitting balance — endurance;

DHS 107.17(1)(j)1.k. k. Prosthetic check-out;

DHS 107.17(1)(j)1.L. L. Hemiplegic evaluation;

DHS 107.17(1)(j)1.m. m. Arthritis evaluation; and

DHS 107.17(1)(j)1.n. n. Hand evaluation — strength and range-of-motion;

DHS 107.17(1)(j)2. 2. Sensory integrative skills:

DHS 107.17(1)(j)2.a. a. Beery test of visual motor integration;

DHS 107.17(1)(j)2.b. b. Southern California kinesthesia and tactile perception test;

DHS 107.17(1)(j)2.c. c. A. Milloni-Comparetti developmental scale;

DHS 107.17(1)(j)2.d. d. Gesell developmental scale;