DHS 107.17(1)(j)2.f.f. Marianne Frostig developmental test of visual perception;
DHS 107.17(1)(j)2.g.g. Reflex testing;
DHS 107.17(1)(j)2.h.h. Ayres space test;
DHS 107.17(1)(j)2.i.i. Sensory evaluation;
DHS 107.17(1)(j)2.j.j. Denver developmental test;
DHS 107.17(1)(j)2.k.k. Perceptual motor evaluation; and
DHS 107.17(1)(j)2.L.L. Visual field evaluation;
DHS 107.17(1)(j)3.3. Cognitive skills:
DHS 107.17(1)(j)3.a.a. Reality orientation assessment; and
DHS 107.17(1)(j)3.b.b. Level of cognition evaluation;
DHS 107.17(1)(j)4.4. Activities of daily living skills:
DHS 107.17(1)(j)4.a.a. Bennet hand tool evaluation;
DHS 107.17(1)(j)4.b.b. Crawford small parts dexterity test;
DHS 107.17(1)(j)4.c.c. Avocational interest and skill battery;
DHS 107.17(1)(j)4.d.d. Minnesota rate of manipulation; and
DHS 107.17(1)(j)4.e.e. ADL evaluation \ men and women;
DHS 107.17(1)(j)5.5. Social interpersonal skills — evaluation of response in group;
DHS 107.17(1)(j)6.6. Psychological intrapersonal skills:
DHS 107.17(1)(j)6.a.a. Subjective assessment of current emotional status;
DHS 107.17(1)(j)6.b.b. Azima diagnostic battery; and
DHS 107.17(1)(j)6.c.c. Goodenough draw-a-man test;
DHS 107.17(1)(j)7.7. Therapeutic adaptions; and
DHS 107.17(1)(j)8.8. Environmental planning — environmental evaluation.
DHS 107.17(2)(2)Services requiring prior authorization.
DHS 107.17(2)(a)(a) Definition. In this subsection, “spell of illness” means a condition characterized by a demonstrated loss of functional ability to perform daily living skills, caused by a new disease, injury or medical condition or by an increase in the severity of a pre-existing medical condition. For a condition to be classified as a new spell of illness, the recipient must display the potential to reachieve the skill level that he or she had previously.
DHS 107.17(2)(b)(b) Requirement. Prior authorization is required under this subsection for occupational therapy services provided to an MA recipient in excess of 35 treatment days per spell of illness, except that occupational therapy services provided to an MA recipient who is a hospital inpatient or who is receiving occupational therapy services provided by a home health agency are not subject to prior authorization under this subsection.
DHS 107.17 NoteNote: Occupational therapy services provided by a home health agency are subject to prior authorization under s. DHS 107.11 (3).
DHS 107.17(2)(c)(c) Conditions justifying spell of illness designation. The following conditions may justify designation of a new spell of illness:
DHS 107.17(2)(c)1.1. An acute onset of a new disease, injury or condition such as: