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:
DHS 107.17(2)(c)1.a.a. Neuromuscular dysfunction, including stroke-hemiparesis, multiple sclerosis, Parkinson’s disease and diabetic neuropathy;
DHS 107.17(2)(c)1.b.b. Musculoskeletal dysfunction, including fracture, amputation, strains and sprains, and complications associated with surgical procedures;
DHS 107.17(2)(c)1.c.c. Problems and complications associated with physiologic dysfunction, including severe pain, vascular conditions, and cardio-pulmonary conditions; or
DHS 107.17(2)(c)1.d.d. Psychological dysfunction, including thought disorders, organic conditions and affective disorders;
DHS 107.17(2)(c)2.2. An exacerbation of a pre-existing condition including but not limited to the following, which requires occupational therapy intervention on an intensive basis:
DHS 107.17(2)(c)2.a.a. Multiple sclerosis;
DHS 107.17(2)(c)2.b.b. Rheumatoid arthritis;
DHS 107.17(2)(c)2.c.c. Parkinson’s disease; or