Peer Review is defined by the American Physical Therapy Association
as: A system by which peers with similar areas of expertise assess
the quality of Physical Therapy provided, using accepted practice
standards and guidelines.
To educate members and to answer community concerns about the quality
of Physical Therapy services.
The Problem Identification/Peer Review (PI/PR) Process is applicable
to all areas of Physical Therapy.
The same PI/PR process is applied in 3 phases:
Phase I: Review of self by self
Phase II: Therapist/Department Peer Review- by either peers internally
or by external peer reviewer via internal request
Phase III: Therapist/Department Peer Review- by external peer reviewer
(either Peer Review Director or a trained Peer Reviewer or a panel
of 2-3 Peer Reviewers), per external request.
Payers and governmental agencies may request the
PI/PR process for consultation or education
Medical necessity of PT services
Appropriateness of PT care
Timeliness of PT services
Utilization of personnel
Appropriateness of billing
Educational presentations are available on:
PT Practice
Billing and coding
Guide to Physical Therapist Practice
PT Documentation
MNAPTA Problem Identification/Peer Review serves
as a resource to Physical Therapists through consultation, education,
and publications.
MNAPTA members may attend the annual Peer Reviewer
training free of charge (with required purchase of the PI/PR manual)
The PI/PR manual is available for purchase as a
resource (without peer reviewer training) through the MNAPTA office
or Peer Review Director
Contact the Peer Review Director for information
on individualized educational presentations and peer review consultation
including chart reviews
The Problem Identification/Peer Review process, developed in the
early 1980’s, has been used by Physical Therapists, and has been
requested by payers and governmental agencies.
The Minnesota Chapter APTA Problem Identification/Peer
Review (MNAPTA PI/PR) process was developed, ratified, and is revised
by MN APTA members.
MN APTA has over 70 Physical Therapists trained
as peer reviewers.
MN APTA has developed working relationships with
over 35 state agencies, review organizations and third party payers
in the area of PI/PR.
MN APTA PI/PR process is highly regarded by Physical
Therapists across the nation for its high level of professionalism
and leadership in peer review.
Inter-reviewer reliability studies of the Problem
Identification/Peer Review process are performed to monitor and
ensure consistency between reviewers.
MN APTA PI/PR process is lead by the MN APTA Peer Review Director.
Physical Therapists and external agencies with inquiries should
contact the Peer Review Director at the MN APTA office. When a case
is accepted for review, the Peer Review Director selects the reviewer(s)
based on the complexity of the case and area of Physical Therapy
practice. The identities of the individual Physical Therapist peer
reviewers are protected.
:
Director or Peer Review, MNAPTA
1711 West County Road B, Suite 102 South
Roseville MN 55113-4036
Phone 651.635.0046
Fax 651.635.0112
Email: peerreview@mnapta.org
Minnesota statute on review organizations
145.61,subd. 5 (f), (i), (l) to gather and review information relating
to the care and treatment of patients for the purposes of...
145.62 Limitation on liability for persons providing information
to review
145.64 Confidentiality of records of review organization.
MN APTA Resources - contact MN APTA Chapter office
Problem Identification/Peer Review Manual
MN APTA Guidelines for Documentation
MN APTA Guidelines for Role Delineation
MN APTA Guidelines for Physical Therapy Provided Through Specialized
Maintenance Therapy
APTA Resources (available through APTA at 1-800-999-2782, ext 3395;
or on-line at www.apta.org
APTA Standards of Practice
APTA Guidelines for PT Documentation
APTA Guidelines for Peer Review Training
APTA Guidelines for Claims Review
APTA Guide to Physical Therapist Practice
Documentation on Pain
Deborah A. Madanayake, PT, GCS
MN APTA Peer Review Director
Documentation regarding pain. . . . what a pain! As a
peer in co-agony, I’d like to offer some relief. At the risk of
sounding simplistic, here are a few “words for thought”.
Documentation Example 1:
Findings: Neck pain 8/10; pain interferes with performance of job
duties.
Goal: Neck pain decreased to <3/10 so as not to interfere with
job performance.
Documentation Example 2:
Findings: Shoulder pain 7/10; difficulty with ADL.
Goal: Shoulder pain decreased to 2/10; ADL without pain.
Now consider the following:
Documentation Example 1 – revised:
Findings: Patient reports neck pain 8/10 within 5 minutes of sitting
at work-station, typing on keyboard.
Goal: Patient will sit at work-station and type on keyboard for
30 minute periods, four times per workday, with neck pain less than
3/10 in order to perform required job duties.
Documentation Example 2 – revised:
Findings: Right shoulder pain reported as 7/10 when flexed and abducted
>50 degrees during attempts to shampoo hair in shower.
Goal: Patient able to flex >110 degrees, abduct >45 degrees,
externally rotate >90 degrees at right shoulder, with pain <2/10,
to allow shampooing of hair in shower.
Physical Therapists are experts at dissecting
the components of functional movement. We are proficient at treating
not only impairments, but also the consequences of those impairments.
It is important to document the link between the patient’s pain
and its impact on his/her function in home/work/community roles
and responsibilities. A clear determination of the patient’s functional
limitations has multiple benefits:
1. the focus
of treatment is clarified
2. the response to treatment
can be clearly documented in patient-specific terms
3. the patient’s individual
issues are identified and treated, leading to improved patient satisfaction
4. the medical necessity for
intervention is supported
Using a pain scale is a first step in
recording a patient’s pain. Documenting functional limitations,
or the consequences of the pain, adds another important dimension.
Let your expertise shine!
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