Transcription of OT Evaluation Clinician - Kinnser Software
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OT Evaluation Clinician - Kinnser Software
Kinnser Software 2016 OT Evaluation Page 1 of 11 OT Evaluation Clinician : Patient Name (Last Name, First Name) & MRN: Mileage: Gender: Agency Name/Branch: M F Date: / / Time In: Time Out: DOB: / / HCPCS Select the home health service type that reflects the primary reason for this visit: (G0152) Services Performed by a qualified occupational therapist (G0158) Services performed by a qualified occupational therapist assistant (G0160) Establishment or delivery of a safe and effective occupational therapy maintenance program Select the location where home health services were provided.
© Kinnser Software 2016 OT Evaluation Page 1 of 11 OT Evaluation Clinician: Patient Name (Last Name, First Name) & MRN: Mileage: Gender: Agency Name/Branch:
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