Current through 2024-51, December 18, 2024
Subsection 144-101-II-68.02 - DEFINITIONS68.02-1Functionally Significant Improvement: demonstrable, measurable increase in the member's ability to perform specific tasks or motions that contributes to independence outside the therapeutic environment.68.02-2Long-Term Chronic Pain: is any pain that has lasted or is expected to last more than sixty (60) days and impacts or is expected to impact a member's level of function for more than sixty (60) days.68.02-3Maintenance Care: occupational services provided to a member whose condition is stabilized after a period of treatment or for whom no further functionally significant improvement is expected.68.02-4Occupational Therapy Practitioner: an individual who is licensed as an Occupational Therapist, Registered/Licensed (OTR/L), Occupational Therapist, Licensed (OT/L), Certified Occupational Therapy Assistant, Licensed (COTA/L) or Occupational Therapy Assistant, Licensed (OTA/L).68.02-5Occupational Therapy Services: the assessment, planning and implementation of a program of purposeful activities to develop or maintain adaptive skills necessary to achieve the maximal physical and mental functioning of the individual in the individual's daily pursuits. The practice of "Occupational Therapy" includes, assessment and treatment of individuals whose abilities to cope with the tasks of living are threatened or impaired by developmental deficits, the aging process, learning disabilities, poverty and cultural differences, physical injury or disease, psychological and social disabilities or anticipated dysfunction68.02-6Pain Management Care Plan: is a plan of care ordered by a rendering or servicing provider, which must include the use of at least one (1) therapeutic treatment option.68.02-7Practitioner of the Healing Arts: Medical Doctors, Doctors of Osteopathy, and all others registered or licensed in the healing arts, including, but not limited to, nurse practitioners, podiatrists, optometrists, chiropractors, physical therapists, occupational therapists, speech therapists, dentists, psychologists and physicians' assistants.68.02-8Rehabilitation Potential: documented expectation of measurable functionally significant improvement in the member's condition in a reasonable, predictable period of time as the result of the prescribed treatment plan. 68.02-9Terminal Illness: is a medical condition resulting in a prognosis that a member has a life expectancy of six (6) months or less if the illness runs its normal course. C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-68, subsec. 144-101-II-68.02