HCPCS Procedure: G0160

Name of the Procedure:

• Common Name: Occupational Therapy Maintenance Program
• Medical Term: Service performed by a qualified occupational therapist in the home health setting for creating and maintaining a safe and effective occupational therapy maintenance program

Summary

This procedure involves an occupational therapist visiting a patient’s home to establish or deliver a maintenance program aimed at improving or sustaining the patient's functional abilities and safety in daily activities. Each session typically lasts around 15 minutes.

Purpose

• Medical Conditions Addressed: Conditions like stroke recovery, arthritis, Parkinson’s disease, multiple sclerosis, and other chronic or debilitating illnesses.
• Goals/Outcomes: To enhance or preserve the patient’s functional skills, ensure safety, and promote independence in their home environment.

Indications

• Symptoms/Conditions: Difficulty in performing daily activities, loss of function or mobility, and risk of accidents at home.
• Patient Criteria: Patients who require ongoing occupational therapy to maintain their functionality and safety but have reached a plateau in terms of improvement.

Preparation

• Pre-Procedure Instructions: Patients should have a safe and clear working space in their home.
• Diagnostic Tests: An initial evaluation by an occupational therapist to determine the specific needs and condition of the patient.

Procedure Description

1. Initial Assessment: The occupational therapist assesses the patient’s home environment and functional abilities.
2. Program Development: A tailored maintenance program is created focusing on exercises, environmental modifications, and adaptive techniques to enhance daily living activities.
3. Implementation: The therapist guides the patient through the program, ensuring safe and correct execution of activities.
4. Review and Adjustment: The program is periodically reviewed and adjusted based on the patient’s progress and any changes in condition.

• Tools/Equipment: Adaptive devices (e.g., grab bars, adaptive utensils), exercise equipment (e.g., resistance bands).
• Anesthesia/Sedation: Not applicable.

Duration

Each visit or session typically lasts 15 minutes, but the full program may require multiple sessions depending on the patient’s needs.

Setting

The procedure is performed in the patient's home, providing a familiar and comfortable environment for the patient.

Personnel

• Occupational Therapist: A licensed professional specialized in helping patients improve their functional abilities and safety.

Risks and Complications

• Common Risks: Minor discomfort or fatigue from exercises.
• Rare Risks: Falls or injuries if exercises are not performed correctly. These are managed through close supervision and adjustment of the program.

Benefits

• Expected Benefits: Improved or maintained functional abilities, enhanced safety, and greater independence in daily activities.
• Realization of Benefits: Benefits can be seen gradually over time as the patient consistently follows the maintenance program.

Recovery

• Post-Procedure Care: Ongoing participation in the maintenance program.
• Recovery Time: Continuous, as the goal is maintenance rather than recovery.
• Restrictions/Follow-Up: Regular follow-up sessions with the occupational therapist to monitor progress and make necessary adjustments.

Alternatives

• Other Options: Physical therapy, exercise programs, home health aide assistance, or assistive devices without therapy.
• Pros and Cons: Alternatives may lack the personalized approach and specialized training that occupational therapy provides.

Patient Experience

• During Procedure: The patient may feel guided support while practicing exercises and using adaptive equipment.
• After Procedure: Improvement in performing daily tasks and feeling more secure at home. Pain management involves adapting exercises to avoid discomfort.