--- title: Therapy Notes to prevent Medicare Denials description: Prevent Medicare denials with Kris B. Harmony's expert therapy note guidance. Ensure accurate documentation for skilled interventions. image: https://56632.fs1.hubspotusercontent-na1.net/hubfs/56632/images/home/Blog%20Post%20Images%202023/blog-image-3.jpg --- ** [![Artboard 1@4x-100 (1)](https://56632.fs1.hubspotusercontent-na1.net/hub/56632/hubfs/Artboard%201@4x-100%20(1).jpg?width=1514&height=594&name=Artboard%201@4x-100%20(1).jpg "Artboard 1@4x-100 (1)")](https://krisbharmony.com/) June 2, 2010 # Therapy Notes to prevent Medicare Denials ![Kris B. Harmony, OTR/L, LNHA, MBA](https://56632.fs1.hubspotusercontent-na1.net/hubfs/56632/300.jpg) Kris B. Harmony, OTR/L, LNHA, MBA ![Therapy Notes to prevent Medicare Denials](https://56632.fs1.hubspotusercontent-na1.net/hubfs/56632/images/home/Blog%20Post%20Images%202023/blog-image-3.jpg) The Art of Writing Supportive Therapy Notes to prevent Medicare Denials Denial trending nationally has evidenced that Medical Reviews are focusing on  higher functioning patients and conversely, they are also focusing on lower functioning patients. Reviews prone to denial have been noted on patients with documented behaviors or cognitive barriers, which may be perceived as appropriate for restorative nursing management.  This type of claim requires documentation to support deficits, potential for further gains and skilled interventions provided. It is critical that documentation of skilled therapy interventions to manage specific deficits be reflected in the therapy documentation. Documentation should establish deficits requiring skilled therapy intervention and through objective measurements clearly state that the patient is making progress toward goals. Frequently Kris B Harmony's chart audits identify rehab documentation of the high level patients and low level patients that does not consistently reflect the need for continued skilled rehabilitation services, progress or functional outcomes.   Weekly progress notes must detail progress towards goals and specify individualized skilled interventions. Kris B Harmony recommends the following format for each weekly therapy progress note: Current status for each stated goal. Ensure ongoing deficits are detailed. Specific progress toward each goal. Ensure specific gains within levels of care are documented if a patient does not increase in functional level. Detailed patient individualized skilled interventions provided (e.g. modalities, progressive exercise and activities, trials of devices and techniques, teaching and training). Assessments and changes to the treatment plan (e.g. with set-back or new discharge plan to re-establish goals). Continued need for skilled therapy interventions (consider specific needs to reach discharge goal, risks without skilled interventions and ongoing deficits). Avoid subjective statements of progress ("no gains"). Kris B Harmony recommends detailed review of therapy documentation for patients continuing at a Rehab  Ultra High level after 30 days to ensure that documentation reflects the skilled levels of care provided. Kris B Harmony can provide facilities with additional information on this topic.    ## Follow Kris B Harmony [** Visit Our **YouTube Channel** ](https://www.youtube.com/@krisbharmony) [** Follow Us on **Facebook** ](https://www.facebook.com/krisbharmony/) [** Follow Us on **Instagram** ](https://www.instagram.com/krisbharmony) [** Follow Us on **Twitter** ](https://twitter.com/KrisBHarmony) [** Follow Us on **LinkedIn** ](https://www.linkedin.com/in/krisbharmony) ## Get Expert Tips in your inbox Subscribe to our blog ## Might Be Interesting --- --- --- [ September 30, 2024 ## Medicare Open Enrollment 2025 and Medicare Advantage Plans OIG Involvement Medicare Open Enrollment Read more *→* ](https://krisbharmony.com/blog/medicare-open-enrollment-2025-and-medicare-advantage-plans-oig-involvement) [ August 14, 2024 ## PDPM Calculator and Analytics Hopforce, Inc added a Length of Stay Analysis view to the PDPM Analytics, the comprehensive data analytics tool that is an extension of the PDPM Calculator. 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Read more *→* ](https://krisbharmony.com/blog/pdpm-calculator-and-analytics) [ April 26, 2024 ## Understanding the Latest Updates on Staffing Requirements in Long-Term Care Facilities Understanding the Latest Updates on Staffing Requirements in Long-Term Care Facilities Read more *→* ](https://krisbharmony.com/blog/understanding-the-latest-updates-on-staffing-requirements-in-long-term-care-facilities) ![KrisBHarmony logo](https://56632.fs1.hubspotusercontent-na1.net/hub/56632/hubfs/kbh-logo-2023.png?width=213&height=116&name=kbh-logo-2023.png) Kris B Harmony LLC 3121 Firenze Court Las Vegas, Nevada 89128 [(617) 595-6032](tel:+6175956032) [**](https://www.facebook.com/krisbharmony/) [**](https://twitter.com/HarmonyHlthcare/) [**](https://www.youtube.com/channel/UCay0x-du7R9l_IjCxuhfRow) [**](https://www.linkedin.com/company/harmony-healthcare) ![KrisBHarmony logo](https://56632.fs1.hubspotusercontent-na1.net/hub/56632/hubfs/Logo-KrisB%20(1).png?width=208&name=Logo-KrisB%20(1).png) Empowering People who are systematically marginalized and impacting changes in our laws, our culture, and society. 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