ProviderPulse
Improving Maximum Medical Improvement Scores in CPI
Corporate News
October 2011
When looking to improve Clinic Performance Initiative (CPI) scores, accurate completion of closing WC164 documents is a must. The following details provide your clinic the tools needed to succeed in the maximum medical improvement (MMI) metric.
A closing WC164 form is evaluated for completeness and should include the following:
All information must be legible.
Permanent work restrictions must be noted in section 6C.
- Specific physical limitations/restrictions must be provided.
- “Same,” “no change,” or “as tolerated” are not accepted responses.
- If no restrictions apply, indicate “no restrictions.”
Date of MMI must be provided in section 8.
Maintenance care must be addressed in section 8.
- Frequency, type and duration are required details, if applicable.
Permanent impairment must be addressed in section 9.
- If no impairment, indicate “no permanent impairment”.
- If impairment rating is complete, worksheets and narrative should accompany the closing WC164 form.
- If impairment rating is complete, but worksheets and narrative are not yet available or transcribed, indicate the date worksheets and narrative will be sent.
- If impairment rating requires referral or return appointment, indicate the date, time and provider to whom injured worker is referred. (The referring office maintains responsibility to set this appointment.)
Physician signature or printed name is required (signature or printed name of mid-level practitioner alone is not acceptable).
Date of report field must be complete.
In next month’s Provider Pulse, look for additional CPI tips in which we address modified duty and interim WC164 forms.
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