Compression Test
DOI: 1/20/2015. Patient is a 39-year-old male mason tender/laborer who sustained multiple injuries to his left elbow, low back and left leg while standing on the scaffold plank, when it broke and he fell. He is status post debridement of the left elbow lateral epicondylitis with V-Y tendon lengthening on 12/08/15.
Per the PT note dated 01/28/16, the patient has attended 9 visits for his left elbow. Patient has noted improvement with left elbow mobility and range of motion (ROM), but still has weakness and tenderness to palpation to the left extensor mass throughout.
Based on the latest medical report dated 02/04/16 by Dr. Wright, the patient complains of intermittent pain in his left elbow that is exacerbated by activity. He also complains of pain, numbness and paresthesias in the distribution of the ulnar nerve of his left hand. He is taking Zorvolex, which is beneficial and he tolerates well. …show more content…
He has a positive Tinel’s and ulnar nerve compression test over the cubital tunnel. Sensation is decreased in the distribution of the ulnar nerve. Range of motion (ROM) is 0 to 128 degrees. Strength is 4/5. Assessments include left elbow lateral epicondylitis, status post debridement of the lateral epicondyle with V-Y tendon lengthening and left cubital tunnel syndrome. Patient will benefit from additional course of PT to enhance the strength and restore strength and function of his left elbow. Left cubital tunnel release is also requested.
Per verification to the provider’s office, the patient has completed 18 post-operative PT sessions for the left elbow from 12/08/15 through 03/14/16.
IME records review dated 11/17/15 by Dr. D’Ambrosio is attached.
Is the request for 18 Physical Therapy Visits for the Left Elbow between 5/11/2016 and 7/10/2016 medically necessary?
C-4 for Preauthorization Request.
NY Medical Treatment Guideline does not address the
Per the PT note dated 01/28/16, the patient has attended 9 visits for his left elbow. Patient has noted improvement with left elbow mobility and range of motion (ROM), but still has weakness and tenderness to palpation to the left extensor mass throughout.
Based on the latest medical report dated 02/04/16 by Dr. Wright, the patient complains of intermittent pain in his left elbow that is exacerbated by activity. He also complains of pain, numbness and paresthesias in the distribution of the ulnar nerve of his left hand. He is taking Zorvolex, which is beneficial and he tolerates well. …show more content…
He has a positive Tinel’s and ulnar nerve compression test over the cubital tunnel. Sensation is decreased in the distribution of the ulnar nerve. Range of motion (ROM) is 0 to 128 degrees. Strength is 4/5. Assessments include left elbow lateral epicondylitis, status post debridement of the lateral epicondyle with V-Y tendon lengthening and left cubital tunnel syndrome. Patient will benefit from additional course of PT to enhance the strength and restore strength and function of his left elbow. Left cubital tunnel release is also requested.
Per verification to the provider’s office, the patient has completed 18 post-operative PT sessions for the left elbow from 12/08/15 through 03/14/16.
IME records review dated 11/17/15 by Dr. D’Ambrosio is attached.
Is the request for 18 Physical Therapy Visits for the Left Elbow between 5/11/2016 and 7/10/2016 medically necessary?
C-4 for Preauthorization Request.
NY Medical Treatment Guideline does not address the