MRI of the left shoulder with contrast dated 05/30/2017 showed a complete, full thickness tear with a moderate retraction of approximately 2-2.5 cm within the distal supraspinatus tendon. The remainder of the examination was otherwise unremarkable with no abnormal findings relative to the glenoid labrum or the tendon of the long head of the biceps.
A PT note dated 08/11/2017 indicated that the claimant reported left shoulder pain rated at 9/10 at worst. He was diagnosed with a complete rotator cuff tear or rupture of the left shoulder, superior glenoid labrum lesion of the left shoulder, spontaneous rupture of the other tendons of the left shoulder, and impingement syndrome of the left shoulder. A rehabilitative therapy for 2 visits a week for 6 weeks was recommended.
A PT note …show more content…
Based on the submitted documentation, the claimant was diagnosed with a complete rotator cuff tear or rupture of the left shoulder, superior glenoid labrum lesion of the left shoulder, spontaneous rupture of the other tendons of the left shoulder, and impingement syndrome of the left shoulder. He was status post arthroscopic rotator cuff repair on 06/23/2017 with remaining deficits in the range of motion, strength, and pain. It was noted that as of 11/14/2017, he had already completed 22 visits of physical therapy. The request for additional post-op physical therapy visits exceeded the recommendation of ODG. Further, treatment guidelines recommend fading of treatment frequency plus active self-directed home PT. At this point, the claimant is expected to be able to perform home exercise program, independently. Therefore, the request for post-op physical therapy re-evaluation and treatment, twice weekly for 3 weeks, left shoulder, per 11/14/17 order is not medically
A PT note dated 08/11/2017 indicated that the claimant reported left shoulder pain rated at 9/10 at worst. He was diagnosed with a complete rotator cuff tear or rupture of the left shoulder, superior glenoid labrum lesion of the left shoulder, spontaneous rupture of the other tendons of the left shoulder, and impingement syndrome of the left shoulder. A rehabilitative therapy for 2 visits a week for 6 weeks was recommended.
A PT note …show more content…
Based on the submitted documentation, the claimant was diagnosed with a complete rotator cuff tear or rupture of the left shoulder, superior glenoid labrum lesion of the left shoulder, spontaneous rupture of the other tendons of the left shoulder, and impingement syndrome of the left shoulder. He was status post arthroscopic rotator cuff repair on 06/23/2017 with remaining deficits in the range of motion, strength, and pain. It was noted that as of 11/14/2017, he had already completed 22 visits of physical therapy. The request for additional post-op physical therapy visits exceeded the recommendation of ODG. Further, treatment guidelines recommend fading of treatment frequency plus active self-directed home PT. At this point, the claimant is expected to be able to perform home exercise program, independently. Therefore, the request for post-op physical therapy re-evaluation and treatment, twice weekly for 3 weeks, left shoulder, per 11/14/17 order is not medically