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The OpenText SOCKS Client supports IWA authentication using HTTP in the background to 'open the door' for SOCKS. This feature requires an IP surrogate on the ProxySG appliance. Configure the ProxySG appliance and OpenText SOCKS client as follows:

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Since clients are allowed to use either resolved addresses or domain names, a convention from cURL exists to label the domain name variant of SOCKS5 "socks5h", and the other simply "socks5". A similar convention exists between SOCKS4a and SOCKS4.[18]

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2. This procedure is reasonable and necessary only when it requires the skills of an OT and is designed to address specific needs of the patient and is part of the written POC.

3. Treatment techniques utilized include, but are not limited to: recall of information, tabletop graded activities focusing on attentional skills (e.g., cancellation tasks, mazes), graded processes in steps which the patient must follow to complete the task, and computer programs that focus on the above.

4. Development of cognitive skills must be reasonable and necessary to restore and improve functioning of the patient. Documentation must relate the training to expected functional goals that are attainable by the patient.

5. Services provided concurrently by physicians, NPPs, OTs and speech therapists may be covered, if separate and distinct goals are documented in the written plan of treatment.

Sensory Integrative Techniques

The use of sensory integrative techniques is considered reasonable and necessary when patients must develop adaptive skills for sensory processing. When there has been a disruption of the auditory, vestibular, proprioceptive, tactile and/or visual system, interventions are required to assist the patient in remaining functional in their environment. The loss of sensory systems often compromises the safety of the patient; therefore, therapy should provide adaptations that allow the patient to interact with their environment to promote well-being.

Self-Care/Home Management Training

The coverage criteria of self-care/home management training is found in the CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations Manual, Chapter 1, Part 3, 170.1.

"Self-care/home management training describes a group of interventions that focuses on ADL skills and compensatory activities needed to achieve independence or adapt to an evolving deterioration in health and function. These include activities such as dressing, bathing, food preparation, and cooking. The patient/client may require adaptive equipment and/or assistive technology in the home environment. This includes training the patient/client and/or caregiver in the use of the equipment."

Community/Work Reintegration Training

Services that are related solely to specific employment opportunities, work skills, or work settings are not reasonable and necessary for the diagnosis and treatment of an illness or injury and are excluded from coverage by 1862(a)(1)(A) of the Social Security Act.

Services that are covered include complex IADLs a person must do to maintain independence in the community. These tasks involve interaction with the physical and social environment. Examples of these activities may include telephone skills, written communication, handling mail, use of money, shopping, emergency procedure use/skills and use of assistive technology device/adaptive equipment. This service is only covered when the skilled intervention of OT is required to achieve established goals.

Work Hardening/Conditioning

"Work hardening and work conditioning are different interventions. Work hardening is an interdisciplinary program that is focused on tasks required for a specific job and uses real or simulated work activities to restore physical, behavioral, and vocational functions. Work hardening addresses productivity, safety, physical tolerances, and worker behavior. In contrast, work conditioning describes a work-related, intensive treatment program designed to restore strength, flexibility, and function so that the patient/client can return to work." These interventions are not covered.

Wheelchair Management Training

Wheelchair management "includes assessing if the patient/client needs a wheelchair, determining what kind of wheelchair is appropriate, including its size and components, measuring the patient/client to ensure proper fit, and fitting the patient/client into the chair once it is received. It also includes time associated with training the patient/client and/or caregiver in transfers in and out of the chair as well as propulsion on all surfaces. It is important for the therapist to provide instructions for safety so as not to risk skin breakdown or a fall."

1. This service trains the patient in functional activities that promote optimal safety, mobility and transfers. Patients who use wheelchairs for mobility may occasionally need skilled input on positioning to avoid pressure points, contractures, and other medical complications.

2. This procedure is reasonable and necessary only when it requires the skills of an OT and is designed to address specific needs of the patient and must be part of an active written plan of treatment directed at a specific goal.

3. The patient and/or caregiver must have the capacity to learn from instructions.

4. Typically, 3 to 4 sessions should be sufficient to teach the patient and/or caregiver these skills.

5. For wheelchair propulsion training, documentation should relate the training to expected functional goals that are attainable by the patient.

Wound Care Selective Debridement

a) Debridement

Debridement is indicated whenever necrotic tissue is present on a documented open wound. Debridement may also be indicated in cases of abnormal wound repair. Debridement techniques usually progress from non-selective to selective but can be combined. Debridement will not be considered a reasonable and necessary procedure for a wound that is clean and free of necrotic tissue.

b) Conservative Sharp Debridement

Conservative sharp debridement is a minor procedure that requires no anesthesia and is performed on an outpatient basis. Scalpel, scissors, forceps and high-pressure waterjet may be used and only clearly identified devitalized tissue is removed. Generally, there is no bleeding associated with this procedure.

Wound(s) Care Non-Selective Debridement and Negative Pressure Wound Therapy

a) Enzymatic Debridement

Debridement with topical enzymes is used when necrotic substances to be removed from a wound are protein, fibrin and collagen. The manufacturer's product insert contains indications, contraindications, precautions, dosage, and administration. It would be the clinician's responsibility to comply with the product insert/guidelines.

b) Autolytic Debridement

This type of debridement is indicated where manageable amounts of necrotic tissue are present, and there is no infection. Autolytic debridement occurs when the enzymes that are naturally found in wound fluids are sequestered under synthetic dressings. Autolytic debridement is contraindicated for wounds that contain infection.

c) Mechanical Debridement

Wet-to-moist dressings may be used with wounds that have a high percentage of necrotic tissue. Wet-to-moist dressings should be used cautiously as maceration of surrounding tissue may hinder healing.

Hydrotherapy and wound irrigation are also forms of mechanical debridement used to remove necrotic tissue. They also should be used cautiously, as maceration of surrounding tissue may hinder healing.

d) Negative Pressure Wound Therapy

Negative Pressure Wound Therapy is a non-invasive treatment, by which controlled localized negative pressure is delivered to a wide variety of acute, sub-acute, and chronic wounds. Negative Pressure Wound Therapy should be used cautiously as maceration of surrounding tissue may hinder healing.

Physical Performance Test or Measurement

This testing may be reasonable and necessary for patients with neurological or musculoskeletal conditions, when such tests are needed to formulate or evaluate a specific written plan of treatment, or to determine a patient's functional capacity.

Assistive Technology Assessment

This assessment requires professional skill to gather data by observation and patient inquiry and may include limited objective testing and measurement to make clinical judgments regarding the patient's condition(s). Assessment determines, e.g., changes in the patient's status since the last visit and whether the planned procedure or service should be modified. Based on these assessment data, the professional may make judgment about progress toward goals and/or determine that a more complete evaluation or re-evaluation is indicated.

Specifies the protection scope (aka realm name) which is to be reported tothe client for the authentication scheme. It is commonly part of the textthe user will see when prompted for their username and password. e24fc04721