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The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
April, 2002, Vol. 02, Issue 04
Medical Codes for 2002
By Ed Denning, MEd, LMT
When I attended massage therapy school, I was provided limited information regarding medical codes, and part of what I did receive was incorrect. That background is what got me interested in reading and writing about medical codes.
If you used medical codes (CPT & ICD) in 2001, then you will use the same codes in 2002.There have been no changes.
Listed below are some of the codes most frequently utilized by massage therapists. The first list comprises codes that are useable by massage therapists; the second list consists of codes that are not recommended, and explains why they are not recommended.
97010 Hot and cold packs 15 minutes Self-explanatory
97124 Massage 15 minutes Lists specific strokes
97039* Unlisted modality 15 minutes Use of tools
* I include this code only because I know in some states, massage therapists may use devices that mimic massage techniques, or perform allowable therapeutic procedures. This requires constant attendance, and may require a written report and statement of justification.
97139 Unlisted Procedure 15 minutes Therapeutic procedures not covered by 97124 or 97140.
As with 97039, this code may require a written report and a statement of justification.
97140 Manual therapy 15 minutes Therapy not covered by 97124
97001 & 97002 For physical therapy only
97112 Not the code for neuromuscular therapy
97530 An occupational therapy code
99201 For physicians only (has a diagnostic component)
All of the abovementioned codes are derived from two manuals: The International Classification of Disease 9th Edition, Clinical Modification Manual (ICD 9 CM) and The Current Procedural Terminology Manual (CPT).
ICD 9 CM
The ICD 9 CM Manual classifies disease around the world. It is used by health care providers in any country involved in recordkeeping of diseases within the country. These classification codes have a history dating back to the early 1700s, when a French physician wanted to see if he could predict the mortality rate in newborn to five-year-old children. He was quite successful.
The manual is in its 9th edition. It has been highly successful at making statistical comparisons and recordkeeping between countries unified under a single system. It is because of the ICD Manual that we know that the particular diet prevalent one country suppresses the development of cancer, and in another country reduces heart conditions, and so on.
The ICD 9 CM Manual is produced by the World Health Organization (WHO). The WHO has been working on an ICD 10 CM version, which the U.S. will eventually adopt. Versions of the ICD 10 are already in use in Canada and Australia. When it will be adopted in the U.S. is unknown at this time by this author.
Massage therapists are not qualified to select ICD codes. We are allowed to cite them if we have a qualified source. That's why massage therapists need to have a physician's script before they start therapeutic work. Massage therapists who wish to submit billing for insurance need only call the physician of record and ask for the ICD code used. Since the physician's office has a serious vested interest in correct coding, they will be happy to provide you with the correct code.
The Current Procedural Terminology Manual (CPT) is a manual of procedure codes. It was first released for publication in the mid 1960s. Its goal is to describe every medical "procedure" of any kind using a specific number. The CPT codes are now firmly entrenched in the insurance and medical communities. These industries communicate using the CPT and ICD codes. All serious medical practitioners know the codes for their modality of work.
Massage therapists may select from the CPT Manual any code that describes a "procedure" they utilized. You are responsible for the code you choose (or use). Because of the nature of "procedures," many of the codes are highly specific and can only be used by those with training in narrow specialties. The codes tend to be training-dependent. This isn't explained to novices trying to read the manual.
An example is the meaning of the word "physician." In a general dictionary, the word is defined as "a healer." In the CPT Manual, a medical definition is used: "a graduate of a licensed medical school." This is just one of many ways in which an interpreter of CPT codes can get into trouble. Unless you have experience or training that assists you in identifying the vocabulary with specific medical meaning, what appears to be a common word can have an uncommon meaning.
All of the codes that might be used by a massage therapist are in a three-page section of the CPT Manual entitled " Physical Medicine and Rehabilitation." These codes all begin with the digits 97. Any code that does not begin with 97 requires licensure beyond the training level of a massage therapist. Use of a code not appropriate to the licensure of the therapist is considered to be misrepresentation of licensure. Typically such use is referred to as fraud.
Those who do not want us to do coding like to use the "fraud" word prominently. Do you know of anyone personally who has been accused of fraud? Probably not. Nor is it likely that you could be accused of such behavior. To be fraudulent, one must knowingly misrepresent him/herself. If you make an error, that's not fraud.
Did you know that nearly (if not all) auto insurance companies cover massage therapy? Educate your clients! Learn about codes before you need them. Did you know that codes can change from year to year? New codes are added and old codes are dropped. It is the therapist's responsibility to know about such changes. We all need a reliable coding source to save us the frustration of rejected insurance forms due to a coding change.
Have you heard of the Health Insurance Portability and Accountability Act (HIPAA)? The result of federal legislation, HIPAA places a mandate on insurance companies to simplify and expedite insurance submissions. Although no one knows at this time what the repercussions of HIPAA will be for the average billing massage therapist, the law goes into effect by this time next year.
Joining one of the major professional massage organizations means that you are supporting the organizations that protect our future. They represent us in meetings with groups, organizations and at political events. They provide for our safety and protect us from inappropriate legal action. They research and provide services on a national scale. They are a valuable resource for the entire massage community. I encourage you to join at least one.
Ed Denning is a licensed massage therapist in Ohio. He is coordinator of the massage therapy program at Stark State College of Technology, and also serves on the Massage Therapy Advisory Committee of the Ohio State Medical Board.
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