Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
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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