resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
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.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
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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