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Treating Acute and Chronic Neck Pain With Ischemic Compression and Exercise
There are many reasons not to manipulate the neck with cavitation: the patient is too old, their neck is too tight, etc. But the most common reason is that plenty of patients are afraid of "the crack," mostly because of the bad publicity about that procedure.
It Pays to be a Foodie
If there is an inner foodie in you, just waiting to burst out—this article is for you! Do you want to know how I know? I'm that girl. My middle name might as well be "Foodie." I love food! And if my patients are any indication, many of them do as well.
Implications of Section 2706: The Non-Discrimination Provision Survey
In late April 2014, NCCAOM diplomates received an email survey with the subject line: "End discrimination against acupuncturists" polling CAM practitioners for a Request for Information from the Department of Health and Human Services, released in mid-March.
Treating Chronic Depression with Acupressure
In Traditional Chinese Medicine there already exists a comprehensive theory linking the body and mind.
Make Low-Level Laser Therapy Part of Your Evidence-Based Practice
Low-level laser therapy (LLLT), also referred to as photobiomodulation, has been increasingly utilized in the clinical setting over the past decade.
Chronic heightened emotional states create a perfect breeding ground for illness. Through my practice I noted the increasingly obvious relationship between one's mental focus on negative thinking, emotions, resistance to experiencing feelings and disease.
Solving the Pain Puzzle
Legendary former New York Yankees baseball player Yogi Berra once said, "You can observe a lot just by watching." He would have been a great chiropractor. We are trained to become experts with our hands: palpation, adjusting, soft-tissue release, etc.
Micro-Needle Dermal Roller Use in the Treatment Room
Recently micro-needle dermal rollers have been getting a lot of media attention. As a practitioner who specializes in acupuncture facial rejuvenation, I know that skin needling with a dermal roller (also known as collagen induction therapy), promotes the natural reproduction of collagen and elastin, making the skin feel smoother and tighter.
Why Drugs and Supplements Can't Cure Disease
Chronic diseases are the outcome of disease-promoting, goal-oriented behaviors. So, the notion that diseases can be cured with drugs or supplements should be abandoned. Hypertension is the best example of this.
News in Brief
Life to Open Branch Campus in Italy; Northwestern Research Arm Benefits From Big Donation.
Foundation for Chiropractic Progress Announces First Group Member
The Michigan Association of Chiropractors has joined the Foundation for Chiropractic Progress as its first group member.
The Acupuncture Now Foundation: What Our Profession Needs
Although acupuncture is growing in popularity it continues to be underutilized due to misunderstandings about its true potential. Only a fraction of those who could be helped by acupuncture know enough to seek it out.
The Death of the Travel Card
As long as I have been in practice, the travel card has stood as the primary style of documentation for chiropractic. It is quick, simple and direct. Unfortunately, the rules have changed.
Peer Points: Promoting TCM Knowledge
When Elaine Wolf Komarow, LAc, received her first acupuncture treatment in 1989, she said it changed her life. "I felt more aware, calmer, and happier. I was so fascinated by the changes that I began to learn everything I could about the underlying philosophy of Chinese medicine," said Komarow.
Chinese Medicine: The Natural Way to Children's Wellness
As a child, I did not like going to the doctor. For the most part, when I had to go I wasn't feeling good to begin with, and I was heading into a sterile environment to be awkwardly probed by a man in a white coat for a very short, impersonal period of time.
Introduce Your Patients to Collagen Induction Therapy
Cutaneous (skin) aging generally occurs from either intrinsic or extrinsic processes. Intrinsic aging results from natural skin tissue damage and degeneration.
DC App – The Next Generation
According to a survey by technology firm CDW, health care professionals gain approximately 1.2 hours per day in productivity simply by using a tablet computer in practice.
Meat in the Middle
Have you ever wondered what's the truth about meat? Is it really as bad as many people think?
Five Element Acupuncture Can Enhance Your Practice
For eight years I have been teaching and supervising TCM students at an acupuncture college in Colorado, in Five Element acupuncture.
Capturing the Essence of Tai Chi
Over the last 12 years, I have been working on one of the few documentaries about Tai Chi. It's called The Professor: Tai Chi's Journey West and it's about Cheng Man-Ching who moved to New York in the 1960s.
Following the Thinking of the Classics
I have heard about the "best time of day" to carry out certain examinations or therapies. For example, I remember making a note years ago that early morning is the best time to take someone's pulses.
Avoiding "Just a Pop Doc" Syndrome
Yes, it's harsh. Patients don't like to admit it. They have an unspoken plan when they first visit you: to come one time, get rid of their pain and then get rid of you. They know it's unrealistic, but they'd like to pay nothing for this service.
Treating Menopausal Women in Your Practice
I love what I do for a living. It's a great way to trade health for bread. And no topic of health, with the right bedside manner, is taboo.
Are You Ready for the 2016 Patient?
In October, Apple released its iOS 8 operating system for the iPhone and iPad. The new system includes Health, a new app that will interface with an ever-growing number of other apps.
We Get Letters & Email
Is It Time for a Popeye Moment? The Flaw in Recommending Chiropractic as a Career.
Inspire Your Patients to Make Healthy Choices
Have you tried to get your patients to change their eating habits or their diet and couldn't get them to succeed? Were they confused and unsure of what the right thing was to eat? You are not alone!
Acupuncture Detox as Part of Drug Rehabilitation
In the U.S., more than 2,000 alcohol and drug rehabilitation programs have added ear acupuncture to their practice. The development of the protocol was determined by Lincoln Hospital as it delivered 100 acupuncture treatments daily.
The Power of Mu Xiang to Treat Irritable Bowel Disease
Bloating and gas pain is something that everyone has had to deal with at one point or another; however, that's usually reserved for holiday dinners and other large gatherings.
Step by Step: Long-Term Treatment of Soft-Tissue Injuries Combines Skill and Care
Treating soft-tissue injuries with long-lasting results starts the moment an individual enters the office. When it comes to pain, the only thing that matters to the patient is relief.
Are You Ignoring the 10,000-Hour Rule?
Having trained interns and mentored new practitioners, it has been my observation that their No. 1 clinical concern is adjusting skills. Their second clinical concern is their ability to read X-rays. Physical diagnostic skills are a distant third.
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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