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Let the Patient Tell Their Story
Often when a patient presents with an injury, they want to tell their story. People by nature like to talk about themselves, particularly when they're worried about their health.
The Problem With Prolonged Sitting
We need to constantly talk to our patients about spending less time sitting and about what can go wrong with poor sitting postures. The fact is we sit too long in repetitive malpositions.
News in Brief
NBCE Launches Computer-Based Testing Era; California Chiropractors Get Expanded DOT Exam Privileges; New Jeff Hays Documentary.
Thoughts to Live By
When speaking to your patients about their health make sure to ponder the following points and have them assess if they are making themselves even more sick by the thoughts they have about life. Are these some of the traits and thoughts that your patients might have?
MPA Media Wins Seven Publishing Awards
MPA Media, publisher of Acupuncture Today, among other titles, has been recognized for editorial and design excellence with an unprecendented seven publishing awards by the ASBPE, the nation's largest organization for business-to-business publications.
If You Get a Request for Records, Respond!
In our previous two articles, we discussed two of the main reasons for denial when chiropractic records are reviewed by Medicare contractors.
Thoracolumbar Syndrome: The Great Mimic
The thoracolumbar junction is a common area of joint dysfunction. The most obvious cause is dysfunctional breathing or lack of diaphragmatic breathing. Treating this breathing problem will ultimately be the long-term cure for the syndrome.
Help Secure Our Future by Sharing It
The National Board of Chiropractic Examiners (NBCE) conducts one of the most comprehensive surveys of the U.S. chiropractic profession every 4-5 years.
Improving Our Political Effectiveness
The November 2014 elections are right around the corner; members of Congress, governors and state legislators are all running. Now is a good time to talk frankly about our overall political involvement.
A Glimpse Into China's Top Brain Hospital
The sounds of the city pass through the open window are overwhelming the microphone - car horns, construction machinery - and then there's the family at the adjacent bed talking loudly on cell phones, yet you can still hear the faint beep of our patients monitoring equipment.
Uncle Sam Needs You
Scrutiny into the Department of Veterans Affairs (DVA) continues to grow after efforts to reform the DVA by the former Secretary of Veterans Affairs, Eric Shinseki, were deemed "a stunning period of dysfunction" by Senate Minority Leader Mitch McConnell (R-Ky.).
The Science Behind Happiness
Are you happy right now? Whether yes or no, there are a myriad of reasons why you feel that way. A whole academic discipline has developed to find out what causes or obstructs happiness, and how to amplify it.
Medicalization and Mindfulness
The past several years have seen a veritable explosion of research on mindfulness. Research abstracts we've published in each issue of Health Insights Today under the heading "Mind-Body News" have increasingly reported on studies about mindfulness interventions.
When Big Pharma Meets Chinese Medicine
Earlier this year, Bayer made a media splash with their decision to buy the Dihon Pharmaceutical Group Co., a Chinese TCM manufacturer.
Rethinking GMO: Less Panic, More Context
Some of you may have noticed that after writing parts 1 and 2 of “Genetic Modification of Organisms for Human Consumption” a while back [Nov. 15, 2013 and Jan. 1, 2014 issues], part 3 never appeared.
The Spirit of the Point
After receiving a large amount of positive feedback on my San Zhen Protocols series, I have decided to focus this article on some relevant clinical aspects of acupuncture therapy prior to moving on to San Zhen Protocols III.
Healing Community Trauma in Israel and Palestine
It's the beginning of August and Israel and Hamas have just agreed to a 72-hour ceasefire after a month of brutal fighting. In the last four weeks, 1,830 Palestinians and 67 Israelis have been killed.
Get Ready For AOM Day
This year, AOM Day 2014 falls on Friday, (October 24th). This is a great opportunity to make your AOM Day celebration or event even bigger by extending it throughout the weekend!
A Healthy Dose of Failure is Vital to Your Success
As an acupuncturist I tend to see people after they have already suffered for years and "tried everything." They are so desperate for some relief that they want to know everything about how to get better, right now.
History of Animal Acupuncture: Part II
In Part I of this article, I had gone back to 1969 and tried to describe the atmosphere and events of that year that engulfed many of the younger generation, some who were all the core members of the National Acupuncture Association.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 1)
When we think of lower back pain, we tend to think in terms of the lower lumbar spine and the SI joint. These joints and their discs are obviously important. However, we tend to miss fixations that occur just above – in the upper lumbar spine. Three questions come to mind: 1) Why is the upper lumbar spine so important? 2) Why do we miss the fixations here? 3) How can we adjust them?
September, 2002, Vol. 02, Issue 09
CPT Code 99201 and All 99 Codes
By Ed Denning, MEd, LMT
Some massage therapists are being encouraged to use 99201 and other codes that begin with 99 to report office or other outpatient visits for the evaluation and management of new patient.I strongly recommend not using any codes beginning with 99 by any massage therapist who is also not a physician. These are physician codes only.
Going beyond opinion, I cite the following information:
1. Page 9 of the 2002 CPT Manual* lists and defines code 99201 in this manner: Office or other outpatient management of a new patient, which requires these three key components:
2. Page 6 of the manual defines medical decision-making in this manner:
Medical decision-making refers to the complexity of establishing a diagnosis and/or selecting a management option as measured by:
Pay special attention to how the three qualities of medical decision-making noted above tie together. They are listed with semi-colons and the word "and," meaning that medical decision-making must include all three qualities. There is no selectivity in the statements. All three must be present present for proper use of the code.
Straightforward medical decision-making has a component that requires the clinician to make decisions regarding "the risk of significant complications, morbidity and/or mortality ..." Massage therapists are not qualified to make decisions regarding complications, morbidity or mortality.
Additionally there is a table on page 7 of the manual that I believe clearly ties straightforward decision-making with decisions regarding complications and/or morbidity or mortality.
For the reasons listed above, I urge all massage therapists who do billing to stop using 99 codes. Even if the use of such codes is accepted by an insurance company, it carries with it a risk that a change of policy, applied retroactively, could result in significant problems for the therapist. It is your responsibility to use the correct code. If an insurance company tells you to use a 99 code, get the company's recommendation in writing.
For those who want to use CPT codes that apply to office visits, at this time my only recommendation is that you appeal to your associations to pursue the creation of CPT codes designed specifically for massage therapy. Only associations would be able to get new CPT codes approved by the American Medical Association (AMA).
It is not difficult or dangerous to use CPT codes, but like anything else, it takes time and patience. I recommend that massage therapists use only those codes for which there is documentation. Using a code that has not been established through documentation is to assume (perhaps naively) that you have been taught correctly.
*American Medical Association, Current Procedural Terminology, CPT 2002 Standard Edition; Chicago, Illinois 60612.
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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