resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
Fibromyalgia: Put the Pain in Its Place
While some fibromyalgia patients respond favorably to regular chiropractic care, others experience minimal relief. Unfortunately, many of these patients must rely on pharmacological management to relieve their constant pain.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
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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