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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.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
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.
Spotlight on Acupuncture Research at IRCIMH
Acupuncture and Traditional Chinese Medicine were well-represented at the International Research Congress on Integrative Medicine and Health (IRCIMH)- 2014 which took place in Miami from May 13–16.
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."
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.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
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.
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.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
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.
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.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
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.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
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.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
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.
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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