resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
April, 2003, Vol. 03, Issue 04
CPT Codes: To Use, or Not to Use?
By Ed Denning, MEd, LMT
CPT Codes 97001 and 97002
97001: Physical therapy evaluation
97002: Physical therapy re-evaluation
I wrote to the American Medical Association (AMA) Information Services Committee in 1998 regarding the use of 97001 and 97002 by massage therapists.The committee's first response left room for wide interpretation. In April 2002, I wrote a follow-up letter that resulted in the following response:
This response states clearly that only physical therapists are qualified to use these two codes. Massage therapists should not use these codes unless they are physical therapists by licensure; even then, such use would be under the restrictions of the physical therapy licensure of the state in which they practice.
The AMA writes and produces the only CPT manual used in the U.S., and are the final arbiters of a given code's meaning. In this case, its initial explanation was later corrected/modified, resulting in a recommendation against use by massage therapists. This is why your coding information needs to be updated annually. Codes can and do change in meaning and interpretation; new codes are added, and old codes are deleted.
CPT Code 97112
Therapeutic procedure, one or more areas, each 15 minutes; neuromuscular re-education of movement; balance; coordination; kinesthetic sense; posture; and proprioception.
In March 2001, I wrote another letter to the AMA Information Services Committee regarding CPT code 97112, requesting the following information:
The AMA response included the following:
Massage therapists certified in PNF stretching can use this code to report that service; certified Hellerwork practitioners also can use this code to report their work. Massage therapists might interpret their ability to desensitize as fulfilling another aspect of this code. Such an interpretation may or may not result in payment and would be stretching the intention of the code. This code is definitely not referring to neuromuscular therapy in any way. The majority of massage therapists should not use this code.
CPT Codes 97124 and 97140
97124: Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion).
97140: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.
In March 2002, I wrote a letter to the AMA Information Services Committee seeking the following information:
The AMA response follows:
My Interpretation of Codes 97124 and 97140
97124 is for increasing circulation and to promote tissue relaxation to the muscles. The specific techniques involved would be effleurage, petrissage and/or tapotement. This code is reported in units of 15 minutes. If your treatment is based on or consists of a basic relaxation massage (Swedish massage), this is the code to use.
97140 is used to describe therapy which increases active pain-free range of motion, increased extensibility of myofascial tissue and facilitates return to functional activities. This code is reported in units of 15 minutes. This code would be used for the techniques stated. It would include neuromuscular therapy, positional release, stretching and nearly any therapeutic technique performed manually for the purposes mentioned in the first sentence.
Caution: There are coding strategies going around which have the apparent purpose of billing for higher amounts of money by using multiple codes to describe the therapy session. Such coding decisions are not that difficult to make. What did you actually do in the session? How many units of time did you spend doing 97124? How many units of time did you actually spend doing 97140? Could a client tell when you had transitioned from one treatment code to another?
Do your clinical notes reflect the techniques for which you are coding? Can you justify your billing by clear delineations within your clinical notes? What was actually performed within the session determines the billing that takes place.
I believe that the vast majority of massage therapists cannot justify the use of 97124 and 97140 within a single treatment session, based on their clinical notes. If you choose to bill using multiple codes, you will need to spend a considerable amount of time writing clinical notes to support your billing practices.
CPT Code 97530
Therapeutic Activities, direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes. I wrote yet another letter to the AMA requesting the following information:
The AMA response included the following paragraph:
This code is not recommended for use by massage therapists. Dynamic activities to improve functional performance refers to a series of movements to perform specific functions. The series of movements is therapeutic in nature; it is planned and specific.
An example would be a series of movements designed to gradually increase flexibility, strength and coordination through the use of graduated weights. The action is designed to simulate related activities such as picking up a plate and lifting it up into a cupboard, picking up a hammer and placing it in another location, etc.
97530 is a code used to report a series of movements involving flexibility, strength and coordination specifically designed for recovery of everyday functionality. This code is intended for use by occupational therapists who receive the specific training needed to design therapeutic activities. If you have not received that specific training, you should not use this code. (A weekend seminar is insufficient.)
Editor's note: Mr. Denning notes in his article that billing codes are subject to annual change, and as Massage Today reported recently, new codes specific to alternative therapies are in the works. If you are currently or plan on using codes to bill for services, do your homework!
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.