resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
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.
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