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Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
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Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
How Much Do You Know About the Benefits of Birds Nest?
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The Tide is Rising in the Acupuncture Profession
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5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
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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