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F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
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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