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Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
October, 2004, Vol. 04, Issue 10
About Coding for Insurance Billing
By Vivian Madison-Mahoney, LMT
According to the number of phone calls and e-mails I have received from massage professionals across the nation, as well as a recent survey by the American Massage Therapy Association (AMTA), there are a variety of current procedural terminology (CPT) codes used by massage therapists for billing insurance.Many of those codes used are deleted codes, codes not in our scope of practice, codes that raise red flags with insurers, and codes used in conjunction with correct codes.
When I began billing insurance in 1984-85, I billed using code 97139 (an unspecified procedure code). I used the term "soft tissue manipulation," eliminating the words "massage or massage therapy." This worked fine for several years, until Blue Cross came upon the scene and only reimbursed $12 for an hour-long session.
As always, I tried to find ways to get into the system. I searched for ways to increase income from those whose reimbursement was extremely low and find exposure for massage therapists in general. I began to practice with other codes. Workers' compensation in Florida -- as with most states -- was way behind the times when it came to coding, so I had to bill differently with them. Over the years, we expanded the codes we used and were reimbursed for.
I had always thought that we massage therapists would be content if we were allowed to use just a few codes and were decently paid. As time went on and reimbursement began to increase, we began to reduce the number of codes we experimented with to simplify things. Because I am a CEU provider for insurance billing seminars and home-study courses, I became a lot more conservative in order to protect you, who now bill insurance companies.
Now it is to the point where the procedure codes 97124 (massage) and 97140 (manual therapy techniques) are the only ones necessary for basic Swedish massage, myofascial release and manual traction. Because reimbursement is now at a fair rate, many "techniques" are aspects of massage or myofascial release. Of course, there are always those codes for other modalities, which may be used if within a therapist's scope of practice, such as whirlpool, infrared, contrast baths, electrical stimulation, hydrotherapy, paraffin baths, etc. Be sure you know the scope of practice for the state you live in.
Insurers often want to only reimburse for a 15-minute segment of time, even though American Medical Association CPT coding descriptions indicate the codes are for each 15 minutes. Usually, four 15-minute segments of time are the maximum allowed for hands-on procedures. Documentation is the key to getting paid for time and codes used, along with following the prescriptions written by treating or authorized physicians.
As time goes on, I am sure coding changes or definitions will work more in our favor, but until then, let's use common sense. Do not go overboard; it only raises red flags with insurance companies, and can set us back many years. Stay strictly within your scope of practice and to what the physician writes on the prescription. Make sure your notes reflect what the prescription calls for and that your bills reflect both the prescription orders and your documentation.
Click here for more information about Vivian Madison-Mahoney, LMT.
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