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Chiropractic Research in Review
Occupational LBP in Primary- and High-School Teachers; Treating MVA Complications With Chiropractic Care; Neck Pain: Immediate Effects of Active Scapular Correction; Taping Benefits Stride, Step Length in Fatigued Runners.
Environmental Toxins: Cause of Modern Illness, Part 2
In Part I of this article, we detailed the variety of environmental toxins assaulting our bodies. These include pesticides and herbicides; plastics; preservatives; cosmetics; gasoline additives, solvents and glues; and heavy metals.
Age and Fertility: Why We Should Worry Less About Age and More About Overall Health
Recently, on one of the acupuncture alumni forums, the topic of age and fertility came up when a practitioner posted a question regarding a patient that was about to turn 40-years-old.
AWB Makes a Difference in the Yucatan
We are in the sleepy town of Izamal, located about an hour from the Merida airport where our group arrived last night. Later that morning, on a bus winding through the dusty roads of the Yucatan, fourteen acupuncturists, two facilitators from AWB and two tour guides make their way to the small rustic town of Popola.
Taking the Freeze Out of Adhesive Capsulitis
Adhesive capsulitis or "frozen shoulder" is a relatively common condition resulting in severe shoulder pain and global loss of glenohumeral joint range of motion. Incidence of the condition is approximately 3 percent in the general population.
We Get Letters & Email
Rethinking Our Approach to Immunization; Coming Together for the Good of Our Patients.
The Way of Zen Performance Enhancement
Working with elite athletes and implementing various techniques to keep athletes focused and at their optimal performance for a sustained period of time includes incorporating various meditation techniques that counterbalance their sport-specific physical and mental demands, which is an important element of success throughout the years.
Animal Acupuncture Gaining in Popularity
We have just finished the year of the fire hoarse and now it is time to spend some time alone, daydreaming and thinking outside the box in terms of where our profession is headed. The sheep person is well organized and creative so this should not be difficult to do.
Movement Assessments: The DC's Sphygmomanometer
I think back to when I was going through chiropractic school outpatient clinic. I was embarrassed to have my family and friends come in for treatment because initial evaluations took three hours to complete.
News in Brief
While indignation may be your immediate reaction to H.R. 5780, the Protecting the Integrity of Medicare Act of 2014, the American Chiropractic Association suggests the legislation is just what the chiropractic profession needs.
How to Use Online Video as a Tool to Market Your Practice
Health care practitioners, including chiropractors, should consider online videos as a key element of their Internet marketing strategy. In the next three years, videos are expected to account for nearly 70 percent of all consumer online traffic, according to Cisco.
Acupuncture and its Place in the Integrative Healthcare Practice: The Need to Move from Modality to Profession
Acupuncture and oriental medicine (AOM) has grown and flourished from its inception thousands of years ago in China. In surrounding regions of Asia, AOM developed as a response to differing cultural, pathological, health and wellness care needs.
Right Back Where We Started?
More than 25 years after Judge Susan Getzendanner issued her historic opinion in the Wilk v AMA anti-trust case, evidence suggests that despite increasing collaboration between doctors of chiropractic and their allopathic medical counterparts, when it comes to organized medicine, we may be right back where we started.
Ringing in the Billing New Year
What are the new modifiers that replace modifier 59? Will they allow doctors of chiropractic to be paid for 97140, manual therapy, when done with chiropractic manipulation?
Helping to Create the Healthiest Generation
The imperative to create the "Healthiest Generation by 2030," envisioned by the American Public Health Association (APHA), was in full force at the APHA's 142nd Annual Meeting held in New Orleans from November 15-19, 2014.
Show Up and Show Respect
I was recently asked about my chiropractic philosophy. My answer surprised my questioner.
Professionalism and Evidence-Based Health Care
Today's chiropractors are facing a conundrum with the Affordable Care Act and its health care reform requirements, including evidence-based practice and health technology assessment.
The Conscious Evolution of Healing: Importance of Opening the Sensory Portals in Classical Chinese Medicine
The Chinese medical classics are not just clinical guides. They give advice; ways we can awaken more fully into conscious awareness.
Two for One: The Cervical Distraction Test
In today's healthcare system, diagnoses and treatment plans follow a western medical model - especially if you work with attorneys or insurance companies.
Happy New Year 2015 Gong Hoy Fat Choi
Welcome to the year of the sheep! We begin a new year guided by the sign of a quietly and creatively organized animal.
I Felt it in My Fingers First
I'm not afraid to say it. Massage therapists make better acupuncturists. I'll tell you how I know, but first I have a question: What do a microcurrent device, a laser and a hippie massage therapist have in common?
The Static Postural Pelvic Exam
I include a static postural analysis in my evaluation routine whether you are a patient in pain or an elite-sport athlete in training. In my day-to-day practice, I require patients to stand still while I "just look" at them.
Three for One: The Cervical Distraction Test
Taking the time to do an exam is important, but it is time spent. The exam serves as a way to physically validate your clinical impression following a history and clinical consultation.
The App Advantage: Get More for Less
You may have noticed the list of "app-exclusive" articles in the directory on the front page of the print issue and in the Table of Contents on page 4. You can't find these articles in print or even in our online archives.
Fight Colorectal Cancer With Folic Acid
CRC is the second most common cause of cancer mortality in the U.S. and Canada. Although genetic susceptibility plays a role in the etiology of CRC, dietary factors, including certain vitamins, have also been shown to influence the development of the disease in various studies.
Trouble Down Under: San Zhen Therapy for Lower Jiao Issues
In the last several columns, I have discussed many clinical options for utilizing San Zhen or Three Needle Therapy. In this installment, I will continue this trend and discuss several foundational patterns which can be found in several very common clinical presentations.
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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