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The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
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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