resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Case Histories from Bali: Treating Balinese Chidren with TCB and Shonishin
When I moved to the island of Bali in 2005, I offered my services in Bumi Sehat, which means Healthy Mother Earth, a free birthing center for poor and disadvantaged local women located in Ubud.
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
February, 2006, Vol. 06, Issue 02
Coding for Insurance Billing and Medicare Issues
By Vivian Madison-Mahoney, LMT
From the phone calls and e-mails I've received from massage therapists across the country and a recent survey taken by AMTA, it's evident there are a variety of CPT Codes being used by massage therapists for billing insurance.Many of those codes used include deleted codes, codes not in our scope of practice, codes that raise red flags with insurers for a variety of reasons and correct codes used in conjunction with incorrect codes.
Coding and billing requirements and opportunities have changed over the years. When I began billing insurance in late 1984, I billed by 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 my first Blue Cross case.
It was an eye opener when Blue Cross only reimbursed $12 for a full hour session. After continued research and questions, I soon learned about the fifteen minute increment billing requirements by some insurers. In my desire to find ways to get massage therapists in the system so to speak, I began to do more research and began practicing with other codes. It was then I learned that Blue Cross would only reimburse for CPT Code 97124 (massage). Billing the way Blue Cross required I was then reimbursed $48 for the full hour. Getting an increase from $12 to $48 was an exciting time!
Workers' compensation in Florida, at that time (as with many states yet today), was way behind the times when it came to coding, so I had to bill differently with them using codes not used with any other carrier. Over the years, my office expanded the use of codes as we were reimbursed for them. However, as time went on and the reimbursement amounts began to increase, we began to reduce the number of codes we experimented with to simplify things.
Because I am a provider of CEU'S for insurance billing seminars and home study courses, I became a lot more conservative in order to protect you, who now bill insurance companies. It's now to the point where possibly the only available and necessary procedure code(s) are 97124 (massage) for basic Swedish massage, and 97140 (Manual Therapy Techniques), because it encompasses myofascial release, manual traction and manual lymphatic drainage and because reimbursement now is at a fairer rate in most cases.
There are many "techniques" of massage, but there are no codes to represent these "techniques." We must use those procedure codes available to us that are within our scope of practice. Of course, there always are those codes for modalities which might be used if within a therapists scope of practice, such as whirlpool, infrared, contrast baths, electrical stimulation, hydrotherapy, paraffin baths, etc. Be sure you know and stay within the scope of practice for the state you practice in.
Documentation is the key to getting paid for the time spent and the codes used. Following the doctor's prescriptions, billing for the same procedure or modality that is on the prescription and documenting exactly that, are the keys to being better paid without delays, denials or reductions, and only accepting cases that will reimburse a massage therapist. Not all types of cases are reimbursable to a massage therapist.
As time goes on, I am sure coding changes or definitions will work more in our favor but until it does, let's use common sense and don't try to go overboard as it only raises red flags with insurance companies that could set us back many years. Stick to your scope of practice and with what is written on the prescription. Make sure your progress (SOAP) notes reflect what the prescription calls for and that your bills reflect both the prescription orders and your documentation.
There is a company called Alternative Link/ABC Coding working on an entirely different coding system for each alternative provider. These codes ultimately would incorporate each technique used by a massage therapist or other alternative care providers. However, until these codes can be used by all therapists and accepted by all insurers, I will be keeping in close contact with them. I will inform you of any changes or abilities to use this coding system when it becomes available. For more information on this coding system please contact Connie Koshewa at: .
The Medicare Issue
For more information on the coalition to Preserve Patient Access to Physical Medicine and Rehabilitation, please contact me if you did not receive this information on my recent "Massage Insurance Updates" e-mail. If you are not on that list but want to be, please e-mail your request to me at .
Click here for more information about Vivian Madison-Mahoney, LMT.
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