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Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
February, 2009, Vol. 09, Issue 02
By Rita Woods, LMT
I thought that choosing to present information on facial reflexology would be an easy write. I use points on the face in my work and give a lot of credit to the many benefits my clients experience from this work. However, providing you with one workable system would mean ignoring other systems that provide equal or greater benefits so I decided to do what I teach my students - don't worry about naming the points or memorizing what they do; just cover the whole face and you'll get great results! Our focus here is not to treat a specific ailment but to provide whole body relaxation and balance during a massage session.
Most therapists are familiar with acupressure points and understand they are points along a meridian. Acupressure points and acupuncture points sort of go hand-in-hand in our business. There are systems of facial reflexology that use the acupressure points to bring about healing and balance elsewhere in the body. The points used might be Stomach 7 (St 7),which lies about an inch in front of the ear, or Large Intestine 20 (LI 20), which is beside the nostril. There is a system of Chinese facial rejuvenation using such acupressure points; in our facelift massage work, we try to focus on the points specific for that.
There are also systems of facial reflexology that mimic foot reflexology by projecting the soles of the feet onto the face. In this instance, each foot is superimposed over the face with the heels at the chin area and toes extending above the eyebrows. Each foot lies to the side of the nose with the big toes touching in the mid-forehead. In this system, the organs that you normally think of on the soles are now on the face.
In a similar projection, the whole body can be superimposed over the face in another system of facial reflexology. In this case, the torso resides over the bridge of the nose with the buttocks at the end of the nose. The head is in the center of the forehead. The arms warp over and around the eyes with the hands at the outside corners of the eyes. The legs surround the mouth with the knees at the corner and the feet coming together at the base of the chin. You know they say there is truth in a lot of clichés and this projection is no exception. Here's how I remember it: The head is the "third eye," "brown-nosing" places the buttocks at the end of the nose (don't laugh, I said it's how I remember it!), arms around the eyes means to "take it all in" and legs around the mouth means to "walk your talk." This system also allows you to visualize and work various body joints on the face.
Dien' Cham' is a Vietnamese system of facial reflexology that incorporates more than 500 points and claims to successfully treat many common ailments. They divide the face into grids to help locate the specific points and use an instrument such as the rounded end of a ball point pen as a tool to massage the points.
The Chinese also have "microsystems" of the face and head. The entire body can be worked just on the nose alone. Every organ and anatomical feature can be found down the bridge and the sides of the nose. Another microsystem incorporates the whole face for placement of the same anatomy. As an example in this system, the back begins just in front of the ear and runs down the jaw line.
There are still more systems and theories that we just don't have time to include but the point is simple - the face is an area that contains many points and reflex zones that when massaged can have benefits throughout the body. In fact, there are few areas on the face that are not involved with one reflexology system or another. Using the last 10 minutes of a massage for facial reflexology will benefit the client greatly. Next let's talk about how to work these points.
As a general rule, working from top to bottom relaxes and working from bottom to top activates. I like to relax first then, if the client is getting up soon, finish with a few bottom to top strokes to energize them. Along this same thought, short massage/activation of a point (4-5 seconds) typically excites the system while longer massage (45 seconds to several minutes) tones or relaxes the system. Although you are working lightly on the face, the client may still experience some discomfort if a point is sensitive. In this case, intermittent pressure can help calm the point. Some suggest a slight circular movement in clockwise direction for points. Some suggest only to lightly massage the point. Treat each point or area with a deliberate stroke but seam them together as a single movement.
Other things to keep in mind - some female clients won't want you to disturb their make up. If possible, ask your client to wash their face before doing any detailed face work. Use a lubricant that will not clog pores - jojoba works well for this as does a high quality skin care moisturizer. Avoid if rash is present or the client has signs of eczema or psoriasis. Especially if you are not accustomed to dealing with skin issues.
The face and scalp are easy targets for us to get to and offer a plethora of benefits to your clients. And let's face it, it makes for easy work on the therapist. Add a new service to your menu and start offering facial reflexology!
Click here for previous articles by Rita Woods, LMT.
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