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How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
November, 2012, Vol. 12, Issue 11
Practice Building with Self-Care Tips
By David Kent, LMT, NCTMB
Our patient's lives are affected, on many levels, by their pain. They spend a lot of time and money receiving treatment and are looking for the best return on their investment. Building a successful practice that stands out from your competition includes providing self-care tips.Patients need to know how to care for themselves between treatments. They appreciate, respect and recommend your practice when you deliver useful information that is easy to understand and implement into their daily lives. Here are some suggestions for delivering self-care tips. I have also included links to video clips that discuss these concepts in more detail.
After a cleaning procedure at a dental clinic, the hygienist provides a new toothbrush with samples of toothpaste and floss with patient self-care tips. They explain and demonstrate proper techniques for brushing and flossing (See image 1). The hygienist also stresses that implementing these simple recommendations will prevent costly oral disease, pain and medical procedures. They finish by giving you the samples, collecting payment and scheduling the next appointment. This is a time proven practice-building model in the healthcare profession. (Read "Practice Building: Getting Inside Your Patient's Head," MT, January 2011).
Patients often ask their massage therapist for advice or guidance pertaining to self-care. Just like a dentist or other healthcare provider, you can easily provide cost effective self-care tips. However, you can only make recommendations within your legal scope of practice, so stay current with the laws.
Treatment can be more specific when patients are assessed and educated about their postural patterns, restricted joint range of motion, myofascial trigger points and how they cause pain (see image 2.) Poor posture and improper biomechanics while walking, running or performing any repetitive movement can perpetuate or reestablish a patient's pain. These patterns develop over hours, days, and years from holding in positions that caused some myofascial tissues to habitually stay shortened and others lengthened. Other activities that contributes to poor posture in today's modern world include a lack of physical exercise, being overweight, sleeping on one side or supine with a pillow under the head and knees, sitting the majority of the day while eating, driving, at a desk or computer, watching TV, etc.
With the digital camera built into an iPhone, smart phone, tablet or iPad, you can instantly take postural analysis photos and gait videos. No special software is needed, just the camera built into the device. Zoom-in on photos and show patients their forward head and high shoulder posture (see image 3). Play the gait video, assessing the positions and movements of the lower and upper extremities. This level of education leaves a lasting impression of your ability to quickly identify the musculoskeletal cause of a patient's pain while instantly providing visual evidence of your objective findings and how it supports their subjective complaints. A picture is worth a thousand words so show each patient the myofascial causes of their pain, then explain how your treatments and self-care tips can help. (Read "Practice Building with Postural Analysis," MT, January 2012).
Patients are more likely to implement self-care tips that are simple and easy to make a part of their daily lives at home, work or when traveling. Every patient has unique challenges and they must individualize their own self-care routine. Explain what muscles and joints are being stretched, where they are located and why restoring proper movement helps their symptoms improve. To establish and maintain proper posture, gait and other movements the muscles throughout the body must be able to completely contract, relax and lengthen. The cervical, thoracic and lumbar spine must flex, extend and rotate. The ribs should move with breath and each scapula fully retract, protract, elevate, depress and rotate on the rib cage. All of the joints in the body need to properly move as they are designed.
As a visual aid, I use videos, anatomical models and even a slinky, to help patients understand the movements that take place throughout their vertebral column and rib cage. Next, I show them the movements I perform daily to maintain good postural and normal range of motion in the joints throughout my body. I am able to communicate to my patients with first hand knowledge and experience. I show my patients how I stretch, depending on the environment, sitting on a chair or standing holding onto a desk, table or counter top.
I demonstrate how I use an exercise ball throughout the day to stretch and maintain good range of motion (see images 4a and 4b). I also mention how to select the correct size, safety tips and major differences between the various types on the market.
My schedule is busy and changes frequently. I downloaded a yoga application onto my iPhone and now I have a variety of 20-minute routines with me anytime, anyplace, at home, between treatments or when traveling. I integrate yoga into my self-care routine and share how it helps both physically and mentally.
Patients often do not know how or when to use ice. This is a perfect opportunity to provide self-care tips that are simple, cost effective and set your practice apart from the competition. Review the importance of a towel between the ice pack and skin, indications and contraindications. Create a fact sheet about the use of ice to give to your patients.
For patients with acute soft tissue injures, I show them helpful tips for applying ice. I freeze water in 9-ounce cups to create large ice cubes. I keep them handy in the freezer at the clinic or in a cooler when on out calls. This size allows for application on large or multiple areas.
So the patient can conveniently start ice applications, I send them home with a few 9-ounce ice cubes by placing the ice in a freezer strength (Zip Lock) plastic bag.
Ice is extremely beneficial, but not always a practical option. Many people find topical analgesics helpful for providing relief of their symptoms.
Medical doctors give patients samples of drugs. You can provide samples of topical analgesics. One company will supply you, free of charge, patient education brochures with your name and phone number printed on them with a sample packet of the topical analgesic attached. This is a free way to promote your business. Topical analgesics sell for a fifty percent profit and are great way to increase your income. Place a counter top display case of the product in your treatment room and checkout counter. Also take a counter top display when preforming chair massage or at public events like health fairs.
The economy today does not allow people to miss work or lose income. They need treatment that is cost effective and provides long-term solutions. I hope this article showed you how to take the best from the dental model and redesign it for your practice. Give every patient the gift of knowledge and standout from your competition. Teach them how to care and maintain their bodies to avoid pain and unnecessary emergency treatments. Educate them on posture, gait and self-care tips. Give them a gift bag, just like the dentist, with sample packs of the topical analgesic, ice cups, recommendation sheets and your business card with the date and time of their next treatment. Good luck and I wish you success.
Editor's Note: Check out this exclusive practice building video from David Kent: www.youtube.com/playlist?list=PLVpoWkt4aQvK9mUJNL_OMZ9zEIZqutwC9
Click here for more information about David Kent, LMT, NCTMB.
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