resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
May, 2011, Vol. 11, Issue 05
CPT Codes Revealed
By Vivian Madison-Mahoney, LMT
I have received many, many questions (via email and phone) regarding CPT (Current Procedural Terminology) Codes and massage therapists. This article is intended to help answer some of those common questions.In particular, I've been asked numerous times about a massage therapist's ability to use CPT Code 97140 (Manual Therapy Techniques) versus a physical therapist's ability to use it.
97140 Vs. 97124
The CPT Code Book definition of 97140 is: "Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes."
You may also document myofascial release using this code. Most of us perform more than just basic Swedish massage when providing treatment to medically prescribed cases with a written prescription from the treating physician indicating diagnoses, duration and frequency. However, if what you perform is basic Swedish massage, then use CPT Code 97124.
CPT Code 97124: "Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)."
Often insurance companies will deny the massage practitioner the use of 97140, stating that it is a "PT Code" (i.e. physical therapy) and therefore, not in "your scope of practice". This is not true if you have training in myofascial release, manual therapy, manual lymphatic drainage, manual techniques such as neuromuscular therapy, structural alignment or other deeper tissue techniques, and if your training is sufficient to benefit the patient's medical condition. If you can stand up in a court of law and explain what you do, how you do it, why you do it and how it benefited the patient, then feel free to use 97140. If not, be safe and stick with basic Swedish massage, CPT 97124. These are the determining factors, and should never be whether or not it might pay more.
Documentation is the key. With 97140, one must document the region (in conjunction with the prescribed diagnosis), exactly what was performed, and the time spent on each body area (e.g., 15 minutes). Remember when we are billing insurance, we follow the CPT, ICD-9 and other insurance-related rules and regulations. Fifteen minutes is 15 minutes, not 8 minutes or other Medicare rules. This is the same information I provide to fraud investigators and insurance adjusters when they have invited me to do presentations for them.
Please note the following statement is taken straight from the AMA CPT Coding Manual (2011 ed., located in the introductory pages). This is the same information that I use to help many massage therapists across the country to be paid on denied claims for using CPT Code 97140.
Current Procedural Terminology
About 97001: Initial Evaluation and 97002: Re-Evaluation.
It is suggested these codes be used by PTs even though the CPT Code Book states no codes are for any specific provider group and even though massage therapists across the nation are using this code, I highly suggest (based on information received from the insurance industry) that for now we not use these codes.
The reason we suggest not using 97001 and 97002 is because in the CPT Code Book it is followed by codes specifically for Occupational Therapy (97003-97004) and then for Athletic Training (97005-97006), thus indicating the codes are specific to those licensed in those professions. Had there been only the 97001-97002 codes, it might be different.
About 97799: Unlisted Physical Medicine Procedures and/or Rehabilitation.
This code is required to be submitted BR "by report". Massage therapists providing an initial evaluation/assessment should have a sufficient report in the first place. There is also not a fee schedule for this code so ask an insurance adjuster in advance.
I hope all of this information helps you to better understand these codes. Just know that insurance adjusters are not trained in our type of work therefore are looking for (and have the right to ask for) additional information prior to reimbursement of claims. This is for the protection of policyholders as well.
Get Proper Training
One more note on insurance reimbursement. Billing insurance for reimbursement is much more than knowing a code and having a specific form; it is about knowing the guidelines inside-out and upside-down. Get proper training just as you did in order to provide hands-on services. Training and licensing is to "protect the public". Since we are treating ill or injured people and billing for payment from their insurance monies, consider knowing insurance billing for the same purpose: to protect the public as well as yourself.
Click here for more information about Vivian Madison-Mahoney, LMT.
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