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Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
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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