This document provides guidance on physical therapy coding practices. It discusses standardizing coding to ensure consistent practices throughout the Military Health System. Several physical therapy coding issues are covered, including activities of daily living training, gait training, osteopathic manipulative treatment, incident-to services, and billing for evaluations and re-evaluations. Documentation requirements and rules for coding timed procedure codes are also addressed. The presentation aims to clarify physical therapy coding practices and answer coding questions.
Endodontic surgery is a surgical procedure to treat endodontic problems. There are several types of endodontic surgery procedures described in the document, including incision and drainage to drain pus from infected areas, periapical surgery such as apicoectomy to remove the infected root tip, and retrograde filling to seal the root canal. Postoperative evaluation methods like reimplantation of extracted teeth and use of endodontic implants are also discussed. Contraindications, surgical techniques, and prognosis factors are provided. The document provides an overview of different endodontic surgical procedures and their indications.
The document discusses clinical decision support systems (CDSS), which are software designed to aid clinical decision making by matching patient characteristics to a computerized knowledge base. It describes several types of CDSS including knowledge-based systems, alerts and reminders, diagnostic assistance, therapy critiquing and prescribing decision support. It also discusses different knowledge representations, functionally classified systems, benefits and limitations of CDSS, and their future directions.
This document describes the mini-open transforaminal lumbar interbody fusion (TLIF) technique. Key points include:
1. Mini-open TLIF provides the benefits of TLIF with less soft tissue disruption through a smaller incision and muscle splitting approach.
2. The technique involves facetectomy, bilateral decompression if needed, interbody cage insertion, and percutaneous pedicle screw fixation through tubular retractors.
3. Advantages over open TLIF include less blood loss, reduced postoperative pain, and shorter hospital stay. However, it requires microsurgical skills and has a steep learning curve.
Data Management - a top Priority for Healthcare PracticesData Dynamics Inc
The healthcare industry has become increasingly data-driven and poised to take a leap into the future, thanks to an increasingly tech-savvy and demanding patient-consumer base. While the Healthcare Data Ecosystem is presently fragmented and often, insufficient, pioneering firms see vast opportunities to be a part of the Healthcare revolution through proper management of their massive amount of Data.
Healthcare has unique data management challenges that other industries do not face, so the solutions that worked in those fields cannot simply be replicated. Challenges in healthcare data management include -
1. Data environment consolidation in acquisitions and mergers
2. Managing the rapid growth of unstructured healthcare data
3. Adhering to the strict healthcare regulations and reforms
On top of this, Healthcare organizations have to ensure that their data management solution must have a dependable & active security protocol to safeguard sensitive information of patients as per HIPAA norms. With the exponential increase in data, risk is only going to amplify.
In case of mergers & acquisitions, a sizable challenge for large healthcare corporates is the Amalgamation and Streamlining Data with the parent company’s processes. This becomes tedious and cost intensive as merging two data environments that are often radically different from each other into a single system, is difficult and tedious.
Healthcare companies need consumer-driven data strategies with patients at the forefront of their planning. How? To know, read on.
Data Dynamics is a leader in intelligent file management solutions that empower enterprises to seamlessly analyze, move, manage and modernize critical data across hybrid, cloud and object-based storage infrastructures for true business transformation.
This document discusses the computerization of hospital management information systems through information technology developments. It covers major areas of IT development like hardware, software, and information systems design. The focus is on using current technologies to improve the effectiveness and efficiency of managing healthcare institutions. Specific areas that can be computerized are discussed, like patient services and management systems. Critical components of developing an integrated patient-based health information system and the organization's management information system are outlined, including conceptual frameworks, recommended approaches, and considerations around database design.
Endodontic surgery is a surgical procedure to treat endodontic problems. There are several types of endodontic surgery procedures described in the document, including incision and drainage to drain pus from infected areas, periapical surgery such as apicoectomy to remove the infected root tip, and retrograde filling to seal the root canal. Postoperative evaluation methods like reimplantation of extracted teeth and use of endodontic implants are also discussed. Contraindications, surgical techniques, and prognosis factors are provided. The document provides an overview of different endodontic surgical procedures and their indications.
The document discusses clinical decision support systems (CDSS), which are software designed to aid clinical decision making by matching patient characteristics to a computerized knowledge base. It describes several types of CDSS including knowledge-based systems, alerts and reminders, diagnostic assistance, therapy critiquing and prescribing decision support. It also discusses different knowledge representations, functionally classified systems, benefits and limitations of CDSS, and their future directions.
This document describes the mini-open transforaminal lumbar interbody fusion (TLIF) technique. Key points include:
1. Mini-open TLIF provides the benefits of TLIF with less soft tissue disruption through a smaller incision and muscle splitting approach.
2. The technique involves facetectomy, bilateral decompression if needed, interbody cage insertion, and percutaneous pedicle screw fixation through tubular retractors.
3. Advantages over open TLIF include less blood loss, reduced postoperative pain, and shorter hospital stay. However, it requires microsurgical skills and has a steep learning curve.
Data Management - a top Priority for Healthcare PracticesData Dynamics Inc
The healthcare industry has become increasingly data-driven and poised to take a leap into the future, thanks to an increasingly tech-savvy and demanding patient-consumer base. While the Healthcare Data Ecosystem is presently fragmented and often, insufficient, pioneering firms see vast opportunities to be a part of the Healthcare revolution through proper management of their massive amount of Data.
Healthcare has unique data management challenges that other industries do not face, so the solutions that worked in those fields cannot simply be replicated. Challenges in healthcare data management include -
1. Data environment consolidation in acquisitions and mergers
2. Managing the rapid growth of unstructured healthcare data
3. Adhering to the strict healthcare regulations and reforms
On top of this, Healthcare organizations have to ensure that their data management solution must have a dependable & active security protocol to safeguard sensitive information of patients as per HIPAA norms. With the exponential increase in data, risk is only going to amplify.
In case of mergers & acquisitions, a sizable challenge for large healthcare corporates is the Amalgamation and Streamlining Data with the parent company’s processes. This becomes tedious and cost intensive as merging two data environments that are often radically different from each other into a single system, is difficult and tedious.
Healthcare companies need consumer-driven data strategies with patients at the forefront of their planning. How? To know, read on.
Data Dynamics is a leader in intelligent file management solutions that empower enterprises to seamlessly analyze, move, manage and modernize critical data across hybrid, cloud and object-based storage infrastructures for true business transformation.
This document discusses the computerization of hospital management information systems through information technology developments. It covers major areas of IT development like hardware, software, and information systems design. The focus is on using current technologies to improve the effectiveness and efficiency of managing healthcare institutions. Specific areas that can be computerized are discussed, like patient services and management systems. Critical components of developing an integrated patient-based health information system and the organization's management information system are outlined, including conceptual frameworks, recommended approaches, and considerations around database design.
Law Related to Governing the Commissioning of Hospital
Laws Governing the Qualifications / Practice and Conduct of Professionals
Law Governing Storage / Sale of Drugs and Safe Medication
Law Governing Biomedical Research
Law Governing to Management of Patients
Law Governing Medico Legal Aspects
Law Governing The Safety of Patients, Public and Staff within the Hospital Premises and Environmental Protection
Law Governing the Safety of Patients, Public and Staff within the Hospital Premises
Laws Governing the Employment of Manpower
Law Governing to Professional Training and Research
Regulations Governing the Business Aspects of Hospital
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...Nawanan Theera-Ampornpunt
This document discusses the implementation of HL7 and HL7 CDA standards for healthcare messaging exchange in Thailand. It provides background on the speaker, Nawanan Theera-Ampornpunt, and outlines Thailand's vision for eHealth, current status, and the role of standards. It then describes HL7 standards including versions 2 and 3, the Reference Information Model, and Clinical Document Architecture. The document outlines Ramathibodi Hospital's experience implementing HL7 messaging and CDA documents for lab results exchange. Next steps involve encouraging broader CDA adoption.
This document provides an introduction to telemedicine, including its definition, history, types, applications, benefits, limitations, and future directions. Telemedicine involves the use of telecommunications technology to provide medical care from a distance. It has evolved from early uses of telegraphy, radio, and television to today's applications using computer and internet technologies like video conferencing, remote patient monitoring, and mobile health apps. Telemedicine allows improved access to care, cost savings, and medical education. While limitations include infrastructure and acceptance issues, its future is promising as technologies advance to enable more services like remote surgery and live monitoring via mobile devices.
Topic: Hospital Management System | Course: Management Information System | B...Binte Zahra
This document outlines a hospital management system (HMS) presented by several students. It discusses the need for centralized hospital management to replace manual systems. The goals of HMS are to standardize data and provide efficient, cost-effective services. The HMS process links patients, staff, and administrators. Key HMS modules include patient management, pharmacy management, appointment scheduling, and financial management. The major benefits of HMS are immediate access to data, time savings, and improved treatment decisions.
This document discusses legal and professional issues for nurses. It covers what defines a profession, codes of ethics, sources of law including statutes, regulations, and court decisions. It discusses intentional torts like assault, battery, and defamation as well as unintentional negligence. It emphasizes the importance of documentation, informed consent, privacy, and following policies to minimize liability for nurses.
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
This document discusses principles for managing acute infection after operative fracture fixation. It notes an infection rate of 1-2% for closed fractures and 6-7% for open fractures. Risk factors for surgical site infection include older age, comorbidities, drugs, prior infections, and emergency operations. Factors contributing to acute infection include contamination, a medium for bacteria to grow, mechanical instability, and dead soft tissues. Strict protocols around cleaning, masking, handwashing, and isolating MRSA patients can reduce contamination risk. Careful surgical technique, debridement, hemostasis, and temporary fixation can address other risk factors. Signs of acute infection include swelling, pain, fever and elevated inflammatory markers. Aggressive wound revision
HASTANE OTOMASYONU DERS NOTLARI ve SUNUMLARI
Hospital Information Systems Lecture notes and presentations,
HASTANE OTOMASYONU
Prof.Dr. Halit Hami OZ-10-Hastane Otomasyonu-ECZANE MODÜLÜ
Design and Implementation of Hospital Management System Using JavaIOSR Journals
This document describes the design and implementation of a Hospital Management System (HMS) using Java. The HMS was developed to address challenges with manual hospital management processes and provide benefits like streamlined operations and enhanced patient care. It includes modules for patient management, services management, appointments, the pharmacy, admissions and accounting. The system uses a database to store patient and medical records and allows users to view records, diagnoses and drug prescriptions. Test results showed the HMS met user requirements and provided functionality like registering patients, viewing inpatient data and the drug database. It was concluded the HMS can help hospitals enhance patient care and increase organizational profitability by improving operational control and streamlining processes.
Implant failures can occur for various reasons and can be classified in different ways. Implant failures are generally defined as the inability of an implant to fulfill its intended purpose of providing functional, aesthetic, and phonetic support. Failures may occur due to biological or mechanical factors related to the patient, surgical technique, implant selection, or prosthetic elements. Peri-implantitis is a common cause of late implant failure resulting from bacterial infection and/or biomechanical overload. Treatment depends on the severity and timing of the failure.
Describes about Technology, health care trend, design converge to enhance patient care and rules for Smart Hospitals. For more information visit: http://www.transformhealth-it.org/
HASTANE OTOMASYONU DERS NOTLARI ve SUNUMLARI
Hospital Information Systems Lecture notes and presentations,
HASTANE OTOMASYONU
Prof.Dr. Halit Hami OZ-12-Hastane Otomasyonu-RADYOLOJİ MODÜLÜ
This document provides an overview of hospital administration topics covered across 5 units. It includes questions for assessment on key areas like hospital management, human resource management, recruitment and training, supportive services, communication and safety. The overview introduces concepts such as the distinction between hospitals and industries, challenges in hospital administration, equipment and functional planning, principles of human resource management, recruitment, selection and training processes, roles of various hospital departments, and safety and security programs.
This document discusses kyphoplasty for treating acute osteoporotic vertebral compression fractures. It begins by thanking various professors and outlines the purpose of studying kyphoplasty's role in managing such fractures by analyzing clinical and radiographic outcomes to evaluate its efficacy and safety. Vertebral compression fractures are a common osteoporosis complication and can cause spinal deformities, pain, disability and reduced function. Kyphoplasty is a minimally invasive procedure that can restore height and provide immediate pain relief with fewer complications than vertebroplasty. The document discusses patient selection criteria, technique, potential complications, and outcomes of kyphoplasty for treating osteoporotic vertebral compression fractures.
This document provides an overview of clinical decision support systems (CDS). It begins by defining clinical decisions and decision making, and discusses some of the pitfalls of human decision making. The roles of information technology in clinical decision making are then examined. The document defines CDS and provides examples of different types of CDS, including alerts and reminders, reference tools, order sets, and diagnostic decision support. It also reviews CDS architecture and discusses issues related to CDS implementation, such as usability, alert fatigue, and unintended consequences. The document concludes by emphasizing that CDS should supplement rather than replace clinicians and that both technical and human factors must be considered in CDS design.
The document provides information on developing policies and procedures for a healthcare compliance program. It discusses the importance of having both policies that establish how things should be done, as well as procedures that specify how to implement the policies. An example policy on physician education is given, along with an accompanying procedure that outlines the specific steps for conducting post-audit provider education. The summary emphasizes that a clear understanding of both policies and procedures is necessary for an effective compliance program.
The lungs are protected by the ribcage. Air enters our lungs via the trachea or wind pipe. When the air enters our lungs,the muscle called the diaphragm goes downwards. When we breathe out the diaphragm moves up and air is expelled from the lungs.
This document provides information on various diseases of the lungs including atelectasis, bronchiectasis, emphysema, bronchial asthma, adenocarcinoma lung, pulmonary edema, and bronchopneumonia. For each condition, it discusses etiology, pathogenesis, diagnosis, clinical manifestation, morphology, and management. It also includes histopathology slides illustrating various lung pathologies such as alveolar collapse, inflammatory changes, fibrotic changes, and remodelling of airways in asthma.
This document provides an overview of physiotherapy and rehabilitation. It discusses various physiotherapy techniques including electrotherapy like shortwave diathermy, ultrasound, TENS; cryotherapy; exercise therapy techniques like active exercises, PNF, and hydrotherapy. It also covers the role of physiotherapists in assessing, managing, and treating medical conditions to relieve pain and improve mobility. The principles and stages of rehabilitation including medical, psychological, and social rehabilitation are outlined. The overall goal of physiotherapy and rehabilitation is to restore optimal health and functioning.
Law Related to Governing the Commissioning of Hospital
Laws Governing the Qualifications / Practice and Conduct of Professionals
Law Governing Storage / Sale of Drugs and Safe Medication
Law Governing Biomedical Research
Law Governing to Management of Patients
Law Governing Medico Legal Aspects
Law Governing The Safety of Patients, Public and Staff within the Hospital Premises and Environmental Protection
Law Governing the Safety of Patients, Public and Staff within the Hospital Premises
Laws Governing the Employment of Manpower
Law Governing to Professional Training and Research
Regulations Governing the Business Aspects of Hospital
HL7 & HL7 CDA: The Implementation of Thailand's Healthcare Messaging Exchange...Nawanan Theera-Ampornpunt
This document discusses the implementation of HL7 and HL7 CDA standards for healthcare messaging exchange in Thailand. It provides background on the speaker, Nawanan Theera-Ampornpunt, and outlines Thailand's vision for eHealth, current status, and the role of standards. It then describes HL7 standards including versions 2 and 3, the Reference Information Model, and Clinical Document Architecture. The document outlines Ramathibodi Hospital's experience implementing HL7 messaging and CDA documents for lab results exchange. Next steps involve encouraging broader CDA adoption.
This document provides an introduction to telemedicine, including its definition, history, types, applications, benefits, limitations, and future directions. Telemedicine involves the use of telecommunications technology to provide medical care from a distance. It has evolved from early uses of telegraphy, radio, and television to today's applications using computer and internet technologies like video conferencing, remote patient monitoring, and mobile health apps. Telemedicine allows improved access to care, cost savings, and medical education. While limitations include infrastructure and acceptance issues, its future is promising as technologies advance to enable more services like remote surgery and live monitoring via mobile devices.
Topic: Hospital Management System | Course: Management Information System | B...Binte Zahra
This document outlines a hospital management system (HMS) presented by several students. It discusses the need for centralized hospital management to replace manual systems. The goals of HMS are to standardize data and provide efficient, cost-effective services. The HMS process links patients, staff, and administrators. Key HMS modules include patient management, pharmacy management, appointment scheduling, and financial management. The major benefits of HMS are immediate access to data, time savings, and improved treatment decisions.
This document discusses legal and professional issues for nurses. It covers what defines a profession, codes of ethics, sources of law including statutes, regulations, and court decisions. It discusses intentional torts like assault, battery, and defamation as well as unintentional negligence. It emphasizes the importance of documentation, informed consent, privacy, and following policies to minimize liability for nurses.
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
This document discusses principles for managing acute infection after operative fracture fixation. It notes an infection rate of 1-2% for closed fractures and 6-7% for open fractures. Risk factors for surgical site infection include older age, comorbidities, drugs, prior infections, and emergency operations. Factors contributing to acute infection include contamination, a medium for bacteria to grow, mechanical instability, and dead soft tissues. Strict protocols around cleaning, masking, handwashing, and isolating MRSA patients can reduce contamination risk. Careful surgical technique, debridement, hemostasis, and temporary fixation can address other risk factors. Signs of acute infection include swelling, pain, fever and elevated inflammatory markers. Aggressive wound revision
HASTANE OTOMASYONU DERS NOTLARI ve SUNUMLARI
Hospital Information Systems Lecture notes and presentations,
HASTANE OTOMASYONU
Prof.Dr. Halit Hami OZ-10-Hastane Otomasyonu-ECZANE MODÜLÜ
Design and Implementation of Hospital Management System Using JavaIOSR Journals
This document describes the design and implementation of a Hospital Management System (HMS) using Java. The HMS was developed to address challenges with manual hospital management processes and provide benefits like streamlined operations and enhanced patient care. It includes modules for patient management, services management, appointments, the pharmacy, admissions and accounting. The system uses a database to store patient and medical records and allows users to view records, diagnoses and drug prescriptions. Test results showed the HMS met user requirements and provided functionality like registering patients, viewing inpatient data and the drug database. It was concluded the HMS can help hospitals enhance patient care and increase organizational profitability by improving operational control and streamlining processes.
Implant failures can occur for various reasons and can be classified in different ways. Implant failures are generally defined as the inability of an implant to fulfill its intended purpose of providing functional, aesthetic, and phonetic support. Failures may occur due to biological or mechanical factors related to the patient, surgical technique, implant selection, or prosthetic elements. Peri-implantitis is a common cause of late implant failure resulting from bacterial infection and/or biomechanical overload. Treatment depends on the severity and timing of the failure.
Describes about Technology, health care trend, design converge to enhance patient care and rules for Smart Hospitals. For more information visit: http://www.transformhealth-it.org/
HASTANE OTOMASYONU DERS NOTLARI ve SUNUMLARI
Hospital Information Systems Lecture notes and presentations,
HASTANE OTOMASYONU
Prof.Dr. Halit Hami OZ-12-Hastane Otomasyonu-RADYOLOJİ MODÜLÜ
This document provides an overview of hospital administration topics covered across 5 units. It includes questions for assessment on key areas like hospital management, human resource management, recruitment and training, supportive services, communication and safety. The overview introduces concepts such as the distinction between hospitals and industries, challenges in hospital administration, equipment and functional planning, principles of human resource management, recruitment, selection and training processes, roles of various hospital departments, and safety and security programs.
This document discusses kyphoplasty for treating acute osteoporotic vertebral compression fractures. It begins by thanking various professors and outlines the purpose of studying kyphoplasty's role in managing such fractures by analyzing clinical and radiographic outcomes to evaluate its efficacy and safety. Vertebral compression fractures are a common osteoporosis complication and can cause spinal deformities, pain, disability and reduced function. Kyphoplasty is a minimally invasive procedure that can restore height and provide immediate pain relief with fewer complications than vertebroplasty. The document discusses patient selection criteria, technique, potential complications, and outcomes of kyphoplasty for treating osteoporotic vertebral compression fractures.
This document provides an overview of clinical decision support systems (CDS). It begins by defining clinical decisions and decision making, and discusses some of the pitfalls of human decision making. The roles of information technology in clinical decision making are then examined. The document defines CDS and provides examples of different types of CDS, including alerts and reminders, reference tools, order sets, and diagnostic decision support. It also reviews CDS architecture and discusses issues related to CDS implementation, such as usability, alert fatigue, and unintended consequences. The document concludes by emphasizing that CDS should supplement rather than replace clinicians and that both technical and human factors must be considered in CDS design.
The document provides information on developing policies and procedures for a healthcare compliance program. It discusses the importance of having both policies that establish how things should be done, as well as procedures that specify how to implement the policies. An example policy on physician education is given, along with an accompanying procedure that outlines the specific steps for conducting post-audit provider education. The summary emphasizes that a clear understanding of both policies and procedures is necessary for an effective compliance program.
The lungs are protected by the ribcage. Air enters our lungs via the trachea or wind pipe. When the air enters our lungs,the muscle called the diaphragm goes downwards. When we breathe out the diaphragm moves up and air is expelled from the lungs.
This document provides information on various diseases of the lungs including atelectasis, bronchiectasis, emphysema, bronchial asthma, adenocarcinoma lung, pulmonary edema, and bronchopneumonia. For each condition, it discusses etiology, pathogenesis, diagnosis, clinical manifestation, morphology, and management. It also includes histopathology slides illustrating various lung pathologies such as alveolar collapse, inflammatory changes, fibrotic changes, and remodelling of airways in asthma.
This document provides an overview of physiotherapy and rehabilitation. It discusses various physiotherapy techniques including electrotherapy like shortwave diathermy, ultrasound, TENS; cryotherapy; exercise therapy techniques like active exercises, PNF, and hydrotherapy. It also covers the role of physiotherapists in assessing, managing, and treating medical conditions to relieve pain and improve mobility. The principles and stages of rehabilitation including medical, psychological, and social rehabilitation are outlined. The overall goal of physiotherapy and rehabilitation is to restore optimal health and functioning.
Suspension therapy uses specialized equipment to provide passive and assisted exercises for various joints. There are three main types of suspension - axial, pendular, and vertical - which differ based on where the supporting hook is placed in relation to the joint and center of gravity. The suspension unit was invented and consists of fixed points, supporting ropes, slings, and other attachments to position the patient for passive range of motion exercises of shoulders, elbows, hips, knees, and ankles. Suspension therapy provides advantages over other methods like continuous passive motion by allowing resistance to be added to muscle work as needed.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost mental well-being.
Physiotherapy involves various techniques to treat physical ailments and injuries, including manipulative therapy, electrotherapy, hydrotherapy, and ice therapy. Manipulative therapy uses techniques like massage and passive mobilization of joints to increase mobility. Electrotherapy applies different electric currents for purposes like pain management and tissue repair. Hydrotherapy uses water properties for joint mobility, strength training, and rehabilitation. Ice therapy reduces pain and swelling through cryotherapy.
The trachea is a cartilaginous tube that extends from the larynx to the lungs. It divides at the carina into the right and left main bronchi. The right bronchus is wider, shorter and more vertical, while the left is smaller but longer. The bronchi continue dividing within the lungs to form the bronchial tree which supplies the lungs. Each lung has a root, hilum, lobes, borders and surfaces. The lungs are supplied by the pulmonary arteries and veins and are innervated by the pulmonary plexus.
Physiotherapy uses physical measures like heat, light, ultrasound, water, electricity and exercises to treat orthopedic injuries and conditions through both passive and active techniques. The goals of physiotherapy are to treat and prevent disability and deformity. Physiotherapy can be either short term for minor issues like soft tissue injuries or long term for more serious conditions like fractures, spinal injuries, and chronic diseases. Treatments include exercises, electrotherapy, massage, mobilization and various modalities like ultrasound, heat and cold therapy.
Physiotherapy has evolved from ancient practices by Hippocrates and Galenus to treat injuries. It was established in the late 19th century in Britain and developed further during World War II to treat large numbers of injured soldiers. Physiotherapy uses various physical techniques without drugs, including exercise, massage, heat and electricity, to treat diseases and disabilities. It aims to relieve pain, improve mobility and function. Key techniques include electrotherapy like ultrasound and TENS, various exercises and equipment for gait training and rehabilitation.
Physiotherapy involves evaluating, diagnosing, and treating a range of diseases, disorders, and disabilities using physical means. Physiotherapy management is provided for conditions such as musculoskeletal disability, cardiorespiratory dysfunction, central nervous system trauma/disease, and more. Physiotherapy includes both inpatient and outpatient services for treatments like orthopedics, trauma, and spinal injuries/surgeries.
The Insurance Act of 1938 was the first legislation governing all forms of insurance in India and provided strict state control over the insurance business. It aimed to safeguard policyholder interests and establish norms for smoothly conducting the insurance business and minimizing disputes. Subsequent acts like the Insurance Regulatory and Development Authority Act of 1999 established regulatory authorities to further protect policyholders, regulate the industry, and ensure its orderly growth.
The document provides a summary of information from various coding and reimbursement conferences and resources. It discusses changes to CPT and ICD-9 codes for 2011 related to topics like E/M documentation, vaccine administration, physical therapy caps, and cardiac catheterization codes. It also addresses questions around coding issues including monitoring studies, endoscopy procedures, and hip arthroscopy.
The document summarizes changes to CPT codes for 2014, focusing on new codes, deleted codes, and code revisions. Key changes included 107 new Category I codes, 40 deleted Category I codes, and 103 revised Category I codes. There were also changes to codes related to evaluation and management, integumentary procedures, musculoskeletal procedures, and cardiovascular procedures. Physicians are responsible for understanding coding changes and ensuring accurate billing.
This document summarizes changes to CPT codes for 2011, focusing on changes to evaluation and management codes, integumentary system codes, and new codes related to annual wellness visits and H1N1 immunizations. New codes were added for subsequent observation care and annual wellness visits. Codes for debridement were revised and codes for H1N1 immunization administration and pandemic vaccine were added.
Understanding the Impact of the CMS Physician Final Rule on Patient CareConference Panel
Join us for an informative webinar on the CMS Physician Final Rule 2023, which will provide insights on the latest updates to physician payment and coding guidelines for the upcoming year. It is crucial for healthcare providers and staff to be aware of the key changes proposed by CMS and understand which items will be implemented in 2023.
For all healthcare providers and offices that bill Medicare or Medicaid, staying up-to-date with CMS yearly changes is essential. This webinar will delve into the details of the CMS Physician Final Rule for 2023, outlining all the changes that providers and staff need to know.
Don't miss this opportunity to gain critical insights into the CMS Physician Final Rule 2023 and ensure that your practice is prepared for the upcoming changes. Join us for a comprehensive overview of the new guidelines and their implications for physician offices.
Register,
https://conferencepanel.com/conference/cms-physician-final-rule-2023
Building the Case for Integrating the Surgical Services Suite l MD BuylineMD Buyline
The document discusses the benefits and considerations for integrating operating rooms and implementing hybrid operating rooms, including improved efficiencies, outcomes, and cost savings through automation, telemedicine, and real-time information access, though the significant costs require weighing clinical and financial factors carefully and targeting high-volume procedures for sufficient return on investment. Multiple technology and vendor options are presented for integrated operating rooms and their components, as well as hybrid operating room imaging systems, tables, and the financial challenges of achieving utilization needed to offset costs.
Improvement & Transformation TTO project Final Report Out Jan 16Nick Holding
The document summarizes process improvement efforts to reduce turnaround times for patient discharge medications (TTOs) and discharge summaries at a hospital. Key findings include:
- TTO lead times were reduced by 67% (3 hours) through testing various changes over two kaizen events.
- One ward saw patient discharge delays reduced by an average of 10 hours per day.
- Changes could release up to 300 hours of bed time per day across inpatient units.
- Areas of focus included ordering, picking, delivering, and producing TTOs and discharge summaries more efficiently.
This document provides information about a prototype remuneration system for dental practices. It discusses general principles such as splitting a practice's contract value between capitation (number of patients) and activity (treatment levels). It describes how expected capitation and activity are calculated based on historic patient lists and UDA delivery. Capitation is counted based on appointments, and activity is counted through FP17 submissions depending on whether treatment is for patients on the practice list. The process involves calculating the contractor's expected capitated population and expected minimum activity levels.
The document discusses various modules of a Hospital Management System (HMS). It describes modules for managing the inpatient department (IPD), outpatient department (OPD), laboratory tests, pharmacy operations and billing, nursing services, radiology equipment and tests, physiotherapy treatments, and operation theaters. The HMS allows hospitals to automate processes, maintain patient records and test results, generate bills, and improve overall efficiency through digitization.
This training pack provides guidance on remuneration for practices operating under prototype agreements. It outlines that a practice's contract value will be split between a capitation element based on patient numbers, and an activity element based on minimum treatment levels. It also describes the two remuneration blends that will be tested - blend A with capitation covering band 1 and activity covering bands 2 and 3, and blend B with capitation covering bands 1 and 2 and activity band 3. Practices must meet expected capitation and activity levels to receive their full contract value, and can earn an additional 2% for exceeding these levels.
The document summarizes a conference presentation on touch therapies in palliative care. It discusses the benefits of touch therapies like massage therapy and caring touch interventions. It provides evidence that these therapies can reduce pain, anxiety and improve quality of life for palliative patients. The document reviews credentialing requirements, delivery models, costs and steps to implement touch therapy programs. It encourages facilities to offer these services to enhance patient experience and concludes by thanking presenters and providing resources for those interested in starting programs.
Presentation by David Wonderling, Head of Health Economics at National Guideline Centre, Royal College of Physicians and Lauren Ramjee, Senior Health Economist, Royal College of Physicians.
This workshop outlines the principles of health economic evaluation for the NHS.
Compliance and Implementation Strategies for CMS Physician Final Rule 2023Conference Panel
Each summer, CMS (Centers for Medicare & Medicaid Services) releases its proposed physician payment and coding change guidelines for the upcoming year. After gathering feedback from the physician community, CMS published the final rule on November 1, 2022, which either confirmed or modified issues from the initial proposal. The provider comments have the potential to influence CMS to deviate from its original guidelines. It is of utmost importance for healthcare providers and their staff to be aware of the specific items that will be implemented in 2023 and those that CMS has decided not to move forward with. The aspects of the proposed rule that were not implemented for 2023 may signal issues that are still under consideration for 2024. Notably, this year brings significant changes to Evaluation and Management (EM) services, as well as prolonged services, necessitating a complete overhaul in coding practices outside of the office setting. Additionally, there are new criteria for determining prolonged services for Medicare patients. Being well-informed about these updates will be crucial for providers to navigate the evolving landscape of Medicare reimbursement and ensure optimal patient care.
Register,
https://conferencepanel.com/conference/cms-physician-final-rule-2023
This document discusses care plan oversight (CPO) billing for physicians supervising patients receiving home health or hospice care. It defines CPO and how it differs from certification/recertification. Requirements for CPO billing include the physician providing at least 30 minutes of supervision per month and documenting services. Eligible services, documentation methods, and claim filing procedures are outlined. The document encourages agencies to educate physicians on CPO to increase referrals and profits.
This document provides guidelines for participants in a table top exercise (TTX) simulation regarding preparedness and response to a novel coronavirus (COVID-19) outbreak. The objectives of the TTX simulation are to test response plans, identify gaps, strengthen coordination between agencies, and review procedures. The simulation will use a scenario of an imported COVID-19 case and will be facilitated over half a day with breaks. Participants are instructed to respond based on their real roles and responsibilities. Reference materials on COVID-19 are provided and the simulation and debrief will be followed by an action planning session to identify steps to enhance preparedness.
This is all the information that is available.Chapter 5 – Activity.pdfprajeetjain
This is all the information that is available.
Chapter 5 – Activity-Based Costing
St. Francis Healthcare and Dialysis Clinic
St. Francis Healthcare and Dialysis Clinic (SFHDC) is an independent, nonprofit full-service
renal dialysis clinic. The clinic provides two types of treatments. Hemodialysis (HD) requires
patients to visit a dialysis clinic three times a week, where they are connected to special,
expensive equipment to perform the dialysis. Peritoneal dialysis (PD) allows patients to
administer their own treatment daily at home. The clinic monitors PD patients and assists them in
ordering supplied consumed during the home treatment. The total and product-line income
statement for the clinic is shown below:
CLINIC INCOME STATEMENT
TOTAL
HD
PD
Revenues
Number of patients
164
102
62
Number of treatments
34,067
14,343
20,624
Total revenue
$3,006,775
$1,860,287
$1,146,488
Supply costs
Standard supplies (drugs, syringes)
664,900
512,619
152,281
Episodic supplies (for special conditions)
310,695
98,680
212,015
Total supply costs
975,595
611,299
364,296
Service costs
General overhead (occupancy, administration)
785,825
Durable equipment (maintenance, depreciation)
137,046
Nursing services (RNs, LPNs, nursing administrators
equipment technicians)
883,280
Total service costs
1,806,151
1,117,463
688,688
Total operating expenses
2,781,746
1,728,762
1,052,984
Net income
$225,029
$131,525
$93,504
Treatment Level Profit
Average charge per treatment
$129.70
$55.59
Average cost per treatment
120.53
51.06
Profit per treatment
$9.17
$4.53
The existing cost system assigned the traceable supply costs directly to the two types of
treatments. The service costs, however, were not analyzed by type of treatment. The total service
costs of $1,806,151 were allocated to the treatments using the ration-of-cost-to-charges (RCC)
method developed for government cost-based reimbursement programs. With this procedure,
since HD t4reatments represented about 61% of total revenues, HD received an allocation of
61% of the $1.8 million service expenses.
For many years, the clinics such as SFHDC received much of their reimbursement on the basis
of reported costs. Starting in 2015, however, payment mechanisms shifted, and now SFHDC
received most of its reimbursement on the basis of a fixed fee not the cost of the service
provided. In particular, because HD and PD procedures were categorized by the government as a
single category – dialysis treatment-the weekly reimbursement for each patient was the same
$389.10. As a consequence, the three HD treatments per week led to a reported revenue per HD
treatment of $129.70, and the seven PD treatments per week led to a reported revenue per PD
treatment of $55.59.
Both procedures appeared to be profitable, according to the clinic’s existing cost and revenue
recognition system. Francis Bernadone, the controller of SFHDC was concerned, however, that
the procedures currently being used to assign common expenses may not be representative of.
This training pack provides guidance for dental practices participating in a contract reform programme as prototypes. It outlines the principles for calculating prototype remuneration, which will be split between a capitation element and an activity element. The expected patient list and minimum activity levels will be calculated based on historical data with adjustments. Practices can be allocated to Blend A or Blend B, which determine whether capitation covers bands 1 and 2 or bands 1 and 3, and which activity is counted. Worked examples are provided to demonstrate how the capitation and activity elements are calculated for each blend.
This document discusses guidelines for occupational safety and health (OSH) in the workplace during the COVID-19 pandemic. It recommends temperature checks, wearing face masks and shields, frequent disinfection of common areas, and physical distancing. It also provides guidelines for reducing transmission, reducing contact between employees, managing symptomatic and asymptomatic employees, conducting contact tracing, and reporting illness. The document aims to help employers prevent and control the spread of COVID-19 in the workplace to protect employee safety and health.
Tsoon is a specialized appointment scheduling software for Occupational Health :
- for all types of medical visits
- allows employees and / or managers to plan visits
- relieves nurses in the planning process
- supports doctors in the management of their activities
- optimizes the times and logs all the exchanges.
Presentation from the 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks, organised by the European Centre of Disease Prevention and Control - Stockholm, 11-13 February 2015
Tsoon is a specialized appointment scheduling software for Public Health :
- for all types of medical visits
- allows patients to schedule visits
- relieves nurses in the planning process
- supports doctors in the management of their activities
- optimizes the times and logs all the exchanges.
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1. 2010 UBO/UBU Conference
Health Budgets &
Financial Policy
Briefing: Physical Therapy Coding
Date: 25 March 2010
Time: 1010–1100
1
2. 2010 UBO/UBU Conference
Turning Knowledge Into Action
Objective
To standardize Physical Therapy coding practices
throughout the AFMS…and the rest of the MHS
– PT coding issues
– Confusing coding problems
– Questions
2
3. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Acronyms
AAROM = Active Assistive Range of Motion
– ABD* = Abduction
– ADD* = Adduction
– ADL = Activities of Daily Living
– B = Bilateral/Both
– CP = Cold Pack
– DTR = Deep Tendon Reflex
– ext = extension
– FWP = Full Weight Bearing
– GT = Gait Training
– HEP = Home Exercise Program
– HP = Hot Pack, or MHP = Moist Hot Pack
*(careful, more than one meaning)
–
3
4. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Acronyms
–
–
–
–
–
–
–
–
–
IM* = Ice Massage
LBP = Low Back Pain
mob = Mobilized, Mobilization
OMT = Osteopathic Manipulative Therapy
POC* = Plan of Care
PROM = Passive Range of Motion
US = Ultra Sound, Ultrasonography
VO = Verbal Order
WP* = Whirlpool, Warm Pool, Wet Pack
*(careful, more than one meaning)
4
5. 2010 UBO/UBU Conference
Turning Knowledge Into Action
•
•
•
•
•
PT Coding Issues
Activities of Daily Living
Gait Training
Osteopathic Manipulative Therapy
Incident-to services (aka Technician services)
When are PT evaluations/re-evaluations coded
5
6. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Activities of Daily Living
– CPT® Code 97535
– Self–care/home management training (e.g., activities
of daily living (ADL) and compensatory training, meal
preparation, safety procedures, and instructions in
use of assistive technology devices/adaptive
equipment) direct one-on-one contact by provider,
each 15 minutes
– APTA advises - This code should be utilized when a
patient is trained in the use of assistive technology to
assist with mobility, seating systems and
environmental control systems for use in the home
environment (e.g., wheelchair mobility using a mouth
control)
6
7. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
97535 – Self Care Management
Designed for ADL training/return to function at home
– Cooking
– Cleaning
– Transfers in/out of vehicle or bathroom
– Transfers out of actual hospital bed (not plinth)
7
8. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Gait Training
– CPT® Code 97116
– Watching, evaluating and training on the manner or
style of walking, including rhythm and speed. Three
phases of gait include the stance phase, the swing
phase, and the double support phase.
Crutch training included
8
9. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Osteopathic Manipulative Treatment
– CPT® codes 98925-98929
– Generally performed by Doctors of Osteopathy (DO)
More appropriate in PT is CPT® code 97140 Manual
therapy techniques (e.g., mobilization/ manipulation,
manual lymphatic drainage, manual traction), one or
more regions, each 15 minutes
– Manual therapy based on time (use units of service)
as well as regions
9
10. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
98925-98929 OMT codes
Civilian PTs do not use this code
DoD guidelines allow PTs to utilize OMT when appropriate
10
11. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
V57.1 Encounter for other physical therapy
– Per BDQAS – for the first quarter of FY10 utilized
85,679 times for the AF
– To be assigned in primary/first listed position
– Condition diagnoses coded secondarily
Don’t assign V57.1 when patient presents for evaluation or
re-evaluation – even when treatment starts that day
– Assign referred condition in primary/first listed position
11
12. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Incident-to Services (aka Technician services)
– UBO restricts use of conventional incident-to services
– Appointment made to the technician if they are the
provider of that therapeutic service
– PT co-signatures are not required as services will not
be billed although still generates RVUs for the clinic
Still needs a supervising provider named on
encounter (not necessarily a co-signature)
– All tech services are provided under a therapist or
physician documented plan of care
12
13. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
When are PT evaluations re-evaluations coded
– CPT® Code 97001 evaluation
– CPT® Code 97002 re-evaluation
– Evaluations may occur when a new diagnosis is
present to develop plan of care
– Re-evaluations may occur when improvement or
decline of patient condition was not anticipated to
determine any changes to plan of care
Patient not meeting documented long and/or short
term goals
13
14. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Documentation
– All methods of therapy must be documented in the
patient record
– Timed codes are coded per units of at least 8 minutes
for one unit (see slide 17 for table)
– Do not combine timed codes in separate
modalities/therapeutic procedures to get one unit of
service – if under 8 minutes that modality/procedure
will not be coded
14
15. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
What is the most important thing to remember about
coding?
If it wasn’t documented…
it wasn’t done!
#1 issue from the coder’s is supporting documentation
15
16. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Rule of 8’s
Most CPT codes are based on units of time
– Rule of 8’s (>8 or multiples of 15+8)
• 1 unit= ≥ 8 minutes but < 23 minutes
• 2 units
= ≥ 23 minutes but < 38 minutes
• 3 units
= ≥ 38 minutes but < 53 minutes
• 4 units
= ≥ 53 minutes but < 68 minutes
MUST validate number of units against total treatment time
– If in clinic for 3 different modalities…
– 97110 x 12 min; 97112 x 10 min; 97010 x 20 min
– How many units can you charge???
Answer: 1 Unit of 97110: Timed 1-on-1 services = 22 min, 1
Unit of 97010: Supervised services (untimed)
16
17. PT Coding Issues
2010 UBO/UBU Conference
Turning Knowledge Into Action
Unit of
Service
1
Greater than or
equal to
08 minutes
2
23 minutes
3
38 minutes
4
53 minutes
5
68 minutes
6
83 minutes
7
98 minutes
8
113 minutes
And fewer than
23 minutes total for all time-based
modalities
38 minutes total for all time-based
modalities
53 minutes total for all time-based
modalities
68 minutes total for all time-based
modalities
83 minutes total for all time-based
modalities
98 minutes total for all time-based
modalities
113-minutes total for all time-based
modalities
128-minutes total for all time-based
modalities
17
18. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Documentation
–
–
–
Physical Therapy Evaluations:
Initial Evaluations (97001) include:
Therapist evaluates the patient
– History
– Examination
– Assessment
– Treatment plan
Re-evaluations (97002) include:
Re-examination
Assessment of progress
Modifications to plan
18
19. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Documentation
–
Elements inclusive to examination or re-examination that
are not coded separately
Muscle testing 95831-95834
Range of motion 95851-95852
Health and Behavior Assessment/Intervention 9615096155
Physical Performance Test 97750
Assistive Technology Assessment 97755
Orthotic/Prosthetic checkout 97762
MNT 97802-97804
MTMS 99605-99607
19
20. PT Coding Issues (Q&A)
2010 UBO/UBU Conference
Turning Knowledge Into Action
Is there a limit to re-evaluation codes per pt?
(If I have to do re-evaluation 3 x wk due to changes, is it
alright to charge it each time?)
If these changes were…
◦ Unanticipated
◦ Due to complications,
additional surgeries and/or
procedures, or the instability
of the pt’s condition
◦ Require you to adjust your
goals/treatment plan
YES
If these changes were…
◦ Expected
◦ Normal progression w/
course of care
◦ Built into your POC
◦ Require minimal
modification of your plan
◦ No changes to your goals
NO
20
21. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Modalities – Supervised
– The “supervised modalities” (97010-97028) do not
require direct one-on-one contact by the provider.
Only one unit can be coded per visit, regardless of the
number of body parts treated
– Direct supervision – must be physically present and
available in the clinic
Modalities – Constant Attendance
– The “constant attendance modalities” (97032-97039)
require that a provider have direct one-on-one contact
with the patient for the minutes represented by the
code
21
22. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Therapeutic Procedures (97110-97546)
– Therapist required to have direct (one-on-one) patient
contact
– Constant attendance required unless group therapy
(97150)
– Personal supervision requires that the provider is in
the same room of the patient during the entire
procedure and in the immediate vicinity of the patient.
22
23. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues (Q&A)
T or F: We code what our patients do during their
treatment session.
FALSE
– Technicians and therapists code what THEY do in the
clinic…NOT what their PATIENTS do in the clinic.
– Remember…the following are necessary in order to
code for workload/reimbursement
REASONABLE
& MEDICALLY NECESSARY
ADEQUATELY DOCUMENTED
Rendered by a QUALIFIED PROFESSIONAL
SKILLED services provided under a PLAN of CARE
23
24. PT Coding Issues (Q&A)
2010 UBO/UBU Conference
Turning Knowledge Into Action
How can I bill for the time one patient is exercising in the
gym doing exercises on the equipment?
If, while exercising, the PT or PTA
is monitoring the pt’s pulse and
BP and instructions are given
related to target HR and
adjustments are made to the
speed/angle of the treadmill…
observations are being made and
recorded, the service would be
considered skilled and billable.
All of the components of the
service that represent skilled care
must be documented.
YES
Supervision of one patient
performing exercises in the
absence of provision of skilled
services is not billable.
NO
24
25. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues (Q&A)
Can joint mobilization be coded and charged by techs?
YES, there is nothing in the DoD coding guidelines
preventing military technicians from using 97140.
– Military technicians need to have this training
documented in their AFTR.
– The supervising therapist is the final authority and
responsibility in educating/training/certifying that the
technician working under their plan of care is qualified
to provide joint mobilizations.
25
26. PT Coding Issues
2010 UBO/UBU Conference
Turning Knowledge Into Action
Modalities (97010 – 97039)
Supervised
– Codes 97010-97028
– Does not require direct
patient contact (1-to-1)
– Time is NOT a factor
– Only 1 unit/visit
Constant Attendance
– Codes 97032-97039
– Requires 1-on-1
• Provider maintains
visual, verbal, and/or
manual contact with
the patient throughout
procedure
Time based—include time
required to perform all
aspects of service
26
27. PT Coding Issues
2010 UBO/UBU Conference
Turning Knowledge Into Action
Supervised Modalities
CPT Code
Definition
97010
Hot / Cold pack
97012
Traction, mechanical
97014
E-stim (unattended)
[Indications other than wound care]
97016
Vasopneumatic device therapy
97018
Paraffin Bath
97022
Whirlpool / Fluidotherapy
97024
Diathermy treatment
Untimed codes Do not require 1-on-1
May only be used once per visit (regardless of number of areas treated)
*Disposable electrodes are included and cannot be billed separately
27
28. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Supervised Modalities
– Documentation Requirements
– Use codes 97010-97028
– Supervised by provider but does not require direct
patient contact (one-to-one)
– Time is not a factor—only 1 unit can be reported for
each encounter
28
29. PT Coding Issues
2010 UBO/UBU Conference
Turning Knowledge Into Action
Constant Attendance Modalities
CPT Code
Definition
97032
Electrical Stimulation (attended)
97033
Electric current
therapy/Iontophoresis
97034
Contrast bath therapy
97035
Ultrasound therapy
97036
Hydrotherapy
Requires 1-on-1
Provider maintains visual, verbal, and/or manual contact with the patient
throughout procedure
Time based—include time required to perform all aspects of service
29
30. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
Constant Attendance
– Documentation Requirements
Use CPT codes 97032–97039
Requires one-on-one contact
– Provider maintains visual, verbal, and/or
manual contact with the patient throughout
procedure
– Time based—include time required to perform
all aspects of service
30
31. PT Coding Issues
2010 UBO/UBU Conference
Turning Knowledge Into Action
CPT Code Definition
97110
97112
Neuromuscular reeducation
97113
Aquatic therapy/exercises
97116
Gait training therapy
97140
Manual therapy
97150
Group therapeutic procedures
97530
Therapeutic activities
97532
Cognitive skills development
97533
Sensory integration
97535
Self care/management training
97537
As of:
Therapeutic exercises
Community/work reintegration
31
32. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
Documentation Requirements
– Skilled services that affect change through the
application of clinical skills and/or services that
attempt to improve function
– Requires direct, one-on-one patient contact by
provider—maintain visual, verbal, manual contact
with patient throughout procedure
– For technicians, must be working under guidance
of privileged provider – plan of care
32
33. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Therapeutic Procedures (97110-97546)
Codes represent the majority of what is done
Requirements as follows:
– Skilled services
– Requires 1-on-1
– Time-based codes
– Provider maintains visual, verbal, and/or manual
contact with the patient throughout the procedure
33
34. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Do we need to document the specific amount of time
spent performing each timed procedure?
– Yes
– 97110 (Therex) x 12 min
SLR x 3 (3x15); SAQ (3x15); Wall Slides 3x25
– 97112 (Neuromuscular Re-Ed) x 13 min
Single Leg stand Rebounder (3x25 tosses w/2#
ball)
3 Dir hip kicks w/Tband on uninvolved (3x10)
– 97010 (ice) x 15 min (untimed-use only once/visit)
Total 1-on-1 time = 25 min
Total treatment time (timed + untimed) = 40 min
Documenting the time required to perform each
individual exercise is NOT mandatory
34
35. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
Can I code for treatment during an evaluation?
– YES, Documentation is the critical component
– For example, if you evaluated a low back pain
patient, you can code 97001 (eval) and then
97110 (10 minutes of therapeutic exercise
instruction…if you instruct the patient and have
them demonstrate proficiency in the same visit).
35
36. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues (Q&A)
Why would we use assisted exercises for ROM
(97110) with PT neuromuscular re-education
(97112)?
– 97110
Exercises
to develop strength, endurance, ROM, and
flexibility
–
97112
Activities
to facilitate re-education of movement, balance,
coordination, kinesthetic sense, posture, and
proprioception
Ankle rehab to restore ROM (97110) and Single leg
standing on a foam pad +/- Rebounder (97112)
As of:
36
37. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
Orthotics and Prosthetics
97760-97762 replaced codes 97504/97520/97703 in 2006
– AMA says: “Orthotic management (97760) includes
assessing the patient; determine the most appropriate
orthotic (e.g., Static vs. dynamic); and designing, selecting,
and fabricating the orthotic.”
– “Also includes further orthotic training during follow-up visits
including exercises performed in the orthotic, instruction in
skin care, and orthotic wearing time.”
Extracted from APTA publication
– Physical Therapy Reimbursement News
– Volume 13, Number 2 (March/April 2006)
Do not use with HCPCS Level II codes (L- and K-section) if in
the description the assessment and fabrication is listed.
37
38. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
Can we use 97530? How is this different form 97110?
– Yes
– Therapeutic exercise (97110)
Includes activities related to strengthening, endurance training,
ROM, and flexibility. These activities can include use of free
weights, exercise machines such as treadmills or ergometers,
and AROM/PROM
– Therapeutic activities (97530)
Utilize dynamic activities to improve functional performance.
Think of this as the “-ing” code, for example “lifting,” “pulling,”
“pushing,” “running,” and “jumping.” If you are providing
instruction in activities related to an actual activity, then the
therapeutic activity code would be appropriate.
Reimbursement, Coding, and Compliance for Physical Therapists
The ABCs of CPT Coding, By Rhea Cohn, PT, MA // APTA Web site
38
39. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Direct Access – Initial Evaluation (situations requiring E
code)
Requirement for E-Codes (2.2.9)
If performing DIRECT ACCESS and this is the first time
the patient has been seen at the MTF for the current injury
(due to external causes) E 800-999 & V71.3 – V71.6 Used
to describe where, why, & how injury occurred
– Coding
724.2 Low
back pain
Exxx.x injury due to fall from ladder
–
Documentation
Should
include DOI, location, if MVA related (state) or if work
related (name of employer)
As of:
39
40. 2010 UBO/UBU Conference
Turning Knowledge Into Action
V Codes
Use V-codes when the initial treatment of a disease or injury has
been completed (via surgical or wound healing), but requires
continued care during the healing phase or long term consequences
of the condition/disease
Aftercare Codes for Injury/Fractures
–
V53.7
V54.89
V54.81
V58.78
–
V67.89
–
–
–
As of:
PT Coding Issues
Orthopedic device fitting and adjustment
Aftercare for healing fracture (NOS)
Aftercare following joint replacement
Aftercare following surgery of the
musculoskeletal system (NEC)
Follow up visit after all treatment is complete and
patient no longer has diagnosis/problem for which
they sought care
40
41. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Patient Education
Capture patient education…which is critical component
is under the one-on-one codes
– 97110
– 97112
– Etc…based on what you are teaching
– Key is to document what was covered
41
42. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues
Group Therapy - 97150
Area of significant controversy
Key issues
– PT/OT services provided simultaneously to two or
more individuals by a practitioner as group therapy.
The individuals can be, but need not be performing the
same activity. The PT/OT or PM Tech involved in the
group therapy must be in constant attendance
[providing feedback/actively involved], but one-on-one
contact is not required.
PM Technician codes = 97150
42
43. 2010 UBO/UBU Conference
Turning Knowledge Into Action
As of:
PT Coding Issues (Scenario)
Patient is a “regular”
She grabs her flow sheet and begins exercising
independently (Bike x 10 min; Hamstring Curls 3 x 15; Leg
Press 3 x 15; Fitter x 10 min) in gym.
The PM tech is working with another patient across the
room.
Patient finishes the treatment and asks the tech for some
ice.
Independent exercise in the clinic is NOT a “skilled
service” and cannot be billed/coded
PM Technician codes = 97010 (1 unit)…THAT’S IT!
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44. 2010 UBO/UBU Conference
Turning Knowledge Into Action
PT Coding Issues
Why can’t I get more than 4 CPT codes…& they’re
missing my units of service?
Problems with SADR
Unable to capture the following:
– Units of service
– Modifiers
– Any CPT or ICD-9 beyond four
CAPER is coming soon to an MTF near you…
44
This and the next slide are some common acronyms…definitely not an all inclusive list
From the PT Bulletin APTA;
Q: How can I bill for patient education?A: The time spent providing patient education is billable time although there is not one specific CPT code for "patient education." APTA recommends that you determine your desired outcome of care related to that education. For example, if you are instructing the patient in a home program of strengthening exercises for the quadriceps, that time can be billed under 97110, therapeutic exercise. If your instruction is related to ergonomic issues in the workplace, the time can be billed under 97537, community/work reintegration training.
By definition, this type of training should be provided in a more real life situation…for example having a simulated kitchen, etc.
Plinth is a base for a column, or support
We’ve had questions regarding a tech performing this service without a therapists plan of care. A plan of care could come as a prescription from a surgeon getting ready to do knee surgery on the patient, or it could come from the patient’s PCM…not always an official POC from a therapist.
This diagnosis code is usually in the top three to five most utilized every month. We perform a lot of physical therapy, which makes this so important to understand and ensure the documentation is adequate which hopefully will help the coding to be more accurate.
Our DoD “incident to” is not the same as CMS/Medicare rules. Our PT, OT, orthotic and Nutrition techs do have count workload so the rules for these techs are not the same as in the rest of the clinics.
Code 97001, Physical therapy evaluation, would be reported for the comprehensive evaluation performed at the first visit. This code is not a time-based code and should be reported once per episode, regardless of how many body parts are involved.
CMS says (Pub 100-02) it’s okay to treat under two separate plans of care (evaluations) on the same day for different problems as long as there are two referrals or requests from different providers. There must be two separate plans of care if this occurs
The intent of a reevaluation is to assess progress and modify or redirect future interventions. May have consecutive re-evaluations if referred for multiple problems and unable to complete in one evaluation
First bullet…whether timed or not, documentation must support each modality or therapeutic procedure. Group therapy documented needs to be coded as group therapy, even if patients are not performing the same exercise…example: three people attending group aquatic therapy, 1 may exercise shoulder, one knee, and one ankle.
First indented bullet…for instance: 10 minutes of unattended e-stim, 20 minutes of aquatic exercises. Total time 40 minutes.
Last bullet…example: 4 minutes of US and e-stim for 3
REMEMBER: document those therapeutic procedures (we’ve got exercises and neuromuscular education) and hot/cold packs
Performed by the PT only
Performed by the PT, not techs
MNT = Medical Nutrition Therapy
MTMS = Medication Therapy Management Services
DOCUMENT!!
Reimbursement, Coding, and Compliance for Physical Therapists
The ABCs of CPT Coding
Documenting in the record doesn’t count for the time in the timed codes.
Documentation must support the service provided.
Total time documented performing the modality
Therapeutic Exercises
My caveat to the last bullet is that even time doesn’t have to be documented for each exercise, documentation still needs to describe what happened-exercises prescribed to patient…with total treatment time
The diagnosis for this would only be the condition the patient was being evaluated for.
For those PT clinics that are direct access, meaning the patient see the PT as a provider in a clinical setting
This is to say…when teaching/educating on a procedure for instance to teach the patient home exercises
Not sure what PM tech is??? Physical Medicine, Preventive Medicine,
CAPER = Comprehensive Ambulatory Professional Encounter Record