Blog Archives | PT Management

Occupational Therapy Webinars

Supervised Exercise Therapy Approved for Medicare Patients with PAD

September 13, 2017
|
Comments off
|

Supervised Exercise Therapy Approved for Medicare Patients with PAD, Medicare Guidelines For Physical Therapy

 

CMS has recently concluded that supervised exercise therapy improves health outcomes for Medicare patients with intermittent claudication due to peripheral artery disease (PAD) and the this exercise therapy is at least […]

Read more

Medicare Therapy Cap and Therapy Cap Exceptions for 2017

August 7, 2017
|
Comments off
|

As we approach the latter months of this year, this is a reminder of how the Medicare therapy cap rules apply during 2017.

 

Regular Medicare Therapy Cap.  The annual Medicare therapy cap is $1,980 for 2017.  As in past years, the cap for physical and speech […]

Read more

Medicare’s Orthotic Documentation Requirements

July 10, 2017
|
Comments off
|

June 2017

CMS has very specific documentation requirements that apply to typical off-the-shelf and custom orthotics and other “DME” supplied by orthopaedic groups and hand therapy practices. DME carriers are auditing claims and specifically requesting this documentation.

Whenever a Medicare provider supplies and bills for DMEPOS […]

Read more
Ancillary Health Care

THE STARK EXCEPTION FOR ANCILLARY PHYSICAL THERAPY AND OTHER ANCILLARY SERVICES

June 30, 2017
|
Comments off
|

The following is a detailed explanation of the “in-office ancillary services” exception in the Stark Rules.

 

Statutory Background

Section 1877 of the Social Security Act, which is commonly referred to as the “Stark Rules,” was enacted in 1989.  As originally enacted, the Stark Rules […]

Read more
Rehab Management Support

North Carolina Medicaid Visit Limitations for Patients Over 20

June 28, 2017
|
Comments off
|

DMA Clinical Coverage Policy No: 10A (amended 6/1/2017)

 

Medicaid patients who are over 20 have visit limits that are listed below. All visit limits refer to combined PT, OT, and ST visits from all therapy providers in any outpatient setting, including hospital outpatient […]

Read more

March 22, 2017 Webinar Attendee Questions and Answers

April 10, 2017
|
Comments off
|

Should we avoid using medical terminology abbreviations?

The use of abbreviations is certainly acceptable and a practice that we use to save time because our brains work faster than our hands. A “best practice” recommendation is for each clinic to compile a list of “approved” abbreviations […]

Read more

Problem with CCI Edits and New PT/OT Evaluation Codes

February 2, 2017
|
Comments off
|

We have been made aware that there is an issue with the NCCI edits related to the new therapy evaluation codes. If the code pairs below are billed on the same day, the code edits will generate an error indicating that these codes cannot be charged on the […]

Read more

Questions & Answers on the New Physical Therapy and Occupational Therapy Evaluation Codes

December 26, 2016
|
Comments off
|

QUESTION: What are the new physical therapy evaluation codes?

ANSWER: 97161 for a low complexity initial evaluation, 97162 for a moderate complexity initial evaluation, 97163 for a high complexity initial evaluation and 97164 for a re-evaluation.

QUESTION: What are the new […]

Read more

Dr. Tom Price-HHS Secretary

December 5, 2016
|
Comments off
|

Dr. Tom Price, who is an orthopaedic surgeon and Republican member of the U. S. House of Representatives, has been nominated to head the Department of Health & Human Services (HHS) which includes CMS.

If confirmed, Dr. Price will be the first orthopaedic surgeon to head HHS and […]

Read more
OT Staffing

Use of 97112 for a Non-Neuro Diagnosis

October 26, 2016
|
Comments off
|

Lately, there have been some concerns about potential denials for using neuromuscular reeducation (97112) for a non-neuro dx.

Some payers are looking for a neuro diagnosis when 97112 is charged because it makes the connection simple. If you use 97112 for treating a […]

Read more