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Eli's Rehab Report

New Trigger Point, Athletic Evaluation Codes Introduced for 2002
CPT 2002 includes several important changes for PM&R practices, including new codes ... Read more
Changes Affect Fractures, Accidents and Dislocations
With the release of CMS Transmittal 01-91, PM&R practices will have to become accust... Read more
News Brief:
CCI Edits Bundle Some Anesthesia Procedures With Injections and E/M
CCI 7.3, which was released in October and affects claims billed through the end of 2001, ... Read more
Reader Question:
Inpatient Spinal Injury Evaluation
Question: What kind of diagnosis code should I use for a spinal cord injury admitted as an... Read more
Reader Question:
Family Conference
Question: When our physiatrists intend to recommend or transfer a patient to a nursing fac... Read more
Reader Question:
J Codes With No Dosage Descriptors
Question: How should we bill pharmaceutical J codes whose long descriptors either do not i... Read more
Reader Question:
Preventive Visit
Question: Our lead physician handles all of the coding in our PM&R practice, and I se... Read more
Reader Question:
Two X-Rays Performed by Different Practitioners
Question: In our facility, the radiologist usually performs all x-rays and interprets the... Read more
You Be the Coder:
Medial Epicondyle Injection
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Avoid Spasticity Claim Denials by Being Familiar With Specific Conditions
PM&R practices are often puzzled by denials for spasticity assessments after... Read more
Manual, Mechanical Traction:
How To Differentiate Between the Codes
Many physiatrists and therapists routinely use traction on their patients, particularl... Read more
Reader Question:
Nerve Conduction Studies
Question: We billed for our first nerve conduction study recently, and only received $311 ... Read more
Reader Question:
Red Flags on Modifier -25?
Question: We've been told that it's difficult to get paid for a trigger point injection a... Read more
Reader Question:
Physician Assistant Orders PT
Question: We employ a physician assistant (PA) who normally sees patients who are returni... Read more
Reader Question:
Sleep Studies by Symptoms
Question: If a sleep study fails to confirm a suspected diagnosis, which diagnosis code sh... Read more
Reader Question:
Inpatient Consult, Rehab Admit Same Day
Question: Your May issue had a reader question on  billing for an inpatient hospital... Read more
Reader Question:
Medical Necessity for DME
Question: I am a physiatrist and I work closely with physical and occupational therapists... Read more
You Be the Coder:
Therapy Re-Evaluation and Modality on the Same Day
Test your coding knowledge.  Determine how you would code this situation before ... Read more
Keep Cool When Coding for Burn Rehabilitation Services
More than 2 million burns occur in the United States each year, over 100,000 of which re... Read more
New Codes, Modifiers:
Payment Methods Increase for Noncovered Services
Many PM&R practices that offer medical nutrition therapy to patients who are easing ... Read more
Reader Question:
Do Therapy Evaluations Require -25?
Question: I was told last fall to use modifier -25 with 97001 through CPT 97004 PT and ... Read more
Reader Question:
Therapeutic Activities and Exercises
Question: Can codes CPT 97530 and CPT 97110 be billed on the same day? Someone told me t... Read more
Reader Question:
Diagnosis Code for Inability To Sit
Question: The physiatrist wrote a diagnosis on a patients chart for patient unable to si... Read more
Reader Question:
Coding for a Postsurgical Visit
Question: One of our patients closed her car door on her hand. She went to the urgent-care... Read more
Reader Question:
J Codes for Corticosteroids
Question: Is there a J code for Depo-Medrol? I recently heard that corticosteroids are r... Read more
Reader Question:
V Code and Therapy
Question: When billing for speech, OT, or PT, and the notes dont reflect a diagnosis, can ... Read more
Reader Question:
Craniosacral Therapy Code
Question: A therapist reported craniosacral therapy on her form. How should we code this?C... Read more
You Be the Coder:
Bad Ragaz Is It Aquatic Therapy?
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Successfully Code Treatment of Pediatric Patients
PM&R practices and clinics often treat pediatric patients for conditions such as cer... Read more
Avoid Undercoding:
Billing for High-Level, Single-System E/M Services
Most physiatrists rely on single-system examinations for their E/M services&nb... Read more
News Brief:
CCI 7.2 Bundles Modalities With PT, OT Home Visits
Effective July 1, 2001, the services of a physical therapist (PT) or an occupational the... Read more
Reader Question:
Code G0180
Question: What is the proper use of G0180? Must the physiatrist always follow the home-hea... Read more
Reader Question:
Lymphatic Drainage Therapy
Question: One of our occupational therapists went to a seminar where she was told to bill ... Read more
Reader Question:
Coding for Fitness Physicals
Question: I perform many fitness physicals, and I write exercise prescriptions and order h... Read more
You Be the Coder:
Facet Joint Injections: One Level or Two?
Test your coding knowledge.  Determine how you would code this situation before loo... Read more
Medicare is Selective About Screening Tests and Procedures for Osteoporosis Patients
The American Academy of Physical Medicine and Rehabilitation estimates... Read more
Use Therapy Codes for Pulmonary Rehabilitation, Not Cardiac
Over 15 percent of patients seeing rehabilitation physicians suffer from cardiac or pu... Read more
News Alert:
Medicare Begins to Accept Preoperative Exams
Physiatrists who perform preoperative exams for patients undergoing hip replacements, ... Read more
Reader Question:
Arthritis with Underlying Cause
Question: How should I code for arthritis if an underlying cause is indicated (in this cas... Read more
Reader Question:
Gait Training
Question: Our therapist did not note the amount of time she spent with a patient, but on ... Read more
Reader Question:
Diagnosis for FOP
Question: I received a chart with a diagnosis for "FOP," which is a bone disease, but I c... Read more
Reader Question:
Clicking Hands
Question: One of our patients presented because her hand "clicks" when she moves her fi... Read more
Reader Question:
Orthotics
Question: Can we bill 97703 for orthotic checkout and 97504 for the fitting and training... Read more
Reader Question:
Therapy Bundling
Question: I am having difficulty with CPT 97530 being bundled with an E/M service. The ... Read more
Reader Question:
Surface EMGs
Question: What is the code for surface EMG? One of our physiatrists performs this for move... Read more
Reader Question:
Bilateral Bursitis
Question: I understand that using multiple modifiers can delay payment, but right and lef... Read more
Reader Question:
Use of Hospitals EMG Equipment
Question: I moved to a new office and don't have my EMG machine set up, so I have patient... Read more
You Be the Coder:
Policemans Disease
Test your coding knowledge.  Determine how you would code this situation before l... Read more
Match Therapy to Nearest Modality For Procedures that Lack CPT Codes
PM&R medicine is changing so quickly that CPT Codes is unable to keep up with the ad... Read more
Improve Pay Up for Pain Management Injections
Pain management injections such as nerve blocks, trigger point and facet joint are being p... Read more
News Brief! PM&R Practices Should Prepare for New ABN
Physiatrists and therapists who use advance beneficiary notices (ABNs) for services that ... Read more
News Brief:
New Requirements for Diagnostic Tests and Therapy Students
Two separate program memoranda released in April demonstrate HCFAs supervision requirement... Read more
Reader Question:
Group Therapy, Different Diagnoses
Question: If we see several patients with different diagnoses during group therapy (CPT 97... Read more
Reader Question:
NP Performing Trigger Point Injection
Question: We hired a nurse practitioner (NP) and arent sure if she can bill for performing... Read more
Reader Question:
After Hours Codes
Question: We maintain an after hours clinic for our rehabilitation patients experiencing p... Read more
Reader Question:
Training Patients on Crutch Usage
Question: We frequently teach our patients how to use crutches when they are recovering f... Read more
Reader Question:
Multiple Procedures
Question: Should I use modifier -51 when performing trigger point injections (CPT 20550 ) ... Read more
Reader Question:
Using Hospitals EMG Machine
Question: I use the EMG machine at a hospital. Do I have to add the modifier -26 to CPT 95... Read more
Reader Question:
Incident to Billing
Question: If a physiatrist sees a patient and writes the original order for treatment, b... Read more
You Be the Coder:
Patient Brings Own Medication for Injection
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Get Paid for Stroke Rehab Care Services by Speech-Language Pathologists
Kirk Douglas, Princess Margaret, Quincy Jones ... all of these celebrities have suffered s... Read more
Code Pain Diagnoses Appropriately to Avoid OIG Scrutiny
Physiatrists are known for their expertise in providing pain management services to patien... Read more
Correction:
Nerve Conduction Study Coding
The article Solutions to Nerve Conduction Study and EMG Coding Challenges in the May 2001 ... Read more
Reader Question:
Discontinued EMG
Question: If an electromyogram (EMG) is discontinued because a patient feels lightheaded, ... Read more
Reader Question:
Billing Water Therapies as Manual Therapy
Question: The April issue of Physical Medicine and Rehab Coding Alert stated that most pay... Read more
Reader Question:
Problem Found During Well Visit
Question: We know that Medicare does not pay for well visits (preventive medicine), but wh... Read more
Reader Question:
Therapy Re-evaluation
Question: We have never used the physical therapy re-evaluation code. What does it entail?... Read more
Reader Question:
Hip Injection
Question: A bursa injection to an osteoarthritis patients hip was performed by a physician... Read more
Reader Question:
Sacroiliac Joint Injections
Question: I need help with developing a charge for CPT 27096 . Our physiatrist believes th... Read more
You Be the Coder:
Medical Student Coverage
Question: We rotate medical students through our rehabilitation center each week, becaus... Read more
Coordinating Care Is Key When Coding Therapy for Prosthetics Patients
Because treating amputees involves numerous medical caregivers, some coders are confused a... Read more
Include Mini-mental Exams in E/M Service To Avoid Improper Billing
Physical medicine and rehabilitation practices that frequently perform mini-mental statu... Read more
News Brief:
CCI 7.1 Bundles Range-Of-Motion Measurements, Muscle Testing With E/M
Effective April 1, 2001, muscle-testing codes 95831-95834 and range-of-motion measurement ... Read more
Reader Question:
Coding for Aircast
Question: What is the correct code for setting up an aircast for a patient with a sprained... Read more
Reader Question:
Two Hospital Visits, Same Day
Question: The physiatrist I work for visited a stroke patient in the neurological unit of ... Read more
Reader Question:
Multiple Injuries
Question: I treated a patient for a left hand sprain and right hand injury, which were inj... Read more
Reader Question:
Anesthetic Injections
Question: We are having trouble getting paid for Marcaine when used as an injected local a... Read more
Reader Question:
Injections Given By Nurse
Question: When our nurse gives injections to patients, we normally bill CPT 99211 (office... Read more
Reader Question:
No-trauma Auto Accidents
Question: One of our patients, who is in rehabilitation from a stroke, was in a car accid... Read more
You Be the Coder:
Range-of-Motion Tests
Question: Is it permissible to bill two units of CPT 95851 when two different extremities... Read more
How to Avoid Common Mistakes When Billing For Water Modalities and Fluidotherapy
Although physiatrists and therapists embrace the virtues of water modalities such as whirl... Read more
Solutions to Nerve Conduction Study and EMG Coding Challenges
Many physiatrists face big coding problems when billing for nerve conduction studies (NC... Read more
Reader Question:
Combination of Therapy Codes
Question: When we bill an E/M code with CPT 97014 and 97124 for workers compensation or a... Read more
Reader Question:
Unexplained High Blood Pressure
Question: We had a new patient come in suspecting that he was suffering from carpal tunnel... Read more
Reader Question:
Ice and Heat on the Same Injury
Question: A patient came in with an injured foot, and the physiatrist gave the patient an ... Read more
Reader Question:
OK to Bill Massage As 97140?
Question: We frequently get denials for 97124 for massage. Is it OK to bill some insurers ... Read more
Reader Question:
Physical Performance Tests
Question: The physical performance test code (97750 ) seems very broad. Can you please tel... Read more
Reader Question:
Translating PT Services Into CPT Codes
Question: How do I bill when the medical record reads as follows: mass. to L-leg 8 min., u... Read more
You Be the Coder:
Injection Under Anesthesia
Question: How do I code a fluoroscopic injection of cortisone into the hip joint for a pat... Read more
Get Paid for Hip Replacement Rehabilitation
Earlier this year, just weeks before his 90th birthday, former President Reagan fell and b... Read more
New Botox Coding Opens Door to Added Reimbursement
"Botulinum Toxin Type A (botox) is being employed more often to treat patients whose pain ... Read more
HCFA Suspends Significant Portion of CCI 6.3
CFA has temporarily suspended version 6.3 of the national Correct Coding Initiative (CCI... Read more
Clarification
In the January 2001 Physical Medicine & Rehab Coding Alert, the reader question Billing PT... Read more
Reader Question:
Teaching Physiatrist and H-reflex
Question: If a teaching physiatrist writes, seen and examined by me, H-reflex by me, can ... Read more
Reader Question:
Factor Time With Wound Care
Question: How should we bill for a visit that involves simple wound care when no debrideme... Read more
Reader Question:
On-call Physiatrist
Question: If our physiatrist is on call for another group and he sees a patient for the fi... Read more
Reader Question:
HCPCS Codes Billed to DME Provider
Question: I know that any codes beginning with E or L must be billed by a durable medical ... Read more
You Be the Coder:
EMG Full Limb vs. Limited Study
Question: How can I tell whether to bill a full limb or a limited study electromyography (... Read more
Clear Up Coding Confusion for Nursing Facility Assessments for Rehab Patients
Comprehensive nursing facility assessments (99301-99303) can confound even the most exper... Read more
Medical Necessity Is Key to Reimbursement for DME Supplies
Physiatrists and therapists often dispense durable medical equipment (DME), prosthetics, o... Read more
HCFA Alert:
Discontinue Use of The New Modifier -60
The December 2000 Physical Medicine & Rehab Coding Alert article CPT Codes 2001 Code... Read more
Reader Question:
Failed Back Syndrome
Question: Our physiatrist just started seeing a new patient who didnt respond to back sur... Read more
Reader Question:
Modifier for EMG Services?
Question: When 95867 is used in combination with CPT 95860 or CPT 95861 , should a modifi... Read more
Reader Question:
Frequency Guidelines for Fluoroscopy
Question: If there is more than one injection site, such as in facet blocks (64470-64476) ... Read more
Reader Question:
Injection and X-ray
Question: Ive been told that if a trigger point injection (CPT 20550 ) and x-ray of the sp... Read more
Reader Question:
Nerve Conduction Studies
Question: Weve been receiving denials for tests such as nerve conduction studies (NCS) a... Read more
You Be the Coder:
Disposable Stim Pads
Question: If we use one-time disposable stim pads in the office, would this be billed to i... Read more
Clinical Examples Can Help Clarify New Cognitive Skills Development Code
As reported in the December 2000 Physical Medicine & Rehab Coding Alert, a new CPT code fo... Read more
Therapists Using Sensory Integrative Techniques Benefit From New Code
When CPT 2001 deleted code 97770, the two codes that were formed from it, 97532 (developme... Read more
Billing for DOs:
E/M Is Not Included in OMT Codes
Because osteopathic physicians (DOs, or osteopaths) are fully licensed physicians who oper... Read more
Correction:
ADL Training
In the November 2000 Physical Medicine & Rehab Coding Alert, the reader question Billing O... Read more
Reader Question:
Acute Injuries
Question: My Medicare carrier does not allow reim-bursement for electromyogram (EMG) test... Read more
Reader Question:
Examination Guidelines
Question: Once the initial history and review of systems portions of an evaluation and ma... Read more
Reader Question:
Billing PT Services Incident to
Question: Our practice has one physiatrist and three physical therapists (PT), and we now ... Read more
Reader Question:
Chronic Conditions
Question: Generally, I see a patient before referring him or her, but if the patient has a... Read more
You Be the Coder:
Greater Occipital Neuralgia
Question: My physician uses the diagnosis greater occipital neuralgia quite often, and I... Read more
Available Years:  2001  2000