As we start the new year, we’re all looking for ways to continue to grow and develop our business. How well were you goals from last year achieved? And when setting goals for this year, will your goals cost you or will it pay in the long term?
Here are five investments that clinics working with coach Erika Trimble are planning to make in their practice this year:
Beginning January 1, 2017, there will be eight new CPT codes that physical therapist and occupational therapists will be required to use. These codes, 97161-97168, will be replacing codes 97001, 97002, 97003, and 97004.
Medicare and all private payers are requiring this change effective January 1, 2017. The new codes will be used to reflect the level of complexity of each patient’s evaluation with three possible levels, low, moderate, and high. At present time, you will not receive higher payments based on complexity.
| Current CPT | Replaced by | ||
| 97001 | PT Eval | 97161 | Physical therapy evaluation: low complexity |
| 97162 | Physical therapy evaluation: moderate complexity | ||
| 97163 | Physical therapy evaluation: high complexity | ||
| 97003 | OT Eval | 97165 | Occupational therapy evaluation: low complexity |
| 97166 | Occupational therapy evaluation: moderate complexity | ||
| 97167 | Occupational therapy evaluation: high complexity | ||
| 97002 97004 | PT Re-eval OT Re-Eval | 97164 | Re-evaluation of physical therapy established plan of care requiring: An examination (including a review of history and use of standardized tests and measures) A revised plan of care (based on use of a standardized patient assessment instrument and/or measurable assessment of functional outcome) |
| 97168 | Re-evaluation of occupational therapy established plan of care requiring: An assessment of changes in patient functional or medical status, along with a revised plan of care An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals A revised plan of care (a formal re-evaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required) | ||
Along with the coding changes, CMS has increased the therapy cap to $1,980 for occupational and $1,980 for physical and speech-language therapy services combined.
BestPT has been updated to meet the changes put forth by CMS and the AMA. Before the end of the year, we suggest you add these new CPT codes to your fee schedule to avoid any disruption in your billing. If you’re unsure how to do this, please let us know and we are ready to help.
For more information:
A physician usually has a very good reason when they stop referring patients. A recent survey found that most physicians do NOT fully read their therapist reports. Communication, clarity, and customer feedback are critical components when it comes to maintaining your relationship with referring physicians. Erika hopes to help you avoid this possibility all together by discussing the three reasons why your reports aren’t being read:
See what bestPT has built for ICD-10 diagnosis codes so your practice will get paid in full and on-time. View this free webinar to see exactly how Physical Therapists can choose the correct ICD-10 codes. Comments so far have been extremely positive, “Very Intuitive” and “Easy to Use.” If you’re not already our client, then schedule a free demo.
See what bestPT has built for ICD-10 for your physical therapy practice to get paid in full and on-time. View this free webinar to see exactly how physical therapists can use these macros and also customize them. Comments so far have been positive, “Very Intuitive” and “Easy to Use.” If you’re not already our client, then schedule a free demo.
My name is Dr. Scott Levine, and like you, home exercises are essential part of our patients getting better. Four years ago, I struggled to get my patients to do their exercises. I would hand a patient an exercise sheet and demonstrate the exercises. Eventually, however, after many follow-ups, I realized that many of my patients were getting poor results because they were not doing the exercises on their own, or not doing them properly.
At the time, available exercise videos were limited and of poor quality, so I started to build a software product to help my clients. The result is MyRxX.com – an exercise video delivery service designed to help therapists and their patients.
MyRxX.com is much more than a video-exercise delivery site. It also functions as a marketing, communications and lead generation site. Each exercise is based on functional strengthening. My background has been specializing in muscle testing and Kinesiology. I created a 12 hour CE course in CE4you.com to teach those interested in how to test all the muscles for weakness. Prescribing the appropriate exercise was an important extension.
Imagine the next time you are introduced to someone, and after they hear you are a Physiotherapist, they start to complain about neck pain. Now you can offer a free video exercise program to help improve the musculoskeletal (MSK) complaints of the participants. I can assure you that the majority will decide to come see you after your gift of exercises. Further their interaction is with all your information surrounding the videos.
This software can help you quickly and simply manage these leads by tracking activity and sending messages to the group. Instead of giving your business card to potential patients, you provide them with exercises through the site. As they follow their exercises online, they are also viewing your clinic information so they know how to reach you for further help. This patient portal becomes an extension to your brand, location and online presence.
The patient portal has a separate patient site called VideoExercises.com which allows them to view their program on any mobile device. In a marketing and communications capacity, the site allows you to upload your own clinic videos. Think of the possibilities – videos like “Welcome to the Clinic,” “Why Ultrasound,” or introducing yourself to potential clients. Better than youtube, because of the virtual wall that keeps them focused on only your prescribed health videos.
Additionally, the Physio-Portal gives quick optics on patient engagement which allows you to monitor your patients’ compliance with the recommended exercises or clinic health videos. I have found that my patients are even more motivated to do their exercises now because they know that I am tracking their progress and keeping them accountable. Imagine your patient comes in and tells you their back pain has returned, instead of feeling the sole responsibility to getting them better, you can now check their engagement and address if they have not been keeping up with their core routine. This transfer has changed the responsibility to an equal partnership.
Physio-patient communication has never been easier or more secure with our 2-way messaging system that connects you and your patients. It is much more responsive than email, and the saved communications can become part of the patient files.
The biggest benefit of the website is its ability to provide high-quality, personalized and easily-accessible exercise programs which improve the quality of your patients’ lives by helping them manage and prevent the pain and disability associated with MSK weakness. Ongoing support and feedback, as well as the ability to access the exercises on their own time will empower your patients to stay active between visits and to have a more direct role in their own health.
This year we are integrating with your Vericle patient management software. This will allow you to click prescribe exercises right from the patients SOAP notes. A seamless, quick method to further your patient care without slowing you down.
For any questions about the MyRxX service, or for further information, please email me personally. I would be happy to connect with you and your team.
Scott Levine (Scott@myrxx.com)
| FEATURE | BENEFIT | BENEFIT OF BENEFIT |
| 2 Click Prescription | Fast | Save Time |
| White Labeled | Exercises are with your branding | Easy to contact, easy to refer |
| Drop down searching | No exercise Knowledge necessary | Accurate Doctor prescriptions |
| Views | See how many times your patient is exercising. | Able to motivate and create accountability with your patient. |
| Leads | Keeps potential patients separate from patient list. Allows for 1-click prescription to large groups of patients. (ie. Giving a running group stretches) | We recommend giving exercises to everyone you meet. It becomes your electronic business card. |
| Messaging | 2-way communication between you and your patients | Keeps you and you patient connected. Patient feels taken care of even when they are not in your office. |
| Progressions (upto 7 levels) | Help patients rehab and get stronger | Easy to choose the next exercise by searching for the next level |
| Customizable | Allows you to create your own programs | Create programs that work for your patient demographic, or simply name the exercise after your clinic. |
| Patient Mobile | Patient sees exercises on phone, tablet. | Exercise anywhere. |
| Doctor Mobile | Send exercises from your phone | Treat from anywhere. |
| 1 License for a clinic of doctors & therapists | Unified look for the clinic, split fee | Low cost |
| Daily Living Videos | Self -searchable videos of ADL | Help prevent injuries |
| Motivational Email | Patient is reminded of your recommendations | Patient is more likely to exercise. |
| Functional Exercises | Rehab based that are real world | Patient gets better with no injuries |
| Transfer to Chiropractic Assistant | Manager can Rx exercises on behalf of the doctors | Now you pass a note and move on. |
| All Workouts created by all doctors are shared and available to everyone | Everyone contributes to the rapid organic growth of the workout library | Learn from others with greater expertise. |
The notion that change is inevitable is contrived but true. If at any point health care ceases to change, then we should all be worried, because if there is no change, inevitably there is no growth. The other side of this coin is the notion that change itself produces worry and confusion.
The climate of health care in the United States has been forever changed and, come what may, it will not go back to what it was. Almost in tandem we are all preparing for the global health care change from the current International Classification of Diseases (ICD)-9 to the monolithic ICD-10 coding system. There is no need to enter a sympathetic nervous system frenzy as long as you are educated on what to expect and have an electronic medical record system that will support your business and transfer to the ICD-10 system in real time.
If you visit the government site http://www.cms.gov/Medicare/coding/ICD10/index.html, you will be instantly greeted with a ticking countdown to the October 1, 2015 ICD-10 compliance deadline. Those who are paying attention recognize that the initial set date for implementation was October 1, 2013. As if awaiting a rapidly approaching train in a station, we scrambled in attempts to prepare staff, billing systems, patient’s, anyone involved in implementation or reception of health care.
ICD-10 coding compliance pertains to any healthcare provider covered by the Health Insurance Portability Accountability Act.1 This of course includes physical therapists, many which are concerned about the cost surrounding updating their technology and training staff. The center for Medicare and Medicaid services (CMS) has created an online module titled The road to 10 available at: http://www.roadto10.org/. Within this site one may find tips for implementation for small practice. A five step plan is provided in effort to guide practitioners to preparation complete with a printable checklist.
The Road to 10 plan includes steps such as “updating your process” which pertains to analyzing company policies and procedures, and analyzing the quality of documentation supplied by staff. The next step is the elephant in the room for most clinics. This involves engaging with partners and vendors and includes recommendations for technology staff.
The CMS recommends ensuring that your electronic medical record vendor has updated their software and is compliant with all codes updated. A key question to ask is whether or not the version of EMR that you are engaging in has 5010 capability. This will indicate whether or not you are able to submit your diagnostic coding to third party payers3. This is also where grumblings from clinicians who have held out with paper charting may be heard echoing through the canyons.
At this point physical therapists have not been mandated to switch to electronic medical records (EMR), however all of our peers have, including family practice doctors, podiatrists, and chiropractors. It is speculated that this may influence referral patterns to physical therapists from referral sources who do not have the capability to send and receive paper charting from those physical therapists who have declined to engage in EMR.
This may create further barriers for these clinicians when the ICD-10 changes come about as training billing and coding staff who operate on a paper based system may take time away from current clinic tasks, and may result in human errors that can be costly. In this regard, EMR can be an enormous asset to small physical therapy practitioners, and the ability to accurately code, and bill electronically can pay for itself quickly due to expedited and improved reimbursement from payers.
With the fear of change one may seek comfort in the fact that Current Procedural Terminology (CPT) codes will not change for the outpatient realm. What we will find when we receive or implement diagnostic coding under the new system is that the terminology is much lengthier and highly specified.
For example, instead of an ICD-9 code of 724.2 Lumbago, under ICD-10 coding the diagnostic term becomes M54.5 Low back pain due to intervertebral disc displacement, or perhaps M54.5 Low back pain due to pregnancy; the diagnostic code involves mechanism of injury and highly specified features of the low back pain (with or without radiculopathy, etcetera).
The American Physical Therapy Association (APTA) has many resources available to practitioners in anticipation of this change as well. Key practice Impacts of the ICD-10 upgrade, Webinars with suggestions for planning ahead, and an upcoming release of clinical examples of phsyical therapy specific coding are all available at: http://www.apta.org/Payment/Coding/ICD10/.4
In the end, the train that is ICD 10 coding is approaching us, and we must board in order to continue practicing physical therapy. Get yourself a map: The road to 10 by the CMS is a good one, and pack your comfortable shoes. In the end we choose our attitude, we can embrace and enjoy this trip with the right amount of preparation and protection from appropriately updated EMR as our insurance. bestPT EMR is ready for ICD 10 and staff is available to guide each individual practice in their implementation of our new coding system.
-Amanda Olson, DPT
13 New members joined bestPT in March 2015.
Each new member benefits from and contributes to our network strength.
Let’s welcome bestPT’s newest members!
5 Common Processing Mistakes You Can Check Right Now…
PHYSICAL THERAPY PRACTICE TO RETURN $634,837 UPON FAILING AN OIG AUDIT
In August 2014, the Office of Inspector General (OIG) released a report of the audit that had been conducted on an Illinois physical therapist. Their review sampled 100 random claims out of the 4,298 Medicare outpatient physical therapy services, totaling $645,966, that had been provided between January 1 and December 31, 2011.
The audit found that 99 of the 100 claims in their random sample contained more than one deficiency. Therefore the government extrapolated the failure rate from the sample and applied it to the entire paid claim population. They are now seeking a refund of $634,837. In other words, the government does not seek a refund for the 100 claims survey but rather for all the claims submitted assuming that they have the same error rate.
Moreover, these sample claims were subjected to a very high level of scrutiny. The report details the deficiencies as follows:
To review the full OIG report go to http://oig.hhs.gov/oas/reports/region5/51300010.pdf.
To improve your chances of surviving an OIG audit, make sure to clearly establish medical necessity, prove that skilled therapy services are performed, and that those services are both reasonable and necessary. Studying physical therapy billing examples, expert guidance, and periodic self-audits in tandem with an automated professionally built and ONC-certified documentation system will help you achieve this goal effectively and efficiently.
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bestPT by Billing Dynamix:
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2 Hudson Street
Marlboro, NJ 07746
(727) 386-9497
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