Physical Therapy Futurology

by Hannah Mullaney, SPT


Me: “What kind of exercise should I do?”

Also me: “Mmmm, it’s too complicated.”

“But I know it’s important for me.”

“Probably costs lots of money. I don’t know.”

“Just do anything, some push ups, planks, squats, jumping jacks!”

“Oh look, I’m out of time.”

These internal conversations abound when it comes to exercise. It is easy to become frustrated and overwhelmed. And the question often begins with, “what kind of exercise do I do?”

The simple answer is this: whatever you will actually do!

Strengthening the heart, building up the bones, balancing the chemicals messengers of the body and brain – a few of the direct benefits of exercise – these powerful outcomes blossom for doing things that challenge and move the body. Every person has distinct and individual interests, and effective, sustainable exercise training comes from doing something that matches someone’s interests with movement.

Guidelines start simple – move more! Take the stairs, park far away, stand on one leg while talking of the phone. But many people want to take that next step. Once people have experienced the relief of finishing a workout, the satisfaction of pushing their limits, or the sense of calm from endorphin release, they are ready for more. Officially, adults are recommended to do moderate to vigorous physical activity for 30-60 minutes, 5 days a week (HHS.gov).

At this point, the options may feel endless – gym membership, Zumba classes, rock climbing, running, biking, swimming, weight lifting, team sports league, golf….the list goes on an on. The volume of opportunities can be overwhelming. Some of these options are more expensive than others, and people need to think about their priorities and budget. Sometimes there are forms of exercise that may be easily overlooked, like roller blading, coaching a child’s soccer team, fishing (especially fishing someplace that can only be reached by hiking), a quick 10 minute circuit of squats, pushups, and planks, and dancing.

All of these things are valid forms of exercise. The trick is to pick something that is fun and interesting and puts a smile on the exerciser’s face.

“I HATE running!” Common sentiment. Solution…don’t run! Yes, it’s important to push oneself past the comfort zone, but, if it really is such a drag, maybe find something that is more interesting. Would running or biking to the movies to meet with friends make a difference? (Then, don’t eat the entire bag of popcorn.) Maybe if running doesn’t jive well, what about dancing? What about 3 v 3 basketball games on lunch break? All of these activities will still increase the heart rate and help make the body happy and healthy.

People talk about SMART goals, and someone who is motivated to move their body more can use these techniques to make their own game-plan. Here is the breakdown of moving more SMART-ly, using the example of someone who wants to swim 800 meters on an upcoming triathlon relay. For this individual, their spouse is doing running while another friend is doing the biking.

 

Specific – set a narrow goal. “I will go to West Side Pool.

Measurable – set a goal with something concrete to measure. “I will go to West Side Pool for 45 minutes.”

Achievable – set at goal that can actually be reached. “I will go to West Side Pool for 45 minutes on Wednesday and Friday afternoons, when I have a shorter work day. Also, I own goggles and know a little bit about swimming, so this is a realistic goal.”

Relevant – set a goal that matters to you personally. In this example, the individual is doing swimming, so swimming is the relevant activity.

Time-based – set a goal that has a clear start and end time. “The triathlon is in 6 weeks.”

 

Therefore, the whole goal is would look like this. “In order to prepared for my part of the triathlon relay, I will go to West Side Pool for 45 minutes on Wednesday and Friday afternoons for the next 6 weeks in order to swim 800 meters without stopping.”

Finally, accountability takes goal-making to goal-attaining. If someone is asking us how we are doing, bugging us about going to the gym, waiting for us at the trailhead at 7am, or trying to workout 5 days a week with us, we are that much more likely to follow through with our good intentions. In the example above, perhaps the spouse can run while the swimmer does laps.

Therefore, if you are thinking about exercising more, my encouragement is to dive right in! Find something enjoyable that you actually want to do. Set a SMART goal. And, very importantly, ask someone to hold you accountable. No need to wait – let’s get moving today!

Physical Therapy Futurology

by Rachel Granzow, SPT

As “rehabilitation” professionals, physical therapists are often considered to be mechanics of sort. Something goes “wrong” with the body and, as a result, movement is impaired, and, often, there is pain.  A PT can improve how the body moves in a variety of ways and as a result, the pain improves.

This process — from symptom, to treatment, then relief — is the typical medical model of intervention. But I wouldn’t call this “health care.” It’s more like “sick care,” because people don’t seek the services of a PT until something is amiss. The job of the PT, in this paradigm, is to help set things right again, to “fix” patients.

At least that’s how things are now. But with medical costs rising along with rates of chronic disease, something has to change. The PT profession is poised in a prime position to make a significant contribution towards preventive care. That is, helping people improve their health BEFORE issues arise and, whenever possible, avoid problems altogether. Here are some ways that the future may look for PT.

Annual checkups

Much like you see a dentist, optometrist, or other specialist provider on a regular basis, you could see a PT for a yearly screening of your “movement system.” Doing so will identify ways to identify risk factors before they turn into major concerns. Having a “PT for life” allows higher quality of care if or when the need for PT arises. 

Click here to read more about annual checkups

On-going disease management

PTs can play a vital role on an interprofessional team for managing many of the most prevalent and costly conditions, including obesity, diabetes, and back pain. Choosing PT as the first-line treatment for these diseases saves money in the long run. As the experts in physical activity, PTs are the best providers to address many of the lifestyle factors that contribute to chronic health conditions.

Click here to read more about PT for pain management

With an aging population, there are increased risks for a variety of health concerns, such as frailty and falls. Improving how seniors are able to move and function in their day-to-day lives is well within the PT wheelhouse. As the “silver tsunami” of the Baby Boomer generation continues to enter this demographic, PTs can work to keep them healthy and active for as long as possible.

Click here to read more about falls

Prenatal and postpartum care

Did you know there’s a PT specialty that focuses on pelvic health? For pregnant women, enlisting a PT in the care team can help with both delivery and recovery after their babies are born. The period of time known as the “4th trimester” is a critical place where PTs can provide support and expertise to mothers. 

Click here to read more about exercise after pregnancy

To be clear, there are many PTs who already provide these services. But as the medical system evolves, demand will increase for this kind of approach. It’s an exciting time to be a PT!

The Five Best Investments You Can Make In Your Business This Year

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:

Reminder: Changes to CPT Code Guidelines for 2017

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 CPTReplaced by
97001PT Eval97161Physical therapy evaluation: low complexity
97162Physical therapy evaluation: moderate complexity
97163Physical therapy evaluation: high complexity
97003OT Eval97165Occupational therapy evaluation: low complexity
97166Occupational therapy evaluation: moderate complexity
97167Occupational therapy evaluation: high complexity
97002

97004

PT Re-eval

OT Re-Eval

97164Re-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)

97168Re-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:

APTA New Eval/Reeval CPT Codes/

APTA New Evaluation Codes Quick Guide

3 Steps to Losing a Referring Physician

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:

3 STeps to Losing a Referring Physician

ICD-10 Diagnosis Codes for physical therapy practices

ICD-10 Codes for Physical Therapy Practices

ICD-10 diagnosis codes in a step-by-step free webinar.

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.

ICD-10 Macros are available for Physical Therapists

ICD-10 Macros for Physical Therapy Practices

ICD-10 Macros Make Documentation Easy

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.

physical therapy billing software ICD-10 cartoon

ICD-10 for Physical Therapists is here!

See what bestPT has built for you to use ICD-10 to get paid in full and on-time by viewing this webinar.

See exactly how it works and then schedule a demo if you’re not already our client.

Comments so far on ICD-10 have been positive, “Very Intuitive” and “Easy to Use.”

 

physical therapy billing software that rocks!

MyRxX.com – Save Time, Help Lives

physical therapy billing integrated with MyRXX

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.

physical therapy billing integrated exercises

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.

physical therapy billing is integrated with MyRxX.com

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)

FEATUREBENEFITBENEFIT OF BENEFIT
2 Click PrescriptionFastSave Time
White LabeledExercises are with your brandingEasy to contact, easy to refer
Drop down searchingNo exercise Knowledge necessaryAccurate Doctor prescriptions
ViewsSee how many times your patient is exercising.Able to motivate and create accountability with your patient.
LeadsKeeps 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.
Messaging2-way communication between you and your patientsKeeps 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 strongerEasy to choose the next exercise by searching for the next level
CustomizableAllows you to create your own programsCreate programs that work for your patient demographic, or simply name the exercise after your clinic.
Patient MobilePatient sees exercises on phone, tablet.Exercise anywhere.
Doctor MobileSend exercises from your phoneTreat from anywhere.
1 License for a clinic of doctors & therapistsUnified look for the clinic, split feeLow cost
Daily Living VideosSelf -searchable videos of ADLHelp prevent injuries
Motivational EmailPatient is reminded of your recommendationsPatient is more likely to exercise.
Functional ExercisesRehab based that are real worldPatient gets better with no injuries
Transfer to Chiropractic AssistantManager can Rx exercises on behalf of the doctorsNow you pass a note and move on.
All Workouts created by all doctors are shared and available to everyoneEveryone contributes to the rapid organic growth of the workout libraryLearn from others with greater expertise.

 

 

physical therapy billing with ICD-10

Is Your Practice Ready for ICD-10?

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.

Then we learned that the change would be delayed one year to October 1, 2014. More scrambling ensued. And then in August we were informed that yet again the change would be delayed for one year to October 1, 2015. Hopefully, this time around, the world will be prepared.

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.

  1. ICD-10. Centers for Medicare and Medicaid Services. Available at: http://www.cms.gov/Medicare/coding/ICD10/index.html . Accessed on June 3rd 2015.
  2. The road to 10: The small physician practice’s route to ICD 10. Centers for Medicare and Medicaid services. Available at:  http://www.roadto10.org/. Accessed on June 4th 2015.
  3. ICD 10 Fact Sheet: Basics for small and rural practices. Available at: http://www.cms.gov/eHealth/downloads/eHealthU_BasicsSmallRuralPrac.pdf. Accessed on June 4th 2015.
  4. ICD 10. American Physical Therapy Association. Available at: http://www.apta.org/Payment/Coding/ICD10. Accessed on: June 4th 2015.

-Amanda Olson, DPT