The Centers for Medicare and Medicaid Services have published eleven (11) Part B scenarios for physical and occupational therapists.  The scenarios include:

1. Billing - CPT Codes:  Not Permitted
2. Billing - CPT Codes:  Permitted
3. Group Therapy -vs- Individual Therapy (I found this particularly interesting)
4. Team Therapy
5. Counting Minutes of Service Units
6. Group and Individual CPT Codes Billed on Same Day
7. Supervision
8. Qualified Personnel
9. Group Frequency
10. Documentation
11. SNF Part B Billing

There is a brief explanation of the difference between group therapy for Part A versus group therapy for Part B at the bottom of the article.

The document is well written, with easy-to-follow explanations.  It might save you some lost billing to read through it.  Check it out at Centers for Medicare and Medicaid Services - 11 Part B Billing Scenarios for PTs and OTs

This is the first year that continuing competence is required for physical therapists in North Carolina.  To help PTs learn and understand the new requirements the North Carolina Board of PT Examiners (NCBPTE) is offering educational sessions across the state.

There is a $25.00 fee for early registration, and the course provides 2 contact hours (0.2 CEUs or 2 points) toward your requirements.

The remaining sessions are:

• February 17, Greenville AHEC.   Contact:  www.eahec.ecu.edu
• March 3,  Raleigh AHEC .     Contact:  www.wakeahec.org
• March 24,  Asheville AHEC.     Contact:  www.mahec.net [This is an evening videoconference available in multiple cities]

Twin bills have been filed in both the Texas House and Senate that, if approved, would allow physical therapists to perform patient evaluations and treatments without the requirement for a physician’s prescription.

Here is a cleaned-up (retyped) version of Senate Bill 433:

 Retype of SB 433: Download

The TPTA website has links to both the House and Senate bills, as well as a one-page summary of speaking points.

What can you do?

Whether you agree with the bill or not - make an informed opinion and then make your opinion count!

First, read the text of the bills.  Next, read the one page summary from the TPTA website.  It has many good points.  Finally, form an opinion and then make it known!  Contact your local representatives in both the Texas House and Senate — send an email, give them a call. Find out who your representative is by following this link:  http://www.fyi.legis.state.tx.us/

PTs in Texas have practiced knowing the exceptions to the referral requirement — but, did you know the exceptions were expanded in February 2008?

Chapter 322.1(a)(2):  Provision of Services now includes the following exception –

• (B) A PT may provide instructions to any person who is asymptomatic relating to the instructions being given without a referral, including instruction to promote health, wellness, and fitness.

The remaining exceptions are: [emphasis added to original text]

• (A) A PT may evaluate without referral.

• (C) Emergency Circumstances. A PT may provide emergency medical care to a person after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity without referral if the absence of immediate medical attention could reasonably be expected to result in a serious threat to the patient’s health, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

• (D) Prior referrals. A physical therapist may treat a patient for an injury or condition that is the subject of a prior referral if all of the following conditions are met.
  • (i) The physical therapist must notify the original referring healthcare personnel of the commencement of therapy by telephone within five days, or by letter postmarked within five business days;
  • (ii) The physical therapy provided must not be for more than 20 treatment sessions or 30 consecutive calendar days, whichever occurs first. At the conclusion of this time or treatment, the physical therapist must confer with the referring healthcare personnel before continuing treatment.
  • (iii) The treatment can only be provided to a client/patient who received the referral not more than one year previously.
  • (iv) The physical therapist providing treatment must have been licensed for one year. The physical therapist responsible for the treatment of the patient may delegate appropriate duties to another physical therapist having less than one year of experience or to a physical therapist assistant. A physical therapist licensed for more than one year must retain responsibility for and supervision of the treatment.

Get more information at the Executive Council of Physical Therapy & Occupational Therapy Examiners website.

A recent study on “work-related musculoskeltal disorders among Nigerian physiotherapists” echos numerous other studies…

PTs are prone to work-related injuries.

The latest study, published in BMC Musculoskeltal Disorders notes the following statistics on the prevelence of work related musculoskeletal injuries by country:

• Australia: 55-91% experience some type of injury
• Canada: 49% experience low back pain
• Kuwait: 70% experience low back pain
• Nigeria: 69.8% experience low back pain
• Turkey: 85% experience some type of injury
• United Kingdom: 68% experience some type of injury
• United States: 45-62% experience low back pain

Work factors that contribute to injury:

• treating a large number of patients in one day
• working in the same position for a long period of time
• lifting or transferring dependent patients
• performing manual therapy techniques

Interestingly, new grads and younger therapists (<30 years old) were more prone to injury usually due to poor body mechanics.

Let’s talk about how you avoid work-related injuries.