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Eli's Rehab Report
Eli's Rehab Report
Eli's Rehab Report - 2007; Volume 8, Number 12
Know the Facts:
Find Out What RACs Are Before They Nail Your Facility
California IRFs get hit hard by these entities -- will CMS step up? If you think your pay...
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Home Health:
Brace for Therapy Scrutiny Under PPS Changes
Even a 6-visit threshold has chance for abuse Get ready for a complete overhaul of how...
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Paper or Electronic Claims Processing?
If you have the choice, you may want to tech it up Most providers these days are required...
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Education:
11 Opportunities to Boost Your Business Know-How
Sign up for these Eli-sponsored audioconferences Need a little extra...
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News Briefs:
Corporate: U.S. Physical Therapy Adds a 'Star' to Its Mix
Houston-- U.S. Physical Therapy is right on track with its goal of expanding its network o...
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News Briefs:
Salaries: HCS Digs Into Rehab Providers' Compensation
Oakland, N.J. -- If you've wanted a benchmark for what you and your rehab colleagues are m...
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News Briefs:
Coding: SLPs Welcome New Dysphagia ICD-9s
Rockville, Md. -- You heard about the AMA's proposed ICD-9s this summer -- well now they'r...
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Reader Questions:
Get a Therapy V Code Refresher for SNFs, HHAs
Question: I've just relocated to an SNF setting from a hospital outpatient therapy depart...
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Reader Questions:
Avoid Ionto Setup Time Billing Blunders
Question: I understand that iontophoresis (97033) is a constant-attendance modality and a...
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Eli's Rehab Report - 2007; Volume 8, Number 11
Inpatient Insights:
Tune In to Some Major Post-Acute Setting Changes on the Horizon
Find out what the CARE tool is and how CMS is using itA CMS demonstration project is in th...
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SNFs:
Don't Miss This Critical Update to Therapy Eval Requirements
CMS transmittal 73 spells out this small but important changeGear up your SNF for more the...
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IRFs:
Navigate the 2008 PPS Final Rule With These Strategies
Outlier threshold takes a major jumpInpatient rehabilitation facilities' 2008 PPS final ru...
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Compliance:
Provider-Based Requirements -- You May Be Missing Key Pieces
3 tips could save you from your FI's watchful eyeIf you're an off-site--but hospital-affil...
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NEWS BRIEFS:
Legislation--SCHIP Stirs the Healthcare Pot
Just because Congress is officially on recess doesn't mean there's not a lot to keep your ...
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NEWS BRIEFS:
LCDs--Palmetto and Canada Zero In on Dysphagia
Palmetto GBA and Cahaba GBA are revising their Local Coverage Determinations on dysphagia ...
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NEWS BRIEFS:
SNFs--CMS Reveals 2008 SNF PPS Final Rule
Skilled nursing facilities' services paid under the Prospective Payment System will see a ...
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Clinical Rehab Roundup
In this recurring feature, Physical Medicine & Rehab Coding Alert provides you with ...
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READER QUESTIONS:
Get the Latest on SLP Education Standards
Question: In the last issue, I read the article on a CMS proposed rule that specified some...
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READER QUESTIONS:
Clear Up Some Modifier 59 Confusion
Question: I've been getting a lot of denials on claims I bill with modifier 59 (Distinct p...
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Eli's Rehab Report - 2007; Volume 8, Number 10
Outpatient Outlook:
Stay in the Loop on Key Changes CMS Proposes for Next Year
Welcome some good news about your recertification periods A new proposed rule from CMS hi...
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Practice Pointers:
Clear up PQRI Confusion -- and Set Yourself up for Some Cash
Find out why you may want to screen a wheelchair-bound patient for falls risk If you're s...
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Legislation:
Keep an Eye on the SCHIP Bill
SLPs in private practice: You may be able to bill Medicare directly if this passes Your 2...
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Security:
Protect Private Information From the Public Eye
Your NPI application could hold the key to leaking critical information Although the init...
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Clinical Rehab Roundup
In this recurring feature, Physical Medicine & Rehab Coding Alert provides you with su...
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News Brief:
Mergers and Acquisitions:New Physiotherapy Associates to 'Change the Face of the Industry
Chicago -- Investors have their eye on the rehab market, and two of them are looking to cr...
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News Brief:
Reimbursement: CMS Considers New Wound-Care Service Regulations
Alexandria, Va. -- Physical therapists performing wound-care services at outpatient hospit...
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News Brief:
Audits: OIG Continues to Target Medical Necessity
Texas City, Texas -- Good documentation always counts -- even after you're reimbursed for...
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Reader Question:
Don't Confuse 'Maintenance Therapy' With Billable Services
Question: We all hear from CMS and private payers that we can't bill for "maintenance the...
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Reader Question:
Pare Down Your Eval Time With a Questionnaire
Question: In our facility, we have a lot of Medicare patients whom we ask very detailed A...
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Eli's Rehab Report - 2007; Volume 8, Number 9
Pay for Performance:
Brace for New Reimbursement Model on the Horizon
Help drive the change rather than wait for what's handed to you Freezing, capping and sl...
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Clinical Rehab Roundup
In this recurring feature, Physical Medicine & Rehab Coding Alert provides you with su...
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Practice Pointers:
Don't Let a 1.5% Bonus From Medicare Slip Through Your Fingers
PQRI isn't just another CMS acronym to write off to the physician world If you're a P...
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SNFs:
Prevent Nursing Documentation From Torpedoing Rehab RUGs
4 ways for nursing and therapists to stay on the same page If nursing and therapy docume...
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Home Health:
Sharpen Your Therapy Prediction to Master New Service Domain
Every therapy visit could make a difference under revised PPS billing You&rsq...
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News Briefs
Tennessee PT Clinic Gets Nailed on Anti-Kickback Statute WASHINGTON, D.C. -- The HHS Off...
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Reader Questions:
Document, but Don't Bill, Re-Evals in Acute Care
Question: I work in an acute-care setting, and I'm wondering how and when my therapists c...
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Reader Questions:
Get a Refresher on Treatment Note Documentation
Question: I recently heard that I don't have to break down the number of minutes I spend ...
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Eli's Rehab Report - 2007; Volume 8, Number 8
Compliance:
Don't Get Burned by a Good Thing--Direct Access, That Is
Know the ins and outs of your state's restrictions if you have direct access States have b...
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Clip and Save:
See Where All the States Stand in the Direct Access Race
Kansas brings the direct access total to 44 states as of May As you can see below, state l...
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Home Health:
Beware Medical Review Under Changing Therapy Threshold
Here's what to do now about the proposed therapy changes On Jan. 1, you'll say goodbye to ...
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IRFs:
Prepare for 2008 Now: Grab the Highlights of Your Proposed IRF PPS Rule
You still can't count comorbidities at the 75 percent threshold No need to be intimidated ...
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NEWS BRIEFS:
Surprise--Study Shows P4P May Not Be Effective
New York, N.Y.--If you're waiting for Medicare to move forward with payment incentives for...
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NEWS BREIFS:
Good News--OTs Eligible for Bonus Under Quality Reporting Initiative
Bethesda, Md.--Occupational therapists up for some extra cash this year will be pleased to...
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NEWS BRIEFS:
Kansas Scores as State No. 44 for Direct Access
Alexandria, Va.--If you're a physical therapist in Kansas, gear up for more patients knock...
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READER QUESTIONS:
Coding Isn't the Issue With This Therapy Claim Denial
Question: An elderly patient who recently had a flu episode was referred to our home heal...
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READER QUESTIONS:
How to Avoid Duplication of Services
Question: Our facility is taking extra care to avoid duplication of services between phy...
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Eli's Rehab Report - 2007; Volume 8, Number 7
Speech Spotlight:
SLPs: Gear up for a Slew of New 787.xx and 389.xx ICD-9s
Look out for more descriptive terms under dysphagia and hearing loss The feds have release...
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Clip & Save ~ Get a Sneak Peek at Proposed ICD-9s for 2008
Speech-language pathology gets a heap of new codes TCI sifted through CMS' Inpatient Prosp...
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Home Health ~ Prepare for Major Therapy Threshold Changes -- or Face Serious Federal Scrutiny
Your episode calculations are about to get a lot more complicated Home health agencies exp...
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NPIs ~ Providers Breathe a Little Easier With 1-Year NPI Extension
But extra leeway may be a trap with other payers You have an extra year to get up to snuff...
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News Brief ~ Tune Your Patients in:
ASHA Lands Spot on NPR
Rockville, Md. -- Promoting your professional services means more than sprucing up yo...
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News Brief ~ Medicare Proposes Higher SNF Payments
Washington, D.C. -- If your rehab services get paid on a skilled nursing facility pro...
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News Brief ~ Feds Crack Down on Validity of IRF Admissions
Washington, D.C. -- If you're a Medicare inpatient rehabilitation facility, you may w...
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Clinical Rehab Roundup
In this recurring feature, Physical Medicine & Rehab Coding Alert provides you with su...
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Reader Question ~ Know Your Discharge Report Must-Haves
Question: I'm wondering what to do if I see a Medicare patient and initially fill out a 70...
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Reader Question ~ Choose the Best Onset Date for Pediatric Patients
Question: I struggle with documenting onset dates with our pediatric cases. For example, f...
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Eli's Rehab Report - 2007; Volume 8, Number 6
Inpatient Insights:
News Flash -- CMS Abruptly Rescinds Transmittal 65
Certain California PTAs can relax about losing their jobs If you're a hospital-based...
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DME:
Good News -- Therapists Exempt From Competitive Bidding Process
But you'll still need accreditation It's official: The final rule implementing Medic...
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Home Health:
Watch for Infrared Therapy Billing Pitfalls Under PPS
Medicare noncoverage could reduce your PPS payment rates by thousands unless you know the ...
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Practice Pointers:
Don't Give up in the face of Per-Diem Reimbursement
4 tips uncover some hidden cash-saving options Therapy providers across the country ...
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News Briefs
Word on the Street: HealthSouth Tinkers With Selling Headquarters Birmingham, Ala. -...
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Clinical Rehab Roundup
In this recurring feature, Physical Medicine & Rehab Coding Alert provides you with su...
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Reader Questions:
Clarify Billable Time With This Scenario
Question: I need advice on how to bill the following scenario: Patient A arrives at the cl...
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Reader Questions:
Cleanly Bill Your Attended Modalities
Question: I have a question regarding the following statement from CMS' therapy services b...
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Eli's Rehab Report - 2007; Volume 8, Number 5
Know the Facts:
Get the Lowdown on Per-Visit Fees -- and How to Voice Your Opinion
Some states are seeing reimbursement as low as $35 per visit You may have heard about --...
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Inpatient Insights:
Nail the 3-Hour Rule Without Cheating the System
Tip: Create a 30-minute buffer to allow for patient breaks Squeezing in those three requ...
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Home Health:
Stay Alert: Therapy Utilization Guidelines to Hit Agencies
Be sure your therapy visit number fits under a new coverage policy limit The feds and pa...
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Clip and Save:
Know Your Visit Limits Down to the Code
Check out Cahaba GBA's new utilization guidelines that affect home health therapy service...
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News Brief:
CMS Extends Acceptance Period for Old 1500 Form
WASHINGTON, D.C. -- If you've obtained updated CMS-1500 forms to accommodate the National...
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News Brief:
Congress Pays Attention to PT Students
ALEXANDRIA, VA. -- Physical therapists who practice in areas suffering healthcare provide...
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News Brief:
Wound Therapy Claims May Go Under the Microscope
COLUMBIA, S.C. -- Watch for claim denials if you bill for negative pressure wound therapy...
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Reader Questions:
Don't Let Medicare Payer Bundle 97605 and 97606
Question: I received a denial for a Medicare claim with active wound care management codes...
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Reader Questions:
Admission Reason Determines V Code
Question: We are a home health agency providing physical therapy and occupational therapy...
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Eli's Rehab Report - 2007; Volume 8, Number 4
Outcomes:
Get the Insiders' Dish on 4 Outcomes Tools
Decide which tool(s) would be best for your facilityCMS has kept you quite busy this year,...
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Inpatient Insights:
Hospital Rehabs--Turn Your Eye to Outpatient Therapy Policies
According to CMS, your expectations aren't far from Part B settings'If you are happily set...
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Billing:
Use These Expert Tips to Prepare for the New UB-04 Form
Make sure your software is ready to handle the changesBy May 23, all institutional paper c...
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Billing:
Welcome 4 Key UB-04 Benefits
The conversion to ICD-10 won't mean another new claim formAlthough adjusting to change can...
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News Brief:
Outpatient Physical Therapy
Congress Re-Introduces Therapy-Cap Repeal BillALEXANDRIA, Va. -- The newly elected 110th C...
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News Brief:
Fraud and Abuse
Ohio Couple Found Not Guilty of Fraudulent BillingAKRON, Ohio -- What appeared to be a sti...
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Outcomes:
Don't Lose Sight of Your Patients' Satisfaction
CALABASAS, Calif. -- Heads up, therapists: Insurers, employers and others that give you bu...
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Home Health:
PT Base Pay and Turnover Rates Increase
OAKLAND, N.J. -- If you're a home health physical therapist, lucky for you, your hourly ra...
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Reader Question:
Check NCCI Edits for Swallow Studies
Question: Sometimes our speech-language pathologist performs a swallow evaluation and vide...
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Reader Question:
Get Answers About Treating Patients in the Home
Question: Can I bill for outpatient physical therapy if I'm treating a patient at his home...
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Eli's Rehab Report - 2007; Volume 8, Number 3
DOCUMENTATION ~ Beef Up Your Documentation With New Outcomes Measurements
Hint: Professional guidelines will help lead the way The Centers for Medicare and Medicaid...
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THERAPY CAPS ~ Say Goodbye to the Manual Exceptions Process -- for Now
And check out a brand-new list of applicable ICD-9 codes Although CMS released updates to ...
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STATE CORNER ~ Take Note:
NJ's Revolutionary Bill Could Help PTs
Find out how auto insurance policies could tie into PT reimbursement You might laugh at th...
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PRACTICE POINTERS ~ Nip Those No-Shows in the Bud -- the Right Way
Warning: Make sure your payers don't frown on payment penalties Every office has them ...
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CLIP & SAVE ~ Let Patients Know Your No-Show Policy Up-Front With This Notice
Follow up with an appropriate warning letter Use this sample written policy and the two sa...
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NEWS BRIEF ~ UGS Wastes No Time Correcting Patient Status Codes
United Government Services is promptly responding to an HHS Office of Inspector General au...
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NEWS BRIEF ~ CIMT Shows Promise for Stroke Victims
Stroke survivors who had lost function in one arm showed dramatic clinical improvements la...
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NEWS BRIEF ~ Beware -- OIG Cracks Down on PT Billing
Your physical therapy billing could be a major hot button in the new year, judging from th...
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READER QUESTION ~ Check Locally for Unna Boot Coverage
Question: Does Medicare reimburse Unna boots for venous insufficiency or any other diagnos...
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READER QUESTION ~ Know When You Need a DME Number for L Codes
Question: I need to report an OT custom splint. Do I need a DME provider number to bill L ...
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Eli's Rehab Report - 2007; Volume 8, Number 2
THERAPY CAPS:
CMS Offers 3 Key Changes to the Therapy Cap for Outpatients
With only a $40 raise, experts weigh in on what will affect you most The therapy cap will ...
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SNFs:
Identify Rehab RUG Patterns That Shout, 'Come Audit Me!'
Spot it if you got it and know what to do next The way your rehab RUGs shake out in your ...
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CLIP & SAVE:
Note the Corrections to CMS' ICD-9 Exceptions List
Many of last year's codes were missing fifth digits A beneficiary's diagnosis determines h...
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DOCUMENTATION:
Check Out Some Major CMS Changes
Transmittal 60 spells it out In addition to sending out a transmittal clarifying the thera...
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Clinical Rehab Roundup
In this recurring feature, Physical Medicine & Rehab Coding Alert provides you with su...
Read more
NEWS BRIEF:
Congress Extends Therapy Cap Exceptions Process
You can breathe a sigh of relief that Congress has decided to extend the therapy cap excep...
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NEWS BRIEF:
PTPN Selects FOTO System to Track
...
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NEWS BRIEF:
California PTs Call Themselves 'Doctor'
If a physical therapist in California received a doctorate of physical therapy (DPT) degre...
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READER QUESTION:
Clear up PT Wound Care Coding Dilemmas
Question: How should I bill wound care provided by a physical therapist in an office setti...
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READER QUESTION:
How Timed Codes for Speech Work
Question: Should I use timed units (that is, 15-minute units) for speech-language patholog...
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READER QUESTION:
Code Carefully for Arch Taping
Question: What CPT code should I use for arch taping if patient education was the main foc...
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Eli's Rehab Report - 2007; Volume 8, Number 1
Get the Lowdown on Referral for Profit:
Why South Carolina Made It Illegal
Find out what your colleagues in that state are doing to stay compliant The highly contro...
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COVERAGE DETERMINATIONS:
Think Twice About Billing Infrared Therapy Treatments
CMS will not reimburse this modality You may be one of the many therapy clinics that love ...
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New Pain Code Guidelines Are In:
Get the Scoop
Report 338.4 only when significant psychological dysfunction is documented Confused about...
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CLIP & SAVE:
Keep a Careful Eye on the OIG's 2007 Work Plan
See where your facility falls into the mix of scrutiny The HHS Office of Inspector General...
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HHAs:
Control Your Destiny With Billing Controls
Look for HIPPS codes that don't jibe Don't rest easy just because your Medicare margins ar...
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NEWS BRIEFS:
New Fee Schedule, Therapy Caps Spell Bad News
Not only will you be facing a $1,780 cap on physical therapy/speech-language pathology and...
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NEWS BRIEFS:
Cahaba Review Reveals 95% Error Rate
Fiscal intermediary Cahaba GBA released its third-quarter results of an inpatient rehabili...
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NEWS BRIEFS:
OIG Snags CORF for Unallowable Payments
If you're a comprehensive outpatient rehabilitation facility, you might want to re-examine...
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NEWS BRIEFS:
Chicago HHA Takes a Hit
You'll want to tighten up your therapy claims oversight -- or risk losing thousands o...
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READER QUESTION:
Be Careful of Multiple Referrals
Question: On the same day, we provided physical therapy to a patient with referrals from t...
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READER QUESTION:
How to Code an Unlisted Body Region
Question: We had an athlete visit our office for therapy due to a strain of the gluteus ma...
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