Eli's Rehab Report
How to Code an Unlisted Body Region
Question: We had an athlete visit our office for therapy due to a strain of the gluteus maximus. I cannot find an injury code for that body part in ICD-9. Is there another valid code I can use? Answer: On the claim form, your best bet is to use the therapist's treatment or therapy diagnosis where allowed by state and local law -- this should serve as the diagnosis of why the patient requires skilled physical therapy services. For example, due to the strain of the gluteus maximus, does the patient have difficulty in walking? If so, you would code 719.7.
North Carolina subscriber
Other possible therapy diagnoses could be abnormality of gait (781.2), or pain in the pelvic region and thigh (719.45). If you are looking for the medical diagnosis of strain of the gluteus maximus, you could code it as an unspecified site of sprain and strain (848.9).
Reader questions were answered by Rick Gawenda, PT, director of physical medicine and rehabilitation at Detroit Receiving Hospital.
Eli's Rehab Report
- 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 [...] - COVERAGE DETERMINATIONS:
Think Twice About Billing Infrared Therapy Treatments
CMS will not reimburse this modality You may be one of the many therapy clinics [...] - New Pain Code Guidelines Are In:
Get the Scoop
Report 338.4 only when significant psychological dysfunction is documented Confused about new postoperative and chronic [...] - 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 [...] - HHAs:
Control Your Destiny With Billing Controls
Look for HIPPS codes that don't jibe Don't rest easy just because your Medicare margins [...] - READER QUESTION:
Be Careful of Multiple Referrals
Question: On the same day, we provided physical therapy to a patient with referrals from [...] - READER QUESTION:
How to Code an Unlisted Body Region
Question: We had an athlete visit our office for therapy due to a strain of [...] - 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 the [...] - NEWS BRIEFS:
Cahaba Review Reveals 95% Error Rate
Fiscal intermediary Cahaba GBA released its third-quarter results of an inpatient rehabilitation facility services review--and [...] - NEWS BRIEFS:
OIG Snags CORF for Unallowable Payments
If you're a comprehensive outpatient rehabilitation facility, you might want to re-examine your billing practices.
The [...] - NEWS BRIEFS:
Chicago HHA Takes a Hit
You'll want to tighten up your therapy claims oversight -- or risk losing thousands of dollars [...]
