In communication with New York Chapter leaders, Aetna has clarified that 97001 and 97002 are not included in a policy change published on page 2 in its September 2012 OfficeLink Updates™.
The publication includes an updated policy for evaluation and management codes billed by certain nonphysician provider types, which becomes effective December 1. The policy states that evaluation and management codes will not be allowed for physical therapists, occupational therapists, speech therapists, audiologists, dieticians, and nutritionists. Aetna representatives have confirmed that the policy applies to codes in the 992xx series, and will not be billable by physical therapists. However, physical therapists will continue to be able to report 97001 and 97002 for evaluation and reevaluation.
A new APTA podcast and transcript provide an overview of the manual medical review process for Medicare claims for beneficiaries who reach $3,700 in outpatient therapy expenditures in a calendar year.
Under the new therapy cap exceptions process, outpatient therapy patients will still be eligible for an automatic exception at the 2012 therapy cap level of $1,880. Therapists will follow the same process of applying the KX modifier on the claim form when a patient exceeds the cap amount. Claims for patients who then meet or exceed $3,700 in therapy expenditures will be subject to a manual medical review process that will be implemented in 3 distinct phases beginning October 1, November 1, and December 1. (See last week's News Now article for more information about provider assignment to the phases.)
Additional information regarding the therapy cap and the manual medical review process is available on APTA's website. CMS also provides a fact sheet and question-and-answer document regarding the process. Next week, APTA will record a webinar that will address the therapy cap and the manual medical review process. News Now will provide a link to the recording, which will be free to members, when it is available.
Earlier this summer, APTA served on an expert panel as part of the American Nurses Association's (ANA) broad-based effort to develop national standards to guide hospitals and other health care facilities in their implementation of policies and equipment to safely lift and move patients.
Ken Harwood, PT, PhD, CIE, represented APTA on the panel that included 26 specialists with expertise in nursing, physical therapy, occupational therapy, ergonomics, architecture, health care systems, and other disciplines to create overarching standards for implementing safe patient handling programs and detailed guidelines for making them work effectively in practice. The Safe Patient Handling National Standards Working Group plans to distribute the standards and guidelines to their professional memberships for comment in October, with publication and release set for March 2013.
The panel is seeking to build a consensus of evidence-based best practices in safe patient handling that will apply to multiple health care professions and settings. The panel's goal is to develop language that can be incorporated nationwide into practices, policies, procedures, and regulations and become the basis for resource toolkits and certifications.
Currently, there are no broadly recognized government or private industry national standards for safe patient handling. Health care facility programs lack consistency, as do regulations in 10 states that have enacted safe patient handling laws. In the meantime, health care professionals continue getting injured, and musculoskeletal injury remains a top concern, says ANA.
Physical therapy interventions for back care in children and adolescents are successful in significantly increasing healthy behaviors and knowledge acquired both in the posttest and in the follow-up, say authors of a meta-analysis published in BMC Musculoskeletal Disorders. The combined treatment of postural hygiene with physical therapy exercise exhibits the best results. The small number of studies limits the generalizability of the results, they add.
The authors located studies from the Cochrane Library, Medline, PEDro, Web of Science and IME, and other sources. The search period extended to May 2012. To be included in the meta-analysis, studies had to use physical therapy methodologies of preventive treatment on children and adolescents and compare a treatment and a control group. Treatment, participant, methodological, and extrinsic characteristics of the studies were coded. Two researchers independently coded all of the studies. As effect size indices, standardized mean differences were calculated for measures of behaviors and knowledge, both in the posttest and in the follow-up. The random and mixed-effects models were used for the statistical analyses. Sensitivity analyses were carried out to check the robustness of the meta-analytic results.
A total of 19 papers fulfilled the selection criteria, producing 23 independent studies. On average, the treatments reached a statistically significant effectiveness in the behaviors acquired, both in the posttest and in the follow-up (d+ = 1.33 and d+ = 1.80, respectively), as well as in measures of knowledge (posttest: d+ = 1.29; follow-up: d+ = 0.76). Depending on the outcome measure, the effect sizes were affected by different moderator variables, such as the type of treatment, the type of postural hygiene, the teaching method, or the use of paraprofessionals as cotherapists.
APTA is launching its first annual Fall Cosponsor Drive and needs your help. Building upon the success of the Federal Advocacy Forum, held April 22-24, APTA wants to reach 200 cosponsors for Medicare therapy cap repeal legislation (HR 1546) and 150 cosponsors for student loan repayment legislation (HR 1426) by December 31. Currently, the bills have 170 and 117 cosponsors, respectively. APTA has been working diligently to educate members of Congress on Capitol Hill about these issues and now needs association members to echo these messages at the local level. Several congressional representatives have requested that PTs, PTAs, and PT students contact their district offices and express their support for these bills. This is your opportunity to contact your representative and ask him or her to cosponsor HR 1546 and HR 1426.
APTA has several resources to help you educate your legislator on these issues. You can identify if your representative is currently a cosponsor, view position papers and background information, and track the progress of the Cosponsor Drive on the Medicare Therapy Cap and Student Loan Repayment Cosponsor Drive webpages. You also can e-mail your representative and ask him or her to repeal the therapy cap and support legislation allowing physical therapy students to participate in loan forgiveness programs.
If you have questions about the Cosponsor Drive, contact APTA's Grassroots and Political Affairs Department at 800/999-2782, ext 3170, or email@example.com.
Being physically during midlife not only helps extend lifespan, but it also increases the chances of aging healthily, free from chronic illness, investigators at the University of Texas Southwestern Medical Center and The Cooper Institute have found.
The association between cardiorespiratory fitness and mortality is well described, say the study's authors. However, it previously had been unknown just how much fitness might affect the burden of chronic disease in the most senior years—a concept known as morbidity compression.
Researchers examined the patient data of 18,670 participants in the Cooper Center Longitudinal Study, research that contains more than 250,000 medical records maintained over a 40-year span. These data were linked with the patients' Medicare claims filed later in life from ages 70 to 85. Analyses during the latest study showed that when patients increased fitness levels by 20% in their 30s, 40s, and 50s, they decreased their chances of developing chronic diseases—congestive heart failure, Alzheimer disease, and colon cancer—decades later by 20%.
"What sets this study apart is that it focuses on the relationship between midlife fitness and quality of life in later years," said Benjamin Willis, MD, MPH, lead author of the study. "Fitter individuals aged well with fewer chronic illnesses to impact their quality of life."
This positive effect continued until the end of life, with more-fit individuals living their final 5 years of life with fewer chronic diseases. The effects were the same in both men and women.
The study was published online August 27 in Archives of Internal Medicine.
A new app from the National Institutes of Health (NIH) offers women access to a year's worth of practical health information, highlighted week by week.
The app can help women identify health risks for themselves and their families, and can help them create and maintain healthy lifestyles throughout their lives. Questions to ask health care providers, a glossary of health terms, and health screening information and links to additional information from NIH institutes and centers expand the mobile app's offerings.
Key features of the app are:
•a personal health section for recording medications, medical conditions, and disabilities
•a journal feature
•a personal goal-setting section for health and lifestyle details
The app is based on the Primer for Women's Health: Learn about Your Body in 52 Weeks, published by NIH's Office of Research on Women's Health.
Content also is accessible without the use of a handheld device, at http://52weeks4women.nih.gov/. In the near future, NIH will launch an app for men's health with similar features.