Today, APTA participated in the Brain Injury Awareness Fair as part of the 12th annual Brain Injury Awareness Day on Capitol Hill. These events aim to educate members of Congress and their staff on the full range of effects of traumatic brain injury (TBI), the challenges and recoveries of people living with brain injury, and the services and supports that are available to them.

Reps Bill Pascrell Jr (D-NJ) and Thomas J. Rooney (R-FL), cochairs of the Congressional Brain Injury Task Force, held a press conference to announce legislation advancing the treatment and prevention of TBIs. 

An afternoon panel discussion titled "Promoting Brain Injury Awareness through Public/Private Partnerships" featured COL Jamie B.Grimes, MD, MC, national director, Defense and Veterans Brain Injury Center; Sara Patterson, associate director of policy, Centers for Disease Control and Prevention; Katie Clarke Adamson, director of health partnerships and policy, YMCA of America; Jeff Miller, chief security officer, National Football League;  Roland Gerritsen van der Hoop, chief medical officer, BHR Pharma, and  Ralph Ibson, national policy director, Wounded Warrior Project.

Check out APTA's TBI webpage for advocacy and education resources on TBI and concussion. 

In a 2-step trial conducted in the United Kingdom, providing active management consultation for patients with acute whiplash injury in emergency departments (ED) did not show additional benefit compared with usual care consultations, say authors of an article published in February in The Lancet. Physical therapy resulted in a modest acceleration to early recovery of persisting symptoms but was not cost effective from the National Health Service's (NHS) perspective. Usual consultations in EDs and a single physical therapy advice session for persistent symptoms are recommended, the authors add. 

Step 1 was a pragmatic, cluster randomized trial of 12 NHS Trust hospitals including 15 EDs that treated patients with acute whiplash associated disorder of grades I-III. The hospitals were randomized by clusters to either active management or usual care consultations. In step 2, the researchers used a nested individually randomized trial. Patients were randomly assigned to receive either a package of up to 6 physical therapy sessions or a single physical therapy advice session. Randomization in Step 2 was stratified by the center. Investigator-masked outcomes were obtained at 4, 8, and 12 months. The primary outcome was the Neck Disability Index (NDI). Analysis was intention to treat, and included an economic evaluation.

In step 1, 12 NHS Trusts were randomized, and 3,851 of 6,952 eligible patients agreed to participate (1,598 patients were assigned to usual care and 2,253 patients were assigned to active management). Of the 3,851 eligible patients, 2,704 (70%) provided data at 12 months. NDI score did not differ between active management and usual care consultations (difference at 12 months 0.5).

In step 2, 599 patients were randomly assigned to receive either a single physical therapy advice session (299 patients) or 6 physical therapy sessions (300 patients); 479 (80%) patients provided data at 12 months. At 4 months, patients who received physical therapy showed a modest benefit compared with advice (NDI difference -3.7, -6.1 to -1.3), but not at 8 or 12 months. Active management consultations and physical therapy were more expensive than usual care and a single advice session. No treatment-related serious adverse events or deaths were noted.

APTA's new carbapenem-resistant Enterobacteriaceae (CRE) webpage contains news, updates, and links to a variety of resources on these drug-resistant bacteria.

As reported earlier this week in News Now, physical therapists and physical therapist assistants play an important role in protecting patients from CRE. CRE have high mortality rates, killing 1 in 2 patients who get bloodstream infections from them. Additionally, CRE easily transfer their antibiotic resistance to other bacteria. CRE are usually transmitted person-to-person, often on the hands of health care workers. Currently, almost all CRE infections occur in people receiving significant medical care. However, their ability to spread and their resistance raises the concern that potentially untreatable infections could appear in otherwise healthy people, including health care providers.

Jacquelin Perry, MD, a physical therapist who trained at Walter Reed Army Hospital (1940-1941) and practiced in the US Army for 5 years, died at her home in Downey, California, on Monday at age 94.

Perry graduated from the University of California, San Francisco, in 1950 as a physician and became board certified as an orthopedic surgeon in 1958. At Ranchos Los Amigos, she was chief of the Pathokinesiology Service for 30 years.

She published hundreds of articles and received APTA's Golden Pen Award and the Helen

J. Hislop Award for Outstanding Contributions to Professional Literature. She was an honorary

lifetime member of APTA. She also received the Orthopaedic Section's Steven J. Rose Excellence in Research Award. 

Throughout her career Perry advocated for the profession of physical therapy and worked closely with numerous physical therapists.

"The name Perry and the word movement are almost synonymous—we hear 'Perry,' and we think analysis of normal and abnormal movement of the trunk, upper extremity, and lower extremity and the restoration of movement through surgery, bracing, electrical stimulation, and exercise," Rebecca L. Craik, PT, PhD, FAPTA, wrote in a 2010 PTJ editorial.

The Centers for Medicare and Medicaid Services (CMS) recently reported that physical therapists and other providers who bill Medicare for outpatient therapy services may have recently noticed an increase in the frequency of Health Insurance Portability and Accountability Act rejection codes on their provider notification letters. Medicare routinely mails these letters to providers when various identified claims cannot be successfully crossed over to their patient’s supplemental insurance companies.

The codes are:

• H51000: The Procedure Code ____ is not a valid CPT or HCPCS Code for this Date of Service
• H51061: 'Procedure Modifier 1' ___ is not a valid CPT or HCPCS Modifier Code
• H51062: 'Procedure Modifier 2'____ is not a valid CPT or HCPCS Modifier Code
• H51063: 'Procedure Modifier 3' ____ is not a valid CPT or HCPCS Modifier Code
• H51064: 'Procedure Modifier 4' ____ is not a valid CPT or HCPCS Modifier Code
• H51108:  _______ is not a valid 'Line Level Adjustment Reason Code.'

(Where you see "_____" directly above, the value [for example, G8978; modifier CH; or CARC 246] was reported, when applicable, on the outbound provider notification letter that billing offices would have received.) 

CMS states that the new functional G-codes, new severity/complexity modifiers, and new Claim Adjustment Reason Code (CARC) 246 for the January 2013 Healthcare Common Procedure Coding System (HCPCS) and CARC updates were inadvertently not loaded. As a result, a moderate number of Part B outpatient therapy claims (claims for physical therapy, speech-language pathology services, and occupational therapy) were rejected in error. The newly added severity/complexity modifiers were as follows:  CH, CI, CJ, CK, CL, CM, and CN.  The new functional G-codes fall within the following ranges:

• G8978—G8999
• G9158—G9176
• G9186

To remedy this issue, the Coordination of Benefits Contractor (COBC) HIPAA validation vendor added the new G-codes to its HCPCS table as of January 28. The vendor then added the new severity/complexity modifiers to its HCPCS table as of February 11. Lastly, the vendor added the new CARC 246 to its table as of February 25. Thus, Medicare participating therapists, physicians, and nonphysician providers should now see a drastic decrease in the incidence of error codes H51000, H51061-H51064, and H51108 reflected on their provider notification letters. 

If your billing office received a provider notification letter from Medicare indicating that claims could notbe crossed over due to one of the H-series error messages described above, there unfortunately is not a way for Medicare to retransmit the affected claims to your patients’ supplemental insurers. Therefore, you will need to bill your patients' supplemental insurers directly. 

To help mitigate this kind of problem in the future, CMS will implement a fail-safe strategy in advance of the scheduled installation of new HCPCS or other code updates. This will ensure that any incorrectly rejected Medicare crossover claims will be repaired by all A/B Medicare Administrative Contractors, thus minimizing the impact to the provider community.

This notice, titled CMS Reports Problem Impacting Crossover of Medicare Part B Outpatient Therapy Claims, can be found in the March 7 issue of Provider e-News.   

APTA has added a new resource to its Balance and Falls webpage to help physical therapists reduce falls that occur during a patient's hospital stay. "Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care" addresses hospital readiness, program management, fall prevention practices, implementation, measurement, and sustainability. Developed by the Agency for Healthcare Research and Quality, the toolkit is designed for multiple uses. The core document is an implementation guide organized under 6 major questions intended to be used primarily by the implementation team charged with leading the effort to put the new prevention strategies into practice. The full guide also includes links to tools and resources found in the Tools and Resources section of the toolkit, on the Web, or in the literature. The tools and resources are designed to be used by different audiences and for different purposes, as indicated in the guide.