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  • Aetna Clarifies 97001/97002 Not Included in Policy Change

    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.

    New Podcast: Introduction to the Therapy Cap Manual Medical Review Process

    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.

    APTA Joins Initiative to Develop National Safe Patient Handling Standards

    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.

    New in the Literature: Back Care in Children and Adolescents (BMC Musculoskelet Disord. 2012. August 21. [Epub ahead of print])

    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.