Category Archives: Current News

Monday, April 16, 2018

Strapping and Kinesiotaping: What’s the Difference?

I often receive questions about the strapping codes, when it would be applicable to use them, are they time-based or not, and what is the difference between strapping and kinesiotaping. First, lets list the strapping codes. According to the American Medical Association, CPT Professional Edition, 2018, the strapping codes are as follows:  

Monday, April 16, 2018

Strapping and Taping Not Covered by Cigna for All Body Parts

Cigna has a medical coverage policy on strapping and taping that has implications for suppliers and providers of outpatient physical and occupational therapy services.In this medical coverage policy, Cigna defines when strapping is and is not medically necessary. Cigna considers strapping medically necessary for the management of immobilization of a joint and restriction of movement…
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Monday, April 9, 2018

Medicare Advantage: How is it Different from Traditional Medicare

As more Medicare beneficiaries choose to switch their medical coverage from traditional Medicare to Medicare Advantage plans (31% in 2015), I receive more and more questions regarding do the outpatient therapy rules and regulations that apply to traditional Medicare also apply to the Medicare Advantage plans. In this article, I will answer the following questions:…
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Monday, April 9, 2018

Using the ABN for Medicare Advantage Plans

The Advance Beneficiary Notice of Non-Coverage (ABN) is used when normally the service(s) or item(s) would be covered by the Medicare program, but under the circumstance, a provider does not think their Medicare Administrative Contractor will pay for a service(s) or item(s). A question I have been receiving lately is can a provider of outpatient…
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Monday, April 9, 2018

CMS Releases NCCI Edits Version 24.1

The Centers for Medicare and Medicaid Services has released the National Correct Coding Initiative (NCCI) Edits Version 24.1. NCCI Edits Version 24.1 is applicable for dates of service April 1, 2018 – June 30, 2018. There are 2 versions of NCCI Edits Version 24.1; one version is for private practice and the second version is…
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Monday, April 2, 2018

Home Health Services and Outpatient Therapy Simultaneously

A question I often receive is does the Medicare program pay for a Medicare beneficiary to receive outpatient therapy services while they are simultaneously receiving home health services under an open home health agency (HHA) plan of care? In this article, I will answer this question plus provide resources for the outpatient therapy provider to…
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Thursday, March 29, 2018

OIG Releases Report on Physical Therapy Billing

The Office of the Inspector General (OIG) has issued a report regarding the findings of a review they conducted on outpatient physical therapy services provided to Medicare beneficiaries between July 1 – December 31, 2013. For calendar year (CY) 2013, the Medicare Part B program paid approximately $1.8 billion for outpatient physical therapy services provided…
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Monday, March 26, 2018

Manual Therapy vs Massage: What’s the Difference?

I often receive the following questions regarding massage and manual therapy: What is the description of massage and manual therapy? Does the Medicare program pay for massage and manual therapy? What is the difference between massage and manual therapy? What is the difference in payment between massage and manual therapy? Do private insurance carriers pay…
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