Re: Important CMS Updates - Manual Exception Process Eliminated

[Guest guest]

here is is

the link is:

_http://www.apta.org/AM/Template.cfm?Section=Archives2 & Template=/Customsource/Ta\

ggedPage/PTIssue.cfm & Issue=03/14/2001#article8076_

(http://www.apta.org/AM/Template.cfm?Section=Archives2 & Template=/Customsource/Ta\

ggedPage/

PTIssue.cfm & Issue=03/14/2001#article8076)

In light of APTA's movement toward realizing _Vision 2020_

(https://www.apta.org/Bulletin? & object=bulletin_home[newsletter.view.issue] & id[1\

]=3952) , an

operational definition of " autonomous practice " was adopted during the March

Board of Directors meeting. Vision 2020 states, " Physical therapists will be

practitioners of choice in clients’ health networks and will hold all

privileges of autonomous practice. " Board members agreed, however, that the term

" autonomous practice " and the related term " autonomous physical therapist

practitioner " needed clarification to ensure that the Association’s efforts

toward

this realization are consistent.

The definitions adopted by the Board are as follows:

" Autonomous physical therapist practice is practice characterized by

independent, self-determined, professional judgment and action.

" An autonomous physical therapist practitioner, within the scope of practice

defined by the Guide to Physical Therapist Practice, provides physical

therapy services to patients/clients who have direct and unrestricted access to

their services, and may refer as appropriate to other health care providers and

other professionals and for diagnostic tests. "

The Board directed APTA staff to identify competencies of the autonomous

physical therapist practitioner, using A Normative Model of Physical Therapist

Professional Education, the Guide to Physical Therapist Practice, other

Association documents, and expert member input. A report is due to the November

2001 Board of Directors meeting

Marc Lacroix

[Guest guest]

Recently I read a defintion of APTA Definition of Autonomous Practice. Now

I can not find it. I would like to distribute it. Can anyone reprint it

for me.

Thanks

Steve Marcum PT

Kentucky

Outpatient Practice

[Guest guest]

Rick,

As always.. thank you for the recent information you have shared with the

group :-) I have briefly read through the new Therapy Cap exception

process. One thing that will be different is the elimination of Manual

exception.. and also, I have noticed that they have changed some of the

ICD-9 codes that will be considered an exempt.

I have used the codes 721.91 on a lot of my patients. I noticed that in the

new list of codes, these are now only secondary codes and can not be used as

primary codes. If I use 721.91, does this mean that I have to use another

code that is considered a primary diagnosis code in the list? Or can I use

a code that is not listed but still get an exemption?

Ughh.. Just when you think that you got a good hold on things... :: shaking

head:::

Thank you in advance for all your replies.. Hope everyone had a great and

safe New Year!

Rhoda Astronomo, PT

President

R.A. Physical Therapy

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Rick Gawenda

Sent: Monday, January 01, 2007 6:35 PM

To: ptmanager

Subject: Important CMS Updates - Manual Exception Process

Eliminated

List Serve,

On December 29, 2006, CMS released Transmittal 63 and

placed this information in Pub 100-02, Chapter 15 on

the very same day providing additional

requirements/recommendations for outpatient therapy

services/documentation.

To view Transmittal 63, click on the link below.

www.cms.hhs.gov/transmittals/downloads/R63BP.pdf

To view CMS Pub 100-02, click on the link below and

start reading on page 119.

Effective January 1, 2007, there will be no manual

exception process. All exceptions will be automatic.

To read more about this, click on the link below to

read Transmittal 1145.

http://www.cms. <http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf>

hhs.gov/transmittals/downloads/R1145CP.pdf

Please read this Transmittal carefully as it places

more responsibility on the provider when using the KX

modifier when the patient does not have an condition

or complexity that supports the automatic process.

If you should have any questions, please send

questions to the entire list serve, if possible, as I

am sure many of us will have the same questions.

Happy New Year!

Rick Gawenda, PT

HPA Government Affairs & Practice Committee

Rick Gawenda, P.T.

Director Physical Medicine & Rehabilitation

Detroit Receiving Hospital

Detroit, MI

Phone:

Fax:

E-mail:rgawendadmc (DOT) <mailto:rgawenda%40dmc.org> org

__________________________________________________

[Guest guest]

Does Transmittal 68 apply to all outpatient facilities - ie hospital

based outpatient?

Looks pretty similar to prior transmittals.

Diane , PT

LMH - Hospital

Antigo, WI

________________________________

From: PTManager [mailto:PTManager ] On

Behalf Of Rick Gawenda

Sent: Monday, January 01, 2007 6:35 PM

To: ptmanager

Subject: Important CMS Updates - Manual Exception Process

Eliminated

List Serve,

On December 29, 2006, CMS released Transmittal 63 and

placed this information in Pub 100-02, Chapter 15 on

the very same day providing additional

requirements/recommendations for outpatient therapy

services/documentation.

To view Transmittal 63, click on the link below.

www.cms.hhs.gov/transmittals/downloads/R63BP.pdf

To view CMS Pub 100-02, click on the link below and

start reading on page 119.

Effective January 1, 2007, there will be no manual

exception process. All exceptions will be automatic.

To read more about this, click on the link below to

read Transmittal 1145.

http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf

<http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf>

Please read this Transmittal carefully as it places

more responsibility on the provider when using the KX

modifier when the patient does not have an condition

or complexity that supports the automatic process.

If you should have any questions, please send

questions to the entire list serve, if possible, as I

am sure many of us will have the same questions.

Happy New Year!

Rick Gawenda, PT

HPA Government Affairs & Practice Committee

Rick Gawenda, P.T.

Director Physical Medicine & Rehabilitation

Detroit Receiving Hospital

Detroit, MI

Phone:

Fax:

E-mail:rgawenda@... <mailto:rgawenda%40dmc.org>

__________________________________________________

[Guest guest]

It is Transmittal 63 and the answer is yes.

Transmittal 63 stresses documentation to support the

medical necessity of treatment in addition to

evidence-based practice/research to support the

services we provide.

Rick Gawenda, PT

HPA Government Affairs & Practice Committee

--- Diane wrote:

> Does Transmittal 68 apply to all outpatient

> facilities - ie hospital

> based outpatient?

>

> Looks pretty similar to prior transmittals.

>

> Diane , PT

> LMH - Hospital

> Antigo, WI

>

> ________________________________

>

> From: PTManager

> [mailto:PTManager ] On

> Behalf Of Rick Gawenda

> Sent: Monday, January 01, 2007 6:35 PM

> To: ptmanager

> Subject: Important CMS Updates - Manual

> Exception Process

> Eliminated

>

>

>

> List Serve,

>

> On December 29, 2006, CMS released Transmittal 63

> and

> placed this information in Pub 100-02, Chapter 15 on

> the very same day providing additional

> requirements/recommendations for outpatient therapy

> services/documentation.

>

> To view Transmittal 63, click on the link below.

>

> www.cms.hhs.gov/transmittals/downloads/R63BP.pdf

>

> To view CMS Pub 100-02, click on the link below and

> start reading on page 119.

>

> Effective January 1, 2007, there will be no manual

> exception process. All exceptions will be automatic.

> To read more about this, click on the link below to

> read Transmittal 1145.

>

>

http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf

>

<http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf>

>

>

> Please read this Transmittal carefully as it places

> more responsibility on the provider when using the

> KX

> modifier when the patient does not have an condition

> or complexity that supports the automatic process.

>

> If you should have any questions, please send

> questions to the entire list serve, if possible, as

> I

> am sure many of us will have the same questions.

>

> Happy New Year!

>

> Rick Gawenda, PT

> HPA Government Affairs & Practice Committee

>

> Rick Gawenda, P.T.

> Director Physical Medicine & Rehabilitation

> Detroit Receiving Hospital

> Detroit, MI

> Phone:

> Fax:

> E-mail:rgawenda@... <mailto:rgawenda%40dmc.org>

>

> __________________________________________________

>

[Guest guest]

Just a question....1st of all, How in the world do you keep updated on all of

the Medicare changes? How do you find all of them? I go on their website and it

takes hours to try and read everything and I still feel like I am missing so

much. What is the difference between Pub. 100-02 Transmittal 63 and Pub. 100-04

transmittal 1145?

This seems to be a Full-Time Job just reading all of the changes,updates etc....

When is there time to actually do the billing, documentation and treating of the

patients?

Cathi Pritchard

Redwood Hand Therapy

Important CMS Updates - Manual

> Exception Process

> Eliminated

>

>

>

> List Serve,

>

> On December 29, 2006, CMS released Transmittal 63

> and

> placed this information in Pub 100-02, Chapter 15 on

> the very same day providing additional

> requirements/recommendations for outpatient therapy

> services/documentation.

>

> To view Transmittal 63, click on the link below.

>

> www.cms.hhs.gov/transmittals/downloads/R63BP.pdf

>

> To view CMS Pub 100-02, click on the link below and

> start reading on page 119.

>

> Effective January 1, 2007, there will be no manual

> exception process. All exceptions will be automatic.

> To read more about this, click on the link below to

> read Transmittal 1145.

>

>

http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf

>

<http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf>

>

>

> Please read this Transmittal carefully as it places

> more responsibility on the provider when using the

> KX

> modifier when the patient does not have an condition

> or complexity that supports the automatic process.

>

> If you should have any questions, please send

> questions to the entire list serve, if possible, as

> I

> am sure many of us will have the same questions.

>

> Happy New Year!

>

> Rick Gawenda, PT

> HPA Government Affairs & Practice Committee

>

> Rick Gawenda, P.T.

> Director Physical Medicine & Rehabilitation

> Detroit Receiving Hospital

> Detroit, MI

> Phone:

> Fax:

> E-mail:rgawenda@... <mailto:rgawenda%40dmc.org>

>

> __________________________________________________

>

[Guest guest]

You can sign up to have Medicare e-mail you with updates. They e-mail their

updates every Friday.

E. , DPT

Bodyscape Integrative Physical Therapy

Pasadena, CA

<br>

<br>

> Does Transmittal 68 apply to all outpatient<br>

> facilities - ie hospital<br>

> based outpatient?<br>

> <br>

> Looks pretty similar to prior transmittals.<br>

> <br>

> Diane , PT<br>

> LMH - Hospital<br>

> Antigo, WI <br>

> <br>

> ____________<wbr>_________<wbr>_________<wbr>__<br>

> <br>

> From: <a

href= " mailto:PTManager%40yahoogroups.com " >PTManager@yahoogrou<wbr>ps.com</a><br>

> [mailto:<a

href= " mailto:PTManager%40yahoogroups.com " >PTManager@yahoogrou<wbr>ps.com</a>]

On<br>

> Behalf Of Rick Gawenda<br>

> Sent: Monday, January 01, 2007 6:35 PM<br>

> To: <a

href= " mailto:ptmanager%40yahoogroups.com " >ptmanager@yahoogrou<wbr>ps.com</a><br>

> Subject: Important CMS Updates - Manual<br>

> Exception Process<br>

> Eliminated<br>

> <br>

> <br>

> <br>

> List Serve,<br>

> <br>

> On December 29, 2006, CMS released Transmittal 63<br>

> and<br>

> placed this information in Pub 100-02, Chapter 15 on<br>

> the very same day providing additional<br>

> requirements/<wbr>recommendations for outpatient therapy<br>

> services/documentat<wbr>ion.<br>

> <br>

> To view Transmittal 63, click on the link below.<br>

> <br>

> www.cms.hhs.<wbr>gov/transmittals<wbr>/downloads/<wbr>R63BP.pdf<br>

> <br>

> To view CMS Pub 100-02, click on the link below and<br>

> start reading on page 119. <br>

> <br>

> Effective January 1, 2007, there will be no manual<br>

> exception process. All exceptions will be automatic.<br>

> To read more about this, click on the link below to<br>

> read Transmittal 1145.<br>

> <br>

><br>

<a

href= " http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf " >http://www.cms.\

<wbr>hhs.gov/transmit<wbr>tals/downloads/<wbr>R1145CP.pdf</a><br>

><br>

<<a

href= " http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf " >http://www.cms.\

<wbr>hhs.gov/transmit<wbr>tals/downloads/<wbr>R1145CP.pdf</a>><br>

> <br>

> <br>

> Please read this Transmittal carefully as it places<br>

> more responsibility on the provider when using the<br>

> KX<br>

> modifier when the patient does not have an condition<br>

> or complexity that supports the automatic process.<br>

> <br>

> If you should have any questions, please send<br>

> questions to the entire list serve, if possible, as<br>

> I<br>

> am sure many of us will have the same questions.<br>

> <br>

> Happy New Year!<br>

> <br>

> Rick Gawenda, PT<br>

> HPA Government Affairs & Practice Committee<br>

> <br>

> Rick Gawenda, P.T. <br>

> Director Physical Medicine & Rehabilitation<br>

> Detroit Receiving Hospital <br>

> Detroit, MI <br>

> Phone: <br>

> Fax: <br>

> E-mail:<a href= " mailto:rgawenda%40dmc.org " >rgawendadmc (DOT) <wbr>org</a>

<mailto:rgawenda%<wbr>40dmc.org> <br>

> <br>

>

____________<wbr>_________<wbr>_________<wbr>_________<wbr>_________<wbr>__<br>

>

[Guest guest]

Cathi,

Here is a link where you can sign up for automatic

e-mails from CMS.

http://www.cms.hhs.gov/apps/mailinglists/

Here is a link to the Transmittal page on the CMS

websites.

http://www.cms.hhs.gov/Transmittals/

Go there at least once a week and see what has been

released and if it pertains to therapy.

Your Medicare contractor's website would also be good

for you to visit often and some up for their automatic

e-mail notices.

This will get you started.

Rick Gawenda, PT

HPA Government Affairs & Practice Committee

--- Redwood Hand Therapy wrote:

> Just a question....1st of all, How in the world do

> you keep updated on all of the Medicare changes?

> How do you find all of them? I go on their website

> and it takes hours to try and read everything and I

> still feel like I am missing so much. What is the

> difference between Pub. 100-02 Transmittal 63 and

> Pub. 100-04 transmittal 1145?

> This seems to be a Full-Time Job just reading all of

> the changes,updates etc.... When is there time to

> actually do the billing, documentation and treating

> of the patients?

>

> Cathi Pritchard

> Redwood Hand Therapy

> Important CMS Updates -

> Manual

> > Exception Process

> > Eliminated

> >

> >

> >

> > List Serve,

> >

> > On December 29, 2006, CMS released Transmittal

> 63

> > and

> > placed this information in Pub 100-02, Chapter

> 15 on

> > the very same day providing additional

> > requirements/recommendations for outpatient

> therapy

> > services/documentation.

> >

> > To view Transmittal 63, click on the link below.

> >

> > www.cms.hhs.gov/transmittals/downloads/R63BP.pdf

> >

> > To view CMS Pub 100-02, click on the link below

> and

> > start reading on page 119.

> >

> > Effective January 1, 2007, there will be no

> manual

> > exception process. All exceptions will be

> automatic.

> > To read more about this, click on the link below

> to

> > read Transmittal 1145.

> >

> >

>

>

http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf

> >

>

>

<http://www.cms.hhs.gov/transmittals/downloads/R1145CP.pdf>

> >

> >

> > Please read this Transmittal carefully as it

> places

> > more responsibility on the provider when using

> the

> > KX

> > modifier when the patient does not have an

> condition

> > or complexity that supports the automatic

> process.

> >

> > If you should have any questions, please send

> > questions to the entire list serve, if possible,

> as

> > I

> > am sure many of us will have the same questions.

> >

> > Happy New Year!

> >

> > Rick Gawenda, PT

> > HPA Government Affairs & Practice Committee

> >

> > Rick Gawenda, P.T.

> > Director Physical Medicine & Rehabilitation

> > Detroit Receiving Hospital

> > Detroit, MI

> > Phone:

> > Fax:

> > E-mail:rgawenda@...

> <mailto:rgawenda%40dmc.org>

> >

> >

> __________________________________________________

> >