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Podiatrist Billing for Physical Therapy

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Noridian: Outpatient Therapy Resources

Noridian JE Part B Outpatient Therapy Resources

MLN Education Tool

Quick Reference Chart: Descriptors of G-codes and Modifiers for Therapy Functional

Novitas: Physical Therapy Plan of Care

Novitas: Physical Therapy Plan of Care Requirements

Drugs and Biologicals Pub-100 Ch 17

Drugs and Biologicals Pub-100 Ch 17

Billing Requirements for OPPS

Billing Requirements for OPPS Providers with Multiple Service Locations

Standard Written Order (SWO)

Dates of Service on or After January 1, 2020

Select the title to see a summary and a link to the full article.

CMS-Coverage for Therapeutic Shoes for Individuals with Diabetes

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Therapeutic shoes and inserts can play a vital role in a diabetic patient's health. Medicare may cover one pair every year and three pairs of custom inserts each calendar year if the patient qualifies and everything is handled correctly.  Medicare Benefit Policy Manual explains what is needed for a person with diabetes to ...

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New Biofeedback Codes to replace 90911 Eff 2020-01-01

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CMS announced 90912 and 90913 are to be used starting January 2020 in place of 90911. According to CMS MLN, these new codes, designated as “sometimes therapy”, are reported to furnish these services outside a therapy plan of care when appropriate. Codes are permitted to be used by physicians and Non-Physician Practitioners (NPPs), ...

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Medical ID Theft

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Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...

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The OIG Work Plan: What Is It and Why Should I Care?

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The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...

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Act Now on CMS Proposal to Cover Acupuncture for Chronic Low Back Pain

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Now is the time to comment on a proposal to cover acupuncture for chronic low back pain. This comment period is the part of the HHS response to the opioid crisis. You only have until August 14th to officially comment.

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5 Ways to Minimize HIPAA Liabilities

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Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...

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Will the New Low Level Laser Therapy Code Solve Your Billing Issues?

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Low level laser therapy (LLLT), also known as cold laser therapy, is a form of phototherapy which uses a device that produces laser beam wavelengths, typically between 600 and 1000 nm and watts from 5–500 milliwatts (mW). It is often used to treat the following: Inflammatory conditions (e.g., Rheumatoid Arthritis, Carpal ...

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Electrical Stimulation and Electromagnetic Therapy Devices

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Electrical Stimulation and Electromagnetic Therapy Devices can be used for pain, muscle atrophy, help spinal cord injuries, treat symptoms caused by other medical conditions and can be used in the treatment of wounds. This Regence BC/BS article lists codes and devices and gives guidance on coding from Medicare Advantage viewpoint.

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Clinical Staff vs. Healthcare Professional

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State scope of practice laws and regulations will help determine who is considered Clinical staff and Other qualified Health Care professionals.  Physician or other qualified healthcare professionals:  Must have a State license, education training showing qualifications as well as facility privileges.  Examples of Qualified Healthcare professionals: (NOTE: this list is not all-inclusive, please refer to your payer ...

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Physical Therapy Caps Q/A

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Question: How do I code it so that PT services in a chiropractic office don’t count against their PT visit max? Is there a way to code claims so that they are considered chiropractic only? But still get compensated enough? We have been running into some issues as of late ...

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Select the webinar title to view a summary and link to the webinar video.

Confusing Codes for Chiropractors - 97110 versus 97112 versus 97530

In this webinar, you'll get a deep dive into three therapeutic procedure codes. Dr. Gwilliam, a chiropractor and certified professional coder, will take you thorough the ins and outs of therapeutic exercises, activities, and neuromuscular reeducation. They will be compared and contrasted with examples to make sure everyone leaves with the confidence to document and bill them correctly.

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Neuromuscular Reeducation, Massage Therapy - Proper Use, Documentation and Coding

In this webinar, Dr. Howard Levinson (Forensic Consultant) will address the erroneous use and billing of Neuromuscular Reeducation, Massage Therapy and Hydrotherapy in chiropractic clinics. He will offer strategies regarding how these services may be used appropriately in the chiropractic setting and provide documentation and coding information.

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Posture Rehab and Motor Control Exercise

Join the Posture Expert, Dr. Steven Weiniger, and find out why the American College of Physicians recommends motor control exercise (MCE) for low back pain over drugs and surgery. Learn how StrongPosture® MCE protocols synergizes with chiropractic by correlating the individual’s unique perceptions with objective benchmarks to systematically correct sensorimotor errors and functionally strengthen posture.

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How to Use Medical Codes for PI Care

Can you or can you not use “medical” codes (fracture, surgery, illness, etc.) for PI care? Is it legal? Why would you even consider them?

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Coding and Documenting Physical Therapy Treatment Modalities

Presented by Evan Gwilliam DC MBA BS CPC NCICS CCPC CCCPC CPC-I MCS-P CPMA May 22nd, 2018 Tuesday @ 10:15 AM PT, 11:15 AM MT, 12:15 PM CT, 1:15 PM ET Ever wonder how to get paid for that e-stim or ultrasound? Do payers give you a hard time and ...

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Proving Medical Necessity and Functional Improvement

Medicare is required by law to pay for care that is medically necessary. Medicare considers functional improvement to be the primary indicator of medical necessity for chiropractic care. It is up to you, the doctor, to prove functional improvement and medical necessity with your documentation. Dr. Short will show you how to use common practice tools to document functional improvement, medical necessity and maximum medical improvement. You will learn: -What is Medicare’s definition of medical necessity. -What does Medicare’s determination of Medical Necessity mean to your care plan. -How to prove medical necessity. -How to report this information to Medicare. -How to determine Maximum Medical Improvement.

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Proper Coding and Billing for Drugs, Biologicals and Injections

Proper Coding and Billing for Drugs, Biologicals and Injections

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Physical Therapy Resources

  • Reimbursement Guide (Deskbook)
  • ICD-10-CM Specialty Specific Code Book
  • Provider Documentation Guides
  • ICD-10-CM Comprehensive Code Books
  • and more...


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