Occupational Therapy Marketing to Physician - PDF by nfp88488


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									                                                                                            February 2009

Spotlight On Therapy Services At DRMC
Delta Regional Medical Center’s Outpatient Rehabilitation &          •   Spine care program with lordex decompression system
sports Medicine offers a full range of rehabilitation services       •   Myofascial release
including physical, occupational, and speech therapy.                •   Posture education and back safety
Delta Regional’s Outpatient Rehabilitation & sports Medicine         •   Developmental activities
program includes comprehensive therapy for everyone from             •   Early intervention (0-3 years old)
infants to senior citizens. Experienced therapists provide           OCCuPATiONAl ThERAPy
treatment options for children with developmental delays,
individuals with sports or work related injuries, and patients       Occupational therapists help their patients develop skills
recovering from a stroke or surgery.                                 for the job of living and working. The primary goal of an
                                                                     Occupational Therapy (OT) program is to assist patients in
PhySiCAl ThERAPy                                                     regaining quality of life after injuries such as burns, head
Physical therapists specialize in treating disabilities related to   injury, spinal cord injury, or work related injury. Stroke victims
motor and sensory impairments. They are trained in all aspects       and children with sensory dysfunction, development delay,
of anatomy and physiology related to normal function, with an        or ADD/ADhD are also helped by OT because it improves
emphasis on movement.                                                interaction between the brain and body. At DRMC’s Outpatient
                                                                     Rehabilitation and Sports Medicine, our occupational
People who might benefit from physical therapy:                      therapists use specialized treatment techniques and
• People with painful conditions resulting from arthritis or         equipment to help patients regain upper extremity function
  injury                                                             and improve their ability to perform activities of daily living.
• People with balance disorders
• Patients recovering from surgery                                   Continued on Pg. 4
• Stroke patients
• People with sports or other kinds of injuries affecting their
• Patients suffering from neck pain or low back pain
• People suffering from neurological disorders such as
  Parkinson’s Disease
• Children with developmental delays or physical disabilities
Physical Therapy programs available at Outpatient
Rehabilitation and sports Medicine:
• The only aquatic therapy program in the area
• Pain management including hivamat Deep Oscillation
  Therapy and Game Ready Cold and Compression therapy
• Wound healing therapy
• Bioness foot-drop system
• Stroke /Neurological rehabilitation program

                                                   In ThIs Issue:
                                                   Put In The extra effort When Documenting Consultations In Your Practice
                                                   DRMC Cardiac Physicians • Agha Raza, MD, Neurologist, Joins DRMC Staff
Delta	Regional	•	Vital	Signs	                                                                                              February 2009

HIPPA Pitfalls To
Look For In Your                                   Put In The Extra Effort When Documenting
                                                   Consultations In Your Practice:
Physician Practices
                                                   CoNSIDER	THESE	TIPS	To	MAINTAIN	CoMPlIANCE	
     Not	providing	the	notice	of	privacy	
     practices	(NPP),	even	though	they	
     require	patients	to	sign	a	statement	
                                                   M    edicare	and	third-party	insurance	
                                                        auditors	often	examine	evaluation	
                                                   and	management	(E/M)	codes.	Recently,	
                                                                                                 report	inpatient	consultation	codes	for	
                                                                                                 other	places	of	service,	such	as	nursing	
                                                                                                 homes	or	rehabilitation	facilities.
	    indicating	they	had	been	provided	            Medicare	auditors	have	focused	on	
	    with,	and	read,	the	NPP.	                                                                   TIP	#2:	FolloW	THE	THREE	RS
                                                   documentation	for	consultations.
•	 Not	having	documented	internal	                                                               When	physicians	or	qualified	NPPs	
                                                   Auditors	have	seen	many	cases	in	which	       document	consultations,	they	should	
	 information	security	and	privacy	
                                                   physicians	and	qualified	nonphysician	        follow	the	three	Rs:
	 policies	for	staff	members	to	follow.	
                                                   practitioners	(NPP)	do	not	adequately	
•	   Exposing	PHI	to	anyone	within	                follow	the	1995	or	1997	Evaluation	and	       Request.	Before	the	consultation,	
	    the	office	facilities	(e.g.,	patient	file		   Management	Documentation	Guidelines	          physicians	and	qualified	NPPs	
	    folders	left	out	on	the	check-in	desk	                                                      should	remember	to	follow	this	dual-
                                                   for	these	types	of	cases.	Both	sets	of	
	    unattended,	patient	file	folders	left	                                                      documentation	process:
                                                   E/M	guidelines	are	admissible;	however,	
	    in		the	wall	pockets	outside	
                                                   providers	can	only	use	one	set	of	            1.	 The	requesting	physician	should	
	    examination	rooms	with	health	
	    information	facing	out	and	visible,	          guidelines	at	a	time	and	may	not	switch	      send	the	consulting	physician	a	written	
	    etc.)	                                        back	and	forth	between	the	two	when	          request	that	includes	the	reason	for	
                                                   assigning	codes	for	a	single	episode	         the	consultation.	The	requesting	
•	 Healthcare	workers	calling	out	the	
                                                   of	care.	Providers	must	also	follow	the	      physician	should	document	this	request	
	 full	names	of	patients	in	the	waiting	
	 room	or	in	front	of	other	patients.	             consultation	guidelines	published	in	the	     and	place	a	copy	of	the	request	in	the	
                                                   Medicare	Claims	Processing	Manual,	           patient’s	medical	record.	In	addition,	
•	   Not	obtaining	consent	from	patients	                                                        the	requesting	physician	should	place	
                                                   publication	100-04,	chapter	12,	section	
	    to	film	them	and	then	use	the	
                                                   30.6.10	to	support	billing	of	consultation	   a	copy	of	the	request	in	his	or	her	plan	
	    video,	or	to	tape	audio	with	them	for	
                                                   codes.                                        of	care.	When	the	requesting	physician	
	    marketing	purposes.	
                                                   Auditors	scrutinize	consultation	             documents	the	chart	by	hand,	his	or	her	
•	   Not	providing	any	training	or	                                                              notes	must	be	legible.
	    ongoing	awareness		 	                         documentation	mainly	because	the	
	    communications,	or	providing	                 reimbursement	for	this	type	of	visit	is	      2.	 	If	the	notes	are	not	legible,	third-
	    training	just	once,	and	never	again.		        higher	than	the	reimbursement	for	office	     party	payers,	including	Medicare	will	
•	   Insecure	disposal	of	PHI,	such	as	            visits	of	similar	documentation	levels.	      treat	the	visit	as	though	there	was	no	
	    unshredded	into	open	and	publicly	            When	physicians	and	qualified	NPPs	           documentation	and	as	though	the	visit	
	    available	trash	bins,	into	the	trash	         do	not	accurately	follow	the	guidelines,	     did	not	occur.	Therefore,	Medicare	and	
	    dumpster	behind	the	office	building,	         Medicare	and	other	insurance	carriers	        other	payers	will	recoup	money	from	the	
	    etc.	                                         may	either	down-code	or	deny	the	claims	      physicians	or	qualified	NPPs	because	
•	 Not	documenting	or	retaining	                   in	most	instances,	which	results	in	          they	would	have	determined	that	the	visit	
	 information	about	PHI	changes	and	               lost	reimbursement.	To	ensure	that	the	       should	not	have	been	paid.
	 access	as	required	by	law.	                      documentation	matches	the	coding,	            Render	an	opinion	or	advice.	The	
                                                   consider	the	following	tips	outlined	         consulting	physician	or	qualified	NPP	
                                                   below.                                        must	then	render	his	or	her	opinion	or	
                                                   TIP	#1:	KNoW	THE	CoRRECT	CoDES                advice	regarding	the	patient’s	problem	
                                                   Report	office/outpatient	consultation	        and	document	it	in	the	patient’s	medical	
                                                   codes,	99241–99245,	and	inpatient	            record.
                                                   consultation	codes,	99251–99255,	for	new	 Report	information	in	a	shared	record	
                                                   patients	or	established	patients.	Also,	  or	in	a	formal	letter.	If	the	consulting	
                                                                                             physician	or	qualified	NPP	does	not	
February 2009	                                                                                           Delta	Regional	•	Vital	Signs

share	the	patient’s	medical	record	with	    When	choosing	the	consultation	code,	         TIP	#6:	TAKE	PRoCEDuRE	CoDES	INTo	
the	requesting	physician	or	qualified	      also	consider	that	outpatient	codes	          ACCouNT
NPP,	then	the	consulting	physician	         include	only	face-to-face	time	with	the	      To	code	procedures	rendered	during	
or	NPP	should	send	a	letter	to	the	         patient.	Inpatient	codes,	however,	include	   the	consultation,	append	modifier	-25	
requesting	physician	or	qualified	NPP.	     face-to-face	time	as	well	as	time	spent	on	   to	the	consultation	code.	For	example,	
If	the	consulting	physician	does	share	     the	hospital	floor	on	the	patient’s	behalf.   a	physician	or	qualified	NPP	may	
the	patient’s	medical	record	with	the	      TIP	#4:	uNDERSTAND	CoNSulTATIoN	              request	a	consultation	from	a	podiatrist	
requesting	provider,	the	report	should	     REquIREMENTS                                  regarding	a	foreign	body	in	a	patient’s	
be	entered	into	that	record.	The	report	                                                  foot.	When	a	podiatrist	performs	an	
should	always	include	a	thank	you	letter	   The	following	situations	do	not	qualify	
                                            as	consultations	according	to	Medicare	       expanded	problem-focused	consultation,	
for	the	consultation	request	as	well	as	                                                  code	99242,	he	or	she	should	report	the	
state	the	consultant’s	opinion	regarding	   standards:
                                                                                          consultation	code	with	a	modifier	-25	
the	patient’s	medical	problem.              •	 When	there	is	no	written	request	for		 	   appended	to	the	code,	99242-25,	and	
TIP	#3:	INCluDE	E/M	DoCuMENTATIoN	          	 an	opinion	or	advice	(i.e.,	a	reason)	      report	code	28192	for	the	removal	of	a	
CoMPoNENTS                                  	 regarding	a	specific	patient	problem	       foreign	body	from	the	foot,	deep.
When	a	physician	or	other	qualified	        •	 When	the	physician	or	other	qualified	     TIP	#7:	REVIEW	CoDES	FoR	FolloW-uP	
NPP	documents	the	visit,	the	following	     	 NPP	who	renders	the	opinion	or	gives	       VISITS
three	major	key	components	must	all	be	     	 the	advice	does	not	write	a	report	
                                                                                          Remember	to	use	appropriate	codes	
documented	at	the	same	visit	level	and	     For	example,	when	an	emergency	room	          based	on	the	location	of	the	follow-up	
included	in	the	patient’s	medical	record:   (ER)	physician	tells	a	patient	to	see	an	     visits.If	the	patient	returns	to	the	office,	
1.	 History                                 ear,	nose,	and	throat	(ENT)	physician	        the	consulting	provider	should	report	
2.	 Exam                                    for	follow-up	care	for	tonsillitis,	the	      codes	in	the	99211–99215	range	for	an	
3.	 Medical	decision-making                 ER	physician	treats	the	immediate	            established	patient	office	visit.
                                            problem	of	tonsillitis	and	suggests	that	
To	document	the	same	visit	level,	for	      the	patient	see	an	ENT	for	further	care.	     If	the	consulting	provider	sees	the	patient	
example,	all	three	components	must	be	      Because	the	ER	physician	is	not	asking	       again	in	an	inpatient	setting	or	at	a	rehab	
either:                                     for	an	opinion	or	advice	concerning	the	      facility,	report	subsequent	care	codes	
1.	 Problem-focused                         tonsillitis,	the	ENT	should	bill	an	office	   99231–99233.	Report	codes	99307–99310	
2.	 Expanded	problem-focused                visit,	not	a	consultation.                    for	visits	subsequent	to	consultations	
3.	 Detailed	with	medical	decision		    	                                                 rendered	in	a	nursing	facility.
                                            TIP	#5:	REVIEW	CoDES	FoR	
	 making	of	low	complexity                  PREoPERATIVE	CoNSulTATIoNS                    TIP	#8:	AVoID	ExCESSIVE	REquESTS	
4.	 	Comprehensive	with	medical	decision                                                  FoR	CoNSulTATIoNS	IN	THE	SAME	
	 making	of	moderate	complexity             To	bill	a	preoperative	clearance	             GRouP	PRACTICE
5.	 Comprehensive	with	medical	decision     consultation,	include	the	appropriate	
                                            diagnosis	codes	on	the	claim.	For	            Physicians	or	other	qualified	NPPs	in	
	 making	of	high	complexity	                                                              the	same	group	practice	may	request	
                                            example,	include:
For	example,	when	a	physician	or	other	                                                   consultations	from	each	other	when	
qualified	NPP	reports	code	99244	           •	   The	diagnosis	code	that	indicates	the    the	consulting	provider	has	specific	
(consultation	level	four,	typically	60	     	    reason	for	the	surgery	                  knowledge	in	a	relevant	medical	area	
minutes),	he	or	she	must	include	a	         •	   one	of	the	preoperative	diagnosis	       that	exceeds	the	requesting	provider’s	
comprehensive	history	and	exam	and	         	    codes,	such	as	V72.81–V72.84	            knowledge.	However,	do	not	allow	
exhibit	moderate	medical	decision-          •	   other	diagnosis	codes	that	have	         continual	requests	for	consultations	
making.	Code	99244	also	requires	that	      	    a	bearing	on	the	patient’s	medical	      between	members	of	the	same	group	to	
the	patient	is	experiencing	problems	       	    condition	                               become	routine	practice.
that	are	of	moderate	to	high	severity.	     In	the	absence	of	any	sign	or	symptom	of	
Additionally,	counseling,	coordination	     a	disease	or	sickness,	Medicare	and	other	
of	care,	and	time	must	be	included	when	    third-party	payer	auditors	would	deem	
determining	the	visit	level.                the	visit	a	screening,	and	you	should	
                                            report	a	routine	physical	visit	code.
Delta	Regional	•	Vital	Signs	                                                                         February 2009

DRMC Cardiac Physicians
                          DR. STEvEN ChAPMAN                                 DR. JOhN hERzOg
                          MD	from	Bowman	Gray.	                              MD	from	ole	Miss.	
                          “It	is	a	sobering	responsibility	to	have	the	      “lifestyle	choices	that	we	make	from	
                          opportunity	to	take	a	beating	heart	and	           childhood...whether	we	smoke,	what	we	
                          repair	the	damage	that	age,	heredity	or	           eat,	whether	we	get	enough	exercise	and	
                          lifestyle	choices	have	caused.		                   other	factors	can	increase	the	risk	for	
                          As	a	Cardiovascular	and	Thoracic	Surgeon	          heart	disease.		
                          and	a	member	of	the	heart	team	at	Delta	           By	identifying	a	patient’s	risks,	we	can	
                          Regional	Medical	Center,	I	get	to	witness	         help	them	stop	or	slow	the	damage	to	their	
                          this	kind	of	miracle	every	day.”                   hearts	with	lifestyle	changes,	medication	
                                                                             and	a	structured	exercise	program.”

                          DR. kEN hAhN                                       DR. MiChAEl MANSOuR
                          MD	from	Chicago	Medical	School.                    MD	from	ole	Miss.	
                          “I	noticed	that	Chicago	and	Greenville	            “Good	cardiovascular	care	is	a	team	
                          have	much	in	common...an	overwhelming	             effort.		Patients	working	with	their	family	
                          prevalence	of	cardiovascular	disease,	diets	       physician	can	make	a	major	impact	
                          rich	in	saturated	fat,	and	unpredictable	          on	preventing	and	treating	disease	by	
                          weather	patterns.		                                controlling	diabetes,	hypertension,	obesity,	
                          our	cardiovascular	team	at	Delta	Regional	         cholesterol,	and	improving	inactivity.		
                          is	well	equipped	to	handle	all	aspects	of	         Working	together	we	offer	the	most	
                          cardiovascular	disease.”                           advanced	care	available	in	the	treatment	of	
                                                                             heart	disease.”

                          DR. hugh gAMBlE                                    DR. N. WATTANASuWAN
                          MD	from	ole	Miss.	                                 Residency	at	long	Island	Hospital.
                          “DRMC	has	assembled	a	group	of	                    “our	Delta	area	is	known	to	have	a	high	
                          physicians	that	provide	the	highest	               prevalence	of	cardiovascular	disease.		
                          quality	of	cardiovascular	care	available.		
                                                                             our	goal	as	cardiologists	is	not	only	to	
                          Elective	care	is	more	convenient	at	home	          treat	heart	and	vascular	problems,	but	
                          and	emergency	care	is	more	readily	                also	to	prevent	you	and	our	loved	ones	
                          available	when	needed.	                            from	having	these	problems.		
                          The	quality	of	life	for	the	citizens	of	the	       I	am	committed	to	work	with	each	and	
                          entire	Delta	will	be	improved	by	the	access	       every	one	of	you	to	make	our	community	
                          to	comprehensive	cardiovascular	medical	           better	and	healthier.”
                          DR. BEN FOlk                                       DR. JOhN TuRNER, iv
                          MD	from	ole	Miss.	                                 MD	from	Tulane.
                          “When	I	started	the	cardiology	program	            “As	pleased	as	I	have	been	having	
                          at	Delta	Regional	Medical	Center	in	               returned	to	Greenville,	I	am	more	pleased	
                          1986,	I	was	the	only	cardiologist	in	              with	the	accomplishments	of	the	medical	
                          the	Mississippi	Delta	and	the	only	                community	and	the	healthcare	system	in	
                          cardiologist	in	Greenville	until	1997.	            the	Delta.
                          With	the	addition	of	cardiac	surgery	in	           I	am	proud	to	be	a	part	of	DRMC’s	
                          1997,	we	have	been	able	to	expand	the	             progressive	commitment	to	healthcare	
                          available	cardiology	services	in	Greenville.	      excellence.		I’m	excited	about	the	future	
                                                                             of	cardiovascular	care	for	our	community,	
                          It	is	amazing	to	see	how	the	cardiac	              and	I	look	forward	to	the	expansion	and	
                          program	at	Delta	Regional	Medical	Center	          advances	in	cardiovascular	health	for	our	
                          has	progressed	in	the	past	19	years.”              residents.”

Happy Birthday
Khaled	N.	Abu-Hamdan,	M.D.                     Kenneth	Hayles,	M.D.       Jean	Barker,	M.D.
February	1	                                    February 3                 February	13
Alan	l.	Billsby,	D.o.                          leon	lenoir,	M.D.
February	1                                     February	10
February 2009	                                                                                               Delta	Regional	•	Vital	Signs

Continued from cover                                                  •    voice disturbance
Occupational Therapy programs available at Outpatient                 •    Cognitive disorders
Rehabilitation and sports Medicine:                                   •    Autism
                                                                      •    Poor speech intelligibility
• Bioness advanced neuroprosthesis for upper limb paralysis           •    Chewing or swallowing disorders
• lymphedema management with the only certified
  lymphedema therapist in the area                                    At DRMC’s Outpatient Rehabilitation and Sports Medicine,
• Scar management                                                     our Speech Therapy Team specializes in the following
• Splinting                                                           interventions:
• Aquatic therapy                                                     • Stroke/Neurological rehabilitation
• handy therapy for orthopedic hand injuries and wound                • Dysphagia Management utilizing vital Stim
  management                                                          • Sensory integration
• Shoulder rehabilitation                                             • Early intervention (0-3 years old) for speech, language and
• Stroke/Neurological rehabilitation program                            swallowing
• Sensory integration                                                 • Traditional techniques for treatment of voice, fluency and
• Early intervention (0-3 years old)                                    intelligibility
                                                                      If your patients have suffered an injury or illness that is
SPEECh ThERAPy                                                        keeping them from carrying out daily activities or if a child
speech therapists treat patients with communication and               exhibits delays in developmental milestones, the therapists at
swallowing disorders. Speech, language, or swallowing                 Delta Regional’s Outpatient Rehabilitation & sports Medicine
disorders can be present from birth or can be caused by               can help.
environmental factors, illnesses, developmental delays, or            To learn more about Outpatient Rehabilitation & sports
injuries to the brain or spinal cord.                                 Medicine, or to schedule an appointment, please call
Conditions/Disabilities that may benefit from speech therapy:         662-334-2021.
• language disorder or delay
• Stuttering

  CME Topics
  February 10, 2009                                                       March 19, 2009
  Dr. Wade Banker & Dr. Benoit Blondeau                                   Dr. Robert Tiel
  12:15 PM, DRMC One East Conference Room                                 12:15 PM, DRMC One East Conference Room
  Diagnosis and Management of liver Tumors                                Surgery of the Peripheral nerves, (tumors, trauma,
  MD, NP, RPh, and other Allied health Care Professionals                 entrapments
                                                                          MD, NP, RPh, and other Allied health Care Professionals
  March 5, 2009
  Dr. Robert Mobley                                                       For additional information please contact Angie Savoie,
  6:00 PM, greenville Country Club                                        Quality Specialist, at 662-725-2699.
  Designed for success series III
  MD, NP, RPh, and other Allied health Care Professionals

 Delta Regional Medical Center complies with the legal requirements and the rules and regulations defined by the Americans with Disabilities
 Act. If you require special accommodations, please contact Angie Savoie @ 725-2699 prior to the activity.
 DISCLOSURE: DRMC requires that CME faculty disclose, during the planning of an activity, the existence of any personal financial or other
 relationships they or their spouses/partners have with the commercial supporter of the activity or with the manufacturer of any commercial
 product or service discussed in the activity.
Delta	Regional	•	Vital	Signs	                                                                                              February 2009	

Agha Raza, MD, Neurologist, Joins DRMC Staff
                           D     elta	Regional	Medical	Center	
                                 announces	the	addition	of	Agha	
                            Raza,	M.D.,	Neurologist,	to	its	medical	
                                                                       Dr.	Raza	began	his	medical	training	at	the	King	Edward	Medical	
                                                                       College	in	lahore,	Pakistan.	He	went	on	to	serve	his	Internship	
                                                                       at	Hennipin	County	Medical	Center	in	Minneapolis,	MN	and	his	
                            staff.	Dr.	Raza	is	Board	Certified	        Residency	in	the	Department	of	Neurology	at	the	university	of	
                            in	Neurology	and	a	member	of	the	          Minnesota,	in	Minneapolis,	where	he	also	was	a	Fellow	in	Clinical	
                            American	Academy	of	Neurology.             Neuro-physiology.	At	the	prestigious	Mayo	Clinic	in	Rochester,	
                            Neurology	is	a	medical	specialty	          Dr.	Raza	was	a	Fellow	in	Peripheral	Nerve	Disorders.	Dr.	Raza	
                            dealing	with	disorders	of	the	nervous	     completed	an	additional	Fellowship	in	Neuromuscular	Disorders	
                            system.	Specifically,	it	deals	with	the	   at	the	university	of	Vermont.	He	has	spent	five	years	as	a	staff	
                            diagnosis	and	treatment	of	nervous	        neurologist	at	Waldo	County	General	Hospital	in	Belfast,	Maine.
system	disorders,	including	diseases	of	the	brain,	spinal	cord,	       “Dr.	Raza’s	outstanding	credentials	will	be	a	great	asset	to	the	
nerves,	and	muscles.		Neurologists	are	trained	to	investigate,	        medical	community	in	the	tri-state	Delta	region,”	stated	l.	Ray	
diagnose,	and	treat	neurological	disorders	and	perform	                Humphreys,	FACHE,	CEo	of	Delta	Regional	Medical	Center.	“He	is	
examinations	of	the	nerves	of	the	head	and	neck;	muscle	strength	      truly	a	leader	in	his	field,	who	will	join	our	staff	in	our	mission	of	
and	movement;	balance,	ambulation,	and	reflexes;	and	sensation,	       improving	the	health	of	the	citizens	and	communities	we	serve.”
memory,	speech,	language,	and	other	cognitive	abilities.	This	         Dr.	Raza	stated	“I	am	very	excited	to	join	the	staff	at	DRMC	and	
specialty	is	an	important	addition	to	DRMC’s	growing	number	of	        very	much	look	forward	to	serving	this	wonderful	community	for	
unique	medical	specialties.	“The	Greenville	area	has	been	without	     a	long	time.”	Dr.	Raza’s	office	is	located	at	1703	Hospital	Street	in	
a	neurologist	for	over	a	year	now.	our	medical	community	and	          Greenville	and	his	office	number	is	662-335-2103.
our	hospital	patients	certainly	will	welcome	the	additional	
expertise	that	Dr.	Raza	will	provide	here	locally,”	stated	Philip	
Doolittle,	MD,	Delta	Regional	Medical	Center’s	Chief	of	Staff.

                                                                                            1400	E.	union	Street	•	Greenville,	MS	38703

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