What scares you most about ICD-10? Is it the countless codes you will have to learn, the lack of success the Canadian Healthcare system suffered during the implementation of ICD-10, or the potential productivity losses?
What you are right about is the complexity and expansion of the code set; the approximate 13,000 previously used ICD-9 codes have grown to more than 68,000 codes for ICD-10. However, you must realize that your practice will not be dealing with all of these codes, but you can most certainly expect that your practice will have to become very familiar with a couple dozen new codes. Just as all new concepts and information require time to process, you can expect that over time and with repetitive use, you will find yourself gradually becoming accustomed to the new ICD-10 guidelines with ease.
Why Canadian Authorities Struggled with ICD-10
It could be considered that Canada had much more adapting to endure during their implementation of ICD-10 than we will have to. In Canada, all medical coding submissions were paper based prior to the implementation of ICD-10. So when the time for ICD-10 implementation came around, Canadian coders were not only making a transition to the use of a computer software over physical books but also developing their knowledge of a new code set.
The large cost of implementation for the new technology is a huge factor that was overlooked. The fact that this and many other major changes that occurred were largely underestimated made the transition to ICD-10 for Canadian authorities and users such a struggle.
How to Avoid the Same Mistakes
A tough transition period for Canadian Medical Services is what led to their high productivity losses after the switch from ICD-9; since we do not face the same challenges we are a step ahead. Until October 1st we will not truly know whether we will be hit with the same productivity losses but there is much we can do to prepare and avoid disaster.
Take advantage of the ICD-10 preparation materials provided to you, many of these free materials will be able to get you and your practice on track for a smooth transition to ICD-10. Make sure your entire organization is informed about the changes so everyone is on-board when the October 1st deadlines rolls around the corner.
Check out the ICD-10 Quick Start Guide to ensure you are taking all the steps required for your practice to successfully implement ICD-10 https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD10QuickStartGuide20150622.pdf.
The Special Olympics (SOI) unites millions of adults and children with intellectual disabilities, volunteers, coaches, families, and healthcare practitioners all with the goal to educate participants about healthy living, fitness and nutrition. With close to 4.5 million athletes from about 170 different countries, the Special Olympics flourishes with diversity of race, ethnicity, and culture, it stands as the largest sports organization for people with intellectual disabilities (ID).
A large part of the Special Olympics is the Healthy Athletes Program that aims to provide and improve health care services for people with intellectual disabilities. Free health services are given to athletes to measure a range of physical capabilities including:
- Aerobic fitness
FUNfitness is a program guided by the American Physical Therapy Association (APTA) and Special Olympics Healthy Athletes that performs free screenings for the athletes, educates on how to rehabilitate injured areas and improve overall fitness of everyone involved in the program.
Physical therapists apply their knowledge and training during the screening to perform assessments of the athlete’s major muscles. The physical therapists will generally measure flexibility performance of the hamstring, calf, shoulder rotator, and hip flexor. They are not limited to those measures though, they will also assess the functional strength of the abdominal, upper, lower extremity muscles as well as balance and stance of the athlete. Aerobic fitness will come into play with a Step test or Wheel test, for people who cannot step for a duration of two minutes; both tests measure cardiovascular fitness.
Licensed physical therapists who are interested in starting this event in their country: take note, Special Olympics actually provides a “Train the Trainer” program to get you started. Even if you are not a physical therapist, there are many ways to get involved in Healthy Athletes FUNfitness program! Physical therapy students and physical therapy aides are extremely beneficial assistants in many areas of the event, providing direct aid to therapists and athletes.
Special Olympics – Train the Trainer
Visit this site to find events near you to see how you can make a difference in the Healthy Athletes Program! The direct interaction with athletes, and practitioners for the Special Olympics is an extremely rewarding and memorable experience that will open your eyes to the power of sports!
An extremely important step for bringing a patient back to good health is the ability of a doctor to determine the best plan of care. This is why Patient Centered Outcomes Research Institute (PCORI) was authorized by Congress in 2010. In the five years, since PCORI has been established, the board has successfully raised millions of dollars that it continues to use wisely to increase research within the healthcare industry.
POCRI has brought together a wide selection of hospitals, clinics, and private practices within the North American healthcare industry to establish the National Patient Centered Clinical Research Network (PCORnet). Currently there are as many as 27 participants in POCRnet. However, recently approximately $142.5 million has been invested into expanding its research initiatives including Physical Therapy! Part of the plan to broaden research is to expand the network to a total of about 34 participants. This will give PCORI a wider set of data to use for research; specifically, the population set will be more diverse, and the number of possible conditions to study will increase.
In addition to performing its own research, POCRI supports researchers and institutions around the United States who aim to explore the same goals based on Patient-Centered Outcomes Research (POCR) and clinical effectiveness research (CER). In 2015 POCRI has funded research for countless projects with organizations including Duke University, the Mayo Clinic, Johns Hopkins University, and the Epilepsy Foundation.
The studies PCORI funds aim to improve patient outcomes and clinical effectiveness. Clinical effectiveness research is not only helpful for doctors and practitioners who apply treatment plans but also for patients who have to decide on what measures to take for recovery. Why go through a major surgery when a few months of physical therapy can produce just as good results? These types of questions and decisions are are important to both the doctor and the patient. Although institutions are trying to change to an outcome-based system, until there is more evidence of progress it is important for the average person to understand that a vast amount of research is yet to be performed to better understand the differences between treatment plan outcomes. In order to get the best treatment by doctors, the first step for improvement is supporting institutions such as PCORI.
To learn more about PCORI and to support research on PORI and CER visit: http://www.pcori.org/about-us.
The advancement of the Center on Health Services Training and Research (CoHSTAR) is fast becoming a savior for physical therapy health services. In recent years, CoHSTAR has been receiving sufficient funding and support from prestige educational institutions and associations. In fact, Brown University was actually given a $2.5 million grant from the Foundation for Physical Therapy to establish CoHSTAR. The American Physical Therapy Association (APTA) gifted the CoHSTAR more than $1 million in donations to support its cause. These major donations along with many other valuable contributions have given Boston University, Brown University, and the University of Pittsburgh the ability to put together strong physical therapy health service programs to perform more research in this field.
The integration of services provided by these three institutions will provide access to a variety of resources, the universities have collaborated and have already developed a pilot study program focusing on the following:
⦁ Analysis of large data sets
⦁ Rehabilitation outcomes measurement
⦁ Implementation science and quality assurance
These are four focuses that CoHSTAR aims to perform additional research on through its on-going funding efforts, CoHSTAR will be providing $25,000 to each new focus of study in the healthcare industry that is approved. This expense will support researchers, as well as therapists, as the researchers become more knowledgeable about topics such as improved outcome measurement methods, and better payment models they will then present their findings. The therapists will then be trained by the researchers to better their methods of therapy and treatment. Time will tell whether this was money invested wisely or thrown away, but in the meantime physical therapy students would be well advised to take advantage of this opportunity!
Visit http://www.foundation4pt.org/explore-our-impact/center-of-excellence/ to get involved & support CoHSTAR!
As we quickly approach the halfway point for July, the US Centers for Medicare and Medicaid Services (CMS) is showing huge signs of encouragement with their handling of ICD-10 claim submission testing. The improvements in the acceptance of claim files has grown almost exactly 10% since the first round of testing, the third round of ICD-10 testing that was performed In mid-June showed a 90% acceptance of claim files!
These testing statistics portray the rapidly growing improvements in ICD-10 claim submission. In fact, reports have shown that the majority of rejections were not directly related to ICD-10, CMS stated that most errors were resultant of claims filed within the testing environment and these errors are not expected to be experienced when claims are filed in a non-testing environment.
Now that we’ve seen the success of ICD-10 claim submission, it is important to begin to think about how we can make a smooth transition to becoming a compliant ICD-10 user. Due to the Health Insurance Portability Accountability Act, (HIPAA), you will be required to make this transition to ICD-10. So how can you get ahead of the game??
ICD-10, Free Reading Materials
One wise move you and your practice can make is to start by using Road to 10, a free online source offered by CMS amongst other things it will help you get a head-start figuring out how ICD-10 will need to be used in your company. If that doesn’t meet your need, you can also begin to look into the ICD-10 Quick Start Guide so that when October 1st approaches, you will be all set. Lastly, you may also want to check out the American Physical Therapy Association (APTA) guidelines in these coming weeks to be fully prepared!
Take the initiative, use these resources so that when October 1st rolls around the corner, you will have no trouble adapting!
As we approach the October “deadline”, many of us have been wondering wither it will actually happen this time, will the US finally adopt ICD-10 as standard procedure??!
There has been signs and messages that perhaps this time it’s really happening, however based upon recent events you would not be considered foolish if you believe it will actually happen this time!
CMS (Centers for Medicare and Medicaid Services) has stepped up and released their guidance notes on how to submit ICD-10 coding, but they didn’t stop there, they have also proposed an ICD-10 “Coordination Center” and more importantly, they have made a new ICD-10 Ombudsman position! His main responsibility will be to answer questions and provide guidance on successful claims submission.
That’s a huge relief, it shows that CMS is prepared and ready to aid and support the healthcare community. Yet the biggest concern remains specifically, is my cash flow going to be severely affected by this transition? It’s all fair and well to have an Ombudsman but if he is not helping me to get paid then what good is he??
Well, CMS has in fact FULLY considered this, in fact they have addressed it directly and it was summed up perfectly in this statement. “Medicare claims, for the first year of ICD-10 use, will not be denied or audited based solely on the specificity of diagnosis codes, as long as the codes on such claims are from the correct family of codes in the new code set”. However, this statement was actually from AMA president Steven Stack, why? Well it was released as part of a joint announcement that the AMA (American Medical Association) will fully support CMS’s proposals to ease the transition!
It would seem that all barriers and obstacles are falling with CMS and AMA now on the same page, failing some unforeseen event ICD-10 will be happening this October.
Competition in any industry is inevitable; graduates of physical therapy are no different, they compete for jobs and clinicians compete for clients. Given this situation, it is important to recognize the factors that will make you and your practice stand out.
Studies have shown that patient satisfaction increases with the quality of the treatment provided and above all the relationship between the therapist and the patient.
As a student, I have been able to witness the effects of strong and weak relationships between patients and physical therapists. One of the happiest patients I have witnessed complimented the service of the clinic and always refers to the staff as her family! She has been visiting the clinic for two and a half years and in this time strong relationships have been developed and nurtured with the therapists. In this specific case, the amount of time spent at the clinic naturally helped their relationship grow.
On the other hand, patients who have short treatment plans that last only one to two weeks generally have a tougher time feeling at home at the clinic without additional effort exerted by the therapists. One vital aspect of forming a strong, positive relationship with patients is to present yourself in a happy, hopeful, and spirited manner, it is important for the patients to feel encouraged by the therapist about a fast, and efficient recovery. A positive mood will give the patient the motivation to continue exercising at home, this was observed especially in elderly patients; many of them tend to feel disinclined to finish their exercise reps or to give full strength while performing exercises.
To an outsider, it may seem like fixing this problem is simple; provide a higher level of care. However, as a student it is easy to appreciate the stresses faced at the workplace by physical therapists and how it can directly reflect upon the quality of patient interaction.
From writing evaluations, follow up data, handling patient records and keeping up with appointments the therapist has a lot of worries and responsibilities!
Antiquated methods of record keeping can also contribute to this problem instead of alleviating it, in our next post we will look at what you can do to make more time for patients and cultivate those important long lasting relationships.
Oftentimes cell phones are considered a distraction at the workplace. The mere presence of your cell phone next to your computer at work stirs an urge to forget all responsibilities and instead spend time on apps such as twitter, instagram, and vine. What seems like just a few harmless minutes spent on the phone, becomes hours that have now put a significant delay on your work schedule. However, this tendency and attachment to the cell phone should not be seen in a negative light by employers especially in the world of physical therapy; rather, clinicians should take advantage of this technological age to improve efficiency of both the therapists and the patients.
By using some of the great physical therapy apps on the market, therapists can take full advantage of their cell phones while remaining on top of their schedules. Some of the functions of these applications include recording high definition video, and performing an in depth analysis of that video using features that permit an array of actions. Slow motion playback, added commentary, and zoom are some of the various viewing and editing options. These videos can also be easily shared with therapists, and patients.
The technology of the apps give therapists an accurate visual record of a patient’s progress, and easy means of communication. This helps eliminate potential for misdiagnosis and mistreatment because both the insurance company and doctors who approve and provide the diagnosis for the patients will be able to monitor the condition of the patient. The therapist simply shoots a shot clip using his cellphone, performs an analysis, saves the video, and shares it.
The effectiveness of applications portrays the benefits of using technology in the physical therapy department. A web-based system is the key to increase efficiency. Instead of viewing the cellphone as a hindrance to productivity, PT Practice Pro along with physical therapy app creators take advantage of this technological age by producing modern systems for clients and users.
Texan law makers have just rolled out their proposal for the Lone star state’s budget for the next 2 years, and it ain’t pretty!
The long and short of it is this, Texas providers have had payments reduced in 2010, 2012, and 2014 and now for 2016 and 2017 we are looking at almost $350 million in Medicaid funding to be cut. Not only is it the biggest cut to funding in over a decade bu
t it will be effectively cutting funding to the most vulnerable in society, young children and the elderly.
These therapy services typically helps children with genetic disorders, birth defects, physical or cognitive disabilities as well as those born prematurely, so that they may function in daily life. For seniors and adults, the therapy can help in recovery from a broken hip or with progressive diseases like Alzheimer’s or Parkinson’s.
Many studies have proven that early intervention produce cost savings, so this move is not particularly well thought-out and likely to be very harmful not only to vulnerable Texans in need of care, but potentially to the State itself!
The impact of the Alberto N. v. Don Gilbert lawsuit settlement has been one of the most significant in determining legal cases regarding how therapy and other related benefits are delivered to Medicaid beneficiaries under the age of 21. However this proposed cut is in direct contradiction to this ruling, meaning an increase in litigation (and therefore expenses) to the state!
However, the Health and Human Services Commission and Senate Finance Chair Jane Nelson’s office said the reduction was proposed because the rates paid in Texas are in fact higher than in other states or those paid by private insurance plans and Medicare. They also added that “These therapies are needed and very important to those who rely on them. Members felt strongly that we make sure we are paying fair rates that are in line with other states.”
Linda Edwards Gockel of the HHSC (Health and Human Services Commission) commented that they are “not concerned” and don’t think the move will reduce access to care in Texas. She also added that the number of therapy providers in Texas Medicaid grew by 30 percent between 2009 and 2014.
Time will tell…
Physical Therapy Outcomes have been a significant ally to reporting in the Physical Therapy world. In today’s most current PT news, we are hearing that the payment model is vastly moving away from Fee for Service and closer to Evidenced Based Payment. Reporting Outcomes measures will assist with affirming the patient’s condition and the need for skilled therapy.
What is reported?
After completing your patient assessment, there are primary functional status measures that are recorded.
Initial Functional Status
Specific to the patient body part or impairment, an assessment is completed to support needs for treatment. Generally, this assessment calculates a score for the patient which represents the patient’s functional ability.
Predicted Goal Status
The patient’s assessment, degree of impairment and condition will be reflective of the patient characteristics allowing the therapist to establish a prediction. This process is significant both for precision and accuracy.
Discharge Functional Status
Patient assessments will be completed as needed during care as well as on the last treatment visit. The goals is to track the improvement of patient function.
These outcome measures prove treatment effectiveness which supports medical necessity. As physical therapist, the goal is to restore function, reduce pain and prevent physical disability.
Reporting these Physical Therapy Outcome measures not only increase your strength of reimbursement from the insurance. When you are tied down with the constant implementation of new insurance rules and regulations, proving the need for skilled therapy and medical necessity, reporting physical therapy outcomes are to your advantage. In the near future, reporting physical therapy outcomes will become a mandatory reporting practice. Get started now so you can be ahead of the mandatory change.
If you would like additional information about Physical Therapy Outcomes or any other hot topic in the Physical Therapy Industry, please see our library of blog articles.