Physical therapy website design doesn't have to be complicated. You just need to know where to start.
Ascend 2016—the ultimate rehab therapy business summit—is just a few short months away. Similar to the 2015 event, this year’s conference will give attendees the opportunity to earn CEUs, glean insights from a lineup of esteemed speakers, and network with some of the top rehab industry leaders. In addition to these benefits, though, we’re happy to continue the tradition of recognizing one deserving rehab therapy business with the Practice of the Year award.
Over the years, WebPT has a hosted a slew of billing webinars and published dozens of billing-related blog posts. And in that time, we’ve received our fair share of tricky questions. Now, in an effort to satisfy your curiosity, we’ve compiled all of our most common brain-busters into one epic FAQ. Don’t see your question? Ask it in the comments below. (And be sure to check out this separate PT billing FAQ we recently put together.)
Questions related to:
• Modifier 59
• Other Modifiers
• Advance Beneficiary Notice (ABN) of Noncoverage
• Contracts and Fee Schedules
• 8-Minute Rule
• Functional Limitation Reporting
• Cash-Pay Patients
How does WebPT help me bill better?
WebPT prompts users to apply modifier 59.
When WebPT detects that you have billed two codes that form a CCI edit pair, the system will alert you and ask whether you performed these services separately and distinctly of one another—and, therefore, should receive payment for both. If you attest that this is the case, WebPT will automatically apply modifier 59 to the appropriate code.
For WebPT Members
To activate this feature, please follow the steps below. Note that you’ll need to complete these steps for each insurance plan. We recommend applying this to commercial and government plans only (i.e. no workman’s compensation, legal/lien, and auto liability policies).
- Select “Display Insurance,” located on the left side of the WebPT Dashboard.
- Click “Edit” on the individual insurance for which you want to activate the feature.
- Once the insurance editing screen opens, check “Apply CCI edits”; then, select “Save.”
For Non-WebPT Members
If you’re not yet a WebPT Member, you can see this functionality and an array of other awesome features in a free, live online demonstration. Request one here.
WebPT tracks the therapy cap.
WebPT offers the Medicare Cap Report, which enables you to view Medicare beneficiaries’ progress toward the therapy cap and see whether therapists have affixed the KX modifier for those patients who have, in fact, exceeded the cap. In addition to tracking the therapy cap, WebPT alerts providers when a patient is:
- approaching the cap
- exceeding the cap (time to attach the KX modifier!)
- approaching the manual medical review threshold ($3,700)
- exceeding the manual medical review threshold
To learn more about the Medicare Cap Report and WebPT’s other compliance reporting and tracking capabilities, check out this blog post.
WebPT calculates the 8-minute rule.
As this blog post explains, “WebPT automatically double-checks your work for you and alerts you if something doesn’t add up correctly. All you have to do is record the time you spend on each modality as you go through your normal documentation process, along with the number of units you wish to bill. If those two totals don’t jibe, WebPT will not only let you know something’s off, but we’ll also tell you whether you overbilled or underbilled. That way, you can quickly identify and fix the problem—and thus, ensure accurate payment. Plus, you’ll have a detailed record of the services you provided on each date of service—something many local MAC auditors request to substantiate billing claims and processes.”
WebPT handles PQRS reporting.
WebPT is a certified PQRS registry. This means we collect PQRS claims data and submit it to Medicare on your behalf. We also have all the PQRS reporting requirements in our system, so depending on the Medicare beneficiary and visit, we’ll prompt you to complete the appropriate measure. Learn more about PQRS with WebPT.
What diagnosis code flows over from WebPT into my billing?
When you use WebPT, your treatment diagnosis is the one that is billed—not the medical diagnosis.
In January, we hosted a webinar focused on the importance of outcomes tracking in physical therapy. In addition to explaining why it’s absolutely critical that therapists collect objective data on patient progress, we highlighted a few of the reports available in WebPT Outcomes. With the move to a value-based payment environment already in full swing, outcomes tracking is a hot topic in the physical therapy space, and that meant lots of thoughtful question from our webinar audience.
We’re all for helping physical therapists create and retain loyal customers. After all, improving patient retention is one of the absolute best ways to grow your business. All the hard work you put into branding and marketing your practice won’t go very far unless you’re able to attract your target audience, help them successfully complete their plans of care, and send them out into the world as raving fans.
Before we belt out our best renditions of “Auld Lang Syne,” light off fireworks, and make some new resolutions, let’s take a moment to look back at the top WebPT Blog posts of 2015. Grab a glass of sparkling cider, kick back, and relax—because you’re in for a treat. Here are the WebPT articles that rehab therapists read the most this year (based on page views). This list includes blog posts published between January 1 and December 21, 2015:
What goes into planning the premier rehab therapy business summit? Well, it takes faith, trust, and just a little bit of pixie dust. Okay, so maybe that’s how Peter Pan helps his peeps fly. But even if hosting a successful event doesn’t require pixie dust, happy thoughts—and a ton of hard work—do help us plan.
I think Julie Andrews was spot-on when she sang the following verse about physical therapists: “When the dog bites, when the bee stings, when you’re feeling sad, you simply remember your defensible documentation, and then you don’t feel so bad.” That is how it goes, right? No? Whoops. Looks like I mixed up some of the lyrics.
Like the many Land Before Time sequels, the versions of our ICD-10 FAQ keep on-a-comin’. But—unlike those beloved dinosaur tales—I don’t anticipate 12 more versions (plus a TV series) will be necessary to cover what’s to come with ICD-10. Still, the questions continue to roll in—albeit a bit slower than they did a couple of months ago. However, most of the inquiries we’ve received in recent weeks have been super specific. That’s why, our most recent webinar—the ICD-10 Open Forum—included an extended audience Q&A session hosted by Dr. Heidi Jannenga and compliance expert Rick Gawenda. In case you missed it, I’m going to make like Littlefoot and take on some of our most frequently questions from the webinar while chewing on some prehistoric ferns (or something like that):
Where do I find information on state regulations related to ICD-10?
We suggest contacting your payers, as well as consulting your state association’s website/state practice act, to get the most up-to-date, state-specific information.
What’s the difference between R53.1, Weakness, and M62.81, Muscle weakness (generalized)?
According to this resource, M62.81 is typically classified as a disorder characterized by a reduction in the strength of muscles in multiple anatomic sites, or a reduction in the strength of muscles in multiple anatomic sites. R53.1, on the other hand, is a sign or symptom associated with:
- weakness and diminished or absent energy and strength;
- debility, or lack or loss of strength and energy;
- physical weakness, lack of strength and vitality, or a lack of concentration;
- lack of physical or mental strength;
- liability to failure under pressure or stress or strain;
- weakness; and/or
- lack of energy and strength.
If I shouldn’t use unspecified codes, then why are they even an option?
The unspecified codes exist in case there truly is not another, more specific option available. However, if a more specific option is available, you absolutely should use it.
If a patient experiences muscle weakness in a specific area, should I use M62.81?
The clinical description for M62.81 reads, "A disorder characterized by a reduction in the strength of muscles in multiple anatomic sites." Because this code describes weakness in multiple anatomic sites, it would not be appropriate for weakness that exists in a specific location. As mentioned in our other FAQs, if available, you should always code for the underlying condition causing the muscle weakness first.
Can I list a condition like poor balance as a primary diagnosis?
You should code first for the underlying condition (i.e., what's causing the patient's balance issues). If you can’t determine the underlying condition, ICD-10 code R26.81, Unsteadiness on feet, might be a good option.
What code should I use for difficulty walking? R26.2 or R26.89?
Depending on your evaluation, you might discover the reason behind the disordered movement is best described by one code more than the other. Each code has its own synonyms that can help you make your selection.
For example, this resource explains that the description synonyms for R26.2, difficulty walking are:
- Difficulty walking
- Walking disability
The description synonyms for R26.89, Other abnormalities of gait, and mobility are:
- Cautious gait
- Gait disorder due to weakness
- Gait disorder, painful gait
- Gait disorder, weakness
- Gait disorder, postural instability
- Gait disorder, multifactorial
- Toe walking and toe-walking gait
- Limping/limping child
Should I code for accidents/incidents that affected my patients in the past?
You cannot—and should not—code for what you don’t know. If you can’t say for certain that the accident/incident directly correlates to the patient’s current condition, don’t code for it.
What if I have a highly-specific clinical coding question, and I can’t find the answer?
We’re happy to answer your questions to the best of our abilities. However, if the example is extremely clinical in nature, we can’t give you a definitive answer. But, we do know of a resource exactly for these types of situations. If you are able to supply supporting documentation for your particular scenario, you can submit your coding questions via this AHA portal.
How does WebPT protect providers from making ICD-10 coding errors?
WebPT prompts users to select the most complete code possible and does not allow users to bill incomplete codes. However, you’ll still need to use your clinical judgement to make the proper selection from all of the available codes.
Will WebPT allow providers to use ICD-9 codes for patients with dates of service prior to October 1?
Yes. WebPT automatically recognizes whether the patient should have ICD-9 or ICD-10 codes based on the date of service on the note.
Global PT Day of Service is right around the corner—this upcoming weekend, to be exact. What does that day signify? Well, it means that on October 17, 2015, physical therapists all across the globe are joining together to donate their time in service to their local communities. In the spirit of giving, our founder and COO, Dr. Heidi Jannenga—along with a crew of WebPT employees—will join together with students and other physical therapists across the Phoenix valley to make a positive impact on our community.