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- Просмотров 28 493
Gawenda Seminars Outpatient Therapy
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Добавлен 12 ноя 2019
Gawenda Seminars & Consulting is the outpatient therapy industry's foremost authority on therapy documentation coding and billing.
This is the official channel of renowned speaker and expert, Rick Gawenda, who provides tips and advice in the areas of CPT coding, ICD-10 coding, billing, documentation, compliance, revenue enhancement, practice management, and denial management, as they relate to outpatient therapy services for Physical Therapy, Occupational Therapy and Speech Therapy.
This is the official channel of renowned speaker and expert, Rick Gawenda, who provides tips and advice in the areas of CPT coding, ICD-10 coding, billing, documentation, compliance, revenue enhancement, practice management, and denial management, as they relate to outpatient therapy services for Physical Therapy, Occupational Therapy and Speech Therapy.
How Soon an Initial Plan of Care Must be Signed
Do you know how soon a practitioner must certify an outpatient plan of care for it to be considered timely?
To learn more about certifications and recertifications for Medicare for outpatient physical therapy, occupational therapy, and speech therapy: gawendaseminars.com/faq/certifications-recertifications/
Learn more about Gawenda Seminars and Consulting
gawendaseminars.com
To learn more about certifications and recertifications for Medicare for outpatient physical therapy, occupational therapy, and speech therapy: gawendaseminars.com/faq/certifications-recertifications/
Learn more about Gawenda Seminars and Consulting
gawendaseminars.com
Просмотров: 17
Видео
Who Can Certify a Medicare Plan of Care
Просмотров 35День назад
There are two types of providers that can certify (or recertify) a plan of care under the Medicare program. In this video I’m going over each of them and the types of practicioners that have the authority to do so. To learn more about the plan of care requirements for Medicare for outpatient physical therapy, occupational therapy, and speech therapy: gawendaseminars.com/faq/plan-of-care/ Learn ...
Can You Use Duration or Frequency Ranges in a Medicare Plan of Care?
Просмотров 11114 дней назад
If you’ve ever been writing a Plan of Care and wondered if you could use a range for frequencies and durations (6-8 weeks, 1-2 sessions, etc), you aren’t alone. Here’s the deal: Medicare (and many private providers) are silent on use of ranges. Meaning they don’t specify if you can or can’t. However, I do not believe in using ranges for several reasons (mentioned in the video!) To learn more ab...
The Preferred Method to Write the Duration of Treatment for a Medicare Plan of Care
Просмотров 14021 день назад
Did you know that you have 3 different options for writing the duration of treatment for a Medicare plan of care? In this video, I’ll be discussing the pros and cons of each and advising the best option. The goal is to avoid having to write an updated plan of care - which costs you time (and money!) To learn more about the plan of care requirements for Medicare for outpatient physical therapy, ...
What are the Required Elements for a Medicare Plan of Care?
Просмотров 151Месяц назад
Are you familiar with all the required elements for a Medicare Plan of Care? Minimum Requirements Include: - The type of treatment - The amount of treatment - The frequency & duration of services - A Diagnosis - Function-based long-term goals - Signature of therapist In this video I’m going into more detail about these requirements. Subscribe to my channel for new videos every week with more Fr...
Can I Bill Dry Needling Under Other CPT Codes?
Просмотров 189Месяц назад
As of January 1, 2020, two new CPT codes were introduced for dry needling: CPT codes 20560 and 20561 (learn more about those codes here: ruclips.net/video/JaB7vG529yM/видео.htmlsi=ITFDnvop1uh00Bb2). I am frequently asked if you can bill dry needling under other CPT codes such as neuromuscular education, manual therapy, or manual electrical stimulation. To learn more about Dry Needling:gawendase...
Does the Medicare Program Reimburse for Dry Needling?
Просмотров 157Месяц назад
As of January 1, 2020, 2 new CPT codes were introduced for dry needling: CPT codes 20560 and 20561 (learn more about those codes here: ruclips.net/video/JaB7vG529yM/видео.htmlsi=ITFDnvop1uh00Bb2). In this video I’m diving into the specifics about how the Medicare program addresses dry needling when done under an outpatient therapy plan of care. I’ll also go over how you can charge a medicare be...
CPT Codes for Dry Needling | Coding & Billing for Outpatient Therapy Services
Просмотров 161Месяц назад
Are you aware that as of January 2020, two new CPT codes have been introduced specifically for Dry Needling? The choice between these codes depends on the number of muscles into which needles are inserted. It is important to note that both of these codes are untimed service-based codes. To learn more about Dry Needling: gawendaseminars.com/faq/dry-needling/ Learn more about Gawenda Seminars and...
Do you have to be enrolled in the Medicare program to issue an ABN (Advance Beneficiary Notice)?
Просмотров 642 месяца назад
A question I get asked a lot is "Do I have to be enrolled in the Medicare program to issue an ABN?" Well - the answer might surprise you. Want to learn more about ABNs? Click here: gawendaseminars.com/faq/abn/ Learn more about Gawenda Seminars and Consulting gawendaseminars.com
Issuing an ABN to a Medicare Beneficiary for Services that are Statutorily Non-covered by Medicare
Просмотров 742 месяца назад
In this video, we address a frequently asked question regarding the Advanced Beneficiary Notice (ABN) for Medicare services. If you're unsure about when to issue an ABN, this video is for you! We break down the scenarios where an ABN is necessary and clarify what "statutorily non-covered" services mean. Join us to get clear, concise answers to help you navigate Medicare's regulations confidentl...
If the Annual Therapy Dollar Threshold is Exceeded, Should You Issue an Advance Beneficiary Notice?
Просмотров 1142 месяца назад
In this video, we explore the intricacies of when to issue an Advanced Beneficiary Notice (ABN) to Medicare beneficiaries who have exceeded the annual therapy dollar threshold. We cover the conditions under which you should and should not issue an ABN, and the importance of the KX modifier for claims. For a deeper understanding of the ABN process, click here: gawendaseminars.com/faq/abn/ Don't ...
Who Can You Issue an ABN (Advance Beneficiary Notice) On?
Просмотров 952 месяца назад
Ever wondered when you can use an ABN (Advance Beneficiary Notice of Non-Coverage)? Many therapists know about using ABNs for traditional Medicare beneficiaries, but there’s a crucial detail you might be missing. Learn who can issue an ABN and the common mistakes to avoid, especially regarding Medicare Advantage and other insurance plans. Don’t miss these essential insights for properly handlin...
When to issue an Advance Beneficiary Notice (ABN) of Non-Coverage to Medicare Beneficiary
Просмотров 2132 месяца назад
Confused about issuing Advance Beneficiary Notices (ABNs) to Medicare beneficiaries? This video clears the fog. Learn when and why to issue ABNs, especially when Medicare coverage might be uncertain, like during concurrent home health and outpatient therapy or for procedures like Iontophoresis. Whether you're a practice owner, manager, or healthcare pro, mastering ABNs is key to compliant billi...
What is Included in the Payment for the L Code for the Orthotic?
Просмотров 2453 месяца назад
What is Included in the Payment for the L Code for the Orthotic?
Plan of Care
Просмотров 4 тыс.3 года назад
Learn what the minimum requirements are to be included in a Medicare outpatient therapy plan of care.
Can an Assistant Bill CPT Code 97750?
Просмотров 3 тыс.3 года назад
Can an Assistant Bill CPT Code 97750?
When Do I Apply the KX Modifier? Part 2
Просмотров 2,6 тыс.4 года назад
When Do I Apply the KX Modifier? Part 2
When Do I Apply the KX Modifier? Part 1
Просмотров 2 тыс.4 года назад
When Do I Apply the KX Modifier? Part 1
Dry Needling: Can I Bill Medicare Patient's Cash
Просмотров 1,6 тыс.4 года назад
Dry Needling: Can I Bill Medicare Patient's Cash
National Correct Coding Initiative - NCCI
Просмотров 1,9 тыс.4 года назад
National Correct Coding Initiative - NCCI
Can Services of an Assistant be Billed to TRICARE
Просмотров 5784 года назад
Can Services of an Assistant be Billed to TRICARE
What is Gawenda Seminars & Consulting?
Просмотров 2,8 тыс.4 года назад
What is Gawenda Seminars & Consulting?
APTA states that you must have documentation on file when using KX modifier. In case of an audit, if you don't have any documentation (updated plan of care) then how are you supposed to justify medical neccessity?
Thanks to a long-awaited final rule passed down from the Department of Defense (DoD), starting April 16, 2020, all eligible PTAs and OTAs may begin treating Tricare patients and receiving reimbursement under the Tricare program. ... Tricare's qualification and supervision requirements will be similar to Medicare's.Mar 17, 2020
If a provider is approved to do therapy but allowing another therapist to do the treating under the auth issued can I bill it?
Could you bill when performing an ABI?
Please do some videos on PT and OT eval and re evals. When xan reeval be allowed
Who does your video editing and recording? Always such outstanding quality.
Rick, put your link(s) in the description of the video - all your links, website, FB, Twitter, etc
No additional doc required, but, you better make sure you're justifying physical therapy services in your notes and maybe an ABN at some point. That's my understanding anyway.
it certainly doesn't hurt! With 70% of healthcare fraud being committed by PROVIDERS (per the Association of Certified Fraud Examiners), we are already the target in these investigations. I have seen a horrible lack of supporting documentation by the physical therapists I have covered for in over the last 20 years. It's amazing they are getting paid at all. It doesn't take more than a sentence or two to go beyond the "requirement" which could later on implicate the therapist in not just fraud, but waste and abuse. Better to be safe, than sorry later. Just my .02.
OK, is that meaning that w/ time the money we has been paid (for services provided) will be automatically with-drown from our accounts as in 2014 yr CMS has ability to do that for the audit process ? ? ? ?
This is very helpful. As insurance rules continue to change, it is vital to have guys like Rick explaining it simply. Love this!
Thank you for the kind words.
Awesome! Thank you :)
You are welcome!
Is any progress being made in California on dry needling?
But will it be at a reduced reimbursement rate like the new Medicare guidelines? If so, would most companies use PTAs to treat Tricare patients or continue to use PTs?
Always great content and value. Thanks for sharing!
Great job Rick! I appreciate everything you do for outpatient PT.
Thank you Tom! Appreciate the kind words!