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Using ICD-9 Codes and CCI Edits in the

Outpatient Rehab Setting

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A 90-minute interactive audioconference

Wednesday, October 18, 2006

ii Using ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

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iv Using ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

Dear Colleague,

Thank you for participating in our “Using ICD-9 Codes and CCI Edits inthe Outpatient Rehab Setting” audioconference with Rick Gawenda,PT, moderated by Kevin Moschella. We are excited about the opportunityto interact with you directly and encourage you to ask our experts yourquestions during the audioconference. If you would like to submit a ques-tion before the audioconference, please send it to [email protected] provide the program date in the subject line. We cannot guaranteethat your question will be answered during the program, but we will do ourbest to take a good cross section of questions.

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vUsing ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

Agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi

Speaker profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii

Exhibit A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Presentation by Rick Gawenda, PT

Exhibit B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37ICD-9-CM Volume 1- Index to Diseases

Exhibit C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39ICD-9-CM Volume 2- Tabular List

Exhibit D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41AdminaStar Federal: ICD-9 Codes that Support Medical Necessity

Exhibit E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46TrailBlazer Health: ICD-9 Codes that Support Medical Necessity

Exhibit F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66Chart of CCI Edits

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68

Contents

vi Using ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

Agenda

I. Introduction to ICD-9 codes

II. Identify the differences between diagnosis codes and procedure codes

III. ICD-9 outpatient therapy coding guideline A. How to find the ICD-9 codesB. What is a medical diagnosisC. What are treatments diagnoses

IV. Three ways Medicare contractors may or may not use ICD-9 codes to support medical necessity

A. Contractors who don’t use codes at allB. Contractors who use codes to support all CPT codesC. Contractors who use codes to support each CPT code

V. ICD-9 codes commonly used in outpatient rehab

VI. CCI Edits A. DefinitionB. Provider specificC. Documentation to support the use of modifier -59

VII. Reading the CCI edit chart A. Column 1/Column 2/Mutually ExclusiveB. Gawenda Seminar chartC. CMS Web site chart

VIII. ExamplesA. PT re-eval examplesB. OT re-eval examplesC. SLP examples

Live Q&A

viiUsing ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

Speaker profiles

Rick Gawenda, PT

Rick Gawenda is the director of physical medicine and rehabilitation at Detroit Receiving Hospital and ownerof Gawenda Seminars. He has worked in all areas of therapy within the hospital setting. He has providedvaluable education and consulting to both hospitals and his peers in the areas of coding, billing, documenta-tion, reimbursement, and the appeals process for Medicare denied claims.

Mr. Gawenda is on the editorial advisory board for Advance for Directors In Rehabilitation, and Briefings onOutpatient Rehab Reimbursement and Regulations. He is a member of the American College of HealthcareExecutives, American Physical Therapy Association (APTA), Michigan Physical Therapy Association (MPTA),MPTA Insurance Policy Committee, and the Program Committee of the Health Policy & Administration sectionof the APTA. He serves as the liaison between the MPTA and United Government Services, which is theMedicare fiscal intermediary for the state of Michigan.

Mr. Gawenda has provided his expertise for many articles in Briefings on Outpatient Rehab Reimburse-ment and Regulations and Eli’s Rehab Report on topics such as advance beneficiary notices, Medicarecertification/recertification, utilization of “L” codes as they relate to therapy, and the use of aides in therapy. Inaddition, he has written articles for Advance for Directors in Rehabilitation on topics such as CPT coding,modifier -59, and the Medicare appeals process.

Exhibit A

Presentation by Rick Gawenda, PT

EXHIBIT A

2 Using ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

1

Using ICD-9-CM Codes andCCI Edits in an OutpatientRehab Setting

Presented by:

Rick Gawenda, PT

October 18, 2006

2

Objectives

� Differentiate between an ICD-9 code andCPT code

� Differentiate between a medical diagnosisand treatment diagnosis

� Discuss and understand ICD-9-CM codingguidelines

� Understand how ICD-9 codes supportmedical necessity by the various insurancepayers

3Using ICD-9 Codes and CCI Edits in the Outpatient Rehab Setting

EXHIBIT A

3

Objectives (cont’d)

� Define and distinguish between mutuallyexclusive edits and column 1/column 2 edits

� Be able to read the CCI edit chart andappropriately append modifier-59 to thecorrect CPT code(s)

� Be able to document appropriately to supportthe treatments provided and the use ofmodifier-59

4

ICD-9-CM

� International classification of diseases9th Revision, with clinical modification

� Updated annually in October

� Current edition is 6th

� Effective from Oct 1, 2006-Sept. 30,2007

EXHIBIT A


5

ICD-9-CMICD versus CPT

� ICD-9 codes describe the diagnosis and/orcondition that requires skilled therapyservices

� CPT codes describe the interventions thatwere provided by the therapist or assistant toreturn the patient to their maximum functionalstatus

� Both must be supported by thedocumentation

6

ICD-9-CMVolumes

� Volume 1 – Index to Diseases

� Volume 2 – Tabular List

� Volume 3 – Index to Procedures


EXHIBIT A

7

ICD-9-CMVolume 1- Index to Diseases

� Contains 3 sections

� Section 1 - Alphabetical index ofdiseases and injuries (See Exhibit B)

� Section 2 – Table of drugs andchemicals

� Section 3 – Alphabetical index toexternal causes of injuries andpoisonings

8

ICD-9-CMVolume 2 – Tabular List

� Diagnostic codes are listed in numericalorder

� Contains chapters which arerepresentative of anatomical systems ortypes of condition

� Chapters are broken down into sectionsof related groups of codes

� See Exhibit C

EXHIBIT A


9

ICD-9-CMCoding Guidelines

� Use both the Alphabetical list and the Tabularlist when locating and assigning a code

� Code the primary diagnosis first, followed bythe second, third, etc.

� Code to the highest level of specificity

� Utilize 4th and 5th digits when required

� Can have both a medical and treatmentdiagnosis on the claim

10

ICD-9-CMCoding Guidelines (cont’d)

� Lack of all the appropriate digits (i.e. 5th digit)will result in a rejection or denial

� If rejected, the supplier or provider cancorrect the ICD-9 code and re-submit forpayment

� If denied, the supplier or provider must appealthe denial through the Medicare contractor orother payers denial process


EXHIBIT A

11


� Medical diagnosis always provided by thephysician

� Treatment/therapy diagnosis provided by thetherapist, where allowed by state and locallaw, based on their initial examination of thepatient.

� Coders must choose the ICD-9 code basedon either the medical diagnosis provided bythe physician or the treatment diagnosisbased on the therapists documentation of theinitial examination

12


� Treatment diagnosis can be the primarydiagnosis on the claim form

� For example, physician may write the medicaldiagnosis as CVA

� PT, OT, and SLP’s do not treat CVA’s� They treat the hemiparesis, abnormality of

gait, aphasia, dysphagia, etc.� Some Medicare contractors do not accept

CVA as a payable ICD-9 code that supportsmedical necessity

EXHIBIT A


13

ICD-9-CM

� Medicare contractors do 1 of 3 thingswith ICD-9 codes in terms of medicalnecessity in their respective localcoverage determinations(LCD’s)

14

ICD-9-CM (cont’d)

� Do not have a list of ICD-9 codes thatsupport medical necessity. Supplier orprovider can utilize any ICD-9 code as theprimary or secondary diagnosis code. Ifreviewed, documentation would support theuse of that ICD-9 code

United Government ServicesMutual of OmahaFirst Coast Service Options


EXHIBIT A

15

ICD-9-CM (cont’d)

� Have a list of ICD-9 codes in their LCDthat supports the medical necessity ofall CPT codes on that claim(See Exhibit D)

AetnaAdminaStar Federal

16

ICD-9-CM (cont’d)

� ICD-9 codes linked with specific CPT codes tosupport medical necessity of that specific intervention

� May need more than 1 ICD-9 code on the claim inorder to support the medical necessity of all CPTcodes billed

� This is the most restrictive

� See Exhibit E

TrailBlazer HealthWisconsin Physician ServicesNoridian Administrative Services

EXHIBIT A


17

ICD-9-CMDisclaimer

� The following slides are to provide theparticipants with a general knowledge ofvarious medical and treatmentdiagnoses that pertain to therapy

� Please refer to the ICD-9 coding bookas most of these diagnoses require 5digits or to a lesser extent, 4 digits

18

ICD-9-CM307.XX

� 307.0 – Stuttering

� 307.9 – Other and unspecified specialsymptoms or syndromes, not elsewhereclassified(i.e. lisping, communication nototherwise specified)


EXHIBIT A

19

ICD-9-CM315.xx

� 315.00 – Reading disorder, unspecified� 315.01 – Alexia� 315.02 – Developmental dyslexia� 315.2 – Other specific learning difficulties� 315.31 – Expressive language disorder� 315.32 – Mixed receptive-expressive

language disorder� 315.4 – Developmental coordination disorder� 315.5 Mixed development disorder

20

ICD-9-CM340-349

� Other Disorders of the CNS

� 340 – Multiple sclerosis

� 342 – Hemiplegia and hemiparesis

� 343 – Infantile cerebral palsy

� 344.0 – Quadraplegia & quadraparesis

� 344.1 – Paraplegia of both lower limbs

� 344.2 – Diplegia of both upper limbs

EXHIBIT A


21

ICD-9-CM340-349 (cont’d)

� 344.3 – Monoplegia of lower limb

� 344.4 – Monoplegia of upper limb

� 344.6 – Cauda equina syndrome

� 346 - Migraine

22

ICD-9-CM350-359

� Disorders of the Peripheral NervousSystem

� 351.0 – Bell’s palsy

� 352 – Disorders of other cranial nerves

� 353 – Nerve root & plexus disorders

� 358.0 – Myasthenia gravis

� 359 – Muscular dystrophies and other myopathies


EXHIBIT A

23

ICD-9-CM 430-438Cerebrovascular Disease

� 438 – Late effects of cerebrovascular disease� 438.1 – Speech and language deficits� 438.2 – Hemiplegia/hemiparesis� 438.3 – Monoplegia of upper limb� 438.4 – Monoplegia of lower limb� 438.81 – Apraxia� 438.82 – Dysphagia� 438.83 – Facial weakness� 438.85 - Vertigo

24

ICD-9-CMDiabetes

� 250.0X

� 250.6X

� 250.7X

� 250.8X

� 707.9

� 707.10-707.15, 707.19

� 5th digit needed to specify type of DM

EXHIBIT A


25

ICD-9-CM710-719

� Arthropathies and Related Disorders

� 710.4 - Polymyositis

� 714.0 - Rheumatoid arthritis

� 715 – Osteoarthrosis & allied disorders

� 717 – Internal derangement of knee(includes degeneration or rupture ofarticular cartilage or meniscus of knee)Check 4th and 5th digit

26


� 717.7 – Chondromalacia of patella

� 717.81 – Old disruption of LCL

� 717.82 – Old disruption of MCL

� 717.83 – Old disruption of ACL

� 717.84 – Old disruption of PCL

� 717.85 – Old disruption of other ligaments of the knee


EXHIBIT A

27


� 718.2 – Pathological dislocation� 718.3 – Recurrent dislocation of joint� 718.4 – Contracture of joint� 718.5 – Ankylosis of joint� 719.0 – Effusion of joint� 719.4 – Pain in joint� 719.7 – Difficulty in walking� Check for 5th digit classification for all of the

above except for difficulty walking

28

ICD-9-CM720-724 Dorsopathies

� 720.0 – Ankylosing spondylitis

� 720.2 – Sacroilitis

� 721 – Spondylosis and allied disorders

� 721.4 – Thoracic or lumbar spondylosis with myelopathy

� 722 – Intervertebral disc disorders

� 723.0 – Spinal stenosis in cervical region

EXHIBIT A


29

ICD-9-CM720-724 Dorsopathies (cont’d)

� 723.1 – Cervicalgia

� 724.01 – Spinal stenosis thoracic region

� 724.02 – Spinal stenosis lumber region

� 724.2 – Lumbago

� 724.3 – Sciatica

� 724.4 – Thoracic/lumbar radiculitis

� 724.6 – Disorders of sacrum

� 724.7 – Disorders of coccyx

30

ICD-9-CM725-729

� Rheumatism, excluding the back

� 726.11– Calcifying tendinitis of shoulder

� 726.12 – Bicepital tenosynovitis

� 726.31 – Medial epicondylitis elbow

� 726.32 – Lateral epicondylitis elbow

� 726.33 – Olecranon bursitis

� 726.4 – Bursitis of hand or wrist


EXHIBIT A

31


� 726.5 – Enthesopathy of hip region

� 726.6 – Enthesopathy of knee

� 726.64 – Patellar tendinitis

� 726.65 – Prepatellar tendinitis

� 726.7 – Enthesopathy of ankle/tarsus

� 726.71 – Achilles bursitis or tendinitis

32


� 727.6 Rupture of tendon-nontraumatic� 727.61 Complete rupture of rotator cuff� 727.62 Tendons of biceps (long head)� 727.63 Extensor tendons hand/wrist� 727.64 Flexor tendons hand/wrist� 727.65 Quadriceps tendon� 727.66 Patellar tendon� 727.67 Achilles tendon� 727.68 Other tendons foot and ankle

EXHIBIT A


33


� 728 - Disorders of muscle, ligament, and fascia

� 728.87 – Muscle weakness

� 729.1 - Fibromyositis

34

ICD-9-CM780-799

� Symptoms, Signs, and Ill-DefinedConditions

� 780.7 – Malaise and fatigue

� 780.71 – Chronic fatigue syndrome

� 780.93 – Memory loss

� 781.2 – Abnormality of gait

� 781.3 – Lack of coordination - ataxia


EXHIBIT A

35


� 784.3 – Aphasia

� 784.41 – Alphonia (loss of voice)

� 784.5 – Dysarthria, dysphasia, slurred speech

� 784.61 – Alexia and dyslexia

� 787.2 – Dysphagia

36


� 625.6 – Stress incontinence, female

� 788.30 – Urinary incontinence unspecified

� 788.31 – Urge incontinence

� 788.32 – Stress incontinence, male

� 788.33 – Mixed incontinence, (male and female), stress and urge

EXHIBIT A


37

ICD-9-CM800-829

� Fractures

� 805-809 –Fractures of neck and trunk

� 810-819 – Fractures of upper limb

� 820-829 – Fractures of lower limb

38

ICD-9-CM830-839

� Dislocation� 831 – Dislocation of Shoulder� 832 – Dislocation of elbow� 833 – Dislocation of wrist� 834 – Dislocation of finger� 835 – Dislocation of hip� 836 – Dislocation of knee� 837 – Dislocation of ankle� 838 – Dislocation of foot


EXHIBIT A

39

ICD-9-CM840-848

� Sprains and Strains of Joints and Adjacent Muscles

� 840 – Shoulder and upper region

� 841 – Elbow and forearm

� 842 – Wrist and hand

� 843 – Hip and thigh

� 844 – Knee and leg

� 845 – Ankle and foot

� 846 – Sacroiliac region

� 847 – Unspecified parts of back

� 848 – Other and ill-defined (Symphysis pubis)

40

ICD-9-CM905-907

� 905 Late effects of musculoskeletal andconnective tissue injuries

� 906 Late effects of injuries to skin andsubcutaneous tissues

� 907 Late effects of injuries to thenervous system

EXHIBIT A


41

ICD-9-CM922

� 922 Contusion of trunk

� 922.31 Back

� 922.33 Interscapular region)

� 923 Contusion of upper limb

� 924 Contusion of lower limb and of otherunspecified sites

42

ICD-9-CM923

� 923 Contusion of upper limb

� 923.0 Should and upper arm

� 923.1 Elbow and forearm

� 923.2 Wrist and hand9s), except finger(s)alone

� 923.3 Finger

� 923.8 Multiple sites of upper limb

� Check for 5th digit


EXHIBIT A

43

ICD-9-CM924

� 924 Contusion of lower limb and of otherunspecified sites

� 924.0 Hip and thigh

� 924.1 Knee and lower leg

� 924.2 Ankle and foot, excluding toe(s)

� 924.3 Toes

� 924.4 Multiple sites of lower limb

� Check for 5th digit

44

ICD-9-CM925-929

� Crushing Injury

� 926 – Crushing injury of trunk

� 927 – Crushing injury of upper limb

� 928 – Crushing injury of lower limb

� 929 – Crushing injury of multiple and unspecified sites

EXHIBIT A


45

ICD-9-CMBurns (940-949)

� 941 - Burns of head, face, and neck� 942 – Burn of trunk� 943 – Burn of upper limb, except wrist and

hand� 944 – Burn of wrist and hand� 945 – Burn of lower limbs� 946 – Burns of multiple specified sites� 948 – Burns classified according to extent of

body surface involved� 949 – Burn unspecified

46

ICD-9-CM950-957

� Injury to Nerves and Spinal Cord

� 952 – Spinal cord injury

� 953 – Injury to nerve roots and spinal plexus

� 955 – Injury to peripheral nerves of shoulder girdle and upper limb

� 956 – Injury to peripheral nerves of pelvic girdle and lower limb

� 957 – Injury to other and unspecified nerves


EXHIBIT A

47

ICD-9 Free Websites

� http://icd9cm.chrisendres.com/index.php?action=contents

� www.e-mds.com/services/icd9/

� http://cedr.lbl.gov/icd9.html

48

National Correct CodingInitiatives (NCCI)

� Implemented to combat abusive andfraudulent billing practices

� Initiated in 1996

� Expanded to hospital outpatient departmentsin August 2000

� Current version is 12.3 for private practiceand physician owned therapy clinics and 12.2for all other settings

EXHIBIT A


49

National Correct CodingInitiatives (NCCI) (cont’d)

� CCI edits expanded to Rehab Agencies,SNF Part B, CORF’s, and Home HealthAgencies under Part B on January 1,2006

� Reference for above:

http://www.cms.hhs.gov/MedlearnMattersArticles/downloads/SE0545.pdf

50

NCCI EditsPre-Test #1

� Therapist provided the followinginterventions:1 unit 97022 (Fluidotherapy)1 unit 97110 (Therapeutic Exercise)1 unit 97140 (Manual Therapy)1 unit 97530 (Therapeutic Activity)

� Which CPT code requires modifier-59be appended to it to be reimbursed?


EXHIBIT A

51

Modifiers

� In certain circumstances, specific CCIedits will be bypassed if requiredmodifiers are present

� Modifier-59

52

Modifier - 59

� Distinct Procedural Service� Indicates that a procedure or service was distinct or

independent from other services performed on thesame day

� Used to identify procedures/services that are notnormally reported together, but are appropriateunder the circumstances

� Documentation must support use of modifier – 59in that the procedures/services were provided atseparate and distinct times, were medicallynecessary and required the skills of a therapist ortherapist assistant under the supervision of atherapist

EXHIBIT A


53

Modifier-59 DocumentationExample

� 9:00AM-9:30AM, aquatic therapy of (listwhat was provided), 9:45AM-10:10AM,land-based exercises of (list what wasprovided)

� Aquatic therapy of (list what wasprovided) followed by land-basedexercise of (list what was provided)

54

CCI Edits

2 types of edits

1.) Mutually exclusive codes

2.) Column 1/Column 2 codes

See Exhibit F


EXHIBIT A

55

Mutually Exclusive Codes

� Codes that cannot be billed together because theywould not normally be performed together

� Speech group (92508) and speech therapy treatment(92507)

� Group therapy (97150) and therapeutic exercise(97110) or neuromuscular re-education (97112)

� Mechanical traction (97012) and manual therapy(97140)

� Paraffin bath (97018) and whirlpool (97022)

56

NCCI EditsPre-Test #2

� Patient received the followinginterventions on the same date:1 unit 92507 (Speech Treatment)2 units 97110 (Therapeutic Exercise)2 units 97116 (Gait Training)3 units 97535 (Self Care)

� Which CPT code requires modifier-59be appended to it to be reimbursed?

EXHIBIT A


57

Column 1/Column 2 Codes

� Codes in which one of the codes isconsidered a component of a morecomprehensive code on the bill

� Aquatic therapy (97113) and therapeuticexercise (97110)

� Therapeutic activities (97530) and gaittraining (97116)

� Therapeutic exercise (97110) and PT re-eval(97002) or OT re-eval (97004)

58

Column 1/Column 2 Codes(cont’d)

� Therapeutic activities (97530) and self care(97535)

� Therapeutic activities (97530) and aquatictherapy (97113)

� Orthotic management and training (97660)and therapeutic exercise (97110) orneuromuscular re-education (97112) or gaittraining (97116) or manual therapy (97140)


EXHIBIT A

59

Column 1/Column 2 Codes(cont’d)

� Swallowing treatment (92526) andtherapeutic exercise (97110)

� Swallowing treatment (92526) and cognitivetherapy (97532)

� Swallowing treatment (92526) and Neuro re-education (97112)

� Swallowing treatment (92526) andtherapeutic activities (97530)

� Swallowing treatment (92526) andunattended e-stim (G0283) or manual e-stim(97032)

60

CCI Edits

� Are applicable to one specific disciplineof therapy billing different procedureson the same day that require modifier-59

� Are applicable when multiple disciplinesof therapy (same provider) occur to thesame beneficiary on the same daybilling procedures that require modifier-59

EXHIBIT A


61

CCI Edit Example

� Pt receives 60 minutes of SLP treatment(92507) on 09/05/03

� Pt receives 30 minutes of therapeuticexercise (97110) and 30 minutes of gaittraining (97116) in PT on 09/05/03

� Pt receives OT consisting of 30 minutes oftherapeutic activities (97530) and 30 minutesof Neuro Re-ed (97112) on 09/05/03

62

CCI Edit Example (cont’d)

� By discipline, none of the procedures requiremodifier-59 to be reimbursed

� Since this patient was seen on the same dayby more than one discipline, need to checkbetween all disciplines (cross-check) as theneed for modifier-59 does apply by theprovider of the service

� CMS billing system does not recognizetherapy specific modifiers (GN, GO, GP)


EXHIBIT A

63

CCI Edit Example (cont’d)

� Would need to append modifier-59 to97110, 97112, 97116, and 97530

� Documentation would need to supportthat the services were performed atseparate and distinct times

� Not appending modifier-59 in thisexample would cost you approximately$240 in lost reimbursement

64

CCI Updates

� Updated quarterly

� www.gawendaseminars.com

� http://www.cms.hhs.gov/NationalCorrectCodInitEd/

� Private practice and physician owned therapyclinics, click on NCCI Edits – physicians. Allother settings, click on NCCI Edits - Hospital

EXHIBIT A


65

References

• American Medical AssociationCurrent Procedural Terminology; CPT2006; Standard Edition

• Ingenix St. Anthony Publishing/MedicodeCoding and Payment Guide for the PhysicalTherapist; 2006, 11th Edition

• Ingenix St. Anthony Publishing/MedicodeICD-9-CM Expert for Hospitals-Volumes1,2, & 3. 2005. 6th Edition

66

Resources

� http://www.cms.hhs.gov/TherapyServices/


Find your Carrier or Fiscal Intermediary


EXHIBIT A

67

References for BillingInternet-Only Manuals

� http://www.cms.hhs.gov/Manuals/

� Click on Internet-Only Manuals

� Click on Pub 100-4Medicare Claims Processing Manual

� Choose the appropriate chapter dependingon your setting

68

Billing References

� Chapter 5, Part B OutpatientRehabilitation and CORF Services

EXHIBIT A


69

Rick Gawenda, P.T.

� [email protected]

� [email protected]


� (313) 745-3533

� Cell phone: (734) 717-1101

70

Thank you

Exhibit B

ICD-9-CM Volume 1- Index to Diseases

EXHIBIT B


Pain(s)

joint 719.40 ankle 719.47 elbow 719.42 foot 719.47 hand 719.44 hip 719.45 knee 719.46 multiple sites 719.49 pelvic region 719.45 psychogenic 307.89 shoulder (region) 719.41 specified site NEC 719.48 wrist 719.43

Exhibit C

ICD-9-CM Volume 2- Tabular List

EXHIBIT C


Pain(s)

√5th 719.4 Pain in joint

The following fifth-digit subclassification is for use with codes 719.0-719.6, 719.8-719.9; valid digits are in {brackets} under each code.

0 site unspecified1 shoulder region2 upper arm3 forearm4 hand5 pelvic region and thigh6 lower leg7 ankle and foot8 other specified sites9 multiple sites

Exhibit D

AdminaStar Federal: ICD-9 Codes that Support Medical Necessity

Source: http://www.adminastar.com

EXHIBIT D


ICD-9 Codes that Support Medical Necessity

It is the responsibility of the provider to code to the highest level specified in the

ICD-9-CM (e.g., to the fourth or fifth digit). The correct use of an ICD-9-CM code

listed below does not assure coverage of a service. The service must be reasonable

and necessary in the specific case and must meet the criteria specified in this

determination.

The following list includes symptom, condition and specific diagnosis codes.

Physical therapy services are generally directed toward physical impairments

represented by symptoms and conditions. However in many instances, the ICD-9-

CM symptom and condition narratives do not describe circumstances for which

physical therapy services may be reasonable and necessary. Specific diagnosis

codes (e.g., bronchiectasis, Tietze's disease, Colles' fracture) are therefore

included for these situations. In order for the ICD-9-CM code to support medical

necessity for PT services, the symptom or condition for which PT is being rendered

should be coded along with the underlying medical condition.

138 LATE EFFECTS OF ACUTE POLIOMYELITIS

315.4 DEVELOPMENTAL COORDINATION DISORDER

333.83 SPASMODIC TORTICOLLIS

342.00 FLACCID HEMIPLEGIA AND HEMIPARESIS AFFECTING UNSPECIFIED

SIDE

342.01 FLACCID HEMIPLEGIA AND HEMIPARESIS AFFECTING DOMINANT SIDE

342.02 FLACCID HEMIPLEGIA AND HEMIPARESIS AFFECTING NONDOMINANT

SIDE

342.10 SPASTIC HEMIPLEGIA AND HEMIPARESIS AFFECTING UNSPECIFIED

SIDE

342.11 SPASTIC HEMIPLEGIA AND HEMIPARESIS AFFECTING DOMINANT SIDE

342.12 SPASTIC HEMIPLEGIA AND HEMIPARESIS AFFECTING NONDOMINANT

SIDE

342.80 OTHER SPECIFIED HEMIPLEGIA AND HEMIPARESIS AFFECTING

UNSPECIFIED SIDE


DOMINANT SIDE


NONDOMINANT SIDE

342.90 UNSPECIFIED HEMIPLEGIA AND HEMIPARESIS AFFECTING

UNSPECIFIED SIDE

342.91 UNSPECIFIED HEMIPLEGIA AND HEMIPARESIS AFFECTING DOMINANT

SIDE


EXHIBIT D

SIDE

342.92 UNSPECIFIED HEMIPLEGIA AND HEMIPARESIS AFFECTING

NONDOMINANT SIDE

344.01 QUADRIPLEGIA C1-C4 COMPLETE

344.02 QUADRIPLEGIA C1-C4 INCOMPLETE

344.03 QUADRIPLEGIA C5-C7 COMPLETE

344.04 QUADRIPLEGIA C5-C7 INCOMPLETE

344.09 OTHER QUADRIPLEGIA

344.1 PARAPLEGIA

344.2 DIPLEGIA OF UPPER LIMBS

344.30 MONOPLEGIA OF LOWER LIMB AFFECTING UNSPECIFIED SIDE

344.31 MONOPLEGIA OF LOWER LIMB AFFECTING DOMINANT SIDE

344.32 MONOPLEGIA OF LOWER LIMB AFFECTING NONDOMINANT SIDE

344.41 MONOPLEGIA OF UPPER LIMB AFFECTING DOMINANT SIDE

344.42 MONOPLEGIA OF UPPER LIMB AFFECTING NONDOMINANT SDE

344.60 CAUDA EQUINA SYNDROME WITHOUT NEUROGENIC BLADDER

344.61 CAUDA EQUINA SYNDROME WITH NEUROGENIC BLADDER

344.89 OTHER SPECIFIED PARALYTIC SYNDROME

353.0 BRACHIAL PLEXUS LESIONS

353.1 LUMBOSACRAL PLEXUS LESIONS

353.2 CERVICAL ROOT LESIONS NOT ELSEWHERE CLASSIFIED

353.3 THORACIC ROOT LESIONS NOT ELSEWHERE CLASSIFIED

353.4 LUMBOSACRAL ROOT LESIONS NOT ELSEWHERE CLASSIFIED

353.5 NEURALGIC AMYOTROPHY

353.6 PHANTOM LIMB (SYNDROME)

353.8 OTHER NERVE ROOT AND PLEXUS DISORDERS

354.0 CARPAL TUNNEL SYNDROME

354.1 OTHER LESION OF MEDIAN NERVE

354.2 LESION OF ULNAR NERVE

354.3 LESION OF RADIAL NERVE

EXHIBIT D


354.4 CAUSALGIA OF UPPER LIMB

354.5 MONONEURITIS MULTIPLEX

354.8 OTHER MONONEURITIS OF UPPER LIMB

355.0 LESION OF SCIATIC NERVE

355.1 MERALGIA PARESTHETICA

355.2 OTHER LESION OF FEMORAL NERVE

355.3 LESION OF LATERAL POPLITEAL NERVE

355.4 LESION OF MEDIAL POPLITEAL NERVE

355.5 TARSAL TUNNEL SYNDROME

355.6 LESION OF PLANTAR NERVE

355.71 CAUSALGIA OF LOWER LIMB

355.79 OTHER MONONEURITIS OF LOWER LIMB

355.8 MONONEURITIS OF LOWER LIMB UNSPECIFIED

356.1 PERONEAL MUSCULAR ATROPHY

386.11 BENIGN PAROXYSMAL POSITIONAL VERTIGO

386.50 LABYRINTHINE DYSFUNCTION UNSPECIFIED

438.20 HEMIPLEGIA AFFECTING UNSPECIFIED SIDE

438.21 HEMIPLEGIA AFFECTING DOMINANT SIDE

438.22 HEMIPLEGIA AFFECTING NONDOMINANT SIDE

438.30 MONOPLEGIA OF UPPER LIMB AFFECTING UNSPECIFIED SIDE

438.31 MONOPLEGIA OF UPPER LIMB AFFECTING DOMINANT SIDE

438.32 MONOPLEGIA OF UPPER LIMB AFFECTING NONDOMINANT SIDE

438.40 MONOPLEGIA OF LOWER LIMB AFFECTING UNSPECIFIED SIDE

438.41 MONOPLEGIA OF LOWER LIMB AFFECTING DOMINANT SIDE

438.42 MONOPLEGIA OF LOWER LIMB AFFECTING NONDOMINANT SIDE

438.50 OTHER PARALYTIC SYNDROME AFFECTING UNSPECIFIED SIDE

438.51 OTHER PARALYTIC SYNDROME AFFECTING DOMINANT SIDE

438.52 OTHER PARALYTIC SYNDROME AFFECTING NONDOMINANT SIDE

438.53 OTHER PARALYTIC SYNDROME BILATERAL


EXHIBIT D

438.6 ALTERATIONS OF SENSATIONS

438.7 DISTURBANCES OF VISION

438.83 FACIAL WEAKNESS

438.84 ATAXIA

438.85 VERTIGO

454.0 VARICOSE VEINS OF LOWER EXTREMITIES WITH ULCER

454.1 VARICOSE VEINS OF LOWER EXTREMITIES WITH INFLAMMATION

454.2 VARICOSE VEINS OF LOWER EXTREMITIES WITH ULCER AND

INFLAMMATION

454.8 VARICOSE VEINS OF LOWER EXTREMITIES WITH OTHER

COMPLICATIONS

457.0 POSTMASTECTOMY LYMPHEDEMA SYNDROME

457.1 OTHER LYMPHEDEMA

Exhibit E

TrailBlazer Health: ICD-9 Codes that Support Medical Necessity

Source: http://www.trailblazer.com


EXHIBIT E

Trailblazer’s ICD-9 Codes That Support Medical Necessity

Medicare is establishing the following limited coverage for CPT/HCPCS code 97110 -

therapeutic exercise:

Covered for:

274.0 Gouty arthropathy

274.9 Gout, unspecified

332.0 - 332.1 Parkinson’s Disease

333.83 Spasmodic torticollis

333.90 - 333.91 Other and unspecified extrapyramidal diseases and abnormal movement disorders

334.0 - 334.4 Spinocerebellar disease

334.8 Other spinocerebellar diseases

335.0 Werdnig-Hoffmann disease

335.10 - 335.11 Spinal muscular atrophy

335.19 Other spinal muscular atrophy

335.20 - 335.24 Motor neuron disease

335.29 Other motor neuron disease

335.8 - 335.9 Other anterior horn cell diseases, unspecified

336.0 - 336.3 Other diseases of spinal cord

336.8 Other myelopathy

337.20 - 337.22 Reflex sympathetic dystrophy

337.29 Reflex sympathetic dystrophy of other specified site

340 Multiple sclerosis

341.1 Schilder’s disease

341.8 - 341.9 Other demyelinating diseases of central nervous system, unspecified

342.00 - 342.02 Flaccid hemiplegia

342.10 - 342.12 Spastic hemiplegia

342.80 - 342.82 Other specified hemiplegia

342.90 - 342.92 Hemiplegia, unspecified

343.0 - 343.4 Infantile cerebral palsy

343.8 - 343.9 Other specified infantile cerebral palsy, unspecified

344.00 - 344.04 Quadriplegia and quadriparesis

344.09 Other quadriplegia and quadriparesis

344.1 - 344.2 Paraplegia, diplegia of upper limbs

344.30 - 344.32 Monoplegia of lower limb

344.40 - 344.42 Monoplegia of upper limb

344.5 Unspecified monoplegia

344.60 - 344.61 Cauda equina syndrome

344.81 Locked-in state

344.89 Other specified paralytic syndrome

344.9 Paralysis, unspecified

348.1 Anoxic brain damage

351.1 Geniculate ganglionitis

353.0 - 353.6 Nerve root and plexus disorders

353.8 Other nerve root and plexus disorders

354.0 - 354.5 Mononeuritis of upper limb and mononeuritis multiplex

EXHIBIT E


354.8 - 354.9 Other mononeuritis of upper limb, unspecified

355.0 - 355.6 Mononeuritis of lower limb and unspecified site

355.71 Causalgia of lower limb

355.79 Other mononeuritis of lower limb

355.8 Mononeuritis of lower limb, unspecified

356.0 - 356.4 Hereditary and idiopathic peripheral neuropathy

356.8 - 356.9 Other specified idiopathic peripheral neuropathy, unspecified

357.0 Acute infective polyneuritis

357.9 Unspecified inflammatory and toxic neuropathy

358.00 -358.01 Myasthenia gravis

358.1 - 358.2 Myoneural disorders

358.8 - 358.9 Mononueuritis of lower limb and unspecified site

359.0 - 359.6 Muscular dystrophies and other myopathies

359.81 Critical illness myopathy

359.89 Other myopathies

359.9 Myopathy, unspecified

436 Acute, but ill-defined cerebrovascular disease

457.0 - 457.1 Noninfectious disorders of lymphatic channels

524.60 - 524.63 Temporomandibular joint disorders

524.69 Other specified temporomandibular joint disorders

681.00 - 681.01 Cellulitis and abscess of finger

682.3 - 682.7 Other cellulitis and abscess

711.00 - 711.08 Pyogenic arthritis

711.10 - 711.19 Arthropathy associated with Reiter’s disease and non-specific urethritis

711.20 - 711.29 Arthropathy in Behçet's syndrome

711.30 - 711.39 Postdysenteric arthropathy

711.40 - 711.49 Arthropathy associated with other bacterial diseases

711.50 - 711.59 Arthropathy associated with other viral diseases

711.60 - 711.69 Arthropathy associated with mycoses

711.70 - 711.79 Arthropathy associated with helminthiasis

711.80 - 711.89 Arthropathy associated with other infectious and parasitic diseases

711.90 - 711.99 Unspecified infective arthritis

712.10 - 712.19 Chondrocalcinosis due to dicalcium phosphate crystals

712.20 - 712.29 Chondrocalcinosis due to pyrophosphate crystals

712.30 - 712.39 Chondrocalcinosis, unspecified

712.80 - 712.89 Other specified crystal arthropathies

712.90 - 712.99 Unspecified crystal arthropathy

713.0 - 713.8 Arthropathy associated with other disorders classified elsewhere

714.0 - 714.2 Rheumatoid arthritis and other inflammatory polyarthropathies

714.30 - 714.33 Juvenile chronic polyarthritis

714.4 Chronic postrheumatic arthropathy

714.81 Rheumatoid lung

714.89 Other specified inflammatory polyarthropathies

714.9 Unspecified inflammatory polyarthropathy

715.00 Osteoarthrosis, generalized, site unspecified

715.04 Osteoarthrosis, generalized, hand


EXHIBIT E

715.09 Osteoarthrosis, generalized, multiple sites

715.10 - 715.18 Osteoarthrosis, localized, primary

715.20 - 715.28 Osteoarthrosis, localized, secondary

715.30 - 715.38 Osteoarthrosis, localized, not specified whether primary or secondary

715.80 Osteoarthrosis involving, or with mention of more than one site, but not specified as

generalized, site unspecified


generalized, multiple sites

715.90 - 715.98 Osteoarthrosis, unspecified whether generalized or localized

716.00 - 716.09 Kaschin-Beck disease

716.10 - 716.19 Traumatic arthropathy

716.20 - 716.29 Allergic arthritis

716.30 - 716.39 Climacteric arthritis

716.40 - 716.49 Transient arthropathy

716.50 - 716.59 Unspecified polyarthropathy or polyarthritis

718.20 - 718.29 Pathological dislocation

718.30 - 718.39 Recurrent dislocation of joint

718.40-718.49 Contracture of joint

719.00 - 719.09 Effusion of joint

719.10 - 719.19 Hemarthrosis

719.20 - 719.29 Villonodular synovitis

719.30 - 719.39 Palindromic rheumatism

719.40 - 719.49 Pain in joint

719.50 - 719.59 Stiffness of joint, not elsewhere classified

719.7 Difficulty in walking

720.0 - 720.2 Ankylosing spondylitis and other inflammatory spondylopathies

720.81 Inflammatory spondylopathies in diseases classified elsewhere

720.89 Other inflammatory spondylopathies

722.0 Displacement of cervical intervertebral disc without myelopathy

722.10 - 722.11 Displacement of thoracic or lumbar intervertebral disc without myelopathy

722.2 Displacement of intervertebral disc, site unspecified, without myelopathy

722.30 - 722.32 Schmorl’s nodes

722.39 Schmorl’s nodes, other

722.4 Degeneration of cervical intervertebral disc

722.51 - 722.52 Degeneration of thoracic or lumbar intervertebral disc

722.6 Degeneration of intervertebral disc, site unspecified

722.70 - 722.73 Intervertebral disc disorder with myelopathy

722.80 - 722.83 Postlaminectomy syndrome

722.90 - 722.93 Other and unspecified disc disorder

723.0 - 723.5 Other disorders of cervical region

724.01 - 724.02 Spinal stenosis, other than cervical

724.09 Spinal stenosis, other region

724.1 - 724.6 Other and unspecified disorders of back

724.70 - 724.71 Disorders of coccyx

724.79 Disorders of coccyx, other

726.0 Adhesive capsulitis of shoulder

EXHIBIT E


726.10 - 726.12 Rotator cuff syndrome of shoulder and allied disorders

726.19 Other specified disorders of shoulder

726.2 Other affections of shoulder region, not elsewhere classified

726.30 - 726.33 Enthesopathy of elbow region

726.39 Other enthesopathy of elbow region

726.4 - 726.5 Peripheral enthesopathies and allied disorders

726.60 - 726.65 Enthesopathy of knee

726.69 Other enthesopathy of knee

726.70 - 726.73 Enthesopathy of ankle and tarsus

726.79 Other enthesopathy of ankle and tarsus

726.8 Other peripheral enthesopathies

726.90 - 726.91 Unspecified enthesopathy

727.00 - 727.06 Synovitis and tenosynovitis, unspecified

727.09 Other synovitis and tenosynovitis

727.1 - 727.3 Other disorders of synovium, tendon, and bursa

727.40 - 727.43 Ganglion and cyst of synovium, tendon and bursa

727.49 Other ganglion and cyst of synovium, tendon and bursa

727.50 - 727.51 Rupture of synovium

727.59 Other rupture of synovium

727.60 - 727.67 Rupture of tendon, nontraumatic

727.81 Contracture of tendon (sheath)

728.11 - 728.12 Muscular calcification and ossification

728.2 Muscular wasting and disuse atrophy, not elsewhere classified

728.6 Contracture of palmar fascia

728.71 Plantar fascial fibromatosis

728.83 Rupture of muscle, nontraumatic

728.85 Spasm of muscle

729.1 Myalgia and myositis, unspecified

729.4 - 729.5 Other disorders of soft tissues

729.81 - 729.82 Other musculoskeletal symptoms referable to limbs

757.0 Hereditary edema of legs

781.0 - 781.3 Symptoms involving nervous and musculoskeletal systems

781.92 Abnormal posture

781.99 Other symptoms involving nervous and musculoskeletal systems

782.3 Edema

799.4 Cachexia

805.00 - 805.08 Fracture vertebral column without mention of spinal cord injury, cervical, closed

805.10 - 805.18 Fracture of vertebral column without mention of spinal cord injury, cervical, open

805.2 - 805.9 Fracture of vertebral column without mention of spinal cord injury

806.00 - 806.09 Fracture of vertebral column with spinal cord injury, cervical, closed

806.10 - 806.19 Fracture of vertebral column with spinal cord injury, cervical, open

806.20 - 806.29 Fracture of vertebral column with spinal cord injury, dorsal [thoracic], closed

806.30 - 806.39 Fracture of vertebral column with spinal cord injury, dorsal [thoracic], open

806.4 - 806.5 Fracture of vertebral column with spinal cord injury, lumbar

806.60 - 806.62 Fracture of vertebral column with spinal cord injury, sacrum and coccyx, closed

806.69 Closed fracture of sacrum and coccyx with other spinal cord injury


EXHIBIT E

806.70 - 806.72 Fracture of vertebral column with spinal cord injury, sacrum and coccyx, open

806.79 Open fracture of sacrum and coccyx with other spinal cord injury

806.8 Unspecified closed fracture of vertebral column with spinal cord injury

807.00 - 807.09 Fracture of rib(s), closed

807.10 - 807.19 Fracture of rib(s), open

807.2 - 807.5 Fracture of sternum, larynx, and trachea

808.0 - 808.3 Fracture of pelvis

808.41 - 808.43 Fracture of pelvis, other specified part, closed

808.49 Fracture of pelvis, other specified part, closed, other

808.51 - 808.53 Fracture of pelvis, other specified part, open

808.59 Fracture of other specified part of pelvis, open, other

808.8 - 808.9 Fracture of pelvis, unspecified

809.0 - 809.1 Ill-defined fractures of bones of trunk

810.00 - 810.03 Fracture of clavicle, closed

810.10 - 810.13 Fracture of clavicle, open

811.01 - 811.03 Fracture of scapula, closed

811.09 Other fracture of scapula, closed

811.10 - 811.13 Fracture of scapula, open

811.19 Other fracture of scapula, open

812.00 - 812.03 Fracture of upper end of humerus, closed

812.09 Fracture of upper end of humerus, closed, other

812.10 - 812.13 Fracture of upper end of humerus, open

812.19 Fracture of upper end of humerus, open, other

812.20 - 812.21 Fracture of humerus shaft or unspecified part, closed

812.30 - 812.31 Fracture of humerus shaft or unspecified part, open

812.40 - 812.44 Fracture of humerus lower end, closed

812.49 Fracture of other part of lower end of humerus, closed

812.50 - 812.54 Fracture of humerus lower end, open

812.59 Fracture of other part of lower end of humerus, open

813.00 - 813.08 Fracture of radius and ulna, upper end, closed

813.10 - 813.18 Fracture of radius and ulna, upper end, open

813.20 - 813.23 Fracture of shaft of radius and ulna, closed

813.30 - 813.33 Fracture of shaft of radius and ulna, open

813.40 - 813.44 Fracture of radius and ulna, lower end, closed

813.50 - 813.54 Fracture of radius and ulna, lower end, open

813.90 - 813.93 Fracture of radius and ulna, unspecified part, open

814.00 - 814.09 Fracture of carpal bone(s), closed

814.10 - 814.19 Fracture of carpal bone(s), open

815.00 - 815.04 Fracture of metacarpal bone(s), closed

815.09 Closed fracture of multiple sites of metacarpus

815.10 - 815.14 Fracture of metacarpal bone(s), open

815.19 Open fracture of multiple sites of metacarpus

816.00 - 816.03 Fracture of one or more phalanges of hand, closed

816.11 - 816.13 Fracture of one or more phalanges of hand, open

817.0 - 817.1 Multiple fractures of hand bones

818.0 - 818.1 Ill-defined closed fractures of upper limb

EXHIBIT E


820.00 - 820.03 Transcervical fracture, closed

820.09 Transcervical fracture, other, closed

820.10 - 820.13 Transcervical fracture, open

820.19 Transcervical fracture, other, open

820.20 - 820.22 Pertrochanteric fracture, closed

820.30 - 820.32 Pertrochanteric fracture, open

820.8 - 820.9 Fracture of unspecified part of neck of femur

821.00 - 821.01 Fracture of other and unspecified parts of the femur, shaft or unspecified part, closed

821.10 - 821.11 Fracture of other and unspecified parts of the femur, shaft or unspecified part, open

821.20 - 821.23 Fracture of lower end of femur, closed

821.29 Other fracture of lower end of femur, other, closed

821.30-821.33 Fracture of lower end of femur, unspecified part, open

821.39 Fracture of lower end of femur, other, open

822.0-822.1 Fracture of patella, closed

823.00-823.02 Closed fracture of tibia and fibula, upper end

823.10-823.12 Open fracture of tibia and fibula, upper end

823.20-823.22 Open fracture of tibia and fibula, shaft

823.30-823.32 Open fracture of tibia and fibula, shaft

823.80-823.82 Closed fracture of tibia and fibula, unspecified part

823.90-823.92 Open fracture of tibia and fibula, unspecified part

824.0-824.7 Fracture of ankle

824.8-824.9 Unspecified fracture of ankle

825.0-825.1 Fracture of one or more tarsal and metatarsal bones

825.20-825.25 Fracture of other tarsal and metatarsal bones, closed

825.29 Closed fracture of other bones of foot (except toes)

825.30-825.35 Fracture of other tarsal and metatarsal bones, open

825.39 Open fracture of other bones of foot (except toes)

826.0-826.1 Fracture of one or more phalanges of foot

827.0-827.1 Other, multiple, and ill-defined fractures of lower limb

830.0-830.1 Dislocation of jaw

831.00-831.04 Dislocation of shoulder, Closed

831.09 Other closed dislocation of shoulder

831.10-831.14 Open dislocation of shoulder, unspecified

831.19 Open dislocation of shoulder

832.00-832.04 Dislocation of elbow, Closed

832.09 Other closed dislocation of elbow

832.10-832.14 Dislocation of elbow, Open

832.19 Other open dislocation of elbow

833.00-833.05 Dislocation of wrist, Closed, unspecified part

833.09 Other closed dislocation of wrist

833.10-833.15 Dislocation of wrist, Open, unspecified part

833.19 Other open dislocation of wrist

834.00-834.02 Dislocation of finger, Closed, unspecified part

834.10-834.12 Dislocation of finger, Open, unspecified part

835.00-835.03 Dislocation of hip, Closed, unspecified

835.10-835.13 Dislocation of hip, Open, unspecified


EXHIBIT E

836.0-836.4 Dislocation of knee

836.50-836.54 Other dislocation of knee, closed

836.59 Other closed dislocation of knee

836.60-836.64 Other dislocation of knee, open

836.69 Other open dislocation of knee

837.0-837.0 Dislocation of ankle

838.00-838.06 Dislocation of foot

838.10-838.16 Dislocation of foot, Open

840.0-840.6 Sprains and strains of shoulder and upper arm

840.8 Sprains and strains of other specified sites of shoulder and upper arm

840.9 Sprains and strains of unspecified site of shoulder and upper arm

841.0-841.3 Sprains and strains of elbow and forearm

841.8-841.9 Sprains and strains of elbow and forearm

842.00-842.02 Sprains and strains of wrist and hand

842.09 Other sprains and strains of wrist

842.10-842.13 Sprains and strains of hand, unspecified site

842.19 Other sprains and strains of hand

843.0-843.1 Sprains and strains of ileofemoral (ligament)

843.8-843.9 Sprains and strains of hip and thigh

844.0-844.3 Sprains and strains of knee and leg

844.8-844.9 Sprains and strains of knee and leg

845.00-845.03 Sprains and strains of ankle

845.09 Other sprains and strains of ankle

845.10-845.13 Sprains and strains of foot

845.19 Other sprains and strains of foot

846.0-846.3 Sprains and strains of sacroiliac region

846.8-846.9 Sprains and strains of sacroiliac region

847.0-847.4 Sprains and strains of other and unspecified parts of back

847.9 Sprains and strains of unspecified site of back

848.0-848.3 Other and ill-defined sprains and strains

848.40-848.42 Other and ill-defined sprains and strains of sternum

848.5 Other and ill-defined sprains and strains of pelvis

923.00-923.03 Contusion of upper limb

923.09 Contusion of multiple sites of shoulder and upper arm

923.10-923.11 Contusion of elbow and forearm

923.20 - 923.21 Contusion of wrist and hand(s), except finger(s) alone

923.3 Contusion of finger

923.8 - 923.9 Contusion of upper limb

924.00-924.01 Contusion of Hip and thigh

924.10-924.11 Contusion of knee and lower leg

924.20-924.21 Contusion of ankle and foot, excluding toe(s)

924.3-924.4 Contusion of lower limb and of other and unspecified sites

926.0 Crushing injury of external genitalia

926.11-926.12 Crushing injury of back and buttock

926.19 Crushing injury of other site

926.8 - 926.9 Crushing injury of multiple sites of trunk or unspecified site

EXHIBIT E


927.00-927.03 Crushing injury of shoulder region

927.09 Crushing injury of multiple sites of shoulder and upper arm

927.10-927.11 Crushing injury of elbow and forearm

927.20-927.21 Crushing injury of wrist and hand(s), except finger(s) alone

927.3 Crushing injury of finger(s)

927.8 - 927.9 Crushing injury of multiple sites of upper limb or unspecified site

928.00-928.01 Crushing injury of hip and thigh

928.10-928.11 Crushing injury of knee and lower leg

928.20-928.21 Crushing injury of ankle and foot, excluding toe(s) alone

928.3 Crushing injury of toe(s)

928.8 Crushing injury of multiple sites of lower limb

952.00-952.09 Cervical spinal cord injury without evidence of spinal bone injury

952.2-952.4 Spinal cord injury without evidence of spinal bone injury

952.8 Spinal cord injury, multiple sites of spinal cord, without evidence of spinal bone injury

953.0-953.5 Injury to nerve roots and spinal plexus

953.8 Injury to multiple sites

955.0-955.9 Injury to peripheral nerves(s) of should girdle and upper limb

956.0-956.5 Injury to peripheral nerve(s) of pelvic girdle and lower limb

956.8-956.9 Injury to peripheral nerve(s) of pelvic girdle and lower limb

997.61 Late amputation stump complication, neuroma of stump

V43.60 - V43.66 Organ or tissue replaced by other means, joint

V43.69 Other joint replaced by joint

V49.67 Shoulder amputation status

V49.70- V49.77 Lower limb amputation status

V54.09 Aftercare involving internal fixation device

V54.81 Aftercare following joint replacement

V54.89 Other orthopedic aftercare


balance and coordination:

Covered for:

274.0 Gouty arthropathy

274.9 Gout, unspecified

332.0-332.1 Parkinson’s disease

333.0 Other degenerative diseases of the basal ganglia

333.83 Spasmodic torticollis

333.90-333.91 Other and unspecified extrapyramidal diseases and abnormal movement disorders

334.0-334.4 Spinocerebellar disease


335.0 Werdnig-Hoffman disease

335.10-335.11 Spinal muscular atrophy


335.20-335.24 Motor neuron disease

335.29 Other lateral sclerosis


EXHIBIT E

335.8-335.9 Anterior horn cell disease

336.0-336.3 Other diseases of spinal cord


337.20-337.22 Reflex sympathetic dystrophy

337.29 Reflex sympathetic dystrophy of other specified site



341.8-341.9 Other demyelinating diseases of central nervous system

342.00-342.02 Flaccid hemiplegia

342.10-342.12 Spastic hemiplegia

342.80-342.82 Other specified hemiplegia

342.90-342.92 Hemiplegia, unspecified

344.00-344.04 Quadriplegia

344.09 Other quadriplegia

344.1-344.2 Other paralytic syndromes

344.30-344.32 Monoplegia of lower limb

344.40-344.42 Monoplegia of upper limb

344.60-344.61 Cauda equina syndrome




351.1 Geniculate ganglionitis

353.0 - 353.6 Nerve root and plexus disorder

353.8 Other nerve root and plexus disorders


356.8 Other specified peripheral neuropathydiopathic peripheral neuropathy

357.0 - 357.2 Inflammatory and toxic neuropathy


358.00 - 358.01 Mysasthenia gravis

358.2 Toxic myoneural disorders





359.9 Other Muscular dystrophies and myopathies

369.01 Profound impairment, both eyes; better eye: near-total impairment; lesser eye: not

further specified

369.03 - 369.04 Profound impairment, both eyes


369.12 - 369.14 Moderate or severe impairment; better eye: severe impairment; lesser eye

369.16 - 369.18 Moderate or severe impairment; better eye: moderate impairment; lesser eye

369.24 - 369.25 Moderate or severe impairment both eyes

457.0 Postmastectomy lymphedema syndrome

711.00 - 711.09 Pyogenic arthritis

711.10 - 711.19 Arthropathy associated with Reiter’s disease and non-specific urethritis

711.20 - 711.29 Arthropathy in Behcet's syndrome

EXHIBIT E


711.30 - 711.39 Postdysenteric arthropathy

711.40 - 711.49 Arthropathy associated with other bacterial diseases

711.50 - 711.59 Arthropathy associated with other viral diseases

711.60 - 711.69 Arthropathy associated with mycoses

711.70 - 711.79 Arthropathy associated with helminthiasis




712.10 - 712.19 Crystal arthropathies





713.0 - 713.8 Arthropathy associated with other endocrine and metabolic disorders


714.30 - 714.33 Polyarticular juvenile rheumatoid arthritis












generalized, site unspecified


generalized, multiple sites












719.10 - 719.19 Hemarthrosis



719.40 - 719.49 Pain in joint



EXHIBIT E

720.0 - 720.2 Ankylosing spondylitis and oher inflammatory spondylopathies















724.01 - 724.02 Spinal stenosis

724.09 Spinal stenosis, other

724.1 Other and unspecified disorders of back

724.70 - 724.71 Disorder of coccyx

724.79 Other disorders of coccyx













726.90 - 726.91 Unspecified Enthesopathy

727.00 - 727.06 Synovitis and tenosynovitis



727.40 - 727.43 Ganglion and cyst of synovium, tendon, and bursa

727.49 Other ganglion and cyst of synovium, tendon and bursae


727.59 Other rupture of synovium

727.60 - 727.67 Nontraumatic rupture of tendon

727.81 Nontraumatic rupture of other tendons of foot and ankle





EXHIBIT E


728.83 Rupture of muscle, non-traumatic





781.0 Abnormal involuntary movements


782.3 Edema

809.0 - 809.1 Ill-defined fractures of bones of trunk

810.00 - 810.03 Fracture of clavicle,closed

810.10 - 810.13 Fracture of clavicle,open

811.01 - 811.03 Fracture of scapula, closed

811.09 Other fracture of scapula, closed

811.10 - 811.13 Fracture of scapula, open

811.19 Other fracture of scapula, open

812.00 - 812.03 Fracture of upper end of humerus, closed

812.09 Fracture of upper end of humerus, closed, other part

812.10 - 812.13 Fracture of upper end of humerus, open

812.19 Fracture of upper end of humerus, open, other part

812.20 - 812.21 Fracture of humerus, shaft or unspecified part, closed

812.30 - 812.31 Fracture of humerus, shaft or unspecified part, open

812.40 - 812.44 Fracture of lower end of humerus, closed

812.49 Fracture of other part of lower end of humerus, closed

812.50 - 812.54 Fracture of lower end of humerus, open

812.59 Fracture of other part of lower end of humerus, open

813.00 - 813.08 Fracture of radius and ulna, upper end, closed

813.10 - 813.18 Fracture of radius and ulna, upper end, open

813.20 - 813.23 Fracture of shaft of radius and ulna, closed

813.30 - 813.33 Fracture of shaft of radius and ulna, open

813.40 - 813.44 Fracture of radius and ulna, lower end, closed

813.50 - 813.54 Fracture of radius and ulna, lower end, open

813.90 - 813.93 Fracture of radius and ulna, unspecified part, open

814.00 - 814.09 Closed fracture of carpal bone

814.10 - 814.19 Open fracture of carpal bone

815.00 - 815.04 Closed fracture of metacarpal bone(s)

815.09 Closed fracture of multiple sites of metacarpus

815.10 - 815.14 Open fracture of metacarpal bone(s)

815.19 Open fracture of multiple sites of metacarpus

816.00 - 816.03 Closed fracture of phalanx or phalanges

816.11 - 816.13 Fracture of one or more phalanges of hand

817.0 - 817.1 Multiple fractures of hand bones

820.00 - 820.03 Transcervical fracture, closed

820.09 Transcervical fracture, other, closed

820.10 - 820.13 Transcervical fracture, open

820.19 Transcervical fracture, other, open

820.20 - 820.22 Pertrochanteric fracture, closed


EXHIBIT E

820.30 - 820.32 Pertrochanteric fracture, open

820.8 - 820.9 Fracture of neck of femur

821.00 - 821.01 Fracture of femur, shaft or unspecified part, closed

821.10 - 821.11 Fracture of femur, shaft or unspecified part, open

821.20 - 821.23 Fracture of other and unspecified parts of the femur, lower end, closed

821.29 Other fracture of lower end of femur, closed

821.30 - 821.33 Fracture of other and unspecified parts of the femur, lower end, open

821.39 Other fracture of lower end of femur, open

822.0 - 822.1 Fracture of patella

823.00 - 823.02 Closed fracture of tibia and fibula, upper end

823.10 - 823.12 Open fracture of tibia and fibula, upper end

823.20 - 823.22 Closed fracture of shaft of tibia and fibula

823.30 - 823.32 Open fracture of shaft of tibia and fibula

823.80 - 823.82 Closed fracture of unspecified part of tibia and fibula

823.90 - 823.92 Open fracture of unspecified part of tibia and fibula

824.0 - 824.9 Fracture of ankle

825.0 - 825.1 Fracture of one or more tarsal and metatarsal bones

825.20 - 825.25 Fracture of other tarsal and metatarsal bones, closed

825.29 Closed fracture of other bones of foot (except toes)

825.30 - 825.35 Fracture of other tarsal and metatarsal bones, open

825.39 Open fracture of other bones of foot (except toes)

826.0 - 826.1 Fracture of one or more phalanges of foot

830.0 - 830.1 Dislocation of jaw

831.00 - 831.04 Closed dislocation of shoulder

831.09 Closed other dislocation of shoulder

831.10 - 831.14 Open dislocation of shoulder

831.19 Open dislocation of shoulder

832.00 - 832.04 Closed dislocation of elbow

832.09 Other closed dislocation of elbow

832.10 - 832.14 Open dislocation of elbow

832.19 Other open dislocation of elbow

833.00 - 833.05 Closed dislocation of wrist

833.09 Other closed dislocation of wrist

833.10 - 833.15 Open dislocation of wrist

833.19 Other open dislocation of wrist

834.00 - 834.02 Closed dislocation of finger

834.10 - 834.12 Open dislocation of finger

835.00 - 835.03 Closed dislocation of hip

835.10 - 835.13 Open dislocation of hip

836.0 - 836.4 Dislocation of knee

836.50 - 836.54 Other dislocation of knee, closed

836.59 Other closed dislocation of knee

836.60 - 836.64 Other dislocation of knee, open

836.69 Other open dislocation of knee

837.0 - 837.1 Dislocation of ankle

838.00 - 838.06 Closed dislocation of foot

EXHIBIT E


838.10 - 838.16 Open dislocation of foot

840.0 - 840.6 Sprains and strains of shoulder and upper arm

840.8 - 840.9 Sprains and strains of shoulder and upper arm

841.0 - 841.3 Sprains and strains of elbow and forearm

841.8 - 841.9 Sprains and strains of elbow and forearm

842.00 - 842.02 Sprains and strains of wrist

842.09 Other sprains and strains of wrist

842.10 - 842.13 Sprains and strains of hand

842.19 Other sprains and strains of hand

843.0 - 843.1 Sprains and strains of hip and thigh

843.8 - 843.9 Sprains and strains of hip and thigh

844.0 - 844.3 Sprains and strains of knee and leg

844.8 - 844.9 Sprains and strains of knee and leg

845.00 - 845.03 Sprains and strains of ankle


845.10 - 845.13 Sprains and strains of foot


846.0 - 846.3 Sprains and strains of sacroiliac region

846.8 - 846.9 Sprains and strains of sacroiliac region

847.0 - 847.4 Sprains and strains of other and unspecified parts of back

847.9 Sprains and strains of unspecified site of back

848.0 - 848.3 Other and ill-defined sprains and strains

848.40 - 848.42 Other and ill-defined sprains and strains of sternum

848.5 Sprains and strains of pelvis

923.00 - 923.03 Contusion of shoulder and upper arm

923.09 Contusion of shoulder and upper arm, multiple sites

923.10 - 923.11 Contusion of elbow and forearm

923.20 - 923.21 Contusion of wrist and hand(s), except finger(s) alone

923.3 Contusion of finger

923.8 - 923.9 Contusion of upper limb

924.00 - 924.01 Contusion of hip and thigh

924.10 - 924.11 Contusion of knee and lower leg

924.20 - 924.21 Contusion of ankle and foot, excluding toe(s)

924.3 - 924.4 Contusion of lower limb and of other and unspecified sites

926.0 Crushing injury of external genitalia

926.11 - 926.12 Crushing injury of other specified sites of trunk

926.19 Crushing injury of other site of trunk

926.8 - 926.9 Crushing injury of multiple sites of trunk or unspecified site

927.00 - 927.03 Crushing injury of upper limb

927.10 - 927.11 Crushing injury of elbow and forearm

927.20 - 927.21 Crushing injury of wrist and hand(s), except finger(s) alone

927.3 Crushing injury of finger(s)

927.8 - 927.9 Crushing injury of multiple sites of upper limb or unspecified site

928.00 - 928.01 Crushing injury of hip and thigh

928.10 - 928.11 Crushing injury of knee and lower leg

928.20 - 928.21 Crushing injury of ankle and foot, excluding toe(s) alone


EXHIBIT E

928.3 Crushing injury of toe(s)

928.8 Crushing injury of multiple sites of lower limb

953.0 - 953.5 Injury to nerve roots and spinal plexus

953.8 Injury to multiple sites of nerve roots and spinal plexus

955.0 - 955.9 Injury to peripheral nerve(s) of shoulder girdle and upper limb

956.0 - 956.5 Injury to peripheral nerve(s) of pelvic girdle and lower limb

956.8 Injury to multiple nerves of pelvic girdle and lower limb

997.61 Late amputation stump complication, neuroma of (amputation) stump


V43.69 Organ or tissue replaced by other joint

V43.7 A limb replaced by other means

V45.4 Arthrodesis status

V49.60 - V49.67 Upper limb amputation status

V49.70 - V49.77 Lower limb amputation status

V54.09 Aftercare involving internal fixation device

V54.81 Aftercare following joint replacement

V54.89 Other orthopedic aftercare


aquatic therapy:

Covered for:





711.00-711.09 Pyogenic arthritis

711.10-711.19 Arthropathy associated with Reiter’s disease and non-specific urethritis

711.20-711.29 Arthropathy in Behcet's syndrome

711.30-711.39 Postdysenteric arthropathy

711.40-711.49 Arthropathy associated with other bacterial diseases

711.50-711.59 Arthropathy associated with other viral diseases

711.60-711.69 Arthropathy associated with mycoses

711.70-711.79 Arthropathy associated with helminthiasis

711.80-711.89 Arthropathy associated with other infectious and parasitic

diseases


712.10 - 712.19 Crystal arthropathies





713.0 - 713.8 Arthropathy associated with other disorders classified elsewhere


714.30 - 714.33 Polyarticular juvenile rheumatoid arthritis unspecified


EXHIBIT E


























719.40 - 719.49 Pain in joint


720.0 - 720.2 Ankylosing spondylitis and other inflammatory spondylopathies















724.01 - 724.02 Spinal stenosis

724.09 Spinal stenosis, other

724.1 - 724.6 Other and unspecified disorders of back

724.70 - 724.71 Disorders of coccyx

724.79 Other disorders of coccyx


EXHIBIT E













726.90 - 726.91 Unspecified Enthesopathy

727.00 - 727.06 Synovitis and tenosynovitis



727.40 - 727.43 Ganglion and cyst of synovium, tendon, and bursa

727.49 Other ganglion and cyst of synovium, tendon and bursae


727.60 - 727.67 Nontraumatic rupture of tendon

727.81 Nontraumatic rupture of other tendons of foot and ankle





728.83 Rupture of muscle, non-traumatic






V49.71 - V49.77 Amputation status


gait training:

Covered for:

138 Late effects of acute poliomyelitis

332.0-332.1 Parkinson’s Disease

333.0 Other degenerative diseases of the basal ganglia

333.90-333.91 Other and unspecified extrapyramidal diseases and abnormal movement disorders


334.8-334.9 Other spinocerebellar diseases, unspecified

335.0 Werdnig-Hoffman disease

335.10-335.11 Spinal muscular atrophy


335.20-335.24 Motor neuron disease

EXHIBIT E


335.29 Other motor neuron disease

335.8-335.9 Other anterior horn cell diseases, unspecified

336.0-336.3 Other diseases of spinal cord




341.8-341.9 Other demyelinating diseases of central nervous system, unspecified




342.90-342.92 Hemiplegia, unspecified

344.2 Diplegia of upper limbs

344.30 - 344.32 Monoplegia of lower limb

344.40 - 344.42 Monoplegia of upper limb

344.60 - 344.61 Cauda equina syndrome




353.0 - 353.6 Nerve root and plexus disorders

353.8 - 353.9 Other nerve root and plexus disorders, unspecified

354.0 - 354.5 Mononeuritis of upper limb and mononeuritis multiplex

354.8 - 354.9 Other mononeuritis of upper limb, unspecified

355.0 - 355.6 Mononeuritis of lower limb and unspecified site

355.71 Causalgia of lower limb

355.79 Other mononeuritis of lower limb

355.8 Mononeuritis of lower limb, unspecified


356.8 - 356.9 Other specified idiopathic peripheral neuropathy, unspecified


357.81 -357.82 Other inflammatory and toxic neuropathy

357.89 Other inflammatory and toxic neuropathy

357.9 Unspecified inflammatory and toxic neuropathy

358.00 -358.01 Myasthenia gravis

358.1 - 358.2 Myoneural disorders





359.9 Myopathy, unspecified

369.01 Better eye: total impairment; lesser eye: total impairment


369.12 - 369.14 Moderate or severe impairment; better eye: severe impairment; lesser eye

369.16 - 369.18 Moderate or severe impairment; better eye: moderate impairment; lesser eye

369.24 - 369.25 Moderate or severe impairment both eyes; better eye: moderate impairment

436 Acute, ill-defined, cerebrovascular disease

736.79 Other acquired deformities of ankle and foot


EXHIBIT E

755.30 - 755.38 Reduction deformities of lower limb

755.61 - 755.64 Other anomalies of lower limb, including pelvic girdle


781.92 Abnormal posture

781.99 Other symptoms involving nervous and musculoskeletal systems


V49.71 - V49.77 Lower limb amputation status

V57.81 Orthotic training

Exhibit F

Chart of CCI Edits

Source: http://www.gawendaseminars.com/cci10.xls


EXHIBIT F

Welcome to GawendaSeminars.com

CCI 12.3 - Correct Coding Initiative (CCI) Edits For Therapy Most Commonly Utilized CCI Edits

CCI Edits PT, OT, and SLP Most Common CCI Edits

CCI 12.3 Effective Dates For private practice: 10/01/06-12/31/06 For all other settings: 01/01/07-03/31/07

CPT Code Description Timed? Exclusive Column 290911 Biofeedback for Incontinence N 90901n; 97032y; 97110y;

97112y; 97530y; 97535y; 97550y

92506 Speech Evaluation N92507 Speech Treatment N 97110y; 97112y; 97150y;

97530y; 97532y92508 Speech Group N 92507y 97110y; 97112y; 97150y;

97530y; 97532y92526 Treatment of Swallowing Dysfunction N 92511y; 92520y; 97032n;

97110y; 97112y; 97150y; 97530y; 97532y; G0283n

92597 Evaluation of Voice Prosthetic N 97755n92607 Evaluation of Speech Generating Device Y 92506y; 92597n 92507y; 92508y;

92609y;97755n92608 Eval of Speech Device (additional 1/2 hour) Y 97755n92609 Training and Fitting for Device N 92506y; 92507y; 92508y;

97755n92610 Evaluation of Swallowing N 92511y92611 Radiopaque Swallow Study N 92511y; 92610y92612 Flexible Fiberoptic Endoscopic Swallow Eval N 92511n; 92511n; 92520n;

92610y; 92611y; 92614n95831 Muscle testing, extremity (excluding hand) or trunk N 95851n; 97140y95832 Muscle testing, hand N 95852n; 97140y95833 Muscle testing, total eval body, excluding hands N 95831n; 95832n; 95851n;

97140y95834 Muscle testing, total eval body, including hands N 95831n; 95832n; 95833n;

95851n; 95852n; 97140y96105 Assessment of Aphasia Y 96110y97001 PT Eval N 97750n; 97755n; 97762n

95831n; 95832n; 95833n; 95834n; 95851n; 95852n

97002 PT Re-eval N 97001n 97750n; 97755n; 97762n 95831n; 95832n; 95833n; 95834n; 95851n; 95852n

97003 OT Eval N 97750n; 97755n; 97762n 95831n; 95832n; 95833n; 95834n; 95851n; 95852n

97004 OT Re-Eval N 97003n 97750n; 97755n; 97762n 95831n; 95832n; 95833n; 95834n; 95851n; 95852n

97012 Mechanical Traction N 97140y 97002y; 97004y; 97018yG0281 Electrical Stimulation - Stage 3-4 Wounds N G0283y 97002y; 97004y; 97032yG0283 Electrical Stimulation - Other Than Wound Care N 99186n 97002y; 97004y; 97032y97016 Vasopneumatic device N 97002y; 97004y; 97018y;

97026y97018 Paraffin Bath N 97022y 97002y; 97004y; 99186y97022 Whirlpool N 97002y; 97004y; 99186y97024 Diathermy N 97002y; 97004y; 97018y;

97026y; 99186y97026 Infrared N 97018y; 97022y; 97002y; 97004y; 99186y97028 Ultraviolet N 97022y 97002y; 97004y; 97018y;

97026y; 99186y97032 Electrical Stimulation Y 97002y; 97004y97033 Electrical Current Y 97002y; 97004y97034 Contrast Bath Y 97002y; 97004y97035 Ultrasound Y 97002y; 97004y97036 Hubbard Tank Y 97002y; 97004y97039 Physical Therapy Treatment Y 97002y; 97004y97110 Therapeutic Exercises Y 97002y; 97004y; 99186n97112 Neuromuscular Re Education Y 97002y; 97004y; 97022y;

97036y; 99186n97113 Aquatic Therapy/Exercises Y 97002y; 97004y; 97022y;

97036n; 97110y97116 Gait Training Y 97002y; 97004y; 99186n97124 Massage Y 97002y; 97004y; 99186n97139 Physical Medicine Procedure Y 97002y; 97004y

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HCPro continues to offer the expert advice and practical guidance that you've come to rely on to meet yourdaily challenges. This valuable information will be available to you 24 hours a day, seven days a week, viathe Internet.

The Greeley Company, a division of HCPro: www.greeley.comGet connected with leading healthcare consultants and educators at The Greeley Company's Web site atwww.greeley.com. This online service provides the fastest, most convenient, and most up-to-date informationon our quality consulting and national training offerings to healthcare leaders. You will find a complete listingof all of our products and services, including consulting services, seminars, conferences, and links to otherHCPro offerings.

At www.greeley.com, you will find the following:• Detailed descriptions of all of The Greeley Company's consulting services• A catalog and calendar of Greeley's national seminars and conferences, as well as available CMEs• Faculty and consultant biographies that introduce our senior-level clinicians, administrators, and faculty,

who are ready to assist your organization with your consulting needs and seminars• An “ask the expert” Q&A• A list of Greeley clients• A link to free e-mail newsletters

HCPro's Healthcare Marketplace: www.hcmarketplace.comLooking for even more resources? You can shop for the healthcare management tools you need at HCPro'sHealthcare Marketplace (www.hcmarketplace.com). Our online store makes it easy to find what you need,when you need it, in one secure and user-friendly e-commerce site.

At HCPro's Healthcare Marketplace, you'll discover all of the newsletters, books, videos, audioconferences,online learning, special reports, and training handbooks that HCPro has to offer.

Shopping is secure, and purchasing is easy with a speedy checkout process.

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