Cardiovascular and Pulmonary Section Electronic Newsletter April, 2011 Dear Section Members, Hopefully by now all of you are beginning to enjoy the long-awaited Spring! It seems that winter was never going to depart. It is wonderful to finally see the beautiful flowering trees and colorful flowers popping up. I hope those of you who went to CSM in New Orleans enjoyed the programming. We had over 9,000 attendees which was wonderful, but brought on some problems with room sizes for some sections. The Section Presidents and Program Chairs along with the APTA are aware of the issues and will be meeting to discuss solutions. We want people who attend CSM to find it a positive learning experience and not a frustrating one. Our Section is always looking for volunteers interested in getting involved in the various activities that we participate in. Please go to our Web site to see what committees we have that you might want to join. Working on committees is a great way to get to know other members of our Section and to learn a lot in the process. I will be representing the Section as the delegate at the House of Delegates this June. You can go to the APTA website to see what issues the House will be discussing as well as see the candidates for the various offices. As always do not hesitate to contact me with any questions/concerns that you might have. Best regards, Ethel Frese, PT, DPT, MHS, CCS President Table of Contents Legislative/Reimbursement Update Section Member Profile – Komal Deokule Section Awards and CSM Highlights Specialization Corner – FAQs CPPT Journal Update Welcome to New Section Members PT-PAC CSM Challenge Results
Transcript
Cardiovascular and
Pulmonary Section Electronic Newsletter
April, 2011
Dear Section Members, Hopefully by now all of you are beginning to enjoy the long-awaited Spring! It seems that winter was never going to depart. It is wonderful to finally see the beautiful flowering trees and colorful flowers popping up. I hope those of you who went to CSM in New Orleans enjoyed the programming. We had over 9,000 attendees which was wonderful, but brought on some problems with room sizes for some sections. The Section Presidents and Program Chairs along with the APTA are aware of the issues and will be meeting to discuss solutions. We want people who attend CSM to find it a positive learning experience and not a frustrating one. Our Section is always looking for volunteers interested in getting involved in the various activities that we participate in. Please go to our Web site to see what committees we have that you might want to join. Working on committees is a great way to get to know other members of our Section and to learn a lot in the process. I will be representing the Section as the delegate at the House of Delegates this June. You can go to the APTA website to see what issues the House will be discussing as well as see the candidates for the various offices. As always do not hesitate to contact me with any questions/concerns that you might have. Best regards, Ethel Frese, PT, DPT, MHS, CCS President
Table of Contents
Legislative/Reimbursement Update
Section Member Profile –
Komal Deokule
Section Awards and CSM Highlights
Specialization Corner – FAQs
CPPT Journal Update
Welcome to New Section Members
PT-PAC CSM Challenge Results
Legislative/Reimbursement
Committee Report Ellen Hillegass, PT, EdD, CCS, FAACVPR
Questions continue to be sent my way regarding billing and coding for Pulmonary Rehabilitation, therefore I will continue to provide this information in this column.
A National Coverage Determination (NCD) exists for Pulmonary Rehabilitation for individuals with a diagnosis of COPD (FEV1 % predicted < 80%) who are covered under Medicare insurance. PT codes should not be utilized for these patients in the outpatient hospital setting or physician office but rather should be billed using the G0424 if Pulmonary Rehabilitation is being provided according to the guidelines set up by CMS. If these same patients require physical therapy for other impairments, then it is recommended that they see Physical Therapy first, improve their functional impairments, and then be referred to Pulmonary Rehabilitation. Billing physical therapy at the same time they are in pulmonary rehabilitation is highly discouraged by CMS and could raise concern. Individuals with a COPD diagnosis who require physical therapy should be seen in a physical therapy setting and billed using the normal 97000 series.
Individuals with a pulmonary dysfunction other than COPD should be evaluated for functional impairments and billed as they have been billed in the past utilizing 97000 codes or if their Medicare Administrative Carrier (MAC) has a Local Coverage Determination for PR, should be billed as they LCD requires for PR for individuals with other diagnoses.
On a separate legislative issue, for your information only a bill has been introduced in the North Carolina legislative session to attempt to license exercise physiologists in that state. If you
reside in North Carolina, you may want to contact your legislator to discuss the scope of practice of PT versus what is proposed for
a scope of practice of EPs.
Again, if you have any legislative or reimbursement issues that are occurring in your region, please do not hesitate to contact
Ellen.
The NCCI Policy Manual for Medicare Services, Version 16.3, was published October 1, 2010. It included the following edits affecting pulmonary rehabilitation and some related respiratory services.
Effective October 2010, certain procedure codes have been bundled into HCPCS G0237-G0239 and into G0424, based on existing code descriptors and the CMS 2010 Final Rule for Pulmonary Rehabilitation Programs. The code descriptors for G0237, G0238, and G0239 include necessary “therapeutic procedures” and all related “monitoring” services. Therefore, if pulmonary function tests (PFTs) are performed at the same patient encounter as the services described by G0237-39 or G0424, CMS considers these tests to constitute “monitoring”. Consequently, PFTs are not separately reportable with G0237-39 or G0424. However, if the patient has an indication for PFT unrelated to the services described by HCPCS G0237-39 or G0424, the PFT may be reported separately if performed at a separate patient encounter. CPT/HCPCS codes under the PFT category include 94010, 94150, 94200, 94240, 94250, 94260, 94350, 94360, 94370, 94375, 94400, 94450, 94680, 94681, 94690, 94720, 94725, and 94750. Pulmonary stress testing codes 94620 and 94621 are also considered monitoring and included in G0237-39 and G0424 services. In the same way, CPT codes 94667 and 94668 (manipulation of chest wall…) are included in the code descriptors for HCPCS G0237-39 and are not separately billable.
This appears to be just the beginning of bundling of codes.
Legislative Update Continued
April, 2011
Section Member Profile
Komal Deokule, PT, MSc. Physio.,
MCSP (UK), MPNZ (NZ), MIAP (India)
Komal earned a Bachelor of Physiotherapy from Maharaja Sayajirao University, India in 1992 and an MSc in Physiotherapy from University College of London, Britain (UK), in 1999. She practiced her skills as a Clinical Specialist in the respiratory and cardio-thoracic surgery specialties in the UK until 2004. Komal then worked in New Zealand as a lead cardiopulmonary PT and was attached to Otago University as a clinical tutor. She moved to the US in 2007. Her international experience includes several years of practice in India, Great Britain and New Zealand.
Currently Komal practices in several healthcare facilities in FL and serves as Adjunct Faculty at the University of St. Augustine, teaching cardiopulmonary PT. She enjoys teaching PTs and other healthcare professionals.
Komal’s cardiopulmonary experience includes working with patients with heart-lung transplants, cardiac and thoracic surgeries, patients in ICUs, and in outpatient cardiac and pulmonary rehabilitation. She was responsible for the initiation of some PT led cardiac and pulmonary rehab programs in the UK and developed several assessment tools and informational packets. Komal has a keen interest in research and has presented her work at international conferences. She serves as a reviewer for the journal for the Association of Chartered Physiotherapists in Respiratory Care (ACPRC). Her academic achievements include a survey on rehab in ICU looking into rehabilitation techniques used at different stages of weaning.
Highlight written by: Lynn Millar, PT, PhD
April, 2011
The Cardiovascular and
Pulmonary Section is now on
Facebook.
Check us out and “like” our page
for a way to network quickly with
other members and get section
updates.
Komal’s article entitled “Effects of Body Position on Gas
Exchange with relation to Mechanical Ventilation and Ventilation-Perfusion” earned her the
ACPRC Medic-Aid Award.
April, 2011
SECTION AWARDS GIVEN OUT DURING
CSM IN NEW ORLEANS FEB 9-12
Section Mentor Award: Anne Mejia Downs PT, MPH, CCS
Annie has mentored therapists to become
academic faculty, therapists and students to have greater
involvement in the Section, and has spread the word of
cardiovascular and pulmonary physical therapy to outside
organizations.
Section Merit Award: Anne Swisher, PT, PhD, CCS
Through much hard work, persistence, and dedication, Anne was responsible for having the Cardiopulmonary Physical Therapy Journal listed in PubMed Central in the past year. The listing will increase the visibility, impact, and number of manuscript submissions for our journal.
2012 Linda Crane Memorial Lecture Award: Larry Cahalin, PT, PhD, CCS
SECTION RESEARCH AWARDS 2011 Research Award-Best Platform Presentation:
Jennifer Dekerlegand, "Outcomes of patients with left ventricular assist devices admitted to acute rehabilitation: A pilot study"
2011 Research Award-Best Poster Presentation:
Sharon A. Martino, Sue A. Sisto, Peter J. Morelli, "Changes in body composition, fitness levels and cardiac risk factors following a 10 week exercise and nutrition program for overweight/obese children"
CALL FOR PROPOSALS Now accepting proposals for the 2011
Cardiovascular and Pulmonary Section Research Grant.
This year $5000 is available. Information about the grant
and application instructions are located on the section website (cardiopt.org).
Proposals must be received by Christine Wilson, PhD, PT, Research Committee Chair ([email protected]) by 11:59 pm PST on Sunday, May 15, 2011.
Direct any questions related to the grant to Dr. Wilson.
Cardiovascular and Pulmonary Specialization Corner
News from the CPPT Journal: - Stay tuned! The Editorial Board is developing 2 special issues for 2012. - The topics will be “Early Mobilization” and “Heart Failure”. - There will be a call for papers in the upcoming June 2011 issue. Begin thinking now about
submitting a paper in one or both of these topic areas.
3. Is the CCS focused on outpatient care?
No. Many CCS’s do work in an
outpatient environment, but there are
also an equal amount that work in the
inpatient setting.
CCS’s are regularly in the ICU and
step-down settings seeing patients.
The home health setting is also
becoming an area where CCS’s are
seen more frequently.
Specialization can demonstrate a
commitment to cardiovascular and
pulmonary care beyond the basic
levels in all of these settings.
4. I haven’t had any research published.
How can I meet the research component
of applying for the CCS?
There are other ways to meet the
requirement. For example:
Doing a platform or poster
presentation at a state or national
conference may meet the requirement.
Assisting the author of a research
paper (i.e. collecting data, developing
the tool used to perform the research,
interviewed subjects, etc.) may meet
the research requirement.
Advice is to submit what you can in
regards to your involvement in a
research project along with any
supporting information.
Check out the FAQs section of the website for more answers to these questions.
December Catherine Ann Amendolara, PT Teresa R Blem, PT D Marie Clark, PT Janet Co, PT Dawn Marie Dukes, SPTA Kenneth Llanos Fabugais, PT Linda Diane Gilham, PT Nancy Mohrmann, PT Marcus Lee Nauman, PT Michele Ortiz, PT, DPT Tricia Young Patsilevas, SPT Denise D Stetter, PT Peter Szymanski, SPT Brain Lee White, PT January Taleria LaShawn Alston, SPT Evelyn J Ardon, SPT Shiren Gabi Assaly, SPT Jerome Harrison Beeler, PT, DPT Lauren Eileen Bowles, PT Erin Liesel Carpenter, SPT Juliann Michelle Chacko, PT Rachel Cohen, SPT Jeffrey Lynn Deets, PT
April, 2011
Christopher Michael Farr, SPTA Kelly Fecke, SPTA Elizabeth Smith Garfield, PT Nicole E Gee, BS Ericka Ruzzeddu Grace, SPT, MSPH, MSW Sarah Elizabeth Hankes, PT Emily Elizabeth Houser, PT Tracy Jane Keenoy, PT Laura Michele LoVasco, PT, GCS Nancy Knipp, SPT Donald C Laufer, PT Kwang Ja Lee-longhi, PT Michelle Elizabeth Liepold, PT Donna Maria Millan, PT, DPT Parth P Patel, SPT Sarah M Post, SPT Jigar Ashwinkumar Shah, PT Jerry Richard Smith, PT Nancy Pol Stith, PT Ronald James Tester, PT Jessica Lyn Vernier, SPT Alice Jeannine Walker, PT
Welcome New CVP Section Members Joining Between
December 2010 - February 2011
Nancy Ann Goldner, PT Jamie Lee Grandizio, SPT Jeremy Michael Juanich PT Randall John Kruger, PT Martin Stuart Lutz, PT, MPT Mabelle Teodoro Medina, PT Lori A Mizell, PT Catherine Ngoc Pham, SPT Kristen Brooke Qualls, PT Ceneida Ramirez, PT Michele Lea Rojek, PT William Charles Sanford, PT Omer Mohamed Taha, PT Kristen S Ton, SPT Devita Martina Vaughan, SPT Brandon Weipert, SPT Orrin Tell Whitten, PT February F Richard Clements, PT Sarah Ann Donker, PT Heidi Joyce Engel, PT Michael Steven Essa, SPT Christian Esteban, PT
Welcome
PT-PAC’s Annual CSM Section
Competition And the winner is: The Cardiovascular and Pulmonary Section
Our section had a 23.2% increase in donations.
2nd was the Hand Rehabilitation Section
Overall section participation also increased by half a percentage point.
Thank you to all of our members that donated at CSM. We may be a small section, but we are mighty!
