"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Sunday, October 5, 2008

Use the ICF Core Set to diagnose lower back pain

Sooner or later physical therapists will be required by Medicare and commercial insurance companies to identify the impairments we treat by using the ICF Core Set.

Might as well start now.

Basically, you do it now when you select an ICD-9 code for your patient when you bill American Medicare.

For instance, 724.04 is lower back and leg pain due to spondylotic changes. While accurate, in many cases, this pathologic diagnosis is also not very informative for PT decision-making.

Like, what body part is stiff?

Are the hips affected?

Should I manipulate the patient's lumbar spine?

Which muscles need strengthening?

While the ICF Core Set is no substitute for clinical training, experience and a sharp mind it is a step in the right direction of getting physical therapists away from thinking about pathology and thinking about function.

Link the patients' activity limitations to their impairments in body structure and function.

Your assessment of the link is your physical therapy diagnosis.

Free Tutorial

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.