"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

Friday, June 4, 2010

Can physical therapists make decisions like doctors?

Try this interactive worksheet from First Coast Service Options (FCSO) - the Medicare Administrative Contractor for A/B services for Florida. The worksheet is intended for physician training to improve correct coding of Evaluation and Management CPT codes.

I tried it.

Plug in your actions from your evaluation is the areas of History, Examination and Medical Decision Making and the Worksheet will spit out its best guess of which E/M code you should bill as if you were a physician.

The interesting thing is that my typical physical therapy evaluation corresponds to a Level 3 E/M codes (99203). Of course, physical therapists can't bill E/M codes because we are not physicians.

If you consider, however, the condition of our patients, the tests and measures physical therapists use, the complexity of our decisions and the risks we face I wonder if altering payment systems to allow PTs to bill E/M codes for certain patients makes sense?

Consider an uncomplicated ankle sprain. Evidence-based decision rules can rule out an ankle fracture with greater precision than a physician's diagnosis.

Physical therapists can refer for imaging when appropriate or treat immediately - saving costs and getting patients productive more quickly.

Similar characteristics between my PT eval and a physicians' eval include the following:
  • History: Detailed
  • Examination: Detailed
  • Medical Decision Making: Moderate Complexity
You try it and see what you get - can you make a decision like a doctor?

Free Tutorial

Get free stuff at BulletproofPT.com

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.