Re: Evaluation for Manipulation of TKA?

March 11, 2008

In this situation, we tend to perform and charge Re-eval (97002) because

there has been a significant change in the status of the patient. It may

also be appropriate to establish new goals and/or a new plan of care

because the patient's potential for ROM gains have likely changed.

Suzanne LeBlanc, PT, MPT

Director, Rehabilitation Services

Willamette Falls Hospital

Oregon City, OR

x6870

scott hankins

Sent by: PTManager

03/11/2008 01:16 PM

Please respond to

PTManager

To

PTManager

cc

Subject

Evaluation for Manipulation of TKA?

Group,

Is it necessary to perform another evaluation for a manipulation post TKA

for a client whom I have been seeing already for a TKA? I was told that we

have to evaluate again (charge a 97001) since she had a new procedure done

on her knee or a new diagnosis.

Or should I just do a reeval (charge 97002)?

Thanks to anyone who can clarify this for me.

Hankins, PT

President

Synergy Therapies, LLC

---------------------------------

Never miss a thing. Make Yahoo your homepage.

March 11, 2008

:

You should evaluate.

From a practical/factual point of view there is no difference, clinically

speaking, does it (eval/reeval)?!

But because of the procedure, you " can " and must charge a 97001. It's a new

diagnosis anyway.

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Armin Loges, P.T.

armin@...

www.restoretherapies.com

From: scott hankins

Sent: Tuesday, March 11, 2008 2:48 PM

To: PTManager

Subject: Evaluation for Manipulation of TKA?

Group,

Is it necessary to perform another evaluation for a manipulation post TKA for a

client whom I have been seeing already for a TKA? I was told that we have to

evaluate again (charge a 97001) since she had a new procedure done on her knee

or a new diagnosis.

Or should I just do a reeval (charge 97002)?

Thanks to anyone who can clarify this for me.

Hankins, PT

President

Synergy Therapies, LLC

---------------------------------

Never miss a thing. Make Yahoo your homepage.

March 11, 2008

, and group:

I am sorry for jumping too quickly at answering initially.

I misunderstood the case for a failed TKA that was going to see for manual

PT (manipulation).

clarified it as being a s/p MUA and therefore he is right about no change

in " diagnosis " .

However, MUA can be " at times " [shoot, from an arthrokinematics perspective,

ALWAYS] very traumatic, however, with significant increase in pain,

edema/effusion and even possible iatrogenic results.

Eval? Re-Eval?

affirms that it may vary case by case. And he is probably right.

However, I am going to be my usual self, and submit that the prefix " re " means

" again " , therefore RE-evaluating is nothing more than evaluating AGAIN. And

, I am sorry, but there is no difference in skill from an evaluation to a

re-evaluation. Complexity? It is the same knee. Shouldn't it be the same

complexity? (plus, how complex can a knee eval really be anyway?)

- no need to be reminded of the fee schedule differentials for 97001 97002, by

the way - I am being " philosophical " AGAIN...

It also bothers me a little, the excessive use of the word ethics in this

server. A high horse, at a minimum, in my opinion...

Lets admit that there are scum bags (pardon the " french " ) in every aspect of

life ( governor Spitzer of NY to remind us of that...lol), and therefore equally

amidst us PTs, but in my impression, PTs in general are the most ethical of the

professional groups out there.

That being said, I can't see the possible lack of " ethics " , , for billing

a 97001.

None of this codes are time codes.

How long does it take you to eval a knee? (rhetorical).

Does it take you that much less than to evaluate it again? (RE prefix omitted,

LOL).

Are you afraid of being unethical for not taking you extra time to right goals

on a piece of paper?

If so, all of us that use electronic documentation should feel terrible. Indeed

loose sleep over it!

Worry not, because the 3rd party payer only pays for what their policy dictates

them to pay anyway. They can deny 97001 if they don't allow it. The " ethics "

police won't come get you for " overutilization " .

Is it unethical?

Hmmm, I don't know....Shoot, actually I do!

I believe my ethical " hierarchy " leans toward patient safety and proper care,

and considering those possible pesky iatrogenic events that can always happen

during a MUA, I should EVALUATE, even if they won't pay for it and I have to

re-file as a 97002 so I can pay my clinic's rent at least.

In my politically incorrect - in your face - foot-in-the mouth mentality, the

bottom line is again, we are asking " technician' questions, and answering them

with " technician " type answers. (No pun intended).

After all, the ONLY difference between both options, when the rubber meets the

road, should be the title on the top of the report.

Armin Loges, P.T.

TAMPA, FL

armin@...