Guest guest Posted May 23, 2011 Report Share Posted May 23, 2011 Hi , Good question. I would also like to add to this: Are clinics requiring patients to get their own prescription or does the clinic stock the medication? ( we mostly use dexamethasone and require the patient to get their own prescription). We have tried, unsuccessfully, to find out by our state PT board if we can keep the medication in the clinic name and provide it for patients when we have a prescription for ionto. I was of the understanding that iontophoresis was not covered by insurance. We ask the patient to purchase the electrodes each visit and do not charge for the visit. Lori Libolt, OTR/L,CHT ReBound Physical, Occupational, and Hand Therapies 805 Orchard Drive Suite2 Bellingham, WA 98264 360 752-1575 From: PTManager [mailto:PTManager ] On Behalf Of Thagard Sent: Monday, May 23, 2011 7:08 AM To: PTManager Subject: Iontophoresis What is everyone using for Iontophoresis these days... Are you doing Ionto in the clinic ? Is the patient using patches at home? If so, how are you supplying them? I was told by a consultant that Medicare is only paying for 2 iontophoresis visits in the clinic because of the widespread use of the patches at home. Thagard Director, Rehabilitation Sampson Regional Medical Center 405 Beaman St Clinton, NC 28328 This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient you are notified that disclosing, copying, distributing, or taking any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error please notify the sender and delete the email. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Sampson Regional Medical Center. Finally, the recipient should check this email and any attachments for the presence of viruses. Sampson Regional Medical Center accepts no liability for any damage caused by any virus transmitted by this email. If you have further questions or issues, you may contact Sampson Regional Medical Center at . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2011 Report Share Posted May 23, 2011 We are using the Hybresis units from Empi in the clinic, it's a 3 minute application with a small portable unit and then they leave with the patch on. We keep the Dex here in the clinic and get it supplied by the hospital as we are affiliated, but we do need our own pharmacy license and a pharmacy inspection 1X a month. We charge all but Medicare, with Dr. RX, and as far as I know we are getting re-imbursed. J. A. Ivey MPT Adult Physical Therapy Manager CHRISTUS St. Sports Medicine 440 St. s Dr. Suite 100 Santa Fe, NM 87505 ph: Fax: Cell: .Ivey@... P Please consider the environment before printing this e-mail ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Libolt, Lori F. Sent: Monday, May 23, 2011 11:44 AM To: 'PTManager ' Subject: RE: Iontophoresis Hi , Good question. I would also like to add to this: Are clinics requiring patients to get their own prescription or does the clinic stock the medication? ( we mostly use dexamethasone and require the patient to get their own prescription). We have tried, unsuccessfully, to find out by our state PT board if we can keep the medication in the clinic name and provide it for patients when we have a prescription for ionto. I was of the understanding that iontophoresis was not covered by insurance. We ask the patient to purchase the electrodes each visit and do not charge for the visit. Lori Libolt, OTR/L,CHT ReBound Physical, Occupational, and Hand Therapies 805 Orchard Drive Suite2 Bellingham, WA 98264 360 752-1575 From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Thagard Sent: Monday, May 23, 2011 7:08 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Iontophoresis What is everyone using for Iontophoresis these days... Are you doing Ionto in the clinic ? Is the patient using patches at home? If so, how are you supplying them? I was told by a consultant that Medicare is only paying for 2 iontophoresis visits in the clinic because of the widespread use of the patches at home. Thagard Director, Rehabilitation Sampson Regional Medical Center 405 Beaman St Clinton, NC 28328 This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient you are notified that disclosing, copying, distributing, or taking any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error please notify the sender and delete the email. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Sampson Regional Medical Center. Finally, the recipient should check this email and any attachments for the presence of viruses. Sampson Regional Medical Center accepts no liability for any damage caused by any virus transmitted by this email. If you have further questions or issues, you may contact Sampson Regional Medical Center at . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2011 Report Share Posted May 23, 2011 We are using the Hybresis units from Empi in the clinic, it's a 3 minute application with a small portable unit and then they leave with the patch on. We keep the Dex here in the clinic and get it supplied by the hospital as we are affiliated, but we do need our own pharmacy license and a pharmacy inspection 1X a month. We charge all but Medicare, with Dr. RX, and as far as I know we are getting re-imbursed. J. A. Ivey MPT Adult Physical Therapy Manager CHRISTUS St. Sports Medicine 440 St. s Dr. Suite 100 Santa Fe, NM 87505 ph: Fax: Cell: .Ivey@... P Please consider the environment before printing this e-mail ________________________________ From: PTManager [mailto:PTManager ] On Behalf Of Libolt, Lori F. Sent: Monday, May 23, 2011 11:44 AM To: 'PTManager ' Subject: RE: Iontophoresis Hi , Good question. I would also like to add to this: Are clinics requiring patients to get their own prescription or does the clinic stock the medication? ( we mostly use dexamethasone and require the patient to get their own prescription). We have tried, unsuccessfully, to find out by our state PT board if we can keep the medication in the clinic name and provide it for patients when we have a prescription for ionto. I was of the understanding that iontophoresis was not covered by insurance. We ask the patient to purchase the electrodes each visit and do not charge for the visit. Lori Libolt, OTR/L,CHT ReBound Physical, Occupational, and Hand Therapies 805 Orchard Drive Suite2 Bellingham, WA 98264 360 752-1575 From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Thagard Sent: Monday, May 23, 2011 7:08 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Iontophoresis What is everyone using for Iontophoresis these days... Are you doing Ionto in the clinic ? Is the patient using patches at home? If so, how are you supplying them? I was told by a consultant that Medicare is only paying for 2 iontophoresis visits in the clinic because of the widespread use of the patches at home. Thagard Director, Rehabilitation Sampson Regional Medical Center 405 Beaman St Clinton, NC 28328 This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient you are notified that disclosing, copying, distributing, or taking any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error please notify the sender and delete the email. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Sampson Regional Medical Center. Finally, the recipient should check this email and any attachments for the presence of viruses. Sampson Regional Medical Center accepts no liability for any damage caused by any virus transmitted by this email. If you have further questions or issues, you may contact Sampson Regional Medical Center at . Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 23, 2011 Report Share Posted May 23, 2011 Hi everyone, Any discussion on iontophoresis brings up some points to be made: 1. For reimbursement questions, you have to check each insurance's policy (or have your billing department do it). Medicare payment will depend on the LCD (local coverage determination) for the contractor that your state uses. Some Medicare contractors pay for ionto, some do not. The specifics of what they pay for should be in the LCD. I have not heard of them only paying for 2 visits. If this is a new policy then there should be a communication from the contractor to your billing department about it. Otherwise the LCD is still the policy in place. It is good for those that see Medicare outpatient, Part B, even if you are hospital-based, to be aware of and read the LCD for your contractor as well as Part B Medicare Benefits Policy. It helps put Medicare policy into perspective and give you a better understanding of payment issues with Medicare including iontophoresis. BUT it is contractor specific for LCD's so you would have to look up your local LCD. Same goes for other insurances: you have to know the coverage policy on ionto for each insurance. I would suggest that if your department uses iontophoresis on a regular basis, consider having your billing department or person make a list for PT staff listing who pays and who doesn't, what the coverage is etc. This will help reduce using ionto only to find out that payment is denied. 2. Be careful about the medication. Very few states have laws in their PT statutes that govern medication. These are normally found in the Pharmacy Board or Medical Board laws and generally are very specific on the prescription of, storage of and use of medications. From past discussions and from my clinic's experience, we work with patients and their doctor to get a prescription for any medication used in therapy including Dexamethasone. We are an outpatient private practice so hospital-based clinics will have different policies based on accrediting bodies like JCAHO and state laws. We will use the medication only for that patient. It helps to have a compounding pharmacy in the area to get the correct compound or medication for therapeutic use once we have a prescription. We do not store medication after patient discharge and dispose of it properly. We have to do this because the local pharmacy laws prevent us from getting and using medication without a prescription. Bottom line, check the PT statutes and if nothing is there regarding medications then check the Pharmacy or Medical Boards and be careful to follow the appropriate laws for your state. 3. As far as delivery systems, I have seen or heard of using Hybresis and standard machines. The research is mixed on whether Hybresis is any superior to standard practice except in the time and cost saving (as the cost is passed on to the patient if insurance doesn't cover). Both systems work, just depends on what your clinic can afford in start-up costs (the Hybresis units are expensive), time use and type of patients that you use iontophoresis with. Hybresis does have an advantage of being easier for home use as well. 4. I always remind people that clinical decision making using evidence-based practice should be the first thing to guide your use of ionto, not payment. If your judgment and the evidence point that iontophoresis is the best treatment for a particular impairment, then discuss it with the client. We(our profession) often sell good treatments short because they are not paid for when we should be trying to use the best treatments no matter what. Despite what insurances say, iontophoresis is NOT investigational for a number of problems and there is evidence that it is effective. From Medicare patients without coverage, remember to fill out an ABN form and for other insurances with no coverage, make sure you discuss it with your patients and offer them the choice. We have had a number of patients, when given the choice, opt to pay for the treatment in those cases where the evidence supported its use. M. Howell, P.T., M.P.T. Howell Physical Therapy Eagle, Idaho thowell@... This email and any files transmitted with it may contain PRIVILEGED or CONFIDENTIAL information and may be read or used only by the intended recipient. If you are not the intended recipient of the email or any of its attachments, please be advised that you have received this email in error and that any use, dissemination, distribution, forwarding, printing or copying of this email or any attached files is strictly prohibited. If you have received this email in error, please immediately purge it and all attachments and notify the sender by reply email. From: PTManager [mailto:PTManager ] On Behalf Of Libolt, Lori F. Sent: Monday, May 23, 2011 11:44 AM To: 'PTManager ' Subject: RE: Iontophoresis Hi , Good question. I would also like to add to this: Are clinics requiring patients to get their own prescription or does the clinic stock the medication? ( we mostly use dexamethasone and require the patient to get their own prescription). We have tried, unsuccessfully, to find out by our state PT board if we can keep the medication in the clinic name and provide it for patients when we have a prescription for ionto. I was of the understanding that iontophoresis was not covered by insurance. We ask the patient to purchase the electrodes each visit and do not charge for the visit. Lori Libolt, OTR/L,CHT ReBound Physical, Occupational, and Hand Therapies 805 Orchard Drive Suite2 Bellingham, WA 98264 360 752-1575 From: PTManager <mailto:PTManager%40yahoogroups.com> [mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On Behalf Of Thagard Sent: Monday, May 23, 2011 7:08 AM To: PTManager <mailto:PTManager%40yahoogroups.com> Subject: Iontophoresis What is everyone using for Iontophoresis these days... Are you doing Ionto in the clinic ? Is the patient using patches at home? If so, how are you supplying them? I was told by a consultant that Medicare is only paying for 2 iontophoresis visits in the clinic because of the widespread use of the patches at home. Thagard Director, Rehabilitation Sampson Regional Medical Center 405 Beaman St Clinton, NC 28328 This email and any files transmitted with it are confidential and intended solely for the use of the individual or entity to whom they are addressed. If you are not the intended recipient you are notified that disclosing, copying, distributing, or taking any action in reliance on the contents of this information is strictly prohibited. If you have received this email in error please notify the sender and delete the email. Please note that any views or opinions presented in this email are solely those of the author and do not necessarily represent those of Sampson Regional Medical Center. Finally, the recipient should check this email and any attachments for the presence of viruses. Sampson Regional Medical Center accepts no liability for any damage caused by any virus transmitted by this email. If you have further questions or issues, you may contact Sampson Regional Medical Center at . Quote Link to comment Share on other sites More sharing options...
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