Treating with multiple therapists

[Guest guest]

We have a unique situation in our clinic I'd like to get the groups thoughts

on. We have a patient that has dealt with lower extremity lymphedema for a

number of years and in recent history has been able to manage this at home.

We have been seeing him for the last month after a recent functional decline

for gait training, balance training, and strengthening to help him regain

his function. He was ill two weeks ago(flu) and was immobile for a couple

of days, which exacerbated his lymphedema. We have a therapist in our

community that he has seen previously that he wishes to see for his

lymphedema, but wants us to continue working with him on his gait and

balance.

We have a staff member that could provide the lymphedema treatment, but he

wants to return to his previous therapist for this. I've talked to him

about her doing his gait and balance training as well, but he refuses to do

this with her because of a previous poor experience. In trying to respect

his wishes, I was thinking about 'tag-teaming' the treatment with this other

therapist by having her perform(and bill) for the manual aspect of his

lymphedema treatment and scheduling his treatment with us immediately

afterwards to address with gait and balance deficits.

My question is, if we use distinct ICD codes, have distinctly different

goals, and don't overlap treatment, can we both see and bill the patient in

this type of 'co-treatment' on the same date of service. The patient has

Medicare and my clinic is a private practice while the other therapist is

hospital based.

I realize the simple thing would be for one clinic to do the complete

treatment, but so far the patient has resisted this.

Thanks for your input,

Gabe Freyaldenhoven, PT

River Valley Therapy and Sports Medicine