To David Wells: medicare/codes...

[Guest guest]

Hi David, Thanks so much for taking the time to respond to my post. I

appreciate the clarification. One last question though---do you know

if this focus on coding is going to make it more likely (as in,

perhaps paving the road) for medicare/medicaid reimbursement to

happen? Any idea how soon that might happen? One of the reasons that

I am interested in this is that I am planning to start a family before

long, and it would be nice to be able to work part-time at a hospital

if we ever get to the point of being hired by them (and

medicare/medicaid will be necessary for that).

 

Everyone keeps mentioning the ABC codes, and I don't have any idea

what they're about. If by chance you could give me a brief

enlightenment, that'd be great, but adressing the first part of my

email is more important to me.

 

Thanks so much for your time,

 

Laura

 

 

 

Chinese Medicine , acuman1@a... wrote:

> David Wells' replies:

>

> Dear Laura,

>

> I only used the example of 20 patients a day in the article I wrote to

> acupuncturists such as yourself on the email list of AAOM. No

> indication of a normal daily work load was given to the AMA's Relative

> Unit Committee. The information that led to the work value of the

> codes was derived from a survey of acupuncturists across the country.

> We never asked how many they see in a day. We only asked what steps

> they took and how many minutes was required for each step to perform a

> standardized treatment. I was not one of the acupuncturists surveyed,

> nor was anyone on the committee.

>

> In regards to your question about a range of reimbursement, neither I

> nor the association can even suggest a range of numbers. Any hint of

> guidance in this regard is considered " collusion " and is punishable

> under the federal Racketeering and Corrupt Organizations Act (RICO).

> Sorry. That's why I gave a suggestion as to how you might arrive at a

> fair market price on your own.

>

> David Wells

>

> and

>

> Dear Dave Molony,

>

> I don't know what Richard is referring to and cannot comment on the

> accuracy of the statement regarding Florida or New Mexico (presumably

> their work comp systems). All I know is the Medicare conversion

> factor, which is 37.8925. This equates to a paltry $22.74 for the

> initial 15 minutes of acupuncture. However, the Medicare fee schedule

> is considerably below market. I addressed the issue of " what to charge

> and what will they pay me? " in my article. Personally, I do not base

> my charges on what someone other than the patient is willing to pay.

>

> Regards,

> David Wells

>

>

> So there you have it. If you are going to do a medicare only

practice using

> only acupuncture and not doing an examination deep enough to qualify

for E & M

> coding or a second acupuncture 15 minutes (such as a second side),

you have to

> treat a lot of patients, similar to my clinical training in China,

where I

> was in a room of 8 tables and rotated thru them with a nurse staying

ahead of me

> taking needles out. Needless to say, I don't have that style of

practice

> today, but some may want to. Let's face it. When a government is

involved

> (nationalized healthcare?), people get less personalized care. Now,

is this

> something we should not have done? If we didn't participate, it

would have been worse

> yet.

> As I said earlier, I am still a BIG proponent of the ABC codes, as

is the

> AAOM, I assume (I am writing this personally and not as a rep of

AAOM, so I

> cannot pretend to provide their take on this). Use the ABC codes

every time you

> send insurance billing out, and use CPT as a backup, but learn how

to use it too

> your best ability by taking a course on coding and working with your

state and

> national organization to bring your scope up to par so that you can

bill for

> items other than acupuncture alone, if you use those things, you

should bill

> for them. For instance, cupping is vasopnumatics. I suspect that

there will be

> organizations providing educational programs on coding for

acupuncture coming

> out of the woodwork soon.

>

> David Molony

> 101 Bridge Street

> Catasauqua, PA 18032

> Phone (610)264-2755

> Fax (610) 264-7292

>

>

>