5 Key Concepts for Adding Rehabilitative Services to Your Orthopedic Practice

Practice Management

Many orthopedic and spine practices are adding rehabilitative services, including physical therapists and athletic trainers, to make the practice a "one-stop shop" for patient care. Here are five key concepts for adding these services to your practice.

1. Decide whether your therapists should see Medicare patients.
Another consideration for practices is whether or not its PT program will see Medicare patients. Resurgens decided not to see these patients because of the additional regulations on documentation requirements CMS places on therapy providers. "It can be a full-time job to manage the administration involved in treating and receiving reimbursement for these patients in a large practice," says Jeff Goldberg, director of operations for Resurgens Orthopaedics, a 90-plus physician orthopedic practice with 20 locations in and around Atlanta. "We weighed the risks and the benefits and in the end determined that referring our Medicare patients to the quality private therapy providers in our communities was the best model for our practice." This decision actually helps generate goodwill in the community because the practice continues to refer a number of its patients to these private PT providers, Mr. Goldberg notes.

From "6 Key Questions to Ask When Considering an Ancillary Physical Therapy Program at Your Practice."

2. Encourage direct communication between physicians and therapists.
This partnership promotes direct and continued communication between the physician and the therapist because their groups are in such close proximity. This is advantageous for the physician because he or she can follow the patient through rehabilitative treatment and make sure the patient receives appropriate care. This arrangement can also foster group meetings between the patient, therapist and physician to devise treatment plans. The professionals can also devise and discuss the patient's treatment plan more easily in person. "If therapists have a question, they can walk upstairs or next door and ask the physician directly," says Pat Hinton, executive director of the Jacksonville (Fla.) Orthopaedic Institute. "Rehabilitation is a very large and significant contributor to a patient's outcome."

From "6 Advantages to Orthopedic Practices Partnering With Rehabilitation Specialists."

3. Accurately code for rehabilitation services.
Evaluations can include assessments and documentation of the patient's history, function level, systems review, specific tests, diagnosis and prognosis. Unique evaluation and re-evaluation codes for physical therapists include CPT codes 97001 and 97002. Codes for occupational therapists include CPT codes 97003 and 97004. Tests and measurements as a component of evaluation and re-evaluation. They can be coded using CPT codes 97750-97755.

From "AAOS: 6 Coding Tips for Rehabilitative Services."

4. Use certified athletic trainers as physician extenders. As medical experts, who prevent, diagnose, treat and habilitate injuries, the athletic trainer has an extensive musculoskeletal background. Certified athletic trainers can be used as office assistants, DME experts, rehabilitation educators and they can take the patient's histories before the appointment. "Our goal is to return the patient to full function and to provide the physician with services that improve the productivity and overall quality of care," says Kathy I. Dieringer, EdD, ATC, co-owner and president of D&D Sports Med in Denton, Texas, and chair of the National Athletic Trainers' Association Clinical and Emerging Practices Athletic Trainers' Committee.

From "5 Ways for Orthopedic to Use Athletic Trainers as Physician Extenders."

5. Send athletic trainers to local high schools. A representative onsite at the high schools can increase the practices visibility among the athletes. Athletic trainers should be available at high school practices two or three times a week in order to examine injuries as they occur or the trainers can advise athletes on treatment for recurring pain. The trainer acts as a liaison between the coaches and the physician. If the athletes are familiar and comfortable with the athletic trainer, they will be more likely to visit the trainer's practice for serious injury treatment. "Having an athletic trainer at the schools gets the practice name and group out there," says David Geier Jr., MD, director of MUSC Sports Medicine in Charleston, S.C. "The trainer is the first person the parents come in contact with after the injury."

From "5 Best Practices for Community Outreach in Sports Medicine and Orthopedic Practices."

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