Guidelines

ACOEM Recognizes the Value of Chiropractic for Chronic Spinal Pain

By Frank M. Painter|April 4, 2012|Chiropractic Care, Chronic Pain, Guidelines, Spinal Manipulation|

ACOEM Recognizes the Value of Chiropractic for Chronic Spinal Pain

SOURCE: Dynamic Chiropractic 2008 (Sep 23); 26 (20): 1

Tina Beychok, Associate Editor

Pain is the most prevalent health condition among U.S. workers and the most expensive in terms of lost productivity. Recent studies suggest more than six in 10 adults over the age of 30 experience chronic pain. Furthermore, health care expenditures for back and neck pain have risen to more than $80 billion a year in the U.S. – a dramatic increase over the past eight years, without evidence of improved health. In addition to the costs of lost productivity, an estimated $64 billion per year is lost due to workers continuing to work, even though pain reduces their job performance. This phenomenon is called “presenteeism.”

Unfortunately, workers’ comp can be a quagmire of contradictory and insufficient rules and regulations as to what treatments are and aren’t covered. The American College of Occupational and Environmental Medicine (ACOEM) has been in the process of revising its Occupational Medicine Practice Guidelines, which have not always taken a positive view of chiropractic manipulation. In fact, the second edition of the guidelines, released in 2005, was heavily criticized by some in the chiropractic community. [1]

ACOEM’s latest chronic pain guidelines (a chapter of the overall guidelines) may represent a step in the right direction in terms of recognizing the value of chiropractic care. The guidelines actually recommend manipulation for chronic, persistent low back or neck pain and cervicogenic headache. [2] This is significant because in the past, the guidelines failed to recommend manipulation, even when other treatment strategies (medication, etc.) were rated as less effective.

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The CCE and Section 602.13

By John Wiens DC|January 24, 2012|Guidelines|

As has been (not so) widely reported, the National Advisory Committee on Institutional Quality and Integrity (NACIQI) of the US Department of Education met on December 14, 2011 to consider the Council on Chiropractic Education’s petition for renewal of recognition. The process of continuing the recognition of an existing agency is generally unremarkable, often requiring only 15 minutes or so of discussion.

This proceeding involving CCE was anything but routine, with four hours of public comments, agency responses, and deliberations. In the end the Department of Education staff identified over 40 compliance issues that the CCE needs to address within the next year. These areas of deficiency exceeded the norm for re-accreditation violations. Chairman Wickes referred to the quantity of citations as “an embarrassing number.” The CCE expects an official letter from NACIQI approximately 90 days from the hearing date and they expect to be granted a maximum of 12 months from the date of this document to address the identified deficiencies. The Council predicts a deadline of March 2013 to complete a compliance report to NACIQI’s committee liaison.

Following overwhelming written and oral testimony to the committee expressing concerns about the CCE from the profession at large, the NACIQI added the following statement: “In addition to the numerous issues identified in the staff report, NACIQI asks the agency to demonstrate compliance with Section 602.13 dealing with the wide acceptance of its standards, policies, procedures, and decisions; and to address how its standards advance quality in chiropractic education.” (more…)

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A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

By Frank M. Painter|September 12, 2011|Guidelines, Whiplash|

A Systematic Review of Chiropractic Management of Adults with Whiplash Associated Disorders: Recommendations for Advancing Evidence-based Practice and Research

The Chiro.Org Blog

SOURCE: Journal of the Academy of Chiropractic Orthopedists 2011 (Mar); 8 (1)

By: Lynn Shaw, Martin Descarreaux, Roland Bryans, Mireille Duranleau, Henri Marcoux, Brock Potter, Rick Ruegg, Robert Watkin, Eleanor White

The literature relevant to the treatment of Whiplash Associated Disorders (WAD) is extensive and heterogeneous.

Methods: A Participatory Action Research (PAR) approach was used to engage a chiropractic community of practice and stakeholders in a systematic Review to address a general question: ‘Does chiropractic management of WAD clients have an effect on improving health status?’ A systematic review of the empirical studies relevant to WAD interventions was conducted followed by a review of the evidence.

Results: The initial search identified 1155 articles. Ninety-two of the articles were retrieved, and 27 articles consistent with specific criteria of WAD intervention were analyzed in-depth. The best evidence supporting the chiropractic management of clients with WAD is reported. For the review identified ways to overcome gaps needed to inform clinical practice and culminated in the development of a proposed care model: The WAD-Plus Model.

Conclusions: There is a baseline of evidence that suggests chiropractic care improves the cervical range of motion (cROM) and pain in the management of WAD. However, the level of this evidence relevant to clinical practice remains low or draws on clinical consensus at this time. The WAD-Plus Model has implications for use by chiropractors and interdisciplinary professionals in the assessment and management of acute, sub-acute and chronic pain due to WAD. Furthermore, the WAD-Plus Model can be used in the future study of interventions and outcomes to advanced evidenced-based care in the management of WAD.

There are more articles like this @ our:

Whiplash Page

The FULL TEXT Article:

Background

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How To Use the Evaluation & Management (E&M) Codes Properly: Part III

By Frank M. Painter|September 11, 2011|Evaluation & Management, Guidelines|

How To Use the Evaluation & Management (E&M) Codes Properly:

Part III: Mastering the E/M Guidelines

The Chiro.Org Blog

SOURCE: Chiropractic Economics

By Kathy Mills Chang, MCS-P

Part III: Mastering
the Evaluation & Management
(E&M) Guidelines

Jump to: Part 1 or Part 2

The medical decision making component ties it all together.

Welcome to part three this focus series on the evaluation and management (E/M) guidelines. This will wrap up what you need to know to stay compliant with E/M coding for the Centers for Medicare and Medicaid Services (CMS).

In the last installment, the elements of your patient’s examination were reviewed and you learned how it is the second of the three key elements of the patient’s E/M service. Now, the third part of this E/M documentation series will unravel the final component of the E/M code: medical decision making (MDM). For chiropractors, this is usually the diagnosis and treatment plan.

Three key components of the E/M guidelines:

Patient history
Examination
Medical Decision Making (MDM)

Remember that your patient’s medical record should establish a chronological record of exams, tests and results, and treatments and treatment plans (including the diagnosis and prognosis of the illness or disease). The medical record should corroborate the reimbursement request and is requisitioned by most payers for adjudication of claims when reimbursement is in question. (more…)

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How To Use the Evaluation & Management (E&M) Codes Properly: Part II

By Frank M. Painter|September 10, 2011|Evaluation & Management, Guidelines|

How To Use the Evaluation & Management (E&M) Codes Properly:

Part II: A Closer Look at E/M Guidelines

The Chiro.Org Blog

SOURCE: Chiropractic Economics

By Kathy Mills Chang, MCS-P

Part II: A Closer Look at
Evaluation & Management
(E&M) Guidelines

Jump to: Part 1 or Part 3

Make sure you know how to fulfill the “examination” component. In part one of this series, the components of a patient’s history were reviewed, and you learned how it is the first of three elements that help you justify and document your evaluation and management (E/M) service. In the second part of this series, you’ll learn about the objective information required to properly document the examination.

Remember, the medical record establishes a chronological record of exams; tests and results; treatments; and treatment plans, including the diagnosis and prognosis of the illness or disease. Its job is to corroborate the reimbursement request and is requisitioned by most payers for adjudication of claims when reimbursement is in question.

For this reason, your medical record is a vital piece of the reimbursement puzzle, too. Understanding all the requirements, including those of the examination, is critical.

There are four levels of E/M services that are based on four types of examinations: (more…)

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How To Use the Evaluation & Management (E&M) Codes Properly: Part I

By Frank M. Painter|September 9, 2011|Evaluation & Management, Guidelines|

How To Use the Evaluation & Management (E&M) Codes Properly:

Part I: The 3 Key Components of the E/M Guidelines

The Chiro.Org Blog

SOURCE: Chiropractic Economics

By Kathy Mills Chang, MCS-P

Part I: The 3 Key Components of
the Evaluation & Management
(E&M) Guidelines

Jump to: Part 2 or Part 3

In order to document your history, diagnosis, and treatment of patients in accord with rules set out by the Centers for Medicare and Medicaid Services (CMS) and the Office of Inspector General (OIG), your patient record should address: (1) Patient history, (2) Examination, and (3) Medical decision-making (MDM). These three components are addressed in the following three articles, which also make reference to the Sample Worksheet included with Part III

As regulatory and insurance guidelines tighten, the quality of your evaluation and management documentation is more important than ever before.

Just like a great story, the patient’s notes for an episode of care must have a beginning, middle, and end. This article is a review of the first of three parts of evaluation and management (E/M) documentation, and its focus is on the beginning of the patient’s story — the history. More information on the next two key E/M components will be presented in future issues of this magazine. (more…)

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