Direction on Demand from Encompass Consulting & Education, LLC</= title>  <link rel=3DthemeData href=3D"July_2008_files/themedata.thmx"> <link rel=3DcolorSchemeMapping href=3D"July_2008_files/colorschememapping.x= ml">  <style>  </style>  </head> <body bgcolor=3Dwhite lang=3DEN-US link=3Dblue vlink=3Dpurple style=3D'tab-= interval:.5in'> <div class=3DSection1> From: &= nbsp; &nbs= p; = Pauline M. Franko [pmfranko@encompassmedicare.ccsend.com] on behalf of Pauline M. Franko [pmfranko@encompassmedicare.com]<o:p></o:p></sp= an> Sent: &= nbsp; &nbs= p; &= nbsp; Sunday, July 13, 2008 4:18 PM<o:p></o:p> To: &nb= sp; = &nb= sp; pmfranko@encompassmedicare.com<o:p></o:p> Subject: &nbs= p; &= nbsp; <sp= an style=3D'font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Direction on Demand from Encompass Consulting & Education,= LLC<o:p></o:p> <o:p> </o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"100%" style=3D'width:100.0%;padding:.75pt .75pt .75pt .75pt'> <div> You are receiving = this email from Encompass Consulting & Education, LLC because you subscrib= ed on our website or have recently attended one of our seminars and indicated that you wished to subscribe. To ensure that you continue to receive emai= ls from us, add <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@e= ncompassmedicare.com</a> to your address book today. If you haven't done so already, click to <a href=3D"http://visitor.constantcontact.com/c.jsp?t=3D1102169398931.previe= w.SUBSCRIBER.SEQNO.2811339113.2&m=3D1101399613904&wl=3DF&id=3Dp= review" target=3D"_blank">confirm</a> your interest in receiving email campaigns = from us. <o:p></o:p> <div> <o:p></o:p><= /span> </div> <div> You may <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZf5= Cw4pNfqOqfZLL0WK6qc2pPa0BaexdSF7p0yELZlGJIKy5jPpx1EIyljIwWctHlQ11CdSk28u9r6= PqLHe4hdKkEltlfpCbTrYfz3MYZtxTn4Kf6dA%3D%3D&id=3Dpreview.1101399613904" target=3D"_blank">unsubscribe</a> if you no longer wish to receive our em= ails.<o:p></o:p> </div> </div> </td> </tr> </table> </div> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i1025" src=3D"http://rs6.net/on.jsp?t=3D1102169398931.0.1101399613904.0&o=3Dht= tp://ui.constantcontact.com/images/p1x1.gif" alt=3D" "><o:p></o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D610 style= =3D'width:457.5pt; mso-cellspacing:1.5pt;background:#CC3366;mso-yfti-tbllook:1184;mso-padding= -alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'background:white;padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padd= ing-alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <img border=3D0 wid= th=3D600 height=3D129 id=3D"_x0000_i1026" src=3D"http://origin.ih.constantcontact.com/fs035/1101399613904/img/1.j= pg?a=3D1102169398931" vspace=3D2 alt=3D"Direction on Demand" align=3Dcenter><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1;height:45.0pt'> <td colspan=3D2 style=3D'background:white;padding:0in 0in 0in 0in;heigh= t:45.0pt'> Encompass Consulting & Education, = LLC E-Zine= <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style=3D'padding:0in 0in 0in 3.75pt'> Vol. 3, No. 4<= /span><o:p></o:p><= /p> </td> <td style=3D'padding:0in 3.75pt 0in 0in'> July, 2008<o:p></o:p><= /p> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#CCCCCC;mso-yfti-tb= llook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:#CCCCCC;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <o:p> </o:p> <a href=3D"#column" color=3D"#003366" shape=3Drect>Encom= pass 2008</a><o:p></o:p> <a href=3D"#article1.= bg1" color=3D"#003366" shape=3Drect>Q&A:= How should I bill co-treatments?</a><o:p></o:p> <a href=3D"#article1.= bg2" color=3D"#003366" shape=3Drect>Q&A:= Do I need to get an NPI number?</a><o:p></o:p> <a href=3D"#article2.= bg1" color=3D"#003366" shape=3Drect>News From Medicare: </a><o:p></o:p> <a href=3D"#article4.= bg1" color=3D"#003366" shape=3Drect>Our Comp= any</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dtop style=3D'background:#CC3366;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <div> <o:p></o:p> </div> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#C= CCCCC; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:ye= s'> <td style=3D'padding:0in 0in 0in 0in'> <div> <a na= me=3Dcolumn shape=3Drect> </a>Encompass 2008<o:p></o:p><= /span> </div> <img border=3D0 width=3D91 height=3D110 id=3D"_x0000_i10= 27" src=3D"http://origin.ih.constantcontact.com/fs035/1101399613904/img/2= .jpg?a=3D1102169398931" vspace=3D10 alt=3D"Pauline M. Franko, PT, MCSP"><o:p></o:p></b= > Locations for our "Medicare Made Easy 2008" for SNF <o:p></o:p></span= > Birmingham, Al - July 18/19 <o:p></o:p> Comfort Inn, Homewood<o:p></o:p> St Louis, MO - Sept 22-23<o:p></o:p> Comfort Inn & conference Center, near airport<o:p></o:p></= span> Chicago, IL - Sept 26-27<o:p></o:p> Comfort Suites, Oakbrook Terrace<o:p></o:p> Las Vegas, NV - Oct 3-4<o:p></o:p> Clarion Hotel & Suites<o:p></o:p> We are cancelling our scheduled seminar in Atlantic city due to the extremely high room rates. We are moving the location to the Philadel= phia Area.<o:p></o:p> We have been looking at our Part B schedule and will be developing our d= ates for the latter part of the year to make sure we are as completely up = to date as we can be. Any suggestions for locations? <o:p></o:p><= /i> Our Part B course will be increased in contact hour to allow for case stu= dy work from admit to D/C including use of tests and measures and billin= g. <o:p></o:p> </td> </tr> </table> </td> <td width=3D420 rowspan=3D2 valign=3Dtop style=3D'width:315.0pt;backgro= und:white; padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 7.5pt'></td> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 1.5pt'> Dear Pauline,<= /span> <o:p></o:p> Thank you for your subscription to "Direction On Demand", a free e-zine from Encompass Consulting & Education, LLC. <o:p></o:p> Congress finally passed the bill to reverse the cut in t= he PFS and extend the exception process. See our "News from Medicare" section.<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:2.25pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:2.25pt'></td> </tr> <tr style=3D'mso-yfti-irow:2;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'padding:1.5pt 1.5pt 1.5pt 1.= 5pt; height:1.5pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:1.5pt'></td> </tr> </table> <a name=3Darticle1.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> Q&A= : How should I bill co-treatments?<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</spa= n><o:p></o:p></s= pan> I was recently talking with a friend of mine that is an occupational therapist. = ; (I am a physical therapist) We were talking about co-treats. = She asked me what was the correct way to bill a co-tx. She said her= self and the PT at her facility had been treating a CVA pt. The= pt. required max X 2 for all mobility. When they went to the pts ro= om he was still in bed. They sat him EOB and did a seated balance activity. The PT guarded the pt on the bed while the OT had the= pt. perform grooming activities. The PT and OT then transferred the= pt. to the chair which required max X 2. They spent 30 mins. with t= he pt. in the pt's room and both billed 30 mins for the treatment. = Is this correct. The OT asked me and I have no idea.<o:p></o:p></s= pan> Answer:= <o:p></o:p></s= pan> Medicare requi= res the total time split between the two therapists. This regulation appl= ies to both Part A and Part B services. Therefore in your example, the ti= me should have been split 15 mins each therapist.<o:p></o:p></spa= n> You can find t= his rule in the RAI manual (your MDS coordinator should have this) on pag= e 3 -188. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle1.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#9= 9CCCC; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> Q&A= : Do I need to get an NPI number?<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</spa= n><o:p></o:p></s= pan> 1) I am a phys= ical therapist who is employed by a free standing outpatient orthopedics clinic , in Florida. I am curious as to whether I need to obtain an N= PI number. My boss stated that we all use a common "provider" number for the entire facility and it would not be necessary for me to get my own NPI anyway. Is he correct???<o:p></o:p> 2) Does each therapist need to get such as number anyway, even if it is not needed= ?<o:p></o:p> 3) What if we decide to obtain one after the deadline??? Would it still be possible= to get an NPI number at any time during the year???<o:p></o:p>= Answer:= <o:p></o:p></s= pan> The provider of service needs the NPI number, not their employees. If in the future y= ou open your own private practice you will be able to get one at that ti= me. Getting one is extremely easy and takes very little time. The May 23rd deadline is not the last day to get one but is the day that everyone billing Medicare must use the NPI number only. Their legacy numbers f= rom Medicare will not be sufficient to get paid. <o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> News Fr= om Medicare: <o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Congress final= ly passed the bill HR 6331 - the Medicare Improvements for Patients a= nd Providers Act by a 69-30 margin. The bill now goes to the Preside= nt for signature. Although the President has indicated that he will veto= the bill due to decreases in the Medicare Advantage Program, there is eno= ugh support in Congress to have the veto overturned. The President has 10 days from July 9th to sign the bill into law. <o:p></o:p></spa= n> In the meantim= e, the caps remain in effect and claims cannot be submitted with the KX modifier <o:p></o:p> CMS published = the Proposed Rule for 2009: Revision to payment Policies Under the Physic= ian Fee Schedule and Other Revisions to Part B. CMS is proposing:<o:p= ></o:p> 1) A revised method to calculate the Fee Schedule with revision on how it creates = the Relative Value (RV) codes.<o:p></o:p> 2) For CORF: <= /span>they are proposing <o= :p></o:p> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l4 level1 lfo1;tab-stops:lis= t .5in'>The duties of the CORF physician be amended to include medical supervision of nonphysician staff.<o:p></o:p></li> </ul> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l1 level1 lfo2;tab-stops:lis= t .5in'>The duties of the CORF physician be amended to include medical supervision of nonphysician staff.<o:p></o:p></li> </ul> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l2 level1 lfo3;tab-stops:lis= t .5in'>The Conditions of Participation relating to extension locations.<o:p= ></o:p></li> </ul> = 3) For Rehab Agencies: </sp= an>CMS is proposing<o:p></o:p> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l3 level1 lfo4;tab-stops:lis= t .5in'>To delete the requirement that a Rehab Agency provide social or vocational services.<o:p></o:p></li> </ul> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo5;tab-stops:lis= t .5in'>Define an extension location.<o:p></o:p></li> </ul> However, in the section relating to the wording in the Code of Federal Regulations, t= hey have not changed the requirement for the 30 day review of the P= OT by the physician/NPP. Maybe this was just an oversight, howev= er, it needs to be addressed. <o:p></o:p> And Finally, f= or those of you in California, New York and Florida <s= pan style=3D'mso-bookmark:"article2\.bg1"'>who were part of the = RAC (Recovery Audit Contractors) demonstration, do not think you suffered= in vein. CMS announced that the demonstration was a great success, recou= ping almost $700 million for the Medicare Trust Fund. <o:p></o:p></= span> CMS is now in = the process of naming the new 4 permanent RACS who will be in all 50 stat= es by 2010.<o:p></o:p> For those of y= ou who have not heard of the RACs, they are a Program Safeguard Contract= or whose purpose is to identify over and under payments from closed out claims. The review claims processed in the fiscal years no sooner tha= n 1 year and no later than 5 years ago. Once the new fiscal year starts in October '08, they will be looking at '04, '05, '06 and '07.<o:p></o:p= > They are paid based on a percentage of the monies they recoup. Sounds like the old = RACK to me (just for the history buffs). <o:p></o:p> As soon as the contractors are name we will have it on the website. For those of you= in transition from your old contractor to a new MAC, you will not be und= er the recovery contractor until 3 months after the transition to the new MAC has been fully completed for all providers.<o:p></o:p></sp= an> Enjoy Your Sum= mer <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle4.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> Our Com= pany<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Direction on Demand is brought to you by Encompass Consulting & Education, LLC= . A therapist owned company specializing in Consulting and Educational services for therapists and other professionals providing Medicare services in SNF, Rehab Agencies, Private Practice, and Hospital Outpatient Facilities.<o:p></o:p> Pauline M. Fra= nko, PT, MCSP is owner and president of the company and is also known as t= he "Medicare Advisor" for the "Advance for" family of News Magazines.She acts as a resource for the respected Eli Reports a= nd is on the editorial board of the "MDS Alert" and "Outpatient Physical Therapy Coding Alert". <o:p></o:p></sp= an> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr 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MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C8F16C.BFCACC80" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Windows® Internet Explorer®. ------=_NextPart_01C8F16C.BFCACC80 Content-Location: file:///C:/F809C638/July_2008.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Direction on Demand from Encompass Consulting & Education, LLC</= title>  <link rel=3DthemeData href=3D"July_2008_files/themedata.thmx"> <link rel=3DcolorSchemeMapping href=3D"July_2008_files/colorschememapping.x= ml">  <style>  </style>  </head> <body bgcolor=3Dwhite lang=3DEN-US link=3Dblue vlink=3Dpurple style=3D'tab-= interval:.5in'> <div class=3DSection1> From: &= nbsp; &nbs= p; = Pauline M. Franko [pmfranko@encompassmedicare.ccsend.com] on behalf of Pauline M. Franko [pmfranko@encompassmedicare.com]<o:p></o:p></sp= an> Sent: &= nbsp; &nbs= p; &= nbsp; Sunday, July 13, 2008 4:18 PM<o:p></o:p> To: &nb= sp; = &nb= sp; pmfranko@encompassmedicare.com<o:p></o:p> Subject: &nbs= p; &= nbsp; <sp= an style=3D'font-family:"Calibri","sans-serif";mso-bidi-font-family:Calibri; color:black'>Direction on Demand from Encompass Consulting & Education,= LLC<o:p></o:p> <o:p> </o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"100%" style=3D'width:100.0%;padding:.75pt .75pt .75pt .75pt'> <div> You are receiving = this email from Encompass Consulting & Education, LLC because you subscrib= ed on our website or have recently attended one of our seminars and indicated that you wished to subscribe. To ensure that you continue to receive emai= ls from us, add <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@e= ncompassmedicare.com</a> to your address book today. If you haven't done so already, click to <a href=3D"http://visitor.constantcontact.com/c.jsp?t=3D1102169398931.previe= w.SUBSCRIBER.SEQNO.2811339113.2&m=3D1101399613904&wl=3DF&id=3Dp= review" target=3D"_blank">confirm</a> your interest in receiving email campaigns = from us. <o:p></o:p> <div> <o:p></o:p><= /span> </div> <div> You may <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZf5= Cw4pNfqOqfZLL0WK6qc2pPa0BaexdSF7p0yELZlGJIKy5jPpx1EIyljIwWctHlQ11CdSk28u9r6= PqLHe4hdKkEltlfpCbTrYfz3MYZtxTn4Kf6dA%3D%3D&id=3Dpreview.1101399613904" target=3D"_blank">unsubscribe</a> if you no longer wish to receive our em= ails.<o:p></o:p> </div> </div> </td> </tr> </table> </div> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i1025" src=3D"http://rs6.net/on.jsp?t=3D1102169398931.0.1101399613904.0&o=3Dht= tp://ui.constantcontact.com/images/p1x1.gif" alt=3D" "><o:p></o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D610 style= =3D'width:457.5pt; mso-cellspacing:1.5pt;background:#CC3366;mso-yfti-tbllook:1184;mso-padding= -alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'background:white;padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padd= ing-alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <img border=3D0 wid= th=3D600 height=3D129 id=3D"_x0000_i1026" src=3D"http://origin.ih.constantcontact.com/fs035/1101399613904/img/1.j= pg?a=3D1102169398931" vspace=3D2 alt=3D"Direction on Demand" align=3Dcenter><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1;height:45.0pt'> <td colspan=3D2 style=3D'background:white;padding:0in 0in 0in 0in;heigh= t:45.0pt'> Encompass Consulting & Education, = LLC E-Zine= <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style=3D'padding:0in 0in 0in 3.75pt'> Vol. 3, No. 4<= /span><o:p></o:p><= /p> </td> <td style=3D'padding:0in 3.75pt 0in 0in'> July, 2008<o:p></o:p><= /p> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#CCCCCC;mso-yfti-tb= llook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:#CCCCCC;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <o:p> </o:p> <a href=3D"#column" color=3D"#003366" shape=3Drect>Encom= pass 2008</a><o:p></o:p> <a href=3D"#article1.= bg1" color=3D"#003366" shape=3Drect>Q&A:= How should I bill co-treatments?</a><o:p></o:p> <a href=3D"#article1.= bg2" color=3D"#003366" shape=3Drect>Q&A:= Do I need to get an NPI number?</a><o:p></o:p> <a href=3D"#article2.= bg1" color=3D"#003366" shape=3Drect>News From Medicare: </a><o:p></o:p> <a href=3D"#article4.= bg1" color=3D"#003366" shape=3Drect>Our Comp= any</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dtop style=3D'background:#CC3366;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <div> <o:p></o:p> </div> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#C= CCCCC; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:ye= s'> <td style=3D'padding:0in 0in 0in 0in'> <div> <a na= me=3Dcolumn shape=3Drect> </a>Encompass 2008<o:p></o:p><= /span> </div> <img border=3D0 width=3D91 height=3D110 id=3D"_x0000_i10= 27" src=3D"http://origin.ih.constantcontact.com/fs035/1101399613904/img/2= .jpg?a=3D1102169398931" vspace=3D10 alt=3D"Pauline M. Franko, PT, MCSP"><o:p></o:p></b= > Locations for our "Medicare Made Easy 2008" for SNF <o:p></o:p></span= > Birmingham, Al - July 18/19 <o:p></o:p> Comfort Inn, Homewood<o:p></o:p> St Louis, MO - Sept 22-23<o:p></o:p> Comfort Inn & conference Center, near airport<o:p></o:p></= span> Chicago, IL - Sept 26-27<o:p></o:p> Comfort Suites, Oakbrook Terrace<o:p></o:p> Las Vegas, NV - Oct 3-4<o:p></o:p> Clarion Hotel & Suites<o:p></o:p> We are cancelling our scheduled seminar in Atlantic city due to the extremely high room rates. We are moving the location to the Philadel= phia Area.<o:p></o:p> We have been looking at our Part B schedule and will be developing our d= ates for the latter part of the year to make sure we are as completely up = to date as we can be. Any suggestions for locations? <o:p></o:p><= /i> Our Part B course will be increased in contact hour to allow for case stu= dy work from admit to D/C including use of tests and measures and billin= g. <o:p></o:p> </td> </tr> </table> </td> <td width=3D420 rowspan=3D2 valign=3Dtop style=3D'width:315.0pt;backgro= und:white; padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 7.5pt'></td> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 1.5pt'> Dear Pauline,<= /span> <o:p></o:p> Thank you for your subscription to "Direction On Demand", a free e-zine from Encompass Consulting & Education, LLC. <o:p></o:p> Congress finally passed the bill to reverse the cut in t= he PFS and extend the exception process. See our "News from Medicare" section.<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:2.25pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:2.25pt'></td> </tr> <tr style=3D'mso-yfti-irow:2;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'padding:1.5pt 1.5pt 1.5pt 1.= 5pt; height:1.5pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:1.5pt'></td> </tr> </table> <a name=3Darticle1.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> Q&A= : How should I bill co-treatments?<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</spa= n><o:p></o:p></s= pan> I was recently talking with a friend of mine that is an occupational therapist. = ; (I am a physical therapist) We were talking about co-treats. = She asked me what was the correct way to bill a co-tx. She said her= self and the PT at her facility had been treating a CVA pt. The= pt. required max X 2 for all mobility. When they went to the pts ro= om he was still in bed. They sat him EOB and did a seated balance activity. The PT guarded the pt on the bed while the OT had the= pt. perform grooming activities. The PT and OT then transferred the= pt. to the chair which required max X 2. They spent 30 mins. with t= he pt. in the pt's room and both billed 30 mins for the treatment. = Is this correct. The OT asked me and I have no idea.<o:p></o:p></s= pan> Answer:= <o:p></o:p></s= pan> Medicare requi= res the total time split between the two therapists. This regulation appl= ies to both Part A and Part B services. Therefore in your example, the ti= me should have been split 15 mins each therapist.<o:p></o:p></spa= n> You can find t= his rule in the RAI manual (your MDS coordinator should have this) on pag= e 3 -188. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle1.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#9= 9CCCC; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> Q&A= : Do I need to get an NPI number?<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</spa= n><o:p></o:p></s= pan> 1) I am a phys= ical therapist who is employed by a free standing outpatient orthopedics clinic , in Florida. I am curious as to whether I need to obtain an N= PI number. My boss stated that we all use a common "provider" number for the entire facility and it would not be necessary for me to get my own NPI anyway. Is he correct???<o:p></o:p> 2) Does each therapist need to get such as number anyway, even if it is not needed= ?<o:p></o:p> 3) What if we decide to obtain one after the deadline??? Would it still be possible= to get an NPI number at any time during the year???<o:p></o:p>= Answer:= <o:p></o:p></s= pan> The provider of service needs the NPI number, not their employees. If in the future y= ou open your own private practice you will be able to get one at that ti= me. Getting one is extremely easy and takes very little time. The May 23rd deadline is not the last day to get one but is the day that everyone billing Medicare must use the NPI number only. Their legacy numbers f= rom Medicare will not be sufficient to get paid. <o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> News Fr= om Medicare: <o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Congress final= ly passed the bill HR 6331 - the Medicare Improvements for Patients a= nd Providers Act by a 69-30 margin. The bill now goes to the Preside= nt for signature. Although the President has indicated that he will veto= the bill due to decreases in the Medicare Advantage Program, there is eno= ugh support in Congress to have the veto overturned. The President has 10 days from July 9th to sign the bill into law. <o:p></o:p></spa= n> In the meantim= e, the caps remain in effect and claims cannot be submitted with the KX modifier <o:p></o:p> CMS published = the Proposed Rule for 2009: Revision to payment Policies Under the Physic= ian Fee Schedule and Other Revisions to Part B. CMS is proposing:<o:p= ></o:p> 1) A revised method to calculate the Fee Schedule with revision on how it creates = the Relative Value (RV) codes.<o:p></o:p> 2) For CORF: <= /span>they are proposing <o= :p></o:p> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l4 level1 lfo1;tab-stops:lis= t .5in'>The duties of the CORF physician be amended to include medical supervision of nonphysician staff.<o:p></o:p></li> </ul> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l1 level1 lfo2;tab-stops:lis= t .5in'>The duties of the CORF physician be amended to include medical supervision of nonphysician staff.<o:p></o:p></li> </ul> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l2 level1 lfo3;tab-stops:lis= t .5in'>The Conditions of Participation relating to extension locations.<o:p= ></o:p></li> </ul> = 3) For Rehab Agencies: </sp= an>CMS is proposing<o:p></o:p> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l3 level1 lfo4;tab-stops:lis= t .5in'>To delete the requirement that a Rehab Agency provide social or vocational services.<o:p></o:p></li> </ul> <ul type=3Ddisc> <li class=3DMsoNormal style=3D'color:black;mso-margin-top-alt:auto; mso-margin-bottom-alt:auto;mso-list:l0 level1 lfo5;tab-stops:lis= t .5in'>Define an extension location.<o:p></o:p></li> </ul> However, in the section relating to the wording in the Code of Federal Regulations, t= hey have not changed the requirement for the 30 day review of the P= OT by the physician/NPP. Maybe this was just an oversight, howev= er, it needs to be addressed. <o:p></o:p> And Finally, f= or those of you in California, New York and Florida <s= pan style=3D'mso-bookmark:"article2\.bg1"'>who were part of the = RAC (Recovery Audit Contractors) demonstration, do not think you suffered= in vein. CMS announced that the demonstration was a great success, recou= ping almost $700 million for the Medicare Trust Fund. <o:p></o:p></= span> CMS is now in = the process of naming the new 4 permanent RACS who will be in all 50 stat= es by 2010.<o:p></o:p> For those of y= ou who have not heard of the RACs, they are a Program Safeguard Contract= or whose purpose is to identify over and under payments from closed out claims. The review claims processed in the fiscal years no sooner tha= n 1 year and no later than 5 years ago. Once the new fiscal year starts in October '08, they will be looking at '04, '05, '06 and '07.<o:p></o:p= > They are paid based on a percentage of the monies they recoup. Sounds like the old = RACK to me (just for the history buffs). <o:p></o:p> As soon as the contractors are name we will have it on the website. For those of you= in transition from your old contractor to a new MAC, you will not be und= er the recovery contractor until 3 months after the transition to the new MAC has been fully completed for all providers.<o:p></o:p></sp= an> Enjoy Your Sum= mer <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle4.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> = ·</sp= an> Our Com= pany<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Direction on Demand is brought to you by Encompass Consulting & Education, LLC= . A therapist owned company specializing in Consulting and Educational services for therapists and other professionals providing Medicare services in SNF, Rehab Agencies, Private Practice, and Hospital Outpatient Facilities.<o:p></o:p> Pauline M. Fra= nko, PT, MCSP is owner and president of the company and is also known as t= he "Medicare Advisor" for the "Advance for" family of News Magazines.She acts as a resource for the respected Eli Reports a= nd is on the editorial board of the "MDS Alert" and "Outpatient Physical Therapy Coding Alert". <o:p></o:p></sp= an> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr 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