From: Lawrence Low Subject: [C] New Medicare Documentation Hello list members, Can anyone delineate the new guidelines as far as proving medical necessity for Medicare now that we no longer have to have an x-ray. Thanks in advance for the info. Larry ------------- Date: Sun, 16 Jan 2000 16:54:38 -0600 From: "James A. Roth" Subject: RE: [C] New Medicare Documentation While claims with dates of service on or after Jan. 1. 2000 are not required to have an x-ray to demonstrate the existence of a spinal subluxation, chiropractors have the option to continue to use x-rays as part pf their documentation. Chiropractors that choose not to x-ray the patient, document the subluxation using the P.A.R.T. diagnosis process. From January 1 to March 31, Medicare carriers will be given discretion as to what information they will require for the documentation of a subluxation. The five Parts of P.A.R.T.S. P-Pain/Tenderness. The perception of pain and tenderness is evaluated in terms of location, quality, and intensity. The patient's description and location are obtained, with the location and intensity of tenderness produced with palpation of osseous and soft tissues noted. A-Asymmetry/Alignment. Asymmetrical qualities on a sectional or segmental level are noted. This would include observation of posture and gait, as well as palpation for misalignment of vertebral segments. R-Range of Motion, Abnormality. Changes in active, passive and accessory joint motions are noted. These changes may be an increase or decrease in mobility. It is thought that a decrease in motion is a common component of joint dysfunction. T-Tissue Tone, Texture, Temperature Abnormality. Changes in the characteristics of contiguous and associated soft tissues, including the skin, fascia, muscle and ligament are noted. S-Special Test. Those testing procedures that are specific to a technique system are performed. The compilation of findings P.A.R.T.S. evaluation then serves as a guide in decisions about which areas of the spine require manipulative adjustments. ----------------- From: RdeanH@aol.com Date: Sun, 16 Jan 2000 20:52:31 EST Subject: Re: [C] New Medicare Documentation Unfortunately HCFA did not accept the S in PARTS. They recognize only PART. That means things like the Activator leg check don't qualify. You must have 2 of the 4 and 1 must be either A or R. R. Dean Harman, DC ---------------- From: Brett3333@aol.com Date: Mon, 17 Jan 2000 20:21:38 EST Subject: Re: [C] New Medicare Documentation In a message dated 01/16/2000 9:14:52 PM Eastern Standard Time, atebby@earthlink.net writes: << I thought that the P.A.R.T. diagnosis process was something dreamed up by the folks at the ACA. Has this process been adopted by Medicare? No, I don't think that it has. Alan Tebby>> Actually, Alan, Medicare has adopted the PART system and it was published in their most recent Medicare Physician Supplement -- fresh from the Medicare folks themselves. - Brett L. Kinsler, DC (Brett3333@aol.com) --------------- From: RdeanH@aol.com Date: Tue, 18 Jan 2000 00:37:42 EST Subject: Re: [C] New Medicare Documentation Yes, HCFA adopted PART in lieu of x-rays. Drs may still use x-rays as always. The ACA had wanted PARTS but HCFA turned down the S part. Dean --------------- From: RdeanH@aol.com Date: Tue, 18 Jan 2000 00:37:43 EST Subject: Re: [C] New Medicare Documentation Sorry guys and gals--HCFA did not accept the S in PARTS. You must record 2 of the 4 with one of them either A or R. Dean In a message dated 01/16/2000 2:54:09 PM Pacific Standard Time, jrothdc@bigplanet.com writes: << S-Special Test. Those testing procedures that are specific to a technique system are performed. >> ---------------- From: RdeanH@aol.com Date: Tue, 18 Jan 2000 23:30:20 EST Subject: Re: [C] New Medicare Documentation In a message dated 01/18/2000 andreb@hub.ofthe.net writes: << What if you do take xrays, will you have to use the PART documentation? Andre >> My understanding is that if you continue to take x-rays, nothing changes--continue to document the x-ray date in whatever box your particular carrier requires. R. Dean Harman, DC ------------------