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Survey of billing and coding for counterstrain tender points
Karen T Snider1, Jane C Johnson
1Department of Osteopathic Manipulative Medicine, A.T. Still University-Kirksville College of Osteopathic Medicine, 800 W Jefferson St, Kirksville, MO 63501-1443, USA. ksnider@atsu.edu
The Journal of the American Osteopathic Association
|June 19, 2012
Summary
Osteopathic physicians show varied approaches to billing for counterstrain tender points, with most favoring a structural examination but inconsistent diagnosis. This leads to challenges in accurate evaluation and management service coding.
Area of Science:
- Osteopathic manipulative medicine
- Medical billing and coding
- Somatic dysfunction diagnosis
Background:
- Counterstrain tender points are sometimes named incongruently with their physical locations.
- This discrepancy complicates the accurate assignment of evaluation and management service codes for physician billing.
Purpose of the Study:
- To evaluate osteopathic physicians' perspectives on billing and coding practices for counterstrain tender points with incongruent anatomical locations.
- To understand the approaches physicians take when diagnosing somatic dysfunction for these specific tender points.
Main Methods:
- A survey was distributed to osteopathic physicians who utilize counterstrain in their practice.
- Physicians reported their methods for physically examining incongruent tender points and diagnosing somatic dysfunction for billing.
- Responses were classified as either a structural (anatomical) or functional (neighboring dysfunction) approach.
Main Results:
- Ninety percent of respondents predominantly used a structural approach for physical examination of tender points.
- Twenty-one percent predominantly used a functional approach for somatic dysfunction diagnosis.
- Significant inconsistencies were observed among physicians regarding the approach for individual tender points and across different demographics (sex, specialty, years in practice).
Conclusions:
- Osteopathic physicians exhibit differing opinions on the physical examination and diagnostic approaches for incongruent counterstrain tender points.
- These differences indicate a lack of standardization in determining the physical examination component and diagnostic codes (ICD-9) for these cases.
- The findings highlight potential challenges in consistent and accurate medical billing and coding within osteopathic manipulative medicine.
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