LHC options

[Guest guest]

If one reads the appendices of the LHC report from UCSF, it appears

that LHC took a somewhat stronger stance than this expert adviser.

The UCSF report suggests expansion of the legal scope with necessary

educational requirements as one option. LHC considers that option but

in the end weighs against it. I would not say they outright dismiss

it as one option rather that they recommend others as more preferable.

UCSF notes something of interest and possible importance here,

though. They note that acupuncturists possess the linguistic and

multicultural skills that make them well suited to address certain

primary care needs.

 

With the well known GP shortage, this may be an opening for some kind

of add-on certificate in gatekeeper level primary care. UCSF also

notes that optometrists can get an add on drug prescribing certificate

as a model for our field. While LHC leaves open this option, it does

not recommend it. But the current governor might think this was a

clever private sector option for the healthcare crisis. Thus another

opening. Why require dual licensure if there is a model for an add-on

certificate that will insure public safety. In fact, perhaps we

should consider an add-on model that could also be applicable to other

fields like physical therapy and nursing so we could enlist alliances

under the common banner of helping to relieve the GP shortage.

 

Nursing schools would be a logical place to teach this type of

coursework. LHC seemed pretty firm that such coursework should not be

taught at OM schools. That would automatically make it seem that the

only option is some kind of add-on certificate, but at least there is

an option for which a strong case could still be made. That still

leaves a few pressing questions. Such as whether it would still be

acceptable for Lac to code for nonspecific pain complaints such as ICD

code 729.1 (neuromuscular pain) even if the authority to code for

actual diseases (like osteoarthritis) was lost. It is also perhaps

worth noting that while all this fuss was being made about titles and

education and scope by a few vocal lobbyists last year, an

occupational analysis by UCSF found that very few LAc ever ordered lab

tests or x-rays. However it ws unclear how many Lac regularly

submitted insurance paperwork with diagnoses outside their scope.

Patients may have had such diagnoses made by an MD in almost all such

cases, but no formal transfer of records is typically done to verify

this.

 

UCSF also did allow that their were other reasons besides western dx

to order labs and that it could be beneficial to the public for Lac to

have some limited scope in this area. Again, with an add-on

certificate. This latter certificate would encompass substantially

less material and yield less authority than a complete dx certificate,

but it would still have to be done at a western med school in all

likelihood. Again, some general certificate that might be applicable

to several professions could be a great legitimizer here. So there

are some openings to insure the continuation of current practice for

those who rely on doing western dx or billing insurance, etc.

Ironically, these add-ons will be necessary for those at any level of

the profession, including DAOM grads. Also, it is likely that those

who were allowed to practice with only 1350 hours education are going

to have a few years to do some very specific CEUs or retire (probably

herbology and red flag sigs). LHC is clear that the previous level of

hours of 2350 in CA was adequate to protect the public.

 

Thus while all hope is not lost, I think the dream of an entry level

doctorate in OM is effectively over in this state and by extension,

everywhere else, as well. OTOH, the possibility of getting the state

to allow an add-on western dx certificate such as LHC has proposed and

I have described could actually result in LAc gaining access to a far

greater scope of practice than we ever imagined. Once a complete

western dx certificate is available, it might be possible to get

limited drug prescribing add-ons and be able to independently practice

combined drug/herb therapy. There was no way any such extension of

power could ever happen under the basic acupuncture practice act

itself. Face it, for those who are interested, it would be a far

better education in WM, thus better for the public. Schools could

focus on OM and only those who wanted the add-ons would need to go

that route. LHC also recommends the development of private boards for

advanced certification, stating that is the normal route to

demonstrate expertise beyond basic competence in WM. Perhaps we

should work towards expanding our scope in this indirect way instead

of wasting resources trying to preserve what would effectively be a

lesser status.

 

[Guest guest]

Such as whether it would still be

acceptable for Lac to code for nonspecific pain complaints such as ICD

code 729.1 (neuromuscular pain) even if the authority to code for

actual diseases (like osteoarthritis) was lost.

>>>>Non specific codes are not permitted by HIPA. You must use the highest level

code

Alon

 

 

[Guest guest]

LHC also recommends the development of private boards for

advanced certification, stating that is the normal route to

demonstrate expertise beyond basic competence in WM. Perhaps we

should work towards expanding our scope in this indirect way instead

of wasting resources trying to preserve what would effectively be a

lesser status.

>>>>On that note we just has our first national exam of the american board of

oriental physical medicine at the AAOM meeting.

Alon

 

 

[Guest guest]

Hi all,

I'm a certified coder (from my previous work life).

 

Please be careful with codes!

 

The best rule is code oly what you know. don't stretch,

twist, spindle or mutilate the diagnosis into something

more specific than what it is.

 

IF you have a solid western dx from another source,

and that is what you're treating, go ahead and use it.

 

" Pain " is fine to use if that is all you know and that

is what you're treating.

The code for pain can be very specific to location

on the body.

 

HIPPA has nothing to do with coding perse.

 

If the only dx you have is non-specific, that is what

you MUST use by law.

 

The slope gets slippery when providers try to embellish

and project what the cause of the pain is.

 

Until there is a definitive diagnosis, it is within all

coding rules, regulations and guidelines to code the symptom.

 

Coding is tricky stuff.

Good luck!

Jean

 

 

> Such as whether it would still be

> acceptable for Lac to code for nonspecific pain complaints such as

ICD

> code 729.1 (neuromuscular pain) even if the authority to code for

> actual diseases (like osteoarthritis) was lost.

 

> >>>>Non specific codes are not permitted by HIPA. You must use the

highest level code

> Alon

[Guest guest]

HIPPA has nothing to do with coding perse.

>>>Well I do not know how much insurance work you do but I had several claims

that came back demanding a higher (ie more specific) codes stating it is a HIPPA

requirement. I never studies HIPPA but that is what the insurance companies have

told me

alon