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Thread Title: Acupuncture and 24 visit limit
Created On Friday October 24, 2008 9:39 AM


Millie
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Friday October 24, 2008 9:39 AM

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For injuries 1-1-04 and after, I understand there is a 24 visit cap on chiropractic, occupational therapy, and physical therapy. Does acupuncture fall into any of these catagories and also have a 24 visit cap?

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jonbrissman@verizon.net
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Friday October 24, 2008 2:19 PM

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Hi, Millie. There is a similar thread in the Legal forum. Acupuncture is not specifically mentioned in LC Sect. 4604.5, which caps reimbursement at 24 physical therapy, 24 chiropractic, and 24 occupational therapy visits. Although acupuncture in included in the Physical Medicine section of the Official Medical Fee Schedule, it is unclear whether acupuncture could be considered physical therapy so as to be capped under the statute.

One could make an argument that acupuncture should have been included in the Medicine section of the OMFS, because the skin is breached and the therapy is applied to internal neural pathways. Physical Medicine appears to be wholly externally applied. (I am not a physician so the foregoing is just my lay understanding).

A definition about whether acupuncture is or is not physical therapy for purposes of LC Sect. 4604.5 would be helpful. Until and unless that definition is forthcoming, I will advance the argument in the prior paragraph. If someone has a compelling argument to the contrary, I might reassess.

JCB

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jakelast@aol.com
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Saturday October 25, 2008 1:15 PM

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I would not think acupuncture to fall under the rubric of Physical therapy. PT is defined in the B & P code:

2620. (a) Physical therapy means the art and science of physical or
corrective rehabilitation or of physical or corrective treatment of
any bodily or mental condition of any person by the use of the
physical, chemical, and other properties of heat, light, water,
electricity, sound, massage, and active, passive, and resistive
exercise, and shall include physical therapy evaluation, treatment
planning, instruction and consultative services. The practice of
physical therapy includes the promotion and maintenance of physical
fitness to enhance the bodily movement related health and wellness of
individuals through the use of physical therapy interventions.

I don't think acupuncture falls into the category. While I have no researched the issue, I believe acupuncture requires special licensing as it punctures the skin. A physician can do it but not a chiropractor unless he/she is licensed as an acupuncturist.


Jake Jacobsmeyer

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jonbrissman@verizon.net
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Saturday October 25, 2008 4:31 PM

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Thanks for the B&P reference, Jake. I agree with everything you said, but that doesn't necessarily make it right. The B&P definition could be read broadly enough, in my opinion, to include acupuncture. I'd like to see the Administrative Director rule on the issue. I think she would agree with us, but I'm not willing to bet on the issue.

Jon

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Jpod
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Monday October 27, 2008 9:06 AM

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For what it is worth a physician once told me that anything that pierces the skin is considered surgery. He pointed out a shot is considered surgery.

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gaiassoul1@yahoo.com
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Tuesday October 28, 2008 3:55 PM

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however we have already seen this defeated in cases where epidurals are not back surgery.

The physician is way off in what is the actual definition of surgery per the AMA.

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Millie
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Wednesday October 29, 2008 9:58 AM

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Thanks so much all of you!
Millie

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Jpod
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Wednesday October 29, 2008 1:47 PM

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Ginger you are referring to workers' comp and legal decisions involving the interpretation of workers comp statutes. The doctor was stating how he was trained in medical school. I raised to it to show perspective.

Clearly acupuncture is closer to surgery than PT or OT. How anyone could stretch the 24 visit cap to acupuncture is beyond me.


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gaiassoul1@yahoo.com
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Wednesday October 29, 2008 3:49 PM

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I disagree with the statement in its entire premise. Surgery is work done by a surgeon....accupuncturists and the like are not surgery, but that is all semantics..I was not referring to comp or the legal decisions, I was referring to the AMA definition.

Close only counts in handshoes and hand grenades....

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JTQUILTER
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Wednesday October 29, 2008 4:10 PM

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HANDSHOES??? I think you meant HORSESHOES -

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gaiassoul1@yahoo.com
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Wednesday October 29, 2008 10:00 PM

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yep I did, and that is what happens when you operate with a migraine.

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postscript2
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Thursday October 30, 2008 11:04 AM

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I heard that acupuncture was great for relieving migraines!

LCS

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art...
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Thursday October 30, 2008 11:47 PM

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" HANDSHOES??? I think you meant HORSESHOES -"-- In a world where we all occasionally get our mords wixed up, I thought she meant "Hand-shoes and horse grenades".

YMMV...

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Jpod
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Friday October 31, 2008 7:19 AM

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And there is another little pun in there too:

"yep I did, and that is what happens when you OPERATE with a migraine."

Operate=surgery ;-)

Not good to do surgery with a migraine......

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gaiassoul1@yahoo.com
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Friday October 31, 2008 7:20 AM

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accupuncture is good for some types of migraines and worthless for others......47 years of a defective chromosone has taught much...compounding head injury taught more.

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