Pommel Cushions February 11, 2008
Posted by cutlaborcost in physical therapy.Tags: cushion, physical therapy, Pommel
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What is a pommel?
A pommel refers to an object resembling a ball, or the protuberant part of a saddlebow.
What is a pommel cushion?
A pommel cushion is a cushion with an upward-projecting protuberance at its front part. This modification prevents a wheelchair-borne patient from slipping down on the seat.
When are pommel cushions indicated?
Two main indications of pommel cushions are posture support, and hip positioning.
Pommel cushions are mainly indicated for patients who have weak trunk muscles or weak muscles of the lower extremities, and tend to slide down in their wheelchairs. Pommel cushions help prevent forward sliding and decreases the risk of falls from the wheelchair. Pommel cushions may also be used for patients with spasticity of the lower extremities to maintain both hips in the abducted position when seated on the wheelchair.
Patients with altered mental status can often benefit from adaptive devices that aid wheelchair positioning and decrease risk of falls from a wheelchair. A logical progression of wheelchair safety devices to prevent falls would be:
- provide wheelchair cushion to all patients
- add a personal wheelchair alarm to patients who have poor balance and increased fall risk or patients with prior history of falls
- change standard cushion to pommel cushion to patients who have weak trunk or lower extremity musculature
- add a lap buddy or change wheelchair alarm to seatbelt alarm for confused patients with poor balance who tend to stand up without supervision
- change lap buddy to lap tray for confused patients who cannot be restricted by a wheelchair
- remove all devices and provide a merry walker
When all devices fail to restrict patient movement, and patient is still at high risk for falls, the possibility of a chemical restraint should be discussed with the attending physician.
A picture of a pommel cushion can be found here: http://www.sammonspreston.com/images/products/6760L.JPG
Sources:
Sammons Preston Professional Rehab Catalog 2007, pp. 982-984
Online Medical Dictionary (2008). Accessed at http://cancerweb.ncl.ac.uk/cgi-bin/omd?pommel
CPT Codes February 9, 2008
Posted by cutlaborcost in physical therapy.Tags: CMS, CPT codes, HCPCS, medicaid, medical billing, medicare, physical therapy, PT, PT assistants
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What are CPT Codes?
CPT stands for “current procedural terminology.” CPT codes are a set of codes developed several medical organizations in the United states for the purpose of helping the U.S. federal government to administer the health insurance program Medicare.
CPT codes are numeric, and code for medical, surgical, and diagnostic services. The codes and descriptions are copyright 2007 by the American Medical Association.
Who developed the CPT Codes?
The CPT codes were first developed by the American Medical Association (AMA), and published in 1966. The Centers for Medicare and Medicaid Services (CMS) eventually adopted CPT as part of their coding system.
Are CPT codes the only codes used in Medicare?
The set of CPT codes is only a subset of a larger group of codes. The coding system actually includes two levels of codes:
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Level I Codes – CPT codes
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Level II Codes – HCPCS or national codes
Why was the coding system created?
The coding system provides a common billing language for health care providers and payers. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 standardized all health care claim formats by naming the CPT and HCPCS codes as the procedure code set for physician services, PT and OT services, clinical lab tests and other medical services. This occurred on August 17, 2000.
What is the HCPCS?
HCPCS stands for Healthcare Common Procedure Coding System. HCPCS is commonly pronounced as “hick-picks.” These codes supplement the CPT coding system, and describes some supplies, orthotics and prosthetics, and durable medical equipment. These codes are used primarily for Medicare and Medicaid billing. The code consist of one alphabetical character (A through V), followed by four numbers.
Examples of common HCPCS codes used in physical therapy include:
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Walker, E0130
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Wheelchair, E0950
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Ankle-foot orthosis, L1900
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Quad cane, E0105
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Cane, E0100
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Crutches, E0110
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Forearm crutches, E0111
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TENS, A4595
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Knee orthosis, E1810
A list of HCPCS alphanumeric codes can be found here: http://www.cms.hhs.gov/HCPCSReleaseCodeSets/downloads/INDEX2008.pdf
Source:
E.R. Strunk, “Code Creation,” Advance for Physical Therapists and PT Assistants . 18,6 (2007), pp. 48-49, 62.
Wikipedia website. (2008). Accessed at http://en.wikipedia.org/wiki/HCPCS.
N ational Government Services website. (2008). Accessed at http://www.empiremedicare.com/trainb/lmpbback.htm
