OMT Billing + Study guide stuff that doesn't fit anywhere else

Question 1

Ottowa ankle rules

Answer 1

Perform radiograph if there is pain in the malleolar region with:

1. Bone tenderness at posterior edge of distal 6cm or the tip of the lateral malleolus
2. Tenderness at posterior edge of distal 6 cm or tip of medial malleolus
3. Inability to bear weight for at least 4 steps both immediately after injury and at time of eval

Question 2

Ottawa rules for foot

Answer 2

A foot radiograph should be performed if there is pain in the midfoot region with:

1. Bone tenderness at navicular bone
2. Bone tenderness at the base of the 5th metatarsal
3. Inability to bear weight for at least 4 steps both immediately after injury and at time of eval

Question 3

Contraindications to OMT

Answer 3

Patient refusal

Acute fracture

Surgical emergency

Potential CA

No cranial OMT in acute head bleeds (dural hematoma)

Question 4

What is the spinal curve compensation for psoas strain?

Answer 4

Loss of lordosis

Question 5

What is the spinal curve compensation for aging?

Answer 5

Increased kyphosis

Question 6

Transition zones of Zink patterns (review)

Answer 6

OA, C1, C2 (Cranio-cervical)

C7, T1 (Cervico-thoracic)

T12, L1 (Thoraco-lumbar)

L5, Sacrum (Lumbo-pelvic)

Question 7

Contraindications to OMT

Answer 7

Patient refusal
Acute fracture
Surgical emergency
Potential cancer
No Cranial OMT in Acute Head Bleeds (Dural Hematomas)

Question 8

OMT billing regions (10)

Answer 8

Head (cranial and OA)

Cervical (include scalenes)

Thoracci

Ribs

Upper extremity (subscapularis TP)

Abdomen

Lumbar

Pelvis

Sacrum

Lower extremity

Question 9

If you have multiple treated somatic dysfunctions in the same region but on different sides, do they count separately on billing?

Answer 9

NO

i.e. L talus SD, L Knee SD, R fibular head SD all count as one region

Question 10

OMT billing codes

98925

Answer 10

1-2 regions

Question 11

OMT billing codes

98926

Answer 11

3-4 regions

Question 12

OMT billing codes

98927

Answer 12

5-6 regions

Question 13

OMT billing codes

98928

Answer 13

7-8 regions

Question 14

OMT billing codes

98929

Answer 14

9-10 regions

Question 15

Most common modifier for OMT billing attached to a visit

Answer 15

25 Modifier

Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service

Question 16

OMT modifier for a distinct procedural visit to indicate two or more procedures were performed during the same visit to different sites on the body

Answer 16

59

If performing OMT and another procedure such as trigger point injections