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Steve Hill
05-11-1995, 06:34 AM
Dear Bruce:

(It would have been better to send this to you directly, if I had had your
email address,
so I hope other people on the list find this interesting...)

Here is my...
VARIABLE FEE SCHEDULE

Procedure CPT Code one condition two conditions

Dynamic Electromyography 95861+ 22
Dynamic Joint Rotations 95851+ 22
Dynamic Joint Torque Curves 97752
Manual Muscle Testing 95833
Dynamic Foot- Floor Forces 97799 *Unlisted procedure
Temporal Gait Parameters 97799 *Unlisted procedure
Video Tape Gait Assessment 97799 *Unlisted procedure

Total Fee? Well, I believe the anti-trust law does not permit colleagues
to discuss the actual $ amounts for medical services. (Otherwise, we all
could get together and fix our prices... which would be unethical). Figure
out how many patients you can expect to run, and then accrue your related
expenses, as much as possible, across those patients (include the service
contracts(hardware and software), commodities, and staffing expenses of
running those patients). Gait labs, by nature are very expensive.
Therefore, many gait labs are heavily subsidized by their institutions
(hospital or university)... but these days, many facilities are being asked
to support themselves as much as possible.


Notes:

*Unlisted procedure: Although Dynamic Foot-Floor Forces, temporal gait
parameters, and video taping are customary components of clinical gait
analysis testing throughout the U.S.A., specific CPT (Current Procedural
Terminology) codes have not yet been established by the American Medical
Association for these particular procedures. Therefore, we presently
identify these procedures using the "Physical Medicine - Tests and Measures"
(97700), "unlisted code" (97799). The other codes we use are basically
adopted Physical Medicine codes, as there are still not any specific gait
lab codes yet.

A "condition" refers to a walking method: such as barefoot, or with Ankle
Foot Orthoses (braces), or crutches, or a walker .

Typically, three walking "trials" are retained for processing in order to
examine consistency of walking pattern.

The most common clinical gait study is the 2 conditions, as many patients
with cerebral palsy or myelomeningocele walk with and without Ankle Foot
Orthoses (braces).

In negotiations, insurance companies sometimes prefer to always pay a set
amount,
regardless of what is done: kinematics, kinetics, EMG, one or two
conditions.

The bill goes out with a copy of the complete report (text and plots), and a
copy of a "letter of necessity" which details the above CPT codes and the
components of the gait study they identify.

I hope this is some help.
All the best!

Steve : )

O (o)xx
< ) \_ |
( / | \
/ \ / | \
< L ___ ___
_____________________________
Stephen W. Hill, B.Sc.
Kinesiologist/Administrative Director
SIU Motion Analysis Laboratory (1420)
Instructor of Clinical Surgery
Southern Illinois University School of Medicine
751 North Rutledge Street
Lower Level, Suite 0300
Springfield, IL 62702 USA
phone: (217) 782-6556
fax: (217) 782-7323
e-mail: shill@surg800.siumed.edu

----------
From: owner-biomch-l
To: Multiple recipients of list BIOMCH-L
Subject: Gait Charges
Date: Wednesday, May 10, 1995 1:29PM

I have been asked to rework the current billing scheme in our gait
laboratory.
I am interested in finding out how other labs are breaking down charges for
gait analysis (i.e. kinematics, kinetics, EMG, #trials, etc.) and the dollar
amounts, specifically for CP gaits. I will post a compiled summary of
replies
unless the reply asks that the charges be kept confidential.

Thanks,

Bruce MacWilliams


--
/***********************************/
/*** Bruce A. MacWilliams ***/
/*** Orthopaedic Biomechanics ***/
/*** Johns Hopkins University ***/
/*** Baltimore, MD ***/
/***********************************/