Author Topic: PT with Wii and PS3  (Read 2188 times)

oneround

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PT with Wii and PS3
« on: October 04, 2010, 02:32:24 PM »
I am currently reseaching PT and some facilities that are actually charging pt's to come in and use the PS3 and WII as part of their rehab.  I have never heard of this and to my belief would stand firm in saying that this is a non covered benefit.  One facility I recently visited not only statefd that they are coding it but submitting and getting paid for it! When I asked what code they were submitting they indicated an unlisted procedure code and are getting paid for it.

Again, I see something very wrong with this picture and advised that this facility may want to run an audit and start returning any payment that they have received for these services.

I have researched this through many of my resources and I do not find any thing supports billing this or better yet even having a code for it.    Have any of you in this forum came across this or know of this and can share your insites with me so as to further educate me if I am tottaly missing something here.

Thanks
« Last Edit: October 04, 2010, 02:33:58 PM by oneround »
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
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Corporate Compliance
Sharp HealthCare

DMK

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Re: PT with Wii and PS3
« Reply #1 on: October 04, 2010, 04:33:42 PM »
Maybe "exercise instruction"?  So they make sure the patient is doing it right at home?  It sounds a bit out there to me, unless the program they're using is their program, designed by them, not one that the patient can buy.

Wow, that's pushing the envelope......

Michele

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Re: PT with Wii and PS3
« Reply #2 on: October 04, 2010, 08:56:09 PM »
I would think that it would matter if the PT were watching and supervising the activities.  If they were using the Wii or the PS3 to have the patient do activities or exercises that were part of their PT program then maybe......but I haven't heard of this before.  But if the patient is just coming in to use their Wii or PS3 but isn't even being supervised, then it doesn't sound right to me.

Michele
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PMRNC

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Re: PT with Wii and PS3
« Reply #3 on: October 05, 2010, 06:06:50 AM »
Seriously?  If this is true, I'm going to get a PT to come to my house and bill my insurance company for my use of my own Wii Fit!
Linda Walker
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DMK

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Re: PT with Wii and PS3
« Reply #4 on: October 05, 2010, 10:09:02 AM »
I asked my doctor about this today.  He said that the Wii has a great vestibular and balance training programs, and the program gives immediate feedback.  They are currently developing a program for convalescence homes to help prevent falls.  Wow! 

He says it's the same thing as lifting weights.  You can do it at home, but if the PT is observing or helping it's a professional component.

PMRNC

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Re: PT with Wii and PS3
« Reply #5 on: October 05, 2010, 10:53:33 AM »
Sorry..but this is why the health insurance industry is BROKEN.  Next I suppose we will expect insurance companies to PAY for the WII or PS3?  Think about it.. they pay for rental of TENS units and other things that the patient could purchase rent.. is that next.. sorry I am having hard time on that one. Might be the insurance side of me coming through.
Linda Walker
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DMK

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Re: PT with Wii and PS3
« Reply #6 on: October 05, 2010, 01:48:49 PM »
I completely agree with you.  I could see, maybe, one PT visit for instruction to transition to a home program.  And the TENS unit scam is horrifying!  We can buy the TENS units for $30-$50 dollars and the service companies are HOSING the patients and the insurance companies for units, pads and leads.  In the Worker's Comp system it was even worse. In California most of those loopholes have been closed.

I'm like you, the insurance side comes out.  There's stuff that should be paid and stuff that absolutely should not!

PMRNC

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Re: PT with Wii and PS3
« Reply #7 on: October 05, 2010, 05:34:38 PM »
I remember when I would get claims for Air Conditioning systems..THOUSANDS of them.. later on carriers started to pay portions for allergies! ??? 

When insurance companies start paying for Wii's and video game consoles????  ???  And if they pay for patient's to play ..well shoot what about my gym membership???
Linda Walker
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oneround

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Re: PT with Wii and PS3
« Reply #8 on: October 05, 2010, 05:54:41 PM »
I can understand the cardio benefit of it but come on to actually set it up in shop and start billing for it.  And just what would justify 'supervision'?  Would that be making sure that the patinet perfected their Wii/PS3 golf swing.  Maybe this is all to new for me to swallow but wow.  In review of the provider i reviewed they were submitting this as an unlisted procedure to the carrier and the carrier was paying this unlisted procedure without one request for the chart notes.  I eventually see a recoup coming soon on this.  I eventually asked what prompted the provided to code and bill for these services and they told me that 'it's the new thing and everyone is doing it!'  I could only scratch my head and silently chuckle.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

PMRNC

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Re: PT with Wii and PS3
« Reply #9 on: October 05, 2010, 07:02:22 PM »
LOL Golf Swing..that would be a tough one since every orthopedist in the country will tell you that GOLF is the most UN-Natural sport on the planet..LOL 

So they were billing for this using unlisted procedure/CPT?  Was it ONE carrier that just was paying w/out notes? I would research that further..if it is ONE carrier.. ok maybe I would say I'd buy it..but if they say it's more than one carrier I'm guessing that there was some false documentation going on too. No way are insurance carriers going to reimburse that..not yet anyway!
Linda Walker
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