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VPTA Annual Conference October 15-17, 2010
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Friday, October 15
| Track I |
Employing an Evidence-based Approach to the Treatment of Patients Following Total Knee Arthroplasty: From the Hospital to Home |
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Speakers: Kevin E. Brueilly, PT, PhD - biography
Morey J. Kolber, PT, PhD, OCS, Cert MDT, CSCS - biography
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Total knee replacement surgery is one of the most common surgeries performed worldwide. The rehabilitation process of the patient following total knee arthroplasty (TKA) is commonly navigated by the physical therapist in various clinical settings, but most frequently encountered in the acute care hospital.
The nuances of the surgical procedure, prosthesis types, and pain control methods associated with rehabilitation are rapidly evolving and can substantially impact the rehabilitation process enacted by the physical therapist.
This presentation and discussion will provide the physical therapist with an in-depth review of the rehabilitation of patients following TKA from the acute to outpatient setting. Additionally, attendees will be guided through a case-based, logical progression using the latest evidence associated with the rehabilitation of patients following TKA.
Upon completion of this course, you will be able to:
- Discuss the available evidence associated with current surgical procedures, prostheses, physical therapy interventions, and methods of pain control following TKA
- Recognize the impact that varying procedures, prostheses, pain control methods, and rehabilitation strategies can have on rehabilitation following TKA
- Apply concepts learned regarding TKA rehabilitation to their own personal setting in an effort to maximize patient outcomes in all settings
- Apply the process of evidence-based rehabilitation-including performing a literature search and using strategies for locating relevant materials-and interpret and apply the available evidence for the patient following TKA as it relates to their practice setting
- Apply clinically useful and scientifically practical methods to contribute to the evidence in the rehabilitation of any type of patient
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| Track II |
Treating the Knee: An Evidence-based Approach |
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Speaker: Chad Taylor, PT, CPT, SCS, ATC, CSCS - biography
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This course will provide the clinician with evidence-based practice guidelines on common knee pathologies seen in outpatient physical therapy. A review of the diagnostic utility of history and examination procedures for the knee will be discussed.
This course will include discussion on current evidence and clinical rationale for rehabilitation strategies and treatment progressions for the following: medial collateral and lateral collateral ligament injuries, anterior cruciate and posterior cruciate ligament injuries/reconstructions, meniscal injuries and treatment methods for both meniscectomies and meniscus repairs, and articular cartilage injuries. Current evidence on treatment of patellofemoral pain will also be discussed
Upon completion of this course, you will be able to:
- Review a thorough evidence-based examination of the knee with an emphasis on special tests
- Use clinical decision-making processes to establish a differential diagnosis synthesized from data obtained by the examination
- Learn current evidence to treat patellofemoral pain
- Develop evidence-based rehabilitation programs for specific ligamentous pathologies of the knee
- Understand the theories for increased risks and prevention of ACL injuries in female athletes
- Design and provide appropriate rehabilitation programs for different knee pathologies (non-ligamentous) based on evidence
- Develop a greater understanding of osteoarthritis of the knee, including progression of the disease
- Integrate functional testing and treatment progression into the rehabilitation process for knee injuries
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| Track III |
Activity-based Therapies in Pediatric Settings |
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Speaker: Karen E. Good, PT, OCS - biography
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The basis of neurological development and regeneration is patterned neural activity. Based on animal studies and clinical evidence, we know that optimizing activity using activity-based therapies (ABT) may help optimize neurologic function/organization and gains in independence.
ABT includes new and traditional physical therapy interventions in an intense- care delivery model. This course reviews ABT theory, evidence, and principles in conjunction with pediatric physical therapy examination, assessment, and prescription of ABT. The participant will learn about implementation of functional electrical stimulation ergometry, neuromuscular electrical stimulation (NMES) to augment patterned and nonpatterned activities, dynamic standers and body-weight-supported gait therapy. The clinical evidence supporting such interventions will be presented.
Participants will gain basic knowledge and practical skills related to NMES and gain insight on how to apply common technology and equipment in activity-based therapy programs in the clinical and home settings of pediatric patients. Participants will learn how to administer and interpret examination tools to document evidence of patient progress.
Upon completion of this course, you will be able to:
- Define activity-based therapy (ABT)
- List examples of ABT and how each might be prescribed
- Identify benefits of ABT
- Describe therapeutic parameters for the application of neuromuscular electrical stimulation (NMES) in pediatrics
- Identify standard measures of function that can be used in the clinic setting to document patient progress
- Describe how ABT programs can be executed in various pediatric settings, including clinic, school, home, and community
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Saturday, October 16 & Sunday, October 17
| Track IV |
Outpatient Therapy CPT/ICD9 Coding, Billing, and Documentation for Rehabilitation Reimbursement |
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Speaker: Rick Gawenda, PT - biography
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This course covers the correct use of CPT codes, as well as G & L Health Care Financing Administration Common Procedure Coding System (HCPCS) Level II codes.
Modifiers used by physical, occupational, and speech therapists will be discussed with an emphasis on Modifier-59 due to National Correct Coding Initiative (NCCI) edits.
This course also covers ICD-9-CM coding guidelines and provides participants with the most widely utilized ICD-9 codes in outpatient therapy.
Billing scenarios will be discussed and reviewed to ensure that physical therapists are accurately charging patients for their services. This course will examine the most common reasons claims are denied and thoroughly review Medicare Part B and other third-party payer documentation guidelines for initial evaluations, re-evaluations, progress reports, daily notes, certifications/re-certifications, plan of care, and physician orders required for outpatient therapy reimbursement.
Reimbursement guidelines and regulation resources and references will be provided.
Upon completion of this course, you will be able to:
- Define service-based versus timed-based CPT codes
- Understand and effectively use CPT codes and G & L HCPCS Level II codes
- Define, identify, and understand NCCI edits
- Recognize when it is appropriate to use Modifier-59 and how to document to support the use of Modifier-59
- Apply (and comprehend) ICD-9-CM coding guidelines to outpatient therapy services
- Understand how various insurance payers utilize ICD-9 codes in determining medical necessity
- Charge correctly for the services you provide
- Understand Medicare's "8-minute rule"
- Identify reasonable and necessary criteria for skilled therapy services
- Describe and implement the necessary components of documentation to support skilled therapy services for reimbursement
- Develop and write short- and long-term function-based goals based on the patient's functional deficits
- Identify and understand plan of care and certification/re-certification requirements for Medicare Part B therapy services
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| Track V |
Evidence-based Practice in Outpatient Orthopedics*
*Satisfies continuing education requirements for direct access renewal certification |
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Speaker: Terry L. Grindstaff, PT, PhD ATC, SCS, CSCS,*D - biography
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In order to prepare the clinician for assuming the responsibility of direct access in orthopedics, it is important to develop clinical-reasoning skills in orthopedics. Efficient clinical-reasoning skills can help the clinician in developing a focused plan of care while recognizing the potential of red and yellow flags that may warrant consultation with another medical professional.
This course will review how to properly screen for medical problems that may present as musculoskeletal symptoms as well as the use of case studies to help participants recognize specific clinical reasoning errors.
Upon completion of this course, you will be able to:
- Understand the necessity for medical screening based on a clinical subjective examination and the necessity for outside referral
- Define radiology clinical predictor rules in order to identify potential physician referral in case study analysis
- Describe the clinical-reasoning process to help develop clinical pattern recognition
- Discuss faulty clinical-reasoning strategies
- Utilize clinical-reasoning forms
- Develop a physical therapy diagnosis using clusters of tests
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| Track VI |
Impact of Vision on Function |
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Speakers: Phebe Burgess, MS, OTR/L, SCLV - biography
Dannette Fortney, OTR/L - biography
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Vision impairments are common and increase with age. Vision is the primary sense by which the central nervous system (CNS) receives information about the surrounding environment in order to make decisions.
With vision loss and/or impairment due to neurological injury, disease, or the aging process-the CNS may receive misinformation resulting in decreased functional status and safety.
This course will cover the following: anatomy of the eye, visual processing systems, different types of vision loss due to neurological injury, major eye diseases due to aging, signs and symptoms of vision loss, impact of types of vision loss on functional mobility, treatment strategies, documentation, and appropriate referrals to other members of the rehabilitation team.
Lab sessions will provide practical application of the treatment strategies and the opportunity to experience types of vision loss during functional mobility.
Upon completion of this course, you will be able to:
- Define the structures of the eye and the visual pathways
- Describe the impact of visual impairments on function and mobility
- Understand and demonstrate effective treatment strategies to increase outcomes with adults with visual impairments
- Define rehabilitation team member roles in the continuum of care for vision loss/impairment
- Use vision-related language to facilitate communication with other team members
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