Developing a manipulation under anesthesia program at your ASC may provide you with a new revenue source. MUA is a non-invasive pain management technique performed by chiropractors, osteopathic physicians and medical doctors. The procedure involves stretching and deep massage of soft tissues as well as specific joint manipulations, performed while the patient is under anesthesia. MUA is an effective way to tap into the potentially lucrative field of pain management, without increasing costs.
To create an effective and compliant MUA program, there are several steps you must take. Bruce Fischer, DC, CCSP, of Boca Surgical Group describes five of the most critical.
1. Find out if chiropractic physicians are able to obtain privileges at your center. The laws governing non-MDs differ from state to state, so you must determine if chiropractors can obtain staff priviges, Dr. Fischer says. "This is the most important factor in starting an MUA program because chiropractic physicians are usually the main referral sources for the MUA cases," he says.
2. Ascertain facility reimbursement for the billable MUA codes. Many ASCs which have considered starting an MUA program stop their research at this step when they come across CPT code 22505 (MUA of the spine), says Dr. Fischer. "MUA of the spine is mainly a non-covered code for most major insurance carriers, much to the surprise of the ASC administrators," he says. "Although workers' compensation, personal injury protection and Medicare cover 22505, most other major carriers do not. But MUA does not only pertain to the spine."
MUA of the extremities is also commonly performed and billed for, he says. CPT codes 27275 (manipulation of the hip), 27194 (manipulation of the pelvis) and 23700 (manipulation of the shoulder) are often accepted by insurance carriers. A typical reimbursement from an in-network MUA can range between $600-$1,200. Out of network reimbursements can range 3-4 times the in-network rate.
3. Discuss MUA with current physicians and anesthesiologists. As with adding any specialty, you will want to involve your physicians, especially those that perform pain management, and spine surgery. It is also important to discuss the addition of MUA with the in-house anesthesiologists to address any questions or concerns they may have about the procedure. You will also want their help with the next critical step: recruitment.
4. Contact local potential referral sources and gauge interest. Once you have made the decision to add MUA, the next step is to reach out to chiropractors, physiatrists, pain management physicians and orthopedic surgeons in your community and identify those that can perform the technique and have interest in doing so at your ASC, Dr. Fischer says. The best way to do this is to have an open house at your center. This is an effective way to not only gain exposure for your center but it also can help form a network between the potential new physicians and the established ones.
5. Training and certification. "MUA training of the staff and certification of all physicians wanting to perform the procedure is the standard of care and is essential," Dr. Fischer says. Several chiropractic colleges offer post-graduate training courses and co-sponsor other training programs. The course is typically 32 hours and covers the history, procedure protocol, technique, indications, contraindications, clinical justification, coding, billing, risk management, documentation requirements and much more. The courses are usually taught in the center itself, he says.
For more information on how to start an MUA program in your center, contact Dr. Fischer at (561) 347-6682.
To create an effective and compliant MUA program, there are several steps you must take. Bruce Fischer, DC, CCSP, of Boca Surgical Group describes five of the most critical.
1. Find out if chiropractic physicians are able to obtain privileges at your center. The laws governing non-MDs differ from state to state, so you must determine if chiropractors can obtain staff priviges, Dr. Fischer says. "This is the most important factor in starting an MUA program because chiropractic physicians are usually the main referral sources for the MUA cases," he says.
2. Ascertain facility reimbursement for the billable MUA codes. Many ASCs which have considered starting an MUA program stop their research at this step when they come across CPT code 22505 (MUA of the spine), says Dr. Fischer. "MUA of the spine is mainly a non-covered code for most major insurance carriers, much to the surprise of the ASC administrators," he says. "Although workers' compensation, personal injury protection and Medicare cover 22505, most other major carriers do not. But MUA does not only pertain to the spine."
MUA of the extremities is also commonly performed and billed for, he says. CPT codes 27275 (manipulation of the hip), 27194 (manipulation of the pelvis) and 23700 (manipulation of the shoulder) are often accepted by insurance carriers. A typical reimbursement from an in-network MUA can range between $600-$1,200. Out of network reimbursements can range 3-4 times the in-network rate.
3. Discuss MUA with current physicians and anesthesiologists. As with adding any specialty, you will want to involve your physicians, especially those that perform pain management, and spine surgery. It is also important to discuss the addition of MUA with the in-house anesthesiologists to address any questions or concerns they may have about the procedure. You will also want their help with the next critical step: recruitment.
4. Contact local potential referral sources and gauge interest. Once you have made the decision to add MUA, the next step is to reach out to chiropractors, physiatrists, pain management physicians and orthopedic surgeons in your community and identify those that can perform the technique and have interest in doing so at your ASC, Dr. Fischer says. The best way to do this is to have an open house at your center. This is an effective way to not only gain exposure for your center but it also can help form a network between the potential new physicians and the established ones.
5. Training and certification. "MUA training of the staff and certification of all physicians wanting to perform the procedure is the standard of care and is essential," Dr. Fischer says. Several chiropractic colleges offer post-graduate training courses and co-sponsor other training programs. The course is typically 32 hours and covers the history, procedure protocol, technique, indications, contraindications, clinical justification, coding, billing, risk management, documentation requirements and much more. The courses are usually taught in the center itself, he says.
For more information on how to start an MUA program in your center, contact Dr. Fischer at (561) 347-6682.