Let's Help Each Other

Physical therapy is changing rapidly. As a PT with more than thirty years of experience, the changes observed in the last ten years triple those of the first twenty years. The pace of change is not slowing down. The Medigraph Blog will serve as a forum that will enable us to exchange ideas and assist each other. This blog will be used to share billing, documentation, and any other ideas to improve any aspects of our profession. If we share what we have learned, we can develop a resource that enables our collective understanding to advance our careers.

As profit margins grow smaller and expenses grow larger, we need to assist each other to survive and prosper. If we share our experiences we can help each other to grow professionally, administratively, and financially. Our professional lives, our livelihood, and our personal lives are intertwined. Our resources individually are limited. Together we can accomplish more than we can individually. Let's help each other


Tom Kane, PT
MediGraph Software

Senate Passes Two Month Extension
12/23/2011 3:07:00 PM

The House of Representatives and Senate have passed a bill that provides a two month extension on the scheduled 27.4% reduction in payment for Medicare services.   This bill also extends the therapy cap exception through February 2012. The haouse and senate will  reconvene in January and they will begin work on a compromise bill for a longer term extension on these issues.  I encourage everyone to join the PTeam of the APTA who represents pysical therapist interests in these matters. http://www.apta.org/pteam/


Regards and Happy Holidays,

Tom Kane, PT

MediGraph Software

Goal Statements
12/5/2011 11:12:00 PM

The use of pre-established functional measurements and outcome questionnaires satisfy the objective-evidence based criteria that RACs employ to determine medically necessary.  Another important component of writing a RAC audit proof note is to include ADL functional goals. 

 Goal Statement Examples:

  1. Increase patient’s independent stair ambulation to 12 steps, enabling the patient to access the second floor of his home by increasing lower extremity strength and ambulation training.
  2. Increase functional range of motion of the involved shoulder to enable the patient to independently engage a seat belt while driving.
  3.  Increase the patient’s lower extremity strength to enable the patient to transfer from sitting to standing safely to avoid a reoccurrence of falling during this process. 


  1. Measure diagnosis related impairments:  objectively measure  strength (hand held dynamometer),  ROM (bubble inclinometer), sensory deficits (Moberg, Semmes Weinstein). etc. 
  2. Employ peer reviewed diagnosis related outcome questionnaires (Oswestry, Knee Outcome Survey, Shoulder Disability Scale, etc.) and functional tests (Six Minute Walk, TUG,  Box and Block. Etc.) that have pre-established norms against which the patient’s performance will be measured.
  3. Employ specific goal statements that relate to these impairment measurements, questionnaires, and functional measurements as illustrated above under Goal Statement Examples.
As always, please call to discuss this or any other matter.


Tom Kane, PT