Re: Vol. 29, Issue 8 by Dr. Dwight Whynot I read the response of Dr. Whynot to Dr. Holmes in Volume 29, Issue 11, and it just does not make sense. Could Dr. Whynot send me clarification as I am very interested in the issues of CPT definitions. He states, "If the definitions states "therapist or provider," then your CA can supervise the patient performing the activity. If the definitions states only the "provider," then you (the doctor) must supervise. In CPT, the supervised, not constant attended modalities (97010-97028), obviously do not require the constant attendance of the provider of the service. These are low RVU value codes that do not require significant skill or training, nor do they require one-on-one interface. CPT 97032 - 97036 do require constant attendance by the provider, but these are still low valued codes that do not require significant skill or training. On the other hand, CPT 97110 and up are "Therapeutic Procedures—a manner of effecting change through the application of clinical skill and/or services that attempt to improve function. Physician or therapist required to have direct patient contact." I read Dr Whynot's explanation to be exactly the opposite, indicating that the doctor must attend on the attended modalities (low RVU, low skill) while the unlicensed CA may supervise the high RVU, skill required therapeutic procedures. Again, could he clarify? R. D. Poleete, D.C.
