Minggu, 05 Oktober 2008

Use the ICF Core Set to diagnose lower back pain

Sooner or later physical therapists will be required by Medicare and commercial insurance companies to identify the impairments we treat by using the ICF Core Set.

Might as well start now.

Basically, you do it now when you select an ICD-9 code for your patient when you bill American Medicare.

For instance, 724.04 is lower back and leg pain due to spondylotic changes. While accurate, in many cases, this pathologic diagnosis is also not very informative for PT decision-making.

Like, what body part is stiff?

Are the hips affected?

Should I manipulate the patient's lumbar spine?

Which muscles need strengthening?

While the ICF Core Set is no substitute for clinical training, experience and a sharp mind it is a step in the right direction of getting physical therapists away from thinking about pathology and thinking about function.

Link the patients' activity limitations to their impairments in body structure and function.

Your assessment of the link is your physical therapy diagnosis.