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Qigong and the Internal Branch of the Kidney Channel – Brain Lau

One of the things we were doing is evisceration and kind of exploring those internal branches of the channel. So this is gonna be a very anatomical perspective of that internal branch of the kidney channel. We’ll go over the anatomy.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hello, thanks for joining and thanks to the American Acupuncture Council for having me again. My name’s Brian Lau and I teach with the Sports Medicine Acupuncture Certification Program. I also have a YouTube channel, Jingjin Movement Training, where I go over a lot of channel oriented approaches to movement, especially for the Jing J or channel Send You Perspective.

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So check out my YouTube channel if you get a chance. You’ll see some very similar ideas that I’m gonna be presenting today. So what we’re gonna be looking at today is we’re gonna dive into the internal branch, or at least a portion of the internal branch of the kidney channel. In sports medicine, acupuncture.

We have some three day cadaver dissection classes, and I just finished one. I. One of the things we were doing is evisceration and kind of exploring those internal branches of the channel. So this is gonna be a very anatomical perspective of that internal branch of the kidney channel. We’ll go over the anatomy.

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We’re gonna look at some netter slides. We’re not gonna look at cadaver images, but they’re drawn from, or they’re illustrated from cadaver dissection. Very good illustration, so we should get a somewhat of a clear idea. What those internal branches look like. There’s really no substitute to doing it in person though, but this will be pretty good.

We’ll get a little bit of a window into that internal branch of the kidney channel and then we’re gonna look at a very simple movement exercise that will kinda stretch, move some of those fossil planes engage that internal branch of the kidney channel. This is something you can do for your own cultivation and development.

It’s also a very easy exercise to give to patients. So I’ll give some thoughts on prescribing it to patients. So a lot to look at, but it’ll be a fairly easy and straightforward exercise that we can we can extrapolate from that to be able to put movement into that portion of the channel to really be specific in our thought process for the movement through that plane.

So let’s start with looking at the channels. We’ll go to the presentation. And start right away from one that you’re very common and familiar with is this Deadman image from a manual of acupuncture. We know the kidney channel, so you know, the kidney channel coming up, the medial portion posterior or medial portion of the thigh up into the abdomen.

I would say at the level of the transverse abdominis when you’re needling, that, that would be deep to the rectus abdominis and getting the deepest abdominal layer. Then it goes up into the chest and terminates, but. We’re gonna look at this internal branch, especially in the abdomen area. So let’s zoom into this area that goes from the urinary bladder and to the kidneys.

Many people think this follows the ureters that makes sense, but we’re gonna be looking at a whole fascial plane. First off, let me say from this Deadman illustration that from an illustrative standpoint, he draws or not whoever the illustrator is, they draw this much bigger. The kidneys are very large and it looks like this.

Whole internal branch is very anterior, but that’s not particularly it’s useful for the illustration to see the structures, but it’s not very informative of where this actually lives. It would be just posterior to the midline. So if you think about this internal core, this portion of the internal branch is gonna be on the back portion of the core.

And by core I don’t mean core musculature, I’m talking about the central. The the peritoneal cavity, this is in the back. This is retroperitoneal, so it’s closer to the front of the spine, closer to the back, but it’s pretty center back center. So keep that in mind from this illustration. When you come back and use this as a guide, understand that this is not forward as we’re seeing in the illustration.

So let’s look at some netter images and get a little clarity. So first thing, this is the anterior, the ventral portion of the peritoneal cavity. This isn’t the target we’re looking for today. I just wanna walk you in. This would be pretty much the approach we do when we do eviscera evisceration, where we’re taking the ventral cavity.

We’re taking the contents of the peritoneal cavity out of the body, putting them on a table to study. They’re still connected through their peritoneal connections. They’re still all, it’s all one piece. It’s still organized. You just have to put it on a table and you can study it out of the table instead of trying to look in the ventral cavity.

But when we first start, everything’s intact. So we’ve, reflected back the abdominal muscles. We’ve cut open the peritoneum. This would be the first thing and what is the stomach. You might see a little portion of the liver, but it’s a little more buried under the ribcage, the stomach, and the greater omentum hanging off of the stomach.

It’s not the subject of this of this presentation, but I can note that this, in my opinion is what’s being described by the internal branch of the lung channel because this greater momentum hangs off the stomach much like it’s described as connecting with the stomach. It hangs off the stomach if you lift the greater momentum up, which you can do very easily unless there’s been a lot of peritonitis and scar tissue.

You’ll see that the transverse colon is attached intimately right to the back surface of that greater momentum. And when you look back at the lung channel, it comes off the stomach and links with a large intestine. I think they’re not describing a channel per se, but a plane they’re describing anatomy with this particular internal branch.

We could go more into that another day, but just to highlight the start of what we’re looking at, because once we have that ventral cavity open. We’re gonna start to come in and gently cut away the abdominal contents from the parietal peritoneum from the peritoneal wall. So that’s gonna be our first access.

And over time it’s gonna maybe look something like this. I’ll tell you when we do evisceration, we’re cutting the intestines out also. But we’re gonna come around the intestines and go behind them to the posterior abdominal wall and eventually. You’re gonna see the strong connection of the small intestines to the root of the mesentery that goes basically from the jejunum all the way to the ileum.

So I put this slide in here just to highlight how stronger bound the abdominal contents are to the back of the abdominal wall compared to the front of the abdominal wall. But it also gives us a window in how we would do the evisceration would be coming around the intestines. Maybe this image doesn’t quite show that as well as this image.

This image is showing a cross section so I can see where I might bring that scalpel around the intestines and cut it away from the abdominal wall. I’m gonna follow in front of the kidneys and in front of the perren fat, which is generally much thicker than what in this in this image.

I’m gonna come around the inferior vena cava. Generally, when we do evisceration, we go behind the pancreas. The pancreas, at least a majority of it is retroperitoneal. So you could go in front of the pancreas. We usually go behind the pancreas, take the spleen out, and take the whole abdominal contents out.

So you know, you have one person lifting up. Pulling everything to the right while there’s gentle cutting, maybe move, pull to the left. Gentle cutting. Eventually we bring the whole abdominal contents up, bring the liver away from the diaphragm, clamp the bowels, cut those so we can eventually lift everything and remove the abdominal contents.

And once that happens, this is what something like this. This is a pretty good illustration that doesn’t quite. Look like it would be in, in a a real body. It’s simplified a little bit to make it a little bit easier for, for study for med students and such. But we’ll see that the intestines were removed.

Some things were kept in this case, the pancreas was kept in this netter image. Like I said, I usually go behind the pancreas and bring that out. The kidneys are left in though there’s a lot of perren fat around them. You don’t actually see the kidneys until you remove that fat. The adrenal glands are left in.

A lot of the vasculature is left in so we can study. In dissection, we can study this posterior retroperitoneal space, which is basically what we’re looking at. Especially if the peritoneum was cut off in this illustration, it’s left on. So imagine this film of the peritoneum off, the pancreas out.

That’s what we really end up with, is that retroperitoneal space. And this, in my opinion, is that internal branch of the kidney channel. It could follow the ureters. There’s the ureter. To the kidney from the urinary bladder. So urinary bladder to kidney. So the ureters are in there, but I don’t think of it as necessarily like a line or a space.

I think of it as a plane. I think they’re talking about this retroperitoneal space. And when you’re doing this dissection, it’s amazing how loosely held all of this is. You’re using a scalpel, but sometimes you can just tease it apart with your hands. You have gloved hands of course, but you can tease it apart with the hands and break up.

Some of those little cross links that are connecting the peritoneum to the retroperitoneal space. It’s very loosely held. Now. It’s a large space, so collectively there’s some integrity there, but individual spots of that are pretty loosely held, or at least we want ’em to be fairly loosely held. We want a little bit of movement in that plane.

And this is what I wanna explore with the exercises I’m gonna show is not to think of the movement exclusively as musculoskeletal movement. Yes, the muscles are gonna be active. Yes, the spine’s gonna be moving. But can we sense, can we bring our attention and our awareness to that space that’s in front of the spine and let that sort of elongate and come back up and move.

Can there be some movement there to increase circulation in this internal branch of the kidney channel? So what is in this retroperitoneal space? We have the kidneys. That’s gonna be a big part. The SOAs, you can see a little shadow of the SOAs. Right in here. It’s covered by a lot of the fascia in this retroperitoneal space.

So to view the SOAs, you’d have to remove that fascia, but you can see the outline of it there. The kidneys are intimately tied to the SOAs. So the SOAs would be a big part of it. The ureters going down to the bladder. A lot of the blood vessels. So if we can get movement in this plane what’s gonna happen with the aorta and the inferior vena cavas, those can create a little bit of a stretching and elongation to help for their suppleness because that’s very important that they have a certain amount of suppleness in those vascular structures.

There’s lymph nodes, pancreas is in there, but I’m not sure if that’s relevant for the internal kidney. Channel as much as it is, maybe other aspects. But the pancreas would be in that retroperitoneal space. A lot of nerves coming through there. The perren fat that covers the kidneys, but there’s a lot of other fat back here that has a lot of implications for health.

It’s a very metabolic tissue. So there’s some hormone production from that. I don’t know if movement would help that, but I think that just getting circulation and free movement in that area can’t hurt. I think it has a lot of implications for health, not in an area that’s been explored much in terms of how we understand movement, but I think there could be a lot of implications for improved health, and maybe that’s one of the mechanisms of Qigong and those types of practices is to introduce movement into these internal cavities of the body.

And this one, the kidney channel in particular. All right, so just some, quick sample of some distortion of those. Internal branch of the kidney channels. I could have picked a whole lot of other types of images. But overweight is people who are obese a big portion because that abdominal wall is less tightly held in the front than it is in the back.

So oftentimes that extra weight pulls everything forward. And you can picture how compressed that internal branch of the kidney channel that retroperitoneal space was. How. Close that area is, and how little movement is gonna occur in that retroperitoneal space. Not somebody who’s heavy, but this is not an uncommon posture.

It’s a kidney deficient posture where the pelvis moves forward. We look at this in sports medicine, acupuncture. See a lot of correlations with various types of kidney deficiency, kidney in deficiency. Commonly with this, you see this with older people. This person’s not particularly older, but you see it a lot with elderly too, where the body starts collapsing, where the pelvis shifts anterior and the rib cage collapses down onto the pelvis.

And again, you can imagine that region of that retroperitoneal space. Just posterior to the midline, how compressed that area is, how compressed that area is, and how potentially little movement there is. So we wanna introduce movement, build core strength for this person, which is also involved with the kidney network, but also to start to introduce movement into that retroperitoneal space.

So that’s the last slide. Why don’t we look at the movement. It’s very much a squatting exercise. It’s a Qigong exercise, a type of spinal wave. Very simply, it’s a squat, but I’m focusing on getting an expansion and compression throughout the spine, particularly in the space we’re talking about.

You’ll still be an arm motion, it could be interpreted as a macrocosmic orbit. You know that circulation up and down the spine is the microcosmic orbit. That’ll be inherent in this movement, but then that expresses out into the arms. So you’ll see that there’s an arm component. I wanna start though, on parallel bars and just show this dropping.

You can see it a little bit better when I’m off the ground. You can see the pelvis in that area drop a little bit more than you’ll see in the squatting exercise. That’s not the exercise I’m showing. That’s just for demonstration. So we’ll show a static hold on parallel bars so I can let the pelvis drop and you can visualize that area elongating and softly, gently stretching a little bit.

Then I’ll show it in the squat activity. So let’s move to that position and we’ll look at the exercise today and keep in mind that that kidney channel internal branch. So I wanna start off with an exercise that’ll let you see what I was talking about in the slides with the anatomy.

This isn’t the exercise I wanna show, but it’s a little bit more visible. The next exercise is a little bit more subtle. So this is gonna show just that ability for the lower pelvis to drop and that internal branch of the kidney channel just elongate and stretch and have a little bit of movement and just coming up.

Into a hold on the parallel bars. I wanna initially pull the pelvis up, so I’m engaging my core to pull them, pull the pelvis towards the shoulders, and then let everything relax. So just letting gravity take the pelvis down. So it’s that initial drop sinking of the pelvis. Elongation of the pelvis and the spine, especially the lumbar spine, but that internal branch of the kidney channel will stretch.

So one more time just to see that I’m gonna do this while I’m sitting in just a moment. I just wanna let gravity take the pelvis down so I can get that stretch on the internal branch of the kidney channel. All right. I’m gonna move these.

Move that out the way. Do you want me to move it all the way outta the way, Alan? I guess it’s fine. Fine there. As long as it’s a little more.

So let’s look at the full exercise. So maybe I’ll start with a little bit of a spinal wave motion to warm the spine up. I’ll show this from the side in a moment. I’m just getting things moving. This will start to engage that internal branch of the kidney channel, but a little bit more of the musculature of the front and back is engaged.

I’m just warming up. So just a little bit of spinal wave activity. Let me show that from the side. So if you’re working on these exercises and following along with this, I just wanna initiate that from the pelvis tuck. The pelvis under chest comes down, so rectus abdominis is engaged back, muscles are engaged, front muscles are engaged.

I’m creating a circulation up and down the spine.

Exhale, if I wanna bring my breathing into it. Inhale, exhale, and inhale. I could do other variations of that to get the chest involved, but I’m gonna go into the main exercise now, so I’ll show it first from the side. I wanna get about a pelvic width stance outside of my pelvis could fit on the inside of my feet.

And elongate the spine, chest relaxes, and here’s that part. Whereas on the parallel bars, I want to drop the pelvis down. A little less visible, but it has a feeling of that elongation that you got on the parallel bars. So chest softens, pelvis sinks. Drop the pelvis down. Gauge that internal branch of the kidney channel by letting it just relax and stretch.

Sink. Let it go. I’ll do a few more from the side, and then we’ll look at it from the front.

All right, so chest softens, everything comes slightly in. I have a very slight hollow shape to the spine. Then the next part is I wanna let the pelvis sink. Let the pelvis sink. Let the pelvis sink. Everything’s getting longer inside. Eventually the whole body’s gonna start coming down, but there’s a moment where my pelvis is moving away from my head as I push up, everything’s coming together as I fully stand up, everything’s spreading apart.

Chest is coming higher than the pelvis. Chest sinks down towards the pelvis. Pelvis sits away. Pelvis comes up, chest expands away, chest softens down, pelvis sits away. So I return length to the body. There’s like a compression, a lengthening. I don’t wanna go down all compressed. I don’t wanna lean forward.

I wanna let everything drop, stretch, elongate, relax, soften inside, and just let it go. Okay, so a couple times from the front. So again, the setup is hips can fit between my two feet. So about the inside of my feet are about as wide as my hips. I’m going to open the chest, press up, relax the chest, sit down,

press up, get taller, soften the chest, sit the pelvis away.

Sink down, push up.

And up.

All right, that shows the main exercise, very subtle, quiet exercise. You can show it for patients quite easily. Easy to work with, easy to work with for yourself. But a couple highlights is that you can watch out for is sometimes people don’t have enough strength on the adductors, or excuse me, the abductors, so when they go down, the knees collapse in.

So that might be something to work with. Of course flexibility in the spine. You don’t want ’em to be like you saw from the side, very rigid or sticking their behind out. A lot of that can be strength and flexibility. So I’m gonna take just a quick step forward and note that I might use something to hold onto.

Especially if I’m giving this to patients and they’re new, I have a TRX in my room, so TRX might even be better if there’s a slight angle where they’re holding onto. But even just kitchen sink, parallel bars, a door, something like that, just so they can go down in a controlled manner, let the pelvis sink down and just having something to hold onto can make it a little easier so they can concentrate on not letting the knees pull in.

They keep the shape open, they can. Work on just letting everything soften and just having that extra little support can be very helpful for ’em pushing up. The other thing is they don’t have to go super low, right? If it starts getting distorted, going farther than that, maybe that’s where they stop for now, push up, et cetera, so they build the leg strength, build the flexibility.

Build the relaxation to let the spine go and holding on is a perfectly acceptable way to do it.

So simple exercise, but it offers a ton for patients and even just for your own self practice. All right, so I hope you found that informative. It’s one exercise. I particularly like that exercise and I use it a lot in my own practice, and I do show variations of that to patients. But I think the bigger thing is to start thinking about therapeutic functional type movement patterns and considering that visceral component.

How does that move the inside? How does that move and engage these internal branches of our channel network? It gives you a different perspective on movement instead of just thinking about the muscles that are involved. And I think there’s a ton of implications for health and development and wellness from that.

So play with the ideas. You can use this exercise for this particular internal branch, but it’s not tied to one exercise. It’s a. It’s a thought process that, a change in paradigm, a paradigm shift for movement. So give it a thought, put it into your own practice and see see how it goes.

So thanks again to the American Acupuncture Council. I always appreciate having the opportunity to come on and present. Hope you found this informative. Again, if you wanted some more information, you could look at my YouTube channel, Jingjin Movement Training. I cover a lot of these types of exercises, and again, from a channel perspective but there will be other times we’ll be here with the American Acupuncture Council.

We’ll look at some other ideas with it at that time. So thanks again.

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The Difference Between 97110 and 97530 – Sam Collins

The one I want to give an example to is, one that’s come up quite a bit recently is what is the difference between 9 7 1 1 0 and 9 7 5 3 0.

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Greetings, friends and colleagues. This is Sam Collins, your coding and billing expert for acupuncture. The Profession, acupuncture network of course, and the American Acupuncture Council here to always make sure you have the best and latest information. And one of the things I run into all the time in teaching seminars, but also acting as an expert, is trying to understand what are the differences between certain types of CPT codes.

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The one I want to give an example to is, one that’s come up quite a bit recently is what is the difference between 9 7 1 1 0? 9 7 5 3 0. So let’s go to the slides. Let’s talk about it. What are these two codes? 9, 7 1, 1 0 is exercise, therapeutic exercise 9 7 5 3 0 is therapeutic activities. What is the difference?

How do we understand that? I wanna make sure acupuncturists have a clear understanding, ’cause that certainly can be within scope. Let’s first get into, we have to always make sure we understand the codes well, to choose the right service. Based on the right code, based on the services we’re providing.

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So it says here per CPT that select the CPT code of the procedure or service that accurately identifies the procedure or service performed. Do not select a CPT code that merely approximated. So you can’t say it’s like it. Like I had someone that found out that hot packs aren’t payable by almost all insurances and haven’t been for quite some time.

So he said I’m going to bill hot packs. Infrared heat with the idea being, theoretically any warm body. Emits an infrared portion of the heat spectrum to some degree. That’s not really the intent. Certainly infrared heat is a little bit beyond just a hot pack. So again, we want to be careful of trying to twist things.

If it doesn’t fit exactly, make sure you’re using an unlisted code, which pretty much means it’s not gonna be paid, but use the code that best identifies it. Here we have to remember as an acupuncturist. Can you do more than just deliver acupuncture? Of course, your scope of practice often can be very broad, and I will say certainly look at your state.

If I teach in your state, certainly get a hold of me. We can work on that. Understanding what type of services you can do beyond obviously evaluations, but you’ll often see in your scope it’ll say adjunctive services. The adjunctive services often are very broad. It includes a lot of physical medicine services that might include heat, massage, exercise, and so on.

So do verify your scope. But generally all physical medicine services are generally within scope done with the idea of a traditional medicine slant to it. So let’s take a look specifically at two codes here today. 9 7 1 1 0. You’ll notice as a therapeutic procedure, one or more areas 15 minutes, which means it’s face-to-face time, just like acupuncture and therapeutic exercise Says therapeutic exercise is to develop strength and endurance, range of motion and flexibility.

Okay, so the standard things you do, if you told someone to go out and exercise, what would they think they’re going to improve? I think that’s what we’re seeing with that. Pretty generic, Qigong, if you will, but what about a therapeutic activity? Now you’ll notice the one in the bottom, 9, 7, 5, 3 0 says therapeutic activities, direct one-on-one patient contact by the provider.

So that’s still the same, have to be there. But then it says, use of dynamic activities to improve functional performance. Therein is probably the biggest difference. Exercises generically just to increase strength, flexibility. Therapeutic activities are exercises, but specifically done to create a certain or specific functional outcome.

So 9 7 1 1 0 are movements and physical activities designed to restore function and flexibility. Okay, it. It includes instruction and feedback. So realize when you’re doing this face-to-face, it doesn’t necessarily mean that you’re staring at the person touching them, but you’re supervising, making sure they’re doing it properly, safely, maybe assisting them.

But it does require you be one-on-one. You cannot do exercise with two people at the same time. They can be doing that, but it wouldn’t be this code 9 7 1 1 0 is one-on-one. When you’re with a patient, maybe they’re doing yoga poses, maybe they’re doing tai chi or any type of exercise for strength, flexibility, endurance.

In fact, if you think of exercise generically, it fits almost everything we think of when you go to the gym. Bikes and treadmills, gym equipment, weight equipment, isometric, isotonic, isokinetic, but includes passive things like stretching. Might be assisting the person just in stretching.

So certainly any of that fits. Just make sure you’re documenting what exercises I. How much time you’re spending in doing it. So simple things like knee to chest stretching, maybe a low back rotational stretch, anything like that certainly fits. Notice. These are ones that you might be directing the patient to do.

Now this might be one we probably give them to do it more at home later, but certainly when they’re doing this in the office with you, that is absolutely a billable service. Now, what is the difference of 9, 7, 5, 3 0 exercise? I think we can see pretty easy and straightforward, however. 9 7 5 3 0 says one-on-one patient to improve functional performance.

So this involves functional activities, bending, reaching overhead activities with very specific outcomes to increase a function. So let’s say by example, you had a person that is a grocery store clerk and they hurt their wrist. When you strengthen that wrist, is it just to strengthen or is it to strengthen it to have specific tasks to allow them to do their job at the grocery store?

The same exercise that might be for someone just to strengthen the wrist generically, may be the same for the grocery clerk, but because you’re specifically liking to do a specific task, whether it’s going to be reaching in and out of a bag and lifting items, makes it more an activity. So always think of the outcome, realize all exercises.

Could be therapeutic activities. All therapeutic activities potentially could fit under exercise, depends on the why. So here’s the best way to think of it in choosing it. Look at all these pictures on the right. Could you say to me, oh, Sam, that one is exercise. This one’s a therapeutic activity. We cannot tell from the picture because choosing the code depends on the intent of the task.

So follow me here. If you’re doing abdominal curls, they certainly can be used to strengthen weak abdominal muscles and build as exercise. They come in their stomach muscles are weak. We’re doing abdominal curl strength in the stomach. Great. However, what if the patient is performing the abdominal corals specifically because their abdomen is so weak, they don’t have an ability to rise up from a lying down position or get out of a chair because the stomach is too weak.

Now all of a sudden. Those exercises, yes, they’re strengthening the stomach, but it’s there because we need an outcome that it’s there to perform. Getting in and out of a chair or lying down, that’s the activity and that’s why this is worth more. To give an example, 9 7 1 1 0 has a RVU of about 0.89.

Compared to 9 7 1 9 7 5 3 0, which is 1.15. So you’re gonna see that’s almost a 30% difference. It’s worth quite a bit more because this is designed specifically for that patient, something for them to do, not just generic for everyone. If everyone does the same thing, I’m gonna say, ah, that’s probably exercise.

But best practices determine what is the outcome expected from the task. Is it simply just to strengthen? Or is it a functional performance? When it becomes a functional performance, realize the higher value is you’re designing something specific for this patient’s needs. And I think when you think of most exercises, I think that’s what we do.

Now, obviously if everyone gets the same sheet, the same things, okay? But assuming we’re gonna have some nuanced differences, I think it’s far better to look to make sure we’re choosing the right one, because certainly one is worth quite a bit more. And I want you to be paid what you’re worth. Don’t be afraid to code what you’re doing so long as you document it properly, I will always support you.

That’s what we do at the American Acupuncture Council and the network. To differentiate things. Make sure you have the right resources. That’s what our network does. You’ve been to our seminars, but have you ever thought of, Hey, let’s have an expert on task. I could be part of that. Join our network. We’re with you one-on-one, and you get all our seminars free.

Till next time, my friends, I wish you the best.

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Acupuncture Liability Insurance: Protection From Property Damage

What is one of the advantages of buying acupuncture liability insurance?

With the growing demand for acupuncture, there is also a great need for acupuncture liability insurance to protect one’s acupuncture practice and reputation.

One important advantage of buying acupuncture liability insurance is protection from property damage, which can also cover the effects of natural disasters.

Acupuncture liability insurance protects against property damage by addressing issues in your fixtures, fittings, equipment, and potential losses due to theft, fire, or flood.

Remember, the American Acupuncture Council (AAC) offers an unparalleled track record in acupuncture risk management.

There is a reason acupuncturists have trusted AAC with their business for 50 years.

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Treating the Face – Healing the Whole- Michelle Gellis

When we’re treating the face, we’re treating the entire person because facial acupuncture impacts not just our appearance, but it affects the function of the face, and it also affects a person’s spirit. So when we think about facial. Cosmetic acupuncture, which is what I’m going to talk about first.

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Hi, my name’s Michelle Gellis. I’d like to thank the American Acupuncture Council for an opportunity to present to you today on treating the face as a whole. And this is part one, so you can go ahead and go to the slides.

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So my presentation today is on a multidimensional approach to facial acupuncture. As I mentioned, my name’s Michelle Gellis. I am currently on the doctoral faculty at Ossan University. I’m a formal faculty member and clinic supervisor at the Maryland University of Integrative Health. And I am a published author and regular contributor to the Journal of Chinese Medicine, and I’m a columnist on acupuncture today, and I’ve been teaching facial inter facial acupuncture classes internationally since 2005.

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This is the cup of my. Book that has recently been published on Treating the Face. It is a hard cover 15 chapter book on all aspects of treating the face. And you can scan that QR code if you wanna check it out. So when people think of facial acupuncture, the first thing that comes to mind is cosmetic acupuncture.

But treating the face is much more than just cosmetic. When we’re treating the face, we’re treating the entire person because facial acupuncture impacts not just our appearance, but it affects the function of the face, and it also affects a person’s spirit. So when we think about facial. Cosmetic acupuncture, which is what I’m going to talk about first.

That works with both the body and the face, bringing blood and cheese circulation up to targeted areas in the face. It stimulates collagen and elast in production, improves the tone of the skin and the of the skin. It enhances circulation and reduces inflammation. So puffiness and increases the natural glow of the face.

So you look rested. You have more color in your cheeks. And additionally, because of the. Nature of the acupuncture points on the face, you are supporting your patients’ overall health, their digestion, their immunity, and their overall circulation. Facial acupuncture can erase five to 15 years off of the face, and it’s great for lifting and treating on a very deep level.

The important thing when you are performing facial acupuncture is to use precision needling techniques, which typically involves training with someone who’s very well experienced, who’s been doing facial acupuncture and teaching facial acupuncture for many years. So how does cosmetic acupuncture work?

Cosmetic acupuncture brings blood flow and oxygen up to the face and it brings nutrients to the skin cells so your skin will look better. It does take about 28 days for collagen to regenerate, and that is increased if someone is older. So you really do have to do a series of treatments. It’s not just a one and done.

And once a person has gone through a series of approximately 12 weekly treatments, then usually they can start to spread their treatments out over time and eventually come once a month or just seasonally for touchups. Cosmetic acupuncture also utilizes motorpoint stimulation, and this can help with the functioning of the muscles in the face, and it will therefore balance.

Overactive muscles. Muscles that are too tight, causing the skin to contract or weak muscles, which can cause the skin to sag. It can help to enhance the jawline, giving a more lifted and supported appearance. And it also helps with the mid-face support. And this all happens through proper engagement of the facial muscles.

So if we just look at the layers of the face, we have the skin, then there’s some superficial fat, and then this mass layer. The superficial muscular AP neurotics, AP neurotic system, which is very unique to the face. We have some retaining ligaments, deeper fat on the lower part of the face, and then we have some deeper fascia and the bones and this mass layer.

Is what enables us to make our expressions because the muscles on the face are connected directly out to the skin. So as we can see, we have bone muscle. And skin. And so what happens is as the muscle contracts, the skin moves, and over time when we’re contracting these muscles, either through smiling or frowning, the skin that’s over the muscle will contract and it will eventually form lines and wrinkles and folds.

So here is someone who doesn’t have a lot of signs of aging, someone who’s a little younger. Then as we get older into our fifties, we can begin to see some signs of aging. And then as someone is progressively older, they’ll start to get forehead lines, bolts and more wrinkles.

In addition to wrinkles from facial expressions, gravity can cause the neck to hang down and jowling, especially around the mouth area and the skin on the cheeks and underneath the neck. The platysma bands start to form the cheeks start to sag.

And different facial expressions related to our emotions will cause different sorts of wrinkles. For example, smiling can cause crow’s feet frowning or being angry can cause these lines in between the eyebrows and cursing the lips a lot. If you were pensive, that’s an expression can cause lip lines.

The forehead is a kind of a zone of anger and frustration. The crow’s feet area, smiling. Sometimes sadness, depending the lips from overuse or estrogen loss can lose their. Plumpness and cause wrinkling the chin, if there’s a lot of fear, the chin can pucker and then jowling and the neck area frequently is a sign of cheat deficiency.

So we have emotions that can cause wrinkles cheap. Blood and body fluid are also related to the skin and how the skin looks. If the chi is deficient, you can get a withered looking appearance. If the chi is stagnant, it can block the flow of blood and fluids. So blood causing discoloration and fluids and cause puffiness, especially under the eye area.

So let’s take the liver, for example. If we’re looking at the liver system, we can see that stagnant liver blood can cause liver spots and liver blood deficiency can cause the skin to be dry. And liver cheese stagnation can sometimes manifest as anger and frustration, and this can show up in between the eyes.

So there’s a lot of different ways with our medicine to treat the emotions. A five element. Treatment. If you’re trained in five element, acupuncture can help to balance the organ systems and the emotions. Additionally, using the entry exit points on the face can be very beneficial for opening the face up, getting a smooth flow of Qi between the face and the body, between the Z and the.

Also allowing for a balancing between the organs, facial motor points can be very beneficial for treating the face, especially expression lines. And there are many muscles on the face and neck, as you can see. Some of them are listed here. This is not. A comprehensive list, but this is these are the muscles that we frequently use motor points for when we’re looking to treat some of the emotional manifestations.

Some of the, of some of the expressions. So here for example, we have the expression of anger. So here we have a relaxed face, and here we have an angry face, and you can see how the muscles get contracted. And by using the motor points or the different muscles, which are the motor points are located. The most electrically acceptable part of the muscle.

So you treat the motor point and it treats the muscle and it allows the muscle to get back into normal functioning. And this can help with not only the manifestation, the external manifestation of the emotion, but it can treat the muscle, it can treat the acupuncture point. Which helps to treat the whole person.

Many motor points on the face are acupuncture points.

This is actually an image from my book. This is from a chapter called The Anatomy of Expression. And it’s a little easier to see here. Side by side, a person making the expression, and then a split view of a relaxed face with the motor points and then the contracted muscles on the right.

Facial Gus Sha can be very beneficial for treating the skin, helping to work with fascial adhesions and tension in the face can help to sculpt the face. It’s very relaxing to the patient. It’s very calming to the spirit. I really love Jade Guha tools. I find that they tonify the skin and they help to nourish the blood.

Facial cupping is also a wonderful technique. These small glass facial cups. That are easy to squeeze, are wonderful for treating the face. And of course, when you’re doing facial cupping or facial gua, you never wanna leave any marks on the face. So if you’re going to do either one of these techniques, protocols, please get properly trained.

And everything that’s happened to us in our life gets etched on our face. Our fla, our face reflects our life story and needling the face helps to release stored trauma and can really transform the she on a very skin level. Related to what we do, but in no way a deep level or a spiritual level treatment microneedling using a device like this, a microneedle pen with microneedle cartridges. This can treat very skin level conditions on the face and on the body chest. Back and other parts of the body as well.

And here’s an example of microneedling. You can see on a very skin level, some wrinkles around the mouth. And then after a few treatments the wrinkles are gone. So if you’re interested in learning more about facial acupuncture. There’s a QR code there for my website, facial acupuncture classes.com, and you can find me on Facebook into Instagram, LinkedIn, and TikTok.

Under my name, Michelle Gellis and I have a Facebook group called Facial Acupuncture. Thank you so much.

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HIPAA Warning – Verifying Employee Eligibility – Perry Barnhill

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Hi everybody. This is Perry Barnhill with the Fearless Acupuncturist. Today we are gonna talk about OIG and an exclusion list and what it means to you and why you need to be aware of it. Wanna give a big thanks to the American Acupuncture Council? Go to slideshow please.

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Okay, here we go. Understanding and using the OIG exclusion list. This is about performing certain exclusion checks. On your staff regarding the Office of Inspector General. Let’s talk about that. This is something that we want to check every single month. Now put it in perspective here for you.

We got Health and Human Services at the top, HHS, you’ve heard of that. And then we have OIG, the Office of Inspector General. Now they’re very closely related to the OCR, which is the Office of Civil Rights, and this is where all the HIPAA stuff comes in. These two are basically sisters to each other, and they’re so important that you need to be aware of.

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That’s why we’re talking about this right now. What is the OIG exclusion list and why do we need to check it? Okay, so here’s what it is. The exclusion list is a list of individuals that the government collects that basically shouldn’t be employed in your office. If you’re accepting any federally funded programs such as Medicare, for example, or even if you’re in some acupuncture networks for P-P-O-H-M-O or insurance networks.

Now, if they’re on this list. Is something we need to be aware because we may not keep them employed. This is something we want to ensure compliance with Medicare, Medicaid, like I said, certain contract requirements by regularly verifying employees. Who do we need to check? Okay, now everybody that we need to check is pretty much anybody in our office that’s involved in any kind of patient care or has any kind of access to protected health information.

So you got your staff that’s involved with your patient care. Any employees handling any kind of billing procedures or protocols, personnel. Anybody who has access to protective health information, I’m not talking about a janitorial service or a cleaning service. Those folks though, if you don’t know already, they need or you need to have them fill out certain forms such as non-disclosure statements and agreements.

Because even janitors that come into our office may accidentally see protected health information. And that’s something just on a side note that you need to be aware of and you should have protected and you should be speaking to them about. The Medicare exclusion list. This is a list of an OIG website that I want you all to go to.

Here it is exclusion dotig.hhs.gov. You need to go here, and this is where you need to start doing some check-in. Go in there and enter your employee’s last name and first name, and if you need to, because some people have similar names or same names, use additional details such as their date of birth. If you have other providers in the office, you need to check on them as well to narrow the results.

So how do we interpret these results if their name actually pops up? The good news is if it doesn’t pop up, they’re good to go. You don’t need to worry about it, but if one of your employees or your personnel’s name pop up, make sure you click to verify and redo, review additional details again to make sure it’s not the same person that you have in your office.

So you can enter date of birth NPI numbers if they’re providers for confirmation. And believe it or not, there’s another exclusion list that I want you to check. Even though I’m talking about this and there seems like it’s overwhelming, at least a little bit. It’s easy. It’s very fast. You literally go to those websites, you check in their names.

It pops up very fast, and their name’s either on there or it’s not on there. I. The other one is the SAM exclusion list. This is the next website you want to go to and just double check and make sure nobody in your office is on this list. sam.gov. Just go there. Check how to search is very similar.

You use the entity verification search function and again, you enter the information of the employee’s name or any personnel that you have in your office to make sure they’re not on that list. Some verification tips. Provide as much identifying information as possible. Again, to make sure maybe you got two people with the same name, confirm the details and make sure that they match.

The last thing I want y’all to check is your state-based exclusion checklist. So we got the government, we got the SAM list and then also double check any kind of exclusion list. And again, just to reiterate this, if you accepting any federally funded programs, you have to make sure that none of your employees or anybody in your office is on this list or even other providers.

’cause if they’re on this list and you hire them and they’re employed and they find out. You can get in some big trouble and the fines are pretty steep. So again, where to check for state specific list? Use your state specific portal. Alrighty, and make sure that they’re not on that list as well. How to search?

Very similar. Locate the sections for OAG provider sanctions and you enter your employee’s name and other identifying details if needed and if possible, reviewing the information. Check details again to ensure that it matches the individual. Again, making sure it’s not the person in your office. Maybe they got a same name, and I know I said that a thousand times, but just double check.

Note any active sanctions or exclusions relative to state Medicaid programs. Here’s some best practices for verification. Always verify with multiple data points for the reasons we’ve just talked about. Cross-reference your results. Check the OIG, the Sam and State Base to confirm accuracy and just as important, make sure you document everything as if it’s not documented, they will say, you never ever did it. So make sure you do that and make sure you do it monthly. The importance of regular exclusion lists, compliance meets Medicare, Medicaid, and also many insurance contracts. You have to make sure they’re on this list. Risk management helps prevent potential fraud and abuse.

’cause if those folks are on this list, it’s likely they have some kind, they’ve been convicted of some kind of criminal action, and there’s something going on that you definitely may not want them in your office. All right? Quality insurance ensures that other qualified personnel have access to sensitive patient care and information.

So you gotta be safe there. You gotta protect that information. So here’s some next steps. Just to recap, use OIG website and Medicare exclusion list checks to make sure they’re not on the list. The SAM exclusion list. And also check your state. Record this in your manual. Make sure you record it in your manual.

’cause again, like I said, if it’s not checked, it’s not done and you need to do it monthly. It doesn’t take long. So just make sure you get in there and you get that done. Additional resources, I’ve went over these, but here’s a screen just to check again, different spots you can check. If you don’t know if you’re HIPAA compliant, the likelihood is that you’re probably not.

Many providers may have a form or two in the office, and they think that means that they’re HIPAA compliant. So this is why we came up with the checklist here. Go over this checklist. Look at the boxes here. If you’re not checking every box, the likelihood is very high. Likelihood is that you’re not HIPAA compliant.

Make sure you do so because the fines associated with any HIPAA noncompliance are very scary. You can scan the QR code as well. If you want to schedule a demo, you can go to fearless provider.com right here as you see, and we can go over a demo with you, show you how the program looks, what exactly it looks like on the inside, how to navigate it, how to have your staff navigate if you choose not to.

If you wanna just get started, you can go to fearless acupuncturist.com. You can get started that way as well. If you want to contact me. If you wanna reach out to me ’cause you have questions or concerns or anything like that, please feel free to do i’m more than happy to jump on the phone and jump on the site, go over a demo with you and answer any questions that you may have.

You can contact me at Dr. perry@betterhipaablueprint.com. Also, you can scan the QR code here as well. If you got questions, reach out to me please. I am more than happy to help any and all of you. In the meantime, everybody, have an amazing day and we will talk to you soon.