Teleconference Provides Insight on 2011 Therapy Update Coding

The educational teleconference “Part B: 2011 Therapy Updates” hosted by NHIC, Corp. on June 14 is past history but the information it provided remains current and useful. A quick review of the remnants of this teleconference may answer any questions you have about how to accurately report therapy services to Medicare.

The objective of this teleconference was to provide a clear understanding of changes in reimbursement for therapy services in 2011. Topics of discussion included coverage guidelines and documentation, as well as review of proper billing practices in order to eliminate common denials and errors associated with therapy services.

You can still download the program handout and teleconference Q&A from NHIC Corp.’s website.

It’s a good idea to review both documents because some of the Q&As help clarify topics that were discussed during the presentation. For example:

Q2. In regards to Example #2 on the presentation slides, under Reporting Units of Service, should we bill for the 7 remaining minutes, even if it falls under 7 minute timed code?

A2. The total minutes of active treatment counted for all 15 minute timed codes includes all direct treatment time for the timed codes. It does not imply that any minute until the eighth should be excluded from the total count. Total treatment minutes- including minutes spent providing services represented by untimed codes—are also documented.

Q4. On slide 9, how many treatments am I able to obtain for CPT code 97024?

A4. Only 1 unit of CPT code 97024 is covered per date of service. If no objective and or/subjective improvement is noted after 6 treatments, a change in treatment plan (alternative strategies) should be implemented, or documentation should include the therapist’s rationale for continued diathermy. Documentation must clearly support the need for diathermy more than 12 visits.

Q10. On the slide showing CPT codes that are not permitted – If you do an evaluation for 97001 and 97110 can you use a modifier 59 to cover both? Would there be coverage?

A10. No. Please reference to the NCCI tools found on the Centers for Medicare & Medicaid Services (CMS) website (including the “National Correct Coding Initiative Policy Manual for Medicare Services”) help providers avoid coding and billing errors and subsequent payment denials.

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