Wiki 97110 for combination

AMYDAWN90

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Does anyone have experience with procedure code 97110 and know the guidelines for performing multiple guidelines, in my research, I am unable to find an answer...
Currently, we only bill 97014 and 97012 in our office, however, we do have several doctors who do stretch the patients at times. If there is 8 minutes of stretching being done, along with 10 minutes of stim, are we able to bill 97110 to cover both? Thanks to anyone who has insight into this.
 
A few things going on here.
1. 97014 and 97012 are not 15 minute timed unit codes.
2. 97110 is a 15 minute unit timed code. CPT says at least 8 minutes of direct patient contact is required to report. The medical record must clearly indicate start/stop time and total time of each CPT and all treatments total. Most payers, but not all, follow CMS.
3. See here for CMS 8 minute rule info: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c05.pdf
20.2 - Reporting of Service Units With HCPCS
C. Counting Minutes for Timed Codes in 15 Minute Units
4. You can't combine the service performed for 97014 or 97012 to roll up into 97110. The description and intent of the services are not the same.

Not sure if you or anyone in your group has an APTA membership but there are resources there: https://www.apta.org/your-practice/payment/coding-billing/coding-for-timed-codes
CMS has a chiro section: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56273
CMS has a therapy section: https://www.cms.gov/Medicare/Billing/TherapyServices
(edited for a typo and forgot #4)
 
A few things going on here.
1. 97014 and 97012 are not 15 minute timed unit codes.
2. 97110 is a 15 minute unit timed code. CPT says at least 8 minutes of direct patient contact is required to report. The medical record must clearly indicate start/stop time and total time of each CPT and all treatments total. Most payers, but not all, follow CMS.
3. See here for CMS 8 minute rule info: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c05.pdf
20.2 - Reporting of Service Units With HCPCS
C. Counting Minutes for Timed Codes in 15 Minute Units
4. You can't combine the service performed for 97014 or 97012 to roll up into 97110. The description and intent of the services are not the same.

Not sure if you or anyone in your group has an APTA membership but there are resources there: https://www.apta.org/your-practice/payment/coding-billing/coding-for-timed-codes
CMS has a chiro section: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56273
CMS has a therapy section: https://www.cms.gov/Medicare/Billing/TherapyServices
(edited for a typo and forgot #4)
Thanks for the cited resources, I lost the Medicare Chiro section one and have been meaning to find it. This is very helpful, especially the phrasing "The description and intent of the services are not the same".
Based on the information I have found, 97014 is not a timed element.
 
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