Wiki Osteopathic Manipulative Treatment

[mfredericks73]

I'm wondering if anyone has input regarding OMT.... I have the code set (98925-98929), and I know that a separate E/M can be billed using a 25 modifier. Does anyone have any insight on what, in this situation, would constitute a separate E/M? For example, if the patient comes in and sees the D.O., discusses their issues, and then decide to get an adjustment, I'd think that would warrant a separate E/M. Especially if guidelines state it doesn't have to be for a different dx.

I guess what I'm looking for is any input from anyone who has billed for OMT. Do payers seem to pay for a separate E/M. I'd hate to over-utilize the infamous 25 modifier! The reimbursement for it seems very low, and our D.O (who is fairly new to our practice) feels that this is generally a great source for income. I don't see that, unless I'm billing incorrectly....

Thanks in advance for any advice or tips!

 

[lgardner]

We have one provider in our practice who does OMT. if the patient has come in specifically for the OMT, that is all you can bill for (it was assessed at a previous visit and ordered for a later date).

but...for example, if the patient comes in for a follow-up visit (3 months/6 months, etc. as appropriate) of his/her chronic conditions, there would be an office visit for the chronic conditions assessed as well as the OMT charges.

I hope this helps.


oh...and make sure you use the correct ICD-9 codes for these: 739.0 - 739.9.