Physical Therapy Coding Units

donsqueen

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My physical therapy department believes that they should be able to code 1 unit for each area on which a procedure is performed. This includes procedures coded in 15 minute increments as well as things like paraffin baths and hot/cold packs. I disagree. Where besides the CPT book descriptions can I find documentation to support my position? Also, I have a document that says 15 minute increments are billed in minutes of 8 (ie 8-23 minutes is 1 unit), however, it doesn't say where it came from and I need to provide this documentation to my bosses as well.

Thanks in advance,

Amy
 

kevbshields

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I believe the CMS Claims Processing Manual and Program Integrity Manual both have something to this effect in it.

You may also look to other commentary CMS makes in relation to Phys. Therapy coding, as this should assist you in doing it correctly. (And, yes, I agree with your stance on it.)

From the sounds of it, your time table also came from CMS as well. It is similar, at least, to the one I've seen from CMS.
 
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