Wiki Physical Therapy CPT 97010 Hot/Cold Packs

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msingh23

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Does anyone knows if CPT 97010 are payable by any insurance when bill with CPT 97140 or CPT 97110. I have a nonpaynemt by EBCBS stating as incidental.
Any input appreciated.
 
97010 will be denied

Per AETNA, CPT 97010 is will be denied to all other procedure codes and physical therapy codes as it is incidental to overall services provided. It is not eligible for separate payment. I think all insurance companies consider 97010 in same way and will be denied.

Dr. Suraj G. R. BHMS, CPC
 
Thanks you for your response, appreciated.
Do I completly omit from billing ? or bill each carrier then once denied I then omit.
Thanks
 
Medicare states code is always bundled and will never pay even if billed alone. Since service is provided I would bill it with a (0) amount unless the office policy is not Never bill to anyone including self pay.
 
Part of the problem with this non-billing is if you do not bill it, then the practice management software cannot track and report the services provided and thereby associate the costs of the cold/hot packs with the proper department/provider. Unless your cold/hot packs are free, then there should be a cost allocation for budgeting/tracking purposes. The allowable reimbursement covers this amount, no matter how small the actual cost.
 
We've just recently started going around with this in our practice. If you bill insurer one, you have to them all. My question is regarding the counting of time by the therapist. Is the 97010 counted in the total time even though it's considered bundled? I know it's a one time code not a 8 minute rule code but my therapist says she can't add that into total treatment time because it's not billable. I'm relatively new to PT and just starting to grasp the whole counting minutes process. Any help would be greatly appreciated. Thanks so much.
 
CPT 97010 Fee Search shows:

National Adjusted
Facility $6.09 $6.05
Non Facility $6.09 $6.05

RVU - Nonfacility
National Adjusted 26 TC
Work RVU: 0.06 0.06
PE RVU: 0.10 0.10
Malpractice RVU: 0.01 0.01
Total RVU: 0.17 0.17

RVU - Facility
National Adjusted 26 TC
Work RVU: 0.06 0.06
PE RVU: 0.10 0.10
Malpractice RVU: 0.01 0.01
Total RVU: 0.17 0.17
 
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