Wiki Physical Therapy

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Tracey Thompson

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Hello! I noticed there is not a specific category for physical therapy questions, so I am having to post this in various places. I am in great need of some guidance on PT/OT/ST coding and billing. I know most of the general stuff, but I am looking for a little more in depth knowledge.

Very useful information would include:
Coding and billing errors made most often in Physical Therapy.
Reimbursement most often missed in Physical Therapy.

As always, I am looking to maximize reimbursement for our clients (legally and ethically)! If anyone has some of this information and their disposal or could provide articles with this information, I would greatly appreciated the help.

Thanks!!!
 
Nothing replaces a mentor.

Cyndi-

I have read most of the articles on the APTA website. I am located in TN, but I work for a billing company that provides services nationwide. Unfortuantely, I think it just comes down to reading articles just can't replace a mentor and/or experience. Please let me know if you can think of any other good resources.

Thanks!!
 
Tracey,

I work in outpatient services for a rehabilitation hospital (also in Tennessee) and I've spent the majority of my career in rehab sciences, orthopedics and chiropractic. I'll be happy to help you in whatever way I can. The three quick pieces of advice I can give are:

1. Understand the timed codes and the carrier rules associated with those.

2. Therapists generally tend to be a bit more open to education regarding documentation, etc. so if you see an error is happening repeatedly, don't be afraid to approach them with suggestions. Often, all it takes is a very small change in documentation to change one code to another. For instance, if a patient is doing step ups you would use therapuetic exercise. If the therapist adds a reaching component, it becomes therapuetic activities. This comes in handy when dealing with Cahaba's unit limits per CPT. Of course, it still has to benefit the patient to do the reach but most all patients can benefit from some functional training. It helps that I am right here in clinic with my therapists but you could still form some type of communication, even working for the agency.

3. Alot of clinics choose to double their patients and/or use unlicensed technicians to assist in clinic and this changes the way you should bill, greatly. Also, some insurances require licensed assistants (PTA, COTA, SLP Assistants) to be supervised and co-signed by a licensed therapists. You need to understand the clinic flow to bill rehabilitation services correctly.

I hope this helps get you started and please don't hesitate to email me at candicedixon.cpc@gmail.com if I can help in any other way.

Good luck!

Candice Dixon, CPC
Outpatient Case Manager / Coder
 
Great!

Thank you so much for your advice.

These were all great things that I need to focus and study up on a bit!!
 
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