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Thread: billing 96101

  1. #1
    Join Date
    Apr 2007

    Question billing 96101

    AAPC: Back to School
    How would you bill if 2.2 hours for this service? Our billing system will not show 2.2 Units but does reflect the money for 2.2 Units. I am reading the description for this and it states per hour so the doctor worked for 2.2 hours. So I am wondering if this should be billed as only 2 Units with prolonged Service code also or 3 Units with modifier for reduces services seeing as it was over 2 hours but not quite 3. Any help would be appreciated. Thanks
    Mona Lisa CPC
    MonaLisa LaBonte CPC

  2. #2
    Join Date
    Apr 2007


    You would only bill 2 units.

    Over 1/2 the time specified by the code needs to be done in order to bill one unit of the code. It isn't broken down into less than one unit. If they had spent 2 hours and at least 31 minutes, they could bill 3 units. The code, or an additional unit, isn't billed if 30 minutes or less was done.
    Pam Tienter, CPC, COC, CPC-P, CCS-P, CPMA, CPC-I
    AHIMA Approved ICD-10-CM/PCS Trainer
    AAPC National ICD-10-CM Trainer

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