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cpt 98960

  1. #1
    Default cpt 98960
    Exam Training Packages
    How is this code applied.



    98960 - 98962 Education and Training for Patient Self-Management



    Codes within this range are used to report education and training of a patient when prescribed by a physician but performed by a non-physician provider. Guidelines indicate that a standardized curriculum must be utilized and may be modified to meet individual patient needs.



    The focus of the training should be to teach the patient how to effectively manage their clinical condition. It may also include a patient's caregiver. The service can be provided to either a single patient (98960) or a group of patients (98961-98962).





    And what is meant by a standardized curriculum. I have an idea, just seeking different opinions. I haven't found anything concrete in regards to guidelines for this code.







    Also are you seeing a lot of reimbursement for these services in regards to Medicare and PPO insurance.



    97760 - 97762 Orthotic Management and Prosthetic Management





    I know I just drop a lot of info on you right now, but hopefully you wouldn't mind share your input.



    Respectfully

    Daniel, CPC

  2. Default
    97760 is paid by Medicare, make sure you put modifier GO on it. Not familiar with the other codes
    Ann Marie CPC
    New Britain, CT

  3. #3
    Default
    I think Codes( 98960-98962 ) we can use for diabetic patients for insulin teaching Or patients have Asthma conditions especially for kids who needs to know how to use Nebulizer etc.,

  4. #4
    Location
    Alexandria VA/Orlando FL
    Posts
    11
    Red face Cpt 98960
    Hello,
    I am curious about code 98960 as it relates to my practice. Our Physician's Assistant inquired about what she should bill out for a teaching she gave to a patient that is on Lovenox while pregnant and needs to self inject her meds.

    I thought that 98960 would be appropriate but then the issue of time comes into play with this code as well as the "standardized curriculum"!

    Any thoughts???? Someone suggested using a low level E&M????

    T.C.,CPC

  5. #5
    Location
    Columbia, MO
    Posts
    12,464
    Default
    98960-62 is for nonproviders only. I have used this in an ortho practice when the nursing staff would give instructions to patients in the correct use of Therabands. It worked very well and Medicare as well as other carriers did pay, the average reimbursement for the 98960 was around $38.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    My office does frequent self inj teaching for testosterone. We bill and E/M plus the medication. Is there a code for the teaching since we cant bill for the inj since the pt is physically doing this themselves? I have been looking into 98960. Is this correct?

  7. Default cpt code 98960
    So I work in an oncology practice and my nurses are spending an exuberant amount of time with patients, regarding their treatments and what to expect and I was wondering if 98960 would be an appropriate code to use for this?

    Heather

  8. #8
    Default 98960 inpatient or outpatient
    Can this code be used in the hospital setting for any type of education as long as its ordered by the physician and documented with the info and time of 30 min or greater?? Like ER, patients in observation status, etc.

    thanks this code is new to me so was needing some help .
    jen

  9. Default
    Quote Originally Posted by mitchellde View Post
    98960-62 is for nonproviders only. I have used this in an ortho practice when the nursing staff would give instructions to patients in the correct use of Therabands. It worked very well and Medicare as well as other carriers did pay, the average reimbursement for the 98960 was around $38.
    Please check the modifier -62. It is for Two Surgeons.

  10. #10
    Location
    Frederick, MD
    Posts
    266
    Default
    Quote Originally Posted by LoreenAtkinson View Post
    Please check the modifier -62. It is for Two Surgeons.
    I think what mitchellde means by 98960-62 is the code range from 98960 through 98962. Not the modifier 62.
    Always Seeking

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