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Diabetes counseling 45 mintues

  1. #11
    Default Reference
    Medical Coding Books
    http://www.cms.gov/manuals/downloads/clm104c12.pdf

    Should be page 85. Hope that helps. Message or post if any questions

  2. #12
    Location
    Milwaukee and Madison
    Posts
    6
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    Debra Mitchell
    I was under the impression that the timed services were only for physical therapy codes. I have not been able to find anything to support that this would apply to CPT 98960. Help?

  3. #13
    Location
    Columbia, MO
    Posts
    12,531
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    98960 is a timed service look in your CPT book it says every 30 minutes. The guideline for timed services is across the board not just physical therapy.

    Debra A. Mitchell, MSPH, CPC-H

  4. #14
    Default Reference
    I'll review my documentation tomorrow. But based on my reading, there is a strict basis for coding the first 30 minutes. If it is 29 minutes, cannot round up and cannot code for any. For additional minutes past 30, and again want to review my notes, there is more leeway, for coding an additional unit. Just want to have the documentation in front of me.

  5. #15
    Location
    Columbia, MO
    Posts
    12,531
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    Therre is a section in the CMS manual on coding for Prolonged time codes (99354-99357) in this they provide a chart of the threshold (minimum) times allowed to charge these codes, the 99354 is a 60 minute code the threshold is 30 minutes above the visit time and a 99355 is a 30 minute code the threshold is 15 minutes above the first hour of 99354. I am not sure where you are reading the strict 30 minute thing. The only code that they are strict about is hydration which has to me a minimum of 31 minutes to count the first unit. However there are good reasons for that one. Also look in your CPT book under the 99354-57 section there is a chart that also explains the minmum times. Again this logic applies to all time codes with the exception of hydration.

    Debra A. Mitchell, MSPH, CPC-H

  6. #16
    Default Reference additional
    http://medicalnewswire.com/artman/pu...cle_8156.shtml

    This reference above dated 2006 suggests 30 minutes, and additional requirements, qualifies for 98960.

    http://www.nysdiabetescampaign.org/u...eficiaries.pdf

    This second reference states that multiple units of 98960 can be billed.

    https://www.diabeteseducator.org/Mem...ement_QxA.html

    This third reference states that there is no "specific guidance" for rounding up or down.

    This gets back to time based coding (previous posting reference chapter 12) which does provide better guidance for rounding up or down. As per mitchellde's post above.
    Last edited by jackson7591; 08-24-2011 at 11:19 PM.

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