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Therapy Coding

  1. Default Therapy Coding
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    I need to know how I can prove that only 3 units should be charged for 45 minutes of therapy for code 97110, besides the cpt code book.

    Therapist thinks that if 45 minutes of service were performed, you can legally charge for 4 units of time, especially if the total time spent with the patient is @ 83 minutes (20 minutes on 97032) and (18 minutes on 97140) and (45 minutes on 97110). Please advise. Thanks!

  2. #2
    Location
    Phoenix, AZ
    Posts
    620
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    I could not find the table that we used for PT/OT billing. However, here is a link to a Medicare publication regarding scenarios for PT/OT billing. I hope it helps. http://www.cms.hhs.gov/TherapyServic...Ts_and_OTs.pdf

    I will keep looking for the table because I know it exists somewhere.

    Good luck,
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  3. #3
    Location
    Phoenix, AZ
    Posts
    620
    Default
    Okay, I found it. I had to leave the Medicare website and got the APTA. It's called the 8-minute rule. Here is the link. See letter C on page 7: http://www.cms.hhs.gov/transmittals/...ds/R1019CP.pdf

    I hope you find it helpful.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  4. Default
    Thank you this is exactly what I was looking for as well. I am new to PT billing and the provider keeps telling me that he can bill for different increments of time.

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