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Hello group,

We had a patient call in to complain about her bill today. She stated

that on two visits, she was billed manual therapy, 1 unit and never had

any manual therapy during those visits. I checked back in the

documentation (this is a non-Medicare patient, but our hospital requires

us to bill all payers the same). On the first visit, the only thing

documented in the chart were measurements of range of motion and manual

muscle testing. Under subjective, the patient reported 95% pain relief

and the therapist wrote in the assessment/plan " patient doing well, hold

chart for 2 weeks- if no further complaints, d/c " ). The next and last

visit was 2 weeks later. The patient had an exacerbation. There was

more objective testing documented and some ther ex reviewed and

modified.

Here is what the therapist documented as far as billing: for Visit 1,

she billed Manual Therapy, 15 minutes. For visit two, she billed Manual

Therapy 20 minutes. My take is that since she can't bill re-eval for

Visit 1, she was correct in her billing for that visit. However, she

didn't bill for what she documented on Visit 2- her total time was 20

minutes (1 unit), but she didn't break it down by each procedure- it is

unclear from her documentation as to which unit she spent more time.

So question to the group- do you agree with how she billed? Any

suggestions on a simple way to explain our very complicated billing

system to a patient who has no clue?

Thanks

Meryl W. Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

(office)

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Guest guest

Hi, Merle -

Thanks for raising a pertinent issue!

One very important issue is that one must only bill for the precise CPT Code

which they actually perform. If the therapist performs Range of Motion

Measurements and records their findings, then they may bill for range of

motion measurement. If they also perform manual muscle testing, then they

may bill for manual muscle testing. If they did not perform Manual Therapy

techniques, they may not bill for manual therapy.

When performing manual therapy techniques, one is constantly re-assessing

and proceding as indicated, but this does not add billable CPT Codes to the

visit.

CPT 97002, Re-Evaluation is a separate process -- and a separate document.

It is generally used when there has been a significant change in a patient's

condition, such as when a hip fracture patient who had become able to walk

400 ft on a two wheeled walker on the sidewalk subsequently experiences

seizures, the force of which re-opens a former PEG tube site, and has been

on bed rest for a week. (This happened last month!) Re-eval is not a

billing code to use casually, or just to write up a progress note to the

physician for the patient's follow-up visit. It's a real evaluation of an

existing, rather than new, patient.

Organizations should check their charts intermittently and re-train its

staff to:

1) Do the indicated procedure,

2) Document what they have done, and

3) Bill for exactly what they have done that they have documented.

I once knew a DPM inTexas who combined the billing for two procedures which

he *did* perform into a charge for one " sort of close " procedure which he

*did not* actually perform. The insurance company took action against his

license for fraud, and he was banned from Medicare program for five years.

It's better to coach your staff (and owners, if necessary) to just do the

right thing. Lawyers are far too costly!

Hope that's useful!

Dr. Dick Hillyer, PT

Dr. Hillyer, PT,DPT,MBA,MSM

Hillyer Consulting

700 El Dorado Pkwy W.

Cape Coral, FL 33914

Mobile

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Thursday, June 02, 2011 3:45 PM

To: PTManager

Subject: Billing question

Hello group,

We had a patient call in to complain about her bill today. She stated

that on two visits, she was billed manual therapy, 1 unit and never had

any manual therapy during those visits. I checked back in the

documentation (this is a non-Medicare patient, but our hospital requires

us to bill all payers the same). On the first visit, the only thing

documented in the chart were measurements of range of motion and manual

muscle testing. Under subjective, the patient reported 95% pain relief

and the therapist wrote in the assessment/plan " patient doing well, hold

chart for 2 weeks- if no further complaints, d/c " ). The next and last

visit was 2 weeks later. The patient had an exacerbation. There was

more objective testing documented and some ther ex reviewed and

modified.

Here is what the therapist documented as far as billing: for Visit 1,

she billed Manual Therapy, 15 minutes. For visit two, she billed Manual

Therapy 20 minutes. My take is that since she can't bill re-eval for

Visit 1, she was correct in her billing for that visit. However, she

didn't bill for what she documented on Visit 2- her total time was 20

minutes (1 unit), but she didn't break it down by each procedure- it is

unclear from her documentation as to which unit she spent more time.

So question to the group- do you agree with how she billed? Any

suggestions on a simple way to explain our very complicated billing

system to a patient who has no clue?

Thanks

Meryl W. Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

(office)

----- Confidentiality Notice -----

This e-mail and any attached documents contain confidential information

belonging to the sending entity, Rex Healthcare, and is intended only for

the

use of the individual(s) or entity(s) associated with the recipient

addresses

listed in the message header. The authorized recipient of this information

is

prohibited from disclosing this information to any other party. If you are

not

the intended recipient, you are hereby notified that any disclosure,

copying,

distribution or action taken in reliance on the contents of the email and/or

attachments is strictly prohibited. If you received this e-mail transmission

in

error, please notify the sender immediately to arrange for return or

destruction of this information.

To report abuse or inappropriate use, please email abuse@...

<mailto:abuse%40rexhealth.com> .(B)

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Guest guest

Hi, Merle -

Thanks for raising a pertinent issue!

One very important issue is that one must only bill for the precise CPT Code

which they actually perform. If the therapist performs Range of Motion

Measurements and records their findings, then they may bill for range of

motion measurement. If they also perform manual muscle testing, then they

may bill for manual muscle testing. If they did not perform Manual Therapy

techniques, they may not bill for manual therapy.

When performing manual therapy techniques, one is constantly re-assessing

and proceding as indicated, but this does not add billable CPT Codes to the

visit.

CPT 97002, Re-Evaluation is a separate process -- and a separate document.

It is generally used when there has been a significant change in a patient's

condition, such as when a hip fracture patient who had become able to walk

400 ft on a two wheeled walker on the sidewalk subsequently experiences

seizures, the force of which re-opens a former PEG tube site, and has been

on bed rest for a week. (This happened last month!) Re-eval is not a

billing code to use casually, or just to write up a progress note to the

physician for the patient's follow-up visit. It's a real evaluation of an

existing, rather than new, patient.

Organizations should check their charts intermittently and re-train its

staff to:

1) Do the indicated procedure,

2) Document what they have done, and

3) Bill for exactly what they have done that they have documented.

I once knew a DPM inTexas who combined the billing for two procedures which

he *did* perform into a charge for one " sort of close " procedure which he

*did not* actually perform. The insurance company took action against his

license for fraud, and he was banned from Medicare program for five years.

It's better to coach your staff (and owners, if necessary) to just do the

right thing. Lawyers are far too costly!

Hope that's useful!

Dr. Dick Hillyer, PT

Dr. Hillyer, PT,DPT,MBA,MSM

Hillyer Consulting

700 El Dorado Pkwy W.

Cape Coral, FL 33914

Mobile

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Freeman, Meryl

Sent: Thursday, June 02, 2011 3:45 PM

To: PTManager

Subject: Billing question

Hello group,

We had a patient call in to complain about her bill today. She stated

that on two visits, she was billed manual therapy, 1 unit and never had

any manual therapy during those visits. I checked back in the

documentation (this is a non-Medicare patient, but our hospital requires

us to bill all payers the same). On the first visit, the only thing

documented in the chart were measurements of range of motion and manual

muscle testing. Under subjective, the patient reported 95% pain relief

and the therapist wrote in the assessment/plan " patient doing well, hold

chart for 2 weeks- if no further complaints, d/c " ). The next and last

visit was 2 weeks later. The patient had an exacerbation. There was

more objective testing documented and some ther ex reviewed and

modified.

Here is what the therapist documented as far as billing: for Visit 1,

she billed Manual Therapy, 15 minutes. For visit two, she billed Manual

Therapy 20 minutes. My take is that since she can't bill re-eval for

Visit 1, she was correct in her billing for that visit. However, she

didn't bill for what she documented on Visit 2- her total time was 20

minutes (1 unit), but she didn't break it down by each procedure- it is

unclear from her documentation as to which unit she spent more time.

So question to the group- do you agree with how she billed? Any

suggestions on a simple way to explain our very complicated billing

system to a patient who has no clue?

Thanks

Meryl W. Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

(office)

----- Confidentiality Notice -----

This e-mail and any attached documents contain confidential information

belonging to the sending entity, Rex Healthcare, and is intended only for

the

use of the individual(s) or entity(s) associated with the recipient

addresses

listed in the message header. The authorized recipient of this information

is

prohibited from disclosing this information to any other party. If you are

not

the intended recipient, you are hereby notified that any disclosure,

copying,

distribution or action taken in reliance on the contents of the email and/or

attachments is strictly prohibited. If you received this e-mail transmission

in

error, please notify the sender immediately to arrange for return or

destruction of this information.

To report abuse or inappropriate use, please email abuse@...

<mailto:abuse%40rexhealth.com> .(B)

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Guest guest

So why not correct the CPT codes and send in a corrected claim to ins co?

Usually manal therapy is reimbursed lower than most other CPT so the patient

will end up owing more and prob be sorry he/she complained. I do strictly

billing not therapy so I am speaking from a billing perspective, not how you

should and shouldn't code. But as the billing manager, I would talk to the

therapist, ask for corrected codes and submit a corrected claim. Sounds like if

the patient knows that much about CPT's something is fishy with complaining so I

would be gentle but still get the money the clinic deserves for the treatment.

Heidi Harmon\

Billing Manager

Re: Billing question

Hi, Meryl,

Sounds like this patient has more than a clue. The documentation as you

resented it does not support the charges for manual therapy. Better that

he told you instead of filing a complaint with her insurance company!

Visit 1: MMT is not a manual therapy procedure. It is more closely aligned

ith 97110-Therapeutic Exercise, which is also concerned with strength and

OM. Alternatively, MMT and ROM assessment could be charged with

7750-Physical Performance Test w/ Report *if* the therapist followed

tandardized test protocols and documented the results. There are also

pecific codes for these measurements, if standard protocols are followed

e.g. 95831-MMT extremity excluding hand)

isit 2: The documentation does not support the manual therapy charge,

nless part of the " more objective testing " she performed was joint mobility

esting, palpation of soft tissue, etc. She isn't required to break down

he 20 minutes by procedure, just bill one unit for the timed procedure she

pent the most time on and make sure her documentation supports it.

Explaining our complicated billing system to *staff *is often a challenge,

ut it is critical that managers are proficient with this. We should

ocument staff training in both correct use of the billing code

and*documentation to support that medically-necessary and skilled

are was

rovided to support that code. Every therapist in another therapist's chain

f command may be held legally responsible for her practice of inaccurate

illing. Part of the APTA Code of Ethics is that we bill accurately for

ervices that we provide.

I highly recommend the APTA billing and coding course, and Rick Gawenda's

udio conferences (much more engaging than reading the CPT coding book!)

Diane , PT

ugusta, GA

On Thu, Jun 2, 2011 at 3:45 PM, Freeman, Meryl

Meryl.Freeman@...>wrote:

>

Hello group,

We had a patient call in to complain about her bill today. She stated

that on two visits, she was billed manual therapy, 1 unit and never had

any manual therapy during those visits. I checked back in the

documentation (this is a non-Medicare patient, but our hospital requires

us to bill all payers the same). On the first visit, the only thing

documented in the chart were measurements of range of motion and manual

muscle testing. Under subjective, the patient reported 95% pain relief

and the therapist wrote in the assessment/plan " patient doing well, hold

chart for 2 weeks- if no further complaints, d/c " ). The next and last

visit was 2 weeks later. The patient had an exacerbation. There was

more objective testing documented and some ther ex reviewed and

modified.

Here is what the therapist documented as far as billing: for Visit 1,

she billed Manual Therapy, 15 minutes. For visit two, she billed Manual

Therapy 20 minutes. My take is that since she can't bill re-eval for

Visit 1, she was correct in her billing for that visit. However, she

didn't bill for what she documented on Visit 2- her total time was 20

minutes (1 unit), but she didn't break it down by each procedure- it is

unclear from her documentation as to which unit she spent more time.

So question to the group- do you agree with how she billed? Any

suggestions on a simple way to explain our very complicated billing

system to a patient who has no clue?

Thanks

Meryl W. Freeman, MS PT

Manager, Rex Hospital Outpatient Rehab

(office)

----- Confidentiality Notice -----

This e-mail and any attached documents contain confidential information

belonging to the sending entity, Rex Healthcare, and is intended only for

the

use of the individual(s) or entity(s) associated with the recipient

addresses

listed in the message header. The authorized recipient of this information

is

prohibited from disclosing this information to any other party. If you are

not

the intended recipient, you are hereby notified that any disclosure,

copying,

distribution or action taken in reliance on the contents of the email

and/or

attachments is strictly prohibited. If you received this e-mail

transmission in

error, please notify the sender immediately to arrange for return or

destruction of this information.

To report abuse or inappropriate use, please email abuse@....(B)

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