Guest guest Posted December 2, 2008 Report Share Posted December 2, 2008 Todd, As you probably already know... " The purpose of these notes is simply to create a record of all treatments and skilled interventions that are provided and to record the time of the services in order to justify the use of billing codes on the claim. " (page 36) Also, I have been told by Medicare consultants that time-in/time-out is not sufficient. We do the following: time-in/time-out time for one-on-one procedures time for supervised modalities (eg: traction). For example: time-in: 8am time-out: 9am = 4 units 8am to 8:30 therapeutic ex (one-on-one) 15 minutes traction 15 minutes e-stim = 4 units That way the total and the time-in/time-out minutes are consistent. You want to make it easy for the Medicare auditor to decide that you are not 'low hanging fruit'. I've found that well-designed chart templates and staff training are crucial to ensure that your therapists consistently apply these policies. Once they get into the habit of jotting down the time it's not too difficult. Get a copy of my chart template at http://www.bulletproofpt.com/compliance-plan.htm Also, the reference for Transmittal 88 (page 36) is at http://www.cms.hhs.gov/transmittals/downloads/r88bp.pdf Tim Tim , PT www.BulletproofPT.com TimRichPT@... > > Group, I am looking for non-grey interpretation of the timed/unitmed/total minutes rule in transmittal 88. We are doing an internal audit and the auditor feels that start/stop times are most appropriate and reads start/stop times into the transmittal. I feel that transmittal 88 says the total time, timed minutes are all that is required. Untimed minutes are voluntary (we do include). Is there something that supplants this transmittal that says start/stop times are " best practice " ? Of course, charged units must match your recorded minutes by following the 8 min rule. > > Thanks. > > Todd Mourning, PT > Manager of Therapy Services > Abraham Lincoln Memorial Hospital > 315 8th Street > Lincoln, IL 62656 > > > (direct) > (fax) > > mourning.todd@... > > > ________________________________ > This message (including any attachments) contains confidential information intended for a specific individual and purpose, and is protected by law. If you are not the intended recipient, you should delete this message. Any disclosure, copying, or distribution of this message, or the taking of any action based on it, is strictly prohibited. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2008 Report Share Posted December 3, 2008 Tom, Please specify what part of the scenario I posted did you disagree with? I found your scenario very similar to mine. Another resource I use to help clarify the timing issue is the Part B Billing Scenarios at... http://www.cms.hhs.gov/TherapyServices/02_billing_scenarios.asp Specifically... " 2. Billing - CPT Codes: Permitted In the same 15-minute time period, one therapist may bill for more than one therapy service occurring in the same 15-minute time period where " supervised modalities " are defined by CPT as untimed and unattended -- not requiring the presence of the therapist (CPT codes 97010 - 97028). One or more supervised modalities may be billed in the same 15-minute time period with any other CPT code, timed or untimed, requiring constant attendance or direct one-on-one patient contact. However, any actual time the therapist uses to attend one-on-one to a patient receiving a supervised modality cannot be counted for any other service provided by the therapist. " The timing issue shouldn't be all that controversial. I find the biggest issue is cultural - therapists don't like being told they must check their stopwatch at the beginning and the end of their one-on-one treatments. Unfortunately, we are paid $3.06 billion dollars per year (2006 figures) by Medicare for uncertain outcomes. I don't believe they trust us. Therefore, they micromanage our time to justify their dollars. Bite the bullet and get a watch. I wear a Timex Ironman and I check it frequently. Tim www.BulletproofPT.com timrichpt@... > >> > >> Group, I am looking for non-grey interpretation of the > > timed/unitmed/total minutes rule in transmittal 88. We are doing an > internal audit and the auditor feels that start/stop times are most > appropriate and reads start/stop times into the transmittal. I feel that > transmittal 88 says the total time, timed minutes are all that is > required. Untimed minutes are voluntary (we do include). Is there > something that supplants this transmittal that says start/stop times are > " best practice " ? Of course, charged units must match your recorded > minutes by following the 8 min rule. > >> > >> Thanks. > >> > >> Todd Mourning, PT > >> Manager of Therapy Services > >> Abraham Lincoln Memorial Hospital > >> 315 8th Street > >> Lincoln, IL 62656 > >> > >> > >> (direct) > >> (fax) > >> > >> mourning.todd@<mailto:mourning.todd@> > >> > >> > >> ________________________________ > >> This message (including any attachments) contains confidential > > information intended for a specific individual and purpose, and is > protected by law. If you are not the intended recipient, you should > delete this message. Any disclosure, copying, or distribution of this > message, or the taking of any action based on it, is strictly > > prohibited. > >> > >> > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 3, 2008 Report Share Posted December 3, 2008 Tom, Please specify what part of the scenario I posted did you disagree with? I found your scenario very similar to mine. Another resource I use to help clarify the timing issue is the Part B Billing Scenarios at... http://www.cms.hhs.gov/TherapyServices/02_billing_scenarios.asp Specifically... " 2. Billing - CPT Codes: Permitted In the same 15-minute time period, one therapist may bill for more than one therapy service occurring in the same 15-minute time period where " supervised modalities " are defined by CPT as untimed and unattended -- not requiring the presence of the therapist (CPT codes 97010 - 97028). One or more supervised modalities may be billed in the same 15-minute time period with any other CPT code, timed or untimed, requiring constant attendance or direct one-on-one patient contact. However, any actual time the therapist uses to attend one-on-one to a patient receiving a supervised modality cannot be counted for any other service provided by the therapist. " The timing issue shouldn't be all that controversial. I find the biggest issue is cultural - therapists don't like being told they must check their stopwatch at the beginning and the end of their one-on-one treatments. Unfortunately, we are paid $3.06 billion dollars per year (2006 figures) by Medicare for uncertain outcomes. I don't believe they trust us. Therefore, they micromanage our time to justify their dollars. Bite the bullet and get a watch. I wear a Timex Ironman and I check it frequently. Tim www.BulletproofPT.com timrichpt@... > >> > >> Group, I am looking for non-grey interpretation of the > > timed/unitmed/total minutes rule in transmittal 88. We are doing an > internal audit and the auditor feels that start/stop times are most > appropriate and reads start/stop times into the transmittal. I feel that > transmittal 88 says the total time, timed minutes are all that is > required. Untimed minutes are voluntary (we do include). Is there > something that supplants this transmittal that says start/stop times are > " best practice " ? Of course, charged units must match your recorded > minutes by following the 8 min rule. > >> > >> Thanks. > >> > >> Todd Mourning, PT > >> Manager of Therapy Services > >> Abraham Lincoln Memorial Hospital > >> 315 8th Street > >> Lincoln, IL 62656 > >> > >> > >> (direct) > >> (fax) > >> > >> mourning.todd@<mailto:mourning.todd@> > >> > >> > >> ________________________________ > >> This message (including any attachments) contains confidential > > information intended for a specific individual and purpose, and is > protected by law. If you are not the intended recipient, you should > delete this message. Any disclosure, copying, or distribution of this > message, or the taking of any action based on it, is strictly > > prohibited. > >> > >> > >> Quote Link to comment Share on other sites More sharing options...
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