Re: Billing for Timed Procedures

[Guest guest]

I would refer you to CPT Assistant December 2003

published by the American Medical Association (AMA).

On page 5 and 6, they are discussing manual therapy.

AMA states " As with any 15-minute timed code, it is

important to recognize that a substantial portion of

15 minutes must be spent in performing the pre-,

intra-, and postservice work in order to report code

97140 " . This would also apply to all time based codes.

Keep in mind, most payers do not define substantial

which means it is up to you.

Rick Gawenda, PT

President

Section on Health Policy & Administration

APTA

--- mlavcavitt@... wrote:

> Dear List,

>

> I am interested in finding out what guidelines you

> use (please provide your

> state and the Website/source you are referencing)

> when billing timed

> procedures to non Medicare carriers who fail to

> provide published billing guidelines

> with regard to the minimum number of minutes

> required per unit for 97000

> series timed procedures.

>

> In an APTA Article, entitled " The ABC's of CPT

> Coding, " written by Rhea

> Cohn, PT, MA, there is an excerpt that states,

> " Strictly speaking, CPT defines

> the 97000 series timed codes in 15-minute

> increments. " By the way, GREAT

> ARTICLE. If you haven't read it, it is worth your

> while to do so. It's a couple

> of years old, but is very informative and is a

> useful resource tool to assist

> all PTs in coding correctly.

>

> Thank you in advance for your response.

>

> Vickie

>

>

> D. Cavitt, President

> Medical Legal Alliance, L.L.C.

> 600 Guilbeau Road, Suite A

> Lafayette, LA 70506

> Lafayette Office Phone: (337) 232-2444

> Home Office Phone:

> E-fax:

> Cell:

> E-mail: _mlavcavitt@..._

> (mailto:mlavcavitt@...)

> Web site: _www.medicallegalalliance.com_

> (http://www.medicallegalalliance.com/)

>

> This electronic message and any attachments contain

> information from Medical

> Legal Alliance, L.L.C. that is or may be

> confidential or privileged. The

> information is intended to be for the use of the

> individual or entity named

> above. If you are not the intended recipient, be

> aware that any disclosure,

> copying, distribution or use of the contents of

> this message or attachment is

> prohibited. If you have received this electronic

> message and/or attachment in

> error, please notify the sender immediately at

> or return an

> electronic message error notice to

> _mlavcavitt@..._ (mailto:mlavcavitt@...)

> .

>

>

>

>

>

>

>

>

>

> ____________________________________

>

>

>

>

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>

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>

>

>

>

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[Guest guest]

Adding to my previous response, the American Medical Association gives an

example of providing manual therapy for 25 minutes and they state that would

justify billing 2 units of manual therapy. The AMA also states specific payers

may have their own rules regarding substantial amount of time to bill a unit of

a timed based CPT code This can be found in the February 2004 edition of CPT

Assistant.

Rick Gawenda, PT

President/CEO

Gawenda Seminars

http://www.gawendaseminars.com

I would refer you to CPT Assistant December 2003

published by the American Medical Association (AMA).

On page 5 and 6, they are discussing manual therapy.

AMA states " As with any 15-minute timed code, it is

important to recognize that a substantial portion of

15 minutes must be spent in performing the pre-,

intra-, and postservice work in order to report code

97140 " . This would also apply to all time based codes.

Keep in mind, most payers do not define substantial

which means it is up to you.

Rick Gawenda, PT

President

Section on Health Policy & Administration

APTA

--- mlavcavitt@... wrote:

> Dear List,

>

> I am interested in finding out what guidelines you

> use (please provide your

> state and the Website/source you are referencing)

> when billing timed

> procedures to non Medicare carriers who fail to

> provide published billing guidelines

> with regard to the minimum number of minutes

> required per unit for 97000

> series timed procedures.

>

> In an APTA Article, entitled " The ABC's of CPT

> Coding, " written by Rhea

> Cohn, PT, MA, there is an excerpt that states,

> " Strictly speaking, CPT defines

> the 97000 series timed codes in 15-minute

> increments. " By the way, GREAT

> ARTICLE. If you haven't read it, it is worth your

> while to do so. It's a couple

> of years old, but is very informative and is a

> useful resource tool to assist

> all PTs in coding correctly.

>

> Thank you in advance for your response.

>

> Vickie

>

>

> D. Cavitt, President

> Medical Legal Alliance, L.L.C.

> 600 Guilbeau Road, Suite A

> Lafayette, LA 70506

> Lafayette Office Phone:

> Home Office Phone:

> E-fax:

> Cell:

> E-mail: _mlavcavitt@..._

> (mailto:mlavcavitt@...)

> Web site: _www.medicallegalalliance.com_

> (http://www.medicallegalalliance.com/)

>

> This electronic message and any attachments contain

> information from Medical

> Legal Alliance, L.L.C. that is or may be

> confidential or privileged. The

> information is intended to be for the use of the

> individual or entity named

> above. If you are not the intended recipient, be

> aware that any disclosure,

> copying, distribution or use of the contents of

> this message or attachment is

> prohibited. If you have received this electronic

> message and/or attachment in

> error, please notify the sender immediately at

> or return an

> electronic message error notice to

> _mlavcavitt@..._ (mailto:mlavcavitt@...)

> .

>

>

>

>

>

>

>

>

>

> ____________________________________

>

>

>

>

>

>

>

>

>

>

>

>

>

>

> **************Get the Moviefone Toolbar. Showtimes,

> theaters, movie news &

>

more!(http://pr.atwola.com/promoclk/100000075x1212774565x1200812037/aol?redir=ht\

t

>

p://toolbar.aol.com/moviefone/download.html?ncid=emlcntusdown00000001)

>

>

> [Non-text portions of this message have been

> removed]

>

>