group codes and chart audits

[Guest guest]

Just need some confirmation and maybe some more direction to some black and

white back up.

No matter what insurance you are talking, if  you are seeing 2 patients at one

time, you cannot (or should not I will say)

bill them each individually for the full 4 units they are there (supposing 1

hour tx). Does not matter if its one MC and one BC or 2 MC or 2 WC,

if you are seeing 2 patients at the same time, each of them would get one group

code for their overlapped time, correct? We seem to be having some issues with

that

and any direction to black and white info would be helpful. Thanks again to Rick

Gawenda and Dr.Dick Hillyer and Larry Benz for their thoughts on my last

question.

Next issue is chart audits. The person who always handled quarterly reviews and

chart audits has retired. I had asked on several occasions what is required of

MC to be included in a chart audit and the quarterly meeting itself and was told

that's just what they said, but again, nothing written down. Any help in

pointing to a manual or publication that states what is required to be covered

in compliance meetings and in a chart audit would be helpful.

Thanks,

Damon C. Whitfield, PT, ATC

Michigan

[Guest guest]

Group,

Just need some confirmation and maybe some more direction to some black and

white back up.

No matter what insurance you are talking, if  you are seeing 2 patients at one

time, you cannot (or should not I will say)

bill them each individually for the full 4 units they are there (supposing 1

hour tx). Does not matter if its one MC and one BC or 2 MC or 2 WC,

if you are seeing 2 patients at the same time, each of them would get one group

code for their overlapped time, correct? We seem to be having some issues with

that

and any direction to black and white info would be helpful. Thanks again to Rick

Gawenda and Dr.Dick Hillyer and Larry Benz for their thoughts on my last

question.

Next issue is chart audits. The person who always handled quarterly reviews and

chart audits has retired. I had asked on several occasions what is required of

MC to be included in a chart audit and the quarterly meeting itself and was told

that's just what they said, but again, nothing written down. Any help in

pointing to a manual or publication that states what is required to be covered

in compliance meetings and in a chart audit would be helpful.

Thanks,

Damon C. Whitfield, PT, ATC

Michigan

[Guest guest]

Group,

Just need some confirmation and maybe some more direction to some black and

white back up.

No matter what insurance you are talking, if  you are seeing 2 patients at one

time, you cannot (or should not I will say)

bill them each individually for the full 4 units they are there (supposing 1

hour tx). Does not matter if its one MC and one BC or 2 MC or 2 WC,

if you are seeing 2 patients at the same time, each of them would get one group

code for their overlapped time, correct? We seem to be having some issues with

that

and any direction to black and white info would be helpful. Thanks again to Rick

Gawenda and Dr.Dick Hillyer and Larry Benz for their thoughts on my last

question.

Next issue is chart audits. The person who always handled quarterly reviews and

chart audits has retired. I had asked on several occasions what is required of

MC to be included in a chart audit and the quarterly meeting itself and was told

that's just what they said, but again, nothing written down. Any help in

pointing to a manual or publication that states what is required to be covered

in compliance meetings and in a chart audit would be helpful.

Thanks,

Damon C. Whitfield, PT, ATC

Michigan

[Guest guest]

Group,

Just need some confirmation and maybe some more direction to some black and

white back up.

No matter what insurance you are talking, if  you are seeing 2 patients at one

time, you cannot (or should not I will say)

bill them each individually for the full 4 units they are there (supposing 1

hour tx). Does not matter if its one MC and one BC or 2 MC or 2 WC,

if you are seeing 2 patients at the same time, each of them would get one group

code for their overlapped time, correct? We seem to be having some issues with

that

and any direction to black and white info would be helpful. Thanks again to Rick

Gawenda and Dr.Dick Hillyer and Larry Benz for their thoughts on my last

question.

Next issue is chart audits. The person who always handled quarterly reviews and

chart audits has retired. I had asked on several occasions what is required of

MC to be included in a chart audit and the quarterly meeting itself and was told

that's just what they said, but again, nothing written down. Any help in

pointing to a manual or publication that states what is required to be covered

in compliance meetings and in a chart audit would be helpful.

Thanks,

Damon C. Whitfield, PT, ATC

Michigan

[Guest guest]

That is correct if you are billing using the CPT codes as their definitions

are copyrighted and very specific on this issue. The reference is the CPT

manual. Now is you are seeing them both but treating one while one is

resting and giving each 30 minutes of your time, you can bill them each for

30 minutes even though they were there for 60, they only had 30 minutes of

skilled care.

Sandi Pomeroy, PT

Pomeroy Therapeutics

Dayton, Ohio

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Damon Whitfield

Sent: Thursday, September 29, 2011 9:47 AM

To: PTmanager

Subject: Fw: group codes and chart audits

Group,

Just need some confirmation and maybe some more direction to some black and

white back up.

No matter what insurance you are talking, if you are seeing 2 patients at

one time, you cannot (or should not I will say)

bill them each individually for the full 4 units they are there (supposing 1

hour tx). Does not matter if its one MC and one BC or 2 MC or 2 WC,

if you are seeing 2 patients at the same time, each of them would get one

group code for their overlapped time, correct? We seem to be having some

issues with that

and any direction to black and white info would be helpful. Thanks again to

Rick Gawenda and Dr.Dick Hillyer and Larry Benz for their thoughts on my

last question.

Next issue is chart audits. The person who always handled quarterly reviews

and chart audits has retired. I had asked on several occasions what is

required of MC to be included in a chart audit and the quarterly meeting

itself and was told that's just what they said, but again, nothing written

down. Any help in pointing to a manual or publication that states what is

required to be covered in compliance meetings and in a chart audit would be

helpful.

Thanks,

Damon C. Whitfield, PT, ATC

Michigan

[Guest guest]

That is correct if you are billing using the CPT codes as their definitions

are copyrighted and very specific on this issue. The reference is the CPT

manual. Now is you are seeing them both but treating one while one is

resting and giving each 30 minutes of your time, you can bill them each for

30 minutes even though they were there for 60, they only had 30 minutes of

skilled care.

Sandi Pomeroy, PT

Pomeroy Therapeutics

Dayton, Ohio

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Damon Whitfield

Sent: Thursday, September 29, 2011 9:47 AM

To: PTmanager

Subject: Fw: group codes and chart audits

Group,

Just need some confirmation and maybe some more direction to some black and

white back up.

No matter what insurance you are talking, if you are seeing 2 patients at

one time, you cannot (or should not I will say)

bill them each individually for the full 4 units they are there (supposing 1

hour tx). Does not matter if its one MC and one BC or 2 MC or 2 WC,

if you are seeing 2 patients at the same time, each of them would get one

group code for their overlapped time, correct? We seem to be having some

issues with that

and any direction to black and white info would be helpful. Thanks again to

Rick Gawenda and Dr.Dick Hillyer and Larry Benz for their thoughts on my

last question.

Next issue is chart audits. The person who always handled quarterly reviews

and chart audits has retired. I had asked on several occasions what is

required of MC to be included in a chart audit and the quarterly meeting

itself and was told that's just what they said, but again, nothing written

down. Any help in pointing to a manual or publication that states what is

required to be covered in compliance meetings and in a chart audit would be

helpful.

Thanks,

Damon C. Whitfield, PT, ATC

Michigan