You must, however, make sure to justify your treatment intentions and document them properly in order to avoid scrutiny later. Therapeutic exercise and therapeutic activities are two common interventions that are used to address dysfunction caused by disease and injury. Coding: Patient A: 97110 therapeutic exercise 3 units Patient B: 97035 ultrasound ; 97140 manual therapy 2 units 97110 therapeutic exercise 2 units Patient C: 97110 therapeutic exercise 2 units Rationale: Patient A received three units of therapeutic exercise 97110. Examples include, treadmill for endurance , isokinetic exercise for range of motion , lumbar stabilization exercises for flexibility , and for stretching or strengthening. All the information are educational purpose only and we are not guarantee of accuracy of information. In-network providers cannot bill the patient.
Coding: Patient A: 97150 group therapy ; 97110 therapeutic exercise Patient B: 97150 group therapy ; 97140 manual therapy Patient C: 97150 group therapy ; 97014 electrical stimulation, unattended ; 97110 therapeutic exercise Rationale: From 9:00-9:20, the patients are receiving group therapy services. To be reimbursed for both services, the provider's documentation must support that the group therapy and the therapeutic procedure were performed during separate time intervals. The claim will be denied and returned with a request for records if they are not received with the claim. Please refer to Medical Policy Electrical Stimulation and Electromagnetic Therapy for Wounds for information related to electrical stimulation wound therapy. This includes both cervical and lumbar-pelvic mechanical traction.
For example, overhead shoulder movement can be strengthened by reaching up to place a weighted object on a shelf. These dynamic activities must be part of an active treatment plan and directed at a specific outcome. At 9:45 patient A and patient B are both on floor mats performing various exercises and stretches to improve movement and coordination. Paper claims have a longer processing time and this may hinder your cash flow. Each of the codes is performed for more than 15 minutes, so each shall be billed for at least 1 unit. Modifier 59 is used appropriately when two timed procedures are performed in different blocks of time on the same day. Exceptions for Evaluation Services Evaluation.
If a covered diagnosis is not on the claim, the edit will automatically deny the service as not medically necessary. The codes 97110- 97124 should be used for physical therapy procedures. The physical therapist intermittently observes these eight individuals during their one-hour exercise period. Therapeutic Exercise is considered reasonable and necessary if at least one of the following conditions is present and documented: a. She holds a Bachelor of Science degree in Media Communications - Journalism. Providers should not bill for services performed less than 8 minutes. .
For example, overhead shoulder presses using dumbbells is a therapeutic exercise. They often are surprised when optometrists bill outside the 92000 series, and they erroneously try to recode the procedure into the 92000 series. General Occupational Therapy Guidelines Occupational therapy services are those services provided within the scope of practice of occupational therapists and necessary for the diagnosis and treatment of impairments, functional disabilities or changes in physical function and health status. Massages that are provided as preparation for a physical medicine therapy are considered an integral part of the therapy. Super bill -or- Fee slip, which is better? Documentation must show objective loss of joint motion, strength, or mobility e.
However, the time of patient B and C is not billed as either group or one-on-one, because the therapist is working one on one with Patient A. During the period in which these patients are exercising simultaneously, the physical therapist provides clinical expertise and judgment, such as offering feedback, providing further individualized instruction, implementing modifications and progressions of the exercise program for each patient, or measuring each patient's response to treatment. The deciding factors are always whether the services are considered reasonable, effective treatments for the patientts condition and require the skills of a therapist, or whether they can be safely and effectively carried out by nonskilled personnel. They require the professional skills of a provider and are designed to address a specific functional need of the patient. All the information are educational purpose only and we are not guarantee of accuracy of information. A common question is whether roller table type traction meets the above requirement. They seem very similar to me.
Tests and measures should be performed using a method which allows for comparison of successive measurements, d. When performing other procedures, you may want to consider the Physical Medicine and Rehabilitation codes 97000 series. Article Tags: Click on a tag to see related articles. The guidelines apply to all timed services rendered to the patient in one session. This therapeutic procedure is provided for the purpose of restoring balance, coordination, kinesthetic sense, posture, and proprioception e.
Both of these resources should be used to ensure that your provider is documenting and billing 97110 correctly to prevent documentation errors, coding errors, and payment recoupment. For more info see our. Tiered reimbursement for chiropractors is defined in the 2015 … 97034, 97035, 97036 97039, 97110, 97112, 97113, 97116, 97124, 97139,. © 2015 American Health Care Association. This procedure involves the use of functional activities e.
General Speech-language Therapy Guidelines Speech-language pathology services are those services provided within the scope of practice of speech-language pathologists and necessary for the diagnosis and treatment of speech and language disorders which result in communication disabilities and for the diagnosis and treatment of swallowing disorders dysphagia , regardless of the presence of a communication disability. General Guidelines for Therapeutic Procedures 97110-97546: The following clinical guidelines pertain to the specific therapeutic procedures listed below. Therapeutic exercises may require active, active-assisted, or passive participation by the patient e. If, however, the patient also had benign hypertensive heart disease, then you would include a fifth digit: The proper code would be 402. First, the code is explained, then important tips are listed. However, the total number of timed minutes must be documented. The intent of the service is to increase pain-free range of motion and facilitate a return to functional activities.