Time Based Coding - Private Practice Success in …

1 time Based Coding for Physical Therapists time is recorded Based on constant one-on-one attendance. The AMA designed the codes to be reported in 15- minute intervals. For example, if manual therapy is applied to 2 areas for a total of 30 minutes, CPT code 97140 is reported with two units, one for each 15-min interval. Medicare considerations for time Based codes. 1. Never include the time a patient spends in a non- time Based service such as mechanical traction (97012 ). 2. Pre and post delivery services are not to be counted in determining treatment service time a.

2 The patient should be in the treatment area ready to begin b. Count only the intraservice time c. Do not count resting, toileting or break time d. Do not count time waiting for equipment 3. Total the number of minutes the patient spent in time Based services for that day. 4. Use the following table to select the number of units of service. Total The Number of Minutes on a Given Calender Day Total minutes of time - Total number of Based codes only units to bill The examples given by HCFA in Transmittal AB-00-14 are: 08 22 01.

3 Example 1: If 24 minutes of 97112 and 23 minutes of 97110 were furnished, 23 37 02 then the total treatment time was 47 minutes, so only 3 units can be billed for 38 52 03 the treatment. The correct Coding is 2 units of 97112 and 1 unit 97110, assigning more units to the service that took more time . 53 67 04. 68 82 05 Example 2: If a therapist delivers 5 minutes of 97035 (US), 6 minutes of 97140. (manual therapy), and 10 minutes of 97110 (ther ex.), then the total minutes are 83 97 06 21 and only one unit can be paid.

4 Bill one unit of 97110 (the service with the longest time ) and the clinical record will serve as documentation that the other 98 112 07 two services were also performed. 113 128 08. Chart of time Based Codes Modalities 97032 EMS (manual or attended) ea. 15'. 97033 Iontophoresis ea. 15' Not reimbursed in many states 97034 Contrast Baths ea. 15'. 97035 US ea. 15' Phonophoresis 97035 once for each 15 min. and 99070 once for the steriodal cream 97036 Hubbard Tank ea. 15'. 97039 Unlisted Modality ea. 15' Documentation required Therapeutic Procedures 97110 Therapeutic Exercise ea.

5 15' Without PT present than bill group Ther. Ex. 97150. 97112 Neuromuscular Reeducation ea. 15' PNF, Feldenkrais, Bobath, BAP's board, Desensitization techniques 97113 Aquatic Therapy ea. 15'. 97116 Gait Training ea. 15'. 97124 Massage ea. 15'. 97139 Unlisted Therapeutic Procedure Documentation required 97140 Manual Therapy ea. 15'. 97150 Group Therapeutic Procedures (2 or more). 97504 Orthotic fitting and training ea. 15' Do not include time to design and fabricate the device 97520 Prosthetic training ea. 15'. 97530 Therapeutic activities (dynamic activities) ea.

6 15'. 97532 Development of cognitive skills ea. 15'. 97533 Sensory Integration ea. 15'. 97535 Self care/home management training, ADL's ea. 15' Patient must have capacity to learn 97537 Community/work reintegration training ea. 15' Not covered if solely related to work skills. Rarely coded by PT's 97542 Wheelchair management/training ea. 15'. Tests & Measurements 97703 Checkout for orthotic/prosthetic use ea. 15' Established patient 97750 Physical performance test or measurement ea. 15' IE. Functional Capacity Evaluations.

7 Written report required 97780 Acupuncture, one or more needles; no ems ea. 15' Not covered by Medicare 97799 Unlisted physical medicine/rehab. Service/proc Requires documentation S8950 Complex lymphedema therapy ea. 15' Temporary National Code. Do not use with Medicare Questions regarding billing time Based units should be directed to Dr. Laurie Feinberg at HCFA (410) 786-7069 or email