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MD Relationship Program

Consultation #69 Part 2 of 2

 From the Desk of:

William J Owens Jr DC, DAAMLP, CPC

"CPT Coding and Timed Procedures"

In the first part of this consultation, we talked about cross coding and how to ensure that you are coding your procedures properly for your diagnosis.  That is Coding 101 for your office and is the first step in building a solid foundation for the compliance portion of your practice. 

 

In this second part of the coding consultation, I wanted to tackle the next major issue in Coding 101 and that is the proper utilization of timed procedural codes.  You are aware that some codes include a “global” bundle of services, others are stand alone codes and still others are based on a time component.  As a certified professional coder, I get questions regularly about the timed codes and thought a consultation on that topic would be helpful for most offices.  Therefore, I want to give you the nuts and bolts.  Once you get that, all else will follow. 

The CPT codes have particular standards that apply to time measurement unless there are specific instructions in the CPT manual.  Let’s look at some of the standards in the CPT coding manual. 

 

TIME - Based on “face to face” time with the patient.

A UNIT OF TIME A unit of time is attained when the mid-point is passed.  Example: An hour is attained when 31 minutes have passed. A second hour, therefore, would be attained when a total of 91 minutes has elapsed.  Most therapeutic modalities used in the chiropractic office are based on 15 minute increments.  Therefore, the first 15 minute is reported and billed when the timed therapy reaches 8 minutes.  The second 15 minutes is billed and reported when the patient reaches the 23 minute mark of total time (the FIRST 15 minute therapy, plus the 8 minutes of the SECOND 15 minute therapy).  Having the patient “sign in” and “sign out” of timed procedures is the only way to objectively verify that the procedure was done.

CONCURRENT SERVICESWhen another service is performed concurrently with a time based service, the time associated with that concurrent service should not be included in the time being reported for the time based services.  Example:  CMT 3-4 spinal regions and therapeutic exercise.  The patient’s adjustment time is NOT included in the therapeutic exercise time being reported.  The therapeutic exercise time is recorded separately. 

 

These are critically important areas to understand and master if you have not done that already.  If you have an understanding, please make sure that you are documenting the “in” and “out” times of each patient with a signature.  If you need help, please email me.

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