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When documenting time, include only the time you spend face-to-face with the patient. If a nurse or other hospital member counseled the patient, you can not include it. You can count only physician counseling time. Your documentation needs to demonstrate that more than 50 percent of the visit was spent on counseling.
You can't bill for documentation. Documentation takes time there's not denying that. Even if you have an EMR system that streamlines the process, there's still a lot of effort that goes into creating notes that are complete, correct, and compliant.
97110: Therapeutic Exercise. 97112: Neuromuscular Re-education. 97116: Gait Training. 97140: Manual Therapy. 97150: Group Therapy. 97530: Therapeutic Activities. 97535: Self-Care/Home Management Training. 97750: Physical Performance Test or Measurement.
Yes. It's possible to bypass the edit by using the 59 modifier/X modifier when billing 97140 with the physical therapy evaluation codes (97161, 97162, or 97163). If you don't use the modifier for this combination of codes, CMS will deny the manual therapy code.
The Current Procedural Terminology (CPT) code 97164 as maintained by American Medical Association, is a medical procedural code under the range — Physical Therapy Evaluations.
When selecting time, the provider must have spent a time closest to the code selected. For example, 99214 has a typical time of 25 minutes, and 99213 has a typical time of 15 minutes. If the face-to-face office time is 21 minutes, select code 99214 since it's more than half of the time difference.
If you and your patient spend more than 20 minutes of a 40-minute face-to-face visit together in this manner, a 99215 code is justifiable as long as you have detailed documentation of the context of the counseling and care coordination.
According to CPT, 99214 is indicated for an office or other outpatient visit for the evaluation and management of an established patient, which requires at least two of these three key components: a detailed history, a detailed examination and medical decision-making of moderate complexity. [For more detailed
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