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I would bill:

1 unit of Ther ex

I unit of Manual therapy

I unit ultrasound

The Hot pack is a freebie.

This accounts for the 45 minutes of patient time,

I would document all 4 interventions and responses to treatment etc.

Marcy Stalvey, PT, NCS

Akron General Edwin Shaw Rehab

Akron, OH 44312

ext 5188

>>> bowmanellis@... 01/20/06 11:47AM >>>

I ask for your patience with yet another billing question. What is the

proper way to bill in this scenerio:

10' hot pack

10' ther exerc

17' manual

8' Ultrasound

toatl RX time 45 min.

How about this one:

10 min Hot pack

10 min ther exerc

32 min manual

8 min US

total rx time 60'

thank you for your time,

Looking to start and own 100% of your own Practice?

Visit www.InHomeRehab.com.

PTManager encourages participation in your professional association. Join and

participate now!

Please identify yourself in all postings to PTManager.

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are you billing Medicare or just a commercial carrier?

>

>

> Date: 2006/01/20 Fri AM 11:47:28 EST

> To: PTManager

> Subject: billing scenerio

>

> I ask for your patience with yet another billing question. What is the

> proper way to bill in this scenerio:

> 10' hot pack

> 10' ther exerc

> 17' manual

> 8' Ultrasound

> toatl RX time 45 min.

>

> How about this one:

> 10 min Hot pack

> 10 min ther exerc

> 32 min manual

> 8 min US

> total rx time 60'

>

> thank you for your time,

>

>

>

>

>

>

>

>

> Looking to start and own 100% of your own Practice?

> Visit www.InHomeRehab.com.

> PTManager encourages participation in your professional association. Join and

participate now!

>

> Please identify yourself in all postings to PTManager.

>

Link to comment
Share on other sites

We are billing medicare but want to corporately bill all patients the same.

billing scenerio

>>

>> I ask for your patience with yet another billing question. What is the

>> proper way to bill in this scenerio:

>> 10' hot pack

>> 10' ther exerc

>> 17' manual

>> 8' Ultrasound

>> toatl RX time 45 min.

>>

>> How about this one:

>> 10 min Hot pack

>> 10 min ther exerc

>> 32 min manual

>> 8 min US

>> total rx time 60'

>>

>> thank you for your time,

>>

>>

>>

>>

>>

>>

>>

>>

>> Looking to start and own 100% of your own Practice?

>> Visit www.InHomeRehab.com.

>> PTManager encourages participation in your professional association. Join

and participate now!

>>

>> Please identify yourself in all postings to PTManager.

>>

Link to comment
Share on other sites

We are billing medicare primarily. I'm in a rural hospital and want

to corporately bill all patients the same.

>

> are you billing Medicare or just a commercial carrier?

> >

> > From: " ptgirl19922004 " <bowmanellis@m...>

> > Date: 2006/01/20 Fri AM 11:47:28 EST

> > To: PTManager

> > Subject: billing scenerio

> >

> > I ask for your patience with yet another billing question. What

is the

> > proper way to bill in this scenerio:

> > 10' hot pack

> > 10' ther exerc

> > 17' manual

> > 8' Ultrasound

> > toatl RX time 45 min.

> >

> > How about this one:

> > 10 min Hot pack

> > 10 min ther exerc

> > 32 min manual

> > 8 min US

> > total rx time 60'

> >

> > thank you for your time,

> >

> >

> >

> >

> >

> >

> >

> >

> > Looking to start and own 100% of your own Practice?

> > Visit www.InHomeRehab.com.

> > PTManager encourages participation in your professional

association. Join and participate now!

> >

> > Please identify yourself in all postings to PTManager.

> >

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Share on other sites

I may be confused on this...

But if you bill different payor structures all the same, aren't you

committing insurance fraud of some sort? I see your intentions to

streamline and improve your facility's position, but not all

insurance companies will see it that way. Even if you save one

company money, another may get the shaft (in their eyes) in that you

are not billing according to their particular guidelines.

Also, MCare does not reimburse for ice/heat as some commercial

companies do. Therefore, MCare does not recognize your time totals

as 45 and 60, but as 35 and 50.

None of us liked it when Medicare came up with such an interesting

way to reduce payments when they changed their time periods (not to

mention their not paying for certain procedures based upon

diagnosis, despite the clinical necessity of certain procedures).

However, if ew are to get paid, we must play the game until such

time as we can influence a change.

Lane Blondheim, PT, MT

Active Health and Rehab

Montgomery, AL

334/279-5757 phone

334/279-1257 fax

Lane_Blondheim@...

>

> We are billing medicare but want to corporately bill all patients

the same.

>

> billing scenerio

> >>

> >> I ask for your patience with yet another billing question. What

is the

> >> proper way to bill in this scenerio:

> >> 10' hot pack

> >> 10' ther exerc

> >> 17' manual

> >> 8' Ultrasound

> >> toatl RX time 45 min.

> >>

> >> How about this one:

> >> 10 min Hot pack

> >> 10 min ther exerc

> >> 32 min manual

> >> 8 min US

> >> total rx time 60'

> >>

> >> thank you for your time,

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >>

> >> Looking to start and own 100% of your own Practice?

> >> Visit www.InHomeRehab.com.

> >> PTManager encourages participation in your professional

association. Join and participate now!

> >>

> >> Please identify yourself in all postings to PTManager.

> >>

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Share on other sites

1st senario: You cannot include minutes in total time that are non covered or

bundled services with Medicare. (This came from a Medicare audit). Therefore the

total Medicare billable treatment time would be 35 min. or 2 units. You would

bill 1 unit of manual and 1 unit of ther ex.

2nd Senario: Total treatment time is 50 minutes or 3 units which would would

bill 2 units of manual and one unit of ther ex. The procedures that you spend

the most time on are the ones you will bill first. If it happens that you hae 2

different procedures with the same time, take the one which has the highest

reimbursement.

>

>

> Date: 2006/01/20 Fri PM 06:43:34 EST

> To: PTManager

> Subject: Re: billing scenerio

>

> We are billing medicare primarily. I'm in a rural hospital and want

> to corporately bill all patients the same.

>

> >

> > are you billing Medicare or just a commercial carrier?

> > >

> > > From: " ptgirl19922004 " <bowmanellis@m...>

> > > Date: 2006/01/20 Fri AM 11:47:28 EST

> > > To: PTManager

> > > Subject: billing scenerio

> > >

> > > I ask for your patience with yet another billing question. What

> is the

> > > proper way to bill in this scenerio:

> > > 10' hot pack

> > > 10' ther exerc

> > > 17' manual

> > > 8' Ultrasound

> > > toatl RX time 45 min.

> > >

> > > How about this one:

> > > 10 min Hot pack

> > > 10 min ther exerc

> > > 32 min manual

> > > 8 min US

> > > total rx time 60'

> > >

> > > thank you for your time,

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > >

> > > Looking to start and own 100% of your own Practice?

> > > Visit www.InHomeRehab.com.

> > > PTManager encourages participation in your professional

> association. Join and participate now!

> > >

> > > Please identify yourself in all postings to PTManager.

> > >

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Share on other sites

My understanding of Medicare was that you cannot bill separately for the

hot/cold pack, but that it was bundled into your other treatment

interventions, which would mean you still count the time in your total

treatment time. Is this not true?

Jill Piazza, PT, MSPT

billing scenerio

>> >>

>> >> I ask for your patience with yet another billing question. What

> is the

>> >> proper way to bill in this scenerio:

>> >> 10' hot pack

>> >> 10' ther exerc

>> >> 17' manual

>> >> 8' Ultrasound

>> >> toatl RX time 45 min.

>> >>

>> >> How about this one:

>> >> 10 min Hot pack

>> >> 10 min ther exerc

>> >> 32 min manual

>> >> 8 min US

>> >> total rx time 60'

>> >>

>> >> thank you for your time,

>> >>

>> >>

>> >>

>> >>

>> >>

>> >>

>> >>

>> >>

>> >> Looking to start and own 100% of your own Practice?

>> >> Visit www.InHomeRehab.com.

>> >> PTManager encourages participation in your professional

> association. Join and participate now!

>> >>

>> >> Please identify yourself in all postings to PTManager.

>> >>

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Share on other sites

Jill,

When determining the amount of units you can bill that

are timed, you do not include the minutes of un-timed

codes in the total. Since hot and cold packs are

service-based codes (un-timed), those minutes are not

included.

http://www.cms.hhs.gov/manuals/downloads/clm104c05.pdf

Read section 20.2

Rick Gawenda, PT

Director PM & R

Detroit Receiving Hospital

--- Jill Piazza wrote:

> My understanding of Medicare was that you cannot

> bill separately for the

> hot/cold pack, but that it was bundled into your

> other treatment

> interventions, which would mean you still count the

> time in your total

> treatment time. Is this not true?

>

> Jill Piazza, PT, MSPT

>

> billing scenerio

> >> >>

> >> >> I ask for your patience with yet another

> billing question. What

> > is the

> >> >> proper way to bill in this scenerio:

> >> >> 10' hot pack

> >> >> 10' ther exerc

> >> >> 17' manual

> >> >> 8' Ultrasound

> >> >> toatl RX time 45 min.

> >> >>

> >> >> How about this one:

> >> >> 10 min Hot pack

> >> >> 10 min ther exerc

> >> >> 32 min manual

> >> >> 8 min US

> >> >> total rx time 60'

> >> >>

> >> >> thank you for your time,

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >> Looking to start and own 100% of your own

> Practice?

> >> >> Visit www.InHomeRehab.com.

> >> >> PTManager encourages participation in your

> professional

> > association. Join and participate now!

> >> >>

> >> >> Please identify yourself in all postings to

> PTManager.

> >> >>

Link to comment
Share on other sites

In our Medicare audit we were told that you cannot use the time involved on a

bundled or noncovered service (ionto as an example) in your total treatment

time. You also may not use times when the procedures are performed at the same

time, like a combo which is manual e-stim and ultrasound. Check with CMS

yourself as we all know some of these rules are really open to interpertation.

>

>

> Date: 2006/01/23 Mon PM 10:35:00 EST

> To: <PTManager >

> Subject: Re: Re: billing scenerio

>

> My understanding of Medicare was that you cannot bill separately for the

> hot/cold pack, but that it was bundled into your other treatment

> interventions, which would mean you still count the time in your total

> treatment time. Is this not true?

>

> Jill Piazza, PT, MSPT

>

> billing scenerio

> >> >>

> >> >> I ask for your patience with yet another billing question. What

> > is the

> >> >> proper way to bill in this scenerio:

> >> >> 10' hot pack

> >> >> 10' ther exerc

> >> >> 17' manual

> >> >> 8' Ultrasound

> >> >> toatl RX time 45 min.

> >> >>

> >> >> How about this one:

> >> >> 10 min Hot pack

> >> >> 10 min ther exerc

> >> >> 32 min manual

> >> >> 8 min US

> >> >> total rx time 60'

> >> >>

> >> >> thank you for your time,

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >>

> >> >> Looking to start and own 100% of your own Practice?

> >> >> Visit www.InHomeRehab.com.

> >> >> PTManager encourages participation in your professional

> > association. Join and participate now!

> >> >>

> >> >> Please identify yourself in all postings to PTManager.

> >> >>

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