Guest guest Posted January 20, 2006 Report Share Posted January 20, 2006 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2006 Report Share Posted January 20, 2006 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. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2006 Report Share Posted January 20, 2006 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. >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2006 Report Share Posted January 20, 2006 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. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2006 Report Share Posted January 21, 2006 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. > >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 22, 2006 Report Share Posted January 22, 2006 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. > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 23, 2006 Report Share Posted January 23, 2006 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. >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2006 Report Share Posted January 24, 2006 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. > >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2006 Report Share Posted January 24, 2006 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. > >> >> Quote Link to comment Share on other sites More sharing options...
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