IRF PPS question

[Guest guest]

Here's my scenario:

a therapist treats a patient for 6 minutes (or anything less than 15 minutes).

What do you record for billing purposes? Are you using 15 minute charge units?

If yes, what do you put on the patient's account? 1 unit? Are you rounding up

or down? If yes, what is the round up minute?

Are your therapists documenting actual clock time in their notes?

e.g. start time 9:39 a.m. - 10:29 a.m. for a total of 50 minutes. What do

you bill? 3 or 4 units?

Lori Stoddart, OTR

Inpatient Therapy Manager

Physical Rehabilitation Services

Henry Ford Wyandotte Hospital

Wyandotte, MI

734/246-8963

lstodda1@...

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[Guest guest]

Lori,

If your billing system uses charge codes that are linked to CPT codes then

you follow the definitions. The " eight minute " rule as defined by CMS is a

good place to start for determining what and if you should charge. I have a

hard time believing that there was just 6 minutes of intervention. Make sure

the therapist is accounting for any chart review and consultation with other

staff in preparation for the treatment. My therapists generally round to the

nearest 5 minutes when documenting time so your example would be 9:40 -

10:30 - and we would charge 3 units of whatever. We would bill 4 units after

the 53rd minute of intervention.

Jeff Wheeler PT, GCS

Highline Medical Ctr

Tukwila, WA

IRF PPS question

Here's my scenario:

a therapist treats a patient for 6 minutes (or anything less than 15

minutes). What do you record for billing purposes? Are you using 15 minute

charge units? If yes, what do you put on the patient's account? 1 unit? Are

you rounding up or down? If yes, what is the round up minute?

Are your therapists documenting actual clock time in their notes?

e.g. start time 9:39 a.m. - 10:29 a.m. for a total of 50 minutes. What do

you bill? 3 or 4 units?

Lori Stoddart, OTR

Inpatient Therapy Manager

Physical Rehabilitation Services

Henry Ford Wyandotte Hospital

Wyandotte, MI

734/246-8963

lstodda1@...

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[Guest guest]

Hi, Lori, Jeff, et. al. -

As I recall, the " 8 minute rule " only pertains to outpatient Medicare. If

your staff spends minutes providing skilled service to an IRF resident, I

believe that they should all count toward the necessary 180 per day, five

out of seven days.

That would include the few minutes coaching the patient in rolling over, a

couple sitting up on the side of the bed, standing into a walker, the time

to walk to the rehab gym, then the time of doing exercise, receiving

supportive pain management modalities, practicing ADLs, the rest of the

treatment, and then each of the skilled activities on the way back to the

patient room.

Best regards,

Dr. Dick Hillyer

Dr. W. Hillyer

Hillyer Consulting

Cape Coral, FL 33914

_____

From: PTManager [mailto:PTManager ] On Behalf

Of Jeff Wheeler

Sent: Monday, June 16, 2008 1:39 PM

To: PTManager

Subject: RE: IRF PPS question

Lori,

If your billing system uses charge codes that are linked to CPT codes then

you follow the definitions. The " eight minute " rule as defined by CMS is a

good place to start for determining what and if you should charge. I have a

hard time believing that there was just 6 minutes of intervention. Make sure

the therapist is accounting for any chart review and consultation with other

staff in preparation for the treatment. My therapists generally round to the

nearest 5 minutes when documenting time so your example would be 9:40 -

10:30 - and we would charge 3 units of whatever. We would bill 4 units after

the 53rd minute of intervention.

Jeff Wheeler PT, GCS

Highline Medical Ctr

Tukwila, WA

IRF PPS question

Here's my scenario:

a therapist treats a patient for 6 minutes (or anything less than 15

minutes). What do you record for billing purposes? Are you using 15 minute

charge units? If yes, what do you put on the patient's account? 1 unit? Are

you rounding up or down? If yes, what is the round up minute?

Are your therapists documenting actual clock time in their notes?

e.g. start time 9:39 a.m. - 10:29 a.m. for a total of 50 minutes. What do

you bill? 3 or 4 units?

Lori Stoddart, OTR

Inpatient Therapy Manager

Physical Rehabilitation Services

Henry Ford Wyandotte Hospital

Wyandotte, MI

734/246-8963

lstodda1hfhs (DOT) <mailto:lstodda1%40hfhs.org> org

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