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Eli's Rehab Report

CPT 2001 Codes Contain Changes For Therapeutic Procedures
When the AMA announced CPT changes for 2001 this month in Chicago, physical medicine and ... Read more
Fee Increase and New HCPCS Codes for 2001
On Nov. 1, HCFA published its Final Rule for Revisions to Payment Policies under the Phy... Read more
Reader Question:
Black Box Edits
Question: A claim was rejected because of an edit that isnt published in the CCI. Is there... Read more
Reader Question:
Single System Exam
Question: If a physiatrist is using a single system exam to record information from the p... Read more
Reader Question:
Physicians Signature on Treatment Plan
Question: Your October article on occupational therapy billing stated that the physiatrist... Read more
Reader Question:
Billing for Thermography
Question: Our office performs thermography testing (93740, 93760 and 93762). Medicare and ... Read more
You Be the Coder:
Pulsevac Codes
Question: What is the CPT code for using a Pulsevac for debridement in the rehab facili... Read more
Latest CCI Bundles E/M With Many Procedure Codes Modifier -25 Is the Answer for Payment
Effective Oct. 30, evaluation and management (E/M) services are considered bundled to a mu... Read more
Strict Rules Apply When Employing a Physical Therapist
Having a physical therapist (PT) as part of your physical medicine and rehabilitation (PM&... Read more
Code Confirmatory Consults for Ethically Maximum Return
Physiatrists often code for new or established patient office visits ( CPT 99201 - 99215 )... Read more
Reader Question:
Code Q0086
Question: When is it appropriate to use code Q0086?Georgia Subscriber Answer: In Georgia, ... Read more
Reader Question:
Coding for Preoperative Physicals
Question: How do I code a presurgical physical so we can get paid for the office visit as ... Read more
Reader Question:
Needle EMG
Question: We bill CPT 95860 for an electromyograph (EMG) in addition to A4215 for the act... Read more
Reader Question:
Billing OT Evaluation With ADL Training
Question: If an occupational therapist (OT) instructs a patient in a home exercise program... Read more
Reader Question:
Is Modifier -51 Required for Prolonged Services?
Question: Does CPT 99359 need to be listed separately for each unit of time? And for Medi... Read more
You Be the Coder:
Coding For Supplies When Performing Wound Dressing Changes
Question: I know Medicare does not cover wound dressing changes, but what about the creams... Read more
Optimize Billing for IDET Back Pain Procedure
The U. S. Food and Drug Administration approved intradiscal electrothermal (IDET) therapy ... Read more
Optimize Payment for Occupational Therapy
As an integral part of most patients rehabilitation, occupational therapy is a way to help... Read more
After-hours Codes Ethically Increase Reimbursement
Over the past several years, many physical medicine and rehabilitation (PM&R) practices ha... Read more
Coding for Therapeutic or Bone-healing Ultrasound
Health Care Financing Administrations (HCFA) July 31 announcement that Medicare will cover... Read more
Reader Question:
Car Accident Injuries
Question: A patient presented to the physiatrist with whiplash and back pain resulting fro... Read more
Reader Question:
Rating Workers' Comp Patients
Question: What code should I use when rating a patient at the completion of treatment when... Read more
Reader Question:
Diagnosis Code for Piriformis Syndrome
"Question: Is there a diagnosis code for piriformis syndrome? Georgie Powell Cu... Read more
You Be the Coder:
Emergency During Office Visit
Question: We had an emergency situation in our office when a patient had a seizure during ... Read more
Avoid Using Trigger Point Injection Code When Billing for Prolotherapy
The benefits of prolotherapy for relieving pain and repairing ligament or tendon damage ar... Read more
Get Paid When Physiatrist and Chiropractor Co-manage Patients
To enhance care to physical medicine patients, many physical medicine and rehabilitation ... Read more
Signs/Symptoms Codes Can Boost Reimbursement
Use ICD-9 signs and symptoms codes to provide medical necessity for a procedure or service... Read more
Understanding Starred and Minor Procedures Will Optimize Pay Up
When is a small procedure, such as a biopsy or an injection, considered minor, and when is... Read more
Reader Question:
Billing for Dual Modalities
Question: Can we bill CPT 97014 (electrical stimulation, unattended) and 97033 (iontophor... Read more
Reader Question:
Effective Dates for CCI Edits
Question: Are the CCI edits issued in July of 1999 still current? New York Subscriber... Read more
You Be the Coder:
Billing for Procaine Injections
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Sort Through Spinal Injection Coding Maze to Optimize Reimbursement
One of the most confusing aspects of billing for pain management is assigning the proper... Read more
Get Paid for Nerve Studies Bundled by Erroneous CCI Edit
If you have submitted a recent claim for 95900 (nerve conduction, amplitude and latency/... Read more
Ensure Proper APC Pay Up For Physical Therapy in ED
The outpatient prospective payment system (OPPS) and its ambulatory payment clas... Read more
Reader Question:
Micro TENS Units
Question: On occasion, I will have a patient who I feel is in need of a micro TENS unit.... Read more
Reader Question:
Concurrent Care vs. Consult
Question: One of my multiple sclerosis (340) patients was admitted to the hospital by her ... Read more
Reader Question:
Team Meetings With Other Providers
Question: Our physiatrist treats a fibromyalgia (ICD-9 729.1 ) patient who is in an inpati... Read more
You Be the Coder:
Manual Traction
Test your coding knowledge. Determine how you would code this situation before looking at... Read more
Six Coding Tips to Properly Bill Pressure Ulcer Treatment
According to the federal Agency for Health Care Policy and Research, more than 60,000 peop... Read more
Coding E/M Levels:
Note Counseling and Coexisting Conditions to Optimize Pay Up
Choosing the appropriate evaluation and management (E/M) service level is always challen... Read more
Government Relations Alert:
HCFA Changes Rules for Stimulation of Fractures
The Health Care Financing Administration (HCFA) revised its 20-year-old policy regarding n... Read more
AHIMA Releases New Standards of Ethical Coding
Proper coding for physiatry practices requires up-to-the-minute information, experience ... Read more
Correction:
Rotator Cuff Tendonitis
Our June cover article titled Get Paid for Common Summer Injuries contained an incorrect I... Read more
HCFA Delays OPPS Until Aug. 1, 2000
In a special announcement released on June 2, HCFA Administrator Nancy-Ann Min DeParle an... Read more
Reader Question:
Nerve Blocks
Question: We have received reductions in payment and denials when billing for multiple l... Read more
Reader Question:
E/M With Injection
Question: When billing for an evaluation and management (E/M) service along with an inject... Read more
Reader Question:
Therapeutic Procedure
Question: I have been receiving denials from third-party payers when I bill 97110 (therape... Read more
You Be the Coder:
Knee Injections
Test your coding knowledge. Determine how you would code this situation before looking a... Read more
Get Paid for Common Summer Injuries
The onset of summer and warm weather often causes a great many people to head outdoors and... Read more
Know the Five Key Steps to Successfully Appeal Denials
Insurance denials for ethically claimed services are an irritating and somewhat frequent o... Read more
Understanding Medicare's CCI Is Powerful Compliance Tool
Unbundling, breaking down a single procedure into its component parts and billing for ad... Read more
Reader Question:
Physical Therapy Codes
Question: Can CPT 97530 (therapeutic activities) be billed with 97140 (manual therapy), 9... Read more
Reader Question:
Whirlpool Therapy
Question: Can I bill for two whirlpools if Im giving the patient whirlpools on both feet o... Read more
Reader Question:
Speech Evaluation
Question: We performed a speech evaluation on a stroke patient, and three days later, the ... Read more
Reader Question:
New Practice, Old Patients
Question: I work for a doctor who just left a large group practice to start his own practi... Read more
Reader Question:
Incident-To Billing
Question: Im confused after reading your article on incident-to. Must the physician be pre... Read more
You Be the Coder:
From Hospital to Nursing Facility
Question: Can we bill a hospital-discharge code on the same day as a nursing-facility admi... Read more
Meet the Three-R Test and Get Paid for Intra-office Consults
Nugget: If a visit meets the three-R test, it matches the definition for a consultation a... Read more
Recover the Cost of the Freehand System
Nugget: The Freehand System for quadriplegic patients is new and billers must choose from ... Read more
Optimize Reimbursement for Nurse-only Visits
Nugget: Practices can schedule, bill and expect reimbursement for nurse-only visits, even ... Read more
CCI Version 6.1 Delayed
Due to errors in comprehensive and component code-pair edits, the Health Care Financing ... Read more
Reader Questions:
Billing for Injection, Drug and Drug Amount
Question: We would like to bill for lidocaine ( J2000 , lidocaine hydrochloride) and triam... Read more
Reader Questions:
EMG and Consultation
Question: We had a patient for whom the doctor billed CPT 99245 (office consultation for ... Read more
You Be the Coder:
Patient-requested Physician Change
Question: I was recently called into the hospital to take over the care of a stroke patien... Read more
Maximize Pay Up for Electromyography
Nugget: EMG is a site-specific diagnostic test, and practices must note how many muscles ... Read more
More on Billing Incident to
For many coders, the March Physical Medicine & Coding Alert article which gives billing ad... Read more
Follow HCFAs Coding Guidance to Expedite Pay Up
Nugget: Regardless of the number of therapists and assistants it may take to perform a tre... Read more
Adding a Modifier Can Speed Fluoroscopy Reimbursement
Nugget: The new fluoroscopy code is useful, but dont unbundle if you are using an injectio... Read more
Reader Questions:
Annual Follow-up Exam
Question: At a seminar I was told that if a physician tells a patient to come in once a ye... Read more
Reader Questions:
Family Consultations
Question: I know that CPT Codes 2000 just attempted to clarify the billing rules for cha... Read more
You Be the Coder:
Professional Courtesy Discounts
Question: Is there a specific policy to deal with professional courtesy discounts? Someone... Read more
Correct E/M and E-Codes Can Increase Your Reimbursement
Nugget: In some circumstances its appropriate to bill for E/M services as well as a work-r... Read more
Correctly Bill for Incident to and Optimize Pay Up
Nugget: When billing incident to it is possible to increase the reimbursement from 85 ... Read more
Avoid Common Errors When Billing for Physical Therapy
Nugget: Your notes on the record, along with a complete patient history, may be more impor... Read more
Reader Questions:
Orthotics Billing
Question: How do we bill for orthotics and orthotics fittings for a patient who is just st... Read more
Reader Questions:
How to Code for Evaluation and Therapy
Question: Our office has both a physiatrist and a physical therapist working together. On ... Read more
You Be the Coder:
Consulting Chiropractor
Question: A chiropractor just asked our physiatrist for his opinion on whether a patient h... Read more
Use Caution When Billing Group Therapy and Theraputic Exercise Together
Nugget: Confusion about billing the group therapy code and the therapeutic code together s... Read more
Optimize Reimbursement by using Correct Botox Codes
"Nugget: Coders should bill both the CPT and HCPCS codes for Botox and should check... Read more
Increase Pay Up for Community Reintegration Training
Nugget: Billing for 15-minute increments for one-on-one time spent with the patient is cru... Read more
Use Prolonged Service Codes to Avoid Lost Revenue
Nugget: Many coders dont use prolonged service codes for fear of an audit, but downcoding ... Read more
News Brief:
Two-Year Moratorium Kicks in For $1,500 Therapy Cap
Physical medicine and rehabilitation (PM&R) offices that provide physical therapy, speech... Read more
Reader Questions:
Initial Evaluations
Question: 1. We just hired a physical therapist in our office, and were unsure whether the... Read more
You Be the Coder:
Arthrocentesis
Question: Sometimes when our doctor is performing arthrocentesis, he first aspirates the k... Read more
CPT 2000 Changes Affect Physical Medicine and Rehab Practices
Coding Insight: CPT 2000 adds, deletes and clarifies codes like 97150 that affect physiatr... Read more
Increase Pay Up for Same-day Multiple Nerve Conduction Studies
Coding Insight: Confusion about billing 95900 and 95903 can be cleared up by knowing the c... Read more
Modifier -59 Key to Getting Paid for Multiple Injections
Coding Insight: Use modifier -25 and proper diagnosis codes to increase your chances for r... Read more
Reader Questions:
Prosthetic Limb Training
Question: Were doing prosthetic limb training for a patient who has lost both hands. Do w... Read more
You Be the Coder:
Stroke-Related Muscle Weakness
The Case: Were having an inpatient coding problem: When patients left the hospital after... Read more
Available Years:  2000