Eli's Rehab Report

Question: I understand that iontophoresis (97033) is a constant-attendance modality and a timed code, but what about the setup time? Part of that time involves the therapist's direct, one-on-one contact with the patient, so I would guess that I could bill for that time.

Oregon Subscriber

Answer: You can count certain parts of the setup time toward 97033 (Application of a modality to one or more areas; iontophoresis, each 15 minutes), but you must be very specific as to what kind of setup you're billing. Billable set-up time is the therapist's skilled assessment time prior to the iontophoresis application that will assist the therapist in determining whether iontophoresis is an appropriate intervention. The assessment may include ROM measurements, palpation, etc. It may also include applying the electrodes to the treatment area and setting the parameters of the unit.

You can also count the therapist's post-treatment assessment as skilled time. This may include skin inspection and education provided to the patient, especially if the patient is using the ionto patch and is applying it independently to himself at home.

Keep in mind: Certain setup procedures, such as getting the machine out, putting the machine away, or bringing the patient back to the treatment area, are not billable because they don't require a therapist's skills. But if you are speaking to the patient regarding his pain level and functional status as you are bringing him back to the treatment area, that time may be considered skilled, because that is part of the therapist assessment.

-- Reader Questions reviewed by Rick Gawenda, PT, director of physical medicine and rehabilitation for Detroit Receiving Hospital, and owner of Gawenda Seminars.