Wiki In office procedures

[PDecell]

I'm being told that, when determining the E/M using MDM, the orthopedist still has to note the time spent on manipulations. I've been coding ortho visits for a few years and have never heard that before. I've checked the guidelines and searched the web but can't find any information. I can't figure out why it would be necessary to break out the manipulations by time when they aren't involved with the MDM determination. Any input would be greatly appreciated.

 

[lgardner]

the OMT does not need to be documented with time, in order to bill for it.

However, the manipulation cannot be counted towards MDM for an E/M (either the time spent OR data/risk).

ALSO, remember that in order to bill for an E/M, there must be a service that is "separate and significantly identifiable" from the manipulation.

 

[amyjph]

Are you talking about manipulation of an acute fracture or osteopathic manipulation treatment?
If the provider is reporting closed treatment with or without manipulation, that is not counted toward the MDM since they are separately reporting it.

 

[lgardner]

Are you talking about manipulation of an acute fracture or osteopathic manipulation treatment?
If the provider is reporting closed treatment with or without manipulation, that is not counted toward the MDM since they are separately reporting it.

Good point.

I only have experience with OMT.