2990Re: Billing question on timed codes
- Mar 5, 2008Thank you. So at least for Medicare, you are saying you must do the
service for at least 8 min to use a timed code which states first 15
min. in it's description. And if you attach a 52 modifier that tells
them that you did the 8 min minimum? Plans that are not specific
about a minimum time do not require you to at least 8 min. Am I
understanding that right? Thank you for your help. Diana
--- In MedicalBillers@yahoogroups.com, B Burgess <granbfly@...> wrote:
> I think that may be a payor specific issue. For Medicare, it is at
least 8 minutes up to 23 minutes.
> CPT Assistant Aug 2005 states in part.....................
> Several CPT codes used for therapy modalities, procedures, and
tests and measurements specify that the direct (one-on-one) time
spent in patient contact is 15 minutes. Providers report procedure
codes for services delivered on any calendar day using CPT codes and
the appropriate number of units of service. Under Medicare, for any
single CPT code, providers bill a single 15-minute unit for treatment
greater than or equal to 8 minutes and less than 23 minutes.
> If the duration of a single modality or procedure is greater than
or equal to 23 minutes to
> less than 38 minutes, then 2 units should be billed. Time
intervals for larger numbers of units
> are as follows:
> Units Reported on the Claim Number Minutes
> 3 units > 38 minutes to < 53 minutes
> 4 units > 53 minutes to < 68 minutes
> 5 units > 68 minutes to < 83 minutes
> 6 units > 83 minutes to < 98 minutes
> 7 units > 98 minutes to < 113 minutes
> 8 units > 113 minutes to < 128 minutes
> Does this help ?
> Barbara Burgess, RN, CPC, ACS-EM, PCS
> djgeisel <djgeisel@...> wrote:
> When using a timed code, for instance one that
specifies "first 15
> Min." and you are doing less that that, we append a 52 modifier. Is
> there anything that specifies a minimum time that must be spent to
> the code? This question was asked to me and I can't find anything
> that. Thanks for your help. Diana
> Be a better friend, newshound, and know-it-all with Yahoo! Mobile.
Try it now.
> [Non-text portions of this message have been removed]
- << Previous post in topic Next post in topic >>