Hot chatd direct

So first, let’s talk about the difference between time-based and service-based CPT codes.You would use a service-based (or untimed) code to denote services such as conducting a physical therapy examination or re-examination, applying hot or cold packs, or providing electrical stimulation (unattended).

According to this resource, “it is rare to see an insurance carrier state in writing that they follow Medicare's ‘8-minute rule.’” And that means you must verify the billing protocol for each individual insurance carrier.

For services like these, you can’t bill more than one unit—regardless of the amount of time you spend delivering treatment.

Time-based (or direct time) codes, on the other hand, allow you to bill multiple units in 15-minute increments (i.e., one unit = 15 minutes of direct therapy).

Per the 8-Minute Rule, you would first calculate the total treatment time: 30 min 15 min 8 min 30 min = 83 total minutes According to the chart, you could bill a maximum of 6 units.

However, in this case, when adding up your direct time (time-based) codes, it equals 53 minutes.

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If a payer does not follow the 8-Minute Rule, then “you would follow the definition of substantial determined by the American Medical Association (AMA) when billing time-based CPT codes,” the above-cited resource explains. As if the whole mixed remainder thing weren’t enough to keep you on your toes, here’s one more Rule of Eights curve ball for you: in some cases, you probably shouldn’t bill any units for a service, even though you provided it. As insurance billing expert Rick Gawenda explains in this audio clip, a patient undergoing iontophoresis might only receive direct, skilled treatment from the therapist for two or three minutes; the rest of the time (once the machine is turned on) is not billable because Medicare doesn’t consider it “skilled time.” (As a side note, checking the patient’s skin for damage upon electrode removal would be considered skilled therapy, making it billable time.

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