b'Coding forCODING Update ComplianceTIME-BASEDBy David KeinServicesANJC Coding & Compliance ConsultantLEGAL NUTRITIONUpdateCoding for time-based services is often confusing andassigning more units to the service that took the most misunderstood, especially when it comes to billing fortime. It should be noted that this reporting requirement is multiple units of a code. The AMA states, The reporting ofconsistent with Medicares 8 minute rule.ANJC News time-based codes has continued to challenge users. This ANJC Leadership ANJC News! is largely due to the fact that the AMA used to simply state that As with any 15-minute timed code, it is important to recognize that a substantial portion of 15 minutes must beNUTRITION LEGAL EASEspent in performing the pre-, intra-, and post-service work in order to report the timed code. They further stated that Many private payers either have no stated policy or follow Medicare policy. This has led to significant confusion for providers as to how to code for timed based services.The Rules: ANJC ScholarshipWhen reporting physical medicine and rehabilitation codes,REHAB Update a time-based code can be reported for each 15-minute unit. According to the AMA, to improve clarity and consistency, the standards for reporting time were more clearly defined in CPT 2011. Code-specific revisions were made throughoutModalities and Therapeutic Procedures:LEGAL Q&A CHIRO Assistthe code set (e.g., changes to code descriptors, additional code range-specific guidelines, parenthetical statementsThe most common physical medicine and rehabilitation codes Executive Directors Update that instruct users on the proper usage of time for specificused by chiropractors that must follow these rules are: codes). Furthermore, the addition of the time subheading Constant attendance modalities (97032-97036) such and corresponding guidelines in the Introduction of theas CPT 97035 (Ultrasound) and CPT 97032 (Electrical CPT code book continues to provide a standard method ofStimulation)reporting for those codes that lack specific time instructions. Therapeutic Procedures (97110-97535) such as CPT 97110 These instructions state, a unit of time is attained when the mid-point is passed. For example, in order to bill 1 unit of(Therapeutic Exercise), CPT 97140 (Manual Therapy),Legislative Update and CPT 97530 (Therapeutic Activities).CPT 97110, (Therapeutic procedure, 1 or more areas, each INSURANCE Update INSURANCE Update 15 minutes; therapeutic exercises to develop strength andAll therapeutic procedures (other than group therapy CPT endurance, range of motion and flexibility) the provider97150) require direct one on one contact by the licensed must spend at least 8 minutes face to face with the patient.TECHNIQUE Updateprovider (i.e. visual, verbal and/or manual contact) during Multiple units can be reported on a date of service for oneprovision of the service. This means that you can only provide or more procedures based on the aggregate amount ofthese services to one patient at a time. Time reporting time spent by a provider in direct contact with the patient.requirements for multiple units is as follows:Therefore, if these exercises are performed for 23 minutes1 unitminimum of 8 minutesof face-to-face time with the provider, two units of CPT code 2 unitsminimum of 23 minutesMedicareQ&AMedicare Update 3 unitsminimum of 38 minutes97110 would be reported because 23 minutes is greaterOUR HEALTHthan the midpoint between 15 minutes and 30 minutes, qualifying for two units. Notably, as with any 15-minute4 unitsminimum of 53 minutestime-based code, it is important to recognize that face toWhen documenting time, Medicare has stated that the time face time includes the pre-, intra-, and postservice work thatspent delivering each service, described by a timed code, counts towards the time-based code. should be recorded. The length of the treatment to the Remember this time requirement holds true even ifminute could be recorded instead.reporting two different timed services. For example, if 24Acupuncture:minutes of code 97110 and 23 minutes of code 97140 wereMany chiropractic offices are now offering acupuncture asfurnished, then the total treatment time was 47 minutes;a service. The acupuncture codes all follow the same 15-minute so only 3 units can be billed for the treatment. The correctrules including requiring that the provider must be one-on-one coding is 2 units of code 97110 and 1 unit of code 97140,with the patient. The codes are defined as follows:12 I Summer 2020 www.anjc.info'