b'97810Acupuncture one or more needles, without electrical The third important point of consideration is noted in thestimulation; initial 15 minutes of personal one-on-one contactcode descriptors of 97811 and 97814. Specifically, that with the patient re-insertion of the needle(s) is required for the use of 97811Acupuncture, one or more needles; withoutadd-on codes 97811 and 97814. electrical stimulation, each additional 15 minutes of personalThe fourth critical component is that resting time or when one-on-one contact with the patient, with re-insertion ofthe provider is not face to face with the patient does NOT needle(s) (List separately in addition to code for primarycount towards time. In other words, it is not simply the procedure) duration of acupuncture needle(s) placement that counts 97813Acupuncture, one or more needles, with electricaltowards time spent. stimulation; initial 15 minutes of personal one-on-one contactConclusion:with the patient97814Acupuncture, one or more needles, with electricalA comprehensive understanding of the standards used in the measurement of time is crucial for appropriate code selection stimulation; each additional 15 minutes of personalwhen reporting time-based CPT codes. Providers must be one-on-one contact with the patient, with re-insertion ofcareful to select the appropriate code and the number of units needle(s) (List separately in addition to code for primaryallowed based on recorded time in the record. It is important procedure) to remember that your documentation should accurately There are four additional critical things providers that offerreflect what was billed since documentation is what drives the acupuncture should be aware of as follows:code and unit usage, not the claim form. The first is that each treatment session can include only oneinitial 15-minute increment (i.e., 97810, 97811). InitialDavid Klein, CPC, CPMA, CHC, is the ANJC coding and compli-refers to the first 15-minute increment whether it is electricalance consultant and the co-founder of PayDC, a web-based EHR/stimulation or non-electrical stimulation.Practice Management system that focuses on documentation,The second critical component is Code 97811 is notcompliance and reimbursement. He is a certified professionalrestricted to use solely with code 97810. Rather, code 97811coder and auditor through the American Academy of Professional may also be reported in addition to code 97813, providedCoders and is certified in healthcare compliance through the the non-electrical stimulation (97811) is performed in aHealth Care Compliance Board. He is the founder and president 15-minute increment separate from the 15-minute incre- of DK Coding & Compliance, Inc. a health care consulting firm that ment performed for electrical stimulation (97813). Equally,focuses on audit defense, education, compliance and reimburse-code 97814 is not restricted to use solely with code 97813.ment issues. He can be reached at dave@paydc.com [INSURANCE CONTINUED FROM PAGE 11] Aetna has advised that if you use another clearinghouse besides Availity you will still be able to bill, be reimbursed reject such a claim. Those carriers usually advise simply to useand received ERAs through your clearinghouse. However, the 95 modifier and otherwise bill as usual.the Aetna EOBs, claims verification, eligibility and all other Codes that can be billed as telemedicine and are withinprovider portal services and tools will only be available the chiropractic scope of practice include all evaluationthrough Availity. Also, for in-network providers you would and management codes (99201-5, 99211-5), therapeuticneed to update and confirm your practice information exercise (97110), therapeutic activities (97530), neuromuscularthrough Availity in order to remain active in Aetnas provider re-education (97112), self-care/home management trainingdirectories.(97535) and the newly created telemedicine codes (99421-3)If you already have an account and log-in with Availity for and audio-only telemedicine codes (99441-3). another payer, you will be able to access Aetnas information For more detail on these codes, modifiers, what each carrierand services with your existing log-in credentials. If not, is allowing during the emergency and general informationplease see the Availity-Aetna landing page for information on on performing and billing telemedicine please see ourregistering and/or an informational webinar on the program. Telemedicine Resources page on our website under InsuranceFor Availity-Aetna webpage https://www.availity.com/ Insurance News & Updates Telemedicine Resources.aetnaproviders We also produced several webinars covering telemedicineAetnas announcement is on page 3 of their March 2020 which can be found on our website under Education newsletter which you can download herehttps://anjc.info/Upcoming Webinars Recorded Webinars.wp-content/uploads/sites/9/2020/04/officelink-updates-Aetna-Availity: Aetna has moved its provider portal servicesmarch-2020-olu.pdffrom Navinet to Availity. Per its March 2020 newsletter, as of April 30, 2020, Availity will be its sole provider portal. This was later delayed until May 31st.www.njchiropractors.com I 13'