Tim & Robin Farley wrote:
> I'm a new grad. who is involved in a Pulmonary Rehab program along with a
> respiratory therapist. The program is about 8 months old. I know there
> are no set guidelines as of yet, but we are having difficulty assessing CPT
> codes and what to charge for. As a PT I charge group charge x 2 ( that's
> 15 min. each), yet I am actually with patients for at least 1 1/2 hr. per
> session.
Then you should be charging for 6 units.
> The RT who is the coordinator and is in charge of billing seems
> to think that this is all insurance will reinburse.
What insurance will reimburse is a different issue from what you charge. You
are on slippery ground if you tie the two together.
> We call other programs
> and no one is billing the same way. It is all very confusing.
I agree it is very confusing. It is too involved to give you all the
information in this forum. I would suggest taking one of the APTA coding
workshops. This topic needs 1-2 days of instruction.
> Also we
> charge once for stress testing prior to entry to program but recently at a
> lecture was told we can charge once post program for either 6 min. walk or
> stress test. What CPT code do we use? Is it the same as before and is
> there CPT codes to distingusish between 6 min walk and stress test. During
> this lecture I was told you can charge twice for one or the other but not
> both. Also does anyone charge for PT education. Once a week I introduce a
> HEP and spend at least 15 or more demo. , instructing, with handout. What
> code do you bill under? I would like to share info and ideas about Pul.
> Rehab program for anyone who is interested.
> Thanks in advance :)
> Robin Sheldon MSPT
I would refer you to CPT codes 94010-94799, 97001-97750 as a starting place but
once again I would urge you to take a course. To just open the book and start
using codes without understanding the system is risky. Federal and state
governments have recently put tens of millions of dollars into fraud and abuse
investigation. Two weeks ago President Clinton added another 40 million dollars
towards Federal investigations. Improper coding is a common target of
investigators and PTs can be at risk if there services are not coded properly.
Douglas M. White, PT, OCS
Milton, MA USA
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