Taken right from Medicare's website: ==================================================================
4. Team Therapy: Therapists, or therapy assistants, working together as a "team" to treat one or more patients cannot each bill seperately for the same or different service provided at the same time to the same patient. CPT codes are used for billing the services of one therapist or therapy assistant. The therapist cannot bill for his/her services and those of another therapist or a therapy assistant, when both provide the same or different services, at the same time, to the same patient(s). Where a physical and occupational therapist both provide services to one patient at the same time, only one therapist can bill for the entire service or the PT and OT can divide the service units. For example, a PT and an OT work together for 30 minutes with one patient on transfer activities. The PT and OT could each bill one unit of 97530. Alternatively, the 2 units of 97530 could be billed by either the PT or the OT, but not both. Similarly, if two therapy assistants provide services to the same patient at the same time, only the service of one therapy assistant can be billed by the supervising therapist or the service units can be split between the two therapy assistants and billed by the supervising therapist(s). ================================================================ Source: http://tinyurl.com/2x9geo Ron ----- Original Message ----- From: Cim Viken <[EMAIL PROTECTED]> Sent: Friday, October 05, 2007 To: otlist@otnow.com <otlist@otnow.com> Subj: [OTlist] reply: duplication of services CV> To clarify previous post, examples of Primary Medical diagnosis code are CV> 714.0 rheumatoid arthritis, 438 Late effects of CVA, CV> Examples of "treatment (or therapy) diagnosis code" are 719.7 Difficulty in CV> walking, 438.81 apraxia, 728.87 muscle weakness. I work in hospital setting CV> where coder enter the diagnoses from our evaluations. CV> CV> The definitions of these are quoted from Rick Gawenda, PT course "Outpatient CV> Therapy CPT coding billing and documentation for Rehabilitation CV> Reimbursement." CV> Primary medical diagnosis: this item indicates the medical DX that has CV> related in the therapy disorder and which is most closely related to the CV> current plan of care for therapy. If more than one diagnosis is treated CV> concurrently, the provider enters the diagnosis that represents the most CV> intensive services (over 50 percent of the rehabilitation effort. CV> CV> Treatment diagnosis: This item indicates the DX for which rehabilitative CV> services were furnished. For example, while CVA may be the primary medical CV> DS hemiplegia might be the PT/OT treatment DX. CV> CV> CV> I guess the bottom line is I have a PT claiming OT and PT can't treat some CV> of same diagnoses. Examples are MS, muscle weakness, Lumbar stenosis, CV> My argument is PT and OT have different scope of practices. PT works on CV> exercises and mobility. OT treats occupational performance. Sometimes it's CV> ok for OT and PT to work with the same patient depending of the complexity CV> of diagnosis and overall patient's problem list/goals. (I also am stressing CV> the word sometimes) In other words, this PT claims he can treat them all CV> and he is more qualified. CV> CV> So what are your experiences or opinions? CV> Thank you. CV> CV> Cimberly Viken, OTR/L CV> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
