Tia, 97003 is an untimed code. It was never meant to reflect a 15 minute interval. You may charge for other services on the day of the evaluation. When billing Medicare, some of the codes may not be utilized together due to the correct coding initiative (CCI edits). It would seem that the CCI edits wouldn't be in effect for your situation, so it would, at least on the surface, seem that you would not have to deal with that issue. For purposes of staff productivity it would be better to assign a different value to 97003 (i.e. you could denote evaluations as basic, intermediate and complex and base the number of units (for productivity purposes only) on the length of time to complete the evaluation). 96115 is a non-timed code, however it is not traditionally utilized by rehabilitation professionals in my experience. Most of the definitions of the physical medicine codes list a condition of direct one on one contact with the patient. This would preclude use of the code to bill for documentation time. There is no PM&R code for documentation. In the case of the FWCE, you could bill 97750 at 24 units for a 6 hour assessment. I'm not certain if use of 99199 would be appropriate in your situation, but I know of no Medicare intermediary or private insurance that will accept this code. Average time for evaluation/treatment: That's tough but I suppose 30 minutes to an hour for evaluation. Treatment sessions generally last 30 minutes to an hour as well. The CPT codes mandate one on one treatment for most codes, so generally ordering equipment, documentation, etc. is non-billable but capturable (not a word - but it fits) time (i.e. you can capture the non-billable time on your charge master to assist with productivity determinations). I work primarily in home care and the expectation is 25 visits per week for employees with benefits. I have worked in settings with reasonable productivity set at 75%. I have also worked in some settings where the productivity was set unreasonably higher. If productivity is not set too high, there will be adequate time for non-billable time. Jimmie
-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of [EMAIL PROTECTED] Sent: Tuesday, April 26, 2005 11:06 AM To: OTlist@otnow.com Subject: [OTlist] CPT Codes & Workload Hi everyone, I have been working inpatient at a VA hospital for several years and have not had to worry about billing and CPT codes until recently. We are now having to capture these procedures to justify our time, and the need for more FTEs, so we need to maximize the number of procedures we report, but obviously want to keep it legal and ethical. I would appreciate any info from those in the private sector or other VAs on the following questions. 1. Must we use only 97003 OT Evaluation for the initial OT visit whether it's a full or modified eval and takes 15 mins. or an hour or more? Problem is, we have a lot of 1x visits and it shows up on our stats as 1 unit of 15 mins. 2. If we do above said eval, and in the context of that eval, do w/c or ADL training, or some other therapeutic procedure, can we add the codes for those, too, or does it have to be done on a different day? 3. 97750 Physical performance test or measurement and 96115 Neurobehavioral status exam count for 15 mins and per hour, respectively, with interpretation and written report. Does that mean, for example, an FCWE that takes 6 hrs. with the client, and 2hrs. to write the report, would count as 32 units? 4. Does anyone use the 99199 code to count for documentation time? 5. What is your average time per pt. for an evaluation or treatment, chart review, documentation, ordering w/c & home equipment, etc.? 6. What is the required level of productivity at your facility or in your work setting? And, how much time are you allowed for tx. team meetings, staff meetings, training, in-services, pt./caregiver calls, scheduling, and miscellaneous office tasks? Thanks in advance, Tia Healy WG Hefner VAMC Salisbury, NC -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED] *** NOTICE--The attached communication contains privileged and confidential information. If you are not the intended recipient, DO NOT read, copy, or disseminate this communication. Non-intended recipients are hereby placed on notice that any unauthorized disclosure, duplication, distribution, or taking of any action in reliance on the contents of these materials is expressly prohibited. If you have received this communication in error, please delete this information in its entirety and contact the Amedisys Privacy Hotline at 1-866-518-6684. Also, please immediately notify the sender via e-mail that you have received this communication in error. *** -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED]