Attention Outpatient Therapy Providers
In accordance with CMS Publication 100-4, Chapter 5, Section 20.2:
(Rev.980, Issued: 06-14-06, Effective 10-01-06, Implementation: 10-02-06)
"The beginning and ending time of the treatment should be recorded in the patient's medical record along with the note describing the treatment. The time spent delivering each service, described by a timed code, should be recorded. (The length of the treatment to the minute could be recorded instead.) If more than one CPT code is billed during a calendar day, then the total number of units that can be billed is constrained by the total treatment time. For example, if 24 minutes of code 97112 and 23 minutes of code 97110 were furnished, then the total treatment time was 47 minutes; so only 3 units can be billed for the treatment. The correct coding is 2 units of code 97112 and one unit of code 97110, assigning more units to the service that took the most time."
When submitting documentation for medical review for outpatient therapy services, actual therapy minutes to support the services/HCPCS provided must be included.
Please refer to our documentation guidelines located on our Website under Medical Review by clicking here.
Page Last Updated: Tuesday, 15-Jul-2008 10:34:58 CDT
