What Can Be Billed Together in the Same 15-Minute Time Period
There is a myth that exists that you can’t bill 2 CPT codes during the same 15-minute time period. Well, that myth is only partially true. It is possible to bill 2 CPT codes during the same 15-minute time period. What you can’t do is bill two 15-minute time based CPT codes during the same 15-minute time period or bill an evaluation or reevaluation CPT code with any other timed or untimed CPT codes, including constant attendance modalities (CPT codes 97032 – 97039), therapeutic procedures (CPT codes 97110-97542) and group therapy. Confused? Continue reading below to see how you can bill 2 CPT codes during the same 15-minute time period, but can’t bill two 15-minute time based CPT codes during the same the same 15-minute time period.
So how can a therapist or assistant bill 2 CPT codes during the same 15-minute time period? By billing
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Can you bill 1 unit of unattended ES (97014/G0283) and one unit of ther ex (97110) if you set up ES/IFC from 8:00-8:06 turn it on to run for 20 min and then perform skilled AAROM/AROM on an acute joint pain with edema from 8:07-8:20?
Yes! So how can a therapist or assistant bill 2 CPT codes during the same 15-minute time period? By billing a supervised, untimed, unattended modality code (CPT codes 97010 – 97028) with any other CPT code, timed or untimed, requiring constant attendance or direct one-on-one patient contact.
Likewise – one can bill two untimed codes concurrent to eachother (e.g. compression and estim for an ankle sprain) or untimed and timed concurrent to eachother (heat/ES to lumbar while attended manual therapy to shld)- correct?
Correct!
A little clarification: “or bill an evaluation or reevaluation CPT code with any other timed or untimed CPT codes”
Can we not bill for evaluation and treatment in the same visit?
Can I evaluate for 30 minutes, perform 10 minutes of manual and bill 97001 and 97110?
thank you
You can’t bill an evaluation or re-evaluation during the same time period as any other CPT code. It’s not saying you can’t bill an evaluation or reevaluation on the same day as treatment.
I have an employer telling me that it’s okay to bill two timed codes in the same 15 minute increment for a Medicare patient and non Medicare patient (at the same time). It screams fraud to me. Their interpretation of guidelines notes that it is okay to do so as long as it is not two Medicare patients in that same 15 minute overlap.
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Can a therapist bill 2 units of G0283 when the e-stim is applied at the same time to 2 different body parts?
G0283 is a service-based (untimed) CPT code and can only be billed for 1 unit.
We are having therapist not wanting to bill Hot Pack concurrent with 97110×3 units. From this article, it is saying we can bill 97010 concurrent with 97110?
Correct! In addition, most insurance carriers do not reimburse for hot and cold packs.
What differentiates 97014 (unattended e-stim) and 97032 (attended e-stim)? For example it was mentioned that putting e-stim on a patient and then having them exercise with the unit on would allow for two units to be billed. It was mentioned that 97014 and 97110 could be billed together as you’re billing for the set up time of the e-stim and not the time the unit is on. If you need to be 1:1 for the therapeutic exercise then wouldn’t the electric stimulation also be attended e-stim (97032)? How does NMES/Russian fit into the differentiation between attended and unattended while performing exericse?
An example of manual electrical stimulation would be a hand-held unit where you are providing electrical stimulation to facial muscles due to facial weakness or Bells Palsy.