Can Minutes of a Non-covered Service Count Towards the Total Billable Minutes?
Question
In my state, my Medicare Administrative Contractor (MAC) does not pay for iontophoresis as they consider it investigational and experimental. If I have a traditional Medicare patient that receives 35 minutes of 1 on 1 time that is billed out as therapeutic exercise, but also received iontophoresis that took 5 minutes of skilled one-on-tine to set up and answer patient questions, would it be permissible to ‘use’ the additional iontophoresis time (5 minutes) and add it to the 35 minutes of therapeutic exercise to achieve 40 minutes of total timed minutes, thus allowing 3 units of therapeutic exercise to be billed?
Answer
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Question
I know the Medicare program does not pay separately for the dry needling CPT codes (20560 and 20561). If I have a traditional Medicare beneficiary perform 23 minutes of therapeutic activities, 12 minutes of therapeutic exercise and then I perform dry needling (no manual therapy techniques at all) for 5 minutes, would it be permissible to ‘use’ the additional dry needling time (5 minutes) and add it to the 35 minutes of combined therapeutic activities and therapeutic exercise to achieve 40 minutes of total timed minutes, thus allowing 3 units timed units to be billed?
Answer
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why, if the iontophoresis is NOT covered, is an ABN necessary? I thought ABN’s were use if there was a question of coverage.
Because nationally, CMS does cover Iontophoresis. Some Medicare Administrative Contractors have decided not to pay for it.
A solution is to make sure you provided 3 more minutes of a skilled service that is paid for. I would also submit the claim to include the Ionto and or DN and have the patient sign a ABN for those 2 non covered codes.
How are you tracking your actual time of minutes of service. Do you have a stop watch or are you you using your professional skill and judgement.
That was not the purpose of this article. The purpose of the article is to make sure therapists and assistants understand they can’t count the minutes of non-covered services towards the billable time.