How To Bill For Physical Therapy

Transcription

1 Procedure Codes for Occupational & Physical Therapy Practitioners BILLING CPT DEFINITION HOW ABBREV. CODE BILLED P Physical Therapy Evaluation Event B Physical Therapy Re-evaluation Event O Occupational Therapy Evaluation Event D Occupational Therapy Re-evaluation Event E Application of a modality to one or more areas; hot or cold packs Event F Application of a modality to one or more areas; electrical stimulation (manual) G Therapeutic procedure, one or more areas; therapeutic exercises to develop strength and endurance, range of motion and flexibility H Therapeutic procedure, one or more areas; neuromuscular re-education of movement, balance coordination kinesthetic sense, posture, and proprioception I Therapeutic procedure, one or more areas; gait training (includes stair climbing) J Therapeutic procedure, one or more areas; including effleurage, petrissage and/or tapotement (stroking, compression, percussion) Manual therapy techniques (e.g. mobilization/manipulation, manual L lymphatic drainage, manual traction), one or more regions Therapeutic procedure(s), group (2 or more individuals) Event M N Prosthetic training, upper and/or lower extremities Therapeutic activities, direct (one on one) patient contact Z by provider (use of dynamic activities to improve functional performance) Wheelchair management/propulsion training W Physical performance test or measurement (e.g. R musculoskeletal, functional capacity) with written report Development of cognitive skills to improve attention, S memory, problem solving, (includes compensatory training), direct (one on one) patient contact by the provider, each utes Orthotics fitting and training, upper and/or lower extremities T SEBS 2014 Toll Free: FAX:

2 DSC SERVICE RECORD - PHYSICAL THERAPISTS (and PTAs) A) Provider Name: (please print) B) School: C) School District: D) Position: Please Circle Month July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Please Enter Dates E) STUDENT NAME (LAST NAME, FIRST NAME) F) DATE OF BIRTH G) GENDER M T W Th F M T W Th F M T W Th F M T W Th F M T W Th F TYPICAL PROCEDURE CODES - SEE COMPLETE LIST FOR PHYSICAL THERAPISTS SEBS 2014 Billing Abbreviation CPT Code Description Recorded As/In P PHYSICAL THERAPY EVALUATION (PT only) B PHYSICAL THERAPY RE-EVALUATION (PT only) J THERAPEUTIC PROCEDURE, ONE OR MORE AREAS; INCLUDING EFFLEURAGE M THERAPEUTIC PROCEDURE(S), GROUP (2 OR MORE INDIVIDUALS) S DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, ETC DIRECT CONTACT Z THERAPEUTIC ACTIVITIES, DIRECT (ONE ON ONE) PATIENT CONTACT BY PROVIDER Event Event Minutes Minutes Minutes Minutes I certify that this information is accurate - all services are indicated on the child's IEP. SIGNATURE: DATE: Toll Free: Fax:

3 INSTRUCTIONS FOR COMPLETING THE DSC MULTI-STUDENT PROFESSIONAL SERVICE RECORD 1. Complete the provider, school system and student information section: A) Provider s Name: Enter your proper name. B) School: Enter the name of the school where service was delivered. C) District: Enter the name of your school district where service was delivered. D) Position: Enter your service area. E) Student s Name: List the proper names, last name first, of your assigned caseload. F) DOB: Give the date of birth of each student. G) GENDER 2. Make copies of this partially filled-in form and keep in a file. This way you will only need to write the names, DOB s, etc. of students on your regular caseload ONCE. 3. Keep this form with you. For each month, record your actual service encounters. Be sure to circle the appropriate month and enter the dates in the boxes provided. RECORD the correct billing abbreviation and number of minutes in the appropriate boxes. If the student is absent simply leave the space BLANK. 4. Sign your name and enter the date in the signature box. NOTE: If you are a COTA, the OT supervising you must also sign this box. With the exception of evaluations, ALL SERVICES MUST BE INDICATED IN A STUDENT S IEP. We will be relying on your Service Records and assuming that if it s on your Service Record, the service is indicated in an IEP. If you make a mistake, draw a single line through the error and initial. White out is NOT allowed on records used for medical billing. Please sign and date your service record in BLUE ink only. If you need assistance please call our HELP DESK at SEBS 2014 Toll Free: Fax:

4 DSC PHYSICAL THERAPY NOTES/LOGS Student - Last Name Student - First Name Birth date ICD-9 Code Provider - Last Name Provider - First Name School District IEP Services/Frequency/Duration: IEP Goals and Objectives: IEP Start Date: TYPICAL PROCEDURE CODES - SEE COMPLETE LIST FOR PHYSICAL THERAPISTS SEBS 2014 Billing Abbreviation CPT Code Description Recorded As/In P PHYSICAL THERAPY EVALUATION (PT only) Event B PHYSICAL THERAPY RE-EVALUATION (PT only) Event J THERAPEUTIC PROCEDURE, ONE OR MORE AREAS; INCLUDING EFFLEURAGE Minutes M THERAPEUTIC PROCEDURE(S), GROUP (2 OR MORE INDIVIDUALS) Minutes S DEVELOPMENT OF COGNITIVE SKILLS TO IMPROVE ATTENTION, ETC DIRECT CONTACT Minutes Z THERAPEUTIC ACTIVITIES, DIRECT (ONE ON ONE) PATIENT CONTACT BY PROVIDER Minutes I certify that this information is accurate - all services are indicated on the child's IEP. Signature: Date: Toll Free: Fax:

5 INSTRUCTIONS FOR COMPLETING DSC SERVICE LOGS/THERAPY NOTES 1. Complete the provider, school and student information section: A) Student s Name: List the proper last name, first name, ICD-9 Code. B) Provider s Name: Enter your proper name. C) School: Enter the name of the school where service was delivered. D) District: Enter the name of your school district where service was delivered. E) IEP Services Frequency/Duration: Enter amounts as stated on IEP. (i.e. Ind. 30 min/week) F) IEP Start Date: List the current IEP Date. G) IEP Goals and Objectives: Enter information as stated on IEP. 2. Make copies of this partially filled-in form and keep in a file. This way you will only need to write the name, DOB, goals, etc. of the student ONCE. 3. Keep this form with you. For each encounter, record actual service provided. Date: Date service was given Time In & Number of Minutes: Beginning time and number of minutes for services provided. IEP Goal(s) #: Record the number of the goal(s) worked on. Procedure Code: Record the billing abbreviation for the service provided and number of units for each code (from the bottom of your log, i.e. H, J, etc.) : Therapy session - indicate what took place - record activities and services rendered and note progress. Initial each day that you have an encounter. 4. Sign your name with your certification initials (i.e. LCSW) and enter the date in the signature box. NOTE: If you are a COTA or PTA, the OT/PT supervising you must also sign this box. With the exception of evaluations, ALL SERVICES MUST BE INDICATED IN A STUDENT S IEP. We will be relying on your Notes/Log to reflect services as ordered on the IEP. If you make a mistake, draw a single line through the error and initial. White out is NOT allowed on records used for medical billing. Draw a diagonal line across the remainder of the form (if you did not use the complete page) when no more therapy is to be documented. Please sign and date your Notes/Log in BLUE ink only. If you need assistance please call our HELP DESK at SEBS 2014 Toll Free: Fax:

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8 SPEECH LANGUAGE THERAPY OCCUPATIONAL THERAPY/ PHYSICAL THERAPY Frequently Asked Questions 1. Some procedure codes (and all of the codes from Speech Therapy) are billed by Event. What constitutes an Event? An event is an encounter with a student. There is no time set for that encounter. The amount billed is the same whether you spend utes providing the service listed or an hour providing the service listed. NOTE: Even though a procedure code is designated as an EVENT, you will be recording for services in minutes to correctly document services provided as stated on the IEP. Example for Recording: I60 represents Individual Speech Therapy given for 60 minutes. 2. Is it permissible to bill for more than one service on a given day? YES. If you provide more than one of the listed services, you simply place BOTH billing abbreviations and minutes in the box for that day. This would occur if you provided both Group Therapy (G) and Individual Therapy (I) to the same child; or provided Individual Therapy (I) and an Evaluation (E); etc. 3. If an evaluation stretches over more than one day, should I record it on each day? No. The Event Code for an Evaluation includes the ENTIRE evaluation process, including your direct time with the student, your time scoring and report writing, and your participation at the IEP meeting where program determinations are made for the student. Reminder: Evaluations must be recorded on a day where direct contact with the student can be verified. Example for recording: E1 for Speech, O1 for OT or P1 for PT (Evaluations are recorded as events they are not minutes specific in the IEP) 4. Can I bill for the time I spend consulting with teachers? Many of the students I serve are for consultation only. No. The procedure codes are for direct service to a student. Consultation is not covered. 5. How do I correct an error on my form? Can I use white out? White out is NOT permitted on MEDICAID Service Records. Simply draw a single line through the incorrect entry and initial the correction. You can then add the correct notation (if appropriate) and, if need be, provide a note in the margin that will clarify your notation(s). 6. What should I do with the completed form? At the end of each month, please sign and date your form, we suggest making a copy for your own records (which you can keep in the folder provided), and forward the form with your original signature to your district s designated DSC Coordinator. SEBS 2014 Toll Free: Fax: