[1.2] Documentation & Billing

Question 1

what does CPT stand for in CPT Billing

Answer 1

current procedural terminology

Question 2

types of based services in CPT billing

Answer 2

service vs time based (15 min)

Question 3

given the following example, determine what you would bill & why:

Eval (97162) = 30 min (S)
Ther Ex (97110) = 10 min (T)
Ultrasound (97035) = 10 min (T)

• Total Time = 50 min
• Time Based = 20 min

Answer 3

So the total time is 50 minutes with 20 minutes of time based. Recall that the time based methods go in 15 minute increments for billing.

• Ther Ex and Ultrasound are both time based and both had 10 minutes of application.
• 20 minutes is not > 23 minutes (halfway point), so you can only bill 1 method
• when the methods are the same, you will bill for the most “active time based” option

Bill would be: 97162x1 , 97110x1
(Eval) (Ther Ex)

Question 4

what is the big thing to remember about time based therapy methods

Answer 4

• you have to go in 15 minute increments for billing 1 unit, but crossing the halfway point allows you to bill for 2 units
• you can have a patient with all time based, so you need to determine what is most important with billing without neglecting a method (if possible)