Guest guest Posted February 14, 2005 Report Share Posted February 14, 2005 Not sure where you get your figures, Alon. I just received my first EOB from BC/BS: 97810 + 97811 = higher than they previously gave 97780 -- about $51 in my area (SW Colorado), up from about $45. This equals $102 / hr. It represents a (albeit slight) net increase in compensation for the same procedure. They never paid for separate evaluation / office visit codes before, so the change to the new codes including routine evaluation was a wash. >>>Interesting, perhaps Colorado is different. The two 978 codes are acupuncture, what office code did you use? You cant do it repeatedly. It would be interesting to see what happens, but the so called Medicare conversion, which is what most insu companies use, is 17.5 for the electroacup. I have just received another 17.5 from another acup program via health-net that used to pay $50. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2005 Report Share Posted February 14, 2005 Not sure where you get your figures, Alon. I just received my first EOB from BC/BS: 97810 + 97811 = higher than they previously gave 97780 -- about $51 in my area (SW Colorado), up from about $45. This equals $102 / hr. It represents a (albeit slight) net increase in compensation for the same procedure. They never paid for separate evaluation / office visit codes before, so the change to the new codes including routine evaluation was a wash. Benjamin Hawes, MAOM, Lic. Ac., CORTEZ FAMILY ACUPUNCTURE 1430 E. Main Street, Suite #4 Cortez, CO 81321 (970) 565-0230 _________ > > Message: 18 > Sat, 12 Feb 2005 09:38:58 -0600 > " " <alonmarcus > Re: Fwd: [AACBoard-AnnounceList] CPT SUMMARY > > The new CPT codes for acupuncture became effective January 1, 2005 and by > now, all insurance companies are up-to-date with using them. > >>>Not all > > > > > ______________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2005 Report Share Posted February 14, 2005 you should be able to bill for at least one of each for each visit. And, at least here, they are still reimbursing me for heatlamp (97026) and tuina massage (97124) along with the acu codes. >>>>>That is unusual. In CA i have not seen the blues pay for anything else than acup for LAc's. I do a lot of manual therapies and always have to charge the patient for these if they have any of the blues. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2005 Report Share Posted February 14, 2005 That's terrible! If they start paying me as little as they pay you, I'll have to drop out of the insurance game. I don't know why CO is different. I couldn't before bill an office code with BC/BS unless it was a new pt. evaluation (99204, etc.), so I have no idea if they will allow it now with new patients and the new codes (with 25 modifier). They didn't pay for a reevaluation code (99213) with the new codes, even with the modifier. As for your question, 97810 and 97811 are for different iterations of the same procedure, so there is no conflict using both - one if for the initial 15 min, then other for additional 15 min intervals. As long as you document it - creatively sometimes - you should be able to bill for at least one of each for each visit. And, at least here, they are still reimbursing me for heatlamp (97026) and tuina massage (97124) along with the acu codes. Since Medicare doesn't actually pay for acupuncture, maybe you could argue with them that their valuation is invalid. On the other hand, maybe this is the last straw and we all need to insist on them taking ABC's. Benjamin Hawes, MAOM, Lic. Ac., CORTEZ FAMILY ACUPUNCTURE 1430 E. Main Street, Suite #4 Cortez, CO 81321 (970) 565-0230 > Message: 3 > Mon, 14 Feb 2005 11:48:25 -0600 > " " <alonmarcus > Re: RE: new codes > > Not sure where you get your figures, Alon. I just received my first EOB > from > BC/BS: 97810 + 97811 = higher than they previously gave 97780 -- about > $51 > in my area (SW Colorado), up from about $45. This equals $102 / hr. It > represents a (albeit slight) net increase in compensation for the same > procedure. They never paid for separate evaluation / office visit codes > before, so the change to the new codes including routine evaluation was a > wash. > >>>Interesting, perhaps Colorado is different. The two 978 codes are > acupuncture, what office code did you use? You cant do it repeatedly. It > would be interesting to see what happens, but the so called Medicare > conversion, which is what most insu companies use, is 17.5 for the > electroacup. I have just received another 17.5 from another acup program > via health-net that used to pay $50. > > > > Quote Link to comment Share on other sites More sharing options...
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