Guest guest Posted September 7, 2006 Report Share Posted September 7, 2006 97810 = acuuncture CPT code --- clothoatropos <eastdakota wrote: > Hi everyone, > > I'm new to insurance billing - in fact I don't bill > to insurance but > instead give my patients a receipt that they can > send to their own > insurance company. > > I have a patient who is having trouble claiming my > first visit > because the CPT code I used was not specific enough > to acupuncture. > > What do those of you who bill to insurance use as > your CPT code for > the first visit? I have the codes for " initial 15 > minutes " > and " additional 15 minutes " for acupuncture, but > this does not cover > the hour I spend at the initial office visit. Any > ideas? I know most > insurance companies limit the number of codes they > allow you to bill > for in any one treatment. > > Any advice would be much appreciated. > > Thank you! > Nadia > > Nadia E. Haddad, MS, L.Ac > The Healing Tree > Boulder, CO > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 7, 2006 Report Share Posted September 7, 2006 99201, 99202, 99203, 99204, 99205 = codes for patient evaluation, from least complicated to most also, on your receipt, you should have your federal e.i.n. number and your state license number insurance companies usually want one or more diagnostic codes that relate to the condition you're treating you can also type something like " acupuncture insurance billing codes " into your search engine and visit the various websites to learn more - Aviv Li Stein Chinese Medicine Thursday, September 07, 2006 1:45 AM Re: CPT codes for first visit 97810 = acuuncture CPT code --- clothoatropos <eastdakota wrote: > Hi everyone, > > I'm new to insurance billing - in fact I don't bill > to insurance but > instead give my patients a receipt that they can > send to their own > insurance company. > > I have a patient who is having trouble claiming my > first visit > because the CPT code I used was not specific enough > to acupuncture. > > What do those of you who bill to insurance use as > your CPT code for > the first visit? I have the codes for " initial 15 > minutes " > and " additional 15 minutes " for acupuncture, but > this does not cover > the hour I spend at the initial office visit. Any > ideas? I know most > insurance companies limit the number of codes they > allow you to bill > for in any one treatment. > > Any advice would be much appreciated. > > Thank you! > Nadia > > Nadia E. Haddad, MS, L.Ac > The Healing Tree > Boulder, CO > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 7, 2006 Report Share Posted September 7, 2006 Nadia, The new cpt codes allow us to bill for therapy in increments so your initial could be billed as 1 unit 97810 (first 15 minutes) and then 2 or3 units of 97811 depending upon what you did and the time used. You might also have done some massage that could be additionally billed at 97124, depending upon time and billed in units. These units tend to cover 10-15 minute intervals. You can also bill for initial consultation but then the insurance companies seem to be challenging us on this. There might be reimbursement issues because of your state statutes and how LAc are recognized for insurance in your state. You might need to update your fee schedule as well. Hope this helps. Let me know if you have more questions. Mike W. Bowser, L Ac : lizzzrd: Thu, 7 Sep 2006 08:20:32 -0400Re: CPT codes for first visit 99201, 99202, 99203, 99204, 99205 = codes for patient evaluation, from least complicated to mostalso, on your receipt, you should have your federal e.i.n. number and your state license numberinsurance companies usually want one or more diagnostic codes that relate to the condition you're treating you can also type something like " acupuncture insurance billing codes " into your search engine and visit the various websites to learn more- Aviv Li Stein Chinese Medicine Thursday, September 07, 2006 1:45 AMRe: CPT codes for first visit97810 = acuuncture CPT code--- clothoatropos <eastdakota wrote:> Hi everyone,> > I'm new to insurance billing - in fact I don't bill> to insurance but > instead give my patients a receipt that they can> send to their own > insurance company.> > I have a patient who is having trouble claiming my> first visit > because the CPT code I used was not specific enough> to acupuncture.> > What do those of you who bill to insurance use as> your CPT code for > the first visit? I have the codes for " initial 15> minutes " > and " additional 15 minutes " for acupuncture, but> this does not cover > the hour I spend at the initial office visit. Any> ideas? I know most > insurance companies limit the number of codes they> allow you to bill > for in any one treatment.> > Any advice would be much appreciated.> > Thank you!> Nadia> > Nadia E. Haddad, MS, L.Ac> The Healing Tree> Boulder, CO> > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 7, 2006 Report Share Posted September 7, 2006 Those are physician-only codes, may only be billed by DC, DO, MD, etc. Avery Liz <lizzzrd wrote: 99201, 99202, 99203, 99204, 99205 = codes for patient evaluation, from least complicated to most also, on your receipt, you should have your federal e.i.n. number and your state license number insurance companies usually want one or more diagnostic codes that relate to the condition you're treating you can also type something like " acupuncture insurance billing codes " into your search engine and visit the various websites to learn more - Aviv Li Stein Chinese Medicine Thursday, September 07, 2006 1:45 AM Re: CPT codes for first visit 97810 = acuuncture CPT code --- clothoatropos <eastdakota wrote: > Hi everyone, > > I'm new to insurance billing - in fact I don't bill > to insurance but > instead give my patients a receipt that they can > send to their own > insurance company. > > I have a patient who is having trouble claiming my > first visit > because the CPT code I used was not specific enough > to acupuncture. > > What do those of you who bill to insurance use as > your CPT code for > the first visit? I have the codes for " initial 15 > minutes " > and " additional 15 minutes " for acupuncture, but > this does not cover > the hour I spend at the initial office visit. Any > ideas? I know most > insurance companies limit the number of codes they > allow you to bill > for in any one treatment. > > Any advice would be much appreciated. > > Thank you! > Nadia > > Nadia E. Haddad, MS, L.Ac > The Healing Tree > Boulder, CO > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 7, 2006 Report Share Posted September 7, 2006 Hi Avery, Maybe it's different state to state. I'm in New York and my patients haven't had any problems. Of course, I don't actually take insurance, but a number of my patients turn in my receipts, with the codes, to be reimbursed. Peace, Liz - Avery Jenkins Chinese Medicine Thursday, September 07, 2006 1:50 PM Re: CPT codes for first visit Those are physician-only codes, may only be billed by DC, DO, MD, etc. Avery Liz <lizzzrd wrote: 99201, 99202, 99203, 99204, 99205 = codes for patient evaluation, from least complicated to most also, on your receipt, you should have your federal e.i.n. number and your state license number insurance companies usually want one or more diagnostic codes that relate to the condition you're treating you can also type something like " acupuncture insurance billing codes " into your search engine and visit the various websites to learn more - Aviv Li Stein Chinese Medicine Thursday, September 07, 2006 1:45 AM Re: CPT codes for first visit 97810 = acuuncture CPT code --- clothoatropos <eastdakota wrote: > Hi everyone, > > I'm new to insurance billing - in fact I don't bill > to insurance but > instead give my patients a receipt that they can > send to their own > insurance company. > > I have a patient who is having trouble claiming my > first visit > because the CPT code I used was not specific enough > to acupuncture. > > What do those of you who bill to insurance use as > your CPT code for > the first visit? I have the codes for " initial 15 > minutes " > and " additional 15 minutes " for acupuncture, but > this does not cover > the hour I spend at the initial office visit. Any > ideas? I know most > insurance companies limit the number of codes they > allow you to bill > for in any one treatment. > > Any advice would be much appreciated. > > Thank you! > Nadia > > Nadia E. Haddad, MS, L.Ac > The Healing Tree > Boulder, CO > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 7, 2006 Report Share Posted September 7, 2006 Acu-base offers a free online course for HIPPA Compliance http://www.trigram.com/pages/Products-005-Hipaa.htm which you may find useful live free and healthy Ed Kasper L.Ac., Acupuncturist & Medicinal Herbalist Santa Cruz, CA. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2006 Report Share Posted September 8, 2006 Do you know any codes for herbs? Can they be billed? Lee Tritt Chinese Medicine Chinese MedicineOn Behalf Of mike Bowser Thursday, September 07, 2006 12:12 PM Liz RE: CPT codes for first visit Nadia, The new cpt codes allow us to bill for therapy in increments so your initial could be billed as 1 unit 97810 (first 15 minutes) and then 2 or3 units of 97811 depending upon what you did and the time used. You might also have done some massage that could be additionally billed at 97124, depending upon time and billed in units. These units tend to cover 10-15 minute intervals. You can also bill for initial consultation but then the insurance companies seem to be challenging us on this. There might be reimbursement issues because of your state statutes and how LAc are recognized for insurance in your state. You might need to update your fee schedule as well. Hope this helps. Let me know if you have more questions. Mike W. Bowser, L Ac : lizzzrd: Thu, 7 Sep 2006 08:20:32 -0400Re: TCM - CPT codes for first visit 99201, 99202, 99203, 99204, 99205 = codes for patient evaluation, from least complicated to mostalso, on your receipt, you should have your federal e.i.n. number and your state license numberinsurance companies usually want one or more diagnostic codes that relate to the condition you're treating you can also type something like " acupuncture insurance billing codes " into your search engine and visit the various websites to learn more----- Original Message ----- Aviv Li Stein To: Chinese Medicine Thursday, September 07, 2006 1:45 AMRe: CPT codes for first visit97810 = acuuncture CPT code--- clothoatropos <eastdakota wrote:> Hi everyone,> > I'm new to insurance billing - in fact I don't bill> to insurance but > instead give my patients a receipt that they c ________ Check the weather nationwide with MSN Search: Try it now! http://search.msn.com/results.aspx?q=weather & FORM=WLMTAG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2006 Report Share Posted September 8, 2006 Nadia, On a first visit, you can bill 99201 which is for evaluation and management. Off-hand, I'm not sure how much " time " this code is for, but I typically use it unless a case is very complex. The numbers range from 99201-99205. The first visit is the only time you can use this code. Return visits with new conditions (and I only add this to my 97810 and 97811 acupuncture codes if I haven't seen the patient in more than a year and they have a new condition which requires extensive re-evaluation) is 97211. I have never had a denial for the 99201 code (unless a HMO that I am contracted with has already stated they will not pay). Yes, they are " physician-only " codes but they still pay. I'm in the state of Washington, so perhaps that has something to do with it. Good luck. Barb _____ Chinese Medicine Chinese Medicine On Behalf Of clothoatropos Wednesday, September 06, 2006 10:26 PM Chinese Medicine CPT codes for first visit Hi everyone, I'm new to insurance billing - in fact I don't bill to insurance but instead give my patients a receipt that they can send to their own insurance company. I have a patient who is having trouble claiming my first visit because the CPT code I used was not specific enough to acupuncture. What do those of you who bill to insurance use as your CPT code for the first visit? I have the codes for " initial 15 minutes " and " additional 15 minutes " for acupuncture, but this does not cover the hour I spend at the initial office visit. Any ideas? I know most insurance companies limit the number of codes they allow you to bill for in any one treatment. Any advice would be much appreciated. Thank you! Nadia Nadia E. Haddad, MS, L.Ac The Healing Tree Boulder, CO Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2006 Report Share Posted September 8, 2006 Herbs are not billable for insurance reimbursement. Mike W. Bowser, L Ac : acudoc: Thu, 7 Sep 2006 19:22:21 -0400RE: CPT codes for first visit Do you know any codes for herbs? Can they be billed?Lee Tritt-----Original Message----- Chinese Medicine [Chinese Medicine\ @]On Behalf Of mikeBowserThursday, September 07, 2006 12:12 PMLizRE: CPT codes for first visitNadia,The new cpt codes allow us to bill for therapy in increments so yourinitial could be billed as 1 unit 97810 (first 15 minutes) and then 2 or3units of 97811 depending upon what you did and the time used. You might alsohave done some massage that could be additionally billed at 97124, dependingupon time and billed in units. These units tend to cover 10-15 minuteintervals. You can also bill for initial consultation but then the insurancecompanies seem to be challenging us on this. There might be reimbursementissues because of your state statutes and how LAc are recognized forinsurance in your state. You might need to update your fee schedule as well.Hope this helps. Let me know if you have more questions. Mike W. Bowser, LAcTo: Chinese Medicine:lizzzrd: Thu, 7 Sep 2006 08:20:32 -0400Re: TCM -CPT codes for first visit99201, 99202, 99203, 99204, 99205 = codes for patient evaluation, fromleast complicated to mostalso, on your receipt, you should have your federale.i.n. number and your state license numberinsurance companies usually wantone or more diagnostic codes that relate to the condition you're treatingyou can also type something like " acupuncture insurance billing codes " intoyour search engine and visit the various websites to learn more-----Original Message ----- Aviv Li Stein To:Chinese Medicine Thursday, September 07,2006 1:45 AMRe: CPT codes for first visit97810 = acuunctureCPT code--- clothoatropos <eastdakota wrote:> Hi everyone,> >I'm new to insurance billing - in fact I don't bill> to insurance but >instead give my patients a receipt that they c________Check the weather nationwide with MSN Search: Try it now!http://search.msn.com/results.aspx?q=weather & FORM=WLMTAG[Non-text portions of this message have been removed]--No virus found in this outgoing message.Version: 7.1.405 / Virus Database: 268.11.7/438 - Release 9/5/2006[Non-text portions of this message have been removed] _______________ Check the weather nationwide with MSN Search: Try it now! http://search.msn.com/results.aspx?q=weather & FORM=WLMTAG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 8, 2006 Report Share Posted September 8, 2006 >> On a first visit, you can bill 99201 which is for evaluation and management. Off-hand, I'm not sure how much " time " this code is for, but I typically use it unless a case is very complex. << *** Some thoughts on this: If you practise in a state that does not require either prior Physician diagnosis, or prior Physician Dx plus referral, (note: Referral for an Acupuncture specialty consult is a different matter), then logic compels you to provide Evaluation and Management service before initiating Treatment. Professional conduct requires learning the system that you are interfacing with, at the most basic level to meet minimum standards of public safety. CPT 99201 is defined as a new outpatient visit with a guideline approximate face-time of 10 minutes, but more importantly a Problem-focused Hx and Exam,Straightforward Decision-Making, and a SELF-LIMITED or MINOR presenting problem. You don't do the profession any favors by feeding into an information database that all your acupuncture patients fit these criteria, but at least that's better than giving the impression that Tx doesn't require any Eval. Practise management should not be taught by insurance reps,IMO. Joe Reid jreidomd.blogspot.com *** Quote Link to comment Share on other sites More sharing options...
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