Guest guest Posted January 2, 2005 Report Share Posted January 2, 2005 Hi all, Its the new year, and I was wondering if anyone had information regarding exactly how we are suppose to be billing in the United States? I got a letter from Alternare, so I know that I am suppose to be using the new codes with them, but what about other insurance companies? Should we be using the new codes for all insurance companies at this point? My other question is in regards to the codes. From what I can see the codes are a little different than what we've read about on this forum. For instance, the letter from Uniform (which is a part of Alternare) says that there is a limit to one 97810 and one 97811 code for each visit. This is different from what we had been told---we had been told that we could have three 15 minute codes on rare occassions, for instance. Is this limit only for Uniform, or for all insurance companies? And here is a big question: Should we always include an " office visit return patient " code for each return visit, or only when we have to do a new assessment for an issue? I think the latter is true, but I just want to make sure. From what I can see it looks like we will be billing for one 97810 and one 97811 for each return visit, and therefore we will be paid about the same amount as we have been. Laura Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 2, 2005 Report Share Posted January 2, 2005 Since when does an insurance carrier decide cpt codes? This is not their authority. They can decide to cover or not and they can limit amount of coverage, they cannot tell you how much time to spend with a patient. You have a right to bill for the amount of time you spend. They are mistaken on this one. Insurance companies also have had problems with surgeons billing in 15 minute increments as well. You just need to speak with someone there who knows what is going on. You will now need to use these numbers for all your billing. This is a nationally recognized standard. Hope this helps. Later Mike W. Bowser, L Ac > " heylaurag " <heylaurag >Chinese Medicine >Chinese Medicine > HELP! Coding... >Sun, 02 Jan 2005 01:26:04 -0000 > > > >Hi all, > >Its the new year, and I was wondering if anyone had information >regarding exactly how we are suppose to be billing in the United >States? I got a letter from Alternare, so I know that I am suppose to >be using the new codes with them, but what about other insurance >companies? Should we be using the new codes for all insurance >companies at this point? > >My other question is in regards to the codes. From what I can see the >codes are a little different than what we've read about on this forum. > For instance, the letter from Uniform (which is a part of Alternare) >says that there is a limit to one 97810 and one 97811 code for each >visit. This is different from what we had been told---we had been >told that we could have three 15 minute codes on rare occassions, for >instance. Is this limit only for Uniform, or for all insurance >companies? > >And here is a big question: Should we always include an " office visit >return patient " code for each return visit, or only when we have to do >a new assessment for an issue? I think the latter is true, but I >just want to make sure. > >From what I can see it looks like we will be billing for one 97810 and >one 97811 for each return visit, and therefore we will be paid about >the same amount as we have been. > >Laura > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 2, 2005 Report Share Posted January 2, 2005 Keep in mind that there are greatly differing opinions from certain organizations which support the AMAs CPT codes and others which do not. The caring people at Alternative Link, Inc. (founders of the ABC Codes) will be more than happy to answer any of your questions regarding this political hot bed. (www.alternativelink.com) Richard A. Freiberg, OMD, NMD Founder/Director AOMNC Acupuncture & Oriental Medicine National Coalition www.aomnc.com In a message dated 1/2/2005 3:37:46 PM Eastern Standard Time, director writes: Happy New Year Everyone! For those in the U.S. worried about coding for insurance, let me suggest two locations for good information summary. Visit the AOMAlliance website (www.aomalliance.org) for information about the new codes. There is a link on the front page and it will be helpful to you if you at the bottom of the intial article. Similar information is also available on the website of the AAOM (www.aaom.org). The quick answer is that the old codes are out and the new ones are in. We at the Alliance will be glad to try to help anyone with additional questions or problems. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 2, 2005 Report Share Posted January 2, 2005 Hi Laura: In my experience practicing, I have found its best to call the insurance companies and ask them directly which codes they accept. You can also ask them what the limitations are per visit or per day. Insurance companies are all different, you can't rely on them all being the same, for instance with Blue Shield, depending on the policy the benefits are different. In los angeles I treated several of the LAPD, some had great benefits and others had limited benefits. Also, some insurance policys would allow only 1-2 physical therapy modalities per visit, others offered 3-4 modalities and others only paid for the visit itself with no modalities. As I mentioned in my earlier post, I would take the HJ Ross seminar if you plan to play the insurance game. I learned more in that seminar just out of school than any of the other DC's I was working with, they didn't know you could bill for an ice pack, hot pack or infrared lamp, go figure... Brian heylaurag <heylaurag wrote: Hi all, Its the new year, and I was wondering if anyone had information regarding exactly how we are suppose to be billing in the United States? I got a letter from Alternare, so I know that I am suppose to be using the new codes with them, but what about other insurance companies? Should we be using the new codes for all insurance companies at this point? My other question is in regards to the codes. From what I can see the codes are a little different than what we've read about on this forum. For instance, the letter from Uniform (which is a part of Alternare) says that there is a limit to one 97810 and one 97811 code for each visit. This is different from what we had been told---we had been told that we could have three 15 minute codes on rare occassions, for instance. Is this limit only for Uniform, or for all insurance companies? And here is a big question: Should we always include an " office visit return patient " code for each return visit, or only when we have to do a new assessment for an issue? I think the latter is true, but I just want to make sure. From what I can see it looks like we will be billing for one 97810 and one 97811 for each return visit, and therefore we will be paid about the same amount as we have been. Laura http://babel.altavista.com/ and adjust accordingly. If you are a TCM academic and wish to discuss TCM with other academics, click on this link Please support the running of this group. Make a donation by clicking here, http://tinyurl.com/4xm7g Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 2, 2005 Report Share Posted January 2, 2005 Happy New Year Everyone! For those in the U.S. worried about coding for insurance, let me suggest two locations for good information summary. Visit the AOMAlliance website (www.aomalliance.org) for information about the new codes. There is a link on the front page and it will be helpful to you if you at the bottom of the intial article. Similar information is also available on the website of the AAOM (www.aaom.org). The quick answer is that the old codes are out and the new ones are in. We at the Alliance will be glad to try to help anyone with additional questions or problems. Michael R. McCoy, Ph.D. Executive Director AOMAlliance Quote Link to comment Share on other sites More sharing options...
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