August 10th, 2015
Stop losing hard-earned dollars. Too often, dollars are left on the table at billing time. Adjunctive codes for associated services should be added when they are appropriate. Here are a few examples of coding that are often overlooked.
According to the Relative Value Update Committee (RUC), the RVUs for these two codes for Electrical Stimulation include only 2 wires/pads. Therefore, when there are more than two, the additional wires/pads can be reported using a HCPCS code like A4556-electrodes (per pair).
64550 Application of surface (transcutaneous) neurostimulator
In addition to describing the sale of a TENS unit to a patient (which is for the equipment only), this code also describes the application service. Use it to report the initial application of a transcutaneous electrical nerve stimulation (TENS) unit in which electrodes are placed on the skin by the physician and the patient then takes the unit home. The patient operates the TENS unit at home.
99000 Handling and/or conveyance of specimen for transfer from the physician’s office to a laboratory
There are many offices that are performing these services, but they are not billing for it. This service would be adjunctive (add-on) to any E/M or CMT services for the day when a “specimen” leaves the office. See your ChiroCode DeskBook. Charge a fee that is comfortable and appropriate.
99001 Handling and/or conveyance of specimen for transfer from the patient in other than a physician’s office to a laboratory
The key difference between 90000 and 90001 is “other than a physician’s office.” Thus, if in a home or elsewhere, this would be the appropriate code. Charge a fee that is comfortable and appropriate.
90002 Handling and/or conveyance or service in connection with the implementation of an order involving devices (eg, designing, fitting, packaging, handling, delivery or mailing) when devices such as orthotics, protectives, prosthetics are fabricated by an outside laboratory or shop, but which items have been designed, and are to be fitted and adjusted by the attending physician
Please note that this is “in connection with the implementation of an order involving devices.” From a CPT coding perspective, it is very descriptive of services that happen in many offices that are fitting special shoes, etc. Please note that this code is distinctly different from the CPT code 97703, which is a code for “checkout for orthotics/prosthetic use.”
If this coding review benefits your practice, please make needed updates and changes in your coding and billing protocols. Also, review all of the adjunctive codes within the 90000 to 99091 group, they are of value. Document the services provided and all necessary supporting information.