General Surgery Coding Alert - 2012 Issue 2
D.O. Billing: E/M With Osteopathic Manipulation May Be Billable--If You Know the Rules
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Article Overview
This article reviews billing considerations for osteopathic physicians and the relationship between osteopathic manipulative treatment, evaluation and management services, and related manual therapy coding. It is aimed at coders and billing staff who work with physician claims and need a general understanding of documentation, same-day service reporting, and common areas of confusion in osteopathic claims.
Why This Topic Matters
It helps billing professionals recognize when osteopathic services may involve more than one reported service and highlights why documentation matters for compliant claim submission.
Article Sections
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Clearing the Issue: OMT vs. CMT
This section addresses the distinction between osteopathic manipulative treatment and other manipulation or manual therapy categories. It also references licensure considerations and who commonly reports these services.
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OMT Does Not Include the E/M Service
This section discusses the relationship between osteopathic manipulative treatment and evaluation and management services. It focuses on same-day reporting concepts, documentation concerns, and reimbursement risk when services are not clearly supported.
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Same-day OMT and E/M
This section presents a general same-day billing scenario involving an outpatient evaluation and osteopathic manipulation. It also emphasizes the need for appropriate documentation when services occur on the same date.
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Watch Your Units
This section explains that osteopathic manipulative treatment reporting depends on the number of body regions involved. It highlights the importance of matching the reported service to the documented scope of treatment.
What You Will Learn
- How osteopathic manipulative treatment is discussed in relation to evaluation and management services
- Why documentation is important when more than one service is reported on the same date
- How osteopathic manipulation is distinguished from other manipulation or manual therapy categories
- How body-region reporting affects osteopathic manipulation claims
Who Should Read This
- Medical coders
- Billing staff
- Physician practice managers
- Osteopathic physician office staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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