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Suggest charges

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In this article, solution can refer to TheraOffice or GEHRIMED.

The solution can suggest charges for treatments documented in the Initial Treatment section of an Initial Evaluation, or in the Objective section of a Daily Note. Charges are suggested per rules outlined by CMS' Medicare Claims Processing Manual, Chapter 5, Section 20.

CPT Codes are suggested based on the codes linked within the Treatments section of the note.

Each CPT code in the fee schedule can be assigned Begin and Add minutes, which will determine how many units of a code to suggest. The solution will suggest 1 unit for all Untimed Codes, and will suggest the appropriate number of units for all Timed Codes based on the Fee Schedule being used for the patient.

  • Begin: The number of minutes which must be reached for the first unit to be suggested.
  • Add: The final minute before a second unit is added.

For example, Medicare's Therapeutic Exercise will start on 8 minutes and continue to suggest 1 unit up until the 22nd minute. If the total minutes linked to the treatments is 7, then the suggested units will be 0. If the total minutes linked to the treatments is 9, then the suggested units will be 1. If the total minutes linked to the treatments is 24, the suggested units will be 2.

  1. Go to Documentation > Treatments. Assign each treatment a CPT code and a default number of minutes in the treatment protocols.

  2. Go to Documentation > Billing, and select Suggest Charges.
    Result: The solution gathers each treatment entered in the Initial Treatment or the Objective settings. Then the solution groups each treatment assigned to the same CPT code, summing the total minutes assigned to the treatment. Next, it will suggest the total minutes based off the begin / add assigned to the CPT code.
    Result: The solution reviews the charges added to the Billing section of each note and automatically checks them for errors using the CPT Checks and Diagnosis Checks. If charges are added manually, they must be checked by selecting the Check Charges button.   
  3. Selecting the checkboxes on the left will add that CPT code to the list of charges for the visit.

Notes:

  • For modalities and manual techniques that sometimes are not time dependent, setting these CPT codes begin to 1 and add to 99 will count each treatment as 1 unit.
  • In the Billing section of each note, there is an area which lists the number of minutes which were spent performing Timed Treatments, Untimed Treatments and the Total Time performing treatments altogether. These minutes come directly from the Initial Treatment section of the Initial Evaluation and the Objective section of the Daily Note.