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Tag Archives: Supervised

Physical Therapy supervised (untimed codes) question

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Hello,

I have a question regarding PT supervised code 97010 being billed with another supervised code 97014 in the same 15 minute time period. The information I have found says:

Billing Two CPT Codes for Same 15 Minute Time Period
*Only when one of the services is a supervised service that does not require the presence of the therapist (97010 – 97028)
*One or more supervised modalities may be billed in the same 15 minute time period with any other CPT code requiring constant attendance or direct one-on-one patient contact.

Does this mean since they are both supervised codes and neither are timed codes that they should not both be billed? The office notes say there was 32 minutes of Therapeutic Exercises with 15 minutes of concurrent care for the Cold Pack and EStim for a total of 47 minutes. 2 units of 97110 was billed with 1 unit of 97010 and 1 unit of 97014. Is this correct and all 4 units should be allowed?

Thank you in advance for any advice you can give!

Medical Billing and Coding Forum

There’s a Time and Place for Supervised Exercise Therapy

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Don’t expect Medicare to reimburse SET unless you meet all the requirements. The Centers for Medicare & Medicaid Services (CMS) considers supervised exercise therapy (SET) reasonable and necessary for Medicare beneficiaries with intermittent claudication (IC) for treatment of symptomatic peripheral artery disease (PAD), but there are many requirements for coverage. A National Coverage Determination (NCD) for SET, effective May […]
AAPC Knowledge Center

Supervised CRNA

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Hi, How should we bill for CRNA that was supervised by the Anesthesiologist for a TEE in 2 Room? It Conscious Sedation (QS) but we also have modifier QK, QX for the CRNA. The Attending is attempting to bill under him but should the CRNA have her name under the service provider and also, what documentation should we be looking for? We only have signature for the CRNA. Thank you for your help. This is a new type of cases for us.

Medical Billing and Coding Forum

Coding guidelines for Supervised Exercise Therapy (SET)

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SET involves the use of intermittent walking exercise, which alternates periods of walking to moderate-to-maximum claudication, with rest. SET has been recommended as the initial treatment for patients suffering from IC, the most common symptom experienced by people with PAD.

SET program covers Up to 36 sessions over a 12-week period if all of the following components of a SET program are met: 

The SET program must:

Consist of sessions lasting 30-60 minutes, comprising a therapeutic exercise-training program for PAD in patients with claudication.

Be conducted in a hospital outpatient setting, or a physician’s office.

Be delivered by qualified auxiliary personnel necessary to ensure benefits exceed harms, and who are trained in exercise therapy for PAD.

Be under the direct supervision of a physician, physician assistant, or nurse practitioner/clinical nurse specialist who must be trained in both basic and advanced life support techniques.

Coding Requirements for SET

CPT: 

93668 Peripheral arterial disease (PAD) rehabilitation, per session

ICD 10 Codes:

I70.211 Atherosclerosis of native arteries of extremities with intermittent claudication, right leg 
I70.212 Atherosclerosis of native arteries of extremities with intermittent claudication, left leg 
I70.213 Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs 
I70.218 Atherosclerosis of native arteries of extremities with intermittent claudication, other extremity 
I70.311 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, right leg 
I70.312 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, left leg 
I70.313 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs 
I70.318 Atherosclerosis of unspecified type of bypass graft(s) of the extremities with intermittent claudication, other extremity 
I70.611 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, right leg 
I70.612 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, left leg 
I70.613 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, bilateral legs 
I70.618 Atherosclerosis of nonbiological bypass graft(s) of the extremities with intermittent claudication, other extremity 
I70.711 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, right leg 
I70.712 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, left leg 
I70.713 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, bilateral legs 
I70.718 Atherosclerosis of other type of bypass graft(s) of the extremities with intermittent claudication, other extremity 

Place of Service (POS):

11 Office
19 Off Campus-Outpatient Hospital
22 On Campus-Outpatient Hospital

MACs will deny claims for SET if services are not provided in above POS.

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