As a medical practice, it’s crucial to have a comprehensive understanding of billing and documenting procedures for therapeutic exercises and activities. This not only ensures that your patients receive the care they need but also helps to maximize your revenue. In this guide, we’ll explore the best practices for billing and documenting therapeutic exercises and activities, with a focus on using Nirvana Solutions to streamline your processes and improve your bottom line.
Therapeutic exercises and therapeutic activities are two important and commonly used treatments in physical therapy. However, there are some key differences between the two that have implications for billing and documentation. Understanding these differences is critical for ensuring that your therapy practice is properly reimbursed for the services provided to your patients.
Therapeutic exercises are structured physical movements designed to target specific muscles or muscle groups. These exercises are usually performed with equipment such as resistance bands, weights, or therapeutic balls. They are prescribed by physical therapists to help patients improve strength, flexibility, range of motion, and overall physical function.
Therapeutic activities, on the other hand, are less structured and more functional in nature. They are designed to simulate real-life tasks and activities and may involve the use of equipment such as therapy balls, cones, or balance boards. These activities are typically used to help patients improve coordination, balance, and dexterity.
The distinction between therapeutic exercises and therapeutic activities is important because each has a different code for billing purposes. For example, therapeutic exercises are usually billed using code 97110, while therapeutic activities are billed using code 97530. If a therapist uses a therapeutic activity during a treatment session, but bills it as a therapeutic exercise, it is likely that the insurance company will reject the claim. This can result in significant financial losses for your therapy practice.
Billing for therapeutic exercises and activities is done through a combination of insurance reimbursement and patient responsibility. Insurance plans will typically cover a certain number of physical therapy sessions per year, and the patient is responsible for paying any copays or deductibles. It’s important to note that not all insurance plans cover therapeutic exercises and activities, so it’s crucial to check with the patient’s insurance provider before beginning treatment.
Accurate documentation is crucial for billing purposes because it provides a clear record of the services provided to the patient. This information is used to determine the amount of reimbursement the practice will receive from the insurance provider and to establish the patient’s responsibility for copays or deductibles. Accurate documentation also helps to avoid denied claims and audits, which can be costly and time-consuming.
In order to ensure that your therapy practice is properly reimbursed for therapeutic exercises and therapeutic activities, it is important to maintain accurate and detailed documentation. This includes documenting the type of exercise or activity performed, the duration of the exercise, and the patient’s response to the treatment. It is also important to include any modifications or modifications to the exercise, as well as any special instructions or precautions that need to be taken.
When billing for therapeutic exercises and therapeutic activities, it’s essential to understand the difference between the two and how they’re billed.
For therapeutic exercises, the appropriate code to use is 97110 (Therapeutic exercise to develop strength, endurance, range of motion, and flexibility). This code can be used for exercises performed by the chiropractor or as part of a home exercise program.
For therapeutic activities, the appropriate code to use is 97116 (Therapeutic procedure, one or more areas, each 15 minutes). This code can be used for activities performed by the chiropractor on the patient, such as range of motion exercises and soft tissue mobilization.
It’s also important to note that these codes should only be used if the services are medically necessary and are supported by a clear and accurate medical record.
At Nirvana Solutions, we understand the importance of proper billing and documentation for therapeutic exercises and therapeutic activities. Our team of expert medical billers and coders is well-versed in the latest coding and billing guidelines, and we have a proven track record of helping therapy practices maximize their reimbursements. By partnering with Nirvana Solutions, you can rest assured that your therapy practice will receive the maximum reimbursement for the services you provide to your patients.
Nirvana Solutions is a medical billing company that specializes in helping healthcare practices maximize their revenue. Our platform is specifically designed to streamline the billing and documenting process for therapeutic exercises and activities, making it easier for you to focus on providing quality care to your patients.
With Nirvana Solutions, you can easily manage all of your patient information, including their medical history and insurance information, in one place. Our platform also provides customized templates for documenting therapeutic exercises and activities, making it easy to ensure that all of the necessary information is included in your documentation.
Additionally, Nirvana Solutions integrates with leading electronic health records (EHR) systems, allowing for seamless transfer of patient information and reducing the risk of errors. Our platform also automates many of the manual processes involved in billing, reducing the risk of denied claims and freeing up time for you to focus on your patients.
Accurate and complete documentation is essential for billing therapeutic exercises and activities correctly. When documenting these services, it’s important to include the following information:
Having this information in the medical record will help ensure that your claims are processed correctly and that you receive the appropriate reimbursement for these services.
Therapeutic exercises and activities are important components of chiropractic care, but billing and documenting these services can be a challenge. By understanding the differences between therapeutic exercises and therapeutic activities and how to bill and document them correctly, you can ensure that you receive the reimbursement you deserve. And, with the help of Nirvana Solutions, you can simplify the process and focus on what matters most – providing the best care to your patients.
Q. What is the difference between therapeutic exercises and therapeutic activities?
A. Therapeutic exercises are structured physical movements designed to target specific muscles or muscle groups, while therapeutic activities are less structured and more functional in nature. They are designed to simulate real-life tasks and activities and are used to help patients improve coordination, balance, and dexterity.
Q. Why is it important to distinguish between therapeutic exercises and therapeutic activities for billing purposes?
A. Each type of treatment has a different code for billing purposes, and it is important to use the correct code in order to ensure that your therapy practice is properly reimbursed for the services provided to your patients.
Q. What type of documentation is required for therapeutic exercises and therapeutic activities?
A. In order to ensure proper reimbursement, it is important to maintain accurate and detailed documentation of the type of exercise or activity performed, the duration of the exercise, the patient’s response to the treatment, and any modifications or special instructions.
Q. What are therapeutic exercises?
A. Therapeutic exercises are prescribed by a chiropractor to help improve a patient’s range of motion, flexibility, strength, and balance. These exercises may be performed in the clinic or as part of a home exercise program.
Q. What are therapeutic activities?
A. Therapeutic activities are activities that the chiropractor performs on the patient to help improve their condition. These activities may include range of motion exercises, soft tissue mobilization, and stretching.
Q. What is the appropriate code for billing therapeutic exercises?
A. The appropriate code for billing therapeutic exercises is dependent on the specific exercise being performed and the patient’s condition. The most commonly used codes are 97110 (Therapeutic Exercise) and 97112 (Neuromuscular Reeducation). However, other codes such as 97116 (Gait Training), 97124 (Manual Therapy Techniques), and 97140 (Manual Therapy) may also be used. It is important to consult with a medical billing specialist to determine the most appropriate code for each individual case, as the correct coding can have a significant impact on the reimbursement for the services provided.