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H2012

Ann Posted Fri 22nd of March, 2013 21:34:48 PM

does this code always have to be billed in 60 min increments or can it be billed in other increments?

SuperCoder Answered Mon 25th of March, 2013 15:58:05 PM

Yes use it with 60 min increments(1 hour)as per the code descriptor.

Ann Posted Mon 25th of March, 2013 22:31:14 PM

What if the code is billed over 60 minutes but not 2 hours - what then?

Ann Posted Wed 03rd of April, 2013 16:29:49 PM

we have providers who work for 1 hour and 15 min or 1 hour 45 min how do we bill then?

SuperCoder Answered Thu 04th of April, 2013 08:02:43 AM

Hi, We are researching on this. Thanks for your patience.

SuperCoder Answered Thu 04th of April, 2013 10:37:22 AM

This code (H2012) is not covered by Medicare. The service not separately priced by part B (e.g., services not covered, bundled, used by part a only, etc.). BETOS Classification: Undefined Codes. You might require to check with particular payor to find its billing specifics.

SuperCoder Answered Thu 04th of April, 2013 12:51:49 PM

H2012 is a HCPCS code used by Medicaid stage agencies because no national code exists to meet the reporting needs of these agencies.

I have looked for any Medicaid policies indicating time based billing requirements. I have not found any guidelines and no HCPCS Coding Clinic articles covers the code. You should check with your Medicaid contractor for confirmation. If the contractor does not have specific time based coding guidelines, then you should follow CPT time based coding guidelines. These allow you to code a unit when the half way point has been passed. So for H2012 you would count 1 unit when the 30 minute mark is passed.

Coding for your examples follows:
1 hour and 15 min - H2012, 1 unit
1 hour 45 min - H2012, 2 units

You could count unit 3 starting at 2 hours and 31 minutes.

Jen Godreau, CPC, CPMA, CPEDC

Ann Posted Thu 04th of April, 2013 20:26:04 PM

That's good info, thanks very much.

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