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multiple sessions of 99183

Amc Posted Tue 29th of January, 2013 21:02:17 PM

I do billing for a wound specialist and need help with procedure code 99183 if he performs multiple sessions same date of service. How can we bill for more than one unit same date of service cause most insurance companies been dening stating no more than one session per day. Is there a modifier to use to seperate the billing for multiple sessions?

SuperCoder Answered Tue 29th of January, 2013 21:16:08 PM

A physician can perform HBO for many different reasons, but your pulmonologist may use this form of therapy to treat specific pulmonary conditions caused by carbon monoxide poisoning (986, Toxic effect of carbon monoxide), arterial embolism and thrombosis (444.x), and decompression sickness (993.3, Caisson disease). For each new session of HBO, report 99183 (Physician attendance and supervision of hyperbaric oxygen therapy, per session). You should bill pretreatment, patient preparation or patient education separately with an E/M code (99211-99215). When the registered nurse doesn't need the pulmonologist to attend the procedure, use G0167 (Hyperbaric oxygen treatment not requiring physician attendance, per treatment session).

Local carriers have specific documentation guidelines for submitting an HBO claim. For example, Blue Cross Blue Shield of Oregon's requirements include:

The medical record should reference prior therapies that have failed, the adjuvant surgical and antibiotic therapy, any appropriate culture, and sensitivity reports.

Your pulmonologist's records should describe findings, treatment rendered, observations addressing response to therapy, and complications of therapy.

Include evidence that cardiopulmonary resuscitation was immediately available during the hours of the HBO chamber operation.

Code 99183, Physician attendance and supervision of hyperbaric oxygen therapy, per session, is reported for physician attendance of each session of hyperbaric oxygen therapy. Any services and/or procedures provided in addition to the physician attendance and supervision (eg, E/M services, wound debridement) in the hyperbaric oxygen treatment facility, in conjunction with a hyperbaric oxygen therapy should be reported separately. Physician supervision requires that the physician is present and readily available for intervention. CPT coding guidelines does not specify per session in specific time increments.

SuperCoder Answered Tue 29th of January, 2013 21:16:08 PM

A physician can perform HBO for many different reasons, but your pulmonologist may use this form of therapy to treat specific pulmonary conditions caused by carbon monoxide poisoning (986, Toxic effect of carbon monoxide), arterial embolism and thrombosis (444.x), and decompression sickness (993.3, Caisson disease). For each new session of HBO, report 99183 (Physician attendance and supervision of hyperbaric oxygen therapy, per session). You should bill pretreatment, patient preparation or patient education separately with an E/M code (99211-99215). When the registered nurse doesn't need the pulmonologist to attend the procedure, use G0167 (Hyperbaric oxygen treatment not requiring physician attendance, per treatment session).

Local carriers have specific documentation guidelines for submitting an HBO claim. For example, Blue Cross Blue Shield of Oregon's requirements include:

The medical record should reference prior therapies that have failed, the adjuvant surgical and antibiotic therapy, any appropriate culture, and sensitivity reports.

Your pulmonologist's records should describe findings, treatment rendered, observations addressing response to therapy, and complications of therapy.

Include evidence that cardiopulmonary resuscitation was immediately available during the hours of the HBO chamber operation.

Code 99183, Physician attendance and supervision of hyperbaric oxygen therapy, per session, is reported for physician attendance of each session of hyperbaric oxygen therapy. Any services and/or procedures provided in addition to the physician attendance and supervision (eg, E/M services, wound debridement) in the hyperbaric oxygen treatment facility, in conjunction with a hyperbaric oxygen therapy should be reported separately. Physician supervision requires that the physician is present and readily available for intervention. CPT coding guidelines does not specify per session in specific time increments.

Amc Posted Tue 29th of January, 2013 21:32:31 PM

Thank you for your reply but code G0167 has been deleted. second, I know how to bill an E/M with a 25 modifier with procedure 99183 but my question was how can I bill 99183 (which is 30 mins a session with physician supervision) if performed more that one session ( for an example an hour or more) ??!!

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