Occupational Therapy is basically a therapy that helps when you have some sort of pain, injury, disease, or a disability due to which you can’t do your own work or take care of yourself. When a practice bills for such services, they may opt for billing services from a third party, known as occupational therapy billing services. Different providers offer different sorts of occupational therapy medical billing services.
What is Occupational Therapy?
In occupational therapy (OT), the therapist basically teaches you how to adapt and perform any kind of task despite having a certain type of pain, injury, disease, or disability. In occupational therapy, the patients learn the ways to use tools (if you need them). These tools are known as assistive devices. In occupational therapy, a professional therapist helps with changes in the movements so that you can easily perform the tasks and get your work done. With the help of this therapy, a person can take care of themselves, play sports, or stay active.
This sort of therapy can help you with performing these tasks:
- Eat without the support of others
- Participate in leisure activities
- Perform office tasks
- Bathe or get the shower
- Get yourself dressed
- Clean up around the house
- Do laundry
Who Is an Occupational Therapist?
In order to become an occupational therapist, one needs to get special graduate training in occupational therapy. People usually refer to them as or call them OTs. In order to get a license, one has to pass a national exam to become a certified practitioner. After that, some therapists go under extensive training in order to focus on specific types of treatment, such as hand therapy, helping people with low vision, or helping older or young people. The charges or claims for these services come under occupational therapy billing. In order to have accurate billing, one needs to use accurate occupational therapy billing codes. Down we have mentioned some of the codes that are essential for billing for occupational therapy services.
Common occupational therapy CPT codes and their usage
Evaluations:
For evaluation, there are three different codes you can use to bill:
- Low complexity (97165)
- Moderate complexity (97166)
- High complexity (97167)
Therapeutic Exercise (97110):
In this code, the exercises included are the following:
- For strengthening
- ROM
- Endurance
- Flexibility
It should be noted that this code does not include Functional mobility for ADLs or Mobility Related ADLs (MRADLs).
Neuromuscular Re-education (97112):
Under this code comes all the activities that help in the re-education. This means this code is used for all the activities involved in focusing on stabilization exercises, desensitization, balance, bearing weight, etc.
Manual Therapy (97140):
This code is used by OTs when their main focus is on tissue mobilization, lymphatic drainage, and joint mobilizations.
Therapeutic Activities (97530):
This code can include dynamic activities used to improve functional performance, like stair negotiation, functional mobility, bed mobility, car transfer training, and high/low reaching.
Self-Care (97535):
This code is used for the services that help improve ADLs’ performance. This includes using adaptive equipment, compensatory strategies, self-feeding, etc.
Prosthetic Training (97761):
This code includes training and fitting prosthetic devices’ use and assessing the appropriate device.
Common Occupational Therapy Billing Services Mistakes
In occupational therapy billing, most of the mistakes usually occur due to carelessness, and these mistakes can be easily avoided:
Clerical Mistakes
These types of mistakes include incorrect patient information. For instance, it could be:
- Misspelling of a client’s name
- An incorrect date of birth
- Errors in the policy ID number
Although these mistakes are small, they often result in payment delays. This is why this type of information should be filled and submitted correctly during the first time to save time.
Double Billing
Double billing definitely causes rejection, and this is why a practice should clearly divide the responsibilities among the staff. By doing so, you can avoid confusion as well as avoid rejection.
Missing Documentation
Another common mistake is inadequate information which results in the resubmission of the claim. This is why all information on the initial claims should be provided and double-checked to reduce rejection and denial rates.
Coding Errors In Billing For Occupational Therapy Services And How To Avoid Them
As medical coding is a complex process, this is why it is prone to mistakes. This is why it is essential to understand OT CPT codes in order to avoid coding errors. Here are the most common coding errors that practices should avoid by following the occupational therapy billing guidelines.
Upcoding
The most common reason for upcoding is a misunderstanding of the criteria of the code. As the name suggests, upcoding revolves around using a billing code that exceeds the patient’s current diagnosis or the level of provided treatment. It should be noted that upcoding is illegal. Therefore it is essential to get it right by reading the description found in the CPT Code Manual.
Under coding
Like upcoding, under coding is illegal as well. The under coding is basically the opposite of upcoding. This implies that in this sort of error, a practice reports a diagnosis or procedure that’s less intensive than what its reality dictates. This type of error may result due to an honest mistake. Sometimes this error may also be caused in order to save a patient some money or avoid an audit.
Overusing Codes
There are numerous CPT codes to choose from in occupational therapy medical billing. This is why sometimes one might get tempted to use the one code repeatedly for convenience. This repetition may leave a bad impression on the insurer, and therefore your practice may receive an audit from the payers.
Not Including Telehealth Modifiers
In order to code telehealth services, one has to use a modifier. Like Medicare, most payers and insurers usually require therapists to use the 95 modifiers to portray that the service was offered through telehealth.
UControl Billing’s Occupational Therapy Medical Billing Services
It could be difficult for a practice to manage patients as well as medical billing simultaneously; this is where UControl Billing’s services come in handy! With our occupational therapy medical billing services, your practice’s staff can take care of what really matters, and that is patient care! Our occupational therapy billing services have a proper planned out process that ensures that your reimbursements are well organized and timely. Here are the services that you will get at UControl Billing!
Scheduling & Eligibility Verification
Managing clients becomes difficult without proper scheduling. This is where our services will help your practice, and our experts verify the eligibility as well as proper scheduling of the patient’s visit.
Document Collections
For practice, the patient’s medical history is very important in order to provide proper care. This is because we collect all the related documents and combine them with information about any past prescriptions and arrange it in order. With the help of our occupational therapy billing services, all this becomes very easy.
Billing Services
Our medical billing company is known for its incredible medical coding and billing services. We have certified coders who have full competence over the occupational therapy billing codes and modifiers. When a patient receives a service, our expertise ensures that the appropriate billing codes are created without any error to get the invoice.
Claims Submission
After double-checking the invoice, our expert medical biller prepares for claim submission. In order to get the claim verified from the insurers, we arrange them in a meaningful manner and then electronically submit them. We also keep communicating with the payers in order to get timely reimbursements.
Denial management
In addition, to claim submission, our occupational therapy billing services also include claim management. This implies that you don’t have to worry in case of any claim denial or rejection as our experts will communicate and check the errors and quickly provide solutions.
Why Choose UControl as your Occupational Therapy Medical Billing Services Partner?
Are you still wondering why UControl billing is the best provider? Here is why one should choose us!
- We scale our services up or down according to the needs of the practice.
- All the HIPAA and other security regulations are followed
- We provide customized services for occupational medical billing services
- We have efficient staff that always meet deadlines.
Here are some of the benefits of leveraging our occupational therapy medical billing services:
- Boosted revenue
- Timely claims submission
- Timely reimbursements
- Better control over all billing processes
- No need for other billing software or any tools
- No need to worry about billing technicalities
Frequently Asked Questions (FAQs)
Here are some of the questions that people ask frequently!
What are occupational therapy billing services?
The billing services provided for occupational therapy are known as occupational therapy billing services. These medical billing services include the following:
- Scheduling & Eligibility Verification
- Document Collections
- Billing Services
- Claims Submission
- Denial management
What does an occupational therapist do?
Occupational therapists treat ill, injured, or disabled patients via the therapeutic use of different activities. The job of such a therapist is to recover, develop, improve, and maintain the basic skills needed for living and working.
What are some of the most common occupational therapy billing errors?
Here are some of the most common occupational therapy billing blunders:
- Blunders in fixed ratepayers
- Overusing certain codes
- Under-timing the treatment session
- Using the wrong codes
A couple of years ago, I executed the effective plan of creating a Medical billing and Coding company named U Control Billing. The company aims to bring revolutionary advancements to foster medical billing and coding revenues. As an official member of HIA-LI and MGMA, I feel honored in providing networking opportunities, problem-solving, and improving the revenue management cycle.
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