From Tao to Earth: Patient Care Forms, Acupuncture Insurance Forms, Chinese Herbal Formulary

STANDARDIZED CPT CODES 2006 in the United States
Coding for Services within the US Insurance Payment System

(Complementary From Tao to Earth)

NEW STANDARDIZED CPT CODES 2006

OFFICE - NEW PATIENT CPT CODES Evaluation & Management / Severity / Time

99201 LEVEL 1 Prob. Focus Hist. & Exam + Straight Forward Medical Decision making* / minor / 10 min

99202 LEVEL 2 Expanded Prob Focus Hist. & Exam + St. Forward Med Dec. making* / Lo-Mod. / 20 min

99203 LEVEL 3 Detailed Hist. & Exam Med. + Medical Decision making Low Complexity* / Mod. / 30 min

99204 LEVEL 4 Comprehensive Hist. & Exam + Med. Decision Moderate Complexity* / Mod-Hi / 45 min

99205 LEVEL 5 Comprehensive Hist. & Exam + Med. Decision making High Complexity* / Mod-Hi / 60 min

* All three key components must be present.

OFFICE - ESTABLISHED PATIENT CPT CODES Evaluation & Management / Severity / Time

99211 LEVEL 1 Pt. Eval. Mgmt. (Physician presence may not be required.) / Minimal /5 min.

99212 LEVEL 2 Prob. Focus Hist. & Exam + Str. Forward Medical Decision** / Minor /10 min

99213 LEVEL 3 Expanded Prob. Focus Hist & Exam + Med. Dec. Low Complexity** / Lo-Mod / 15 min

99214 LEVEL 4 Detailed Hist. & Exam + Med. Decision Moderate Complexity** / Mod-H / 25 min

99215 LEVEL 5 Comprehensive Hist. & Exam + Med. Decision High Complexity** / Mod-Hi / 40 min

** Two of the three key components must be present.

Modifiers for OFFICE VISIT Eval. and Mgmt Codes above: (Added to the end of the E/M codes)

--21 ADD. time for prolonged evaluation and patient management

--51 Multiple Services or procedures by same provider/same session

--52 REDUCED Services modifier

See modifiers --25. --32 and --59, --76, --77, --99 for relevancy + Other modifier codes in the AMA CPT Book

TREATMENT PHYSICAL MEDICINE & REHABILITATION CPT

Required supervision by MD or DC in some states, unless Lic.Ac. primary care status.

MODALITIES Supervised: 97010-97028; Provider's constant attendance required: codes 97032-97039

97010 Hot or Cold Packs (supervised)

97014 Elect. Stim. (unattended) For acupuncture with electrical stimulation, see 97813, 97814.

97024 Diathermy (supervised)

97026 Infrared (supervised)

97028 Ultraviolet (supervised)

97032 Elect. Stim. Manual (constantly attended procedure) Each 15 min.

97035 Ultrasound each 15 min. (Constant attendance)

97039 Unlisted modality specify type and time _____________ if constant attendance, ie. moxa

THERAPEUTIC PROCEDURES (Physician or therapist rquired to have direct 1-1 patient contact.)

97124 Massage Procedure (incl. stroking, compression, percussion)

97139 Unlisted Procedure, specify type and time _____________

97140 Manual Therapy techniques (eg myofascial release, mobilization, manipulation, manual lymphatic drainage, manual traction one or more regions each 15 min.

97530 Therapeutic activities, direct (one on one) pt. contact by provider. Use of dynamic activities to improve functional performance, each 15 min.

97532 Development of Cognitive skills to improve attention, memory, problem solving (including compensatory training) 1:1 contact.

97533 Sensory integrative techniques to enhance sensory processing & promote adaptive responses to environmental demands.

97780 Acupuncture code is deleted as of January 1, 2005. See 97810, 97811.

97781 Acupuncture code is deleted as of January 1, 2005. See 97813, 97814.

97802 Medical nutrition therapy. Initial assessment & Intervention with individual. 1:1 contact @ 15 minutes

97803 Medical nutrition therapy, Reassessment & intervention with individual, 1:1 contact @ 15 minutes.

97810 Acupuncture one or more needles without electrical stimulation with 1:1 contact. Initial 15 minutes.

97811 Acupuncture one or more needles without electrical stimulation with 1:1 contact. @ additional 15 minutes

97813 Acupuncture one or more needles with electrical stimulation, Initial 15 minutes of 1:1 contact.

97814 Acupuncture, reinsertion of one or + needles with electrical stim. @ additional 15 minutes of 1:1 contact.

97799 Unlisted physical medicine/rehabilitaiton service or procedure

Modifiers for PROCEDURE Codes: (add these codes to procedures, ie. 97124-22. (See CPT Code Book from the AMA for other modifiers)

--22 ADD time for unusual procedural service

--51 Multiple Proced. other than E/M codes same session & provider: First procedure list as is. Other add'l codes, add --51 to those.

--52 REDUCED Services or cancellation of procedure modifier (add to existing Procedure CPT code)

OTHER SPECIAL CATEGORY CPT CODES (See section re: laser)

64550 TNS surface (transcutaneous) neurostimulator.

99070 Supplies and materials over & above those usually included with office visit.

99070 Supplements (list) Herbs and Nutrition, other

99070 Orthopedic support/ pillows _________

99080 Special Report such as insurance forms, more than the info conveyed in the usual medical communications or stardard reporting form. (Do not use in conjunction with 99455, 99456 for completion of Work. Comp. forms)

99199 Unlisted special services, procedure or report.

CONSULTATION--OFFICE OR OTHER OUTPATIENT FACILITY CPT

New or Established Patient --Evaluation & Managment / Severity / Time

99241 Level 1 Prob. Focus Hist.& Exam + Straight Forward Med. Decision making / Minor/ 15min

99242 Level 2 Expanded Prob Focus Hist & Exam + Str. Forward Decision making / Low / 30 min

99243 Level 3 Detailed Hist. & Exam + Medical Decision making Low Complexity / Mod./ 40 min

99244 Level 4 Comprehensive Hist. & Exam + Med. Dec. Moderate Complexity / Mod-Hi / 60 min

99245 Level 5 Comprehensive Hist. & Exam + Med. Dec. making High Complexity / Mod-Hi / 80 min

Follow-up visits in consultant's office or other outpatient facility that are initiated by the physician consultant are reported using office visit codes for established patients (5 levels respectively 99211-99215)

HOME SERVICES CPT NEW AND ESTABLISHED (authorized physican only, except code 99600)

99341-99345 New Patients Levels (See CPT code book.)

99347-99350 Established Patients (See CPT code book.)

99600 Unlisted Home visit, service, or procedure (physician or non physician health care professional.

OTHER SPECIAL CPT SERVICES CODES

99050 Services requested after office hours in addition to basic service

99052 Services requested between 10 PM and 8 AM in addition to basic service

99054 Services requested on Sundays and holidays in addition to basic service

99056 Services provided at request of patient in a location other than physician's office which are normally provided in the office

99058 Office services provided on a emergency basis

99070 Supplies and materials

99071 Educational supplies, such as books, tapes and pamphlets, provided by the physician for the patient's education at cost to the physician

99075 Medical Testimony

99078 Physician educational services rendered to patients in a group setting (e.g. health care class, obesity or drug rehabilitative instruction)

99080 Special reports such as insurance forms, or the review of medical data to clarify a patient's status --more than the information conveyed in the usual medical communication standard reporting form

99082 Unusual Travel (e.g. transportation and escort of patient)

99090 Analysis of information data stored in computers (e.g. tests, ECGs, blood pressures, etc.). Do not report 99090 if other more specific CPT codes exist, ie. 97750 for muscular skeletal function testing.

99091 Collection & Interpretation of physiologic data digitally stored and/or transmitted by patient or caregiver to physician or qualified health care professional requiring minimum of 30 minutes of time. Don't report this code as separate item when patient presents on same day as the E/M code used. Services described by 99091 would be considered part of the E/M visit in that case.

99199 Unlisted special service, proedcure or report

OSTEOPATHIC MANIPULATIVE TREATMENT

98925 OMT 1-2 body regions involved

98926 OMT three to four body regions involved

98927 OMT five to six body regions involved

98928 OMT seven to eight body regions involved

98929 OMT nine to ten body regions involved

CHIROPRACTIC MANIPULATIVE TREATMENT CMT*

98940 CMT spinal, 1-2 regions

98941 CMT spinal, 3-4 regions

98942 CMT spinal, 5 regions

98943 CMT extraspinal, one or more regions

MUSCLE AND RANGE OF MOTION TESTING

95831 Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk

95832 Muscle testing, hand, with or without comparison with

normal side

95833 Muscle testing, total evaluation of body, excluding hands

95834 Muscle testing, total evaluation of body, including hands

95851 Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine)

95852 ROM etc. hand with or without comparison with normal side

95857 Tensilon test for myasthenia gravis

95858 Tensilon test for myasthenia gravis w/ electromyographic recording

See CPT book from AMA for other related codes

LASER TREATMENT (Surgical codes 17000-17250, 17260-17286) (See CPT Code Book)

17001, 17002 have been deleted. To report see 17003, 17004. Do not report 17004 in conjunction with codes 17000-17003. 17010 has been deleted. To report see specific anatomical site code. 17100-17105 have been deleted. To report see 17000, 17003, 17004. See 17106-17250 for additional related codes.

OTHER:

____ STATE AID CODES Check with your state regulatory board for codes or changes

____ WORK COMP. RVS CODES Check with your state regulatory board for codes or changes

TREATMENT RVS CODES (check with your state)

*CMT Codes include pre-manipulation patient assessment.

*Acupuncture, Chiropractic and osteopathy: Use --25 above with the E/M service codes beyond normal E/M service when warranted

This is a Free supplement from

From Tao to Earth
Focus Practice Management Pubs., Inc.
Email: be@taotoearthpmpubs.com
Phone 1 (800) 800-3139

See website: http://taotoearthpmpubs.com
for future coding or order the CPT code
book directly from the AMA.

Original Design by Claire Flint / Webmaster


	NEW STANDARDIZED CPT CODES 2006 OFFICE - NEW PATIENT CPT CODES Evaluation & Management / Severity / Time 99201 LEVEL 1 Prob. Focus Hist. & Exam + Straight Forward Medical Decision making* / minor / 10 min 99202 LEVEL 2 Expanded Prob Focus Hist. & Exam + St. Forward Med Dec. making* / Lo-Mod. / 20 min 99203 LEVEL 3 Detailed Hist. & Exam Med. + Medical Decision making Low Complexity* / Mod. / 30 min 99204 LEVEL 4 Comprehensive Hist. & Exam + Med. Decision Moderate Complexity* / Mod-Hi / 45 min 99205 LEVEL 5 Comprehensive Hist. & Exam + Med. Decision making High Complexity* / Mod-Hi / 60 min * All three key components must be present. OFFICE - ESTABLISHED PATIENT CPT CODES Evaluation & Management / Severity / Time 99211 LEVEL 1 Pt. Eval. Mgmt. (Physician presence may not be required.) / Minimal /5 min. 99212 LEVEL 2 Prob. Focus Hist. & Exam + Str. Forward Medical Decision / Minor /10 min 99213 LEVEL 3 Expanded Prob. Focus Hist & Exam + Med. Dec. Low Complexity / Lo-Mod / 15 min 99214 LEVEL 4 Detailed Hist. & Exam + Med. Decision Moderate Complexity / Mod-H / 25 min 99215 LEVEL 5 Comprehensive Hist. & Exam + Med. Decision High Complexity / Mod-Hi / 40 min Two of the three key components must be present. Modifiers for OFFICE VISIT Eval. and Mgmt Codes above: (Added to the end of the E/M codes) --21 ADD. time for prolonged evaluation and patient management --51 Multiple Services or procedures by same provider/same session --52 REDUCED Services modifier See modifiers --25. --32 and --59, --76, --77, --99 for relevancy + Other modifier codes in the AMA CPT Book TREATMENT PHYSICAL MEDICINE & REHABILITATION CPT Required supervision by MD or DC in some states, unless Lic.Ac. primary care status. MODALITIES Supervised: 97010-97028; Provider's constant attendance required: codes 97032-97039 97010 Hot or Cold Packs (supervised) 97014 Elect. Stim. (unattended) For acupuncture with electrical stimulation, see 97813, 97814. 97024 Diathermy (supervised) 97026 Infrared (supervised) 97028 Ultraviolet (supervised) 97032 Elect. Stim. Manual (constantly attended procedure) Each 15 min. 97035 Ultrasound each 15 min. (Constant attendance) 97039 Unlisted modality specify type and time _____________ if constant attendance, ie. moxa THERAPEUTIC PROCEDURES (Physician or therapist rquired to have direct 1-1 patient contact.) 97124 Massage Procedure (incl. stroking, compression, percussion) 97139 Unlisted Procedure, specify type and time _____________ 97140 Manual Therapy techniques (eg myofascial release, mobilization, manipulation, manual lymphatic drainage, manual traction one or more regions each 15 min. 97530 Therapeutic activities, direct (one on one) pt. contact by provider. Use of dynamic activities to improve functional performance, each 15 min. 97532 Development of Cognitive skills to improve attention, memory, problem solving (including compensatory training) 1:1 contact. 97533 Sensory integrative techniques to enhance sensory processing & promote adaptive responses to environmental demands. 97780 Acupuncture code is deleted as of January 1, 2005. See 97810, 97811. 97781 Acupuncture code is deleted as of January 1, 2005. See 97813, 97814. 97802 Medical nutrition therapy. Initial assessment & Intervention with individual. 1:1 contact @ 15 minutes 97803 Medical nutrition therapy, Reassessment & intervention with individual, 1:1 contact @ 15 minutes. 97810 Acupuncture one or more needles without electrical stimulation with 1:1 contact. Initial 15 minutes. 97811 Acupuncture one or more needles without electrical stimulation with 1:1 contact. @ additional 15 minutes 97813 Acupuncture one or more needles with electrical stimulation, Initial 15 minutes of 1:1 contact. 97814 Acupuncture, reinsertion of one or + needles with electrical stim. @ additional 15 minutes of 1:1 contact. 97799 Unlisted physical medicine/rehabilitaiton service or procedure Modifiers for PROCEDURE Codes: (add these codes to procedures, ie. 97124-22. (See CPT Code Book from the AMA for other modifiers) --22 ADD time for unusual procedural service --51 Multiple Proced. other than E/M codes same session & provider: First procedure list as is. Other add'l codes, add --51 to those. --52 REDUCED Services or cancellation of procedure modifier (add to existing Procedure CPT code) OTHER SPECIAL CATEGORY CPT CODES (See section re: laser) 64550 TNS surface (transcutaneous) neurostimulator. 99070 Supplies and materials over & above those usually included with office visit. 99070 Supplements (list) Herbs and Nutrition, other 99070 Orthopedic support/ pillows _________ 99080 Special Report such as insurance forms, more than the info conveyed in the usual medical communications or stardard reporting form. (Do not use in conjunction with 99455, 99456 for completion of Work. Comp. forms) 99199 Unlisted special services, procedure or report. CONSULTATION--OFFICE OR OTHER OUTPATIENT FACILITY CPT New or Established Patient --Evaluation & Managment / Severity / Time 99241 Level 1 Prob. Focus Hist.& Exam + Straight Forward Med. Decision making / Minor/ 15min 99242 Level 2 Expanded Prob Focus Hist & Exam + Str. Forward Decision making / Low / 30 min 99243 Level 3 Detailed Hist. & Exam + Medical Decision making Low Complexity / Mod./ 40 min 99244 Level 4 Comprehensive Hist. & Exam + Med. Dec. Moderate Complexity / Mod-Hi / 60 min 99245 Level 5 Comprehensive Hist. & Exam + Med. Dec. making High Complexity / Mod-Hi / 80 min Follow-up visits in consultant's office or other outpatient facility that are initiated by the physician consultant are reported using office visit codes for established patients (5 levels respectively 99211-99215) HOME SERVICES CPT NEW AND ESTABLISHED** (authorized physican only, except code 99600) 99341-99345 New Patients Levels (See CPT code book.) 99347-99350 Established Patients (See CPT code book.) 99600 Unlisted Home visit, service, or procedure (physician or non physician health care professional.
	OTHER SPECIAL CPT SERVICES CODES 99050 Services requested after office hours in addition to basic service 99052 Services requested between 10 PM and 8 AM in addition to basic service 99054 Services requested on Sundays and holidays in addition to basic service 99056 Services provided at request of patient in a location other than physician's office which are normally provided in the office 99058 Office services provided on a emergency basis 99070 Supplies and materials 99071 Educational supplies, such as books, tapes and pamphlets, provided by the physician for the patient's education at cost to the physician 99075 Medical Testimony 99078 Physician educational services rendered to patients in a group setting (e.g. health care class, obesity or drug rehabilitative instruction) 99080 Special reports such as insurance forms, or the review of medical data to clarify a patient's status --more than the information conveyed in the usual medical communication standard reporting form 99082 Unusual Travel (e.g. transportation and escort of patient) 99090 Analysis of information data stored in computers (e.g. tests, ECGs, blood pressures, etc.). Do not report 99090 if other more specific CPT codes exist, ie. 97750 for muscular skeletal function testing. 99091 Collection & Interpretation of physiologic data digitally stored and/or transmitted by patient or caregiver to physician or qualified health care professional requiring minimum of 30 minutes of time. Don't report this code as separate item when patient presents on same day as the E/M code used. Services described by 99091 would be considered part of the E/M visit in that case. 99199 Unlisted special service, proedcure or report OSTEOPATHIC MANIPULATIVE TREATMENT 98925 OMT 1-2 body regions involved 98926 OMT three to four body regions involved 98927 OMT five to six body regions involved 98928 OMT seven to eight body regions involved 98929 OMT nine to ten body regions involved CHIROPRACTIC MANIPULATIVE TREATMENT CMT* 98940 CMT spinal, 1-2 regions 98941 CMT spinal, 3-4 regions 98942 CMT spinal, 5 regions 98943 CMT extraspinal, one or more regions MUSCLE AND RANGE OF MOTION TESTING 95831 Muscle testing, manual (separate procedure) with report; extremity (excluding hand) or trunk 95832 Muscle testing, hand, with or without comparison with normal side 95833 Muscle testing, total evaluation of body, excluding hands 95834 Muscle testing, total evaluation of body, including hands 95851 Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine) 95852 ROM etc. hand with or without comparison with normal side 95857 Tensilon test for myasthenia gravis 95858 Tensilon test for myasthenia gravis w/ electromyographic recording See CPT book from AMA for other related codes LASER TREATMENT (Surgical codes 17000-17250, 17260-17286) (See CPT Code Book) 17001, 17002 have been deleted. To report see 17003, 17004. Do not report 17004 in conjunction with codes 17000-17003. 17010 has been deleted. To report see specific anatomical site code. 17100-17105 have been deleted. To report see 17000, 17003, 17004. See 17106-17250 for additional related codes. OTHER: ____ STATE AID CODES Check with your state regulatory board for codes or changes ____ WORK COMP. RVS CODES Check with your state regulatory board for codes or changes TREATMENT RVS CODES (check with your state) CMT Codes include pre-manipulation patient assessment. Acupuncture, Chiropractic and osteopathy: Use --25 above with the E/M service codes beyond normal E/M service when warranted
	*This is a Free supplement from* From Tao to Earth Focus Practice Management Pubs., Inc. Email: be@taotoearthpmpubs.com Phone 1 (800) 800-3139 See website: http://taotoearthpmpubs.com for future coding or order the CPT code book directly from the AMA.
	Original Design by Claire Flint / Webmaster