Medical Billing Forum

General Category => General Questions => Topic started by: Billing2 on October 22, 2015, 08:20:19 PM

Title: Coding Units for Chiropractic Laser
Post by: Billing2 on October 22, 2015, 08:20:19 PM
So I really need some help on this one.

I have a chiropractic that does laser CPT code 97026. We use a 25 watt laser and you sometimes cant do more than 4-5 minutes on certain regions. So then we should bill with modifier 52 to show lesser service was performed. But really lesser services is not performed because it's a high watt laser.

The provider does not think that's fare because we use a High watt laser it's like doing 8 min, but you only do 4 min.

So they ask can they just put 1 unit and not time. I've always thought of it this way.
It's absolutely vital that time is charted if no time noted in the chart, there is no justification for billing.

Any help I would be very grateful for.
Title: Re: Coding Units for Chiropractic Laser
Post by: Michele on October 23, 2015, 10:17:10 AM
The code 97026 is not a timed code and units would not be indicated.  1 unit is for 1 or more areas of application.  So whether you are doing 4-5 minutes or 8 minutes wouldn't really matter.  I don't think the 52 modifier is needed either as it doesn't sound like the service performed is a reduced service.  They should note in the chart exactly what is done, including time, however that shouldn't affect the billing for this code since it is not a time code.

Title: Re: Coding Units for Chiropractic Laser
Post by: Billing2 on October 23, 2015, 10:35:05 AM
Thank you so much for your help, Michelle.