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Billing with the -52- Reduced Services modifier when teaching StrongPosture exercises

If you are coding insurance services with the -52, Reduced Services modifier when teaching StrongPosture exercises, this is important.

Previously, some practices used -52 with CPT time-based codes for 97110-97548 when less than 15 minutes was spent treating the patient, OR when the treatment lasted less than eight minutes.

 

However, according to the ACA these CPT codes require a set time minimum of eight minutes, and cannot be appropriated reduced with -52.

 

Bottom line:  For best reimbursement and less headaches, do 8+ minutes of exercise.  A possibility: combine shorter time services to achieve time based thresholds.

 

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