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When do I need a HIPAA Business Associate Agreement?
A Business Associate is defined by HHS as, "a person or entity that performs certain functions or activities that involve the use or disclosure of protected health information on behalf of, or provides services to, a covered entity. A member of the covered entity's workforce is not a business associate."
For the complete description of a Business Associate as well as examples of who your Business Associates might be, please see the following link:
Our office recently started using a hand held unit that does manual therapy. Can we bill 97140?
Unfortunately not. CPT does not allow the use of a device for manual therapy techniques. CPT states the following, "Manual therapy techniques consist of, but are not limited to, connective tissue massage, joing mobilization and manipulation, manual traction, passive range of motion, soft tissue mobilization and manipulation, and therapeutic massage. As the code descriptor states, "manual' providers use their hands to administer these techniques. Therefore, code 97140 describes 'hands on' therapy techniques." This information as well as an expanded explanation of 97140 and the use of this code can be found in the CPT Assistant, Volume 9, Issue 3, March 1999.
We sell supplements in our practice and have always used the 99070 code. However, since this is a generic code, we use it for other supplies that we sell too. I wonder if there is a more specific code that we can use for supplements?
Q. We are seeing many Medicare Advantage patients, many of which have plans with a co-pay that is higher than the reimbursement amount for a service. An example is $32.66 for 98941. When sending these claims to the payer, the EOB returns the members responsibility as $35 for a 98941. Don’t these plans have to follow the Medicare fee schedule?
Our office is considering adding a massage therapist that performs standard massage techniques as well as cupping and moxibustion. We are wondering if there is a way to bill insurance for the cupping and moxibusion treatments?
Our office has not ever updated our fee schedule. We use the same fees for several of years. We are concerned of this now because we have added a couple of new services and are unsure if our fee schedule makes sense. Is there a way to evaluate fees?
Our office provides a lot of wellness or integrative services. Many of these services are not covered by insurances. Our obstacle isn't in trying to get by insurance as we collect the proper acknowledgement that these services are patient responsibility. However, the struggle we do have is in understanding how to determine codes for these services for data entry. Currently, we have a a list of codes that we have created internally which seemed to work for a while but now has become confusing. It is difficult to decipher office statistics and when adding new staff, it is difficult to prevent errors in data entry since our codes are loosely defined and there isn't a reliable resource to verify them. Due to these increasing obstacles I wonder if there is a better way?
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