Stop Losing $$$ on Well Woman Exam Claims — CPT Coding Best Practices for Gynecology Practices

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Well-woman exams sound simple. They’re not. Gynecology practices lose thousands every year because payers deny, downcode, or bundle these visits due to coding errors, missing documentation, or confusion between preventive vs. problem-oriented care . If your practice is seeing unpaid or underpaid Well Woman claims, here’s the reality: It’s not the payer. It’s not the patient. It’s your coding workflows—and they’re costing you real money. Below is the no-nonsense breakdown of how to stop revenue leakage immediately. Why Gynecology Practices Keep Losing Money on Well-Woman Exams Most losses happen because of wrong CPT/ICD pairing , incorrect use of preventive codes, and failure to separate problem visits from preventive services. Top revenue killers: 1. Using the wrong preventive CPT code Common mistakes include: Billing 99381–99397  is incorrectly based on age Missing counseling or preventive components that justify higher-level codes Treating a preventive exam...
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Getting Paid for Telehealth Physical Therapy

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Basics of Telehealth Physical Therapy

Medicare covers three types of telehealth physical therapy services i.e., telehealth services, e-visits, and virtual check-ins. But physical therapist still needs to follow a few basic practices for getting paid for telehealth physical therapy, let’s discuss them. During the c, the federal government has broadened access to telehealth services including physical therapy. With revised billing guidelines, all beneficiaries can now connect with their healthcare providers online, and providers will get the same reimbursement for these services as they would for in-person sessions.

Verification of Identity

Given that in the telehealth clinical setting, the beneficiary and therapist are not in the same location and may not have established a prior in-person relationship, it is critical, at least initially, that the identities of the physical therapy providers and beneficiaries be verified. Photo identification is recommended for both the beneficiary and all parties who may be involved in the delivery of care to the beneficiary. The photo identification, at minimum, should include the name of the individual; however, personal information such as address or driver’s license number. 

Informed Consent 

Just as PTs must follow state law requirements and professional best practices for acquiring informed consent for in-person encounters, the same requirements should be followed for the delivery of physical therapy services via telehealth technologies. Given the unique nature of the provision of services through telehealth, there are some special considerations including: 

  • Consent to be photographed, recorded, or videotaped and consent to the storage of the encounter data, if applicable. Disclosure should be made as to how long data will be stored. 
  • Consent procedures should include a hold harmless clause for medical or other information lost because of technology failures. Beneficiaries should be informed of the possibility of failure of the technologies used to provide telehealth services.

Standards of Care 

It is the responsibility of the PT to ensure the standard of care required both professionally and legally per the Practice Act is met. As such, it is incumbent upon the PT to determine which beneficiaries and therapeutic interventions are appropriate for the utilization of technology as a component of, or instead of, in-person provision of physical therapy care.

Physical therapy providers shall be guided by professional discipline, the best available evidence, and any existing clinical practice guidelines when practicing via telehealth. Physical therapy interventions and/or referrals/consultations made using technology will be held to the same standards of care as those in traditional (in-person) settings.

To learn more about Getting Paid for Telehealth Physical Therapy, click here: https://bit.ly/3S0BZdJ, Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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