TIME SENSITIVE VS. NON-TIME-SENSITIVE CPT CODES - WHAT'S THE DIFFERENCE?

As you are probably aware, CPT coding and service units billed affect how a claim is processed. While some CPT codes are time-sensitive -- these codes are used for services that last a specified amount of time, others are non–time-sensitive and are solely based on the type of service provided. Billing the correct CPT code is important to help ensure timely and correct payment.

Our Claims Department has identified an increasing number of claims submitted with CPT codes and/or service units that are not applicable to services rendered. Specifically, units are frequently billed incorrectly, or multiple units are billed in lieu of the correct, time-sensitive CPT code.

To ensure use of the correct CPT code(s), please refer to the 2009 CPT code reference book, or review the Medical Management Program (formerly, the Provider Guide) at this link: http://apps.cignabehavioral.com/web/basicsite/provider/newsAndLearning/providerguide.jsp

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