ITE Only – Lesson 31B The 8-Minute Rule in In Touch EMR

IMPORTANT NOTES ABOUT THE MEDICARE 8-MINUTE RULE:

  • The Medicare 8 minute rule is mandatory for all Medicare patients. For compliance, the Medicare 8 Minute rule cannot be disabled for Medicare patients.
  • The Medicare 8 minute rule requires you to utilize the Flowsheet section of your documentation to enter your charges. Adding row and CPT charges at the claim review tab will be disabled.
  • Ensure that the proper insurance information is selected in In Touch EMR in cases of two or more insurance profiles set up for the patient. Please see lecture on “How to Setup Patient Insurance Profiles Correctly in In Touch EMR” for more information.

Medicare’s 8-Minute Rule for Timed Codes

  • The 8-Minute Rule Chart as defined by Medicare is as follows, and several permutations and combinations of the rule are automatically calculated in In Touch EMR.

        Units     Number of Minutes

    0 Units     < 8 Minutes
    1 Unit     >= 8 Minutes and <= 22 minutes
    2 Units     >= 23 Minutes and <= 37 minutes
    3 Units     >= 38 Minutes and <= 52 minutes
    4 Units     >= 53 Minutes and <= 67 minutes
    5 Units     >= 68 Minutes and <= 82 minutes
    6 Units     >= 83 Minutes and <= 97 minutes
    7 Units     >= 98 Minutes and <= 112 minutes
    8 Units     >= 113 Minutes and <= 127 minutes

     

STEP 1.0. Enable the 8-Minute Rule for Non-Medicare Patients.

  • Go to Edit Patient => Insurance => Click Yes to “Apply Medicare 8 Minute Rule”

    Please keep in mind that the Medicare 8 minute rule applies only to timed codes. The times codes include, but are not limited to the following:

    • 97032 – Electrical Stimulation (Manual)
    • 97033 – Iontophoresis
    • 97035 – Ultrasound
    • 97039 – Unlisted
    • 97110 – Therapeutic Exercise
    • 97112 – Neuromuscular Reeducation
    • 97116 – Gait Training
    • 97124 – Massage
    • 97139 – Unlisted
    • 97140- Manual Therapy
    • 97530 – Therapeutic Activity

STEP 2.0. Add New Flowsheet in the documentation.

Note: For Medicare 8 Minute Rule to compute, duration must be set for timed CPT codes.

STEP 2.1. Save flowsheet.

The 8-Minute Rule Chart

    Units     Number of Minutes

0 Units     < 8 Minutes
1 Unit     >= 8 Minutes and <= 22 minutes
2 Units     >= 23 Minutes and <= 37 minutes
3 Units     >= 38 Minutes and <= 52 minutes
4 Units     >= 53 Minutes and <= 67 minutes
5 Units     >= 68 Minutes and <= 82 minutes
6 Units     >= 83 Minutes and <= 97 minutes
7 Units     >= 98 Minutes and <= 112 minutes
8 Units     >= 113 Minutes and <= 127 minutes

STEP 2.2.. In the Claim Review tab, click Refresh

STEP 2.3. The system will automatically compute the number of units per CPT code based on the logic of the 8 Minute Rule.

SCENARIO 2.0. Total duration of time codes = 40 minutes = 3 units

SCENARIO 2.0. Extra unit can be assigned to either of the treatment codes since they have the same amount of time.

SCENARIO 3.0. Total duration of time codes = 40 minutes = 3 units

SCENARIO 3.1. Treatment code for 33 minutes should be assigned 2 units and the excess will be assigned to treatment code with 7 minutes to comply with the 8 Minute Rule

SCENARIO 4.0. Total duration of time codes = 49 minutes = 3 units

SCENARIO 4.1. All 4 treatment codes took at least 8 minutes but total duration is equivalent to 3 units only. Units will be assigned to treatment codes that took more time. However, the unassigned treatment code should still be reported.

SCENARIO 5.0. Total duration of time codes = 27 minutes = 1 unit

SCENARIO 5.1. All treatment codes are under 8 minutes but total duration is 21 minutes which is equivalent to 1 unit. Since all treatment codes have equal times, the unit can be assigned to any one of them.

ADJUSTING UNITS MANUALLY:

If you need to adjust units manually, you can do so by changing the units under the Claim Review tab.

Note: When you adjust the units manually, ensure that this is final and ready for submission. Proceed with save billing and finalizing the document. If you adjust the unit manually and saved the billing without finalizing the note, the next time you resume the note – the 8 minute rule will override the units and you would need to change the units manually once more according to your preference.