Acupuncture Treatment Will Not Post

Problem

Posting a treatment is refused, or it posts but fewer charges appear on the encounter than expected.

Background

The module refuses only where the figures are impossible or where somebody needs to take responsibility in writing. Everything else is reported as a warning and left to your judgement.

Resolution

“Hands-on time exceeds the time the needles were in”

You cannot have spent 40 minutes hands-on inside a 25-minute retention window, so one of the two figures is wrong. Check Needles in and Needles out against the contact intervals and correct whichever is mistaken.

“The needle count does not balance”

The treatment has needles that have not been accounted for. Check the patient first. If the count is right — a tack left in deliberately, for instance — type a short reason when asked. The reason is stored on the treatment and recorded in the log.

A contraindicated point

Same again: the treatment is not blocked and never was, but the charge waits until somebody types why. Points like LI4 and SP6 in a term pregnancy are used deliberately by practitioners intending to encourage labour, so refusing them outright would be wrong; recording the decision is not.

Fewer charges than expected

The response lists every line that was skipped and why. The usual reasons:

• The line was not ticked. Tick it under Charges.
• It earned no units. Timed codes need at least 8 minutes of hands-on contact. Under 8 minutes there is no timed unit to bill.
• The other initial code won. 97810 and 97813 are mutually exclusive. If e-stim was recorded anywhere on the treatment the session ’s initial code is 97813, and the 97810 line is switched off with a note saying so. The same applies to 20560 and 20561.

“Hands-on time is longer than the whole appointment”

No timed code is suggested, because the contact time recorded is longer than the appointment was booked for. Correct the contact intervals.

The treatment is already posted

A posted treatment cannot be edited or posted again. Reverse the posting first: its charges come off the encounter and the clinical record stays exactly as charted, because reversing a charge does not un-needle a patient.

Warnings that do not stop a posting

These are reported after the charges are written, because they are coding judgements that depend on payer policy:

• An evaluation and management code on the same encounter without modifier 25.
• A second initial acupuncture code on the same date. 97810 and 97813 are once per day, not once per encounter.
• A 97811 with no re-insertion or manipulation recorded, when the code is defined with re-insertion of needles.
• Dry needling on the same date as the timed acupuncture codes, which normally needs a distinct-procedure modifier.

The module never adds a modifier by itself. Where one is needed there is a button that writes it, and the write is recorded against your name.