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How to Bill Using Superbills for Acupuncture Patients in Illinois

As a fellow learner navigating the world of being an acupuncturist in Illinois, I recognize the importance of clear and accurate documentation for billing patients and ensuring they receive appropriate reimbursement from insurance providers. Superbills can be a valuable tool that simplifies the billing process. In this how-to article, I’ll share the information I’ve gathered so far to help you create super bills effectively. If you have any further information that seems pertinent to this post, please share! Let’s embark on this learning journey together!

Gather Essential Patient Information for Billing

Before creating a super bill, you’ll need to collect the following information for each patient:

  1. Patient’s full name
  2. Patient’s address
  3. Patient’s date of birth
  4. Patient’s contact information
  5. Insurance policy details (if applicable)
  6. Diagnosis codes (ICD-10 codes)
  7. Procedure codes (CPT codes)

Understand Diagnosis Codes (ICD-10)

To accurately document your patient’s condition, it’s essential to learn about diagnosis codes. The International Classification of Diseases, 10th Revision (ICD-10), is the coding system used in the United States. Take the time to familiarize yourself with the relevant codes for acupuncture-related conditions. For a quick read on the most frequently used ICD-10 codes, please read this post I wrote on that. I think that this online database is especially helpful as well.

Familiarize Yourself with Procedure Codes (CPT)

Procedure codes, known as Current Procedural Terminology (CPT) codes, describe the services you provide. You’ll want to definitely get familiar with the codes you’ll most commonly use in your acupuncture practice and how you can use them. In order to do so, you may want to scrutinize your state’s outline of your scope of practice and really have an idea of the conditions you expect to treat most- in other words, your niche. All that aside, the four most important and distinct codes for acupuncture (needling) are:

  • 97810 (Initial Acupuncture) Initial 15-minute insertion of needles, personal one-on-one contact with the patient.
  • 97811 (Subsequent Unit of Acupuncture) Use one unit per each additional 15 minutes of personal one-on-one contact with the patient after the initial 15 minutes, with re-insertion of needles.
  • 97813 (Initial Acupuncture with Electrical Stimulation)  Initial 15-minute insertion of needles, personal one-on-one contact with the patient. 
  • 97814 (Subsequent Unit of Acupuncture with Electrical Stimulation) Use one unit per each additional 15 minutes of personal one-on-one contact with the patient, with re-insertion of needles.

These codes come with some intricacies in how they should be used, like which you may pair together and those you cannot, as well as actions during the treatment that must be performed (by you) in order to be able to use that code. If you would like to dive deeper into CPT codes, please visit my article on that topic here.

Choose a Super Bill Template

To simplify the billing process, you can use a pre-designed super bill template. There are several templates available online, or you can create your own using word processing software like Microsoft Word or Google Docs. Make sure your template includes fields for patient information, diagnosis codes, procedure codes, and any additional relevant information.

Fill in Patient Information

Start by entering the patient’s full name, address, date of birth, and contact information at the top of the super bill. If the patient has insurance coverage, include their policy number, group number, and any other relevant insurance details.

Enter Diagnosis Codes

Under the diagnosis section, list the ICD-10 codes that correspond to the patient’s condition. Remember to be specific and accurate to ensure proper billing and reimbursement. If the patient has multiple conditions, list all relevant codes.

Add Procedure Codes That Are Billable

In the procedure section of the super bill, enter the CPT codes that describe the services provided during the visit. Include the code, description, and any additional details necessary for proper billing.

Include Additional Information

If you provided any additional services or supplies to the patient, such as herbal prescriptions or manual therapy, include them in the super bill. Clearly state the details and corresponding codes for each item.

For a more detailed outline of creating a Superbill template, check out my article “Creating an Acupuncture SuperBill”.

Review and Validate Your Bill

Before providing the super bill to the patient, take the time to review all the information entered. Ensure accuracy and completeness, and make sure that the diagnosis codes, procedure codes, and patient details match the services provided during the visit.

Provide Your Super Bill to the Patient!

Finally, provide a copy of the completed super bill to your patient. Encourage them to submit it to their insurance provider for reimbursement. It’s also a good practice to keep a copy for your records.

By following these steps, you can create well-structured and accurate superbills for your acupuncture patients in Illinois. I hope this article provided some helpful information, and I encourage you to explore my other articles on billing if you found this one enjoyable. Stay well and happy, and thank you for reading! 🌼

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