Will the Medicare program reimburse for the multi-layer compression bandaging CPT codes (29581 and 29584) on the same date of service when manual therapy (CPT code 97140) is provided in the same anatomic region? Can the same discipline bill CPT code 97760 (Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes) or CPT code 97761 (Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes) on the same day they bill a reevaluation CPT code? Can the same discipline bill either CPT code 97750 (Physical performance test or measurement), 97755 (Assistive Technology Assessment) and/or 97763 (Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes) on the same day they bill an evaluation or reevaluation CPT code? Can an individual who is both a physical therapist and an occupational therapist bill a physical therapy evaluation and an occupational therapy evaluation on the same date of service to the Medicare program? Can the same discipline report more than one reevaluation CPT code (97164 or 97168) on the same date of service for the same patient? Can the same discipline report more than one evaluation CPT code (97161-97163 or 97165-97167) on the same date of service for the same patient? Where can I read about the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edit changes effective October 1, 2020? Whose responsibility is it to make sure modifier 59 gets appended to a CPT code on the claim form? In our practice, we provide aquatic therapy. In the beginning, patient’s perform all their therapy in the aquatic setting, but as they progress, we provide some of the services in the aquatic setting and also provide therapeutic exercise on land on the same day. Does the Medicare program pay for both aquatic therapy (CPT code 97113) and therapeutic exercise (CPT code 97110) when provided on the same day to the same Medicare beneficiary? As a physical therapist, I work with patient’s who have had lower extremity amputations and on the same day, not only provide prosthetic training, but also gait training? Does the Medicare program pay for both of these CPT codes when provided on the same day? When billing CPT codes 97110 (therapeutic exercise), 97112 (neuromuscular reeducation), 97140 (manual therapy) and/or 97530 (therapeutic activities) on the same day as 95992 (Canalith Repositioning), how do I get paid for 97110, 97112, 97140, and 97530? As a certified hand therapist, I often provide paraffin bath (CPT code 97018) prior to performing manual therapy (CPT code 97140) techniques on a patient. However, with Medicare patient’s, I never get reimbursed for 97022. Am I doing something wrong? I heard that Medicare does not pay for manual therapy (CPT code 97140) when done on the same day as mechanical traction (CPT code 97012). Is that true? When I bill a PT or an OT re-evaluation on the same day I provide treatment to the Medicare beneficiary, I do not get paid for the re-evaluation. Why not? How often does the Centers for Medicare and Medicaid Services (CMS) update CCI edits? What does Column 1 mean in the Column 1/Column 2 correct coding edits table? At one time, CMS had two different sets of CCI edits. One was called mutually exclusive and the other was called Column 2. What happened to the mutually exclusive edits? Do private insurance carriers and Medicaid programs utilize NCCI edits as Medicare does? Do NCCI edits apply only to outpatient therapy services under the Medicare program? What is the purpose of NCCI edits? Why were National Correct Coding Initiative (NCCI) edits developed?

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