Mobile menu

Question – Posted February 10, 2015

Whose responsibility is it to make sure modifier 59 gets appended to a CPT code on the claim form?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 10, 2015

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 10, 2015

As a physical or occupational therapist, it is common to provide manual therapy on the same day as also having the patient perform dynamic functional activities. Does the Medicare program pay for both manual therapy (CPT code 97140) and therapeutic activities (CPT code 97530) when provided on the same day?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted December 20, 2014

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted December 20, 2014

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

How often does the Centers for Medicare and Medicaid Services (CMS) update CCI edits?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

What does Column 1 mean in the Column 1/Column 2 correct coding edits table?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

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?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

Do private insurance carriers and Medicaid programs utilize NCCI edits as Medicare does?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

Do NCCI edits apply only to outpatient therapy services under the Medicare program?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

What is the purpose of NCCI edits?

Answer

This content is for Gold Members only. Please log in above or Register

Question – Posted February 3, 2014

Why were National Correct Coding Initiative (NCCI) edits developed?

Answer

This content is for Gold Members only. Please log in above or Register