Mobile menu

PT & OT Case Scenarios

Question – October 6, 2015

If a patient is referred to physical therapy due to a right total knee replacement one week ago, what would the ICD-10 codes be on the claim form?

Answer

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

Speech Therapy Case Scenarios

Question – October 10, 2015

A patient is referred to speech therapy diagnosed with bilateral vocal cord nodules last week with complaints of hoarseness, vocal fatigue pain in throat that impact her ability to communicate effectively. What ICD-10 would I use on the claim form?

Answer

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

7th Character Questions & Answers

Question – Updated September 27, 2015

I heard the Centers for Medicare and Medicaid Services (CMS) provided an answer about rehabilitation therapy and what 7th character they would use when a 7th character is required. Is that true?

Answer

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

Question – Updated September 27, 2015

Can you provide an example of when a therapist would use the letter “S” as the 7th character when a 7th character is required?

Answer

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

Question – Updated September 27, 2015

Can you provide an example of when a therapist would use the letter “D” as the 7th character when a 7th character is required?

Answer

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

Question – Updated September 27, 2015

Can you provide an example of when a therapist would use the letter “A” as the 7th character when a 7th character is required?

Answer

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

Question – Updated September 27, 2015

If the reason the patient is referred to therapy is due to a traumatic injury such as a fracture, sprain, strain, burn, TBI, concussion, dislocation, etc., the visit I do my initial evaluation, will the 7th character always be the letter “A”?

Answer

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

Question – August 31, 2015

When an ICD-10 code does require a 7th character, which 7th characters will be used by physical therapists, occupational therapists, and speech language pathologists?

Answer

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

Question – August 31, 2015

Can you provide which 7th characters outpatient therapists will primarily use and the definition of each one?

Answer

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

Question – August 31, 2015

When does an ICD-10 code require a 7th character?

Answer

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

Claim Form Questions & Answers

Question – October 4, 2015

If I have a cash-based practice, will I need to provide ICD-10 codes to my patient’s?

Answer

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

Question – September 27, 2015

How many ICD-10 codes can be reported on the UB-04 claim form used by non-private practices?

Answer

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

Question – September 27, 2015

How many ICD-10 codes can be reported on the 1500 claim form used by private practices?

Answer

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

Question – September 23, 2015

If new signs and symptoms develop after the initial evaluation, say visit 3 or 4, should we add those ICD-10 codes to the claim form?

Answer

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

Question – September 23, 2015

As signs and symptoms a patient had at the start of therapy resolve, should we delete those ICD-10 codes from the claim form?

Answer

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

Question – September 23, 2015

What ICD-10 code should be primary, the medical diagnosis or therapy diagnosis?

Answer

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

Question – September 23, 2015

Must every claim we submit have a medical diagnosis that was provided by the physician?

Answer

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

Question – September 23, 2015

In the ICD-10-CM book, which diagnosis codes are medical and which are a therapy or treatment diagnosis?

Answer

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

Question – September 23, 2015

Under outpatient therapy, must the therapist diagnosis code(s) match the physician diagnosis code(s) that was provided on the order or referral?

Answer

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

Question – September 23, 2015

Who determines what ICD-10 code(s) will be placed on the claim form?

Answer

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

Question – September 9, 2015

With the implementation of ICD-10 on October 1, 2015, how many ICD-10 codes will we need to place on the claim form?

Answer

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

Documentation Questions & Answers

Question – September 27, 2015

How does my documentation impact the ICD-10 codes that I report on the claim form?

Answer

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

Question – September 27, 2015

Does the implementation of ICD-10 change how I must document compared to ICD-9?

Answer

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

Question – September 27, 2015

Do I need to list the actual ICD-10 codes in my evaluation and subsequent documentation?

Answer

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

ICD-10 Terminology Questions & Answers

Question – August 24, 2015

In ICD-10-CM book, I often see the abbreviation “NEC” under an ICD-10 code in the Index List or under an ICD-10 code in the Tabular List. What does “NEC” mean?

Answer

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

Question – August 24, 2015

In ICD-10-CM book, I often see the abbreviation “NOS” under an ICD-10 code in the Index List or under an ICD-10 code in the Tabular List. What does “NOS” mean?

Answer

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

Question – August 16, 2015

In the tabular section of the ICD-10-CM book, I often see Excludes 2 under an ICD-10 code with additional ICD-10 codes following the words “Excludes 2”. What does Excludes 2 mean and can you give an example?

Answer

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

Question – August 16, 2015

In the tabular section of the ICD-10-CM book, I often see Excludes 1 under an ICD-10 code with additional ICD-10 codes following the words “Excludes 1”. What does Excludes 1 mean and can you give an example?

Answer

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

General Questions & Answers

Question – September 14, 2015

How will ICD-10 impact or change how we report PQRS measures on our Medicare Part B outpatient’s?

Answer

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

Question – September 14, 2015

How will ICD-10 impact or change how we use CPT codes?

Answer

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

Question – September 10, 2015

For Medicare patient’s, do we have to do an updated plan of care and have it signed by the physician or non-physician practitioner for Medicare patient’s who are continuing with outpatient therapy services on or after October 1, 2015?

Answer

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

Question – September 10, 2015

On October 1, 2015, do we need to do an evaluation or re-evaluation on all of our current patient’s?

Answer

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

Question – August 9, 2015

What is the character “X” used for in the ICD-10-CM codes?

Answer

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

Question – August 9, 2015

Is the first character in ICD-10-CM alpha or numeric?

Answer

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

Question – August 9, 2015

What are the main differences between ICD-10-CM and ICD-9-CM?

Answer

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

Question – July 30, 2015

What is the difference between ICD-10-CM and ICD-10-PCS?

Answer

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

Question – July 30, 2015

What are benefits of switching to ICD-10-CM for outpatient therapy services?

Answer

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

Question – July 30, 2015

After the implementation of ICD-10, is it possible that we could use ICD-10 codes with some insurance carriers and ICD-9 codes with other insurance carriers?

Answer

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

Question – July 30, 2015

Will all insurances mandate we report ICD-10 codes instead of ICD-9 codes?

Answer

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

Question – July 30, 2015

What is the implementation date for ICD-10?

Answer

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