Wiki Billing Group Physical Therapy

candy6196

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We are an orthopaedic physican owned physical therapy clinic. We are in need of advice on how to bill the P.T. Group Therapy code 97150 correctly. For example: P.T. sees Patient A for 2 units of Therapeutic Exercise ( 97110) and 1 unit of Manual Therapy ( 97140) and then after the above mentioned one on one treatment, the P.T. bills the Group Therapy 97150. My question is, how do we bill for this? Do we bill the 97150 as the primary procedure and the 97110 x2 and the 97140 and append with a 59 modifer? Or, do we bill the 97110 X2 and the 97140 as the primary codes and then bill the 97150 with a 59 modifier? This is just so very confusing. Sorry to ramble. Many thanks for any help.
 
I work for a similar practice, and need answers for a similar question. We billed Medicare for 97140-59 and 97150. They paid the latter but denied the former stating that an accompanying code was not billed. I looked up NCCI edits and RVU values, the RVU values on 97140 are larger, so why is 97150 the column 1 code?? I'm going to repost your question.
 
Hello Candy and Nolanspade:)
Phys therpay add in documentation but add minutes in documentation for the day, list specific body part exercised, massaged, warm compresses, Etc., ensure add referral doc and diagnosis code in notations & on claim. Add modifiers of GN, GO, GP per type of phys therapy recieved. I d get it pre autho if possible or check with payer. Can bill all session every 30 days. The therapy types range from music massage (97122-97124 97140 and 9710, art G0176 , acupuncture can use 9211 97810 97814 or special therapy codes(Ie dry needling)97760 ,92507-97533 92609 92618 92597 , 97168 9581-95852, or other special therapy of swallowing. End with dx of Z71
Most pain dx of limbs/extremities are in dx block M79 or M25 dx block and Lumbar or back pain dx blocks M54, M47 or M48.here are other Z code dx may use Z71.82, Z74.09, Z72.3 and M62.81 muscle weakness. If pt suffers due to chronic condition (I69, I63, G20) add that in notes too.
Well hope helped you !;)
Lady T.
 
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