Modifiers for PT

[anuja.devasthali]

Hi Friends,

Please help me with this !

Can we code CPT 97110 & CPT 97750 on same day performed by same provider.
Do we need to add any modifier 51 or 59 to any one of them ?

Thanks,
Anuja.A.Devasthali, CPC-A.

[drspatil]

Originally Posted by anuja.devasthali

Hi Friends,

Please help me with this !

Can we code CPT 97110 & CPT 97750 on same day performed by same provider.
Do we need to add any modifier 51 or 59 to any one of them ?

Thanks,
Anuja.A.Devasthali, CPC-A.

There is no CCI edit inbetween these two CPT codes so we no need to append any modifier with any one of them.

[anuja.devasthali]

Thank you very much.

Anuja.A. Devasthali, CPC-A.

[ceskourup]

This is just something I have found from experience: While there are no CCI or NCCI edits stating that you "have" to amend, having dealt with so many different carriers, so many of them (including medicare) will find that the 97110 is being done inclusive of the evaluation & not necessarily separately payable. If your office is truly performing the therapeutic exercises separately, I would definitely amend it for proper reimbursement. By amending modifier -59 to the 97110 ~ you are stating that you are performing this separately from the complete evaluation of the functional capacity 97750.