In Billing
Nov 21st, 2018
The 2019 Physician Fee Schedule (PFS) final rule doesn’t hold a lot of surprises for physical therapists, as the Centers for Medicare & Medicaid Services (CMS) finalized most of what they proposed for therapy services in July. To the relief of many commenters, however, there is one provision CMS didn’t follow through on — at least ...
In Billing
Apr 5th, 2018
The Office of Inspector General (OIG) did a study of physical therapy claims and documentation for Medicare patients and issued a report this month in March. Their findings are of great concern for the PT and rehabilitation specialty. The OIG reviewed claims from 2013 and found that 61 percent of the Medicare claims for outpatient PT services ...
Reaffirm your knowledge of ICD-10-CM codes and the more specific E/M PT/OT codes introduced in 2017. Coding for physical and occupational therapy (PT and OT) requires an understanding of ICD-10-CM guidelines, and a firm knowledge on how to bill units of timed and untimed therapy CPT® codes. ICD-10 Considerations In therapy encounters, there is often ...
In Audit
Oct 28th, 2014
Physical therapy has made it in the Office of Inspector General’s (OIG’s) work plan for several years running. With medical reviewers on the lookout for high utilization of outpatient physical therapy services, coders and billers need to be vigilant about how their physical therapists are documenting services. Per Chapter 15, Section 220.1.1 of the Medicare ...
Mar 1st, 2013
Follow physical therapy service requirements for new G code and modifier reporting. By Lynn S. Berry, PT, CPC Editor’s Note: After this was published, G9157 was replaced by G9186 Motor speech functional limitation, projected goal status at initial therapy.  You will find more information in the Medicare Claims Processing Manual, Chapter 5. A new, claims-based ...