Eli's Rehab Report

News Brief:

CCI 7.2 Bundles Modalities With PT, OT Home Visits

Published on Sat Sep 01, 2001

PDF

Effective July 1, 2001, the services of a physical therapist (PT) or an occupational therapist (OT) in the home setting (G0151-G0152) can no longer be billed with several of the therapy codes listed in the PM&R section of CPT. The new national Correct Coding Initiative (CCI) edits list the home-service codes as comprehensive codes of which the modalities are components. These codes are listed with the identifying code of 1, which means a modifier such as -59 (distinct procedural service) can be used to bill them separately if documentation supports such use.

The PT home-visit code, G0151, can no longer be billed with the following codes: 97001, 97012-97036, 97110-97124, 97140-97546, 97703, 97750 and Q0086. The OT home-visit code, G0152, can no longer be billed with codes 97003, 97150, 97530-97535, 97542-97545 and 97750.

Also, the new wound-debridement code (97601) is bundled into injection codes 64400-64483 and 90782. Many PM&R practices were already aware that carriers were not reimbursing for the injection and debridement performed together, but now CCI makes that official.

Eli's Rehab Report

Successfully Code Treatment of Pediatric Patients
PM&R practices and clinics often treat pediatric patients for conditions such as cerebral palsy (343-343.9), [...]

Avoid Undercoding:
Billing for High-Level, Single-System E/M Services
Most physiatrists rely on single-system examinations for their E/M services -- either musculoskeletal or neurological -- and [...]

You Be the Coder:
Facet Joint Injections: One Level or Two?
Test your coding knowledge. Determine how you would code this situation before looking at the [...]

News Brief:
CCI 7.2 Bundles Modalities With PT, OT Home Visits
Effective July 1, 2001, the services of a physical therapist (PT) or an occupational therapist [...]

Reader Question:
Code G0180
Question: What is the proper use of G0180? Must the physiatrist always follow the home-health [...]

Reader Question:
Lymphatic Drainage Therapy
Question: One of our occupational therapists went to a seminar where she was told to [...]

Reader Question:
Coding for Fitness Physicals
Question: I perform many fitness physicals, and I write exercise prescriptions and order health profile [...]

View All