Eli's Rehab Report

News Brief:

CCI 7.2 Bundles Modalities With PT, OT Home Visits

Published on Sat Sep 01, 2001

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.

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