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Wiki 97035

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nladow

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Indianapolis, IN
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My physican bills out for Ultrasounds alot. Most payers are paying on it except medicare. They are saying there is a modifier to attach, and i am not familiar with what modifier they are refering to! Is this a service im going to have to get an ABN signed for, or can someone stop my headache and give me a suggestion of a modifer to use? THANK YOU
 
97035 (therapeutic ultrasound) is generally billed in conjunction with physical and/or occupational therapy. In that case, Medicare and Medicaid require modifiers. GP is for physical therapy and GO for occupational therapy.
 
97035 is an "always therapy” HCPCS codes and always require a therapy modifier. Therapy services represented by “always therapy” codes, must follow all the policies for therapy services (e.g., Pub. 100-04, chapter 5; Pub. 100-02, chapters 12 and 15).
 
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