BCBS not paying for 97760 or 97762 (Occupational Therapy)


Spartanburg, SC
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I've had quite a few claims where either 97760 (Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes) or 97762 (Checkout for orthotic/prosthetic use, established patient, each 15 minutes) were billed (no other codes, just one or the other and nothing else billed on the claim) and each code on each claim is being denied as "procedure not paid separately". I've read over the notes our OT did and they truly just either fitted an orthotic or modified one depending on the visit. These were orthotics that were fabricated by the OT in our office. What in the world else could be billed with these codes? OT is a new service we are providing so I don't have as much experience in coding those visits.