Billing 97112 for CVA patients

AmyReed

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I do billing for a physical therapy office in MS. They want to charge 97112 for a patient that suffered a CVA. Unfortunately, none of the dx codes for CVA/late affect of CVA are showing as medically necessary on the MS LCDs. This doesn't make much sense to me given the definition of procedure coe 97112. Any suggestions?
 

mhstrauss

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I haven't looked at the LCD for that code, but does the pt have any dx such as abnormality of gait, hemiparesis, etc, due to the CVA?
 

mitchellde

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first you must use the V57.1 as the first listed dx code, look in the official ICD-9 CM guidelines page 12 #15 for this information, then secondary you use the reason for the rehab, which should be a 438.x code for late effect of CVA.
 
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