jveronick
New
I have a licensed massage therapist (LMT) who performs myofascial modalities that fall under CPT 97140. These claims keep getting kicked back from Medicare saying we need to add or have an incorrect modifier. This provider is also only performing services that fall under 97140, so mod -59 is not needed (Yes, I've researched this as well.) because he's not doing more than one site at a time or more than one CPT service at a time.
I understand that an LMT is not a provider that Medicare recognizes as a provider of services. And I've reviewed and re-reviewed the therapy modifiers and cannot seem to find the correct modifier to submit. We are issuing these patients an ABN that lets them know this service won't be covered by Medicare and, therefore, the patient is responsible for the cost. But I'd like to at least get these claims to go through the system correctly. To date I've tried both GZ and GY and both have been kicked back for a missing or incorrect modifier.
Does anyone else have experience with this particular set of circumstances and can shed some light on the correct modifier???
Julie Veronick, CPC
I understand that an LMT is not a provider that Medicare recognizes as a provider of services. And I've reviewed and re-reviewed the therapy modifiers and cannot seem to find the correct modifier to submit. We are issuing these patients an ABN that lets them know this service won't be covered by Medicare and, therefore, the patient is responsible for the cost. But I'd like to at least get these claims to go through the system correctly. To date I've tried both GZ and GY and both have been kicked back for a missing or incorrect modifier.
Does anyone else have experience with this particular set of circumstances and can shed some light on the correct modifier???
Julie Veronick, CPC