Wiki Denied N572

[jnmbrady]

As anyone received this denial yet? I have a DO billing 99212-25, 98927, 97112GP and they are getting denied with that code from Noridian. Some are deneid some are paid. Any advice?

 

[md62988]

I am receiving this denial also but for 97110 for PT. Have you found any answers?

 

[mhstrauss]

The N572 denial means that you billed a therapy code without including the Functional Status G-code with appropriate status modifier. Medicare started this program early last year (I think), and it became mandatory to begin reporting by July 1st. The Functional Status codes should be used at eval, and about every 10 visits thereafter. I don't remember all the details, but that's the gist of it. You can find specific details on CMS's website.

Hope that helps!

 

[suriv86@gmail.com]

@Meagan Strauss-Can you please suggest what are Functional Status G-code with appropriate status modifier and where do we get those details. If possible please provide appropriate URL to get those details. Thanks in advance