I am in need of some quick help!!! I'm working some old aging from my speech therapist. When she bills out in the office setting- POS 11, do we still need to append modifier GN to those claims for Medicare? The guidelines say 'outpatient setting' but I ran across an article that says
"Part B services provided under plans of care for speech-language pathology or dysphagia services require a GN modifier as a suffix to the CPT code. The requirement applies to physician offices as well as facilities and private practices. Occupational therapy and physical therapy modifiers are GO and GP, respectively. For therapy services that exceed the annual therapy cap, a -KX modifier is required, indicating services are medically necessary and the documentation is available for review."
I can't find any other documentation to support this and need some advice from others who also bill for these services... When our physicians bill out out 92507 or 92506, they get paid.
Thoughts? Opinions??? Advice? It would sure be greatly appreciated!!!!!
"Part B services provided under plans of care for speech-language pathology or dysphagia services require a GN modifier as a suffix to the CPT code. The requirement applies to physician offices as well as facilities and private practices. Occupational therapy and physical therapy modifiers are GO and GP, respectively. For therapy services that exceed the annual therapy cap, a -KX modifier is required, indicating services are medically necessary and the documentation is available for review."
I can't find any other documentation to support this and need some advice from others who also bill for these services... When our physicians bill out out 92507 or 92506, they get paid.
Thoughts? Opinions??? Advice? It would sure be greatly appreciated!!!!!
