Wiki Help! NCCI edits


Saint Charles, MO
Best answers
Where can I find updated NCCI edits?
I code PT, OT, and ST services using the 59 modifier. Our director retired, and we haven't hired a new one yet, so I need some guidance. PLEASE AND THANK YOU!

Michelle Smith, CPC
Stacia 70,
Standard treatment programs in acute rehabilitation include occupational, physical, and speech therapies (OT, PT, and ST, respectively). You need to ensure document minutes, have consult plan of treatment, and body area give treatment. Add modifier 96, 97, GO GN GP depending on services given, add referring doc and dates if new or treatments before current date of treatment on claims. The dx should be medical necessity not just bunch of Z codes as primary dx. As few examples look at dx M25, M79, M54, R41 that matches documented patient care. CPT codes to use 97165-95852 97010-97763 97122-97124 29065, 92547 . Speech 92526-92617 Acupuncture can be billed with eval mgnt CPT 99211-99214 and 97810-97814. Also if given injectables meds, ensure list amount and where given. Pre authorizations of OT PT ST with payer; usually report every 30 days.
I hope helped you somewhat
Lady T