-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Modifiers used in Outpatient Physical Therapy
- Thread starter Nanny7792
- Start date
xandraj
New
Physical Therapy modifiers
You would use the modifier 59 for the physical therapy services, if you are billing Medicare use the GP modifier, that is as long as the therapy is performed by a licensed physical therapist.
You would use the modifier 59 for the physical therapy services, if you are billing Medicare use the GP modifier, that is as long as the therapy is performed by a licensed physical therapist.
GY modifier
We are having trouble with Medicare patients being billed their orthotics (L3030) to DME.
First I tried L3030 GP GA RT and L3030 GP GA LT since we had patient sign a ABN at time of service I thought for sure DME would have balance go to the patient if they are not covering it, but it came back saying we had to right it off since inappropriate modifier.
When I called the first time the rep didn't understand why we had to write it off since we had GA modifier on it and she was going to send it back through. Then a couple months past with no update on our claim so I called again. The second rep pointed out that remark code MA130 was on the remit and per policy on this code the only modifiers available on this code are EY, GY, KX. She suggested I try sending in with GY since the orthotic is not attached to a brace. So I sent in a brand new claim with GY,LT & GYR,LT, and it did get reprocessed as patient responsibility. I was just wondering if any other physical therapy office out there has tried using this modifier on their orthotics. I am a little sceptical about using this modifier since on some websites it says this GY modifier is not appropriate for orthotics.
Along with this question is anyone else haveing trouble with Aetna processing Iontophoresis 97033? They are wanting us to write the entire charge off even if we are not an Aetna provider. Thanks for any input!
We are having trouble with Medicare patients being billed their orthotics (L3030) to DME.
First I tried L3030 GP GA RT and L3030 GP GA LT since we had patient sign a ABN at time of service I thought for sure DME would have balance go to the patient if they are not covering it, but it came back saying we had to right it off since inappropriate modifier.
When I called the first time the rep didn't understand why we had to write it off since we had GA modifier on it and she was going to send it back through. Then a couple months past with no update on our claim so I called again. The second rep pointed out that remark code MA130 was on the remit and per policy on this code the only modifiers available on this code are EY, GY, KX. She suggested I try sending in with GY since the orthotic is not attached to a brace. So I sent in a brand new claim with GY,LT & GYR,LT, and it did get reprocessed as patient responsibility. I was just wondering if any other physical therapy office out there has tried using this modifier on their orthotics. I am a little sceptical about using this modifier since on some websites it says this GY modifier is not appropriate for orthotics.
Along with this question is anyone else haveing trouble with Aetna processing Iontophoresis 97033? They are wanting us to write the entire charge off even if we are not an Aetna provider. Thanks for any input!
Last edited:
fredcpc
Guru
PT for 97022 and 97124 together plus modifiers
We have a PTA billing under the supervision of a PT. The CPT codes are 97022 (whirlpool) and 97124(massage). He is not a Medicare pt. Do we need any modifiers for this encounter? I have looked at several Gx mods and 59 but I am still unsure. Any feedback?
We have a PTA billing under the supervision of a PT. The CPT codes are 97022 (whirlpool) and 97124(massage). He is not a Medicare pt. Do we need any modifiers for this encounter? I have looked at several Gx mods and 59 but I am still unsure. Any feedback?