Wiki Pelvic Muscle Rehab

[fmsawyer]

Our CRNP is doing pelvic muscle rehab on male & female pts for stress incontinence. I am getting conflicting info on how to bill this. Currently we are billing a 51784, 91122, 97032-GP, 97750-GP for each visit. She is performing each of these procedures. However, I have been told these need to be done only 3 times, at the first visit, at a visit in the middle of the program and the last visit. I am also looking for any articles on these codes and/or this entire plan of care. Thanks for you help!

FMSawyer

 

[KristieStokesCPC]

We recently met with Mark Painter - we were told to bill the following:

o Week 1 – Initial consult –
99215 – Level 5 established patient
97032 – E-Stimulation
97750 – Physical Performance
o Week 2
99212 – Level 2 established patient
97032
97750
o Week 3
99212
97032
97750
o Week 4
99212
97032
97750
o Week 5
99215
97032
97750


We were told we can't bill out the 91122 without a constipation diagnosis. You can bill out the 51784 if the documentation supports, but not every visit. I'm not sure what the GP modifier is, I've never seen that one. Hope this helps some....

Thanks

 

[fmsawyer]

Dear Kristie,

Thanks for your response to my post. We have to use the GP mod on the PT codes 97032 & 97750 this indicates the PT is being performed by someone who is not a certified phys. therapist.

In your meeting w/Mark Painter did he indicate using the 25 mod on the E&M codes along with the PT codes? Or is there a different ruling for the use of an E&M code when billed w/PT codes? I have never billed PT codes so I am not sure on this.

Also is there a limitation to the number of visits allowed? Or is dependent on the response the patient is having?

Thanks for your reply.
Faith Sawyer, CPC

 

[KristieStokesCPC]

Faith,

I'm sorry, yes you use a 25 modifier. He didn't say there was a limit. I think we typically go up to 5 visits if the patient is slow to respond, less if they are responding well. AUA coding today doesn't show a limitation cap.

Thanks

Dear Kristie,

Thanks for your response to my post. We have to use the GP mod on the PT codes 97032 & 97750 this indicates the PT is being performed by someone who is not a certified phys. therapist.

In your meeting w/Mark Painter did he indicate using the 25 mod on the E&M codes along with the PT codes? Or is there a different ruling for the use of an E&M code when billed w/PT codes? I have never billed PT codes so I am not sure on this.

Also is there a limitation to the number of visits allowed? Or is dependent on the response the patient is having?

Thanks for your reply.
Faith Sawyer, CPC