Wiki Physical Therapy 97001 Denied by Medicare

Create Wiki
C

cwilson3333

Expert
Messages
289
Location
Hamilton, VA
Best answers
0
New to physical therapy billing.

Need some guidelines when billing Medicare 97001 , PT evaluation and treatment same date, i.e. 97140, 9730, 97710.

Am told by my AR person, that Medicare is rejecting/denying 97001.
No problem with commercial insurances. Always put GP modifier on these codes.

Help
 
Did you also add the functional G codes? Medicare will always deny 97001 and 97002 unless the functional G codes are also attached... That also applies to the Medicare replacement plans...
 
Hi Wendy,

I am new to coding for PT. We have also been getting Medicare denials for 97001. You mentioned we need to use a function G-code as well.

So are you saying we need to first code 97001 with a modifier GP and then on the next procedure line, code a G-code with the appropriate modifier? ie... CI, CJ

Am I understanding this correctly?

Thank you for your help!

Amy
 
Last edited:
You must log in or register to reply here.
Top