Physical therapy 97110

[sdear]

We are getting denials from medicare for 97110, stating additional information is needed. Modifier gp is added and patient have remaining visits.can anyone help with this one?


Thanks

 

[mhstrauss]

We are getting denials from medicare for 97110, stating additional information is needed. Modifier gp is added and patient have remaining visits.can anyone help with this one?


Thanks

What is the denial reason? Are you using the appropriate Functional Status G-codes and modifiers?

 

[sdear]

Physical Therapy 97110

Denial:Claim /service lacks information which is needed for adjuication.We have used the G's when there are other codes on the claim and the claims are getting paid.Should we use G codes when 97110 is billed alone?


Thank you so much for your response!!

SDear

 

[sdear]

What is the denial reason? Are you using the appropriate Functional Status G-codes and modifiers?

Denial:Claim /service lacks information which is needed for adjuication.We have used the G's when there are other codes on the claim and the claims are getting paid.Should we use G codes when 97110 is billed alone?


Thank you so much for your response!!

SDear

 

[mhstrauss]

Denial:Claim /service lacks information which is needed for adjuication.We have used the G's when there are other codes on the claim and the claims are getting paid.Should we use G codes when 97110 is billed alone?


Thank you so much for your response!!

SDear

Yes, the G-codes should be used based on the timing of the session (at eval, every 10th visit, at discharge), regardless of which treatment codes are used, from my understanding. Is there an N572 remark code? I believe that's what the issue is, that you are missing the functional status codes at the 10th visit.