Wiki Physical Therapy Billing Question

[cwilson3333]

Very new to PT billing and need help with this scenario:

Medicare patient, Initial evaluation
Therapist billed 97001... I requested G codes and C modifiers
that I think is required for Medicare

Therapists states: "No functional test [written] performed to determine
G-codes. I did an evaluation/screening only and no plan of care to continue treatment. Patient is blind and severely cognitively impaired-no verbal or written communication possible. All information came from 2 transportation aides. He said he could determine codes by his estimation if needed.

How should this be billed to Medicare {Don't forget, I'm new to PT Billing}

Thanks

 

[kivbar16]

Your therapist will need to add the Functional Limition (G) codes regardless of the patients ability to converse, etc. If there is no plan of care and no intention of a second visit, the therapist will need to use all three codes from the same catagory.

Hope that helps!

 

[cwilson3333]

Physical therapy Help

Thanks Barb,

I'm sure the therapist will understand, but could I get you to help me understand a little better.

I'm familiar with the G codes and C modifiers but want to understand your reply of "all three categories."

Again, thanks for getting back to me. Hope I can touch base with you again if I need help.