Physical Therapy & Medicaid


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I Work In A Physical Therapy Office In North Carolina And Have Been Having Trouble With Reimbursment From Medicaid. I'm Looking For Other Pt Coders In The Area Who Deal With Medicaid. When We Fax Off To Request Authorization We Supply A Specific Diagnosis That The Patient Had Been Referred To Pt For. Medicaid Then Authorizes A Certain Number Of Units For Pt For Within A Certain Time Frame. Later When We Bill And Send Out Our Claim With That Diagnosis(which Was What The Referring Doctor Sent The Patient For), Medicaid Denies With The Reason: 'service Is Not Consistent With/or Not Covered For This Diagnosis/or Description Does Not Match Diagnosis'. Medicaid Won't Tell Me What Diagnosis/cpt Code Combinations Are Not Paid/covered. I'm Wondering If Any Other Pt Offices In The Area Are Experiencing The Same Difficulties??