PT Coding Question: 97002 + 97140

lindseygallo

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Hi Everyone,

Quick question, I code for our Chiropractor, when using Man TX 97140 w/ 98940, we will use -59 to differentiate the services provided. I came across a claim today where out Physical Therapist billed 97002 with 97140, causing the codes to bundle. My question would be do I append the -59 modifier (DX and notes support the use of this modifier) to the re-eval service, or to the Manual Therapy. Thank you!!
 

CodingKing

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Per NCCI Manual it goes on the re-eval code which is the column 2 code

NCCI contains PTP edits with column one codes of the physical medicine and rehabilitation therapy services and column two codes of the physical therapy and occupational therapy reevaluation CPT codes of 97002 and 97004 respectively. The reevaluation services should not be routinely reported during a planned course of physical or occupational therapy. However, if the patient’s status should change and a re-evaluation is medically reasonable and necessary, it may be reported with modifier 59 appended to CPT code 97002 or 97004 as appropriate.
 
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