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Modifier for coding Physical Therapy

  1. Smile Modifier for coding Physical Therapy
    Exam Training Packages
    Hi Friends,

    Please help me with this

    An Internal medicine provider given Physical Therapy to patient. It consisting of total 4 CPT's . Those are as follows :

    1) CPT 97032 [electrical stimulation (manual), each 15 minutes]
    2) CPT 97010 [hot or cold packs]
    3) CPT 97140 [ Manual therapy techniques each 15 minutes ]
    4) CPT 97035 [Application of a modality ultrasound, each 15 minutes]

    How do we code for all these procedures if performed on same day ?
    Do we need to add 59 modifier to any of the procedure ?
    Do we need to add modifier 26 or TC with CPT 97035 as it is an instrument ?

    Thanks.
    Neha Bhatnagar, CPC, CPC-H

  2. Default
    Hi,

    How do we code for all these procedures if performed on same day ?
    We can code all these codes for the same DOS.

    Do we need to add 59 modifier to any of the procedure ?
    NO, they don't need any modifier as they have no edits (only 97010 and 97035 has edits till 1997)

    Do we need to add modifier 26 or TC with CPT 97035 as it is an instrument ?
    we no need to add mod 26 or TC with 97035, (it is not an diagnostic instrument).

    Joseph Amalraj Antonisamy CPC-H
    Last edited by joe_physio09; 05-25-2009 at 02:13 AM.

  3. Thumbs up
    Thanks for your help.

  4. #4
    Location
    CULVER CITY CHAPTER
    Posts
    49
    Default
    Hello All,
    I think you do not code for the hot/cold pad.
    fami

  5. #5
    Default Physical therapy
    We just started doing this in our practice (internal medicine/nephrology) 97032 and 97035 so far we found physical therapy modifier gp and a possible g code for 97032 for medicare beneficiary we are waiting for a response from ins. Anyone else know anything on how to bill these codes it would be helpful to share the knowledge.

    Thanks

  6. #6
    Default
    we just recieved payment for 97032 and 97035 on the same day with modifier gp on both procedure codes just an fyi

  7. Default Modifier usage
    I use a 76 modifier when using 97032 and 97035 on the same date of service for non Medicare insurances and the group code for Medicare. Does anyone get paid for hot or cold packs? I have a couple that pay about $5 and some not at all.
    Candy

  8. Default
    We bill for hot and cold packs but it's often not reimbursed or if it is, it's about $5.

  9. #9
    Location
    Columbia, MO
    Posts
    12,560
    Default
    Quote Originally Posted by ccarver View Post
    I use a 76 modifier when using 97032 and 97035 on the same date of service for non Medicare insurances and the group code for Medicare. Does anyone get paid for hot or cold packs? I have a couple that pay about $5 and some not at all.
    Candy
    Why are you using a 76? 97032 and 97035 are two different codes. 76 is for a repeated service so you would have to use the same code and the exact same service must be repeated. Not the same thing as the same procedure performed on two different areas.

    Debra A. Mitchell, MSPH, CPC-H

  10. #10
    Location
    White Plains, NY
    Posts
    123
    Default Not legal
    In my state, NY, if the provider has no training in PT, he cannot bill the PT codes. Period.
    Lin CPC

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