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Cpt code 97001 and 97002 defination

  1. #1
    Default Cpt code 97001 and 97002 defination
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    Good morning everyone

    How often the Physical therapist can use 97002? Everytime PT used 9701X or 9711X can I use 97002?

    What modifier I need when I use these codes?

    Thank you

  2. #2
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Do you have access to CPT Assistant? If so, check the December 2003 edition. It explains perfectly the correct use of these codes and provides clinical examples.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  3. #3
    Default
    I am sorry . I do not have CPT assistant. Is there any other way I can get a copy or Free website link I can take a look?


    Thank U

  4. Wink
    Quote Originally Posted by kumeena View Post
    I am sorry . I do not have CPT assistant. Is there any other way I can get a copy or Free website link I can take a look?


    Thank U
    Try Modifier 'GO'. As always, document it.

  5. Default
    97002 is for a re-evalution of the plan of care, some carriers require one every 30 days. This visit should include a re-exam for the area of focus- shoulder, knee... it also should include if the patient is improving (ROM, pain etc) and is on target with the goals that have been set at the first evaluation. During the re-eval the PT will set the next session of planned goals.
    Sometimes the plan may need to be adjusted if the patient should encounter another set back that would warrent the provider to adjust the treatment plan, this would need a documented description of the set back in order to charge for the re evaluation out of the normal time frame of 30 days.

  6. Default Re evaluations
    97002 is for a re-evalution of the plan of care, some carriers require one every 30 days. This visit should include a re-exam for the area of focus- shoulder, knee... it also should include if the patient is improving (ROM, pain etc) and is on target with the goals that have been set at the first evaluation. During the re-eval the PT will set the next session of planned goals.
    Sometimes the plan may need to be adjusted if the patient should encounter another set back that would warrent the provider to adjust the treatment plan, this would need a documented description of the set back in order to charge for the re evaluation out of the normal time frame of 30 days.

  7. #7
    Location
    Phoenix, AZ
    Posts
    620
    Default
    I agree with Jeanut on the definition of the re-eval.

    The correct modifier to use if you are billing treatment codes with a 97001 or 97002 is -59. For PT and Medicare patients, you would us GP. GO is for OT patients.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  8. Default Evaluation/ Medicaid/ Mass Health or other Medicaid
    I was wondering if anyone eles has had any experence when a payer will retract money due to the fact that an eval was billed with treatment codes on the same day?

  9. Default
    If they took back pymt - rebill code with a 59 mod - should go thru unless it was too soon for it to be done.

  10. #10
    Default
    My Ortho physician wants to bill 97001. In chart, it says, "continue therapy, discussed with patient and her nurse case manager."

    Would the 97001 be correct? This is not a Medicare patient.

    He's just started using this code, and I'm in the dark about it. I also do not have the CPT assistant, so I would love some helpful feedback on this.

    Thanks!

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