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Medicare PT Coding

  1. Angry Medicare PT Coding
    Medical Coding Books
    Good morning -
    I'm having a bit of difficulty trying to figure out just what Medicare wants when coding our PT services. I've sent 97001, 97112 (with multiple # of services) and I'm getting the CO-4 denial, which is stating that the procedure code is inconsistent with the modifier used (I didn't use any) or a required modifier is missing. I'm not sure what's going on here. I've been coding the 97112 with multiple # of services, instead of putting them on separate lines. I don't know if that's the issue, because when I coded a 97001 with a single unit of 97112, they both denied with the CO-4. Any help would be greatly appreciated!!

    Thank you!

  2. #2
    Are you billing for outpatient therapy care? If so, you need a GP modifier!
    Walker Bachman, CPC, CPPM

  3. #3
    Phoenix, AZ
    You also need a -59 on the 97001.
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  4. Default
    Fantastic.....thank you so much You've made my day.

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