AAPC - Back to school
Results 1 to 4 of 4

Thread: Medicare PT Coding

  1. #1

    Angry Medicare PT Coding

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    Athens, Ga.


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

  3. #3
    Join Date
    Apr 2007
    Phoenix, AZ


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

  4. #4


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

Similar Threads

  1. Medicare PT coding
    By mcarter1017 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 06-16-2014, 10:36 AM
  2. Medicare PT coding
    By mcarter1017 in forum Employment General Discussion
    Replies: 0
    Last Post: 06-13-2014, 07:37 AM
  3. Need help with Medicare coding
    By Ambs1997 in forum Medicare Regulations
    Replies: 4
    Last Post: 05-02-2011, 12:32 PM
  4. Medicare Coding
    By lopezk89 in forum Medical Coding General Discussion
    Replies: 3
    Last Post: 04-04-2011, 11:22 AM
  5. Medicare Down Coding
    By brendalewing in forum Orthopaedics
    Replies: 3
    Last Post: 11-10-2008, 08:30 AM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.