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97112, 97035

  1. Default 97112, 97035
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    Which modifier needs to Pay these Codes(97112, 97032, 97035, 97012) in TMHP? I used AT, GP, but it didn't work? These Therapy codes was done in physicians office.

    Thanks.

  2. #2
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    Is it a Medicare or Medicaid patient?

  3. Default
    Medicaid.

  4. #4
    Location
    Columbia, MO
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    What diagnosis codes did you use, and what is the denial reason stating.

    Debra A. Mitchell, MSPH, CPC-H

  5. #5
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    If it is an adult patient covered under Medicaid, alot of times they require preauthorization for therapy services.

  6. Default
    Dx codes are: 722.2 and 724.2. Reason for denial is: The procedure code is inconsistent with the modifier used or a required modifier is missing.

  7. #7
    Location
    Columbia, MO
    Posts
    12,561
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    Well your modifiers say it was performed by chiropratic and PT. Also you need a V57.1 code first listed if this is for rehab. So can you give more information on the type of practice and did a physical therapist perform the service, and the reason for the service offered.

    Debra A. Mitchell, MSPH, CPC-H

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