We came upon this problem and it was quite frustrating for us. We discovered that some payors make quite a distinction on the way they pay for "physical medicine" codes and the contract for Medical Doctors may be different then for Doctors of Osteopathy. We finally came with an alternative code that seemed to be exempt for all the road blocks and that code is 97140. I would still make use of the modifier "25" if is in addition to another e&m visit if unrelated.
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