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D5/D6 Condition codes

  1. Question D5/D6 Condition codes
    Medical Coding Books
    I bill for a physical therapy practice and recently received a rejection from Medicare on a claim with 3 units of 97110 and two units of G0283. Medicare denied the G code saying missing/incomplete/invalid dates of units of service.

    I thought it might be because we charged 2 units on the G code, especially since they've paid this combination in full on other DOS for this patient. When I called MCR though, the rep told me it was denied because they're considering the Gcode as included with the 97110 even though, as I said, they paid this combination separately before.

    My question though, is regarding D5/D6 condition codes. The rep advised me to cancel this denied claim with a D5/D6 condition code and rebill. I'm not familiar with these codes so I was wondering if anyone could provide me with more information. Where are they entered in the HCFA? Which do I need to use in this case? I tried to search for info on the Cahaba website, but it wasn't all that helpful.


  2. #2
    It is a rule you can only bill G0283 one time per visit. Ck you guidelines .

  3. Default
    Thanks for the information, Lanter. Which guidelines are you refering to?

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