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Old 07-28-2010, 11:03 AM
tdml97@yahoo.com tdml97@yahoo.com is offline
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Question Medicare PT 97002

I am having a problem w/ Medicare paying for this. Is there any reference material on this code only? Specific payable diagnosis? Modifiers needed or not? Time frame on when it can be done?

I appreciate any help I can get with this.

Thanks in advance.

Christina H.

Just needed to add mod 59 to it & got paid.

Last edited by tdml97@yahoo.com; 11-22-2013 at 08:32 AM. Reason: updated
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Old 07-30-2010, 02:22 PM
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cmcgarry cmcgarry is offline
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Are you billing it along with PT modalities the same day? If so, they are hitting the CCI edits. Also, check the Medicare Internet Only Manual; they have a lot of rules for PT.
Lucinda (Cindy) McGarry, CPC-P
Applications Specialist
Avera Health Plans
Education Office Sioux Falls SD Local Chapter
Past President Sioux Falls SD Local Chapter
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Old 08-03-2010, 06:01 PM
ms_rnell ms_rnell is offline
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Use GP modifier on PT billing for medicare.
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Old 08-18-2010, 09:58 AM
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Cyndi113 Cyndi113 is offline
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You always need to add modifier 59 if you are billing for any treatment in addition to the 97002. This code is usually paid every 30 days (re-certification).
Cyndi Allen, CPC, CIRCC
2015 Local Chapter President, Casa Grande, AZ
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Old 11-21-2013, 04:18 PM
armandorj armandorj is offline
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Default question on 97002

Recently the topic has surfaced that 97002 should only be used when you are doing an actually re-evaluation...but other people say you can use it with Medicare and other insurance when you are doing a PR (progress note) and a recertification.
Does anyone know where I can find clarity on this issue.
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