Home Health & Hospice Week

Industry Note:

Revised OT, PT LCDs Contain This Significant Change

If you’re used to using certain codes for myalgia and post-op infection to justify your therapy use, new Local Coverage Determinations will put a stop to that.

Why? In changes to physical therapy and occupational therapy LCDs for Palmetto GBA effective Oct. 1, codes M79.1, T81.4XXD, and T81.4XXS are deleted from the medical necessity support list. Those are the codes for Myalgia, Infection following a procedure, subsequent encounter and Infection following a procedure, sequela, respectively, notes consulting firm Kornetti & Krafft.

See the LCDs, which take effect Oct. 1, at www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34564 and www.cms.gov/medicare-coverage-database/details/lcddetails.aspx?LCDId=34560.

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