Wiki 97032

[veeramani14]

Hi all,

When I bill 97032 with GP modifier am getting the following rejection in my software,

[Medicare] Per payor guidelines, it has been over 30 calendar days since a functional therapy code with appropriate severity modifier has been reported. Please review the medical record and procedure coding on the Claim Edit screen

Can anyone Advise me how to solve this.

Thanks,
Veera.

 

[mitchellde]

As of July 1 you are required to use the functional status codes and modifiers for physical therapy claims. If you do not know what these are you need to look them up there are 42 G codes and 7 modifiers that are required reporting.

 

[veeramani14]

Hi Mitchell, Can I use cpt G8990-G8995 instead of 97032, but I am not sure how to use the 7 modifiers, Is there any link to tell me about the modifier usage. Or the correct modifier should be tell by the provider?

Please clarify me!

Thanks,
Veera.

 

[mitchellde]

you use the G codes in addition to the modalities, there is a ton of information on the internet regarding functional status codes and modifiers, just do a google search using the key term functional status codes for physical therapy. There is too much information for me to try and provide it in this forum, but you need to understand it thoroughly and you need to provide the information to the therapist as they will need to document for the codes and modifiers. None of your claims will pay until you have this information on the claims.