Wiki 97112, 97035

[amobeen]

Which modifier needs to Pay these Codes(97112, 97032, 97035, 97012) in TMHP? I used AT, GP, but it didn't work? These Therapy codes was done in physicians office.

Thanks.

 

[cthompson1446]

Is it a Medicare or Medicaid patient?

 

[amobeen]

Medicaid.

 

[mitchellde]

What diagnosis codes did you use, and what is the denial reason stating.

 

[cthompson1446]

If it is an adult patient covered under Medicaid, alot of times they require preauthorization for therapy services.

 

[amobeen]

Dx codes are: 722.2 and 724.2. Reason for denial is: The procedure code is inconsistent with the modifier used or a required modifier is missing.

 

[mitchellde]

Well your modifiers say it was performed by chiropratic and PT. Also you need a V57.1 code first listed if this is for rehab. So can you give more information on the type of practice and did a physical therapist perform the service, and the reason for the service offered.