Wiki Need help with Physical Therapy Billing

thar1995

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Hello, I need help billing Physical Therapy.
The practice enters the charges and puts GP mod on all items. They said to put a 59 mod on 97112 when it was denied by medicare for B-15 -Service/Procedure requires that a qualifying service/procedure be recieved and covered.
97760 was denied for benefit maximum for time period has been reached.
Original claim had pre-authorized tracking number on it. Medicare forwarded claim to secondary BCBS.
Added 59 to 97112/59/GP, re-filed.

BCBS paid 97760 but not 97112.

Medicare denied both 97112 & 97760 for benifit maximum reached.
Added KX modifier to both 97112/59/KX & 97760/KX.

Medicare denied 97112 for Procedure code inconsistant with modifier used or required modifier is missing.
What is the correct way to bill this, please?
Thanks
 
When you say Medicare denied both 97112 & 97760 for benefit max reached and you added the KX, according to what you have you don't have the GP modifier? It should be billed 97112 GP KX 59 and 97760 GP KX
 
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