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Networker
Hi
Our OT is billing 97760 with 97140 and 97110 for a upper extremity. Orthosis management, therapeutic exercise /manual therapy are all documented.
But these codes have a NCCI edit with modifier allowed. My understanding is modifier 59 can be used only if different body part.
But I found this excerpt in CMS policy, page 25.
https://www.cms.gov/files/document/medicare-ncci-policy-manual-2023-chapter-11.pdf
"Some NCCI PTP edits pair a “timed” CPT code with another “timed” CPT code or a non-timed CPT code. These edits may be bypassed with modifier 59 or XU if the 2 procedures of a code pair edit are performed in different timed intervals even if sequential during the same patient encounter"
Since 97760 and 97140 are timed codes, would a 59 be allowed if done in different blocks?
Am I interpreting this correct?
Thanks
Our OT is billing 97760 with 97140 and 97110 for a upper extremity. Orthosis management, therapeutic exercise /manual therapy are all documented.
But these codes have a NCCI edit with modifier allowed. My understanding is modifier 59 can be used only if different body part.
But I found this excerpt in CMS policy, page 25.
https://www.cms.gov/files/document/medicare-ncci-policy-manual-2023-chapter-11.pdf
"Some NCCI PTP edits pair a “timed” CPT code with another “timed” CPT code or a non-timed CPT code. These edits may be bypassed with modifier 59 or XU if the 2 procedures of a code pair edit are performed in different timed intervals even if sequential during the same patient encounter"
Since 97760 and 97140 are timed codes, would a 59 be allowed if done in different blocks?
Am I interpreting this correct?
Thanks