Wiki PT/OT re-evals

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msrainbird

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I am getting denials for using 97002 & 97004 saying that they are bundled procedures...we are also using 97112/97530 on the same day...I have also had them denied saying there needs to be a corosponding code with it. If I can't use the re-eval codes with the others, can I use the regular eval 97001 & 97003?..I would really appreciate any help you could point in my direction.
 
Re-evals 97002 and 97004 are considered bundled into other treatment given on same day. You can add mod 59 to the re-eval code and get paid, but be sure that your re-eval is well documented in your notes and isn;'t just 'lumped' into the normal tx for the day.

Refer to current NCCI edits for the 97112/97530 scenario.

Hope that helps!
 
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