Billing | PT Management

Cigna Updates Its PT Coverage Policy

April 7, 2021

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Billing, Blog

CIGNA has issued an updated PT/OT coverage policy which can be found at:

https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_Future/CPG135_Physical_Therapy.pdf

This policy provides that CIGNA will not pay for:

Infrared
Vaso
Work hardening
H-Wave
Dry needling
Taping
Laser

This policy also […]

Medicare’s New DMEPOS Prior Authorization Requirement

December 31, 2015

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Billing, Blog, Compliance

As of the beginning of 2016, CMS is starting a prior authorization process for certain DMEPOS. If you have not already heard of this new authorization requirement, you are likely to hear quite a bit about it in the next month or two.

The good news […]

Pre-Op PT Visits

December 9, 2015

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Billing, Blog, Finance, Operations

A number of orthopaedic groups have started seeing patients for pre-op PT visits prior to joint replacements and some other surgeries. Some of this trend is related to the BPCI program, but also works when care is delivered on a fee for service basis.

These […]

ICD-10 7th Character Use Guidelines

October 10, 2015

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Billing, Blog, Coding

We are understandably receiving a lot of questions regarding how and when to use the ICD-10 7th character.

The ICD-1o 7th character is only required when the ICD-10 rules specifically ask for the 7th character and give you a choice as to which […]

Therapy Manual Medical Review Changes for 2015

September 19, 2015

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Billing, Blog

As we get closer to the end of 2015, more of you may be treating Medicare patients who are at or above the $3,700 cap for manual medical review.

Last year, every PT or OT claim above $3,700 was subject to manual medical review […]

continuing education courses for physical therapists

Palmetto Processing Error Causes 97140 Denials

July 11, 2015

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Billing, Blog, Coding

Palmetto Processing Error 97140 Denials to be resolved automatically.

Therapy providers whose Medicare claims are processed by Palmetto may
see some strange denials of 97140 from June 18-July 5, 2015 with explanation code 50 for lack of medical necessity. These denials were due to a […]