Coding

PT/OT Re-Evaluations: CPT and Medicare Guidance on Coding

May 24, 2023
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Payment rates

Medicare pays for re-evaluations at a rate that is about 2X a timed treatment code. Commercial and work comp payment rates are generally in proportion to Medicare rates.

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New Dry Needling Codes

January 13, 2020
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The AMA, which issues and
provides guidance on CPT codes, has issued the following two new CPT codes for
dry needling. 

20560 Needle insertion(s)
without injection(s), 1-2 muscles20561 Needle insertion(s)
without injection(s), 3 or more muscles

Note that these codes are not […]

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Biofeedback code 90911

New Biofeedback Codes

January 13, 2020
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Biofeedback
code 90911 has been deleted and replaced with the following:

90912- Biofeedback training,
perineal muscles, anorectal or urethral sphincter, including EMG and/or
manometry, when performed; initial 15 minutes of one-on-one contact with the
patient.

90913 – Biofeedback training,
perineal muscles, anorectal or urethral sphincter, including […]

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OT Staffing

Use of 97112 for a Non-Neuro Diagnosis

October 26, 2016
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Lately, there have been some concerns about potential denials for using neuromuscular reeducation (97112) for a non-neuro dx.

Some payers are looking for a neuro diagnosis when 97112 is charged because it makes the connection simple. If you use 97112 for treating a […]

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insurance claim form

ICD-10 7th Character Use Guidelines

October 10, 2015
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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 […]

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continuing education courses for physical therapists

Palmetto Processing Error Causes 97140 Denials

July 11, 2015
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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 […]

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Physical Therapy Coding Q and A

Q and A From ICD-10 Coding Webinar

July 6, 2015
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Sessions 1 – 3 / September 2015

The following is a list of the questions submitted by ICD-10 Coding for Physical and Occupational Therapy webinar participants with answers.

When can we begin billing ICD-10 codes?  You cannot file claims with ICD-10 […]

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