What is the CPT code for occupational therapy re-evaluation?

What is the CPT code for occupational therapy re-evaluation?

Code 97168 is used to report occupational therapy re- evaluation that is based on an established and ongoing plan of care.

How do you bill untimed codes?

How do I bill timed and untimed codes? Let’s start with the easier of the two: untimed codes. As mentioned above, you may bill one unit of each untimed service per patient per date of service. Whether you provide an untimed service for five minutes or 50, you will always bill one single unit.

What is KX modifier for?

Modifier KX Use of the KX modifier indicates that the supplier has ensured coverage criteria for the billed is met and that documentation does exist to support the medical necessity of item. Documentation must be available upon request.

What code is G0283?

Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care G0283 – HCPCS Codes – Codify by AAPC.

In which situation is a billable re-evaluation appropriate?

When medical necessity is supported, a re-evaluation is appropriate and is separately billable for: A patient who is currently receiving therapy services and develops a newly diagnosed related condition e.g., a patient that is currently receiving therapy treatment for TKA.

Does 97164 need a modifier?

This payment policy requires that each new PT evaluative procedure code – 97161, 97162, 97163 or 97164 – to be accompanied by the GP modifier; and, (b) each new code for an OT evaluative procedure – 97165, 97166, 97167 or 97168 – be reported with the GO modifier.

Is PT re evaluation a timed code?

This is not a timed code. The AMA CPT Assistant, which provides explanations of how CPT codes should be used, includes the following example of a PT re-eval: A 62-year-old male with low back pain presents for a physical therapy re-evaluation on his eighth visit of his episode of care.

What are untimed codes?

When a therapy service is not defined by a specific timeframe, it is an “untimed” therapy procedure (CPT or HCPCS) code. Untimed codes are billed with a unit of one (1) per date of service. The unit for untimed codes is one regardless of how long the evaluation or service took.

When do you add KX modifier?

The KX modifier, described in subsection D., is added to claim lines to indicate that the clinician attests that services at and above the therapy caps are medically necessary and justification is documented in the medical record.

Where do you put the KX modifier?

The KX modifier is appended on claims at or very close to the $1920 cap, and should not applied from the first visit, even if the therapist knows that the cap will likely be exceeded.

What is difference between 97014 and G0283?

G0238 is a HCPCS code listing electrical stimulation service and 97014 is a procedure code that is for electrical stimulation. So both of these codes are state the same text but are from different National Coding structures.

Does G0283 need modifier?

Medicare does need the modifier GP appended to G0283, just like the other therapy chgs require mod GP. If there is no GP, it should be denied.