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97535 therapy codes

Posted on May 11, 2018 by CPC Exam Medical Coding Updates

does anyone bill medicare for therapy with an optometrist or occupational therapist using these codes? my claims are being returned for missing a modifier. commercial plans pay without issues. does anyone know what modifier(s) I should use? when I search i get GP and GY but the places I find them seem to be geared to chiropractors.

thanks

Medical Billing and Coding Forum

Cpt 97535

Posted on April 11, 2018 by CPC Exam Medical Coding Updates

I’m not sure this is the right forum – but let’s give it a try

97535 is for self-care/home management training each 15 minutes.

The Plan has an exclusion for self-help and education therapy.
I think this should fall under outpatient therapy since it is part of a therapy plan to transition the patient home.

Would this be an exclusion?

Medical Billing and Coding Forum