Medical Billing Forum

Coding => Coding => : adiesp1 December 20, 2011, 08:48:12 PM

: PT
: adiesp1 December 20, 2011, 08:48:12 PM

I received a denial for 97542, reason being service/procedure requires that a qualifying service/procedure be received and covered (denied by Medicare.)  What did I miss?
This was begun on her second visit, first being the initial eval.
Thanks,
Adrienne

: Re: PT
: Michele December 23, 2011, 10:00:12 AM

Did you look in the LCD/NCD's?  They probably have a document that explains when 97542 is covered and what the requirements are.