Medical Billing Forum

Coding => Coding => Topic started by: catooch on September 24, 2010, 11:09:09 AM

Title: 97535 & 97110
Post by: catooch on September 24, 2010, 11:09:09 AM
Hi.  Haven't posted in a while but this site is very informative.  Thank You.

We billed BC/BS of NY 98941, 97110 & 97535.  They denied 97535 saying its part of another service.  If we added a -59 modifier on the 97535 would they pay it?  Thanks Cathy
Title: Re: 97535 & 97110
Post by: Michele on September 24, 2010, 12:34:30 PM
Most BCBS policies allow a global fee for chiropractic, so adding modifiers won't make a difference.  But I must add, one should never just add a modifier to get a service paid.  The provider should indicate if the modifier is appropriate and if it should be applied to the code.   :)
Title: Re: 97535 & 97110
Post by: DMK on September 24, 2010, 04:07:48 PM
97535 (which if I understand is getting them set up on a home program) would be included with 97110.  A modifier wouldn't fix that.
Title: Re: 97535 & 97110
Post by: catooch on September 24, 2010, 06:08:02 PM
thank you
Title: Re: 97535 & 97110
Post by: cbergeron on November 09, 2010, 08:54:30 AM
I always bill 97110 and 97530 together with a 59 on the 97530. If they are done in destinct 15 minute sessions, then it is appropriate. Our PT's know that if they write it on the encounter, it means it was in its own 15 minute slot.
The notes also reflect that.
Good luck!
Chris
Title: Re: 97535 & 97110
Post by: DMK on November 09, 2010, 10:08:25 AM
That would be appropriate since the patient having one-on-one instruction is separate from them doing exercises unattended.