Author Topic: two OT providers treating same patient -  (Read 1273 times)

Anne

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two OT providers treating same patient -
« on: June 09, 2009, 03:37:06 PM »
Patient (ICD-9 code 758.39) is being treated at hospital outpaitent daily by an OT for feeding therapy (Vital Stim).  Another OT will be starting Occupational therapy in the patients home using CPT codes 97003, 97112, 97110, 97530.  We are concerned that ins. carrier might deny since patient is already having another type of OT.  Should a modifier be used?  What is CPT code for Vital Stim therapy?  If same CPT codes are not used, will that be enough to not be denied?

Michele

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Re: two OT providers treating same patient -
« Reply #1 on: June 10, 2009, 07:09:26 AM »
It looks like 92526 might be appropriate.  If you are billing different cpt codes that may help, but I expect you may have denials and you will have to appeal them.  You could make a call to the carrier before hand to have it on file what you are planning on doing and get approval.  That might help make the appeals go smoother.

Good luck

Michele
 
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Anne

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Re: two OT providers treating same patient -
« Reply #2 on: June 17, 2009, 09:16:36 PM »
I called carrier and was told to request a Care Notification, which I did and it was approved.  Have an auth number to put on the claims.   And they will be using different CPT codes, so hopefully will not be a problem.  We'll see.  thanks