Author Topic: CPT 97535  (Read 7146 times)


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CPT 97535
« on: May 28, 2013, 03:38:05 PM »
Has anyone billed this before?  Is it a -59 mod or a GO mod or none at all?  Trying to clear up some confusion.


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Re: CPT 97535
« Reply #1 on: May 28, 2013, 06:53:10 PM »
Go to the front page of this site and search on 97535 (link provided here).  You will get several conversations.

Plus, there is this - answer to the first question asked at the link given below:

Self care/home management (CPT code 97535) is considered a component of the more comprehensive code, therapeutic activities (CPT code 97530). Both interventions may be provided to the Medicare beneficiary on the same date of service, be billed to your Medicare contractor, and be reimbursed by your Medicare contractor. However, to be reimbursed for CPT code 97535, you would have to append modifier-59 to CPT code 97535 on the claim form. In addition, documentation would have to support the medical necessity of both interventions and that the interventions were provided at separate and distinct times of each other.

from here:

If none of this gives you what you are looking for, you might come back with more specifics about the situation that is calling for 97535.