Author Topic: chiropractic and tx  (Read 687 times)

grg61458

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chiropractic and tx
« on: January 08, 2016, 09:39:05 PM »
I'm new to billing, currently am attempting to get our therapy office payments. I'm billing chiropractic evals 99202 or 99214, using mod 25. and two other tx codes and group therapy. tx codes 97110 and 97112 with group 97150. I only been using mod 25 on eval line. Got first payment, it appears only eval was paid, believed I failed to use mod GP ON TX CODES CORRECT?  2nd question I should get back a bunch of underpaid claims, what code do I use to resubmit, I would still have to put the eval code right, but cannot charge?. PLEASE HELP I'M NEW AND I SO WANT TO SUCCEED AT THIS ??? :-\

Michele

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Re: chiropractic and tx
« Reply #1 on: January 09, 2016, 08:01:55 PM »
Do you work in an office?  Or are you a private biller?  The reason I ask is because if you work in an office there should be someone there telling you how to handle these situations.  If you are a private biller (billing service) then you should not be adding modifiers without the provider's office telling you to. 

With that being said:

Someone answered your other post indicating that the -25 modifier is used on the E&M code only.  You don't say why the TX codes are being denied so it's hard to say what you need to do.  The GP modifier is required by Medicare for PT but the GP modifier indicates - Services delivered under an outpatient physical therapy plan of care.  Medicare doesn't cover 97110, 97112 or 97150 when performed by a DC.  They also don't cover 99202 or 99214.  But that may be your problem.

I hope this helps.
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