Medical Billing Forum
Coding => Coding => : Trisha Reyes October 20, 2008, 01:47:22 AM
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Hi Michelle,
I have your book for chiropractic billing, it mentions that medicare will only pay for 98940 and 98942 with the correct primary and secondary diagnosis codes. It that the same for physical therapy? I work for a family practice dr. that also does physical therapy, he used manipulation cpt code 98925 will this be covered by medicare if yes with what specific ICD 9 codes? he also does pain management and always bills 20610 injection when he does manipulation, are the payable together for medicare?
Thank you,
Trisha
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I strongly suggest you purchase the Coding and Payment Guide from Ingenix
www.ingenix.com the information in that booklet is like a bible especially when you have doubts.
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The Medicare rules do not apply to PT or to osteopathic manipulations (98925-98928). Medicare only allows chiropractors (DC's) to bill the 98940-98942 codes and they require specific diagnoses.
If an MD or a DO bills PT charges, or osteopathic manipulation the same rules do not apply.
If you are going to bill the 20610 with other charges, you just need to make sure you have the diagnosis for the 20610, and the diagnosis for the other charges, and you should use the 59 modifier to indicate separate procedure.
Michele