Billing and Coding Guidelines for Outpatient ...

Billing and Coding Guidelines Contractor Name Wisconsin Physicians Service Insurance Corporation Title Outpatient Rehabilitation Therapy Services billed to Medicare Part B Revision Effective Date 10/01/2011 AMA CPT/ADA CDT Copyright Statement CPT codes, descriptions and other data only are copyright 2011 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Current Dental Terminology, (CDT) (including procedure codes, nomenclature, descriptors and other data contained therein) is copyright by the American Dental Association. 2002, 2004 American Dental Association. All rights reserved. Applicable FARS/DFARS apply CMS National Coverage CMS ; CMS , , , 63; Transmittal 88, Rev 5921 CMS , , , , , , , , , , , , CMS , , Coding Information Modifiers GO - Service Delivered Under An Outpatient Occupational Therapy Plan of Care GP - Service Delivered Under An Outpatient Physical Therapy Plan of Care The claim must include one of the following modifiers to distinguish the discipline of the plan of care under which the service is delivered: GO Services delivered under an Outpatient occupational therapy plan of care; or, GP Services delivered under an Outpatient physical therapy plan of care.

codes must be present on all claims and must be coded to the highest degree of accuracy and digit level completeness. Claims lacking ICD-9 codes, coded to the highest degree of accuracy and digit level completeness will be denied as unprocessable. a. Report the patient's specific condition for which the current therapy episode of care

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