Re: Billing Codes 95851 ROM Testing/95831 MMT

[Guest guest]

,

The CMS (I don't know about others entities) identifies 95831 and

95851 SOMETIME as therapy services. These codes ALWAYS represent

therapy services when performed by therapists. These codes aren't

therapy services when:

• It is not appropriate to bill the service under a therapy plan of

care.

• They are billed by practitioners/providers of services who are not

therapists, i.e.,physicians, clinical nurse specialists, nurse

practitioners and psychologists, or they are billed to fiscal

intermediaries by hospitals for outpatient services

performed by non-therapists..

http://www.trailblazerhealth.com/Publications/Training%

20Manual/Physical%20Therapy.pdf

Another question would be, in the State of Florida, who can legally

perform Muscle and Range of Motion Testing?

Wivine B

Medical Billing Specialist

TX

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>

> Hello Group,

>

> I recently had a patient referred to me by another patient. She

was

> in a car accident and did not have a prescription for PT. I sent

her

> to one of my referring doctors for orders. I found out after from

> the patient and the doc's office staff that a technician (not a PT)

> was brought in to test her ROM and muscle strength. The technician

> billed the insurance company for codes 95851 and 95831 grossing

about

> $250 per test.

>

> I found out this technician has no medical background and goes

around

> primarily working with chiropracters performing this test on

> patients. I know very few insurance plans will pay for codes 95851

> and 95831.

>

> Does anyone know who still pays this code? Is this test being

> performed legally by a technician?

>

> Any information would be greatly appreciated.

>

> Thank you,

>

> Yunker, PT

> American Health and Rehabilitation

> Fort Lauderdale, FL

>

>