Ther Ex or Aquatic Therapy?

[Guest guest]

Group,

I have been in discussion with a few PT's regarding the ethics of coding 97110

(Ther ex) and 97113 (Aquatics). Some private contractors; i.e Blue Cross,

reimburse less than for aquatics than ther ex. One PT stated he would like to

bill ther ex instead of aquatics because it pays more. To me this does not sound

unethical, it sounds like a survival strategy. Got to fight to stay alive. But

we do not want to break the law.

His reasoning is because he is doing ther ex in the water and can justify its

use in coding and billing. However, another PT stated if you are doing either

ther ex, gait, ther act, manual or neuro reed in the water you must bill

aquatics.

Is there any rule out there that states we must bill aquatics if we are

performing ther ex, gait, ther act, manual or neuro reed in the water?

Another question is can we do aquatics and land the same day by billing

aquatics and ther ex using a -59 modifier?

Caught in the middle,

Hankins, PT

President

Synergy Therapies, LLC

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