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Re: 97110 & 97032

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Do you have the modifers on it? Which are you using

Re: 97110 & 97032

Hi ,

an you be more specific about your denials? What is being denied and

nder what circumstance? That would help. Also you may look up the list

f required Medicare documentation that is available if you search under

edicare compliance or Medicare audit. I don't have it with me but if

o-one posts it here, I will send it to you this evening. This list has a

hecklist of what Medicare requires in documentation and is there

pecifically to help those that are audited or get denials to know what is

equired.

One thing I also need to ask is that are you sending the H & P (do you

ean the PT evaluation?) or are you sending in the Medicare Certification?

Medicare requires the physician certification not the PT eval. Most

linics today have combined their evaluation form into a Medicare

ertification format so that the evaluation contains all the necessary

nformation for Medicare Certification and that gets sent to the patient's

hysician for signature. The Certification,signed by the physician, daily

otes (in proper Medicare format) and required Medicare Progress Notes

done every 10th visit or 30 days whichever comes first)>must also be

ncluded in most appeals of denials.

If you give us more info about the denials, we can be a little more

pecific with the answer.

hanks.

om Howell, PT, MPT

PTA Payment Specialist

eridian, ID

howell@...

We are getting denials from Medicare requesting documentation and when

we send the H & P is not enought to determine medical necessity. Does

anyone have any suggestion on what else we need to provide or what needs

to be documented in the H & P for reimbursement? Thank you.

L. Bash, CPC, CPC-H

Billing Director

HealthCare America Medical Group

HCA Physician Services

3501 Cortez Road West

Bradenton, FL 34210

Office: ext. 1019

Cell:

Fax:

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