Medicare Part B Coding and Therapy Update

The Centers for Medicare and Medicaid Services (CMS) has issued Change Request 8482, containing updated coding information for Medicare Part B therapy claims.  In addition, the change request makes significant reference to the billing manual for therapy services.  This CMS release is an excellent reference for therapists and billing personnel.  Along with the most recent code updates, the document covers the following topics in detail:

• The therapy caps;
• The therapy caps exceptions process and the use of the KX modifier;
• The exceptions for evaluation services, including updated evaluation codes;
• Billing the relevant diagnosis for the exceptions process;
• Appealing disapprovals to exception requests;
• Documenting the certifying practioners; and
• Mandatory use of new G-codes, and functional and severity tracking.

If anyone has difficulty finding or accessing the reference, please contact me and I will be happy to assist.

Contact: Patrick Cucinelli, pcucinelli@leadingageny.org, 518-867-8827