97002 Procedure Code

Keep getting denial from Medicare and UHC when using this physical therapy re evaluation code when patient has change of diagnosis or returns for therapy after not being seen for 30 days. Should we be using a modifier or is this code not allowed?

re: 97002 Procedure Code

Check both their PT policies. You may need a new auth for what you state is occurring here. Or maybe you should be billing 97001. Some payers require the GP mod.

re: 97002 Procedure Code

I have been using the GP modifer for medicare and still getting denied.