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CMS Manual System

services provided on same day except claims containing condition codes 20, 21,
….. Occupational therapy services requiring skills of a qualified occupational.

Medicare Claims Processing Manual – CMS

20.4 – Coding Guidance for Certain CPT Codes – All Claims. 20.5 – CORF/OPT
….. Use the KX modifier only in cases where the condition of the individual …
therapy cap (PT/SLP or OT), regardless of whether the other services exceed the

CMS Manual System

occupational therapy evaluations have been billed and paid while reporting a GP
….. Codes representing the medical condition that caused the treatment are …

CMS Manual System

Apr 1, 2004 … Form Locator (FL) 36 Occurrence Span Code and Date. R. Form Locator … use of
new condition and value codes with effective dates of October 1, 2003 and
January. 1, 2004. …… Physical therapy, occupational therapy, or.

R3553CP – CMS

Jun 28, 2016 … SUBJECT: New Condition Code for Reporting Home Health Episodes … or have
a continuing need for occupational therapy (OT) services).

CMS Manual System

Oct 5, 2009 … apply to claims that contain patient discharge status code 21. B. Policy: Field
Locator …. results in admission. FLs 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, and 28
– Condition Codes ….. Physical therapy, occupational therapy, or.

Medicare Claims Processing Manual – CMS

40.2.2 – Payment Requirements for Test Procedures (HCPCS Codes 64585,.
64590 and 64595) ….. Occupational Therapy. 520. Federal …. The following
modifier and condition code shall be reported when billing for PRP services only
in the …

Instructions Regarding Processing Claims Rejecting for … – CMS

Apr 5, 2010 … 6638.1 Medicare contractors shall recognize Condition Code 45. X X X X X …
overridden when condition code 45 or the KX modifier is present. X. III.
PROVIDER EDUCATION ….. Physical therapy, occupational therapy, or.

Medicare Questions and Answers

Form Locator (18 -28) would contain condition code X2 (Medicare. EOMB on file.)
… No, the coinsurance days billed ot MA are to be entered as coinsurance days …

B&P CODE SECTION 2570.3. – California Board of Occupational …

Jan 27, 2016 … occupational therapist or as being able to practice occupational therapy …. tissue
surrounds the end of the endoscopy, causing a brief condition …

Indiana Administrative Code –

a truthful, candid, and reasonably complete account of the patient's condition.

Outpatient Therapy Procedures, Hospital billing book

Occupational therapy is covered in the outpatient hospital setting for … Codes in
the EPSDT/HCY OT Program are in fifteen-minute units only. Use the … Condition
code “AJ” must be used on the outpatient claim in field(s) 18-24 on the UB-04.

Medicaid Alert 14-02 – Nysed

May 1, 2014 … A valid diagnosis code is required on all Medicaid claims, per instructions …
Therapy Association (APTA), and the American Occupational Therapy …
diagnosis code that describes the main condition or symptom of the student.

APG Provider Manual – New York State Department of Health

Aug 1, 2012 … 4.22 Specialty Rate Codes Not Subject to APGs… ….. ancillaries; dental
procedures; physical, speech and occupational therapy; and counseling services
. …. E&M code only when the patient's condition requires a significant,.

Home Health Billing Manual –

code in form locators 18 through 28 (Condition Codes) and use the revenue ….
Acute Home Health: All occupational therapy services may be provided to all …

Spectrum of Trauma Care in the State of Ohio – Ohio Department of …

Jan 5, 2017 … and the highest OT errors probably due to the availability of large …… fractures,
so we just used one long-bone fracture; Condition Code 8046 …

Health Care Data System Manual – Mississippi State Department of …

FLs 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, and 28 – Condition Codes – designed to
….. 17 – Date Outpatient Occupational Therapy Plan Established or Reviewed.

Occupational Therapy Rules February, 2015 –

Feb 25, 2015 … Chapters 452 and 454, Occupations Code. Executive … Texas Board of
Occupational Therapy Examiners. ….. term health care condition.

Rehabilitation – Virginia Medicaid Web Portal

Jan 18, 2017 … Manual Update Regarding Notification of CPT Code Changes for … necessary
and/or a member has had a significant change in their medical condition. … For
the new PT and OT therapy evaluation codes (above): 1 unit = 1 …

Provider Type 34 Billing Guide –

With the exception of lymphedema therapy services, codes that are not in the
table are … Coveredd Codess forr Occupationall Therapistss (OT)) – Use modifier
GO when billing these codes. 97003* Occupational … condition, per calendar

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