(no subject)

[Guest guest]

Hello,

I have a couple of questions and I'm hoping I can get some feedback as to

how you might handle this with your billing department. We are a private

Physical Therapy clinic located in Mississippi and treat many Medicare

patients.

We've come across some issues and cannot seem to get a concrete answer from our

local adminstrators.

Would really appreciate any information you might can share with us.

1. Does anyone know what provider UPIN number is used for Federal providers?

Example, we have a VA doctor who has referred a patient to our clinic for

therapy. When we contacted this doctors billing department to get his UPIN

number for billing they informed us that Federal providers have one universal

UPIN number under Mississippi Medicare guidelines. However, we have not been

able to locate this information on their website? When we asked the local

Mississippi administrator they stated, check the website it's in a newsletter.

We asked which newsletter and they stated they were not sure, we would have to

read through them all. Any suggestions?

2. How do you bill Medicare for Traction 97012 and Gait Training 97116?

We continue to have these two procedures denied. Can anyone tell me exactly

what we are allowed to bill when billing these two procedures? We have

checked the CCI edits for mutually exlusive or bundled codes but still cannot

seem

to get a handle on this?

Billing scenario 1.

97110 GP

97110 GP

97116 GP

97116 GP

Medicare denies the gait training, 97116, and allows the ther ex's of 97110.

Billing scenario 2.

97012 GP

97110 GP

97110 GP

97140 GP 59

97140 GP 59

Medicare is allowing the 97140 and 97110 and denying the traction 97012.

Thank you...

Jerri

Office Manger

Accelerated Physical Therapy

Bay St. Louis