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physical therapy place of service 49 question

Carmen Posted Thu 12th of April, 2012 16:31:29 PM

We do the billing for an outpatient Physical Therapy group. The PT's want to work with a local Training/Fitness facility and, actually go to the facility and perform PT on patients there. This would be under this criteria:

* Either the patients already have a physician order in place and the trainers will recommend our therapists

-OR-

* As an example: During their workout a patient injures their back. The trainer gives the patient the number of one of the PT's. The therapist asks a couple of screening questions...(NO medical advice given)...but recommends one of our orthopods to evaluate. If therapy is warranted, the patient is referred to our PT's, and our normal practice per our carrier contracts is in place.

The questions are:

1. Are any/all of these scenarios allowed?

2. What place of service code would be used for going to the fitness facility? (I did not think 11 at all; would 49 be applicable)?

Thank you very much for your help!

SuperCoder Answered Thu 12th of April, 2012 21:31:42 PM

I am providing you a link on indepth PT billing. This is an important guide and covers the scenario you mentioned. Please check page 31-38.
http://www.medicarenhic.com/providers/pubs/Physical%20and%20Occupational%20Therapy%20Guide.pdf
I also believe 49 would be applicalbe rather than 11.

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