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April 10, 2017

Frequency of General Modalities for Outpatient Physical and Occupational Therapy

CGS performed data analysis for CPT codes 97012, 97016, 97018, 97022, 97024, 97032, 97033, 97035, 97036, 97039,G0283 and our analysis revealed that these services are being billed in excess of the frequency edits stipulated  in LCD L34049: Outpatient Physical and Occupational Therapy. Therefore, CGS will be implementing frequency edits for the above codes in KY and OH effective May 25, 2017.

For guidance regarding documentation please refer to  the LCD in the supportive documentation recommendations section for each of the codes above.

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