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CMS to Reinstate Edits as of October 1st

Tuesday, September 8, 2020   (0 Comments)
Posted by: Matthew Nicholas
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CMS to Reinstate Edits as of October 1st

CMS just announced that, effective October 1, it will reverse course and reinstate previously deleted coding "edits" for code pairs that represent common and appropriate physical therapy practice. At issue are edits made as part of the CMS National Correct Coding Initiative that required the use of the 59 modifier or applicable X modifier to make a claim for reimbursement for many code pairings commonly used in physical therapy on the same day—for example, 97530 (therapeutic activities) and 97116 (therapeutic procedure). APTA has since submitted a letter to CMS and Capitol Bridge, LLC, the contractor handling the edits, requesting a halt to the reinstatement of the edits. Read more and watch for updates from APTA.


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