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Coding Guidelines: Part A Outpatient Therapy Billing by Novitas

Novitas guide for   Part A Outpatient Therapy Billing
Physical Therapy
(PT)
Occupational Therapy
(OT)
Speech-Language Pathology (SLP)
Occurrence Codes/Dates
  • 11 - Onset symptom/Illness
  • 29 - Date PT plan of care was established or last reviewed
  • 35 - Date PT began
  • 11 - Onset symptom/Illness
  • 17 - Date OT plan of care was established or last reviewed
  • 44 - Date OT began
  • 11 - Onset symptom/Illness
  • 30 - Date SLP plan of care was established or last reviewed
  • 45 - Date SLP began
Comprehensive Outpatient Rehabilitation Facilities (CORFs) only:
Occurrence code 28 – Date a plan of treatment was established or last reviewed for care
Revenue Codes
042X 043X 044X
HCPCS
Required Required Required
Modifiers
Required for 042X, 043X and 044X
GP – PT plan of treatment GO – OT plan of treatment GN – SLP plan of treatment
Units/Line Item Date of Services
Required Required Required

Comments

  1. pt software
    TherapySource is a physical therapy software solution developed specifically to manage the clinical and administrative processes of outpatient therapy clinics.

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