Results of an Audit: a Case Study
Some time ago I worked with a client who needed help with an appeal. The provider had seen a patient over the course of four weeks for severe low back pain with radiculopathy to the left calf and foot. The provider put together a care plan and outlined goals based upon functional deficiencies. At each encounter, the following codes, among others, were billed:97110 Therapeutic exercises, 97140 Manual therapy. The therapy services were denied for most of the visits. The claims reviewer provided the following partial explanation for the denial:
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