Quick Tip: Reporting Therapy Treatment Plan Information to Avoid Claims are being returned to provider (RTP) for reason codes 31255, 31256, and 31257 on outpatient therapy claims that are submitted without a occurrence code to report the treatment plan information. Outpatient therapy claims billed on or after July 3, 2006, must include the appropriate occurrence code and date to indicate when the therapy treatment plan was established or last reviewed. Each outpatient therapy revenue code has its own occurrence code to report the treatment plan and date information. Preventing Reason Codes 31255, 31256, and 31257 Along with all of your normal billing requirements, all outpatient therapy claims must have the occurrence code and date the treatment plan was established or last reviewed:
In addition to entering this information on the claim, providers may have to update any chargemaster or internal system with this coding information. Providers may have to inform internal staff and, if a billing service is used, let them know that this information is required on Medicare claims. © All current procedural terminology (CPT) codes and descriptors copyrighted by the American Medical Association. |
