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Medical Fee Dispute Resolution Findings and Decision General Information Requestor Name PEAK INTEGRATED HEALTHCARERespondent Name ZURICH AMERICAN INSURANCE COMPANYMFDR Tracking Number M422226401Carriers

How to fill out 99204 and 97750-gp

How to fill out 99204 and 97750-gp

1. To fill out 99204, follow these steps:
2. Gather the patient's medical records and history.
3. Conduct a comprehensive examination of the patient.
4. Document the patient's chief complaint and present illness.
5. Perform a review of systems and document any findings.
6. Assess the patient's medical decision making and complexity.
7. Describe any procedures or tests performed during the visit.
8. Include a diagnosis and treatment plan.
9. Provide the appropriate level of documentation required for 99204.
10. To fill out 97750-gp, follow these steps:
11. Start by identifying the patient's need for physical therapy services.
12. Evaluate the patient's functional limitations and mobility.
13. Develop an appropriate treatment plan to address the patient's needs.
14. Document the goals of the therapy and the specific interventions used.
15. Monitor and assess the patient's progress during each therapy session.
16. Provide ongoing documentation of the therapy sessions and outcomes achieved.
17. Ensure that the therapy provided meets the requirements for 97750-gp.
18. Remember to include the appropriate billing codes and modifiers.

Who needs 99204 and 97750-gp?

1. 99204 is a level 4 CPT code for a new patient comprehensive office visit.
2. It is typically needed by patients who require a thorough evaluation and management of their medical condition.
3. gp is a CPT code for physical performance testing and/or measurement.
4. It is often necessary for patients who need physical therapy services to improve their functional abilities.
5. These services are commonly used in rehabilitation settings to assess and treat patients with mobility issues.
6. Patients who have experienced injuries, surgeries, or have chronic conditions that affect their physical functioning may require 97750-gp.

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What is 99204 and 97750-gp?

99204 is a CPT (Current Procedural Terminology) code used to bill for an established patient office or other outpatient visit that involves a problem-focused medical history, examination, and moderate medical decision making. 97750-gp is a code used for physical medicine and rehabilitation evaluation and management, specifically for patients who require additional therapy services.

Who is required to file 99204 and 97750-gp?

Healthcare providers, such as physicians and physical therapists, are required to file 99204 and 97750-gp when providing services that meet the criteria defined by these CPT codes during patient visits.

How to fill out 99204 and 97750-gp?

To fill out 99204 and 97750-gp, healthcare providers need to document the patient's clinical information, including medical history, examination findings, and the level of medical decision making for 99204. For 97750-gp, providers should document the patient's therapy evaluation details and any necessary reports related to the therapy services.

What is the purpose of 99204 and 97750-gp?

The purpose of 99204 is to classify and bill for specific outpatient visit services provided to established patients. 97750-gp is designed to facilitate the reporting of physical medicine services, particularly evaluations for patients needing rehabilitation therapy.

What information must be reported on 99204 and 97750-gp?

For 99204, providers must report the patient's medical history, findings from the examination, and level of decision making involved in their care. For 97750-gp, providers must report the results of the evaluation, diagnosis, and recommended therapy services.