Part B Coding Coach: 96000-96004 Survival Guide: 3 Simple Rules for Claims Success

Why This Topic Matters

Gait analysis claims are often denied when coverage policy, documentation, or service selection does not match payer requirements. Understanding the scope of the CPT family, carrier variation, and the need for proper support helps reduce denials and post-payment risk.

Article Sections

1. Rule #1: Know the Codes

   Introduces the gait analysis code family and the broad types of diagnostic services included. It also notes the need to align claims with payer-recognized diagnosis support and coverage policy.

2. Rule #2: Check With Your Carrier

   Discusses carrier-specific coverage variation and the importance of verifying benefits and policy before reporting services. It also addresses the possibility of local Medicare guidance affecting coverage.

3. Rule #3: Bill Only for Services Provided

   Focuses on matching reporting to the components actually performed and documented. It covers the general issue of multi-component testing and claims that may involve interpretation and written reporting.