tci Part B Insider - 2006 Issue 10

PODIATRY: Keep Your Gait Analysis Claims Steady

Helpful hint:  Double-check your Medicare carrier's coverage guidelines for each.If you report 97166, 97799 or 95999 for gait analysis, you are walking straight into a denial. Reason: The BCBS Montana Medicare Local Coverage Determination is typical of many carrier determinations when it states: "Gait analysis performed as a diagnostic test is considered inclusive in the E/M service and not separately payable. It should not be coded or billed as 97116 (Therapeutic procedure, one or more areas, each 15 minutes; gait training [including stair climbing]), 97799 (Unlisted physical medicine/rehabilitation service or procedure), or 95999 (Unlisted neurological or neuromuscular diagnostic...

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