RE: BCBS Michigan Denials for Outpatient Occupational Therapy Codes
 

Dear Members,

On 6/3/2020, it was brought to our attention that several Occupational Therapists practicing in Outpatient settings began receiving denials for claims submitted after May 1, 2020 for codes commonly used by OT, including but not limited to the following:
 
97110 (therapeutic exercises)
97112 (neuro muscular re-education)
97014 (electrical stimulation)
 
We immediately reached out to our Liaison with BCBS of Michigan and received the following information: Per the March 2020 version of The Record, several different changes to claims processing were being updated for various provider types.  See original document at: https://www.bcbsm.com/content/dam/microsites/corpcomm/provider/the_record/2020/mar/Record_0320j.shtml

Per this publication, as of May 1, 2020, Occupational Therapy services will be required to be billed using the GO modifier.
If the claims were billed without the modifier, they will need to be rebilled with the modifier.  BCBS has assured us that they will pay in the same way that they paid before 5/1/2020 once the GO modifier is added to the claim. 

If that does not resolve the issue, please notify the MiOTA office immediately.  Thank you!

Sincerely,  

Kirsten Matthews, MA, OTRL, CLT
BCBS Liaison, Michigan Occupational Therapy Association
 
Jeannie Kunz, MOT, OTRL, BCP
Advocacy Director, Michigan Occupational Therapy Association
 
Cathleen Johnson, OTD, OTRL, FMiOTA
Leader of the Executive Committee, Michigan Occupational Therapy Association