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CPT codes, descriptions, and other data only are copyright 2008 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.

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Ohio Part B Carrier
Hot or Cold Packs: Bundling Denials

Denial Reason, Reason/Remark Code(s)
  • B15 (Bundling): Payment adjusted because this procedure/service requires that a qualifying service/procedure be received and covered. The qualifying other service/procedure has not been received/adjudicated.
  • CPT code: 97010
Resolution/Resources
  • This code is listed as 'Status B' in the Medicare Physician Fee Schedule Database (MPFSDB), which means that payment for this service is always included in payment for other services performed on the same date that are reimbursed under the Medicare Physician Fee Schedule
  • Physical Therapy status 'B' codes are codes for which payment is included in the basic allowance of another procedure. Regardless of whether submitted on a claim alone or in conjunction with another therapy code, a separate payment will never be made for the codes and the patient cannot be billed for these services.
  • Do not submit these services to Palmetto GBA unless the patient specifically requests that you do so; for example, the patient requests a denial from Medicare to submit a claim to his/her secondary insurer

The following CPT codes for physical therapy services are designated as 'Status B' in the 2008 Medicare Physician Fee Schedule Database (MPFSDB):

  • 97010
  • 92605
  • 92606
  • 97602 
Reference
  • Find definitions of 'Status Indicators' in CMS Pub. 100-04, chapter 23, section 30.2.2 (PDF, 1.28 MB)
  • Bundled Codes: Status B Indicator: When the Medicare Physician Fee Schedule Database is updated, CMS defines certain services that will not be reimbursed by Medicare Part B. Status B indicates: Payment for covered services is always bundled into payment for other services not specified. When these services are covered, payment for them is subsumed by the payment for the services to which they are incident (an example is a telephone call from a hospital nurse regarding care of a patient). You cannot bill the patient for these services. (The TC modifier is a HCPCS modifier and the 26 modifier is a CPT modifier.) The effective date for these services is January 1, 2009.
Status B HCPCS Codes
A4262
A4263
A4270
A4300
A4550
G0269
Q3031
R0076

Status B CPT Codes
15850
20930
20936
22841
36416
38204
90885
90887
90889
91123
92352
92353
92354
92355
92358
92371
92531
92532
92533
92534
92605
92606
93740
93740 - TC
93740 - 26
93770
93770 - TC
93770 - 26
94005
94150
94150 - TC
94150 - 26
95992
96040
96902
97010
97602
98960
98961
98962
99000
99001
99002
99024
99050
99051
99053
99056
99058
99060
99070
99071
99078
99080
99090
99091
99100
99116
99135
99140
99288
99339
99340
99358
99359
99363
99364
99366
99367
99368
99374
99377
99379
99380

 

last updated on 12/29/2009
CMS