Why Medicare requires documentation

Why Medicare requires documentation if 3 units of 97112, 97113, or 97140 are billed on the same day.

The need for medical documentation for 3 or more units billed for codes 97112, 97113, or 97140 on the same day of service is determined in the National Coverage Provision (NCP) PHYSMED-001. If a patient has 3 or more units billed of one of these procedure codes, on the same date of service, the medical necessity needs to be established as to whether the patient can benefit from the modality if they are already able to perform 3 units at a time.

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