How do you bill for manual therapy?

Manual therapy can only be billed with CMT if the therapy was performed on a different body area, and modifier 59 would be appended to the manual therapy code (97140) to indicate this to the payer. CPT code 97140 is also a timed therapy code, and requires time documentation to support billing.

What is the CPT code for manual therapy?

Version 27.0 Correct Coding Initiative (CCI) Edits

CPT Code Description Timed?
97140 Manual Therapy Y
97150 Group Therapeutic Procedures N
97151 Behavior Identification Assessment Y
97152 Behavior Identification – Supporting Assessment Y

What is billable under manual therapy?

Manual therapy, CPT code 97140, is also a prescribed treatment that helps address loss of joint strength, mobility, and/or range of motion that is ultimately impeding function. Procedures performed under manual therapy include: Manual traction, … Trigger point therapy.

Can OT bill for manual therapy?

3. Occupational Therapy Services. Simply put, if a service is rendered by an occupational therapist, a physical therapist cannot bill for that service. However, most payers—including Medicare Part B—allow PTs and OTs to bill for services provided to the same patient on the same date of service.

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Can 97140 and 97110 be billed together?

Code 97140 Manual therapy techniques (eg, obilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes. Appropriate billing for 40 minutes is for 3 units. Bill 2 units of 97110 and 1 unit of 97140. Count the first 30 minutes of 97110 as two full units.

Does CPT code 97140 need a modifier?

The 97140 CPT code is appended with the modifier -59 or the appropriate -X modifier.

What is the CPT code for manual lymphatic drainage?

The CPT Code Book definition of 97140 is: “Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.” You may also document myofascial release using this code.

How is PT billed?

When using untimed codes, the PT is paid a predetermined fee, no matter the time spent on treatment. These codes can be billed once per treatment session. Timed codes are reimbursed based on the time spent working 1:1 with their patient, and include only skilled interventions.

How are physical therapy visits billed?

Most payers—and providers—prefer to bill using electronic claim forms. However, some payers do still accept paper claims. According to the APTA, the most common form is the Universal Claim Form (CMS 1500), although some payers may have their own.

What is the CPT code for therapeutic activity?

CPT 97530 Therapeutic Activities

CPT code 97530 requires “use of dynamic activities to improve functional performance. Examples of such activities include lifting, pushing, pulling, reaching, throwing, etc.” Billing this code also requires direct, one on one contact, billed in 15-minute increments.

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What is the 8 minute rule?

The 8-minute rule is a stipulation that allows you to bill Medicare insurance carries for one full unit if the service provided is between 8 and 22 minutes. As such, this can only apply to time-based CPT codes.

What is the 8 minute rule in therapy?

A therapist must provide direct one-to-one therapy for at least 8 minutes to receive reimbursement for a time based treatment code. When only one service is provided in a day, you shouldn’t bill for services performed for less than 8 minutes.

What can be billed under therapeutic activity?

Therapeutic activities incorporate the use of multiple parameters, such as balance, strength, and range of motion, for a functional activity. Examples include lifting stations, closed kinetic chain activity, hand assembly activity, transfers (chair to bed, lying to sitting, etc), and throwing, catching, or swinging.

Who can bill CPT code 97140?

American Medical Association (AMA) coding guidelines dictate that it is only appropriate to bill for Chiropractic Manipulative Treatment (CMT) and manual therapy (CPT code 97140) for the same patient on the same visit under certain circumstances.

Can you bill multiple units of 97140?

Appropriate billing is for one unit. The qualified professional (See definition in Pub. 100-02/15, section 220) shall select one appropriate CPT code (97112, 97110, 97140) to bill since each unit was performed for the same amount of time and only one unit is allowed.

What is the CPT code 97140?

97140 CPT Code Description: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes.

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