97140 CPT Code: Know Your Codes
97140 CPT Code: Manual Therapy
97140 CPT Code Description: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes. It’s also been further described to include things like manual trigger point therapy and myofascial release. Manual therapy techniques are used to treat the restricted motion of soft tissues in the extremities, neck, and trunk. The following descriptors outline more detail about manual therapy:
- Manual therapy is used in an active and/or passive fashion to help effect changes in the soft tissues, articular structures, and neural or vascular systems.
- The intent of the service is to increase pain-free range of motion and facilitate a return to functional activities.
- An example is the facilitation of fluid exchange, restoration of movement in acutely edematous muscles, or stretching of shortened connective tissue.
- Manual therapy is used when a loss of motor ability impedes function.
- The National Correct Coding Initiative (NCCI) edits created by the Centers for Medicare and Medicaid Services (CMS) require that the manual therapy techniques be performed in a separate anatomic site than the chiropractic adjustments in order to be reimbursed separately.
Manual Therapy and Chiropractic Adjustment Codes
Chiropractic adjustments have their own set of codes (98940-98942, or 98943 for an extremity). If you report a subluxation diagnosis code, you must perform an adjustment. National Correct Coding Initiative (NCCI) claim edits bundle manual therapy (97140 CPT Code) to chiropractic adjustment codes (98940-98942) when performed in the same anatomic region. If the procedures are performed in separate anatomic regions, you may report them separately by appending modifier 59 to the adjustment code (97410 is the ‘column 2’ procedure). If the claim is properly filed and supported by documentation, the insurer should pay for both procedures. To best support payment and minimize audit red flags, the provider’s notes should include:
- Indications for treatment (manual therapy)
- Treatment goals associated with manual therapy services
- Objective measures used to ensure patient progresses in treatment goals
- Progression towards treatment goals
- Which regions, specifically, were treated with manual therapy and with your chiropractic adjustment; these areas should not coincide if you want to receive separate reimbursement.
- Treatment plan (include frequency and duration)
CPT 97124 Vs 97140
97124 CPT Code Description: Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion). Massage is classified as a therapeutic procedure which is a time-based service. A therapeutic procedure is defined as a manner of effecting change through the application of clinical skills and/or services that attempt to improve function. Therapeutic procedures require direct one-on-one patient contact by a physician or therapist and can only be performed by the physician or an appropriately licensed therapist.
Code 97124 is often prescribed for the friction-based, relaxation type massage that may be less specific than 97140. With Manual Therapy, one would expect to see the services ordered to address the objective loss of joint motion, strength, or mobility, and they must be part of an active treatment plan directed at a specific outcome. For example, stated goals could say, ‘97140 CPT Code is prescribed to increase the flexibility of the quadratus lumborum muscles while activating and stretching the hamstring muscles, to help improve the patient’s capacity for walking up to a mile, and standing longer than one hour at their job as a cashier’. Daily, routine visit documentation of the two services should also include progress toward those stated goals.
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We hope that this article has provided basic guidelines about the 97140 CPT code. If you are looking for overall billing and coding services you can refer to E2E Medical Billing Services. Our accurate and affordable billing services will eliminate billing and coding errors and will increase your practice collection. To know more about our medical billing and coding services, call us at 888-552-1290 or write to us at info@e2eMedicalBilling.com