97124 CPT Code: Know Your Codes
97124 CPT Code: Massage Therapy
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. The following descriptors outline more detail about massage therapy:
- Massage therapy includes effleurage (circular movement), petrissage (lifting, squeezing), and/or tapotement (stroking, compression, percussion).
- The intent of the service is to increase circulation and promote tissue relaxation to the muscles, and the treatment is based on or consists of more basic massage.
- When billed on the same visit as a Chiropractic Manipulative Treatment (CMT) code (98940-98943), carriers often require the -59 modifier appended to the 97124 code to clarify that it’s a distinct and separate procedure from the adjustment.
Time-Based
All time-based therapies (both therapeutic procedures and constant attendance) are billed in 15-minute increments. If provided for less than 8 minutes, the service should not be billed to the payor. It is important to recognize that 15 minutes must be spent in performing the pre-, intra-, and post-service work in order to report the 97124 CPT code. Common components included as part of Therapeutic Procedures include chart reviews for treatment, setup of activities and the equipment area, and review of previous documentation as needed.
Audit-Trigger Code
Payors highly scrutinize the use of massage, particularly if more than one unit of service is billed on the same date and/or if the services is billed for more than three visits. Please note, as a general rule, payors only cover massage when medically necessary. Therefore, when prescribed for relaxation, stress relief, and other clinically appropriate, but not medically necessary reasons, the services should not be billed to the payor. When performed and billed to a payor, modalities/therapies must be medically necessary, consistent with the patient’s chief complaint/clinical findings, diagnoses, and treatment plan.
CPT 97124 Vs 97140
- 97140 CPT Code Description: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes.
- 97140 is used to describe therapy which increases active pain-free range of motion, increased extensibility of myofascial tissue and facilitates return to functional activities. This code is reported in units of 15 minutes. This code would be used for the techniques stated. It would include neuromuscular therapy, positional release, stretching and nearly any therapeutic technique performed manually for the purposes mentioned in the first sentence.
- From a coding perspective, if the therapist is performing therapeutic massage in order to increase circulation and promote tissue relaxation to the muscle(s), then code 97124 Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion) should be reported.
- If the therapist is performing massage as a manual therapy technique in order to increase active pain-free range of motion, increase extensibility of myofascial tissue and facilitate the return to functional activities, then code 97140 Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes should be reported.
We believe that the vast majority of massage therapists cannot justify the use of 97124 and 97140 within a single treatment session, based on their clinical notes. If you choose to bill using multiple codes, you will need to spend a considerable amount of time writing clinical notes to support your billing practices.
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We hope that this article has provided basic guidelines about the 97124 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 [email protected]