Can cpt code 97140 and 97012 be billed together?
Asked by: Dr. Kaley Becker | Last update: May 16, 2025Score: 5/5 (64 votes)
Can you bill for two CPT codes at the same time?
There is a myth that exists that you can't bill 2 CPT codes during the same 15-minute time period. Well, that myth is only partially true. It is possible to bill 2 CPT codes during the same 15-minute time period.
Does 97012 need a modifier?
When billing for mechanical traction services with CPT code 97012 in your chiropractic clinic, you may need to these 97012 modifiers: Modifier 59: Indicates that the traction procedure was performed separately and independently of other services. Modifier GP: Shows that the service provided is therapeutic in nature.
What are the rules for 97140 billing?
Understanding the Time-Based Billing Rules for 97140
This means that in order to bill a unit, at least 8 minutes of that 15-minute increment must be spent providing direct patient contact. Any time less than 8 minutes within an increment cannot be counted towards billing.
What are the rules for Medicare 97140?
Time-Based Billing for CPT Code 97140
This code follows the "8-minute rule" generally imposed for Medicare, which says that there must be at least 8 minutes of therapy to bill for a single unit of 97140. The 8-minute rule is a critical aspect of time-based CPT codes like 97140.
NPI 101 for therapists in private practice
Can 97012 and 97140 be billed together?
Yes, you can bill 97140 and 97012 together. However, it's important to note that billing these codes together requires the use of modifier 59 to indicate that the services were separate and distinct.
Is 97012 a timed code?
The following are examples of untimed codes: Evaluations/Re-evaluations (97161-97168). Group therapy (97150). Supervised modalities (97012).
Does cpt code 97140 need a 59 modifier?
Description of the manual therapy technique(s) location (e.g., spinal region(s), shoulder, thigh, etc.) Time (e.g., number of minutes spent performing the services associated with this procedure) meets the timed-therapy services requirement. CPT code 97140 is appended with the modifier -59 or the appropriate –X ...
What is modifier 59 in medical billing?
The CPT Manual defines modifier 59 as: “Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a. procedure or service was distinct or independent from other non-E/M (Evaluation/Management) services.
Is CPT code 97012 a physical therapy code?
CPT 97012 is designated for mechanical traction therapy and falls under supervised modalities in physical therapy. Here's what healthcare providers need to know to ensure compliant, accurate billing.
How do you know if a CPT code needs a modifier?
- The service or procedure has both professional and technical components.
- More than one provider performed the service or procedure.
- More than one location was involved.
- A service or procedure was increased or reduced in comparison to what the code typically requires.
Do I use modifier 95 or GT?
The two most commonly used modifiers are the GT modifier for telehealth service rendered via interactive audio and video telecommunications systems, and the 95 modifier for synchronous telemedicine service rendered via a real-time interactive audio and video communications system.
How do you write a CPT code with two modifiers?
In the case of more than one modifier, you code the “functional” modifier first, and the “informational” modifier second. The distinction between the two is simple: you always want to list the modifiers that most directly affect the reimbursement process first.
Can I do two CPT at the same time?
You may have more than one CPT authorization at the same time and multiple segments throughout your academic program as long as each position is related and integral to your degree program. CPT is approved on a full-time (less than 20 hours per week) or part-time (more than 20 hours per week) basis.
When to use 59 or 51 modifier?
Modifier -51 would be attached because the biopsy is the lesser-valued procedure done at the same session, and modifier -59 would be attached to indicate that the biopsy, which is normally bundled with excision of the same lesion, was done on a separate lesion from the one that was excised.
Is CPT code 97140 covered by Medicare?
Manual therapy (CPT code: 97140)
Here is a breakdown of each technique and what is required. Medicare states that this treatment may be medically necessary for the treatment of restricted motion of soft tissues involving the extremities, trunk, or neck.
How much is the CPT code 97140?
97140 $65/unit
It is used to treat the restricted motion of soft tissues in order to increase pain-free range of motion and facilitate a return to functional activities. 97124 $160/hour Massage Therapy Massage is the application of systematic manipulation to the soft tissues of the body for therapeutic purposes.
Can 97110 and 97140 be billed together?
Since the time for each service is the same, choose either code for 2 units and bill the other for 1 unit. Do not bill 3 units for either one of the codes. Appropriate billing for 40 minutes is for 3 units. Bill 2 units of 97110 and 1 unit of 97140.
Can modifier 58 and 59 be billed together?
Shouldn't they be billed with modifier 58? No, because although the “same day” could technically be called part of “the post-operative period,” the definition of modifier 59 clearly focuses on “the same day.” That's much more specific than “post-operative.” Further, this is a non-E/M service.
When to use modifier 62?
Two surgeons. Under some circumstances, the individual skills of two or more surgeons are required to perform surgery on the same patient during the same operative session. This may be required because of the complex nature of the procedure(s) and/or the patient's condition.
What is CPT code 97140 used for?
CPT® code 97140: Manual therapy techniques, 1 or more regions, each 15 minutes (Mobilization/manipulation, manual lymphatic drainage, manual traction)
Does 97012 require a modifier?
Modifier 59
59 is used to signify that a chiropractic procedure or service is independent of other codes and needs to be paid separately. A good example of when to use modifier 59 would be chiropractic CPT code 97012 (mechanical traction) and CPT code 97140 (manual therapy).
What is the difference between time-based and service-based CPT codes?
What are time-based CPT codes? Time-based (or constant attendance) codes allow for variable billing in 15-minute increments. These differ from service-based (or untimed) codes, which providers can only bill once regardless of how long they spend providing a particular treatment.
Can 98941 and 97012 be billed together?
We typically bill 98941, 97012 and 97014 together when a patient is receiving manipulation, intersegmental traction and e-stim.