What is CPT 97014 billing guidelines?

Asked by: Willy Grant IV  |  Last update: October 25, 2023
Score: 4.1/5 (6 votes)

CPT defines CPT Code 97014 as "Electrical Stimulation Unattended." CPT Code 97014 is a supervised modality. Supervised modalities are defined as the application of a modality to 1 or more areas, which does not require direct (one-on-one) patient contact by the provider.

What is CPT code 97014 billing guidelines?

The 97014 chiropractic CPT code is used for an unattended EMS treatment, which is performed in the office but does not require the presence of the chiropractic provider. Unattended electrical stimulation is not a timed service. Chiropractors usually administer EMS for 15- to 30-minute sessions.

Does Medicare pay for CPT code 97014?

For example, a March 2003 Communiqué reads, “On March 1, 2003 the procedure code 97014 electrical stimulation (unattended) (EMS) became status I, 'Not valid for Medicare purposes.

Is 97014 a time based code?

CPT 97014 is "electrical stimulation (unattended)." This untimed code is not appropriate for dysphagia treatment if the SLP must be present to activate electrical stimulation at the appropriate moment.

Is CPT 97014 physical therapy?

CPT® 97014, Under Supervised Physical Medicine and Rehabilitation Modalities. The Current Procedural Terminology (CPT®) code 97014 as maintained by American Medical Association, is a medical procedural code under the range - Supervised Physical Medicine and Rehabilitation Modalities.

What is a CPT Code in Medical Billing?

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What is CPT 97014 used for?

CPT 97014 - Electrical Stimulation (unattended)

CPT defines CPT Code 97014 as "Electrical Stimulation Unattended." CPT Code 97014 is a supervised modality. Supervised modalities are defined as the application of a modality to 1 or more areas, which does not require direct (one-on-one) patient contact by the provider.

Is CPT 97140 occupational therapy?

Occupational therapy services covered by CPT code 97140 include joint mobilization, soft tissue mobilization, manipulation, and lymphedema techniques often seen in but not limited to outpatient settings.

How do you bill for electrical stimulation physical therapy?

Functional Electrical Stimulation (FES) or Neuromuscular Electrical Stimulation (NMES) while performing a therapeutic exercise or functional activity may be billed as 97032. Do not bill for CPT codes 97110, 97112, 97116 or 97530 for the same time period.

Can CPT code 97012 and 97140 be billed together?

A good example of when to use modifier 59 would be chiropractic CPT code 97012 (mechanical traction) and CPT code 97140 (manual therapy). If these two treatments were performed on the same date of service, the modifier 59 would be appended to 97140 on the claim form.

Does 97140 need a modifier for Medicare?

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 ...

How do I know if a CPT is covered by Medicare?

Talk to your doctor or other health care provider about why you need the items or services and ask if they think Medicare will cover it. Visit Medicare.gov/coverage to see if your test, item, or service is covered • Check your “Medicare & You” handbook.

What is the Medicare modifier for 97140?

Interestingly, many insurance companies will pay for the 97140 code as long as it is billed with a '59' modifier. Use the 59 modifier (distinct procedural service) with the chiropractic CPT code 97140 when you perform manual therapy during the same encounter as a chiropractic adjustment.

How do I bill CPT 97140?

CPT® code 97140 is to be reported for each 15 minutes of manual therapy techniques provided to one or more regions. For example, if 30 minutes of manual therapy techniques were provided to one or more regions, code 97140 would be reported two times, one for each 15-minute interval.

Is 97140 a physical therapy code?

CPT® code 97140: Manual therapy techniques, 1 or more regions, each 15 minutes (Mobilization/manipulation, manual lymphatic drainage, manual traction) As the authority on the CPT® code set, the AMA is providing the top-searched codes to help remove obstacles and burdens that interfere with patient care.

Can you bill 97124 and 97140 together?

It's important to note that you can never bill 96523 or 97124 with 97140, because these codes represent mutually exclusive procedures.

What is the difference between CPT code 97032 and 97014?

Whether you charge unattended (97014 or G0283 for Medicare) or attended electrical stimulation (97032) depends upon how you provide the modality.

Is 97140 covered by Medicare?

Medicare covers multiple manual therapy techniques with proper documentation. Manual therapy is reported using CPT code 97140. CPT code 97140 – Manual Therapy Techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), 1 or more regions, every 15 minutes.

Does 97012 need a GP modifier?

Importantly, when reporting 97012 to BCBSNC, NC State Health Plan (SHP), MedCost, the Focus Plan, or any plan which utilizes Zelis edits, you must append 97012 with modifier GP.

Can you bill 97035 and 97014 together?

Ultrasound and Electrical Stimulation:

If ultrasound with electrical stimulation is provided concurrently, but did not require constant attendance by the provider, do NOT report 97035. Instead, bill 97014 (electrical stim unattended) or 97039 (unlisted modality) for the ultrasound, but do not bill for both procedures.

Can you bill 97110 and 97140 together?

In this instance, you would bill 2 units of 97110 and 1 unit of 97140. You count the first 30 minutes of 97110 as 2 full units. Then, compare the remaining time for 97110 (33-30=3 minutes) to the time spent on 97140 (7 minutes) and bill the larger, which is 97140. 18 minutes of therapeutic exercise, 97110.

What is the CPT code for electrical nerve stimulation treatment?

The correct CPT code to use for percutaneous electrical nerve stimulation and percutaneous neuromodulation therapy is the unlisted CPT code 64999.

Does CPT code 97140 need a GP modifier?

Importantly, when reporting 97140 to BCBSNC, NC State Health Plan (SHP), MedCost, the Focus Plan, or any plan which utilizes Zelis edits, and you are also billing a CMT code on the same date of service, you must append 97140 with modifier 59 and also modifier GP. (

Who can bill for 97140?

A chiropractic billing company can help providers bill their services correctly and get paid. Here, we are going to discuss how to bill CPT code 97140, manual therapy techniques, 1 or more regions, each 15 minutes (mobilization/manipulation, manual lymphatic drainage, manual traction).

How much is CPT code 97140 reimbursement?

For example, payment for therapeutic exercise (CPT code 97110) will drop by an average of 3.3%, from $31.40 in 2020 to $30.36 this year, with manual therapy (97140) seeing a similar percentage decrease, from $28.87 in 2020 to $27.91 in 2021.