What is CPT 97140 billing guidelines?
Asked by: Don Harris | Last update: December 30, 2023Score: 4.4/5 (42 votes)
CPT code 97140 covers manual therapy techniques such as soft tissue and joint mobilization, manipulation, manual lymphatic drainage, and manual traction.
What is CPT code 97140 manual therapy?
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.
Who can perform CPT code 97140?
According to the edits, chiropractors must be paid for manual therapy (97140) when performed on separate anatomic sites or at separate patient encounters on the same date of service as a chiropractic manipulative treatment (98940—98942).
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. (
What modifier is needed for 97140?
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 modifier.
CPT Code 97110 vs CPT Code 97530 | Medicare Billing & Documentation
Is CPT 97140 massage therapy?
CPT code 97124 is more so directed at massage therapy, while 97140 is actually for manual therapy. When using either of these massage therapy billing codes, be sure to cite these exact treatment procedures in your claim to ensure coverage.
Does Medicare cover 97140?
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.
What is CPT code 97140 with example?
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.
When should GP modifier be used?
The GP modifier indicates that a physical therapist's services have been provided. It's commonly used in inpatient and outpatient multidisciplinary settings. It's also used for functional limitation reporting (FLR), as physical therapists must report G-codes, severity modifiers, and therapy modifiers.
Do you use 59 modifier on 97140 or 97530?
The use of the 59 modifier indicates to the insurance company that each of the services was deemed medically necessary and performed independently of all others. For example, if the therapist bills for manual therapy (97140) and therapeutic activities (97530), in the same session, the 59 modifier is used.
Can you bill 97140 for dry needling?
Absent a specific payer policy, the use of CPT code 97140 for the performance of dry needling should not be utilized.
What can be billed under manual therapy?
97140 Manual Therapy
Sessions that can be billed under this physical therapy CPT code can cover joint mobilization, soft tissue mobilization, muscle energy techniques, manual traction, and manual lymphatic drainage.
What is the difference between 97530 and 97140?
Code 97140 is for manual therapy techniques which do not require active participation of the patient (e.g., soft tissue mobilization, manual lymphatic drainage, manual traction). Code 97530 describes dynamic activities which require patient participation (e.g., throwing, lifting).
Can you bill 97140 and 97161 together?
Yes. It's possible to bypass the edit by using the 59 modifier/X modifier when billing 97140 with the physical therapy evaluation codes (97161, 97162, or 97163). If you don't use the modifier for this combination of codes, CMS will deny the manual therapy code.
What does modifier GP stand for?
Modifier GP: Services delivered under an outpatient physical therapy plan of care.
What is the difference between go and GP modifier?
GO – Service delivered personally by an occupational therapist or under an outpatient occupational therapy plan of care. GP – Service delivered personally by a physical therapist or under an outpatient physical therapy plan of care.
Which modifier should go first?
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.
What are the three example sections of the CPT manual?
- Evaluation and Management.
- Anesthesiology.
- Surgery.
- Radiology.
- Pathology and Laboratory.
- Medicine.
Can you bill CPT 97140 and 97012 together?
Modifier 59
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.
What is CPT code 97112 and 97140?
The reviews involve providers billing CPT codes 97110 (Therapeutic exercises), 97112 (Neuromuscular reeducation), 97140 (Manual therapy techniques), and 97530 (Therapeutic activities.)
How do you bill 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 physical performance test?
Physical Performance Test or Measurement - CPT Code 97750.
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.