Author Topic: Trigger PT therapy 97140?  (Read 4529 times)

dfranklin

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Trigger PT therapy 97140?
« on: July 08, 2010, 03:20:49 PM »
My Chriopractor is doing trigger pt therapy - that is the therapy and they have been using 97140 (manual therapy) but it gets bundled and not paid. My provider is wondering:
 
What code should be used.
 
97124 - massage
97250 myofascial release - sound right but I thought this was PT only code (not to be used by chiro) dont know about that one - let me know
or 97140 - manual therapy
 
If I did bill it wrongly - can we correct and rebill. (now that thye have denied/bundled the other way as 97140) or will that seem wrong somehow.
 
Thanks for your help!

oneround

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Re: Trigger PT therapy 97140?
« Reply #1 on: July 08, 2010, 05:16:29 PM »


df, not sure what the code is getting bundled into but I did come across this in med Assets if it helps

Code 97140, Manual therapy techniques (eg, mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes, would be reported for the soft tissue mobilization to the cervical, thoracic, and lumber spine for a total aggregate time of 25 minutes. Since this is a time-based code, it should be reported twice (or two units) to indicate that the soft tissue mobilization procedure was performed for 25 minutes. A substantial portion of 30 minutes was utilized performing this procedure, therefore it is appropriate to bill two units of this code. A modifier is not required. If the manual therapy provided takes a minor portion of 15 minutes, the provider should either not bill the second service unit (eg, manual therapy for 17 minutes should be billed as one unit) or utilize modifier ‘52’ to accurately describe the service rendered. Although this reporting method reflects the intent of CPT, third-party payers may request that these services be reported differently. It is best to contact your third-party payer for specific reporting guidelines. Coding should not be determined based on number of minutes spent per body part but rather the total aggregate time
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

dfranklin

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Re: Trigger PT therapy 97140?
« Reply #2 on: July 08, 2010, 05:48:31 PM »
Thanks!

It is getting bundled with 98940 or 98941.  I have never seen the provider show 2 units only one.  I usually see it marked down with somewhere between 5 or 10 minutes for 97140 on the chart note.   Is it appropriate that they are paying 97140 within 98940(1)? 

oneround

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Re: Trigger PT therapy 97140?
« Reply #3 on: July 08, 2010, 06:25:32 PM »
I am catching an edit when billing the 97140 with the other codes but I am seeing that a mod. is appropriate on the 97140 to support the unbundled service is documentation does support it.  But I'm not catching where they unbundling is valid without that mod.  I'd be interseted in hearing other thoughts or findings on this


Code / Description 
98941  CHIROPRACTIC MANIPULATION M  Rel Wt: 0.38   
 
 
No bundling issues exist 
97140  MANUAL THERAPY M  Rel Wt: 0.00   
 
 
Code 97140 is a component of Column 1 code 98941 but a modifier is allowed in order to differentiate between the services provided. 
 
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

dfranklin

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Re: Trigger PT therapy 97140?
« Reply #4 on: July 08, 2010, 06:34:00 PM »
What modifier would you use to show the differentiation?

oneround

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Re: Trigger PT therapy 97140?
« Reply #5 on: July 08, 2010, 06:51:03 PM »
Please remember df, Dr's documentation has to support the 59 mod


97140, Manual therapy techniques (eg), mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes, separately when chiropractic manipulation techniques (CMT)–– CPT codes 98940-98943––are provided at the same session? AMA Comment: From a CPT coding perspective, CPT code 97140 is not intended to include CMT. The appropriate CMT procedure code(s) should be reported for those manipulation techniques. Since it is possible that manual therapy technique(s) may be required in addition to CMT procedure(s), it is appropriate to additionally report the manual therapy technique(s) (based on 15-minute intervals of service). For example, manual traction is performed to treat a cervical spine injury and on the same day the chiropractor also performs chiropractic manipulation to the lumbar region. Therefore, code 97140 with modifier 59 and code 98940 should be
reported.

" CPT® Assistant February 1999 Volume 9 Issue 2 "Question Can my doctor report the new CPT code 97140 for manual therapy techniques, when he performs a chiropractic manipulative treatment (CMT), or has this code been developed for use by physical therapists and occupational therapists only? AMA Comment Code 97140 Manual therapy techniques (eg, mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes, does not describe chiropractic manipulative treatment. Chiropractic manipulation (CMT) is described by codes 98940 - 98943. From a CPT coding perspective, in certain circumstances it may be appropriate to report CMT or osteopathic manipulative treatment (OMT) procedures and CPT code 97140. For example, if separate body regions are being addressed by different techniques, then it is appropriate to report these services separately. For example, a patient has severe injuries (such as an auto accident) with a neck injury that contraindicates CMT in the neck region. Therefore, the provider performs manual therapy techniques (as described by CPT code 97140) to the neck region and CMT to the lumbar region. In this case, it would be appropriate to report CPT codes 97140 and 98940. In this example the -59 modifier would be used to indicate that a distinct procedural service was provided. " CPT® Assistant February 1999 Volume 9 Issue 2 "Question Can the new code 97140 (manual therapy techniques) be reported in conjunction with the chiropractic manipulative treatment (CMT) codes (98940 - 98943)? AMA Comment It would not be appropriate to report code 97140 and the CMT code when provided to the same region. However, under certain circumstances, it would indeed be appropriate to report code 97140 and a code from the 98940 98940 98941 98942 - 98943 series to describe the treatment provided. For example, a patient may have severe injuries that contraindicate CMT to the neck region, therefore, the provider performs other manual therapy techniques (as described by code 97140) to the neck region. CMT is provided to the lumbar region. In this case it would be appropriate to report code 97140 for the therapy to the neck, and code 98940 for the CMT to the lumbar region. The –59 modifier would appended to indicate that distinct procedural services were provided. "



Also, you may already be aware but just in case a good chiro source is chirocode.com.  Hope this helped and if there is something I can take home with this please share
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

dfranklin

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Re: Trigger PT therapy 97140?
« Reply #6 on: July 08, 2010, 08:33:34 PM »
Thank You!!!