Medical Billing Forum

Coding => Coding => Topic started by: teddyditt on June 10, 2010, 09:03:35 AM

Title: Massage Therapy codes for chiropractors
Post by: teddyditt on June 10, 2010, 09:03:35 AM
I work for a chiropractor who will not buy a new coding book. Therefore, I have an issue occasionally with codes. The one I need help with now is 97124, which he uses for Massage Therapy. I am getting it denied through major medical insurance. I am wondering if 97140, which is also a massage therapy code is better. Thanks Jan
Title: Re: Massage Therapy codes for chiropractors
Post by: DMK on June 10, 2010, 10:31:22 AM
Both codes work, but they are for different things.  A -59 modifier indicates it's a separate service from the chiropractic adjustment.  97124 is for an actual massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)  We use this for trigger point therapy or A.R.T. performed by the doctor (1 unit) and for massage done in office by our therapist prior to the doctor adjusting.  (30 minutes is 2 units, 60 minutes is 4 units)

97140 Is Manual Therapy techniques.  You'll probably have to indicate what was done with treatment notes attached to the claim.  We've run into certain policies completely disallowing 97140 because it's vague.

Be sure you include a diagnosis indicating there is muscle spasm or myofasciitis.

Good luck!
Title: Re: Massage Therapy codes for chiropractors
Post by: PMRNC on June 10, 2010, 11:32:13 AM
He WON'T buy an updated coding book?  What if you told him you couldn't do the billing because you don't have an up -to-date coding book!
Title: Re: Massage Therapy codes for chiropractors
Post by: Pay_My_Claims on June 10, 2010, 01:43:32 PM
He WON'T buy an updated coding book?  What if you told him you couldn't do the billing because you don't have an up -to-date coding book!

amen on that
Title: Re: Massage Therapy codes for chiropractors
Post by: teddyditt on June 10, 2010, 02:21:22 PM
I would love to do this on my own, but I don't have the connections. He doesn't like to spend money at all. I am stupid and have found websites that I can check codes. He knows that I can do that now. :-(
Title: Re: Massage Therapy codes for chiropractors
Post by: oneround on June 10, 2010, 03:30:08 PM
Although many of these fourms offer excellent advice you should never put your entire trust into websites and or fourms.  Remember most of these offer just others opinions and even after you receive advice and/or an opinion you still want to get into the habit of researching and clarifying the information that was given to you on your own.  It's always good to have hard copy material at your finger tips.  In this business, in order to make a dollar you have to be willing to spend a dollar so from an compliance standpoint I see a whole lot of risk factors here by your provider not wanting to to have up to date information.  And no you are not stupid, because it was intelligence that lead you pose your statement out here.  So as far as your provider, they may not want to fork over what, 160-200 for a complete coding booklet case but heck argue the point, having the most update date information at your fingure tips not only allows for prompt, accurate claims coding and billing, but it also prevents those hefty fines that can be placed on your provider for any unbundling, upcoding and or fraud issues.
Title: Re: Massage Therapy codes for chiropractors
Post by: DMK on June 10, 2010, 03:48:21 PM
Yes, yes, and yes.  I get a little frustrated when there's a "new" code book every year, but I think you may be able to convince the doctor that the more correct his coding, the more likely he'll get paid on time and correctly.

You may even want to get, at minimum, a CPT book to cover your own behind!  You are liable for the billing that goes out.
Title: Re: Massage Therapy codes for chiropractors
Post by: PMRNC on June 10, 2010, 09:11:59 PM
Quote
but it also prevents those hefty fines that can be placed on your provider for any unbundling, upcoding and or fraud issues.

MOST billers are not clued into this..but being an employee does NOT protect you. If the provider gets in trouble and you are billing.. you are getting in trouble as well the liability is EQUAL and does not discrimate. The law is worded so that the biller is supposed to know. Look at many past convictions and you will see the office manager right there with them.   Employee or not, I would tell him, I cannot and will not code without proper and up to date materials.. period, tell him you are protecting YOURSELF and him.