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Therapeutic procedure coding

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cconter:
Can someone explain the difference between 97530 (therapeutic activities) and 97110 (therapeutic procedure).  A clinician at Optum Health said that one is used for when the patient performs exercises in our office (chiropractic office) and the other is for when the D.C. instructs and demonstrates exercises to the patient.  That didn't sound quite right.  Thanks!!

Michele:
I'm not a PT or a DC, but that doesn't sound right to me either.  And it doesn't coincide with the billing/coding I've done for both those provider types.  Both codes are physical medicine codes and any provider qualified to perform them can use them.  Neither are specific to a type of provider.

Michele

cconter:
 Michele, Can you explain the difference between the two codes?... i.e. what instance each one is used for?  Many thanks, Cindy

Michele:
Not being a physical medicine provider, I really don't know the difference.  I do know that my providers (PT's, DO's, & DC's) use them distinctly indicating to me they are different from each other and they know exactly what each one is.

I would ask your provider to explain it to you.  Tell them you need to understand to appeal with the insurance carrier.


Michele
 

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