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Trigger PT therapy 97140?

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dfranklin:
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:


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

dfranklin:
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:
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. 
 

dfranklin:
What modifier would you use to show the differentiation?

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