The following discussion is intended to help PT/OT providers choose when using 97530 is appropriate with documentation examples. … Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. The appropriate billing in this example is 3 units. You should select 1 code (97112, 97110 or 97140) to bill since each unit was performed for the same amount of time and only 1 unit/1 code is allowed. What CPT codes Cannot be billed together?Īn example of a “permanent and non-bypassable” code combination (codes that can’t be billed together, even with a modifier) is: 97001 (Physical Therapy Evaluation) and 97002 (Physical Therapy Re-Evaluation) This code is reported in units of 15 minutes. … 97140 is used to describe therapy which increases active pain-free range of motion, increased extensibility of myofascial tissue and facilitates return to functional activities. …ĩ7124 is for increasing circulation and to promote tissue relaxation to the muscles. To be considered reasonable and necessary, the services must meet Medicare guidelines. Services that do not meet the requirements for covered therapy services in Medicare manuals are not payable using codes and descriptions as therapy services.
stretching of shortened connective tissue. require the dash 59 modifier appended to the 97124 code to clarify that it’s a distinct and separate procedure from the adjustment.
It’s important to note that you can never bill 96523 or 97124 with 97140, because these codes represent mutually exclusive procedures.ĭoes CPT code 97124 need a modifier? The following descriptors outline more detail about massage therapy.
If the care you provide meets the appropriate criteria, you can add modifier 59 to indicate it was a separate service and should be payable in addition to the 97140. CPT® code 97124 describes work including effleurage, petrissage and/or tapotement (stroking, compression, percussion), each 15 minutes. CPT® procedure code 97124 describes the work inherent in massage, which is a separate and distinct service from CMT codes 98940-98943.
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