Basics of 97140 CPT code
Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy helps in improving joint mobility, alignment, tissue repair, lymphatic drainage, and traction. Below is description of 97140 CPT code.
97140 Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes
A qualified health care provider performs manual therapy techniques including, but not limited to, soft tissue and joint mobilization, manipulation, manual traction, and/or manual lymphatic drainage to one or more areas. This code requires direct contact by a qualified health care provider with the patient and is billed in 15-minute units. This is a time-based code and for each 15 minutes of therapy, at least 8 minutes of face-to-face therapy must be provided to be able to report one unit.
Manual therapy techniques include, but are not limited to, connective tissue massage, joint mobilization and manipulation, manual lymphatic drainage, manual traction, passive range of motion, soft tissue mobilization and manipulation, and therapeutic massage. These manual services are performed by qualified health care professionals, who use their hands to administer these techniques. In addition, the parenthetical note under code 97124 specifically instructs that code 97140 should be reported for myofascial release.
According to the edits, chiropractors must be paid for manual therapy (97140) when performed on separate anatomic sites or at separate patient encounters on the same date of service as a chiropractic manipulative treatment (98940—98942).
Modifiers Used with 97140 CPT code
Interestingly, many insurance companies will pay for the 97140 code as long as it is billed with a ’59’ modifier. Use the 59 modifier (distinct procedural service) with the chiropractic CPT code 97140 when you perform manual therapy during the same encounter as a chiropractic adjustment. The 59 modifier instructs the insurance payer’s software not to “bundle” the two procedures together, preventing the denial of your payment. If the manual therapy is not completed for a complete 15-minute unit, you must report it as a reduced service by adding a second modifier 52 to 97140 chiropractic CPT code. You should reduce the price for this procedure by one-half of the fee you charge for the full 15-minute session.
If you perform manual therapy (97140) and chiropractic manipulative treatment (a spinal adjustment) on the same region during the same office visit, your insurance payer might not reimburse you for the 97140 code. For instance, if you are doing the CMT (98940-98942) in the lumbar region of the patient and also doing the 97140 services in the lumbar region, the payer will bundle these two services and 97140 will not be paid.
Manual therapy (97140) and a chiropractic adjustment can be performed on the same area of the patient on the same date of service. And, still, your practice can get paid for these two services. It needs to be two separate encounters.
For example, if a physical therapist in your clinic performed the adjunctive physiotherapy procedure and a chiropractor performed the adjustment, it would qualify as a separate patient encounter. This rule includes only licensed providers, such as chiropractors, physical therapists, and massage therapists.
Reference:
https://myzhealth.io/blog/the-tricky-97140