As a physical therapist, ensuring accurate billing for the services you provide is crucial for maintaining cash flow and avoiding claim denials. One of the key codes used for physical therapy services is CPT code 97140, which refers to manual therapy techniques.
In this guide, we will discuss CPT code 97140, how to use it correctly for billing, and why accurate medical billing and coding are essential for proper reimbursement. By the end of this guide, you’ll have a clear understanding of how to apply the manual therapy CPT code 97140 to ensure your practice receives fair and timely reimbursement for services rendered.
What Is CPT Code 97140?
CPT code 97140 is used for manual therapy techniques that physical therapists use to treat musculoskeletal conditions. This code includes various hands-on interventions such as:
- Joint mobilizations
- Soft tissue mobilizations
- Myofascial release
- Manual stretching
The goal of manual therapy is to increase mobility, alleviate pain, and improve function by using physical touch and manipulation. This code applies when the therapist physically manipulates the patient’s muscles or joints to treat their condition.
Key Services Covered by CPT 97140
- Joint mobilizations: Passive movements applied to joints to improve motion and reduce stiffness.
- Myofascial release: A technique designed to release tension in the fascia (the connective tissue surrounding muscles) to relieve pain and improve movement.
- Soft tissue mobilization: Manual manipulation of soft tissues such as muscles and ligaments to relieve pain and tightness.
- Manual stretching: Hands-on stretching of muscles and tendons to improve range of motion.
How to Use CPT Code 97140 for Accurate Billing
1. Ensure Proper Documentation
Accurate documentation is crucial for using CPT code 97140. The following information should be included in the patient’s records:
- Patient’s condition: Document the reason for manual therapy, including the diagnosis or underlying condition.
- Treatment performed: Specify the type of manual therapy techniques used, such as joint mobilization or myofascial release.
- Duration and frequency: Record the duration of each session and the frequency of treatments provided.
- Patient response: Include notes on the patient’s progress, including improvements in range of motion or pain reduction.
2. Confirm Hands-On Involvement
Manual therapy CPT code 97140 is used for hands-on interventions. It’s important to ensure that the code is only applied when the therapist physically manipulates the patient. This code does not apply to passive activities or exercises performed by the patient independently.
For example, if the therapist provides manual stretching or myofascial release, the code is appropriate. However, if the session involves patient-performed stretches or exercises without therapist intervention, CPT code 97110 (therapeutic exercises) may be more appropriate.
3. Be Aware of Modifiers
Modifiers are often used in conjunction with CPT codes to provide additional details about the service. For CPT code 97140, the following modifiers may be relevant:
- Modifier 59: Used when the manual therapy service is distinct or separate from other procedures performed during the same session.
- Modifier GP: Indicates that the services were provided under the direction of a physical therapist.
Using the correct modifiers ensures proper billing and avoids confusion that can result in claim denials or delays.
Why CPT Code 97140 is Critical for Reimbursement
Accurate Billing and Fair Payment
Accurate use of CPT code 97140 helps ensure that your practice is reimbursed fairly for the time and expertise you invest in providing manual therapy services. Since manual therapy can be a time-intensive and highly skilled procedure, insurance companies and Medicare will rely on the CPT code to determine the reimbursement rate. Proper Revenue Cycle Management ensures that these codes are applied accurately, leading to faster payments and minimizing billing errors.
Incorrect or missing codes can lead to:
- Delayed payments: Claims may be returned for revision, delaying the reimbursement process.
- Underpayment: Failure to use the correct CPT code may result in lower reimbursement rates.
- Claim denials: Incorrect coding can lead to denied claims, requiring time and effort to resubmit.
Insurance Providers and Medicare Requirements
When submitting claims to insurance providers or Medicare, be sure to:
- Ensure that the manual therapy techniques are documented.
- Use the appropriate modifiers to reflect the distinct services provided during the visit.
- Verify that the services provided align with the CPT code to avoid denials.
By following these practices, your physical therapy practice can avoid mistakes that lead to payment delays or denials.
Best Practices for Using CPT Code 97140
1. Stay Updated on Code Changes
CPT codes are updated annually. Ensure that your billing staff stays informed of any changes to the code, such as revisions or new requirements, to ensure compliance and avoid errors.
2. Train Your Billing Staff
Your billing team should be well-trained in the proper use of CPT code 97140. Continuous training ensures they understand when and how to use the code correctly and how to apply it alongside the correct modifiers.
3. Usage
Partnering with a medical billing company that specializes in physical therapy billing can reduce the risk of errors. These professionals are experts in coding and can ensure that CPT 97140 is used appropriately, improving your claim accuracy and payment speed.
Conclusion
CPT code 97140 is essential for properly billing manual therapy services. By understanding how to use this code, ensuring accurate documentation, and staying updated on changes, you can avoid costly errors and improve your practice’s reimbursement rates.
For physical therapists looking to streamline their billing processes, consider working with a trusted medical billing company that specializes in physical therapy services. They can help you optimize your claims and maximize your revenue cycle efficiency.
FAQs
Q: How do I use CPT code 97140?
A: Ensure the therapist provides hands-on therapy and documents the techniques used, duration, and patient response. Use the correct modifiers where applicable.
Q: What modifiers should I use with CPT 97140?
A: Common modifiers include Modifier 59 (distinct procedural service) and Modifier GP (services provided under the direction of a physical therapist).
Q: How can I help with CPT code 97140?
A: A medical billing company ensures accurate coding, correct modifier use, and timely claim submissions, reducing errors and improving reimbursement.
Q: Why is CPT code 97140 important?
A: Correct use of CPT 97140 ensures proper reimbursement for manual therapy services and prevents claim denials and payment delays.
