PURPOSE:Certain CPT Codes Require the Provider, Or the Staff That Is Providing the Service

PURPOSE:Certain CPT codes require the provider, or the staff that is providing the service to not only document the procedure that was performed and the area of the body it was performed on, but also the exact number of minutes required to perform theprocedure.

PROCEDURE:

• CPT Guidelines considers 15 minutes with one-to-one treatment equal to 1 unit of these procedures.
• CMS Guidelines allows for rounding to the nearest 15 minute interval (ex. 8-22 minutes would be equivalent to 1 unit).
• CMS Guidelines also allow combining services to reach a total number of units (i.e., 5 min of 97140 in addition to 7 min of 97110 would constitute one unit of 97110).
• Each carrier has its own policy, which must be reviewed to ensure proper coding.

97110 – Therapeutic Exercises, 1 or more areas, each 15 minutes.

• Treatment goals include: improved, strength, endurance, range of motion or flexibility
• Documentation:
• Specific procedure or exercise performed.
• Time required specifically for each procedure or exercise.
• Time is measured in units
• Document clock time and total minutes
• Area of the body affected.

97112 – Neuromuscular Re-education, 1 or more areas, each 15 minutes.

• Some carriers consider neuromuscular re-education as part of the normal office visit procedure and do not allow separate billing of this procedure.
• If it is performed on the same region as spinal manipulation, the service is included as part of the office visit and cannot be billed separately.
• If it is performed on a different region of the body, but on the same day as spinal manipulation, it may be billed separately with a -59 modifier.

• Treatment goal: Improve balance, coordination, kinesthetic sense, posture and/or proprioception for sitting and/or standing activities.
• Documentation:
• Specific procedure or exercise performed.
• Time required specifically for each procedure or exercise.
• Time is measured in units
• Document clock time and total minutes
• Area of the body affected.

97124 – Massage Therapy

• Treatment goals include: Increased circulation, increased relaxation, decreased pain, decreased muscle spasm, increased range of motion, increased flexibility, and/or decreased scar tissue.
• Some carriers consider massage therapy as part of the normal office visit procedure and do not allow separate billing of this procedure.
• If it is performed on the same region as spinal manipulation, the service is included as part of the office visit and cannot be billed separately.
• If it is performed on a different region of the body, but on the same day as spinal manipulation, it may be billed separately with a -59 modifier.
• Documentation:
• Specific procedure or technique utilized
• Time required specifically for each procedure
• Time is measured in units
• Document clock time and total minutes
• Muscle groups affected

97140 – Manual Therapy

• Treatment goals include: Decreased pain, decreased muscle spasm, increased range of motion, increased flexibility, and/or decreased scar tissue.
• Some carriers consider manual therapy as part of the normal office visit procedure and do not allow separate billing of this procedure.
• If it is performed on the same region as spinal manipulation, the service is included as part of the office visit and cannot be billed separately.
• If it is performed on a different region of the body but on the same day as spinal manipulation, it may be billed separately with a -59 modifier.
• Documentation:
• Specific procedure or technique utilized.
• Time required specifically for each procedure.
• Time is measured in units
• Document clock time and total minutes
• Muscle groups affected.