Chiropractic Coding & Compliance Alert

Published on Tue Sep 23, 2014 PDF

Question: Can we bill 97140 along with chiropractic manipulation done on the same date of service and to the same region? Please suggest.

Minnesota Subscriber

Answer: To get paid for 97140 (Manual therapy techniques [eg, mobilization/ manipulation, manual lymphatic drainage, manual traction], 1 or more regions, each 15 minutes), the provider should complete the therapy that should be on a different date of service and different region than chiropractic manipulation. Following this guideline allows you to differentiate the manual therapy technique from being considered a part of the chiropractic manipulation. Manual therapy may include services like myofacial release, joint mobilization or manual traction. 

As the CPT® position paper on 97140 states, “Under certain circumstances, it may be appropriate to additionally report CMT/OMT codes in addition to code 97140. For example, a patient has severe injuries from an auto accident with a neck injury that contraindicates CMT in the neck region. Therefore, the provider performs manual therapy techniques as described by code 97140 to the neck region and CMT to the lumbar region. As separate body regions are addressed, it would be appropriate in this instance to report both codes 97140 and 98940. In this example, the modifier -59 should be appended to indicate that a distinct procedural service was provided.” 

Only use modifier -59 (Distinct procedural service) in cases in which a different region of the body received the service. Otherwise, it will result in a refund or deduction from future payments.

You can use 97140-59 on an extra spinal body part in the same spinal region if documented as such in the notes (i.e. 98940-98924 used for a treatment of subluxation of the thoracic spine plus 97140-59 performed on the shoulder for 15 minutes).It is safer to stick to the different regions such as CMT, to Cervical, Lumber, Pelvic, Sacral and 97140-59 done in Thoracic region. Feet, hands etc. can be used. You must document location, technique and time to be paid for 97140.