Coding Clarification
Coding Clarification: Proper Use of Testing and Measurement CPT? codes: 95831, 95832, 95851, and 95852
The American Chiropractic Association fields numerous questions concerning CPT codes 95831 and 95832, Muscle testing, manual, and CPT codes 95851 and 95852, range of motion measurements, and report. Questions relate to when it's appropriate to bill these codes in conjunction with other CPT codes such as E/M codes or Chiropractic Manipulative Treatment (CMT) codes. Recent software edits in place for the Medicare Correct Coding Initiative (CCI) state that the above testing and measurement codes are "Mutually exclusive" with CMT codes.
There may be some instances that coding CPT 95851 or 95852 may be necessary. This would predominately occur in an impairment rating of the patient. From CPT coding guidelines, code 95851, Range of motion measurements and report (separate procedure); each extremity (excluding hand) or each trunk section (spine), is intended to report range of motion measurements. CPT code 95851 may be reported for each extremity (excluding hand) measured or for each trunk section measured (e.g. cervical, thoracic, lumbar) or for CPT code 95852 for the hand. The physician's interpretation of the results, with preparation of a separate, distinctly identifiable, signed, written report is also required when reporting CPT 95851 or 95852.
CPT codes 95831, 95832, 95851, and 95852 are designated as "separate procedures." Therefore, if in the process of performing the work described in E/M CPT codes 99201 through 99205 and CPT codes 99212 through 99215, the physician also performs the work described in CPT codes 95831, 95832, 98951, or 95852, then it would not be appropriate to report those codes in addition to the E/M service.
This document was developed by the ACA Coding and Reimbursement Committee. For additional information about this or any other coding matter, please contact the ACA's Office of Professional Development and Research at 800-986-4636.
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