Wiki Dry Hydrotherapy, code 97039, but does it REQUIRE constant attendance?

[Dr675]

Some linear thinking:
Dry hydrotherapy requires the unlisted code 97039 to best reflect the actual service being done, as nothing else fits.
Code 97039 falls under the “constant attendance” section of the CPT codebook.
Therefore, if a provider is doing dry hydrotherapy and billing 97039 for it, do they need to be in constant attendance?

What would you need to see in the records to support this code for this service?

 

[renee dustman]

In an LCD:

Local Coverage Article:​

Billing and Coding: Outpatient Physical and Occupational Therapy Services (A56566)​

It says:

"CPT codes 97032, 97033, 97034, 97035, 97036, and 97039 require direct (one-on-one) contact with the patient by the provider (constant attendance). Coverage for these codes indicates the provider is performing the modality and cannot be performing another procedure at the same time. Only the actual time of the provider’s direct contact with the patient, providing services requiring the skills of a therapist, is covered for these codes."

Documentation Requirements for Unlisted Procedure Codes (97039, 97139, 97799, 29799)

"97039 - In addition to a detailed service description, information in the medical record submitted to the contractor must specify the type of modality utilized and, if the modality requires the constant attendance of the qualified professional/auxiliary personnel, the time spent by the qualified professional/auxiliary personnel, one-on-one with the beneficiary."

Check the LCD for your area. I imagine it says the same thing.