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Wiki Low-level laser
- Thread starter bhong
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code@home
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Coding for Low Level Laser
I had a couple of questions for billing using a low level laser. The S8948 does indicate a low level laser for 15 minutes in one or more area, however; the 97026 indicates infrared. Where the S code is the equipment and the 97026 is a procedure. I am just wondering how one would know which is actually the correct code to use. Some say to use the S code to decrease inflammation and then I have heard to use the 97110 which helps increase the ROM & muscle strength, (along with modifer 52 with each if you do not use the full 15 minutes). Can you help me to understand this and confirm which is actually correct? The chiropractor I bill for uses a low level laser equipment on his patients and we would like to know what to use for billing purposes for the use of this equipment and the procedure performed with it. Any help would be great. Thanks so much!! Lisa
I had a couple of questions for billing using a low level laser. The S8948 does indicate a low level laser for 15 minutes in one or more area, however; the 97026 indicates infrared. Where the S code is the equipment and the 97026 is a procedure. I am just wondering how one would know which is actually the correct code to use. Some say to use the S code to decrease inflammation and then I have heard to use the 97110 which helps increase the ROM & muscle strength, (along with modifer 52 with each if you do not use the full 15 minutes). Can you help me to understand this and confirm which is actually correct? The chiropractor I bill for uses a low level laser equipment on his patients and we would like to know what to use for billing purposes for the use of this equipment and the procedure performed with it. Any help would be great. Thanks so much!! Lisa
nataliecolby
New
From my understanding, don't use the 97026, that is light therapy. There is a difference between light therapy and low-level laser (cold laser) therapy. I am still learning about the low-level laser therapy, but I know not to use the 97026. Use the 97039. Some payers want the 97039 and some want the S8948.
Addition to my previous note above:
If you have received April 2010 Coding edge issue, there is an article that talks about the laser therapy. Title is "Common Chiropractic Coding Modality Errors". 97039 is the correct code for laser therapy.
According to the article when to use S8948, "IF the carrier has adopted HCPCS Level II private payer S codes into its code set, you would instead report cold laser therapy requiring constant attendance using S8948."
Again, referencing to the article, the difference between infrared therapy vs laser therapy.
"1) Infraraed is a supervised modality, whereas laser therapy in most cases requires constant attendance.
2) Infrared is a thermal/heating modality, whereas laser is not (unless a Class IV laser is used). The thermal aspect of infrared is not part of the code description; however, CPT Assistant--although not likely controlling--clarifies that infrared is a "Modality whihc uses light and heat to rinse the tissue temperature 5 to 10 degrees centigrade inthe area of application" "
Hope this helps.
Addition to my previous note above:
If you have received April 2010 Coding edge issue, there is an article that talks about the laser therapy. Title is "Common Chiropractic Coding Modality Errors". 97039 is the correct code for laser therapy.
According to the article when to use S8948, "IF the carrier has adopted HCPCS Level II private payer S codes into its code set, you would instead report cold laser therapy requiring constant attendance using S8948."
Again, referencing to the article, the difference between infrared therapy vs laser therapy.
"1) Infraraed is a supervised modality, whereas laser therapy in most cases requires constant attendance.
2) Infrared is a thermal/heating modality, whereas laser is not (unless a Class IV laser is used). The thermal aspect of infrared is not part of the code description; however, CPT Assistant--although not likely controlling--clarifies that infrared is a "Modality whihc uses light and heat to rinse the tissue temperature 5 to 10 degrees centigrade inthe area of application" "
Hope this helps.
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marcia butler
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97026
I have been using the 97026GP code (for Infrared) from our Therapy Dept. with payment from Medicare. On one resident, I was denied payment for not having a covered DX for this HCPC code. What are the DXs required for this HCPC code?
I have been using the 97026GP code (for Infrared) from our Therapy Dept. with payment from Medicare. On one resident, I was denied payment for not having a covered DX for this HCPC code. What are the DXs required for this HCPC code?