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Physical Therapy Question

  1. #1
    Default Physical Therapy Question
    Medical Coding Books
    I am looking for the proper diagnosis codes and procedure codes for this patients physical therapy services. The report says that the patient is "status post hip replacement". That is the ONLY indication of any type of diagnosis. Would I used V57.1? And if so, what would the other diagnosis be to go along with that?

    As far as the CPT part of states that the services were performed by the PT assistant under the direction of the physical therapist. Patient had...
    15 min wirlpool therapy
    8 mins ice packs
    10 mins therapeutic massage.
    The codes I came up with are 97010, 97022, abd 97124. Would these be correct? Are there any modifiers? The 97124 states that it has to be done by the PT. The report states that it was done by the PT assistant. Is there another "therapeutic massage" code that can be used if it was done by the PT assistant?

  2. #2
    Phoenix, AZ
    Good morning,

    Your PTA is not treating the s/p hip replacement. He/she is working on the ROM, strengthening and pain or swelling. Use the dx on the evaluation report or ask the MD to give you a dx you can bill.

    PTAs can bill all the codes that a PT is allowed as long as they are supervised properly and have license/certificate as required by your state. So yes, the PTA may bill therapeutic massage. However, if you have massage therapists in your office, they should be billing 97124 exclusively. PT/PTAs should be billing Manual therapy. Check and make sure the PTA did therapeutic massage and not myofascial release. Myofascial release is billed with 97140. This is a timed code as is the massage code. Make sure the begin and end times are documented. If not, you cannot bill them. Greater than 8 mins per modality must be documented or you cannot bill them.

    You cannot bill for heat or ice packs. They are a non-billable code. Check your fee schedules.

    As to the whirlpool, as with the massage or manual therapy, this is a timed code. Begin and end times must be documented.

    For the 8 minute rule, check this APTA CPT guideline. It gives the CMS transmittal:

    Good luck
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

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