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Somatic Dysfunction

  1. #1
    Default Somatic Dysfunction
    Medical Coding Books
    How does one credit multiple areas of somatic dysfunction in an audit? Is it based on each location or as one disease as a whole? For example, a patient has 7 regions of somatic dysfunction (the head, each area of the spine, etc.) and each region has a separate diagnosis code. The provider then decides to do OMT on each area (cpt 98928). If this is an established problem that's improving, do you give 1 pt under Number of diagnoses and management options or 7 when trying to determine the MDM?
    Sue Vermette, CPC, CPMA

  2. #2
    Manhattan, NY
    Attached is a great description of documentation requirements for OMT CPTs. It's from the Journal of the American Osteopathic Association. If you are going to code a separate E/M with the OMT CPTs, you follow the same documentation guidelines per the E/M used. Documentation guidelines for OMT services are not the same as an E/M.

  3. #3
    Manhattan, NY
    Sue, here is NY CMS document. It gives more detail regarding documentation for some OMT CPTs.

  4. #4
    Sorry this is so late but thanks for the info!

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