What Is The 97140 CPT Code? Do You Know About It Correctly?

What is the 97140 CPT code? Do you know about it correctly? Don’t lose your reimbursement if you don’t know all the aspects of it.

Table of Contents

CPT code is a complex task, But We make it easy for you Now.

CPT code 97140 is a billing code used to describe manual therapy techniques performed by qualified healthcare professionals, primarily physical therapists, and occupational therapists.

This code is specifically designated for hands-on treatments aimed at improving patient function, reducing pain, and enhancing mobility,

What is the Correct Description of CPT Code 97140?

According to the American Medical Association (AMA), CPT code 97140 refers to the application of manual therapy techniques to one or more regions of the body, with each unit representing 15 minutes of direct patient care. The types of manual therapy techniques covered under this code include:

Joint mobilization and manipulation
Manual lymphatic drainage
Manual traction
Soft tissue mobilization
Myofascial release
Trigger point therapy

These techniques are utilized to assess, measure, or manipulate areas of the body to enhance functional performance or manage pain effectively.

4 Essential Key Features of CPT Code 97140 You Should Know Before Claiming:

Time-Based Billing: Each unit of CPT code 97140 corresponds to 15 minutes of direct patient care. To qualify for billing, therapists can bill for this code in increments, meaning that at least 8 minutes of manual therapy must be performed within that 15-minute block.
Application: This code is utilized for one or more regions of the body and is essential for documenting therapeutic interventions that aim to alleviate pain, enhance mobility, and improve overall function
Documentation Requirements: Accurate documentation is crucial for billing this code. Therapists must clearly outline the medical necessity of the treatment and how it contributes to the patient’s functional improvement. This includes detailing the techniques employed and the duration spent on each.
Combination with Other Codes: CPT code 97140 can often be billed alongside other therapeutic codes, such as those for therapeutic exercises (CPT 97110) or gait training (CPT 97116), as long as they represent distinct services

What is the 97140 CPT code reimbursement?

Typically, the reimbursement rate for CPT code 97140 varies slightly depending on the payer and geographical location.

However, according to standard Medicare reimbursement policies, the typical reimbursement rate for CPT code 97140 is generally around $28.87 per unit, as shown in recent publications and calculators available online

The Essential part of the 97140 code you know about is Common Modifiers for CPT Code 97140

Modifier GP
- This modifier indicates that a physical therapist delivered the services. It is mandatory for Medicare claims and is frequently utilized by other insurers as well
Modifier GO
- This modifier is used when an occupational therapist delivers the services. It helps specify the type of provider administering the manual therapy.
Modifier KX
- This modifier is applicable when the services exceed Medicare’s therapy cap but are still deemed medically necessary. It indicates that the provider has determined the services are reasonable and necessary for the patient’s condition.
Modifier 59
- This modifier can be used when CPT code 97140 is performed in a separate and distinct 15-minute increment from other manual therapy codes or procedures during the same session. It helps prevent bundling of services that should be billed separately.
Modifier 97
- This modifier indicates that manual lymphatic drainage was part of the manual therapy services provided, which is particularly relevant when billing for specialized techniques.

What is the Importance of Modifiers?

Using the appropriate modifiers with CPT code 97140 is crucial for:

Accurate Billing: Ensuring that insurance claims are processed correctly and reimbursed without denial.
Clarifying Services Provided: Providing payers with additional information about the nature of the services rendered, which can be essential for justifying claims.
Avoiding Bundling Issues: Preventing bundling of services that are distinct, thus ensuring that each service performed is compensated appropriately.

How many documents are Required in the 97140 CPT Code?

To support the use of these modifiers effectively, thorough documentation must accompany claims:

Document the medical necessity for manual therapy.
Specify techniques used and body regions treated.
Track time spent on each service accurately to support billing increments.

By understanding and applying these modifiers correctly, healthcare providers can enhance their billing accuracy for CPT code 97140, ensuring they receive appropriate reimbursement for their services while complying with payer requirements.

Experience Hassle-Free Health Claims with Vital Health Services: Fast, First-Class Solutions to Save You Time and Reduce Anxiety!

Benefits of Our Services at Vital Health:

Fast Claims Processing: Get your health claims submitted and processed quickly, so you can focus on what matters most—your recovery.
Expert Support: Our knowledgeable team is here to guide you through every step, ensuring you understand the process and receive the benefits you deserve.
Time-Saving Solutions: We streamline the billing process, allowing you to spend less time on paperwork and more time on your health and well-being.
Reduced Stress: Let us handle the complexities of health claims, alleviating the anxiety that often comes with medical billing.
Maximized Benefits: We work diligently to ensure that you receive the maximum reimbursement possible, helping you make the most of your health insurance.
Personalized Service: Our approach is tailored to meet your unique needs, ensuring you receive the best care and support throughout your experience.
Comprehensive Coverage: We assist with a wide range of health services, making it easy to manage all your claims in one place.
Peace of Mind: With our reliable services, you can feel confident that your health claims are in good hands, allowing you to focus on recovery.
Transparency: We provide clear communication and updates on your claim status, so you’re never left in the dark about your billing.
Ongoing Support: Our commitment to your health doesn’t end with the claim—our team is always here to assist with any questions or concerns you may have.