Chiropractic care goes beyond spinal adjustments; it encompasses a spectrum of therapeutic procedures designed to enhance patients’ well-being. In the realm of chiropractic billing and coding, understanding the nuances of specific Current Procedural Terminology (CPT) codes is crucial. In this comprehensive guide, we’ll delve into the intricacies of five key chiropractic therapeutic procedures: CPT 97140, 97530, 97112, 97760, and 97750.
Here are some common chiropractic billing and coding requirements
1. CPT 97140 – Manual Therapy Techniques
CPT 97140 encompasses various manual therapy techniques employed by chiropractors to address soft tissue and joint restrictions. From massage and myofascial release to trigger point therapy, this code encapsulates the hands-on approaches that play a pivotal role in chiropractic care. Documentation should emphasize the specific technique employed and the areas targeted during the manual therapy session.
In Manual Therapy, there are various techniques involved:
- Soft Tissue Mobilization
- Strain-Counter Strain (aimed at correcting abnormal neuromuscular reflexes causing structural and postural issues, leading to painful ‘tender points’)
- Muscle Energy Technique (utilized to mobilize restricted joints and lengthen muscles)
- Joint Mobilization
- Joint Manipulation (involving high-velocity, low-amplitude thrusts designed to restore lost joint motion range)
This code is considered medically necessary if one of the following condition is present and documented:
» Cervical Radiculopathy
» Restricted joint motion of any region, peripheral or spinal
» As an adjunct to therapy exercises when a patient cannot perform these exercises due to loss of joint motions
» As an adjunct to other therapy (CPTs 97110, 97112, 97530)
» Myofascial release or soft tissue mobilization on 1 or more regions of the body
» Skilled manual techniques applied to soft tissue to treat conditions of soft tissues, articular structures, neural or vascular systems
Example: “Patient received a 15-minute session of manual therapy (97140) focusing on myofascial release for lumbar spine restrictions.”
2. CPT 97530 – Therapeutic Activities
When chiropractors engage patients in dynamic activities to improve functional abilities, CPT 97530 comes into play. This code covers a spectrum of therapeutic exercises, ranging from range of motion exercises to neuromuscular reeducation. Precise documentation should outline the type, duration, and purpose of each therapeutic activity performed.
Therapeutic Activities often focus on mobility, strength, balance, and coordination as their main objectives. Types of Activities that are included:
- Bending
- Pulling
- Twisting
- Lifting
- Carrying
- Catching
- Overhead activities
This code is considered medically necessary if one of the following condition is present and documented:
- Therapeutic activities (CPT 97530) are deemed medically necessary for patients requiring a broad range of rehabilitative techniques involving movement.
- Encompasses a diverse set of techniques designed to enhance movement in either a single body segment or multiple body regions.
- Activities typically target issues related to the loss or restriction of mobility, strength, balance, or coordination.
- Requires the professional skills of a therapist and is tailored to address a specific functional need of the patient.
- These dynamic activities must be an integral part of an active treatment plan and directed toward achieving a specific outcome.
Example: “Conducted a 20-minute session of therapeutic exercises (97530) targeting lumbar flexibility and core stability.”
3. CPT 97112 – Neuromuscular Reeducation
Focused on the restoration of normal movement patterns, CPT 97112 involves neuromuscular reeducation techniques. Chiropractors employ this code when guiding patients through exercises that enhance coordination, balance, and proprioception. Thorough documentation should highlight the specific neuromuscular activities and the areas addressed during the session.
In Neuromuscular Reeducation, there are various techniques involved:
» Proprioceptive neuromuscular facilitation (PNF) techniques:
- Hold Relax
- Contract Relax
- Hold Relax with agonist contraction
» Postural reeducation
» EMG feedback
» Desensitizing techniques
» Balance exercises
» Stability Exercises
» Kinesthetic training
» Movement Reeducation
Example: “Administered a series of neuromuscular reeducation exercises (97112) to improve proprioception and balance in the cervical spine.”
4. CPT 97760 – Orthotic Management and Training
Orthotic management and training fall under CPT 97760, encompassing the assessment, design, and fitting of orthotic devices. Chiropractors may utilize this code when providing guidance on orthotic use or customizing orthotic devices to address musculoskeletal conditions. Documentation should detail the nature of orthotic management and the specific devices involved.
Assessment Includes:
- Physical capabilities
- Level of amputation
- Psychological status
- Patient’s expectation
- Complete Gait analysis
The medical necessity of 99760 are established under the following conditions:
- Presence of a clear indication for the proper use and application of orthotics.
- Documentation of the functional use of the orthotics.
- Application of distinct treatment procedures for both upper and lower extremities.
Example: “Conducted a comprehensive assessment and fitting session for lumbar orthotic support (97760) to address the patient’s lower back pain.”
5. CPT 97750 – Physical Performance Test or Measurement
CPT 97750 involves the administration and interpretation of standardized tests or measurements to assess physical performance. Chiropractors may utilize this code when evaluating a patient’s functional abilities, such as gait analysis or strength testing. Documentation should clearly outline the specific tests performed and the results obtained.
Assessment includes:
- Activities of daily living (ADLs)
- Instrument activities of daily living (IADLs)
- Aerobic capacity
- Equilibrium and balance
- Cognition
- Dexterity
- Functional mobility
- Occupational performance
CPT code 97750 is not covered on the same day as CPT codes 97001-97004 (due to CCI edits). This code can be billed in 15-minute increments.
Example: “Performed a series of physical performance tests (97750) to assess the patient’s lower extremity strength and mobility.”
Navigating Proper Documentation for Chiropractic Therapeutic Procedures
Effective documentation is required in the accurate billing and coding for chiropractic therapeutic procedures. Chiropractors should prioritize:
- Specificity: Clearly delineate the techniques, exercises, or tests performed.
- Duration: Record the time spent on each therapeutic procedure.
- Clinical Rationale: Articulate the therapeutic goals and how each procedure contributes to patient care.
Related Articles:
Is It Chiropractic CPT Code 97014 Or 97032 Or HCPCS G0283? Understanding This Coding Confusion
The ‘Tricky’ 97140 Chiropractic CPT Code: How to Use This Code Appropriately
Know the Top Chiropractic CPT Codes That Can Save Your Billing Time
