Question: Is 97012 A Timed Code?

Regardless of whether you spend 10, 20, or 30 minutes assisting a patient with mechanical traction (CPT 97012), you can only bill 1 unit. On the other hand, manual therapy is a ‘timed’ treatment code, and you may bill 2 units (15 mins each). And this should shed some light on how to document time for Medicare patients.

What does CPT code 97012 mean?

From a CPT® coding perspective, 97012 is a physical medicine mechanical traction modality that does not require attendance.

Is iontophoresis a time-based code?

The following codes are timed codes: 97032 – Electrical Stimulation (Manual) 97033 – Iontophoresis. 97035 – Ultrasound.

Is 97012 a physical therapy Code?

The Current Procedural Terminology (CPT®) code 97012 as maintained by American Medical Association, is a medical procedural code under the range – Supervised Physical Medicine and Rehabilitation Modalities.

Does Medicare pay for 97012?

Services that do not meet the requirements for covered therapy services in Medicare manuals are not payable using codes and descriptions as therapy services. To be considered reasonable and necessary, the services must meet Medicare guidelines.

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Does 97012 need a modifier?

Whether it’s 97012 or 97140, by appending the 59 modifier, you will ensure that you receive reimbursement for both services.

What is the 8 minute rule?

A therapist must provide direct one-to-one therapy for at least 8 minutes to receive reimbursement for a time based treatment code. When only one service is provided in a day, you shouldn’t bill for services performed for less than 8 minutes.

What is a timed CPT code?

What are time-based CPT codes? Time-based (or constant attendance) codes, on the other hand, allow for variable billing in 15-minute increments. You would use these codes for performing one-on-one services such as: therapeutic exercise (97110) manual therapy (97140)

Is estim a timed code?

CPT 97014/G0283 is appropriate for pad-based e-stim, which requires supervision only. Although this is not a time-based service, accepted protocols require 15 minutes to as much as 30 minutes of treatment.

Is diathermy a timed code?

Common services in this category include unattended electrical muscle stimulation, mechanical traction, diathermy, or hot and cold packs. The distinction here is that these services are not timed-based for billing, and may only be billed once per patient encounter, regardless of the number of applications.

Is 97039 a timed code?

97039: Attended Modality, Unspecified Reimbursement is good because it is understood to take more time than an unattended code. The problem with the code is that, being unspecified, it is occasionally rejected by some insurance carriers or hand audited.

What is the modifier for CPT 97140?

CPT code 97140 is appended with the modifier -59 or the appropriate –X modifier.

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Does Medicare pay for CPT 97026?

Medical Necessity Of CPT Code 97026 Infrared application applied in the absence of associated procedures or modalities, or used alone to reduce discomfort, are considered not medically necessary and therefore, are not covered.

Does 97140 need a modifier?

Obviously when interim or final exams are completed, you need to use the appropriate EM code with modifier ie. Code 97140 is time -based [15 minutes] and replaced codes 97122-manual traction; 97250-myofascial release / soft tissue manipulation; 97260-61 -spinal manipulation; and 97265-joint mobilization.

What is the difference between 97140 and 97124?

97124 is for increasing circulation and to promote tissue relaxation to the muscles. 97140 is used to describe therapy which increases active pain-free range of motion, increased extensibility of myofascial tissue and facilitates return to functional activities. This code is reported in units of 15 minutes.

Is CPT code 97010 A timed code?

Constant Attendance Modality Codes Codes 97010-97028 identify supervised modalities, which do not require this type of contact. These time-based codes include the time required to perform all aspects of the service itself, including pre-, intra-, and post-service effort.

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