97140 CPT Code (2023) Description, Guidelines, Reimbursement, Modifiers & Example

97140 CPT code covers all manual traction, manual lymphatic drainage, and manual treatment procedures (mobilization & manipulation). In-network providers cannot bill the patient, which must be made clear.

97140 CPT Code | Description

Myofascial release/soft tissue mobilization in one or more areas may be acceptable and essential for treating restricted smooth tissue motion in the affected extremities, neck, and trunk. The nervous, circulatory, and articular systems, soft tissues, and articular structures are all altered when the soft tissues may treat with skillful manual procedures. 

Each 15-minute session consists of manual treatment treatments (e.g., mobilization, manipulation, manual lymphatic drainage, manual traction) in one or more locations (97140 CPT code). 

Description Coding for manual therapy (often known as “hands-on”) encompasses many methods, including connective tissue massage, joint mobilization, passive range of motion, and therapeutic massage. There is no one-size-fits-all approach to providing these services. Manual treatment techniques may use for 15-minute intervals in one or more locations.

There must be a record of 97140 CPT code for each 15-minute manual therapy session at one or more locations. Code 97140, for example, would be recorded twice, once for each 15-minute interval, if one or more regions got 30 minutes of manual treatment sessions.

CPT Code 97140 requires pre-, intra-, and post-service work of 15 minutes each. A CMT/OMT code, in addition to code 97140, may require in some circumstances. For example, if a patient suffers a neck injury in a car accident, CMT in that area will not recommend. 

Manual therapy techniques are used on the neck, while CMT is used on the lumbar region, as indicated by CPT code 97140. 97140 and 98940 may use since distinct body parts may address in this situation. This example should have the qualifier -59 added to denote the provision of a different procedural service.

Manipulation may be necessary and appropriate for treating painful spasms or restricted soft tissue movements. CPT 97110, 97112, or 97530 may be beneficial and essential to add to other treatment methods.

For the treatment of lymphedema, manual lymphatic drainage/complete exposure therapy may be necessary and appropriate (swollen lymph nodes). Following manual therapies, medication, and serial pressure, bandaging may use, followed by an activity routine to decrease the limbs. The therapy training gives to the therapist.

The nervous, circulatory, and articular systems, soft tissues, and articular structures are all altered when the soft tissues may treat with skillful manual techniques (active or passive). Stretching of shortened muscles or connective tissues is two examples of how fluid exchange may facilitate. 

When loss of joint flexibility and adaptability makes the therapeutic process impossible, CPT code 97140 as an addition to therapeutic techniques may be permitted and necessary. Other therapy techniques, such as CPT 97110, 97112, or 97530, may be used in collaboration with this technique.

Myofascial release/soft tissue mobilization in one or more regions may medically indicate to address restricted motion of soft tissue structures in the impacted extremities, neck, and trunk,

The 97140 CPT code procedure may be medically necessary in conjunction with other therapeutic approaches such as CPT 97110, CPT 97112, and CPT 97530. Painful spasms or restricted soft tissue movement may necessitate manipulation. CPT 97110, CPT 97112, or CPT 97530 may use in conjunction with this surgery.

97140 CPT code, a medical procedure code in the category of Physical Medicine and Rehabilitation Therapeutic Procedures, is maintained by the American Medical Association.

This type of physical therapy uses controlled hand movement and pressure to treat soft tissue and joint problems, such as persistent back pain. In addition to joint mobility and alignment, the manual treatment also aids in tissue regeneration, lymphatic drainage, and traction.

According to CPT® guidelines, 97140 CPT code covers manual therapeutic procedures such as mobilization and manipulation, manual lymphatic drainage, and manual traction. There are specific codes for chiropractic adjustments compared to those used for other types of adjustments (98940-98942, or 98943 for an extremity). 

A subluxation diagnosis code mandates an adjustment, especially if you live in a state that requires a nexus of the spine to bill anything other than an adjustment. When conducted in the exact anatomic location, the National Correcting Code Initiatives (NCCI) statements and edits combine physical therapy (97140) with chiropractor treatment codes (98940-98942).

If the operations may conduct in different anatomic sites, you can report them individually by appending modifier 59 to the modification code (97410 is the “column 2” procedure). The insurer should cover both operations if the claim implements by evidence.

Some of the nation’s top insurance carriers do not routinely cover massage therapy services. A valid and particular massage CPT code may use to obtain insurance reimbursement, depending on the aim of treatment and how the insurance provider defines care.

Those interested in learning more about the benefits of massage therapist insurance can do so right here. Following confirmation that massage therapy is covered, the most specific CPT billing codes are:

• Infrared and ice packs (CPT code 97010)

This procedure has a CPT code of 97124. The following treatment method takes 15 minutes to complete: percussion, compression, and striking

• CPT code 97140: Manipulation, traction, lymphatic drainage, 15 minutes.

CPT code 97124 focuses on massage therapy, whereas CPT code 97140 focuses on manual therapy. Using either of these massage therapy billing codes, specify the same treatment modalities in your claim to ensure coverage. Using these CPT codes for massage treatment will result in the services may cancel by insurance carriers.

97140 CPT Code | Billing Guidelines

Small and medium-sized businesses might avoid dealing with many requests by submitting their original claims with comments. What works best for your practice should be determined.

Aetna often only pays for four types of therapy at a time. If you bill for five or six modalities, but Aetna only pays for four, does it make sense to file a 97140 CPT code appeal? I urge you not to file a request since you will not be entitled to any additional money.

Aetna’s definition of a modality might not be the same as yours. There are exceptions to the four-modality rule, such as office visits. You have the option of going to the doctor’s office in addition to the other four options if that is medically required. On the other hand, some Aetna policies will pay for more than four treatment modalities. It does not imply that Aetna has paid for four modalities, just four codes.

To ensure that your claims may handle correctly, you should provide your doctor’s notes with your initial claim and diagnosis points to aid in the process. 

For more information, see: Aetna’s latest clinical policy bulletin is available here. 0107 is the phone number to call for Chiropractic services.

When billing 97140, make sure the doctor wrote: “Myofascial Release, Manual Therapy, or Code 97140” on the prescription. Code 97124 can only bill if a drug specifically mentions “Massage Therapy.” Each 15-minute block of time you’re billing for should include a description of what you accomplished in that period, with four processes.

97140 CPT Code | Modifiers

Two primary modifier codes use for insurance billing codes for massage therapy. Two procedures of the equivalent kind were performed on the same person on the same day or across multiple days, for example, using modifier code 59. 

If you bill for more than one operation, the insurance companies are told by modifier 59 that each was different and independent. Using the 52nd modifier code, the physician elected to minimize a therapy technique. 

Massage therapists should steer clear of physical therapist CPT codes. Even though some treatments are the same between massage therapists and physical therapists, massage therapists are not qualified or trained in the same way. Claims with the following codes are likely to be denied by insurance companies: 97001–97006, 97110–97112, and 97350–97351.

Fifty-nine modifiers may record if both operations may conduct in separate 15-minute intervals. The first 15 minutes of therapy may be dedicated to one service, while the second 15 minutes will devote to another.

Therapy time blocks may break into smaller chunks. Therapeutic activities for 15 minutes could follow manual treatment before returning for another 5 minutes on the table.

Both CPT code 97530 and modifier 59 are invalid in this situation since they occur in the same time block. In cases where two timed procedures are being performed on the same day but in different blocks of time, modifier 59 is appropriate.

97140 CPT Code Modalities For Manual Therapy

Manual traction may be considered reasonable and necessary for cervical radiculopathy.

Joint mobilization (peripheral or spinal) may be considered reasonable and necessary if restricted joint motion is present and documented.

97140 CPT code may be reasonable and necessary as an adjunct to therapeutic exercises when loss of articular motion and flexibility impedes the therapeutic procedure.

Myofascial release/soft tissue mobilization, one or more regions, may be medically necessary for treatment of restricted motion of soft tissues in involved extremities, neck, and trunk.

Skilled manual techniques (active or passive) are applied to soft tissue to effect changes in the soft tissues, articular structures, neural or vascular systems.

Examples are facilitation of fluid exchange, or stretching of shortened muscular or connective tissue.

The 97140 CPT code procedure may be medically necessary as an adjunct to other therapeutic procedures such as CPT 97110, CPT 97112, and CPT 97530.

Manipulation may be medically necessary for treatment of painful spasm or restricted motion of soft tissues. It may also be used as an adjunct to other therapeutic procedures such as CPT 97110, CPT 97112, and CPT 97530.

Reimbursement

Specific CPT codes for timed, skilled, direct one-on-one treatment may detail this regulation’s payment documentation requirements. There are three CPT codes to look for: CPT codes 97110-97140, 97530-97542, and 97750-97762.

It’s essential to prove the medical necessity of undergoing traction treatment in a clinic for longer than 12 sessions. After a month of self-administered mechanical traction, most cervical issues ca treat at home. To bill for time spent teaching patients how to utilize home traction, use the 97140 CTP code.

Example

When chiropractors do chiropractic manipulative treatment (CMT), they focus on adjusting the spine’s third and fourth segments. The shoulder of the patient treats manually (97140 CPT code). It is possible to link the diagnosis codes adhesive capsulitis (726.0) and muscle spasms (97140) to manual treatment through the diagnosis points (728.85). If reported with modifier 59, manual therapy would be reimbursable separately in this situation.