How To Use CPT Code 97012

CPT 97012 is a code used for the application of mechanical traction to one or more areas of the body, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 97012?

CPT 97012 is a code used in the Current Procedural Terminology (CPT) system to describe the application of a modality to one or more areas of the body, specifically mechanical traction. This treatment is commonly used for patients suffering from degenerative joint disease, herniated discs, and general neck, arm, leg, and back pain, among other conditions.

2. 97012 CPT code description

The official description of CPT code 97012 is: “Application of a modality to 1 or more areas; traction, mechanical.”

3. Procedure

1. The physician evaluates the patient to determine the type of traction, amount of weight to be applied, and duration of treatment.
2. Mechanical traction begins with a series of 10-12 minute sessions, typically 2-3 times a week.
3. For cervical traction, the patient lies on their back, and a head halter is placed under the back of the head and jaw, attached to a machine.
4. For lumbar traction, the patient is placed in a pelvic harness secured to one end of a motorized split-traction table.
5. The traction force is applied either continuously or intermittently during the treatment session.
6. Following each session, electrical muscle stimulation is applied to relax the muscles and ligaments.
7. Expert supervision is required throughout the therapy session to ensure patient safety and comfort.

4. Qualifying circumstances

Patients eligible to receive CPT code 97012 services are those who have been diagnosed with conditions that may benefit from mechanical traction therapy. These conditions may include degenerative joint disease, herniated discs, general neck, arm, leg, and back pain, carpal tunnel syndrome, and other conditions causing nerve root impingement or reduced circulation and fluid movement within spinal discs. The physician must carefully evaluate the patient’s condition, disorder, tolerance level, and the spinal level to be treated before initiating mechanical traction therapy.

5. When to use CPT code 97012

It is appropriate to bill the 97012 CPT code when a patient has been diagnosed with a condition that may benefit from mechanical traction therapy, and the physician has determined that this treatment is medically necessary. The therapy should be provided under the supervision of a qualified healthcare professional, and the patient’s progress should be monitored and documented throughout the course of treatment.

6. Documentation requirements

To support a claim for CPT 97012, the following information should be documented in the patient’s medical record:

• Patient’s diagnosis and medical necessity for mechanical traction therapy
• Type of traction, amount of weight applied, and duration of treatment
• Frequency and duration of therapy sessions
• Progress notes detailing the patient’s response to treatment and any changes in their condition
• Supervision by a qualified healthcare professional during therapy sessions

7. Billing guidelines

When billing for CPT code 97012, it is important to follow the guidelines and rules set forth by the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). Some tips for billing this code include:

• Ensure that the patient’s diagnosis and medical necessity for mechanical traction therapy are clearly documented in the medical record.
• Bill the 97012 CPT code for each area treated with mechanical traction during a single session.
• Verify any payer-specific requirements or limitations on the use of this code.
• Be aware that CPT 97012 is modifier 51-exempt, meaning it is not subject to multiple procedure payment reductions.

8. Historical information

CPT 97012 was added to the Current Procedural Terminology system on January 1, 1990. The code’s description was changed on January 1, 2009, from “Application of a modality to one or more areas; traction, mechanical” to its current description.

9. Similar codes to CPT 97012

Five similar codes to CPT 97012 and how they differentiate are:

1. CPT 97010: This code is used for the application of a hot or cold pack to one or more areas, rather than mechanical traction.
2. CPT 97014: This code describes the application of electrical stimulation to one or more areas, not mechanical traction.
3. CPT 97016: This code is for the application of a vasopneumatic device to one or more areas, not mechanical traction.
4. CPT 97018: This code is used for the application of paraffin bath therapy to one or more areas, not mechanical traction.
5. CPT 97022: This code describes the application of whirlpool therapy to one or more areas, not mechanical traction.

10. Examples

Here are 10 detailed examples of CPT code 97012 procedures:

1. A patient with degenerative joint disease in the cervical spine undergoes mechanical traction therapy to alleviate pain and improve mobility.
2. A patient with a herniated lumbar disc receives mechanical traction therapy to reduce nerve root impingement and promote healing.
3. A patient with chronic neck pain due to muscle tension undergoes cervical mechanical traction to relieve pain and improve range of motion.
4. A patient with carpal tunnel syndrome receives mechanical traction therapy to alleviate pressure on the median nerve and improve hand function.
5. A patient with sciatica undergoes lumbar mechanical traction to reduce nerve root compression and alleviate leg pain.
6. A patient with spinal stenosis receives mechanical traction therapy to widen the spinal canal and relieve pressure on the spinal cord and nerves.
7. A patient with a whiplash injury undergoes cervical mechanical traction to reduce muscle spasms and promote healing.
8. A patient with spondylolisthesis receives lumbar mechanical traction therapy to stabilize the spine and alleviate pain.
9. A patient with facet joint syndrome undergoes mechanical traction therapy to reduce joint inflammation and improve spinal mobility.
10. A patient with a thoracic disc herniation receives mechanical traction therapy to reduce nerve root compression and alleviate pain.