How To Use CPT Code 98925

CPT 98925 describes the procedure of osteopathic manipulative treatment (OMT) involving one to two body regions. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 98925?

CPT 98925 is used to describe a specific procedure called osteopathic manipulative treatment (OMT). This procedure involves the provider applying controlled manual pressure to one or two body regions to treat somatic and nonsomatic disorders. By manipulating the movement of muscles and joints in the body, the provider helps relax the muscles, improve mobility, and alleviate pain. OMT can be used to treat various conditions, including muscle and joint-related disorders as well as nonsomatic disorders like asthma, migraines, carpal tunnel syndrome, sinus disorders, and menstrual discomfort.

2. Official Description

The official description of CPT code 98925 is: ‘Osteopathic manipulative treatment (OMT); one to two body regions involved.’

3. Procedure

1. The provider begins by assessing the patient’s condition and identifying the body regions that require treatment.
2. Using their hands, the provider applies specific manual pressure techniques to the affected body regions, such as the abdomen, chest, head, neck, hip, spine, or extremities.
3. The pressure applied helps relax the muscles, improve joint mobility, and alleviate pain.
4. The provider may use different techniques, such as stretching, resistance, or rhythmic movements, depending on the patient’s condition and response.
5. The procedure is performed for a specific duration, focusing on the identified body regions requiring treatment.
6. Additional sessions may be scheduled as needed to achieve the desired therapeutic outcomes.

4. Qualifying circumstances

CPT 98925 is appropriate for patients who require osteopathic manipulative treatment (OMT) involving one to two body regions. The procedure is performed by a qualified provider who applies manual pressure to treat somatic and nonsomatic disorders. The provider may treat conditions such as muscle and joint-related disorders, asthma, migraines, carpal tunnel syndrome, sinus disorders, menstrual discomfort, and more. It is important to note that the procedure is specific to the treatment of one to two body regions.

5. When to use CPT code 98925

CPT code 98925 should be used when a provider performs osteopathic manipulative treatment (OMT) involving one to two body regions. It is important to accurately document the number of body regions treated to ensure proper coding and billing. If the procedure involves three to four body regions, CPT code 98926 should be used. For five to six body regions, CPT code 98927 is appropriate. Similarly, CPT codes 98928 and 98929 are used for seven to eight and nine to ten body regions, respectively.

6. Documentation requirements

To support a claim for CPT code 98925, the provider must document the following information:

• Patient’s diagnosis and the need for osteopathic manipulative treatment (OMT)
• Specific body regions involved in the treatment
• Date and duration of the procedure
• Techniques used during the procedure
• Progress made by the patient and any additional sessions scheduled
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 98925, ensure that the procedure involves one to two body regions and is performed by a qualified provider. It is important to follow payer policies regarding reporting significant, separately identifiable evaluation and management (E/M) services performed on the same date with modifier 25 appended to the E/M code. Additionally, be aware of the appropriate use of modifiers when reporting OMT procedures involving different numbers of body regions.

8. Historical information

CPT code 98925 was added to the Current Procedural Terminology system on January 1, 1994. The code underwent a change on January 1, 2009, with the updated description specifying the involvement of one to two body regions.

9. Examples

1. A provider performing osteopathic manipulative treatment (OMT) on a patient’s neck and shoulder regions to alleviate chronic pain.
2. A provider applying manual pressure techniques to a patient’s hip and spine regions to improve joint mobility and treat lower back pain.
3. A provider using osteopathic manipulative treatment (OMT) on a patient’s chest and abdomen regions to relieve symptoms of asthma.
4. A provider performing manual pressure techniques on a patient’s head and neck regions to alleviate migraines.
5. A provider applying specific pressure techniques to a patient’s extremities to treat carpal tunnel syndrome.
6. A provider using osteopathic manipulative treatment (OMT) on a patient’s sinus regions to alleviate sinus disorders.
7. A provider performing manual pressure techniques on a patient’s abdomen and pelvic regions to relieve menstrual discomfort.
8. A provider applying controlled pressure to a patient’s extremities and spine regions to improve mobility and treat influenza-related muscle pain.
9. A provider using osteopathic manipulative treatment (OMT) on a patient’s hip and knee regions to alleviate joint pain caused by arthritis.
10. A provider performing manual pressure techniques on a patient’s head and neck regions to relieve tension and stress.