How To Use CPT Code 98928

CPT 98928 describes the osteopathic manipulative treatment (OMT) procedure involving seven to eight 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 98928?

CPT 98928 can be used to describe the osteopathic manipulative treatment (OMT) procedure performed by a healthcare provider. This procedure involves applying controlled manual pressure to seven to eight body regions to treat somatic and nonsomatic disorders. The provider manipulates the movement of muscles and joints in the body, using specific hand pressure over the affected area or surrounding areas. This technique helps relax muscles and joints, improve mobility, and alleviate pain. In addition to treating musculoskeletal disorders, OMT can also be beneficial for patients with asthma, migraines, carpal tunnel syndrome, sinus disorders, menstrual discomfort, influenza, and other nonsomatic disorders.

2. Official Description

The official description of CPT code 98928 is: ‘Osteopathic manipulative treatment (OMT); seven to eight body regions involved.’

3. Procedure

1. The healthcare provider performs controlled manual pressure on seven to eight body regions.
2. The pressure is applied in a specific manner to manipulate the movement of muscles and joints.
3. This procedure helps relax muscles, improve joint mobility, and alleviate pain.
4. The provider may focus on areas such as the abdomen, chest, head, neck, hip, spine, and extremities.
5. OMT can be used to treat somatic and nonsomatic disorders.
6. The provider may use their hands to apply pressure or use other techniques such as stretching or resistance.
7. The procedure aims to restore normal function and promote healing in the affected areas.
8. Additional sessions may be scheduled as needed to achieve optimal results.

4. Qualifying circumstances

CPT 98928 is appropriate for patients who require osteopathic manipulative treatment involving seven to eight body regions. This procedure is suitable for individuals with somatic and nonsomatic disorders, including musculoskeletal conditions and other related ailments. The provider must have the necessary qualifications and expertise to perform OMT. It is important to note that the procedure should only be performed on patients who will benefit from this specific treatment approach.

5. When to use CPT code 98928

CPT code 98928 should be used when a healthcare provider performs osteopathic manipulative treatment involving seven to eight body regions. This code is applicable for patients who require this specific treatment approach to address their somatic or nonsomatic disorders. It is important to accurately document the number of body regions involved to ensure proper coding and billing.

6. Documentation requirements

To support a claim for CPT 98928, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for osteopathic manipulative treatment
• Specific body regions involved in the procedure
• Date and duration of the treatment session
• Techniques used during the procedure, such as manual pressure, stretching, or resistance
• Progress made by the patient and any additional sessions scheduled
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 98928, ensure that the procedure involves seven to eight body regions and is performed by a qualified healthcare provider. It is important to accurately document the regions involved and the techniques used during the procedure. Additionally, check payer policies to determine if a significant, separately identifiable evaluation and management (E/M) service can be reported on the same date with modifier 25 appended to the E/M code. This may allow for additional reimbursement for the evaluation and management service.

8. Historical information

CPT 98928 was added to the Current Procedural Terminology system on January 1, 1994. The code underwent a change on January 1, 2009, to specify the involvement of seven to eight body regions. There have been no further updates or revisions to the code since then.

9. Examples

1. A healthcare provider performing osteopathic manipulative treatment on a patient with chronic back pain, focusing on the spine, hip, and extremities.
2. A provider using OMT to treat a patient with asthma, applying manual pressure to the chest, neck, and head regions.
3. A healthcare professional performing osteopathic manipulative treatment on a patient with carpal tunnel syndrome, focusing on the wrist, forearm, and upper arm regions.
4. A provider using OMT to alleviate migraines in a patient, applying controlled pressure to the head, neck, and shoulder regions.
5. A healthcare provider performing osteopathic manipulative treatment on a patient with sinus disorders, focusing on the facial and head regions.
6. A provider using OMT to address menstrual discomfort in a patient, applying manual pressure to the abdomen and lower back regions.
7. A healthcare professional performing osteopathic manipulative treatment on a patient with influenza, focusing on the chest, neck, and head regions.
8. A provider using OMT to alleviate musculoskeletal pain in a patient, applying controlled pressure to the hip, spine, and extremities.
9. A healthcare provider performing osteopathic manipulative treatment on a patient with shoulder pain, focusing on the shoulder, neck, and upper back regions.
10. A provider using OMT to address musculoskeletal discomfort in a patient, applying manual pressure to the abdomen, hip, and extremities.