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An osteopathic manipulative treatment (OMT) is a hands-on therapeutic approach utilized by osteopathic physicians to address somatic dysfunctions within the body. This treatment method employs various techniques that are akin to those found in physical therapy and chiropractic care, focusing on the manipulation of muscles, bones, and joints. The primary objective of OMT is to facilitate the body's inherent ability to heal itself by alleviating restrictions and blockages in the musculoskeletal system. OMT can be administered as a standalone treatment or in conjunction with other medical interventions such as pharmacotherapy, surgical procedures, rehabilitation programs, patient education, dietary modifications, and exercise regimens. The techniques involved in OMT are diverse and include muscle energy, counter strain, high-velocity low-amplitude thrusts, myofascial release, and lymphatic pumping. The muscle energy technique emphasizes the use of muscle stretching and contracting to improve mobility and function. Counter strain is a method that addresses inappropriate strain reflexes by applying gentle pressure in the opposite direction of the reflex, promoting relaxation. High-velocity low-amplitude thrusts involve delivering a quick, controlled force to a specific joint within its anatomical range of motion to release restrictions and restore function. Myofascial release is a soft tissue technique that utilizes palpation to ease contracted muscles, enhancing blood circulation and lymphatic drainage. Lastly, lymphatic pumping employs manual pressure to facilitate the movement of lymph fluid through the lymphatic system, supporting overall health and recovery. CPT® Code 98928 specifically pertains to OMT procedures involving 7-8 body regions, distinguishing it from other codes that categorize OMT based on the number of body regions treated, such as codes 98925 for 1-2 regions, 98926 for 3-4 regions, 98927 for 5-6 regions, and 98929 for 9-10 regions.
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The indications for osteopathic manipulative treatment (OMT) using CPT® Code 98928 include a variety of conditions that may benefit from the manipulation of the musculoskeletal system. These indications are typically related to somatic dysfunctions that can cause pain, discomfort, or impaired function. The following are explicitly provided indications for OMT:
The procedure for osteopathic manipulative treatment (OMT) as described by CPT® Code 98928 involves several key steps that are performed by a qualified osteopathic physician. Each step is designed to address specific areas of somatic dysfunction across 7-8 body regions:
Post-procedure care following osteopathic manipulative treatment (OMT) is essential for maximizing the benefits of the treatment. Patients may experience some soreness or discomfort in the treated areas, which is typically mild and temporary. It is important for patients to follow any specific instructions provided by the physician, which may include recommendations for rest, hydration, and gentle stretching exercises to enhance recovery. Additionally, patients may be advised to avoid strenuous activities for a short period following the treatment to allow the body to adjust and heal. Regular follow-up appointments may be scheduled to monitor progress and determine the need for further OMT sessions or additional therapeutic interventions.
| Short Descr | OSTEOPATH MANJ 7-8 REGIONS | Medium Descr | OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS | Long Descr | Osteopathic manipulative treatment (OMT); 7-8 body regions involved | Status Code | Active Code | Global Days | 000 - Endoscopic or Minor Procedure | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | STV-Packaged Codes | Type of Service (TOS) | 1 - Medical Care | Berenson-Eggers TOS (BETOS) | P6C - Minor procedures - other (Medicare fee schedule) | MUE | 1 | CCS Clinical Classification | 215 - Other physical therapy and rehabilitation |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GA | Waiver of liability statement issued as required by payer policy, individual case | CR | Catastrophe/disaster related | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care | X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | GW | Service not related to the hospice patient's terminal condition | 24 | Unrelated evaluation and management service by the same physician or other qualified health care professional during a postoperative period: the physician or other qualified health care professional may need to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) unrelated to the original procedure. this circumstance may be reported by adding modifier 24 to the appropriate level of e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AG | Primary physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GE | This service has been performed by a resident without the presence of a teaching physician under the primary care exception | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GZ | Item or service expected to be denied as not reasonable and necessary | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital | PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2009-01-01 | Changed | Code description changed |
| 1994-01-01 | Added | First appearance in code book in 1994. |
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