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How do you bill for light therapy in chiropractic?


How do you bill light therapy chiropractic?

Billing and reimbursement are an important part of chiropractic practice. Appropriate payment for submitted claims is the lifeline for any practice. When it comes to reimbursement a “clean claim” form is important. A “clean claim” form is one that goes through the third-party payer system without raising flags and creating delays, resulting in payment in a timely manner.

In chiropractic two types of therapies are involved:

  • Active Therapy 
  • Passive Therapy

Passive therapy is when something is done to you and it implies lack of patient participation while active therapy means the patient is actively involved in the treatment and the patient’s role is to actively participate in the treatment process, while the clinician’s role is assisting the patient in determining the parameters of activity that will increase function. 

Now let’s understand various CPT codes for active and passive therapies:

CPT Code Active Therapy Procedure

97110

Therapeutic Exercise

 97112

Neuromuscular Re-education

97113

Aquatic Therapy

97116

Gait Training

97530

Therapeutic Activities

CPT Code Passive Therapy Procedure

 97010

Ice Packs

97010

Hot Packs

97012

Mechanical Traction

97014

Electric Muscle Stimulation

97035

Ultrasound

97024

Diathermy

97124

Massage

98940-43

Manipulation

97780

Acupuncture

97026

Infrared

 97140

Manual Therapy Techniques

It is important note here is there is specific CPT codes for laser therapy, either “low-level laser therapy” or “high-power therapy. “Hence irrespective of code you choose always include a statement describing the treatment and therapy.

It is important to know how to use existing CPT codes to bill for light therapy in chiropractic which describes below:

CPT Codes and its description in detail

CPT Codes

Description

97026

  • The code is for “infrared light therapy”.
  • The problem with this code is that it is a code for an old-style heat lamp that produces infrared radiation for superficial heating of tissue; thus, reimbursement is quite low.
  • For some practitioners (physical therapists), Medicare may reimburse it.
  • To improve reimbursement, some providers have tried listing it as an attended modality or adding a –22 modifier to specify “unusual procedural services”

97032

  • This CPT code is for attended electronic photonic stimulation (15 minutes).
  • The code includes a time component. Therefore, you must write down the start and finish times in the patient’s chart.
  • Make brief notes about your treatment protocol and the areas of the body that were treated.
  • Billing might look like, “97032: Attended electronic photonic stimulation,” or, “97032: FDA cleared laser photonic stimulation.

97039

  • This CPT code is for an unlisted modality with constant attendance. The “unlisted” nature of the code can result in rejection or hand audits.
  • The fact that it ends in “9” requires documentation.
  • Make sure to include a one-page description of the services provided and a description of the device.
  • An explanatory notation such as “FDA cleared laser therapy” is helpful.
  • Billing might look like, “97039: Attended infrared therapy,” or, “97039: Attended laser therapy.”

97112

  • This CPT code is for neuromuscular reeducation (15 minutes).
  • The code includes a time component. Therefore, you must write down the start and finish times in the patient’s chart.
  • Make brief notes about your treatment protocol and areas of the body that were treated.
  • Billing might look like, “97112: Neuromuscular reeducation,” or “97112: Neuromuscular reeducation with laser therapy.”

97139

  • This CPT code is for an unlisted therapeutic procedure with constant attendance.
  • The “unlisted” nature of the code can result in rejection or hand audits. The code indicates one-on-one treatment from a provider to a patient.
  • Make sure to include a one-page description of the services provided and a description of the device. The code ends in a “9,” so include a notation such as, “FDA cleared laser therapy.”
  • Billing might look like, “97139: Unlisted therapeutic procedure with FDA cleared laser — constant attendance.”

97799

  • This CPT code is for physical medicine and rehabilitation unlisted service or procedure.
  • The general nature of the code and the “unlisted” nature of the code can result in rejection or hand audits.
  • The fact it ends in “9” requires documentation. Make sure to include a one-page description of the services provided and a description of the device.
  • An explanatory notation such as “FDA cleared laser therapy” is helpful.
  • Billing might look like, “97799: Unlisted service or procedure performed with FDA cleared laser therapy.”

Now, you understand how you can do billing for light therapy in chiropractic however, you need any help, we are always here to help you. Our team of coding and billing experts will take care of your claims and appropriate payment.

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