How do you bill for light therapy in chiropractic?

1. How do you bill for light therapy in 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. www.medicalbillersandcoders.com Copyright ©-2021 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 1

2. 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 www.medicalbillersandcoders.com Copyright ©-2021 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 2

3. 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 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. 97026 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” www.medicalbillersandcoders.com Copyright ©-2021 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 3

4. 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. 97032 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.” 97039 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. 97112 Billing might look like, “97112: Neuromuscular reeducation,” or “97112: Neuromuscular reeducation with laser therapy.” www.medicalbillersandcoders.com Copyright ©-2021 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 4

5. 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.” 97139 Billing might look like, “97139: Unlisted therapeutic procedure with FDA cleared laser —constant attendance.” 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.” 97799 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. www.medicalbillersandcoders.com Copyright ©-2021 MBC. All Rights Reserved Call now 888-357-3226 (Toll Free) info@medicalbillersandcoders.com 5