No matter what kind of a musculoskeletal condition you are treating, manual therapy will play a huge role in the recovery process of your patients. When you learn more about manual therapy, you’ll realize that it is used by physical, occupational, as well as massage therapists and other professionals to help people treat musculoskeletal pain and disability, and thus improve their quality of life. The only thing is, though, when offering this service, you may not be sure whether you’ll be able to cover the costs.
Well, the good news is that the CPT 97410 exists, a code widely used by physical therapists, chiropractors, as well as other healthcare providers, in an effort to get the costs down. That is, to get proper reimbursement. Yet, to get the optimal reimbursement, you will need to have a better understanding of this code, as well as of strategies you can potentially use in order to enhance the reimbursement.
So, that is what we are going to be talking about today. In the simplest words possible, we will first explain what CPT 97410 actually is, and then we will proceed towards giving you a better idea about the types of strategies you can use to enhance your reimbursement in manual therapy. Without any further ado, thus, let us start answering those questions for you.
What Is CPT 97140?
Current Procedural Terminology (CPT) 97410 is actually a time-based code that represents, and is actually used to describe, those manual therapy techniques that are used in physical therapy. Various hands-on procedures are included here, such as manual traction, myofascial release, manual lymphatic drainage, as well as mobilization or manipulation. The code is used during the billing process for those services that involve direct contact between the patient and the healthcare provider.
Typically, the code is billed in 15 minute increments per the specific region treated. Healthcare providers such as physical therapists, chiropractors, as well as massage therapists can really benefit from it, getting the necessary reimbursement after performing these services. The truth is, though, that a lot of providers often encounter some reimbursement challenges, which is why understanding the code is essential, so as not to make any mistakes in the process.
Understand the code with the help of this article as well: https://www.linkedin.com/pulse/97140-cpt-code-guide-manuel-therapy-techniques-brduc/
Strategies for Enhancing Reimbursement
As mentioned, as a healthcare provider, you can find yourself facing certain challenges in the reimbursement process. You can be denied over the lack of medical necessity, over inadequate documentation, as well as over the incorrect use of modifiers or bundling this one with other codes. So, to maximize the reimbursement, you have to know the right strategies.
Stay Informed About the Necessary Policies
First and foremost, you have to stay continually informed about the important insurance provider policies in regard with the CPT 97410. Thus, your goal is to understand the policies. So, regularly review the guidelines, track common denial reasons so as to prevent the same from happening again by proactively addressing recurring issues, and then also remember to understand bundling problems as well as preauthorization requirements. Being properly informed is sure to help you avoid denials and maximize the reimbursements.
Avoid Overuse
If you tend to constantly use the CPT 97410 without proper medical justification, that may raise some red flags. And, it may lead to audits and denials. So, ensure that all of the sessions align with the clinical guidelines, and remember to combine manual therapy with some other interventions when needed, with the aim of avoiding overuse and thus potentially facing denial.
Ensure Proper Documentation
It goes without saying that the documentation has to be detailed and accurate. Thus, include the necessary data in your patient records. Those include specific manual therapy techniques that were used, the body parts that were targeted, functional improvements observed, as well as justification for choosing this solution instead of some other types of treatments.
Work With Experts
Finally, one of the best things you can do is work with experts, and have them help you navigate the complexities of medical billing. Great professionals will know the ins and outs of cpt 97140, claim submissions, as well as insurance negotiations, so working with Holistic Billing Services (Holbie) or other providers can help you receive proper reimbursement. They will offer important services, such as accurate CPT code selection, modifier application, submission and tracking of claims, as well as appeals in case of denial. At the same time, they will keep you up to date with any policy changes, helping you stay in compliance
How to Choose the Right Experts
The only thing you should remember is that choosing the right experts is a must here. So, do your research. Check their experience level and their reputation. And then, have a few interviews as well and assess the quality of communication, while also discussing the fees. In the end, compare all the info and make your final choice.
Disclaimer: The content on Wellness Derive is for informational purposes only and not a substitute for professional medical advice, diagnosis, or treatment. Always consult a healthcare provider for medical concerns.
