Physical Therapy CPT Codes: The Ultimate Guide

Physical Therapy CPT Codes: The Ultimate Guide

Physical therapy CPT codes play a crucial role in ensuring adequate revenue and better operational flow. However, handling CPT codes for physical therapy is more like solving a difficult puzzle. It is natural for physiotherapists like you to feel overwhelmed by the complexity of coding.

The entire focus of physiotherapists is on providing quality care to patients with limited time to manage CPT codes. However, this must not be a reason for losing revenue due to inaccurate medical coding.

Healthcare providers need precision in CPT codes for physical therapy; only then will you be able to improve your revenue cycle management and maximize the bottom line.

This blog is your ultimate guide to physical therapy CPT codes with knowledge to help you with the complexities and accurate usage of codes. Let’s start by understanding the core of CPT codes!

Introducing CPT Codes: Physical Therapy

CPT codes are a classification set by the healthcare industry to simplify the medical billing process. As every treatment, procedure, or diagnosis requires differentiation, codes help seamless translation for claim filing. Also termed as Current Procedural Terminology codes, these are given by the American Medical Association (AMA).

In physical therapy, CPT codes play a major role in simplifying reporting of medical services and acquiring revenue for the same.

If you find medical coding difficult, then understanding the terms of CPT can help you streamline the process. Here are some common terms of CPT:

Code

It is a five-digit number allocated to different treatments, services, and procedures based on medical specialty.

Modifiers

These are two additional digits written along with CPT codes to define the intricacy of a treatment or a procedure.

Evaluation and Management (E&M)

These codes define the initial evaluation of the patient’s ailment along with its continuous management. The range of these codes is 99202 to 99499.

Place of Service (POS)

This code highlights the place where medical services are rendered, such as a hospital, private practice, or individual healthcare provider.

Unbundling

It refers to billing for a part of a procedure and requires separation from a single code.

Global Period

It is the duration of the medical service, such as 90, 10, or 0 days. This is essential for surgical procedures.

Most Common CPT Codes for Physical Therapy

Finding it difficult to carry out medical coding is common for physiotherapists. There are two solutions to handle this situation: handling the complex process yourself or outsourcing medical billing services. Whatever you may decide to choose, it is important to understand the core of physical therapy CPT codes for earning adequate revenue.

Here is the list of physical therapy CPT codes:

Therapeutic Exercise: 97110

Therapeutic exercises help patients with injuries improve their mobility and body function. These exercises can be a part of a patient’s treatment plan or due to a health diagnosis. Anyone can use these exercises to enhance motion and flexibility.

If you want to ensure the accuracy of this physical therapy CPT code, then focus on maintaining accurate documents. Try to include specifications of performed exercises along with the reason behind the exercise and the impact its impact on the patient.

These exercises are related to elevating a patient’s stamina and strength with assisted stretching and resistance training.

Neuromuscular Re-education: 97112

These exercises improve the neuromuscular function of the patient by helping with body balance, coordination between body movements, posture correction, and proprioception. Patients with injury, surgery, neurological conditions, loss of neuromuscular control, and some other general conditions need these exercises.

When it comes to CPT code physical therapy, you need to record every single detail related to exercises such as techniques and effects on the patient.

The code 97112 also includes stabilization exercises, ergonomic training, plyometrics, kinesio taping, inhibition, and more.

Gait Training: 97116

Gait training is exercise that helps patients walk properly after an injury or surgery. This is to ensure the safety of the patient and prevent them from any further damage to the body.

The physical therapy CPT code for this must involve translation of activities done to help patients improve balance and coordination while walking.

To ensure proper billing, you need to record details such as devices used to improve the gait patterns in your patient. Also, documented gait training includes stepping over objects, leg lifts, usage of treadmills, and strength training.

Massage Therapy: 97124

Massage therapy and manual therapy are two different things, and that is why the first step is not confusing the two. The role of massage therapy is to relieve muscle pain, reduce muscle stress, and enhance blood flow.

For proper translation of physical therapy CPT codes, you must document the session details, including the different massage techniques (petrissage, tapotement, and effleurage).

Manual Therapy: 97140

Manual therapy is different from massage therapy, and it includes mobilization techniques for manual lymphatic drainage and traction.

As a physiotherapist, you need to recognize this code clearly and prevent errors during documentation. The CPT code for physical therapy must involve utilized techniques, time spent on therapy, and its effect on the patient. Remember, resistance training is not a part of manual therapy as it is not related to mobility improvement.

Group Therapy: 97150

When two or more people take a treatment under physical therapy together, it is referred to as group therapy. This therapy is usually done in open spaces like a gym to cater to more individuals at one time.

The coding for this involves careful supervision as multiple patients are given therapy at the same time. You must record the number of patients, type of the therapy and every patient’s individual requirement.

Therapeutic Activity: 97530

Therapeutic activities involve a variety of tasks to elevate a patient’s functional performance. The physiotherapist involves patients in these activities at the time of direct contact with them.

For physical therapy CPT codes, make sure to record the timings thoroughly and mention this code every 15 minutes to therapeutic activity.

Self-care/Home Management Training: 97535

If you are offering training to patients regarding self–care and different ways/tools to recover from acute ailment, then you must use this physical therapy CPT code.

You must note down every element of instructions along with tools used along with the patient’s ability to perform self-care.

Physical Performance Test or Measurement: 97750

As the name suggests, the code is simply about physical performance test and measurement of the patient. This includes evaluating the functional and musculoskeletal capacity of the patient.

You must document your findings clearly and include specifics of tests and measurements for accurate coding and billing. You must also record everything according to the treatment plan and the patient’s reaction to the procedures.

Conclusion

Physical therapy CPT code is a vast topic, and its accurate usage requires expert knowledge. Every code requires insightful understanding to ensure effective translation for claim filing. That is why outsourcing medical billing services is a better option to shift the administrative burden.

If you are struggling to keep up with the intricate physical therapy CPT codes, then Eminence RCM can help you.

Eminence RCM is a leading medical billing company proficient in physical therapy CPT codes. We work with a qualified team of coders who are well-versed in the above-mentioned codes. They never miss any details, reduce manual errors, and simplify complex documentation. To go one step ahead, our team utilizes advanced technological tools to streamline administrative and operational management.

We also take care of important aspects such as HIPAA compliance, denial management, and efficient claim processing. Partner with us, and we will handle the complex task for you. As a result, maximize revenue and improve the workflow without any hassle.

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