Medical Billing and Coding Resources
Medical Billing and Coding Resources
Basics of CMS 1500 Most insurances allow you to send an electronic version of CMS 1500, called an 837 file. But, unfortunately, some paper-only payers are still hanging around, and they require that billers print and fill out the entire form. The bad news is that you can’t just look up a PDF of the […]
97750 CPT Code Basics 97750 CPT Code Description: Physical performance test or measurement (e.g., musculoskeletal, functional capacity), with written report, each 15 minutes. Physical testing or measurement describes tests and measurements performed by a physician or other qualified health care professional. A physical performance test or measurement may be reasonable and necessary for patients with […]
97535 CPT Code: Self-Care/Home Management Training 97535 CPT Code Description: Self-care/home management training (e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of assistive technology devices/adaptive equipment) direct one-on-one contact, each 15 minutes. This procedure is medically necessary only when it requires the professional skills of a […]
97530 CPT Code Description: Direct (one-on-one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes. When using 97530, you should focus on tasks ending in ‘ing’ such as carrying, lifting, handling, reaching, transferring, and transporting to improve overall function. Specific examples include hand assembly activities, transfers (chair to […]
97150 CPT Code Basics 97150 CPT Code Description: Therapeutic procedure(s), group (2 or more individuals), untimed. When the therapist is working with several patients at the same time, then CPT code 97150 should be reported. 97150 is not a timed (untimed) code. This means that each individual patient in the group is going to be […]
97140 CPT Code: Manual Therapy 97140 CPT Code Description: Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), 1 or more regions, each 15 minutes. It’s also been further described to include things like manual trigger point therapy and myofascial release. Manual therapy techniques are used to treat the restricted motion of soft tissues […]
97139 CPT Code: Unlisted Therapeutic Procedure (specify) If an existing CPT code does not describe the service performed, an unlisted CPT code may be used. When an existing HCPCS/CPT code does not accurately describe the services performed, the provider submits information, for the payer’s review, to describe the ‘unspecified’ modality(s) or therapeutic procedure(s) performed. The […]
New Cognitive Function Intervention Code Effective January 1, 2020, CPT code 97127 (cognitive function intervention, per day) and Healthcare Common Procedure Coding System (HCPCS) code G0515 are deleted and replaced with two new timed codes: a base code for the initial 15 minutes of cognitive function intervention (97129 CPT Code) and an add-on code for […]
97124 CPT Code: Massage Therapy 97124 CPT Code Description: Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion). Massage is classified as a therapeutic procedure which is a time-based service. A therapeutic procedure is defined as a manner of effecting change through the application of clinical […]
97116 CPT Code Description: Therapeutic procedure, one or more areas, each 15 minutes; gait training (includes stair climbing). The clinician instructs the patient in specific activities that will facilitate ambulation and stair climbing with or without an assistive device. Proper sequencing and safety instructions are included when appropriate. This code requires direct contact and may […]
