CPT CODES - 98940, 98941, 98943, 98942 - Chiropractic billing with AT modifer - Medicare Payment, Reimbursement, CPT code, ICD, Denial Guidelines CPT CODES - 98940, 98941, 98943, 98942 - Chiropractic billing with AT modife The Current Procedural Terminology (CPT ®) code 98943 as maintained by American Medical Association, is a medical procedural code under the range - Chiropractic Manipulative Treatment Procedures. Subscribe to Codify and get the code details in a flash. Request a Demo 14 Day Free Trial Buy No CPT describes the application of modifier -25 when E/M services are reported in conjunction with CMT procedural codes (98940- 98943), The chiropractic manipulative treatment codes include a pre-manipulation patient assessment There has been a recent stir in the Chiropractic billing world recently regarding extraspinal billing! For several years, payers have been requiring a 51 modifier (or a 59 modifier for others) be used on the 98943 Chiropractic extraspinal adjustment when the service is performed in conjunction with a Chiropractic spinal adjustment (98940-98942)
The Start of CPT Code 98943 Problems In my opinion, the first challenge with 98943 stems from the fact that it is essentially a code used only by chiropractors. The CPT code sets itself it is owned by the American Medical Association and they are the ones that dictate new codes to be used, updates, revisions and deletions of CPT codes 97140, manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes, will not be separately reimbursed when billed with 98940-98943 (CMT) for the same region
Includes CPT code: 98943 - Extraspinal - one or more regions 5 extraspinal regions include: Head - includes all manipulations performed to the head, including TMJ, but excludes atlanto-occipital joint. Lower extremities - includes all manipulations performed to the hip, leg, knee, ankle and foot during any visit When submitting claims for CPT code 98943, make sure to have at least the following three items in the initial documentation in order to prove medical necessity; 1) the patient's history/subjective complaints, 2) your examination findings, 3) at least one extremity diagnosis CPT as, a form of manual treatment to influence joint and neurophysiologic function. This treatment may be accomplished using a variety of techniques. A series of three CMT codes (98940, 98941, 98942) describes the number of spinal regions receiving manipulation. A single extraspinal CMT code (98943) i CPT® Code 98943 in section: Chiropractic manipulative treatment (CMT
CPT codes 98925-98929 describe osteopathic manipulative treatment, defined as a form of manual treatment applied by a physician to eliminate or alleviate somatic dysfunction and related disorders. The term somatic dysfunction is used to designate impaired or altered function of related components of the somatic (body framework) system. Procedure code 98943 is a non-covered service. Other Comments. Chiropractic or physician consultation should be utilized for the review process, if there is a question as to the validity of medical necessity of the claim. The following terms are used in this policy Claims submitted for Chiropractic Manipulative Treatment (CMT) CPT codes 98940, 98941, or 98942, (found in Group 1 codes under CPT/HCPCS Codes) must contain an AT modifier or they will be considered not medically necessary. Utilization Guidelines. Payment is to the billing Chiropractor and is based on the physician fee schedule Therapy for information regarding CPT code 97140, Manua ltherapy techniques (e.g., mobilizatoi n/manipual tion, manual lymphatic drainage, manua ltraction), 1 or more regions, each 15 minutes. CPT Code Description CPT Codes - 97010, 97012, 97014, 97032, 97035, 97110, 97124, 97140, 97530, 98940 - 98943, 99201 - 99205, 99211 - 99215. What is it? Sentinel has created this Chiropractic Billing Guide in order to provide clear and helpful information about billing requirements for chiropractic services. This guide lists many procedures and codes
This policy describes Optum's requirements for reimbursement of CPT codes 98940, 98941, 98942 (Spinal Chiropractic Manipulative Treatment) and 98943 (Extraspinal Chiropractic Manipulative Treatment) There are four CPT codes (98940, 98941, 98942, and 98943) that have been developed to assist chiropractic providers with accurately describing and reporting their manipulative treatment services. The work value of the CMT codes includes both cognitive (clinician judgment) and technical (skill) components. The work value or work per unit of time is divided into three sections: preservice, intraservice, and postservice CPT®. CPT Description. Chapter. 90281 - 99607. To see American Medical Association copyrighted content, try or buy SpeedECoder ! Section. 98940 - 98943. To see American Medical Association copyrighted content, try or buy SpeedECoder ! CPT Guidelines - Chiropractic Manipulative Treatment Procedures CPT Code Description 97012 Mechanical Traction Therapy 97014 Electric Stimulation Therapy 97016 Vasopneumatic Device Therapy 97018 Paraffin Bath Therapy 97022 Whirlpool Therapy 97024 Diathermy Treatment 97026 Infrared Therapy 98943 CMT, extra spinal, one or mor
. 98940-98943 manipulation codes cover three components for this service which are all bundled together within the code description. 1) Pre-assessment of the patient, which means you are going to examine the patient, palpate the patient, and possibly perform an orthopedic test The following table identifies the CPT codes that represent the various levels of chiropractic manipulative treatment. For each code, the definition and the requirement for billing is provided: CPT Code Description Documentation Requirement 98940 Chiropractic manipulative treatment (CMT) involving one to two spinal region When billed on the same visit as a Chiropractic Manipulative Treatment code (98940-98943), carriers often require the dash 59 modifier appended to the 97124 code to clarify that it's a distinct and separate procedure from the adjustment. CPT Code 97140 - Manual Therapy Techniques CPT procedure code 97112 Neuromuscular re-education, does not describe chiropractic manipulative treatment and the services are not mutually exclusive. Chiropractic manipulation (CMT) is described by codes 98940, 98941, 98942, and 98943 Billing an Evaluation and Management (E/M) Code on Every Visit with CMT: In general, it is inappropriate to bill an established office/outpatient E/M CPT® code (99211-99215) on the same visit as Chiropractic Manipulative Treatment (CPT ® code 98940-98943) because CMT codes already include a brief pre-manipulation assessment. There are time
the same day as a Chiropractic Manipulative Treatment (CMT) code, 98940-98943. An example of the reason given for this denial is that massage is a part of CMT. CPT® procedure code 97124 describes the work inherent in massage, which is a separate and distinct service from CMT codes 98940-98943 •Chiropractic Manipulative Treatment (98940-98943) •Manual therapy, by CPT® Description procedures include CPT® codes 97110-97139. If any of these procedures are performed with two or more individuals, then only 97150 is reported. Do not code th When billed on the same visit as a chiropractic manipulative treatment code (98940-98943), carriers often require the -59 (or XS) modifier appended to the 97124 code to clarify that it's a distinct and separate procedure being performed in a body region different from the adjustment. Because this is a timed code, indicate the number o
Chiropractic Manipulative Treatment (CMT) (CPT codes 98940-98943) Each CPT code reflects a specific number of regions, regardless of how many manipulations are performed in that region. For example, chiropractic manipulation applied to C3 and C5 during the same visit represent treatment to only one region (cervical) and should be reported with. Initial Authorization Process Overview 6 *Evaluation CPT codes do not require authorization. Documentation Submitted, Reviewed and Decision Rendere CPT Codes stands for Current Procedure Terminology Codes and all these codes are used to describe medical services and procedures, tests, surgeries, etc, performed by a health professional or doctor on a patient.The list of CPT codes in medical billing is updated as per the guidance of the American Medical Association.. CPT codes are the most important part of the medical billing process CPT/HCPCS Codes Group 1 Paragraph: N/A Group 1 Codes: CODE DESCRIPTION 98940 CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 1-2 REGIONS 98941 CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 3-4 REGIONS 98942 CHIROPRACTIC MANIPULATIVE TREATMENT (CMT); SPINAL, 5 REGIONS CPT/HCPCS Modifiers N/A ICD-10 Codes that Support Medical Necessity N/ Chiropractic Manipulative Treatment (CPT codes 98940-98943) Each CPT code reflects a specific number of regions, regardless of how many manipulations are performed in that region. For example, chiropractic manipulation applied to C3 and C5 during the same visit represent treatment to only one region (cervical) and should be reported with CPT.
98940, 98941, or 98942) per date of service. Refer to the Chiropractic Modalities section for a complete listing of CPT physical medicine modality and procedure codes CPT Code: CPT Description: Specific Instructions and Examples: 97014: Electrical stimulation: management services may be coded and paid separately from the chiropractic manipulative therapy services described by CPT codes 98940 to 98943 only if the condition requires a significant, separately identifiable evaluation and management service. Codes and descriptors copyrighted by the American Medical Association's current procedural terminology, fourth edition (CPT-4). These are 5 position numeric codes representing physician and nonphysician services. **** NOTE: *** Acute treatment (chiropractic claims) - This modifier should be used when reporting CPT codes 98940, 98941, 98942 or 98943 for acute treatment.No effect on payment. CC Procedure code change- CARRIER USE ONLY - Used by carrier to indicate that the procedure code submitted was changed either for administrative reasons or because an incorrect. Procedure Code - Description - Undiscounted Fee. 98940 - Chiropractic Adjustment 1-2 region $60. 98941 - Chiropractic Adjustment 3-4 region $75. 98942 - Chiropractic Adjustment 5 regions $85. 98943 - Extra Spinal Adjustment $40. 97124 - Massage Therapy per unit $55. 97140 - Manual Therapy per unit $70. G0283 - Electrical.
• CPT 97140 will not be separately reimbursed when submitted with CPT 98943. • CPT 99070 will not be separately reimbursed when submitted with the following CPT codes: A4550, J1100, J705 2) Medicine [98940, 97941, 98942, 98943, 97124, 97140, 97032, 97035, 97110, 97012] Procedure Code - Description - Undiscounted Fee. 98940 - Chiropractic Adjustment 1- 2 regions - $75. 98941 - Chiropractic Adjustment 3-4 regions - $95. 98942 - Chiropractic Adjustment 5 regions - $115. 98943 - Extremity Adjustment - i.e. shoulder, wrist, ankle. 98929 or 98940-98943 reimburses. If on appeal, it is documented that 97140 was performed on a separate anatomical area or body region . from the osteopathic or chiropractic manipulation procedures, then both procedures may reimburse . separately. Anthem Central Region does not bundle 97140-59 with 98925-98929 or 98940-98942. Based on CPT (CMT) (98940-98943) codes on the same region(s)/body part on the same day. This code may be paid when reported with CMT or OMT codes only if used on a different region(s)/body part on the same day and must be accompanied by CPT modifier 59 which identifies a distinct procedural service i. #1 It is inappropriate to bill an established office/outpatient E/M CPT code (99211‐99215) on the same visit as CMT (CPT 98940‐98943) because CMT codes already include a brief pre‐manipulation assessment. 1. HOWEVER: E/M Code + CMT Codes MAY be proper if new patient o
code 98940, 98941, 98942) with a date of service on or after October 1, 2004, to include the Acute Treatment (AT) modifier if active/corrective treatment is being performed. The AT modifier must not be placed on the claim when maintenance therapy has been provided. Claims without the AT modifier will be considered as maintenance therapy and denied S8948 is a valid 2021 HCPCS code for Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes or just Low-level laser trmt 15 min for short, used in Other medical items or services Data Updated for Q4 2018 CPT Code: 99283 Description: Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care. CPT® procedure code 97124 describes the work inherent in massage, which is a separate and distinct service from CMT codes 98940-98943. CPT® code 97124 describes work including effleurage, petrissage and/or tapotement (stroking, compression, percussion), each 15 minutes appendix exhibit 6 cpt/hcpcs codes subject to daily maximum cpt*/hcpsc description 29200 strap chest 29240 strap shoulder 29260 strap elbow or wrist 29280 strap hand or finger 29520 strap hip 29530 strap knee 29540 strap ankle and/or ft 29550 strap toes 29580 apply paste boot 29581 apply multilay compress lwr leg 29590 apply foot splint 29799 cast/strap procedure 97012 mechanical traction therap
CPT/HCPCS codes for diagnostic services they are allowed to provide as part of this includes a description of the sites. Zip codes are provided in Table 2 for Illinois, Table 3 for Virginia, and CPT code 98943—extraspinal manipulation. The fee amounts per geographic area can be found in Tabl However, our audits reveal significant errors. Most revolve around these three services: physical medicine CPT codes 97014, electrical muscle stimulation, 97010, hot/cold packs and the spinal CMT codes 98940-98942. Since Medicare is required to use CPT coding guidelines, why is the CPT code 97014 denied when billed to Medicare, for example . 431 97001. 432 97001. 433 97001. 434 97001. 439 97001. 10000 69999. 94010 94799. 92502 92599. 92502 92599. 10000 69999. 97001. 70010 76999. 99201 99499. 99201 99499. 90801 90911. 92002 92371. 70010 79999. 10021 69990. 94010 94799. 97001. 93000 93014. 95805 95827. Arial,BoldFECA RCC Requiring CPT. The description of CPT code 97750 is Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes. Does 29540 need a modifier? Because National Correct Coding Initiative edits make 29540 a component part of 20550, modifier 59 lets your payer know that these are distinct services
An AMA Ed Hub™ module, Office Evaluation and Management (E/M) CPT Code Revisions, will help practices understand how these foundational changes will affect their work. The AMA also has a detailed description of the changes and a table illustrating revisions related to medical decision-making documentation CPT® procedure code 97124 describes the work inherent in massage, which is a separate and distinct service from CMT codes 98940-98943. CPT ® code 97124 describes work including effleurage, petrissage and/or tapotement (stroking, compression, percussion), each 15 minutes CPT Code : CPT Description : specific Instructions and Examples : 97110 : Therapeutic exercises : (CMT) (98940-98943) codes on the same region(s)/body part on the same day. This code may be paid when reported with CMT or OMT codes only if used on a different region(s)/body part on the same day and must be accompanied by CPT modifier 59.
CPT CODE 97010 - 97012 - Modality procedure service. 97010 - Application of a modality to 1 or more areas; hot or cold packs Average fee amount $5 -$10. 97012 - Application of a modality to 1 or more areas; traction, mechanical Average fee amount $ 13 - $20. Traction is generally used for joints, especially of the lumbar or cervical. CPT ® Code Set. 98942 - CPT® Code in category: Chiropractic manipulative treatment (CMT) CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. CPT code information is copyright by the AMA. Access to this feature is available in the following products The description of CPT code 97750 is Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes. Does Medicare pay for 97140? CPT CODE 97010, 97124, 97140 , 97012 - Massage Therapy billing
Chiropractic Services (CPT Codes 98940-98942): Overview of Coverage Requirements Coverage of chiropractic services is specifically limited to treatment by means of manual manipulation (i.e., by use of the hands) of the spine to correct a subluxation. Subluxation is defined as a motion segment in which alignment, movement integrity, and/or. CPT (66179 effective 01/01/2015, 66180, 66184 effective. Physical, Occupational - Oxford Health Plans. Jan 1, 2015 Clinical Policy (Effective 01/01/2015) Unless otherwise stated, Oxford policies do not apply to Medicare DESCRIPTION OF SERVICE/BACKGROUND . (CPT code 97140. For CPT codes 98940 - 98943, please refer to Modifier -51 (Multiple Procedures) does not need to be appended to the extraspinal CMT code (98943), when billed in conjunction with chiropractic manipulative treatment (CMT) codes (98940- 98943). According to The CPT® Assistant [December 2013], these are separate and distinct procedures and the use of modifier 51 does not apply 98943 Chiropractic manipulative treatment; CPT Procedure Codes for Complementary Medical Procedures. CODE DESCRIPTOR G0176 Activity therapy such as music, dance, art, or play therapies not for recreation, relate to care and treatment of patient's DESCRIPTION ABC CODE DESCRIPTION The code combinations and outcomes are listed below. CODE DENIAL TO CODES 97124 Incidental 97110, 97112-97113, 97116, 97139-97140, 97150, 97530, 97533, 97535, 97537, 97542, 97545-97546, 98925-98929, 98940-98943
with no more than two modalities per visit. (CPT code 97140. For CPT codes 98940 - 98943, please refer to the policy titled Manipulative Therapy). APPLICABLE CODES The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive with the CMT codes (98940 -98943). Moda Health will deny 98940 - 98943 for invalid modifier combination when billed with modifier 51. 52 Modifier 52 (reduced services) signifies that only part of the code description was performed, some parts were omitted. Do not use modifier 52 with: • Evaluation and management codes
(CPT code 97140. For CPT codes 98940 - 98943, please refer to Manipulative Therapy). Refer to Manipulative Therapy for the policy on chiropractic services. PAYMENT GUIDELINES The codes listed in this policy are for reference purposes only. Listing of a service or device code 2. Identify by CPT procedure code all services performed by the provider during the past year and arrange by CPT code sections: - Surgical - 10000 - 69999 - Radiology - 70000 - 79999 - Lab - 80000 - 89999 - E/M - 99201 - 99499 - Medicine - 90000 - 98943, 99900 - 99199, 99500 - 99602 3. List your current fee for each.
Look up any CPT code, modifiers, and see how each on is billed. From telehealth to CPT codes for pPsychologist and beyond, this free resource will get you fast answers. 98940-98943 Chiropractic Manipulative Treatment Procedures. 98960-98962 Education and Training for Patient Self-Management . Manipulations should be billed using the appropriate CPT manipulation codes: 98940-98942. Do not use E&M procedure codes for manipulations. There are three CPT codes to assist you with accurately reporting manipulative treatment services. The work value (work per unit oftime) of the codes includes both cognitive and technical components an
CPT Procedure Codes Subject to the Legislated Visit Limit Code Description T1015 Clinic visit/encounter, all inclusive 90865 Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) 98943 Chiropractic manipulative treatment (CMT); extraspinal, one or more region Description Included CPT®, NDC, HCPCS Codes Request Type Approval Duration Continuing Outpatient Therapy (BH) 90791-90792, 90832-90853, 99211-99215, 90785 P50 90 days for codes 90791-90792 180 days for codes 90832- 90853, 99211-99215, 90785 Electroconvulsive Therapy (BH) 90791-90792, 90870 P64 90 days for codes 90791-9079 Reimbursement for the Collaborative Care Model. Primary care practices that are providing collaborative care services can now bill for those services using CPT® codes for Psychiatric collaborative care management services (99492, 99493, 99494). Medicare, and some commercial payers, and Medicaid plans are also providing coverage- check the. *The Oncology CPT® Code list for any individual client is highly dependent on the exact program structure selected and can be impacted by multiple: Effective: 1/1/2020 Category CPT® Code: CPT® Code Description Chiro; PT/OT: 97034 Application of a modality to 1 or more areas PT/OT 98943 Chiropractic manipulative treatment (CMT.
Description . A modifier enables a provider to report that a service or procedure has been altered by some specific XP, XU) will not allow additional payment when appended to CPT® codes 63005, 63012, 63017, 63030, 63035, 63042, 63044, 63047 and 63048 when performed in conjunction with 22630, 22632, 22633 and/or 22634. Based on the most. This rate includes rejected and denied claims. Medicare only covers CPT codes 98941, 98942, 98943 for Chiropractic practice. All other CPT codes billed to Medicare will be either deny or reject. Also, while submitting a claim to Medicare for manipulation, you must add the Acute Treatment (AT) modifier if you want to get paid
Most of the CPT codes with an assigned MUE are published by Medicare who updates the table quarterly. MUEs are assigned for a variety of reasons, such as policy or statutory restrictions, clinical benchmarks, etc. Not all MUEs are published, however; some are kept confidential by CMS. The published 2015 MUE table for Practitioners can be found at Description. Manipulation (OMT codes 98925-98929, CMT codes 98940-98943) is a passive maneuver in which a joint(s) is suddenly moved beyond the normal physiological range of movement* without exceeding the boundaries of anatomic integrity. This treatment may be accomplished by a variety of techniques Per CPT® guidelines, 97140 describes manual therapy techniques, such as mobilization and manipulation, manual lymphatic drainage, and manual traction. Chiropractic adjustments have their own set of codes (98940-98942, or 98943 for an extremity) when no other code exists to report what has been done. 3. Report the intended code with modifier 52. i. Example, if the planned procedure is a two-view chest x-ray and only one view of the chest is performed, do not report CPT code 71020-52 (for x-ray chest, two views-reduced service). Instead, report CPT code 71010 (x-ray chest, single view). ii CPT Coding Procedures • Use CPT codes to describe the service or treatment. • Choose the CPT procedure code that best describes the services. • Don't unbundle codes. Example: Don't provide an additional CPT procedural code for oral motor activities if providing speech treatment under CPT 92507 or 92526. Thos
CPT is short for Current Procedural Terminology and the codes published by the American Medical Association. CPT codes are used to classify medical, surgical and diagnostic services and procedures, and range from 00100 to 99499. CPT, ICD-9 and ICD-10 are numeric representations of data that allow for more efficient data retrieval The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel. The CPT code set (copyright protected by the AMA) describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation. CPT Code Description. 47562 Laparoscopy, surgical; cholecystectomy - Average fee 98940-98943. Questions and Answers has assigned maximum fee pricing to Current Procedural Terminology (CPT) code 49083 - Abdominal paracentesis (diagnostic or therapeutic) with imaging guidance. The maximum fee for CPT code 49083 is $412.39. For dates. Medicare chiropractic diagnosis codes 2021. Diagnosis Code Description Medicare Covered Chiropractic Services If the CPT code is 98940, 98941, or 98942 and is billed with one of the following primary diagnosis codes and with modifier AT, then the chiropractic service is covered Find below the latest Radiology CPT codes for for MRI of Brain, Breast, Lumbar Spine and Shoulder: CPT Codes for MRI Lumbar spine In human Lumbar spine is represented by the 5 vertebrae in between the ribcage and the pelvis forming the largest segment of the vertebral column
Some payers are denying Mechanical Traction (CPT Code 97012) on the same date of service as the Chiropractic Manipulative Treatment (CMT 98940-98942). Findings. Here is the rationale of one payer: both mechanical traction and spinal manipulation on the same date of service as the procedures, for all intents and purposes, are redundant The Current Procedural Terminology (CPT) is a set of codes, descriptions, and guidelines intended to describe procedures and services performed by? The common portion of the description is the portion printed in front of the? semicolon. The CPT book is updated? What is the full descriptor for code: 98943. chiropractic manipulation.
Bottom line: when 97530 and one of the physical therapy evaluation codes are billed together on the same day for the same patient, the evaluation code will be denied. This is because in the PTP edits list, 97530 is the Column One code and 97161, 97162, and 97163 are Column Two codes (see the answer to question 1 for more background on Column. Claims processing edits. We regularly update our claim payment system to better align with American Medical Association Current Procedural Terminology (CPT ® ), Healthcare Common Procedure Coding System (HCPCS) and International Classification of Diseases (ICD) code sets. We also align our system with other sources, such as, Centers for.
CPT Code: 99497 Description: Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate. Status Code. Good-bye CPT 96101 and CPT 96102. For 2019 beloved psychological testing codes 96101 and 96102 have vanished. Effective for dates of service on or after January 1, 2019, the Medicine/Central Nervous System Assessments/Tests subsection of the Current Procedural Terminology (CPT®) 2019 eliminated CPT codes 96101 and 96102 CPT Description Record Keeping Requirements 98940 Chiropractic manipulative treatment (CMT) involving one to two spinal regions Medical record must document: Claim must record a diagnosis code in all the applicable regions. 98943 Extraspinal, 1 or more regions Extraspinal (nonspinal) regions are CPT codes 98940 - 98943, please refer to the policy titled Manipulative 97533. 97535. 97537. 97542. 97545. 97546. 97750. 97760. 97761. Service Description - State of Michiga
CPT Codes 95900, 95903, 95904, and 95937 require the number of nerves in the time field. These should be listed on Form 25M or the Form 1500. There is a taking and reading fee for each of these codes in the new Medical Fee Schedule and modifiers are required. Special Services CPT codes will require modifiers Jul 1, 2016 Physical medicine CPT® codes billing guidance .. Timed codes can be identified in CPT® by the code description. The definition will . medicine modalities and procedures described in CPT® codes 97001-97750 if their. Outpatient Rehabilitation - Washington State Health Care Authority. www.hca.wa.gov. Jan 1, 2017. Description: This is the code description per the CPT Manual. . 97140. Required. One prior authorization is issued for diagnosis codes. I97.2, I89.0 and Q82.0 BILLING RESOURCE MANUAL - Georgia Department of. of the clinical components of CPT coding to ensure 3rd party payers are charged at 97153 and 97155: Concurrent billing is not permitted.Only one code should be billed when concurrent care services are performed. 97153 and 97156: Concurrent billing is permitted if the behavior technician, assistant behavior analyst or ABA supervisor is working with the beneficiary (CPT 97153) and the Aba Supervisor or a different ABA supervisor or assistant behavior analyst is conducting.