CPT code for massage therapy is 97124; it falls under Physical Medicine and Rehabilitation Therapeutic Procedures. Massage therapy CPT code 97124 is maintained by the American Medical Association (AMA).
Massage therapy is a practice done by licensed specialists, and it involves the manipulation of human soft tissue and muscles. This therapy increases well-being, typically applied using hands, fingers, knees, elbows, or devices. Massage therapy has several benefits, making it a popular treatment for various health conditions. And with healthcare providers referring their patients to massage therapy, insurance payers are adding it to their “covered” services list.
CPT Code 97124: Code Description
Massage therapy CPT code 97124 code description is as follows:
The therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage, and/or tapotement (stroking, compression, percussion).
Massage therapy CPT code is a time-based code or service, i.e., this code is reported in units of 15 minutes.
This therapy is a therapeutic procedure; therefore, it requires a direct interaction between the physician and the patient. A therapeutic procedure is “effecting change via clinical skills or services in an attempt to improve the functionality.” These procedures should be performed by a physician or a therapist appropriately licensed to do so. Massage therapy includes the following specific techniques:
- Effleurage: massage technique involving circular motions
- Petrissage: massage technique involving squeezing to alleviate the muscle spasm.
- And/or tapotement (stroking, compression, percussion)
According to AAPC:
A massage expert or a therapist performs various types of stroking and other massages on a patient’s body for therapeutic purposes. Massage therapy aims to increase or restore blood circulation and relax the muscles. The therapy technique comprises different styles, light, and firm pressure using hands, palms, fingers, and thumbs.
Errors in CPT code: A massage therapy
Common errors associated with massage therapy CPT codes include the following:
Confusion between the CPT codes:
CPT codes 97124 and 97140 are for two different therapeutic procedures; massage therapy and manual therapy. Confusion in these codes can result in errors in the medical claims and, therefore, claim denials.
Using incorrect modifiers in medical billing:
Modifiers provide additional information and shed light on the services or procedures performed by the physician. This is why using the correct modifier is necessary for proper medical billing. Modifier 59 is used to distinguish between the two codes when it comes to linked therapies, e.g., massage therapy and manual therapy. Modifier 59 is used to report the “Distinct Procedural Services.”
Massage Therapy Vs. Manual Therapy:
When it comes to coding the massage therapy performed, providers often get confused between manual therapy and massage therapy. This is why medical coding and billing errors usually occur when these two are coded at similar times.
Manual Therapy:
CPT Code for manual therapy is 97140. Manual therapy techniques; 1 or more regions; every 15 minutes. This is also a time-based code including the following manual therapy techniques:
- Manual traction
- Mobilisation or manipulation
- Manual lymphatic drainage
The physicians prescribe manual therapy treatment to help address the factors impeding the functionality, including:
- The loss of joint strength
- Mobility
- Range of motion
A manual therapy CPT code can be used only if one or a combination of the following techniques are performed. The patient documentation must specifically highlight any of the methods mentioned below:
- Soft tissue mobilisation
- Manual Traction
- Compression bandaging
- Joint Mobilisation or manipulation
One of the significant differences between manual therapy and massage therapy is the reimbursement/payment. The one-unit payment for massage therapy is higher than one unit of manual therapy. This is the reason why making sure to bill the correct code instead of focusing on higher payments is necessary for proper medical billing. Using the wrong code can result in the medical claim being denied or rejected, landing you in hot waters.
The goal of manual therapy:
The goal of manual therapy is to:
- Restore the soft tissue and muscle function
- Increasing mobility and range of motion without pain
- Increasing myofascial tissue’s extensibility
- Help in relieving the pain by using natural body movements
Manual therapy aims to reduce pain and increase the quality of joint movement. This therapy is applied to a specific area or region to address the exact cause.
The use of the specific code depends on the type of technique the physician is using. For instance, if a physician aims to increase blood circulation, the correct code is CPT code 97124 (massage therapy). However, if the physician aims to restore the “active pain-free range of motion,” the valid code to use is 97140 for manual therapy.
Tips for CPT code 97124 Massage Therapy:
Correct medical billing and coding for massage therapy improve the revenue cycle and reimbursements of the healthcare practice. Several factors are to be considered when billing the CPT code; massage therapy.
Manual therapy and massage therapy are linked codes. It means if these therapies are billed, only one of them is reimbursed even though both services were performed. For this particular scenario, modifier 59 should be used. Following are some of the factors to be considered:
Use of Modifier 59:
Modifier 59 is to report a “distinct procedural service.” It is used when the physician needs to indicate that a particular service is independent of the other services performed. If separate services are performed on the same day or visit, using this modifier for the linked code or same code ensures proper medical billing.
As manual therapy and massage therapy are linked, billing the two services together can be considered double billing. This is why using the modifier 59 can signify that the two services are distinct and separate from one another so that both can be reimbursed.
Complying with the 8-minute rule:
Medicare and Medicaid require a minimum time period for billing a treatment. Complying with the 8-minute rule is a necessity when billing massage therapy and manual therapy. The 8-minute rule was devised because not all the treatments end up for 15 minutes. This is the reason why the physicians or healthcare providers are required to spend at least 8 minutes of a treatment session to bill one unit. As; 8 minutes to 22 minutes are equal to 1 unit. Ensure that the treatment sessions meet the minimum time requirement when medical coding.
What are CPT Codes?
CPT stands for Current Procedural Terminology codes. This code set is maintained by the American Medical Association (AMA). Each and every CPT code is assigned to a specific procedure or service provided by the healthcare practice/physician. It is divided into several categories:
- Category I – These are the most commonly used codes by medical coders to report medical services and procedures. Category I codes are five-digit numeric codes only, ranging from 00100 to 99499.
- Category II – This category comprises codes for performance measurement. Category II codes are supplemental tracking codes. These alphanumeric codes comprise four digits ending with an “F.” These codes are optional, meaning they are not required for proper medical coding.
- Category III – This code set comprises temporary codes for emerging technology, procedures, and services. They are alphanumeric codes, four digits ending with a “T.
Importance of correct Medical Coding:
Correct medical coding is necessary as it directly impacts the revenue cycle and reimbursements. Following are some of the benefits of proper medical coding and billing:
- Reduced errors
- Increased reimbursements
- Improved revenue cycle
- Higher clean claim rate
- Faster payments
- Streamlined workflow and cash flows
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Introduction to Massage Therapy:
Massage therapy is the practice of kneading and rubbing the body using hands, fingers, elbows, palms to improve:
- The blood circulation
- Relax Muscles and soft tissues
Massage therapy is a therapeutic procedure with the aim of improving bodily function. The goal of massage therapy is to:
- Restore the muscle function
- Increase the blood circulation
- Decrease the specific stiffness
There are various types of massage techniques. Some of them include:
- Swedish Massage
- Hot Stone Massage
- Deep tissue massage
- Sports massage
- Trigger point massage
Benefits of Massage therapy:
Several benefits are associated with massage therapy, including both physical and psychological. Significant advantages of massage include:
- Reducing stress
- Increase relaxation
- Improved blood circulation
- Reducing pain and muscle tensions
Along with these, some research shows several other benefits of massage therapy. These studies show that massage therapy is helpful for the following conditions as well:
- Anxiety
- Digestive disorders
- Nerve pain
- Headaches
- Sports injuries
- Lower back pain
- Upper back and neck pain
- Injuries and strains related to soft tissues
Risks of Massage therapy:
Along with some benefits, there are also some risks associated with massage therapy. These risks may be related to another medical condition the patient might have. These conditions may include:
- Bleeding disorders
- Severe osteoporosis
- Infections
- Broken bones
- Burns or healing wounds
Discussing the advantages and disadvantages of massage therapy are important, especially when you are pregnant.
Frequently Asked Questions (FAQs)
1. What is the massage therapy CPT code in Medical Billing?
97124 is the CPT code for massage therapy; it falls under Physical Medicine and Rehabilitation Therapeutic Procedures. CPT code 97124 is maintained by the American Medical Association (AMA). Massage therapy CPT code is a time-based code or service, i.e., 15 minutes. It includes the following specific techniques:
- Effleurage: massage technique involving circular motions
- Petrissage: massage technique involving squeezing to alleviate the muscle spasm.
- And/or tapotement (stroking, compression, percussion)
2. What are the common massage therapy CPT code errors?
When it comes to coding the massage therapy provided, providers often get confused between manual therapy and massage therapy. This is why medical coding and billing errors usually occur when these two are coded at similar times. Common massage therapy billing errors include using an incorrect modifier. Modifier 59 should be used when coding or billing the linked procedures/services.
3. How do you prevent massage therapy CPT code errors?
Correct medical billing and coding massage therapy improve the revenues cycle and reimbursements of the healthcare practice. Modifier 59 can signify that the two services are distinct and separate from one another so that both can be reimbursed. Manual therapy and massage therapy are considered to be linked, which is why modifier 59 should be used to prevent errors like double billing.
https://www.e2emedicalbilling.com/blog/97124-cpt-code-know-your-codes/
A couple of years ago, I executed the effective plan of creating a Medical billing and Coding company named U Control Billing. The company aims to bring revolutionary advancements to foster medical billing and coding revenues. As an official member of HIA-LI and MGMA, I feel honored in providing networking opportunities, problem-solving, and improving the revenue management cycle.
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