Using Manual Therapy CPT Code: A Guide for Physical Therapists

Manual therapy stands as a cornerstone in the toolkit used by physical therapists, offering a hands-on approach to alleviate pain, enhance mobility and functional range, and accelerate patient recovery.

The effectiveness of manual therapy techniques like mobilization, manipulation, and myofascial release can make a significant difference in patient outcomes. However, the benefits of these treatments can only be fully realized when they are accurately documented and billed. Understanding and correctly utilizing codes, such as manual therapy CPT® code 97140, is essential for ensuring appropriate reimbursement and compliance.

Accurate coding is more than a bureaucratic necessity; it directly impacts the financial health of a practice and the quality of care that patients receive. Incorrect coding can lead to denied claims, delayed payments, and even legal complications. Furthermore, thorough and precise documentation supports the validity of the treatments provided, reinforcing their necessity and effectiveness.

In this post, we will delve into the various forms of manual therapy, the key CPT® codes associated with rehabilitation therapeutic procedures used with these treatments, and best practices for using and documenting these codes. By the end, rehab therapy providers will have a clearer understanding of how to navigate the complexities of manual therapy coding and ensure their practices thrive both clinically and financially.

What is Manual Therapy?

Manual therapy is a specialized form of physical therapy that involves skilled, hands-on techniques to mobilize joints, soft tissues, and muscles. These manual techniques are designed to alleviate pain, reduce muscle tension, enhance circulation, and improve overall function and mobility.

The scope of manual therapy encompasses a variety of methods, each tailored to address specific patient needs and conditions. Different forms of manual therapy include:

• Mobilization/Manipulation. These techniques involve the application of controlled force to a joint to restore mobility and function. Mobilization typically involves slow, gentle movements, while manipulation is a more rapid, forceful technique.
• Myofascial Release. This method targets the fascia—the connective tissue surrounding muscles—to relieve tension and improve movement. Therapists use their hands to apply sustained pressure and stretch to the affected areas.
• Manual Lymphatic Drainage. This gentle technique stimulates the lymphatic system to reduce swelling and improve lymph flow. It is particularly useful for patients with lymphedema.
• Trigger Point Therapy. This therapeutic procedure focuses on releasing tight, knotted muscles, known as trigger points, which can cause pain in other parts of the body.

The Benefits of Manual Therapy

Manual therapy plays a vital role in the rehabilitation and recovery process, offering numerous benefits for patients. It’s a versatile treatment option in physical medicine that can be tailored to address a wide range of musculoskeletal issues.

Patients who receive manual therapy as part of their physical or occupational therapy treatment plans or regimens often experience one or more of the following benefits.

• Pain Relief: Manual therapy can significantly reduce acute and chronic pain by addressing the underlying causes, such as joint restrictions and muscle tightness.
• Improved Mobility: By enhancing joint and muscle function, manual therapy helps restore normal movement patterns, making everyday activities easier and less painful.
• Enhanced Recovery: Incorporating manual therapy into a comprehensive treatment plan can accelerate the healing process, allowing patients to return to their normal activities more quickly.
• Holistic Approach: Manual therapy often addresses not just the symptoms but also the root causes of dysfunction, promoting overall health and well-being.

Understanding the diverse applications and benefits of manual therapy is essential for physical therapists who utilize these therapeutic exercises for post-surgical rehabitation and to treat common musculoskeletal ailments (i.e. low back pain, neck pain, shoulder pain, sports injuries, etc.).

This knowledge not only enhances their ability to treat patients effectively but also underscores the importance of accurate coding and documentation to reflect the comprehensive care provided.

Understanding and Using CPT® Code 97140 (Manual Therapy)

CPT® (Current Procedural Terminology) codes are a standardized set of medical codes used to report diagnostics, surgical, and therapeutic procedures to health insurance companies. These codes are essential for accurate billing and documentation of medical services. For physical therapists, understanding and correctly applying CPT® codes is crucial for ensuring proper reimbursement and maintaining compliance with healthcare regulations.

Specifically, CPT® code 97140 is used to bill for manual therapy techniques. This includes joint mobilization/manipulation, manual lymphatic drainage, and manual traction, applied to one or more regions of the body to alleviate pain, improve mobility, and enhance overall function.

Code 97140 is a time-based billing code that is billed in 15-minute increments. This means the 8-minute rule applies and that the documentation must reflect the specific amount of time spent performing a manual therapy technique during each session.

Accurate time tracking and documentation are essential to ensure proper billing and compliance with payer requirements. These include documentation guidelines that require:

• Detailed Notes. Comprehensive documentation should include the specific manual therapy techniques used, the specific body region treated, and the patient’s response to the treatment.
• Explanation of Medical Necessity. Clearly outline the medical necessity for manual therapy in the patient’s treatment plan, including the diagnosis and expected outcomes.
• Session Details. Document the duration of each session and any combination of therapies provided to ensure accurate and compliant billing.

Proper use of this code reflects the quality and necessity of the manual therapy services provided, ensuring appropriate reimbursement and compliance with healthcare regulations.

Combining Code 97140 with Other CPT® Codes

CPT® code 97140 is often used in conjunction with other therapeutic codes to provide a comprehensive treatment plan. Combining manual therapy with other interventions can enhance patient outcomes. For example, a patient with low back pain might receive manual therapy to improve joint mobility, followed by therapeutic exercises to strengthen the supporting muscles and prevent future problems.

The following are procedural codes that are most likely to be used in tandem with manual therapy.

• Therapeutic Exercise (CPT® Code 97110): This code covers exercises aimed at developing strength, endurance, range of motion, and flexibility. Combining manual therapy with therapeutic exercises can enhance recovery by addressing both joint mobility and muscle strength. For example, a patient with shoulder impingement might receive manual therapy (97140) to improve joint mobility and reduce pain, followed by therapeutic exercises (97110) to strengthen the surrounding muscles and prevent recurrence.
• Neuromuscular Re-Education (CPT® Code 97112): Code 97112 involves activities designed to improve balance, coordination, posture, and proprioception. Integrating manual therapy with neuromuscular re-education can be particularly beneficial for patients with neurological impairments or those recovering from significant injuries. For example, a patient recovering from a stroke might benefit from manual therapy to alleviate muscle tightness and improve joint mobility, alongside neuromuscular re-education to restore balance and coordination.
• Electrical Stimulation (Manual) (CPT® Code 97032): This code is used for the application of electrical stimulation to reduce pain and improve muscle function. It can complement manual therapy by enhancing the therapeutic effects on muscles and tissues. A patient with chronic pain, for instance, might receive manual therapy (97140) to address soft tissue restrictions, followed by electrical stimulation (97032) to manage pain.
• Ultrasound Therapy (CPT® Code 97035): This modality involves the use of sound waves to promote tissue healing and reduce inflammation. Combining ultrasound therapy with manual therapy can accelerate recovery and improve outcomes. A patient with tendinitis, for example, might receive ultrasound therapy (97035) to reduce inflammation, followed by manual therapy (97140) to improve tissue mobility.
• Therapeutic Activities (CPT® Code 97530): This code includes dynamic activities to improve functional performance, often used in conjunction with manual therapy to facilitate daily activities and movement. For instance, patient with knee osteoarthritis might receive manual therapy (97140) to improve joint function, followed by therapeutic activities (97530) to enhance functional movement.
• Gait Training Therapy (CPT® Code 97116): This code is used for training patients to improve walking skills. Combining gait training with manual therapy can be beneficial for patients recovering from lower limb injuries or surgeries. As an example, a post-surgical patient might receive manual therapy (97140) to reduce stiffness and pain, followed by gait training (97116) to restore normal walking patterns.
• Self-Care/Home Management Training (CPT® Code 97535): This code includes patient education and training for activities of daily living (ADLs). Manual therapy can be combined with self-care training to enhance patient independence. A patient with rheumatoid arthritis, for example, might receive manual therapy (97140) to improve joint mobility, followed by self-care training (97535) to adapt daily tasks.
• Functional Capacity Evaluation (CPT® Code 97750): This code involves the assessment of a patient’s ability to perform work-related tasks. Manual therapy can be part of the evaluation and treatment process to address physical limitations.

When utilizing multiple codes, it’s important to avoid double-billing. In other words, do not bill manual occupational therapy or physical therapy services under both 97140 and another code for the same service.

It’s also critical physical therapists and occupational therapists use appropriate modifiers when applying billing codes, especially those that indicate that distinct services were provided. For example, Modifier 59 (distinct procedural service) can be used to indicate that manual therapy and therapeutic exercises were separate and necessary services provided during the same session, ensuring successful reimbursement while preventing denials.

Master CPT® Codes to Meet Modern Healthcare Challenges

Accurate coding and documentation for manual therapy, particularly when using CPT® code 97140, are vital components of a successful physical therapy practice. These practices ensure not only appropriate reimbursement and compliance with legal and regulatory standards, but also enhance the quality of direct patient care.

By understanding the various forms of manual therapy, correctly applying relevant CPT® codes, and adhering to best practices in documentation, physical therapists can optimize their treatment plans and financial health.

Thorough documentation also contributes to better patient outcomes. It allows for more effective tracking of progress, coordinated care among healthcare providers, and transparent communication with patients. These factors collectively build trust and reinforce the professional reputation of the practice.

For further information and resources, therapists are encouraged to consult authoritative guidelines and continue their education on the nuances of CPT® coding and documentation. By doing so, they can ensure their practices are well-equipped to meet the challenges of the modern healthcare environment.