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USAA and 97140

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List Mates,

I just recieved this denil letter from USAA - a PI case. I billed a 98940

and 97140 with the modifier to idicate a separate procedure. (They had

previously denied a 97124 - massage therapy.) Any suggestions?

The issue for review is the billing of CPT 97140 (manual therapy) in

conjunction with 98940 (manipulative therapy).

The 1999 edition of CPT includes changes in the Physical Medicine section.

The inclusion of CPT 97140 included all techniques as mobilization,

manipulation, lymphatic drainage, and manual traction. This is a timed

procedure, each 15 minutes, reflecting direct contact with the patient.

The CPT assistant for November 1998 further clarifed this code.

Specifically, the issue indicated that 97140 does not describe chiropractic

or osteopathic treatment. It is further idicated that it would not be

appropriate to bill 97140 and an CMT code when treatment is provided to the

same body region. Accordingly, we are unable to recommend reimburstment for

97140.

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