Insurance Billing Codes for Massage Therapists
The key to getting paid while billing insurance companies
is using the proper insurance billing codes. Bills may be returned or
refused because of improper coding. Providing these codes is just the
first step. You have to know how to use them for what type of massage you
are doing and your unique situation. I highly recommend that you take a
class in insurance billing so that
you can bill efficiently and within your scope of practice.
Billing Form CMS 1500- available at local office supply
stores or through
www.massageinsurancebilling.com Learn how to fill out a HCFA and get paid by
insurance companies when you purchase the
insurance billing manual.
CPT (Current Procedural Terminology) codes for
massage therapy and related procedures - identifies the type of care or the
procedure that is used in that care. The best way to know what codes the
insurance company will accept is to call and ask them!
You can not just bill whatever code that they accept.
You have to bill what ever code you are trained in. Setting your fees for
these codes are another issue. Just because you can get paid
more for certain codes, you have to charge the same amount you charge cash
clients (plus whatever additional billing fee there is) or else it is considered
insurance fraud. Please read more on the blog in the
insurance billing section. Find out the correct code to use and how to
use it by taking the massage insurance
billing distance learning class offered by Vivian Madison Mahoney - one of
the experts in massage billing.
97010- modality; hot or
cold packs- 15 minute increment
97124- massage treatment-15 minute increment
97140- myofascial release, manual therapy- 15 minute increment
97112- neuromuscular re-education- 15 minute increment
Diagnosis codes (ICD codes-International
Classification of Disease)- Diagnosis codes are often needed when billing even
though we are not able to diagnose. This information should come from the
referring physician. If the physician does not write the code on the
prescription, call them directly to get the code. I highly recommend that
you do not try to select your own code from the online code finder or the
information below as each physician may code things differently. I am
providing this information because physicians often write the code but they
don't say what it means.
Call the Physician to get the correct
code.
Also see the ICD-9 code search engines :
http://www.medilexicon.com/icd9codes.php
http://icd9cm.chrisendres.com/index.php
307.81
Headaches, tension
353.0 Thoracic Outlet Syndrome
354.0 Carpal Tunnel Syndrome
526.9 Jaw pain
714.30 Juvenine rheumatoid arthritis
715.9 Osteoarthritis
716.9 Arthritis NOS
719.41 Shoulder Pain
719.42 Elbow Pain
719.43 Wrist Pain
719.45 Hip Pain
719.46 Knee Pain
719.48 Joint pain- multiple areas
719.50 joint stiffness
719.56 Knee stiffness
722.11 displacement of thoracic
723.1 Cervicalgia (neck pain)
723.4 Radiculitis
723.5 Neck stiffness
724.1 Thoracic pain
724.2 Lumar back pain (myofascial pain, low back)
724.4 Thoracic radiculitis
724.5 Back pain: unspecified
726.0 Frozen Shoulder
726.10 Disorder of bursae and/or tendons of shoulder
726.30 Elbow tendinitis
728.85 Spasm of muscle
729.1 Cervical and thoracic Myalgia/Myofascitis/Myositis
729.4 Fascitis NOS
729.52 Leg/Foot pain
729.82 Cramp
780.7 Fatigue
784.0 Headache pain
839.0 Cervical subluxation
913.8 Forearm injury, unspecified
959.3 Wrist injury
E812.0 Collision with Motor Vehicle (driver)
E812.1 Collision with motor vehicle (passenger)
Sprain/ Strain
724.6 Back strain sacroiliac (chronic)
840.8 Sprain/Strain of other
840.9 shoulder (and upper arm, blade )
842.0 Wrist
843.0 Iliofemoral
843.8 Hamstring
845.0 Ankle/Foot
847.0 Cervical
847.1 Thoracic
847.2 Lumbar
846.0 Lumbosacral
846.1 Sacroiliac
848.9 Strain/Sprain NOS
See also:
http://www.massagetoday.com/archives/2004/11/14.html
http://www.massageandbodywork.com/Articles/FebMar2004/cptcodes.html
CPT Coding Issues and Answers By Vivian Madison-Mahoney