Anesthesia Coding Alert

Question: We're adding a massage therapist to provide myofascial release and massage therapy for pain patients. How should we plan to bill her services?

Indiana Subscriber

Answer: Massage therapy services provided by a massage therapist may have limited payer coverage. Medicare and some commercial carriers do not recognize massage therapists as authorized or credentialed providers. As of July 2005, Medicare also clarified that you should not report a massage therapist's services as incident-to therapy under the physician's name and NPI.

Exception: Some state workers' compensation and auto injury carriers do cover a massage therapist's services. Some patients also elect to self-pay for massage therapy services. Check each payer's coverage policy before proceeding with the service.

Coding it: If the carrier in question does recognize massage therapy services, you'll likely report either 97124 (Therapeutic procedure, one or more areas, each 15 minutes; massage including effleurage, petrissage and/or tapotement [stroking, compression, percussion]) or 97140 (Manual therapy techniques [e.g., mobilization/manipulation, manual lymphatic drainage, manual traction], one or more regions, each 15 minutes).

CCI note: Correct Coding Initiative (CCI) edits bundle 97124 into 97140. You cannot bypass the edit with a modifier, including modifier 59 (Distinct procedural service), so you should not bill the services together for the same patient, same provider or same date of service.