Eli's Rehab Report

Question: The April issue of Physical Medicine and Rehab Coding Alert stated that most payers wont reimburse for Hubbard tank and whirlpool on the same day, and that you should not bill the combination as manual therapy. However, when we bill these together, we add the time spent and bill it as manual therapy and always get paid. Why would they reimburse?

Illinois Subscriber

Answer: On your form, you are most likely billing 97140 (manual therapy) without a specific description of what you performed (e.g., whirlpool), so your payer is assuming that you performed one of the services payable under 97140, such as manual traction or manual lymphatic drainage. But if the insurer (or the OIG) came to your office and reviewed your records, they would find that you added together the patients time spent on Hubbard tank (97036) and whirlpool (97022) and incorrectly billed that as several units of 97140. Correct coding dictates that you cannot bill for a service that you have not documented in the patients record, so if you did not perform manual therapy, you absolutely cannot bill for it.