Eli's Rehab Report

Reader Question:

Lymphatic Drainage Therapy

Question: One of our occupational therapists went to a seminar where she was told to bill for lymphatic drainage therapy using CPT 97140 for the manual drainage (about one hour), 97535 for the wrapping and bandaging (about 30 minutes), and 97110 for the therapeutic exercises afterward (about 30 minutes). Is this correct?

Georgia Subscriber
 
Answer: You would bill 97140 (manual therapy techniques) for the lymphatic drainage and for the wrapping and bandaging. In your case, you would charge six units of 97140 -- four for the manual drainage and two for the wrapping. 97535 (self care/home management training [e.g., activities of daily living (ADL) and compensatory training, meal preparation, safety procedures, and instructions in use of adaptive equipment] direct one-on-one contact by provider, each 15 minutes) would not be appropriate for bandaging a patient, because that code is generally reserved for activities of daily living (ADL) training, and most carriers would not cover wrapping and bandaging under this code.
 
Note: If, however, you were teaching the patient how to bandage and wrap, the service might qualify for ADL training. For instance, if the patient just had surgery on her wrists and you were teaching her unique ways to bandage another body part with the injured wrists, that might meet your carriers requirements for billing ADL training.
 
Because many carriers limit the number of units that can be billed under 97140, you should check with your insurer ahead of time to determine whether the 90 minutes (six units) of manual therapy that you performed would be payable for this patient. You are correct in billing 97110 for the therapeutic exercises. Your 30 minutes of service would warrant the OT billing two units of this code.