Eli's Rehab Report

Question: Is 23 minutes of CPT 97140 and 8 minutes of 97110 for a total of 31 minutes actually equal to 3 units, or must this be constrained?


Alabama Subscriber


Answer: If you were reporting 23 minutes of 97140 (Manual therapy techniques [e.g., mobilization/manipulation, manual lymphatic drainage, manual traction], one or more regions, each 15 minutes) alone, that would mean reporting two units of 97140.

If your therapist performed 8 minutes of 97110 (Therapeutic procedure, one or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility) alone, you would report one unit of 97110.

2 units of 97140
+1 unit of 97110
______________
3 units of service

However, if you add 23 minutes and 8 minutes together, you reach 31 minutes of total therapy time. If you look at your time units chart, this is equal to 2 units of service, rather than the 3 units you get when you simply add these codes together.

For Medicare, you must therefore constrain what you report. So because 97110 took only 8 minutes, you would strike off the entire unit of 97110 and not report it.

Editor's note: E-mail me at suzannel@eliresearch.com for a free timetable of the 8-minute rule.