Eli's Rehab Report

Question: I have heard many coding consultants recommend using the Level II site modifiers (such as FA, F1 through F9) when we treat multiple sites (such as two different fingers for manual therapy). But our new office manager said that these modifiers are for surgery only and don't apply to PT services. Is this accurate? 


Pennsylvania Subscriber


Answer: CMS does not specifically dictate whether you should append the finger modifiers to therapy codes, but many private payers advise that you use them to designate the anatomic site that your therapist treated.

But some CPT code descriptions include multiple regions, such as 97140 (Manual therapy techniques [e.g., mobilization/manipulation, manual lymphatic drainage, manual traction], one or more regions, each 15 minutes). The number of billing units you'll report depends on the amount of time the therapist spends on this service rather than how many different areas he treats.

If, however, your carrier limits the amount of time your therapist can spend performing manual therapy and she exceeds it because she treats separate sites, the level II modifiers may help you demonstrate why the PT went over the recommended frequency guidelines or time limits.