Question:
-- Wisconsin Subscriber
Answer:
Based on what you wrote, and assuming the patient received no other one-on-one treatment you should append modifier 59 (Distinct procedural service) to the manual therapy code 97140. Here's how you know which code to attach it to on the claim form:First, go to http://gawendaseminars.com/medicare_cci.aspx to easily access the most recent Correct Coding Initiative edits provided by the Centers for Medicare & Medicaid Services. Look for the relevant codes in the Excel file. When you find the code pair relevant to your situation, append the modifier to the code that appears in the second column (the one on the right-hand side).
In your case, manual therapy is mutually exclusive of mechanical traction if performed and billed on the same day to a Medicare patient receiving outpatient therapy services. By appending modifier 59 to the manual therapy code (97140), you are stating to your Medicare contractor that the therapist provided the services at separate and distinct times of each other and you want to be reimbursed for both services.
Careful:
If you apply the modifier to the wrong code, you'll only get paid for that code, instead of both.