You Be the Coder:
Bad Ragaz Is It Aquatic Therapy?
Published on Mon Oct 01, 2001
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: Our therapist has recently begun performing a therapy called Bad Ragaz, which involves floating the patient in a pool to perform exercises. Is there a code for this? If not, can we bill it as aquatic therapy, therapeutic exercises or any of the other existing codes?
Michigan Subscriber
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Answer: Bad Ragaz is a combination of proprioceptive neuromuscular facilitation (PNF) techniques and aquatic therapy, and there is no specific code for it. Although many PNF techniques are used while the patient is immersed in water, most experts believe that Bad Ragaz is more appropriately coded as "aquatic therapy with therapeutic exercises," CPT 97113 , than as 97112 (neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture, and proprioception).
While experts can usually collect reimbursement for either of these codes when administering Bad Ragaz, the rationale for using 97113 is that most carriers would agree that therapy taking place in water constitutes aquatic therapy, but some carriers might deny a claim for 97112 when the patient performed aquatic exercises rather than standard PNF. This may vary by carrier, so first ask your insurers whether they have a standard code for billing Bad Ragaz. Either way, both codes pay about $30 per unit billed, so you won't be losing money if you switch from 97112 to the more appropriate 97113. | |
