If you are providing massage therapy services to your clients, then you probably understand just how complex running a business can really be. There are just so many things to worry about, and you may find yourself rather overwhelmed with some of them from time to time. And then, there are rules, regulations and codes to follow and be in compliance with in order to do everything the right way and ensure proper operations.
What does the above mean precisely, though? Well, clearly, it means there are massage therapy codes you should follow, if you want to be sure you’re doing everything correctly. And, among them, there is the 97124 CPT Code, known to be quite important for billing. If you have heard of it already, but you aren’t quite sure what it entails and how it works, then you should definitely keep on reading, because below I will give you some more info on what you need to know, by answering some important questions about this particular concept.
What Exactly Is 97124 CPT Code?
Naturally, we are going to begin with the most basic question here – the question of what this concept actually entails. So, to cut right to the chase, the 97124 CPT code is a procedural code used to bill for massage therapy services, often designed to cover some specific massage therapy techniques, such as petrissage, effleurage and similar. The idea is for it to ensure uniformity in billing, and it refers specifically to therapeutic procedures, meaning that it requires direct contact with the patient.
What does that precisely mean, though, and why does it matter? Well, it matters for one simple thing. Basically, the fact that direct contact is required means that the service has to be actively performed by the actual provider, as reimbursement will certainly depend on that. So, it is no wonder that this code is most usually used by massage therapists providing massage therapy, as that is certainly a directly performed service.
Why Is It Important?
Now, the above should have given you a clearer idea on what this particular code actually is. Yet, you may still be wondering why it is that it’s so important. Well, there are several reasons for that. And below I am going to tell you about a few of those, hoping to help you get a clearer overview of the actual importance of this concept.
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First things first, 97124 CPT facilities the process of getting reimbursed by insurance companies. In short, using it properly means you’ll receive the reimbursement for the services you have provided, as many insurance companies will cover these expenses, as long as they are billed under 97124, and as long as they are justified in the treatment plan. The point is, thus, that you can more easily get reimbursed if you use this code when it is justified.
Now, there are certainly some other types of manual therapy techniques out there, such as joint mobilization and similar. Differentiating among those and massage therapy is important, and you can easily do it with the right code. So, to cut to the chase, the 97124 CPT code distinguishes among those various ones, and thus ensures compliance with those billing regulations, as well as prevent claim denials, which is also highly significant.
Another reason why it is important is because it actually helps standardize patient care. In other words, it helps establish best practices for the massage therapists that want to integrate the service into rehabilitation programs. So, the code provides a clear framework that helps document massage therapy as a treatment method, which is certainly of huge importance. Read more on the code.
When Should You Use It?
The next thing you are wondering is when using the 97124 CPT code is actually the right idea. Well, it is actually appropriate when massage therapy is a part of a specific and structured treatment plan, and aimed at achieving certain specific therapeutic goals. Those goals can include everything from pain management and muscle relaxation and recovery to lymphatic drainage, improved circulation, or musculoskeletal issues. In short, you can properly document these medically necessary interventions and then bill them using the 97124 CPT code.
What Documentation Should You Provide?
To justify the reimbursement claims, you will have to provide your insurance provider with the necessary documentation, so as to prove the medical necessity. If you don’t, then your claim is likely to be denies, and that is certainly not what you want. So, what you have to provide is documents on patient’s evaluation and medical necessity, detailed treatment notes, billing and coding compliance, as well as insurance verification and pre-authorization if required. Then, file the claim and get the reimbursement.
