Keeping up with billing code changes that affect your practice can be challenging! I think you will find this updated information on how to properly bill for lymphedema treatment and compression bandaging helpful.
The following 29581-29584 series of billing codes concerning the application of a multi-layer compression system were either newly created or updated in the Current Procedural Terminology (CPT) manual in 2012:
Billing codes for application of multi-layer compression system for…
- 29581 …leg (below knee), including ankle and foot
- 29582 …thigh and leg, including ankle and foot
- 29589 …upper arm and forearm
- 29584 …upper arm, forearm, hand and fingers
The 2012 manual had a parenthetical statement following each of these codes indicating that they could not be reported in conjunction with 97140. The change for 2013 is that this parenthetical statement has been removed, and the 29581-29584 series can now be reported on the same date of service as 97140.
From the American Physical Therapy Association:
APTA representatives had considerable dialog with the CPT editorial panel to explain the coding challenges faced by therapists who perform manual lymph drainage which is then reinforced by the application of compression bandages.
The 2013 CPT Changes book explains:
“The manual therapy technique code 97140 is considered a separate and distinct procedure from the application of a multi-layer compression bandage codes 29581, 29582, 29583, and 29584. Therefore, code 97140 has been removed from the exclusionary parenthetical notes following codes 29581, 29582, 29583, and 29584. This revision will allow appropriate reporting of all distinct procedures performed on a patient.”
The appropriate coding for applying compression bandages to support manual lymph drainage, starting January 1st of this year, is to report the appropriate number of units of 97140 for the time spent performing manual lymph drainage, and one unit of the appropriate strapping code for the compression bandaging.
There is a correct coding initiative edit with the compression bandaging codes in column 1 and 97140 in column 2, which means that you also need to use modifier 59 on the same line as 97140. CCI edit lists are available on the CMS.gov website. Select NCCI Coding Edits in the left navigation box. To view these particular edits, select the first of the two Physician CCI edits files under “related links.” The second of the Physician CCI edits files contains the majority of the edits pertinent to physical therapists, as it includes the 97000 series in column 1.