Some chiropractic physicians may struggle to determine if they should bill for therapeutic exercises or for therapeutic activities. This article from Dr. Evan Gwilliam may help to provide some clarification.
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As chiropractic physicians, we use evaluation and management codes frequently, but not at every encounter, as do our medical counterparts. These are the CPT® codes used to describe the work involved in figuring out what is wrong with a patient and creating a plan to manage him or her.
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Some time ago I worked with a client who needed help with an appeal. The provider had seen a patient over the course of four weeks for severe low back pain with radiculopathy to the left calf and foot. The provider put together a care plan and outlined goals based upon functional deficiencies. At each encounter, the following codes, among others, were billed:97110 Therapeutic exercises, 97140 Manual therapy. The therapy services were denied for most of the visits. The claims reviewer provided the following partial explanation for the denial:
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As part of the latest proposal to fix this problem, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed in 2015.
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