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  • Revised CPT Codes Delayed Until 2016

    The magnitude of proposed changes to an entire family of physical medicine and rehabilitation codes has prompted the editorial panel for the American Medical Association's (AMA) Current Procedural Terminology (CPT) document to postpone finalization of the revisions. Instead, the committee agreed to allow additional time for pilot testing and refinement and has targeted a January 2016 implementation date.

    APTA representatives participated in the most recent editorial panel meeting February 6–8, where the group discussed options for revisions to the 97000 series of the CPT codes (physical medicine and rehabilitation). The panel expressed support for the direction of the coding proposal and made some suggestions for refinements. The codes are set to be pilot tested during the coming weeks.

    APTA is committed to refining the definitions of the new codes and will issue a request for proposals for carrying out the pilot project. Association members can access background information and resources on CPT at APTA's coding and billing webpage, and can also access APTA information on payment reform.


    • I'm glad to see this happening. I was about to email APTA regarding the need for more specific codes based on different PT services provided. I feel researchers are quick to lump everything into codes that exist, for example at a recent CSM talk, VR rehabilitation was being lumped into 97112. I feel this greatly generalizes our field, saying everyone does the same thing. I don't do lymphedema but it's 97140 or 97124, but feel it should have its own code. Another personal example, I'm negotiating specialty contracts with insurance companies and they are denying us at because of the CPT codes saying well our other physical therapists use those codes (97001, 97112, 97530, etc...) and hence we're not a specialty clinic. We only have <10% of cases that are "ortho/pain." WE NEED CPT REFORM FOR THERAPISTS.

      Posted by Nirav Patel, DPT on 2/23/2014 12:36 PM

    • now after icd10 we have cpt also getting delayed, that too till 2016

      Posted by jitendra medical coding on 8/17/2014 1:12 PM

    • Our office is being no longer being paid by Hawaii Workers' Comp under 97140. The denial states "IASTM does not support Manual Therapy as defined by AMA CPT". The use of tools for MT was discussed with the auditing company that reviews local Workers' Comp claims, including mobilization belts and instruments to apply pressure to "trigger points". They responded with expectation of denials of all activities that were not "hands on the patient" We do need more specific codes, but what can we do now to expand or appropriately define 97140.

      Posted by Betty Fackler on 2/4/2016 8:02 PM

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