Osteopathic Manipulation CPT Codes

Osteopathic manipulation CPT codes are separated by body regions. The codes range from 98925 for 1-2 body regions and increases to 98929 for 9-10 body regions. The body regions referred to are: head region, cervical region, thoracic region, lunar region, sacral region, pelvic region, lower extremities, rib cage region, abdomen and viscera region.

Osteopathic Manipulation CPT Codes

Name of code

Description

98925

Osteopathic Manipulative Treatment (OMT)

How many body regions: 1 or 2

98926

Osteopathic Manipulative Treatment (OMT)

How many body regions: 3 or 4

98927

Osteopathic Manipulative Treatment (OMT)

How many body regions: 5 or 6 

98928

Osteopathic Manipulative Treatment (OMT)

How many body regions: 7 or 8

98929

Osteopathic Manipulative Treatment (OMT)

How many body regions: 9 or 10

The ICD-10 codes for osteopathic manipulative therapy range from M99.00 to M99.09, and are given in the table below. [3]

ICD-10 Code

Billing Description of Osteopathic Manipulative Therapy

M99.00Somatic dysfunction involving the head region
M99.01Somatic dysfunction involving the cervical region
M99.02Somatic dysfunction involving the thoracic region
M99.03Somatic dysfunction involving the lumbar region
M99.04Somatic dysfunction involving the sacral region
M99.05Somatic dysfunction involving the pelvic region
M99.06Somatic dysfunction involving the lower limb
M99.07Somatic dysfunction involving the upper limb
M99.08Somatic dysfunction involving the rib cage
M99.09Somatic dysfunction involving the abdomen and remaining regions

ICD-10 Coding System

The International Classification of Diseases 10th Edition (ICD-10), is a complex yet comprehensive coding used to report thousands of diagnoses and treatment procedures performed, with greater emphasis on diagnostic services. The ICD-10 codes are comprised of seven characters including both numbers and alphabets. The breakdown of an ICD-10 code is given as follows. [4]

S42.321A

S42CategoryDisplaced transverse fracture
3CauseFracture of humerus
2LocationShaft of humerus
1LateralityRight arm
AExtensionClosed shoulder

 

Coding Guidelines for Osteopathic Manipulative Therapy

Osteopathic manipulative therapy is performed by qualified healthcare providers on patients in whom somatic dysfunction is diagnosed via analysis of history and physical examination. Following guidelines should be considered by the doctors of osteopathic medicine while encoding for the services.

  1. The CPT codes in the osteopathic manipulative therapy only encode for the procedures performed on the patient.
  2. The evaluation and management services that are beyond the scope of osteopathic manipulative therapeutic procedures, are reported and documented by using the modifier-25. Modifier 25 is used when the evaluation and management services are provided by the same physician on the same day, although the patients may be different.
  3. Separate documentation of the emergency and management services is required despite the similar etiologies and presenting symptoms of these services and the osteopathic manipulative therapy.
  4. While the causes and symptoms are reported separately in the billing document, differential diagnosis is not required if both treatment and evaluation, and management are performed on the same day. [5]

Conclusion

A well-defined coding system is an integral part of the healthcare setups. CPT coding system is comprised of different sequences of five characters, including alphabets and numerals, used by the healthcare provides, insurance companies, and epidemiologists for collecting statistical information. The FDA-approved healthcare procedures are encoded by category I CPT codes. On the other hand, ICD-10 alphanumerical codes are seven characters long and are primarily used for reporting diagnostic procedures. Osteopathic manipulative therapy is a type of alternative medicine that uses mechanical forces to treat somatic dysfunction. Similar to any other healthcare specialty, osteopathic manipulative therapy also employs CPT and ICD-10 codes for reporting the procedures. Evaluation and management services may be reported by using modifier-25.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381089/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865623/
  3. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56954&ver=3
  4. http://www.icd10codesearch.com/training.php
  5. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52435&ver=9&SearchType=Advanced&CoverageSelection=Local&ArticleType=BC%7CSAD%7CRTC%7CReg&PolicyType=Both&s=All&CptHcpcsCode=98929&kq=true&bc=EAAAABAAEAAA&

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