Osteopathic Manipulative Therapy CPT Codes

Owing to the side effects associated with conventional medical and surgical treatments, a significant percentage of the global population is inclined towards an alternative form of treatment. Osteopathic manipulative therapy is a form of alternative medicine that applies a holistic approach to achieve mental, physical, and spiritual wellbeing in an individual. Somatic dysfunction is referred to the impairment of muscles, joints, bones, myofascial structures, and the associated neurovasculature. Osteopathic manipulative therapy involves the assessment of musculoskeletal disorders via palpation, followed by hands-on manipulation of the components of the musculoskeletal system in order to treat the somatic dysfunction. This therapy improves the limited range of movement and alleviates pain and tenderness in the somatic dysfunction. [1]

CPT Codes and Osteopathic Manipulative Therapy 

CPT codes refer to the Current Procedural Terminology codes, which are used to report services offered and procedures performed by qualified healthcare providers, including the doctors of osteopathic medicine. CPT is a list of codes composed of numbers and alphabets and is an integral part of level I of the HCPCS (Healthcare Common Procedure Coding System). CPT codes are the preferable mode of reporting healthcare procedures in the Centers for Medicare and Medicaid Services (CMS), the federal healthcare program. 

CPT codes are classified into three categories based on the procedures they represent. The categories of CPT codes are listed below. 

1. Category I CPT Codes

This category includes the codes which represent the U.S. Food and Drug Administration–approved procedures and services. These procedures are commonly practiced by healthcare providers. The CPT codes in this category are released once per year and are composed of five numerals. For instance, the CPT code of category I, 29580, refers to the post-operative dressing of the lower limb, also known as Unna boot. 

2. Category II CPT Codes 

These CPT codes are used to track the patient attributes and the quality of the examination, evaluation, and treatment provided. For this reason, category II CPT codes are also called supplementary tracking codes. The codes are composed of 4 numerals and a letter ‘F’ at the end. For example, 2029F indicates that the healthcare provider has performed a complete physical skin exam. These codes are released thrice a year. 

3. Category III CPT Codes

While the above two categories are permanent, category III comprises temporary CPT codes. These codes are used to report any new advancements in the field of healthcare. Category III CPT codes are released twice a year. As the codes are approved by the FDA, and their use is validated by the health practitioners, the codes are added to category I of permanent codes. If the codes are not added to category I within five years of their release, the codes are eliminated. [2]

Osteopathic manipulative therapy also employs CPT codes to report and bill the evaluation and treatment procedures. The range of CPT codes for osteopathic manipulative therapy is 98925-98929.

The description of these codes is given in the table below. [3] 

ICD-10 编码系统 

国际疾病分类 10^th 版本 (ICD-10) 是一种复杂而全面的编码，用于报告执行的数千个诊断和治疗程序，更加强调诊断服务。 ICD-10 代码由七个字符组成，包括数字和字母。 ICD-10 代码的分解如下所示。 [4]

整骨手法治疗的 ICD-10 代码 范围从 M99.00 到 M99.09，如下表所示。 [3]

整骨疗法的编码指南

整骨手法治疗由合格的医疗保健提供者对通过病史分析和体格检查诊断出躯体功能障碍的患者进行。在对服务进行编码时，整骨医学医生应考虑以下指南。

1. 整骨疗法中的 CPT 代码仅编码对患者执行的程序。
2. 超出整骨手法治疗程序范围的评估和管理服务，使用修饰符 25 进行报告和记录。当同一医生在同一天提供评估和管理服务时使用修饰符 25，尽管患者可能不同。
3. 尽管这些服务和整骨手法治疗的病因和症状相似，但需要单独记录紧急和管理服务。
4. 虽然在计费文件中分别报告了原因和症状，但如果治疗和评估以及管理在同一天进行，则不需要进行鉴别诊断。 [5]

结论 

定义明确的编码系统是医疗保健设置不可或缺的一部分。 CPT 编码系统由五个字符的不同序列组成，包括字母和数字，被医疗保健提供者、保险公司和流行病学家用于收集统计信息。 FDA 批准的医疗保健程序由 I 类 CPT 代码编码。另一方面，ICD-10 字母数字代码有七个字符长，主要用于报告诊断程序。整骨疗法是一种使用机械力治疗躯体功能障碍的替代医学。与任何其他医疗保健专业类似，整骨疗法也使用 CPT 和 ICD-10 代码来报告程序。可以使用modifier-25 报告评估和管理服务。 

参考

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&