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. 第一類 CPT 代碼

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. II 類 CPT 代碼 

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. III 類 CPT 代碼

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 編碼系統 

國際疾病分類 10^th 版本 (ICD-10) 是一種複雜而全面的編碼，用於報告執行的數千個診斷和治療程序，更加強調診斷服務。 ICD-10 代碼由七個字符組成，包括數字和字母。 ICD-10 代碼的分解如下所示。 [4]

整骨手法治療的 ICD-10 代碼 範圍從 M99.00 到 M99.09，如下表所示。 [3]

整骨療法的編碼指南

整骨手法治療由合格的醫療保健提供者對通過病史分析和體格檢查診斷出軀體功能障礙的患者進行。在對服務進行編碼時，整骨醫學醫生應考慮以下指南。

1. 整骨療法中的 CPT 代碼僅編碼對患者執行的程序。
2. 超出整骨手法治療程序範圍的評估和管理服務，使用修飾符 25 進行報告和記錄。當同一醫生在同一天提供評估和管理服務時使用修飾符 25，儘管患者可能不同。
3. 儘管這些服務和整骨手法治療的病因和症狀相似，但需要單獨記錄緊急和管理服務。
4. 雖然在計費文件中分別報告了原因和症狀，但如果治療和評估以及管理在同一天進行，則不需要進行鑑別診斷。 [5]

結論 

定義明確的編碼系統是醫療保健設置不可或缺的一部分。 CPT 編碼系統由五個字符的不同序列組成，包括字母和數字，被醫療保健提供者、保險公司和流行病學家用於收集統計信息。 FDA 批准的醫療保健程序由 I 類 CPT 代碼編碼。另一方面，ICD-10 字母數字代碼有七個字符長，主要用於報告診斷程序。整骨療法是一種使用機械力治療軀體功能障礙的替代醫學。與任何其他醫療保健專業類似，整骨療法也使用 CPT 和 ICD-10 代碼來報告程序。可以使用modifier-25 報告評估和管理服務。 

參考

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&