Is cox-flexion distraction billable as 97012

October 4th, 2018 - ChiroCode
Categories:   CPT® Coding  

Question

Is cox-flexion distraction billable as 97012? Also, with using the 97140 code in conjunction with a manipulation code, I am aware that they cannot be performed in the same regions. Would this example work: manipulation of the cervical, thoracic and SI regions, billed as 98941, plus lumbar manual traction billed as 97140?

Answer

Unfortunately, Cox Flexion Distraction is not billable as 97012 as it doesn't meet that code criterion. This would typically be part of the CMT (9894-).  

Regarding the 97140...yes, your example would work, depending on payer policy.  Some state that it can't be done in an adjacent region (i.e. lumbar can't be billed if thoracic or SI is manipulated too). You would need to append the 59 modifier to the 97140.  Make sure documentation is clear and there are adequate diagnoses supporting each service and that these diagnoses are pointed properly on the claim form to the appropriate service.

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