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Coding
The CPT Editorial Panel ruled to include OMT codes starting in the 1994 edition of the CPT Manual. (All Physicians Current Procedural Terminology [CPT] five-digit numeric codes, descriptions, numeric modifiers, instructions, guidelines, and other material are copyright American Medical Association.)
Osteopathic manipulative treatment is a form of manual treatment applied by a physician to eliminate or alleviate somatic dysfunction and related disorders. This treatment may be accomplished by a variety of techniques.
Body regions are defined as head, cervical, thoracic, lumbar, sacrum, lower extremity, upper extremity, pelvis, ribs, abdomen and viscera. (Such regions are defined in ICD-9-CM codes 739.0-739.9. This information should be shown on the claim form or in the physician record.
| CPT Codes |
Procedure Description |
98925
98926
98927
98928
98929 |
OMT; one to two body regions involved
OMT; three to four body regions involved
OMT; five to six body regions involved
OMT; seven to eight body regions involved
OMT; nine to ten body regions involved |
The physician, insurance companies, Medicare, Medicaid, workers compensation and all other third party reimbursement systems need to know the following:
- These codes are to be used by physicians for osteopathic manipulative treatments as of January 1, 1994. It is important that all carriers, claims examiners and physicians be educated on the use of these codes so that the present confusion of coding can be resolved.
- These codes are separate and distinct from evaluation and management codes, and should be billed separately.
- These codes are to be used for inpatient and outpatient osteopathic manipulative treatment services along with the appropriate evaluation and management codes.
- These codes define the body regions appropriately for use with osteopathic manipulative treatments.
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