Medicine > Physical Medicine and Rehabilitation > Therapeutic Procedures
CPT Code: 97139
Description: Unlisted therapeutic procedure (specify)
Status: C
Global: XXX
Modifiers
Don’t Use: 50 51 62 66
Documentation Required for Use: 80 81 82
Situational: Other: 59 XE XS XP XU Anatomic: LT RT Global: 58 78 79
Medically Unlikely Edits
Practitioner Services: 1 Adjudication Indicator – 3 Date of Service Edit: Clinical Rationale – Clinical: Data
Hospital Outpatient Service: 1 Adjudication Indicator – 3 Date of Service Edit: Clinical Rationale – Clinical: CMS Workgroup
Multiple Procedure Reduction
Multiple procedure reduction rules do not apply.
Bundling Information
Includes
Unbundling never allowed:
36591 36592
Unbundling allowed w/ modifier Other: 59 XE XS XP XU Anatomic: LT RT Global: 58 78 79 as appropriate:
0213T 0216T 0228T 0229T 0230T 0231T 62320 62321 62322 62323 62324 62325 62326 62327 64400 64402 64405 64408 64410 64413 64415 64416 64417 64418 64420 64421 64425 64430 64435 64445 64446 64447 64448 64449 64450 64461 64463 64479 64480 64483 64484 64486 64487 64488 64489 64490 64493 64505 64508 64510 64517 64520 64530 97164 97168
Hospital Outpatient Prospective Payment System (OPPS)
Status Indicator: A – Services furnished to a hospital outpatient that are paid under a fee schedule or payment system other than OPPS, for example: Ambulance Services; Separately Payable Clinical Diagnostic Laboratory Services; Separately Payable Non-Implantable Prosthetics and Orthotics; Physical, Occupational, and Speech Therapy; Diagnostic Mammography; Screening Mammography..
Not paid under OPPS. Paid by MACs under a fee schedule or payment system other than OPPS. Services are subject to deductible or coinsurance unless indicated otherwise. (Separately Payable Clinical Diagnostic Laboratory Services and Screening Mammography – Not subject to deductible or coinsurance.)
Fee Schedule
Medicare RBRVS
Non-Facility Total 0
Facility Total 0
Medicare
Non-Facility Fee $0.00
Facility Fee $0.00
CPT Assistant
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February 1997, page 10
December 1996, page 10
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Summer 1995, page 5
