CPT 97112 Code – Exercises

CPT 97112

Posture Exercise can be coded CPT 97110 as therapeutic exercise, but in my reading of CPT coding;  CPT 97112 code Neuromuscular Reeducation better describes the clinical and professional service at a similar RVU*.  Despite some carriers (intentional?)  miscategorizations of the neuromuscular reeducation code as “stroke related.”

“Improve movement, balance, coordination, kinesthetic sense, posture and/or proprioception for sitting and/or standing activities” (ChiroCode, 2005)

CPT 97112 Code – Neuromuscular Reeducation

RVU = .78 per 15 minute unit to 1 or more body area(s).

how to get more patientsCLINICAL: Improve movement, balance, coordination, kinesthetic sense, posture and/or proprioception for sitting and /or standing activities. **This code requires one-on-one contact**

INCLUDES: Posture Rehab Protocols Daily Posture Exercise Training, Proprioceptive Neuromuscular Facilitation (PNF), Feldenkrais, BAP Boards

EFFECTIVE BILLING HINT: In order to be reimbursed for an adjustment and neuromuscular reeducation on the same date of service, they must be performed on different areas of the body. Add a -59 modifier to the cpt 97112 code (e.g. 97112-59) to code for neuromuscular reeducation performed on a separate anatomic area from the adjustment. *Adapted from the CPT®, Physicians Current Procedural Terminology, © AMA 2004

RESOURCE:  CPT code information for Medicare’s relative value payment amounts in your area.

POSTURE PRACTICE INFO: Integrating exercise and active care along with chiropractic is essential for an outcome oriented practice. Progressive core stabilization exercises will increase patient participation and improve results as well as retention. Posture rehab exercises are reimbursable, and many insurance companies now require active care plans for authorization of continued treatment. CPT coding exercises in most cases falls with the cpt 97112 code.

Adding Value – And Revenue

Certifying as a posture specialist lets practitioners grow their practice with rehab services. StrongPosture® Exercises takes patients from insurance-covered rehab to personal coverage of wellness care.  Both engaging and effective, the program offers step-by-step protocols, patient education and exercise handouts, referrals, as well as marketing strategies for wellness and corporate programs. Click for the CPEP® info packet.

This article is one of a series on integrating Managed Care, insurance, and personal pay in a practice treating patients for Acute Care, Rehab Care and Wellness Care. If you agree with the Patient Choice philosophy of care, join our newsletter.

Chiropractic Compliance – Billing Procedures 

All chiropractic clinics must now have compliance manuals and logs that document and verify billing procedures and monitor the security of all patient health records and include procedures to prevent fraud and abuse of privacy. Staff hiring and training measures must be in place to prevent patient health information exposure – and this training and audit process must be updated in the chiropractic compliance manual/logs maintained onsite at the clinic.

*RELATIVE VALUE UNITS: Relative Value Units (RVU) allow fee comparisons for different CPT Codes. The RVU of adjusting 1-2 spinal regions (98940) is .70. Adjusting 3-4 spinal regions (98941) has an RVU of .97 (the five regions are cervical, thoracic, lumbar, sacral, and pelvic).