Subpart 1. Multiple modalities. Maximum fees for the chiropractic modalities in the following list are determined according to the following payment schedule when more than one modality on the list is provided to the same patient on the same day. One hundred percent of the fee calculated according to the formula in part 5221.4020 for the modality with the highest relative value and 75 percent of the fee calculated according to the formula in part 5221.4020 for each additional modality. All modalities after the first modality with the highest relative value, shall be coded by adding modifier 51 to the applicable modality code.
97012 Mechanical traction therapy 97014 Electrical stimulation therapy 97016 Vasopneumatic device therapy 97018 Paraffin bath therapy 97022 Whirlpool therapy 97024 Diathermy treatment 97026 Infrared therapy 97028 Ultraviolet therapy 97032 Electrical stimulation 97033 Electric current 97034 Contrast bath therapy 97035 Ultrasound therapy 97036 Hydrotherapy 97039 Unlisted therapy service
Subp. 2. Extraspinal code. If the extraspinal code (98943) is used in conjunction with any of the spinal chiropractic manipulative treatment (CMT) codes (98940 to 98942) on the same day, the extraspinal code must be coded with CPT modifier 51. The CPT modifier 51 reduces the RVU of 98943 when used in conjunction with any of the CMT codes (98940 to 98942) on the same day by 50 percent.
History: 18 SR 1472; 25 SR 1142; 35 SR 227
Posted: Sept. 30, 2010