CPT Code 97018: Application of a Modality to One or More Areas; Paraffin Bath - Chirotouch
March 15, 2024 by ChiroTouch Team Article Coding

In this quick-reference guide to CPT code 97018, we answer frequently asked questions from our community of chiropractors. Follow us for other articles in our ongoing series, courtesy of ChiroTouch, the cloud-based EHR designed specifically for chiropractors. 

NOTE: CPT codes and guidelines can be revised over time. To avoid billing issues, be sure to stay current with annual coding updates and changes to payer guidelines.

About CPT Code 97018: Paraffin Bath Therapy

CPT code 97018 is used to bill for paraffin bath therapy. It is commonly used in chiropractic care to alleviate pain and stiffness in joints, muscles, and connective tissues.

Paraffin bath therapy involves immersing the affected area in melted paraffin wax, providing heat therapy and promoting circulation.

Category or Type of Service

CPT code 97018 falls under the category of Physical Medicine and Rehabilitation services. It’s used to bill for the application of paraffin bath therapy as part of a patient’s treatment plan.

Billing Interval

CPT code 97018 is typically billed per encounter. The duration and frequency of paraffin bath therapy sessions may vary based on the patient’s condition and treatment goals.

When Should Chiropractors Use This Code?

Chiropractors should use CPT code 97018 when providing paraffin bath therapy to patients with conditions such as:

  • Arthritis
  • Tendonitis
  • Muscle strains
  • Joint stiffness

Paraffin bath therapy can help alleviate pain, reduce inflammation, and improve mobility in affected areas, so be sure to document these goals in your paperwork.

When Should Chiropractors Not Use This Code?

Since this code covers a specific modality, it should only be coded when you make use of paraffin bath therapy in an encounter.

CPT code 97018 is particularly prone to “copy-paste” errors, where a patient often receives the same services in an encounter and the code is entered without checking the documentation.

NOTE: Not all jurisdictions may consider paraffin bath therapy within the standard scope of chiropractic care. Verify local regulations and payer policies before using this code.

Which Modifiers Can Be Used With CPT Code 97018?

Modifiers provide additional context or information regarding your encounter. Common modifiers used with CPT code 97018 include:

  • Modifier 25. Indicating separate E/M services on the same day.
  • Modifier 59. Indicating that the service was distinct or independent from other services performed on the same day. This modifier must be used judiciously and only when its specific criteria are met. Overuse of this modifier is a notorious audit flag.
  • Modifier 76. Used to indicate a repeat procedure or service by the same physician or qualified healthcare professional.

What Are the Billing Guidelines and Documentation Requirements Specific to This Code?

Chiropractors must adhere to specific billing guidelines and documentation requirements when using CPT code 97018, including:

  • Ensuring that the application of paraffin bath therapy is medically necessary and supported by the patient’s diagnosis and treatment plan. Insurance companies heavily scrutinize the medical necessity of modalities, so documentation should clearly explain why paraffin bath therapy was specifically chosen over alternative treatments.
  • Documenting the location, duration, and frequency of paraffin bath therapy sessions.

Common Mistakes Made Specific to CPT Code 97018

Some common mistakes made when using CPT code 97018 include:

  • Failing to document the medical necessity of paraffin bath therapy.
  • Using the code for services not covered under this specific CPT code.
  • Inaccurate reporting of the location, duration, or frequency of paraffin bath therapy sessions.
  • Billing for this procedure in a jurisdiction or for a payer that doesn’t recognize this modality as within the standard scope of chiropractic care.

Potential Audit Triggers

Auditors may scrutinize claims involving CPT code 97018 for various reasons, including:

  • Inadequate documentation supporting the medical necessity of the service rendered. A supporting ICD-10 diagnosis code is always required alongside the CPT code for reimbursement.
  • Billing for services not provided or not meeting the requirements outlined by the code.
  • Inconsistencies between reported services and documentation.
  • Excessive frequency of use. Insurers often have limits on the number of times a given therapy can be billed within a set period.

Improving Billing and Coding Processes

Chiropractors can improve the accuracy and efficiency of their billing and coding processes by:

  • Conducting regular audits of billing and coding practices to ensure compliance with coding guidelines and payer policies.
  • Staying informed about changes to billing and coding regulations.
  • Utilizing cloud-based EHR and practice management software tailored to the needs of chiropractors.

By understanding the proper use of CPT code 97018 and adhering to billing and coding guidelines, chiropractors can ensure accurate reimbursement for the services they provide while delivering quality care to their patients.

Streamline Billing for Your Patients with ChiroTouch

Managing your billing shouldn’t be complicated. ChiroTouch has built a collection of efficient, cloud-based tools to help you maintain your practice’s cash flow while giving you more time to treat your patients.

CT Payments gives your patients more payment options beyond their insurance or cash, making payment easier for you and more convenient for them. Accept payment online, settle bills with modern payment apps like Google Pay and Apple Pay, and easily track payments with a ledger that’s seamlessly integrated with your EHR.  

MaxClear does the same for your insurance and other payer systems, creating a data clearinghouse that centralizes your practice’s financial data. MaxClear integrates all your payment processing, from insurance to subscriptions, into one easy-to-manage warehouse with a unified interface. Book a demo and learn how ChiroTouch can give you back the time you need for your patients.

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