CPT Code 97024: Application of a Modality to One or More Areas; Diathermy (e.g., Microwave) - Chirotouch

In this quick-reference guide to CPT code 97024, 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 97024: Diathermy

CPT code 97024 pertains to diathermy, a therapeutic modality frequently employed in chiropractic care for pain management and tissue healing. Diathermy involves the application of high-frequency electromagnetic currents (i.e., microwaves) to targeted areas of the body to promote circulation, relieve pain, and facilitate tissue repair.

Category or Type of Service

CPT code 97024 falls under the category of Physical Medicine and Rehabilitation. It is commonly used by chiropractors as part of a comprehensive treatment plan to address musculoskeletal conditions and promote patient well-being.

Billing Interval

Code 97024 is typically billed per session. However, some payers may have specific requirements for billing in 15-minute intervals. Always consult your payer guidelines for accurate billing practices.

When Should Chiropractors Use This Code?

Chiropractors should consider using CPT code 97024 in the following scenarios:

  • Pain management. Diathermy can be employed to alleviate pain associated with various musculoskeletal conditions, including arthritis, muscle strains, and joint stiffness.
  • Tissue healing. This modality is often utilized to promote tissue repair and accelerate the healing process following injuries or surgical procedures.
  • Adjunct to chiropractic care. Diathermy can complement chiropractic adjustments by preparing the muscles and tissues for manipulation and enhancing treatment outcomes.

When incorporating code 97024 into treatment plans, ensure that the therapy is medically necessary and aligns with the patient’s diagnosis and overall care objectives.

When Should Chiropractors Not Use This Code?

Chiropractors should refrain from using CPT code 97024 in certain situations:

  • Lack of medical necessity. If diathermy is not deemed medically necessary or does not contribute to the patient’s treatment goals, it should not be billed.
  • Unsubstantiated claims. Avoid billing for diathermy sessions that lack documented evidence of their therapeutic benefit or relevance to the patient’s condition.
  • Unsupervised use. Some payers may require that a medical professional supervises the therapy to qualify for this code.

Which Modifiers Can Be Used With CPT Code 97024?

Modifiers can provide additional information regarding the circumstances of the service rendered. Common modifiers used with CPT code 97024 include:

  • Modifier 25: Use this if on the same day as an Evaluation and Management (E/M) service, the infrared therapy session is clearly distinct and goes above and beyond what’s normally expected for the E/M visit.
  • Modifier 59. Modifier 59 may be used if the diathermy session is a distinct and separate service from other procedures performed on the same date. Be sure it meets the specific criteria for Modifier 59 use.
  • Modifier GP. Modifier GP may be applicable if the diathermy treatment is performed as part of a physical therapy plan of care overseen by a physical therapist.

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

Adhering to proper billing guidelines and documentation requirements is essential for accurate reimbursement and compliance. For CPT code 97024, ensure the following:

  • Session duration. Document the duration of each diathermy session to support billing accuracy.
  • Medical necessity. Clearly articulate the medical necessity of microwave therapy in the patient’s treatment plan, including relevant diagnoses and treatment objectives.
  • Treatment notes. Maintain detailed treatment notes that outline the rationale for employing diathermy, the specific areas targeted, and the patient’s response to treatment.
  • Supervision. Some payers may require direct supervision for this code. Check with your payers to understand their specific supervision requirements.
  • Limitations. Medicare has specific coverage limitations for diathermy treatments. Refer to CMS guidelines for detailed information.

What Are Common Mistakes Made Specific to CPT code 97024?

Avoiding common pitfalls associated with CPT code 97024 can help ensure proper billing and compliance. Some prevalent mistakes include:

  • Overutilization. Employing diathermy excessively or without adequate justification can lead to inappropriate billing and potential audit scrutiny.
  • Insufficient documentation. Failing to document the medical necessity and specifics of each therapy session may result in claim denials or audit findings.
  • Inaccurate coding. Ensure accurate coding by verifying the appropriateness of using CPT code 97024 for each patient encounter and confirming adherence to payer guidelines.

What Are Potential Audit Triggers Specific to CPT Code 97024?

Certain factors may trigger audits or scrutiny related to the use of microwave treatment’s CPT code:

  • Unusual billing patterns. An unusually high frequency of diathermy sessions or inconsistencies in billing practices may attract audit attention.
  • Documentation discrepancies. Discrepancies between documented treatment notes and billed services can raise red flags during audits.
  • Lack of medical necessity. Inadequate documentation supporting the medical necessity of diathermy sessions may prompt further review by auditors.

What Can I Do to Improve the Accuracy and Efficiency of My Practice’s Billing and Coding Processes?

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

  • Conducting routine audits of billing and coding practices to identify and address discrepancies or errors.
  • Staying informed about updates and changes to coding regulations and payer policies through ongoing education and training.
  • Leveraging electronic health record (EHR) systems and practice management software to streamline coding workflows and ensure compliance with documentation requirements.

By implementing these strategies, chiropractors can optimize their billing and coding practices, minimize errors, and maintain compliance with regulatory standards.

Saving Time in Billing Gives You More Time for Patients

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