Billing Codes 97110 and 97530: What's the Difference?
Differentiating between billing codes can sometimes be a struggle…we get it!
While we can’t address every billing code out there in a single blog post, we did want to highlight a few CPT codes that often generate a lot of confusion. These CPT codes are 97110 and 97530.
So, let’s get into it.
What are CPT codes?
CPT codes are part of the Current Procedural Terminology, which is a medical coding system developed by the American Medical Association (AMA). CPT codes are used to describe a wide range of medical services, including those provided by chiropractors.
What do CPT codes 97110 and 97530 mean?
- CPT code 97110:Â Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility.
- CPT code 97530:Â Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes.
What are the differences between CPT codes 97110 and 97530?
- The main difference between these two codes is that CPT code 97110 is used to report therapeutic procedure, while CPT code 97530 is used to report therapeutic activities.Let’s break that down further.97110 - This typically involves looking only at one parameter being measured such as active range of motion, prom, a/arom, endurance or strength. All of these are separate activities and therefore billed under therapeutic exercise. Think Physical Therapy activities with this code: stretching, endurance, etc. Also, how to build up strength in one through this activity.
97530Â - This typically is considered a dynamic activity and usually looks at multiple parameters, these could even be functional parameters. It is typically used when you are looking at range of motion and strength, or range of motion and endurance, etc. This Occupational Therapy with this code: how is range of motion WITH this activity? Also, how is one able to function with this activity?
Why do these codes matter? In many states and with many insurances, these 2 CPT codes do not pay the same. One may reimburse more than the other. It’s important to make sure your coding matches the actual activity that you are performing in order to assure accurate treatment and billing is being performed.
We hope that helps clarify the differences a little bit!
Of course, If you still have questions, are looking for additional billing help or are thinking about handing over all things billing, we would love to help!
For more information, schedule a free discovery call with us here: https://calendar.app.google/hdvoec3TXcaMCKdj9. We would love to get to know you and better understand your billing needs.
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