Coding and Billing for Outpatient Rehab Made Easy

CHAPTER 1
97034—Contrast bath. Uses therapeutic heat and cold on distal extremities to reduce
pain and inflammation, to treat extremities affected by reflex sympathetic dystrophy,
rheumatoid arthritis, an acute sprain/strain, and to treat synovitis/tenosynovitis. Many
insurance companies and Medicare contractors allow two to four treatments of this.
Additional treatments may be reimbursed if documentation supports medical necessity
of the intervention and why it requires the unique skills of a PT or OT. This could occur
if the patient has circulatory deficiencies, areas of impaired sensation, open wounds,
fractures, or other similar circumstances.
97035—Ultrasound. This deep-heating modality uses sound waves to decrease pain,
muscle spasm, and joint stiffness, and to increase muscle, tendon, and ligament flexibility.
Medicare does not cover ultrasound for the treatment of pulmonary conditions. 11
97036—Hubbard tank. This modality is used to treat wounds or ulcers, improve circulation,
relieve/reduce muscle spasms, or to treat skin conditions. Use the Hubbard tank
for extensive wounds or conditions that require an extensive area of the body to be
immersed in water.
97039—Unlisted modality. This CPT code should be used rarely—only in instances
where the modality the provider is using is not described by one of the other listed
CPT codes. For example, an ice massage could probably only be billed one to three
times because the provider could train patients to perform it themselves. This code
also may be used to bill for fluidotherapy to insurance carriers that do not want it to be
billed as 97022. Be sure to specify the type of modality applied, the time spent applying
it, and whether there was constant provider attendance when using this code.
Tip: Do not try to bill hot and cold packs under this CPT code to Medicare carriers;
doing so could be considered fraud or abuse. 8
16 © 2006 HCPRO, INC. CODING AND BILLING FOR OUTPATIENT REHAB MADE EASY