Question: Dr. Kotlar, “I just started using therapeutic taping on my patients. Is this a payable service by insurance companies? If yes, how do I bill for it?”
Answer: I have read differing opinions on how to bill and code for therapeutic taping. My opinion may differ from what you’ve heard, so please due your due diligence to educate yourself on this topic and then you’ll be able to make a good informed decision for your particular situation.
Let’s start with a little background. Elastic taping is typically used to facilitate the body’s natural healing process while providing support and stability to muscles and joints without restricting the body’s range of motion. Taping can help alleviate pain and can facilitate lymphatic drainage. It can be applied in various ways and has the ability to reduce inflammation, enhance performance, prevent injury and promote good circulation and healing, and assist in returning the body to homeostasis.
According to the AMA, “Kinesiology tape is a supply. Its application is included in the time spent in direct contact with a patient to provide either re-education of a muscle and movement or to stabilize one body area to enable improved strength or range of motion. The application of tape is usually performed in conjunction with educating the patient on various functional movement patterns. The tape is applied based on the patient’s specific patterns of weakness or strength. The tape is left in place after instruction related to movements designed for improving strength, range, and coordination is provided and documented. However, if the purpose of the taping is to immobilize the shoulder, then the strapping codes may be appropriate as those codes describe the use of a strap or other reinforced material applied post-fracture or other injury to immobilize the joint. If the taping is performed to facilitate movement by providing support, and the tape is applied specifically to enable less painful use of the shoulder and greater function (ie, restricting in some movement, facilitating others), application of tape in this manner is typically part of neuromuscular re-education (97112) or therapeutic exercise (97110), depending on the intent and the outcome desired. This includes application of Kinesiology tape or McConnell taping techniques.”
I have not read any health plan policies that state taping, as a stand-alone service, is payable for alleviating pain, reducing inflammation and promoting good circulation. You can include the amount of time spent taping as part of 97110 or 97112. You should consider stand-alone taping a non-payable service by most health plans. If you need to bill an insurance carrier for taping, I recommend you use CPT code 97139 (unlisted therapeutic procedure) or CPT code 97799 (unlisted physical medicine/rehabilitation service or procedure). You can also bill HCPCS code A4450 per 18 sq. inches of tape (non waterproof) or A4452 per 18 sq. inches of tape (waterproof).
When reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation (e.g., procedure report) along with the claim to provide an adequate description of the nature, extent, need for the procedure, and the time, effort, and equipment necessary to provide the service. If you would like to receive a sample taping procedure report, send an email to email@example.com.
Billing health plans for taping doesn’t necessarily mean it will be reimbursed – sometimes you need to bill just for denial purposes.
Cash or insurance, you need to show clinical necessity for performing the procedure. This includes an exam, history, making a proper diagnosis and report frequency and duration of care. Your SOAP notes should include the clinical rationale for performing the service and if the functional goals are being reached. You should contact all carriers to verify coverage and obtain their policies and guidelines on the procedures prior to billing the insurance company or patient.
I do not recommend billing CPT codes 29200, 29240, 29260, 29280, 29520, 29530, 29540 or 29799 for elastic therapeutic taping. In my opinion these casts and strapping codes are meant to “immobilize” a joint or body part and are therefore should not be used for taping. However, if the purpose of the taping is immobilization, then the strapping codes may be appropriate as those codes describe the use of a strap or other reinforced material applied post-fracture or other injury to immobilize the joint.
Marty Kotlar, DC, CPCO, CBCS is the President of Target Coding. Dr. Kotlar is Certified in CPT Coding, Certified in Healthcare Compliance and has been helping chiropractors nationwide with billing, HIPAA compliance, coding and documentation for over 10 years. Target Coding can be reached at 1-800-270-7044, website – www.TargetCoding.com, email – firstname.lastname@example.org.