CPT Codes for LLLT, PBM, Laser Therapy, Low Level Laser Therapy
Coding for low level laser therapy can be simple despite the lack of a dedicated CPT code.
Many DCs find that incorporating low level laser therapy (LLLT) into their practice can broaden the range of services offered and support business growth. LLLT is used by practitioners for a variety of applications, including temporary relief of minor muscle and joint pain, as well as promoting relaxation of muscle tissue.
Should You Bill for LLLT?
Many chiropractors choose to offer low level laser therapy (LLLT) on a cash-only basis. This is often because several insurance companies classify the treatment as experimental, making coverage inconsistent and reimbursement difficult. A cash-based model can reduce the administrative effort associated with insurance billing.
However, this approach may limit access for some patients. Itās important to note that not all insurance providers handle LLLT the same way, and some may reimburse under certain circumstances. Since LLLT does not yet have a specific CPT code, selecting the most appropriate billing code remains a common challenge for providers who choose to submit claims.
Several codes may be used for LLLT
DCs should do two things when coding for LLLT:
- Use a code that falls into the right category
- Include a one-page statement that describes the treatment and the therapy
97039 ā Physical Medicine and Rehabilitation; constant attendance unlisted modality; 15 minutes
- This seems to be the most recommended code.
- The 15-minute increment works well for the majority of LLLT treatments.
- Codes that end in 9 do require an explanatory notation, such as āFDA cleared laser therapy.ā
97139 ā Physical Medicine and Rehabilitation; constant attendance unlisted therapeutic procedure; 15 minutes
- The upside of using this code is that a therapeutic procedure requires one-on-one, doctor-patient contact.
- An unlisted procedure is likely to be more closely inspected, however.
- An explanatory notation and a one-page description of the treatment and the therapy should accompany this code.
97032 ā Attended Electrical Stimulation; manual; one or more regions; 15 minutes
- In order to use this code, the description needs to be changed to match the service performed. For instance āAttended Electrical-Photonic Stimulationā or āFDA Cleared Laser Photonic Stimulationā could be used.
97799 ā Physical Medicine and Rehabilitation; unlisted service or procedure
- Although the description with this code is appropriate, it requires documentation and the reimbursements are negotiable.
If youāre not sure, ask!
When deciding how to bill for low level laser therapy (LLLT), it may be helpful to review the coverage policies of the insurance provider most commonly used by your patients. Contacting the insurer directly to ask about their billing requirements or coverage criteria for LLLT can help clarify your options.
