An Ultimate Guide to CPT Code for Laser Therapy 2024

American Medical Association designates that CPT Code for Laser Therapy is 0552T. Physicians or qualified healthcare providers administer these sessions.

Overview of CPT-Code

CPT (Current Procedural Terminology) describes medical procedures and services that are performed by healthcare professionals. These codes are used in conjunction with ICD codes. Together, these codes provide a complete picture of the medical services provided to a patient.  Both these coding systems are integral parts of the billing process. The American Medical Association (AMA) develops and maintains CPT codes. These codes are updated annually to reflect the latest medical procedures and technological advancements. This coding system is important for maintaining the financial health of healthcare practices

Uses of CPT Codes

The CPT coding system consists of alphanumeric codes. These are typically five-digit codes. This coding system is used;

1. By healthcare providers to report medical services and procedures to insurance companies for reimbursement.
2. To provide an accurate description of the specific medical process.
3. To describe medical, surgical, and diagnostic services.

Categories of CPT-Codes

There are three main categories of the CPT coding system. These categories include;

1. Category 1: Most frequently used codes that cover the majority of procedures in outpatient and inpatient settings.
2. Category 2: Includes additional tracking codes for accurate results and performance management.
3. Category 3: Includes temporary, emergency, and experimental procedures, services, and technologies. 

Benefits of CPT Codes

CPT coding system is beneficial for the accurate procedure and smooth flow of the process. The benefits include;

1. Standardization: CPT codes provide a standardization. This helps to ensure accuracy and efficiency in billing and reimbursement.
2. Improved communication: CPT codes improve communication between healthcare providers and insurance companies. Both parties can easily understand about the services 
3. Accurate reimbursement: CPT codes help to ensure that healthcare providers are accurately reimbursed for the services they provide. 

Who uses CPT codes?

CPT codes are used by a variety of healthcare professionals, including:

1. Medical Coders and Billers
2. Physician Assistants
3. Outpatient Facilities
4. Physicians
5. Nurses
6. Hospitals

Understanding Laser Therapy

Laser Therapy is a medical treatment where focused beams of light are used to treat various medical conditions. The light of a specific wavelength is used to treat different medical conditions. 0552T is the CPT code for low-level Laser Therapy sessions. This process is non-invasive and operates on the principle of photo-bio modulation. 

How Laser Therapy Works?

Light Amplification by Stimulated Emission of Radiation (LASER) unlike regular light, emits a specific wavelength in a concentrated beam. These beams can be used for various purposes depending on their intensity. There are two types of Laser therapy present in treatments. These are;

1. High-power Lasers: These lasers are often used in surgical procedures to cut or destroy tissue with precision. (removing tumors)
2. Low-level Lasers: LLLT promotes faster healing of wounds, ulcers, or burns.  Don’t generate heat but stimulate healing and reduce inflammation in targeted tissues. (pain management)

Benefits of Laser Therapy

Laser Therapy is more beneficial compared to traditional surgery because it is;

1. Minimally invasive
2. Precise
3. Faster recovery time

Uses of Laser Therapy across Medical Specialties

Laser therapy is utilized across diverse medical specialties. Some important medical treatments include;

1. Removing Kidney Stones.
2. Repairing Detached Retina.
3. Improving the Vision.
4. Removing Body Hair.
5. Sealing Blood Vessels.
6. Sealing Nerve Endings.
7. Treating Hair loss.
8. Relieving Cancer Symptoms.
9. Solving dermatological issues.
10. Useful in orthopedics.

CPT Code for Laser Therapy

Chiropractic care can incorporate laser therapy for various purposes. To ensure proper documentation and billing for these procedures, specific CPT codes are crucial. These codes act as a common language between chiropractors, insurance companies, and patients, guaranteeing transparency and accurate reimbursement. These are a few common CPT codes used for Laser Therapy.

1. 97039: Uncommon Laser Therapy with Attendance.

This code is used for less common chiropractic laser treatments where you’re present throughout.  This treatment is not covered by a specific code and requires your direct supervision throughout.

2. 97139: Unlisted Therapeutic Procedure

This is a more general code for any unlisted therapeutic procedure, including laser therapy. It might require additional documentation explaining the specific laser treatment performed.

3. 97026: Infrared Light Therapy: 

This code is specifically for infrared light therapy, which differs slightly from laser therapy in terms of wavelength and heat generation.

4. 97112: Neuromuscular Reeducation: 

If laser therapy is used alongside manual techniques for muscle retraining, this code might be used alongside a laser therapy code.

Some other CPT codes for Laser therapy include;

1. 90655: Laser treatment of benign skin lesions (removal of scars, tattoos, or birthmarks)
2. 17110: Destruction of benign lesions (laser ablation of tumors or cysts)
3. 43753: Laser coagulation of bleeding wounds or ulcers
4. 64640: Laser nerve ablation (pain management) (Class IV)
5. 75908: Laser treatment of varicose veins
6. 15777: Laser treatment of wounds or ulcers (debridement or promotion of healing)
7. 92527: Laser treatment of eye conditions (cataracts, glaucoma, or retinal disorders)
8. 15774: Laser treatment of scars or keloids
9. 17107: Laser treatment of skin conditions (acne, psoriasis, or vitiligo)
10. 0552T: Cold Laser Therapy 

Billing For Laser Therapy Process

The main issue is that laser therapy currently lacks an insurance-approved billing code. However, it’s worth noting that many treatments, such as those for HIV or Lyme disease, initially didn’t have assigned codes and were only accepted by insurance companies after some time. Billing is one method to make low-level laser therapy a profitable part of your practice. If you’re considering billing, start by examining your local and state regulations.

CPT code for Laser Therapy Billing

Check if you are in a state where Medicare reimburses easily or where there is excellent workers’ compensation or personal injury insurance. For billing laser therapy, practitioners can use the following codes:

1. 97026, Infrared Modality.

This code is suitable for laser therapy but is often associated with infrared heat lamps, resulting in lower reimbursement. It’s still a legitimate option.

2. 97140, Manual Therapy Techniques.

Use this code if the laser therapy involves massage with a laser fitted with a massage head. Ensure the therapy is perceived as a massage service by the patient.

3. 97039, Physical Medicine and Rehabilitation

This is the primary code recommended for low-level laser therapy. Specify a 10-15-minute treatment and note it as “FDA-cleared laser therapy.”

4. 97139, Physical Medicine and Rehabilitation.

This code can also be used, but it specifies a “procedure” rather than a “modality,” which is less ideal. Include “FDA-cleared laser therapy” and a one-page description of the therapy.

Conclusion

CPT codes for laser therapy play an important role in medical billing. The coding system ensures that doctors receive the correct reimbursement. Different codes may be used for different laser treatment applications, it is important to choose the correct code to identify the specific procedure. By understanding CPT coding rules, physicians can improve billing processes, reduce errors, and maximize reimbursement. Information on the latest changes and guidance to improve the effectiveness of laser treatment is useful for patients and clinics.