How to Bill for Low-Level Laser Therapy

posted by Apollo Lasers on Friday, December 26, 2014

Adding new treatments to your practice are all well and good, but how do you bill for them? ChiroEco.com's Dava Stewart offers this quick and easy guide to low-level laser therapy billing and codes. 

There are two big reasons to add new services to your practice:

1. To provide better care for your patients
2. To increase profits

Many have found that low level laser therapy (LLLT) fits both categories. LLLT can be used to effectively treat inflammation, manage pain and treat a variety of wounds and injuries.

Patients obviously benefit because their conditions are treated and improved, and you must bill for the service provided in order to increase profitability. There are options when it comes to billing for LLLT.

Many providers choose to make it a cash-only service. Several insurance companies classify the treatment as experimental, despite the fact that there have been many studies showing that LLLT is effective for a range of conditions. Making it a cash-only service removes the burden of attempting to collect from insurance companies.

Unfortunately, going the cash-only route may put LLLT out of some patients’ reach, and not all insurance companies deny payment for LLLT in all instances. It may well be worth your time to bill for it. The problem, however, is which Current Procedural Terminology (CPT) code should be used because LLLT does not yet have a dedicated code.

Most experts agree that providers should do two things when coding for LLLT:

1. Use a similar code that falls into the right category
2. Include a one-page statement that describes the treatment and the therapy

There are several codes that may be used appropriately for LLLT:

97039 - 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 “FDA cleared laser therapy.”

97139 - 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 - 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 “Attended Electrical-Photonic Stimulation” or “FDA Cleared Laser Photonic Stimulation” could be used.

97799 - Physical Medicine and Rehabilitation; unlisted service or procedure

• Although the description with this code is appropriate, it requires documentation and the reimbursements are negotiable.

In making the decision on how to bill for LLLT, you may want to investigate the policies of the insurer used by the majority of your patients, if there is one. Simply calling the insurer and finding out their policies regarding LLLT may make the decision process easier.