How to code for 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 adding low-level laser therapy (LLLT) to their practice helps provide more comprehensive care for patients as well as increases profits. LLLT can be used to effectively treat inflammation, for pain management and to treat a variety of wounds and injuries.

To bill or not to bill

Many chiropractors 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 be worth your time to bill for it. The problem, however, is which Current Procedural Terminology (CPT) code should be used as LLLT does not yet have a dedicated code.

Several codes may be used for LLLT

DCs should do two things when coding for LLLT:

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

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.

If you’re not sure, ask!

When deciding 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.