Manual therapy (97140) + therapeutic exercise (97110)
Manual therapy and therapeutic exercise to the same body part may bundle — separate anatomy or distinct time blocks required.
Why this pair bundles
Per NCCI Policy Manual, modifier 59 (or XS — separate structure) appropriate when distinct body regions treated.
Modifier-bypass policy
Modifier indicator: 1 — modifier 59 / XE / XP / XS / XU permitted when supporting documentation is on file.
Modifier 59 or XS when performed on different body regions in distinct time blocks. Document anatomy and timing separately.
Documentation requirements
- Time-based documentation per modality
- Anatomical specificity
- Distinct treatment goals per modality
Common clinical scenarios
- PT session with manual therapy to shoulder + exercises for hip = bypass appropriate
- Both modalities to same shoulder same time block = no bypass
Frequently asked questions
Why does CMS bundle 97140 and 97110?
Per NCCI Policy Manual, modifier 59 (or XS — separate structure) appropriate when distinct body regions treated.
When can I use modifier 59 (or X{EPSU}) to bypass?
Modifier 59 or XS when performed on different body regions in distinct time blocks. Document anatomy and timing separately.
What documentation supports separate billing?
Time-based documentation per modality; Anatomical specificity; Distinct treatment goals per modality.
When does this conflict typically arise?
PT session with manual therapy to shoulder + exercises for hip = bypass appropriate; Both modalities to same shoulder same time block = no bypass.
Sources
Catch NCCI 97140/97110 conflicts before submission
ApprovalHelp auto-flags NCCI bundling conflicts on the claim line before you submit. Modifier-bypass eligibility checked against current quarterly NCCI tables. no setup fee.
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