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American Chiropractic Association

Coding Clarification VERTEBRAL AXIAL DECOMPRESSION THERAPY

Vertebral axial decompression therapy is described as an alternative, noninvasive, nonsurgical procedure of applying axial (Y-axis) traction to the spine. It can be used in the treatment of several conditions, including low back pain associated with lumbar disc herniation, degenerative disc disease, posterior facet syndrome, and radiculopathy. The clinical objectives of this therapy include relief of disabling low back pain and return to normal function. Length of the episode of care is partially dependent on the patient's response to treatment. CPT code 97012, Application of a modality to one or more areas, traction, mechanical, is intended to identify a procedure that creates a force to allow for separation between joint surfaces. The degree of traction is controlled through the amount of force (pounds or Newtons) allowed, duration (time) and angle of pull (degree) using mechanical means. Therefore code 97012 would be an appropriate code to report for various types of mechanical traction devices (eg, computerized/ motorized) including vertebral axial decompression. HCPCS code S9090, Vertebral Axial Decompression, per session, is also appropriate to report this procedure. To report this procedure to Medicare Part B use CPT code 97799, Unlisted physical medicine/rehabilitation services or procedures, with modifier GPGY and enter "vertebral axial decompression" in box 19 of the CMS1500 claim form or the equivalent electronic field position. CPT code 64722, Decompression, unspecified nerve(s) (specify) and CPT code 63030, Laminotomy (hemilaminectomy), with decompression of nerve root (s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; one interspace, lumbar are specific surgical codes and should not be reported to describe the vertebral axial decompression procedure. NOTE: Many payers have developed individual policies regarding reimbursement for this procedure; therefore it is advisable to check for their specific reporting guidelines. ________________________ References: CPT 2006 CPT Assistant; November 2004 Medicare National Coverage Determinations Manual; 160.16

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