Office or Outpatient Setting for an Unlisted Therapeutic Procedure
CPT® code 97139 is used to report a therapeutic procedure that does not have a specific CPT® code assigned under the Physical Medicine and Rehabilitation section. It serves as a catch-all code for unique or emerging treatments that fall outside the scope of established, coded modalities—such as a novel manual therapy technique, advanced therapeutic exercise, or device-assisted intervention not yet recognized by a designated CPT® code.
When to Use CPT® Code 97139
Report 97139 when:
- The therapeutic service provided does not have an existing, more specific CPT® code.
- The procedure is physician- or therapist-directed, involving direct patient contact.
- The service is reasonable, necessary, and restorative in nature, consistent with the goals of physical medicine and rehabilitation.
- Adequate documentation is available to justify medical necessity and clinical benefit.
Because this is an unlisted code, it should only be used when no other CPT® code accurately describes the service performed.
Documentation Requirements
Comprehensive documentation is essential to support the use of 97139, including:
- A detailed description of the service or technique performed
- The purpose and expected outcome of the therapy
- The duration and frequency of the session
- The clinical rationale for using a nonstandard or innovative approach
- Provider credentials and direct patient involvement
Payers often require supporting documentation or prior authorization, so clear and complete charting is critical for reimbursement.
Billing Guidelines
- Because 97139 is an unlisted code, reimbursement rates vary and typically require manual review by the payer.
- The claim should include a narrative description of the procedure and its therapeutic intent.
- It cannot be billed in conjunction with another code describing the same service.
- Use appropriate modifiers or supporting codes (e.g., for evaluation, supplies, or equipment) as needed to reflect the scope of care provided.
Example
A provider performs a specialized neuromuscular reeducation technique using an innovative therapy device not yet assigned a dedicated CPT® code. The service is billed under 97139, accompanied by detailed documentation describing the method, duration, and expected functional improvements.
Simplify Custom Procedure Documentation with OptiMantra
When using codes like 97139, clarity and precision in documentation make all the difference. OptiMantra enables providers to easily capture detailed descriptions of unique therapeutic procedures within customizable chart templates, attach supporting notes, and link each entry directly to billing. Its integrated workflow ensures that even nonstandard or emerging therapies are accurately coded, fully documented, and ready for reimbursement—without extra administrative burden.
OptiMantra: Empowering modern providers with flexibility, accuracy, and compliance.
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