by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Feb 13th, 2014 - Reviewed/Updated May 13th
Muscle and Range of Motion Testing guidelines have recently been clarified in the AMA CPT Assistant. “Given the subjective aspect of manual testing, the use of consistent test positions, including accurate joint placement and avoiding the use of compensatory muscle actions, must be integrated into the test in order for MMT to be utilized as an effective evaluation tool.” -AMA CPT Assistant, August 2013
The following table should be used as a standard for Manual Muscle Testing procedures:
Table 1. Manual Muscle Testing Procedures
| Key to Muscle Grading | ||||
|---|---|---|---|---|
| Function of the Muscle | Grade | |||
| No Movement | No contractions felt in the muscle | 0 | 0 | Zero |
| Tendon becomes prominent or feeble contraction felt in the muscle, but no visible movement of the part | T | 1 | Trace | |
| Test Movement | MOVEMENT IN HORIZONTAL PLANE | |||
| Moves through partial range of motion | 1 | 2- | Poor- | |
| Moves through complete range of motion | 2 | 2 | Poor | |
| ANTIGRAVITY POSITION | 3 | 2+ | ||
| Moves through partial range of motion | ||||
| Test Position | Gradual release from test position | 4 | 3- | Fair- |
| Holds test position (no added pressure) | 5 | 3 | Fair | |
| Holds test position against slight pressure | 6 | 3+ | Fair+ | |
| Holds test position against slight to moderate pressure | 7 | 4- | Good- | |
| Holds test position against moderate pressure | 8 | 4 | Good | |
| Holds test position against moderate to strong pressure | 9 | 4+ | Good+ | |
| Holds test position against strong pressure | 10 | 5 | Normal | |
| Modified from 1993 Florence P. Kendall. Author grants permission to reproduce this chart. | ||||
From: NIEHS [National Institute of Environmental Health Sciences]. IMACS [International Myostitis Assessment & Clinical Studies Group] FORM 04: Manual Muscle Testing Procedures. Available www.niehs.nih.gov/research/resources/assets/docs/muscle_grading_and_testing_procedures.pdf. Accessed July 16, 2013.
MANUAL MUSCLE TESTING PROCEDURES
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
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