tci Medicare Compliance & Reimbursement - 2012 Issue 6

D.O. Billing: E/M With Osteopathic Manipulation May Be Billable -- If You Know the Rules

Avoid appending modifier 25 to all cases -- instead, focus on medical necessity in the notes. Because osteopathic physicians (D.O.s or osteopaths) are fully licensed physicians who operate under the same licensing and certification rules as medical doctors (MDs), most of their billing matters are handled in the traditional manner. But because D.O.s also perform osteopathic manipulative treatment, or OMT (98925-98929), many coders have trouble distinguishing between OMT and chiropractic manipulative treatment (CMT, 98940-98943) or manual therapy techniques (97140). Coders who bill for osteopathic services should remember to treat OMT as any other procedure or...

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