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2025 CPT code 98929

Osteopathic manipulative treatment (OMT) of nine to ten body regions.

When billing for OMT and an E/M service on the same day, use modifier 25 with the E/M code to indicate a significant and separately identifiable service.

Modifiers may be applicable. Modifier 25 is used when a separately identifiable E/M service is provided on the same day as the OMT.

Medical necessity for OMT must be established by documenting the presence of somatic dysfunction and its impact on the patient's function and well-being. The treatment should aim to improve mobility, reduce pain, and restore normal musculoskeletal function.

The physician performs the osteopathic manipulative treatment, assessing and treating somatic dysfunction in the patient.

IMPORTANT:For OMT involving fewer body regions, use 98925 (one to two regions), 98926 (three to four regions), 98927 (five to six regions), or 98928 (seven to eight regions).

In simple words: The doctor uses their hands to treat problems in nine to ten areas of your body, like your back, neck, or legs. This treatment helps your muscles and joints move better and can ease pain.

This code represents osteopathic manipulative treatment (OMT) applied to nine to ten body regions. OMT is a hands-on treatment used to diagnose and treat somatic dysfunction and related disorders. The physician uses a variety of manual techniques to restore normal musculoskeletal function.

Example 1: A patient presents with lower back pain, thoracic stiffness, and limited neck mobility. The physician performs OMT on the lumbar, thoracic, and cervical regions, addressing somatic dysfunction in each area, along with additional regions totaling nine., A pregnant patient experiences pelvic pain and discomfort. The physician uses OMT to address dysfunction in the pelvic, sacral, and lumbar regions, and other related areas to improve mobility and reduce pain, treating a total of nine regions., An athlete suffers from multiple injuries affecting their upper and lower extremities, rib cage, and spine. The physician uses OMT across ten body regions to address somatic dysfunction and restore function.

Documentation should include the specific body regions treated, the techniques used, the patient's response to treatment, and any associated diagnoses. If an E/M service is billed on the same day, it should be documented separately and clearly indicate the medical necessity for the additional service. Modifier 25 should be appended to the E/M code.

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