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2025 CPT code 98925

Osteopathic manipulative treatment (OMT) of one to two body regions.

When OMT is performed on more than two body regions, use the appropriate CPT code: 98926 (three to four regions), 98927 (five to six regions), 98928 (seven to eight regions), or 98929 (nine to ten regions).

Modifiers 25 and 59 may be applicable. Use modifier 25 when billing for an E/M on the same day. Use modifier 59 for services not normally done together but appropriate for this encounter. Refer to payer policy for specific guidelines on using these modifiers with 98925.

Medical necessity for OMT is established when the patient exhibits signs or symptoms of somatic dysfunction, such as pain, restricted range of motion, or tenderness. The documentation should clearly link the OMT to the patient's condition and demonstrate how it improves function or alleviates symptoms.

The physician applies controlled manual pressure to specific body regions to address somatic and non-somatic disorders. This involves manipulating the movement of muscles and joints to restore normal mobility and reduce pain.The physician determines the appropriate areas to treat based on the patient's condition.

In simple words: The doctor uses their hands to apply pressure and move muscles and joints in one or two areas of your body. This treatment helps to improve movement and reduce pain.

This code represents osteopathic manipulative treatment (OMT) performed on one or two body regions. OMT is a hands-on treatment used by osteopathic physicians to diagnose, treat, and prevent illness or injury. It involves using gentle pressure and manipulation of muscles and joints to restore normal function and alleviate pain.

Example 1: A patient presents with lower back pain localized to the lumbar region. The physician performs OMT on the lumbar region to alleviate pain and restore mobility., A patient experiences headaches originating in the cervical region. The physician performs OMT on the cervical region and head region to address the headache., A patient with shoulder pain and restricted range of motion receives OMT focused on the thoracic region and upper extremity.

Documentation should include the specific body regions treated, the techniques used, the patient's presenting symptoms, and the treatment's effect on pain and mobility. Any associated diagnoses should also be documented.

** This information is current as of December 1st, 2024, and may be subject to change. Always verify coding guidelines with official resources and payer policies before submitting claims.

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