Palmetto Denying CPT Code 97140

There was a payment issue with Palmetto GBA, Medicare Administrative Contractor for the states of North Carolina, South Carolina, Virginia and West Virginia, with the billing of CPT code 97140, manual therapy. Palmetto was denying payment for manual therapy (97140) unless it was billed with ICD-9 codes 457.0 (postmasectomy lymphedema syndrome), 457.1 (other lymphedema), and 757.0 (hereditary edema of legs). The denials are occurring due to a Local Coverage Article (on Manual Lymphatic Drainage Therapy (A53477)) that went into effect around June 18.

Update today is that Palmetto has posted an article stating that Palmetto GBA has determined that Part B claims for CPT code 97140 have been denied in