Billing Medicare for HIVAMAT

I was at a meeting recently and a company representative told me I could bill Medicare for HIVAMAT therapy for swelling and pain reduction for a wide variety of patient conditions. He referenced a CMS transmittal that says the therapy using this device is billed as 91740. It sounds good but I’m skeptical.

Answer:

You are right to be skeptical. The CMS transmittal referenced does not mention that "HIVAMAT therapy is considered manual therapy (which is billed as 91740)" as stated in the billing information you were given. In fact, 91740 is mentioned only incidentally in this August 3, 2006 transmittal as part of a CMS discussion on how to bill timed therapy codes.  

Per CPT, 91740 involves:  

CPT code 97140, Manual therapy techniques (eg, mobilization/manipulation, manual lymphatic drainage, manual traction), one or more regions, each 15 minutes, was added to CPT in 1999 to accurately report manual (soft tissue and joint) techniques. Manual therapy techniques include, but are not limited to: connective tissue massage, joint mobilization and manipulation, manual lymphatic drainage, manual traction, passive range of motion, soft tissue mobilization and manipulation, and therapeutic massage. As the code descriptor states "manual," providers use their hands to administer these techniques. Therefore, code 97140 describes "hands-on" therapy techniques.

HIVAMAT, as described in its consumer literature, is a pulsed electrostatic energy therapy combined with an oil-based massage. Based on the video of the product's use, the massage is minimal and probably would not meet the definition of "therapeutic" massage.