We have read many different opinions from many coding experts on how to bill and code for elastic therapeutic taping. Many of these coding specialists are friends of ours and we respect their opinions. Now we'd like to provide you with our opinion. Please understand that our opinion may differ from what you've heard, so do your due diligence to educate yourself on this topic and you'll be able to make an informed decision relative to your particular situation.
Taping 101
Let's start with a little background. Elastic therapeutic taping is a taping technique designed to facilitate the body's natural healing process while providing support and stability to muscles and joints without restricting the body's range of motion. Elastic therapeutic taping is commonly utilized to help alleviate pain and facilitate lymphatic drainage by microscopically lifting the skin. It can be applied in hundreds of ways and also is used to re-educate the neuromuscular system, reduce inflammation, enhance performance, prevent injury and promote good circulation and healing, and assist in returning the body to homeostasis.
According to the AMA, "[Elastic therapeutic] tape is a supply. Its application is included in the time spent in direct contact with a patient to provide either re-education of a muscle and movement or to stabilize one body area to enable improved strength or range of motion. The application of tape is usually performed in conjunction with educating the patient on various functional movement patterns. The tape is applied based on the patient's specific patterns of weakness or strength. The tape is left in place after instruction related to movements designed for improving strength, range and coordination is provided and documented. However, if the purpose of the taping is to immobilize the shoulder, then the strapping codes may be appropriate as those codes describe the use of a strap or other reinforced material applied post-fracture or other injury to immobilize the joint. If the taping is performed to facilitate movement by providing support, and the tape is applied specifically to enable less painful use of the shoulder and greater function (e.g., restricting in some movement, facilitating others), application of tape in this manner is typically part of neuromuscular re-education (97112) or therapeutic exercise (97110), depending on the intent and the outcome desired. This includes application of elastic tape or McConnell taping techniques."
CPT Codes
We have not read any insurance carrier policies state that they will cover elastic therapeutic taping for alleviating pain, reducing inflammation, promoting good circulation and returning the body to homeostasis. Therefore, you should consider elastic therapeutic taping a non-insurance-payable procedure. However, if you need to bill an insurance carrier for elastic taping, we recommend you use CPT code 97139 (unlisted therapeutic procedure) or CPT code 97799 (unlisted physical medicine / rehabilitation service or procedure). You can also bill HCPCS code A4450 per 18 sq. inches of tape (non-waterproof) or A4452 per 18 sq. inches of tape (waterproof).
When reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation (e.g., a procedure report) along with the claim to provide an adequate description of the nature, extent, need for the procedure, and the time, effort and equipment necessary to provide the service. (If you would like to receive a sample elastic taping procedure report, send an e-mail to info@targetcoding.com.)
Please understand that because you can bill for elastic taping doesn't necessarily mean it will be reimbursed; sometimes you need to bill just for denial purposes. Whether cash or insurance, you need to show medical necessity for performing the procedure. This includes an exam, history, making a proper diagnosis, and reporting frequency and duration of care. The SOAP notes should include the clinical rationale for performing the service and if the functional goals are being reached. You also need to call all the carriers you bill to verify coverage, and obtain their policies and guidelines on the procedures prior to billing the insurance company or patient.
We do not recommend billing CPT codes 29200, 29240, 29260, 29280, 29520, 29530, 29540 or 29799 for elastic taping. In our opinion, these cast and strapping codes are meant to "immobilize" a joint or body part and therefore should not be used for elastic therapeutic taping. However, if the purpose of the taping is immobilization, then the strapping codes may be appropriate, as those codes describe the use of a strap or other reinforced material applied post-fracture or other injury to immobilize the joint.
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