Infrared light therapy has quickly gained popularity as an effective alternative non-invasive treatment for pain relief. And it seems to still be picking up steam in chiro and PT clinics around the US. As the demand surges, so does the need for efficient billing and coding.
Most providers rely on a potential medical credentialing services to make it compliant and avoid denials. Accurate CPT codes are more critical than ever in your billing for infrared and laser treatments come 2025. Well, this guide makes it a breeze to find everything you need to know.
What is Infrared Light Therapy?
Infrared light therapy, also known as infrared therapy, is a form of non-invasive treatment that uses infrared light to relieve pain and speed up the healing process. This method of non-invasive therapy treats pain, inflammation, and muscle stiffness.
It utilizes wavelengths of light to penetrate soft tissues and promote cellular repair. Chiropractors and physical therapists may also recommend it as part of a pain management or rehabilitation program.
The therapy falls under CPT Code 97026, which is specific for infrared light. This code addresses infrared light used for therapy. However, it does not encompass other forms of phototherapy. Infrared is frequently billed as an add-on with other modalities (manual therapy, exercise, etc.) but a separate code must be used.
Infrared Light Therapy in Contemporary Medicine
Infrared light therapy uses light wavelengths to penetrate tissues deeply. It’s well utilized to reduce pain, promote tissue healing, and enhance blood circulation. Most chiropractic, physical therapy, and rehab clinics now offer a laser therapy service.
This therapy provides excellent treatment options without the need for a surgical procedure that individuals can assume is often invasive, focusing on chronic pain and inflammation; as such, patients who are avoiding medications or surgery have come to love this treatment.
As the demand for infrared and laser therapy increases, clinics have placed their attention on billing. Incorrect billing or coding can result in claim denials, delayed reimbursements, and, in some cases, compliance issues. This is exactly why knowledge of the applicable CPT codes is extremely important for the healthcare professional.
CPT Code 97026 – Infrared Light Therapy
Definition: This refers to the use of infrared light over the soft tissue area of the body for the purpose of increasing blood flow, reducing inflammation as well as enhancing the healing process.
Detailed Description: CPT 97026 includes service during which infrared lamps or other devices are used to irradiate areas of the body. Generally, these devices are able to emit electro-magnetic radiation of the range between 700 nm to 1,400 nm. It is also commonly used for patients who are dealing with arthritis, joint rigidity, or constant muscle pain. If you use this code, document the below:
- Treatment site (e.g., lower back, shoulder)
- Duration of exposure (e.g., 15 minutes)
- Device used and wavelength range
- Patient response and progress
Billing Tip: This is a time-unattended modality. Be sure to indicate whether the session was standalone or part of a broader treatment plan.
CPT Code 97039 – Laser Therapy (Unlisted Modality)
Definition: Unlisted modality code-use when specific therapy (e.g., cold laser, low-level laser therapy) does not have a CPT code.
Detailed Description: CPT 97039 has historically been associated with low-level laser therapy (LLLT) or cold laser therapy of various musculoskeletal conditions. This code includes procedures in which a provider employs light-emitting diodes or laser devices in the range of 600–1000 nm. It is non-thermal and is thought to strengthen cells, decrease inflammation, and perform for nerve pain.
Proper documentation must include:
- Laser model and class (e.g., Class IIIb, 830 nm wavelength)
- Application site(s) and size
- Energy output (joules/cm2)
- Treatment time and number of points treated
- Rationale for choosing this modality
Billing Tip: Many insurers require detailed notes and may also request a comparison to other standard therapies to justify the use of 97039. Always indicate outcomes and patient progress.
CPT Code 99199 – Unlisted Special Service
Definition: 99199 CPT code is designated for reporting services, procedures, or treatments that are not specifically named in the CPT code system.
Detailed Description: This code is appropriate when experimental infrared therapies, investigational equipment, or non-FDA-cleared devices have been used. It is also used for custom or non-replicable treatments that do not fit within a defined CPT.
Required documentation includes:
- Name and purpose of the service
- Device specifications and settings used
- Clinical justification with reference to peer-reviewed research
- Explanation of why no listed CPT code applies
Billing Tip: When submitting claims, attach a comprehensive cover letter along with the literature that supports your claim. The code should be used judiciously and only if no other CPT code is available.
Chiropractic Manipulative Treatment (CMT) Codes
The designation of these codes indicates the manual manipulations that are carried out by chiropractors. The coding of the number of spinal areas is supportive of the services they provide.
CPT Code 98940 – Spinal, 1–2 Regions
Definition: Use this code when one or two spinal regions are adjusted.
Detailed Description: This can be, for instance, the cervical and lumbar spines. The diagnosis should describe the nature of the spinal problem (e.g., subluxations or misalignments), the technique applied (e.g., Diversified, Gonstead), and the exact areas of the body treated.
CPT Code 98941 – Spinal, 3–4 Regions
Definition: Applied when adjusting three to four spinal regions.
Detailed Description: This code pertains to the adjustment of cervical, thoracic, lumbar, and sacral regions. The records must include details of each region’s evaluation, what is not functioning properly, and how the region was treated.
CPT Code 98942 – Spinal, 5 Regions
Definition: This code is for a full-spine adjustment that involves all five spinal regions.
Detailed Description: This code has a high level of scrutiny applied to both the rationale for it as well as its security. Employ only in cases of clinical need to manipulate each region.
CPT Code 98943 – Extra spinal, 1 or More Regions
Definition: Deals with adjustments to joints aside from the spine.
Detailed Description: Commonly used for extremity adjustments, such as the shoulder, elbow, wrist, hip, or knee. Typically used for adjustments at the extremities, i.e., shoulder, elbow, wrist, hip, or knee. Chart notes must indicate joints adjusted, what was discovered, and the response of the patient.
Evaluation and Management (E/M) Codes
Used during consultations and re-exams.
- 99202–99204: New patient exams with increasing complexity.
- 99212–99214: Established patient re-evaluations.
- 99211: Minimal follow-up services.
Other Common Therapy and Modality Codes
- 97140 – Manual Therapy: For mobilization, traction, and myofascial release.
- 97110 – Therapeutic Exercise: Strength and endurance rehab.
- 97112 – Neuromuscular Re-education: For balance and coordination deficits.
- 97530 – Therapeutic Activities: Dynamic tasks to enhance functional performance.
- 97750 – Performance Testing: Measures strength and flexibility.
- 97161–97162 – PT Evaluation: Based on time and complexity.
- 97116 – Gait Training: Improves walking patterns post-injury or surgery.
- 97535 – Self-Care Training: Instruction on managing daily tasks with impairments.
- 97113 – Aquatic Therapy: Used when land-based exercises are limited by pain or disability.
Passive Modalities
- 97010 – Hot/Cold Packs
- 97014 – Electrical Stimulation (Unattended)
- 97032 – Electrical Stimulation (Manual)
- 97035 – Ultrasound Therapy
- 97018 – Paraffin Wax Bath
- 97022 – Whirlpool Bath
- 97012 – Mechanical Traction
- 97033 – Iontophoresis
Radiologic Imaging Codes
- 72020: Single spine view.
- 72040–72072: Multi-view cervical/thoracic spine.
- 72100: Lumbar spine (2–3 views).
- 72170–72190: Pelvis imaging.
- 72200–72220: Sacrum/coccyx imaging.
Your Billing Partner Matters
Medical facilities must understand billing codes to achieve maximum revenue generation. Understanding billing codes enables clinics to deliver better patient satisfaction through popular therapy treatments, including infrared laser therapy. The intricate healthcare setting demands complete attention to all medical billing aspects.
Furthermore, chiropractic medical billing services assist in preventing recurring billing mistakes. The implementation of advanced credentialing platforms serves as a second method for improved support.
Your medical practice will thrive in 2025 and succeeding years if you maintain informed updates and extensive documentation procedures in addition to industry adaptation. Building an accurate billing structure now will create both financial savings and time efficiency during forthcoming years.
