Shared by: DTRRYAN@aol.com Who told you that a 97140 needed to be at a different level? The CPT coding book doesn't relate anything associated with the two procedures. They are in two separate chapters of the coding book. Overlapping of the areas is quite common and chargeable and is reimbursable in 99.9% of all (Outstanding ACN, who is making it up as they go.) Ask them for the literature that shows this common association - BEWARE IT DOESN'T EXIST. Unless some psudeoscientific-elf has decided to misquote or misread literature. Traction provides multiple primary and secondary actions, different from those of manipulation. Some are as follows: Manipulation: (More related to joints and soft tissue) Movement into the paraphysiological space Increased Z line length Increased circulation in and around a joint Reduced firing of muscle spindles Increased mitochondrial response Increased neurotransmitter concentrations Frees up the facet joints so that normal basiliar flow and disc pressures can be maintained Etc. (and I do mean etc.) Traction: (More directed to disc and soft tissue) Negative pressure intradisc, resulting in increased basiliar flow Isometric and isotonic response of paraspinal musculature Increased lymphatic and venous flow Wolfe law takes presence here, strengthening all the surrounding soft tissue due to stressing of the anatomy, about twice that of manipulation as a matter of fact. Etc. Now if you are talking about distraction manipulation, I can see the common factors there, but not osseous manipulation. I am sure you can find a ton of literature on each of these subjects to assist you, but their are so many primaries, that the overlap of the secondariness are of minimal importance, except to cost containment personal. Can anyone clarify the use of 97140 in the following example A patient's complaint is low back pain. He receives 97140 as a manual traction to the low back, then 98940, manipulation also of the low back. I understand that if your treatment was myofascial release to the low using 97140, it would not be payable because myofascial release must be applied to a dfferent anatomical level than the level being manipulated. Does this hold true for manual traction?? (please note this is not mechanical traction) thanks for an informed reply!! The information contained in this e-mail message is intended solely for the recipient(s) and may contain privileged information. Tampering with or altering the contents of this message is prohibited. This information is the same as any written document and is subject to all local/state/federal laws applying to privileged information. Any message shall not be altered in a manner. Anyone who opens or reads this Email is bound to a confidentiality agreement and hereby agrees to keep not share any of the information or subject matter with any outside entity. If you have received this message in error, or are not the named recipient notify the sender and delete this message from your computer.