CPT® Code 97028

Official Description

Application of a modality to 1 or more areas; ultraviolet

Common Language Description

Ultraviolet (UV) therapy, as described by CPT® Code 97028, is a specialized form of phototherapy that utilizes electromagnetic radiation generated by a specific light source. This modality is designed to treat various skin conditions by applying UV light to one or more areas of the body. The treatment can be administered in two primary ways: for larger surface areas, patients typically stand in an illuminated box where their entire body is exposed to the UV light, while their eyes and genitals are protected to prevent any harmful exposure. For smaller, localized areas, the UV light is directed specifically over the affected skin, again ensuring that the eyes and genitals are shielded from direct exposure. The therapeutic effects of UV light therapy are multifaceted. It enhances blood circulation to the skin, which can promote healing and improve skin health. Additionally, UV therapy stimulates the production of collagen, a vital protein that helps maintain skin elasticity and structure. The treatment also activates the production of adenosine triphosphate (ATP), which is essential for cellular energy and metabolism. Furthermore, UV light has anti-inflammatory properties that can help reduce swelling and discomfort associated with various skin conditions. It is particularly effective in alleviating symptoms such as itching. This modality is commonly employed in the management of several dermatological conditions, including psoriasis, eczema, dermatitis, acne, and physiological jaundice in neonates. By harnessing the benefits of UV light, healthcare providers can offer patients a viable treatment option for these challenging skin issues.

1. Indications

Ultraviolet (UV) therapy, as indicated by CPT® Code 97028, is performed for a variety of skin conditions. The following are the explicitly provided indications for this procedure:

Psoriasis - A chronic autoimmune condition characterized by the rapid growth of skin cells, leading to scaling and inflammation.
Eczema - A condition that causes the skin to become inflamed or irritated, often resulting in itchy and red patches.
Dermatitis - An inflammation of the skin that can result from various causes, including allergens, irritants, or underlying health conditions.
Acne - A common skin condition that occurs when hair follicles become clogged with oil and dead skin cells, leading to pimples and lesions.
Physiological jaundice in neonates - A common condition in newborns where there is a buildup of bilirubin in the blood, leading to yellowing of the skin and eyes.

2. Procedure

The procedure for administering ultraviolet (UV) therapy involves several key steps, which are outlined as follows:

Step 1: Preparation of the Patient - The patient is prepared for the treatment by ensuring that the eyes and genitals are adequately protected from UV exposure. This may involve the use of protective goggles and coverings to shield sensitive areas.
Step 2: Selection of Treatment Area - Depending on the condition being treated, the healthcare provider will determine whether to treat a large surface area or a localized area of the skin. For larger areas, the patient will typically stand in an illuminated box designed for full-body exposure.
Step 3: Application of UV Light - The UV light is then applied to the selected area. For large areas, the patient remains in the illuminated box for a prescribed duration, while for smaller areas, the light source is positioned directly over the affected skin.
Step 4: Monitoring During Treatment - Throughout the procedure, the healthcare provider monitors the patient for any adverse reactions or discomfort, ensuring that the treatment remains safe and effective.
Step 5: Conclusion of Treatment - After the prescribed time has elapsed, the treatment is concluded, and the patient is advised on any post-procedure care or follow-up appointments that may be necessary.

3. Post-Procedure

Following the application of ultraviolet (UV) therapy, patients may experience some immediate effects, such as mild redness or a sensation of warmth in the treated areas. It is important for patients to follow any specific post-procedure care instructions provided by their healthcare provider. This may include avoiding direct sunlight for a certain period, applying moisturizers to soothe the skin, and monitoring for any unusual reactions. Patients are typically advised to schedule follow-up appointments to assess the effectiveness of the treatment and make any necessary adjustments to their therapy plan.

Short Descr	ULTRAVIOLET THERAPY
Medium Descr	APPL MODALITY 1/> AREAS ULTRAVIOLET
Long Descr	Application of a modality to 1 or more areas; ultraviolet
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	7 - Physical Therapy Service, for which Payment may not be Made
Multiple Procedures (51)	5 - Special payment adjustment rules on the RVU practice expense component of multiple therapy service applies...
Bilateral Surgery (50)	0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Service Paid under Fee Schedule or Payment System other than OPPS
Type of Service (TOS)	1 - Medical Care
Berenson-Eggers TOS (BETOS)	P6C - Minor procedures - other (Medicare fee schedule)
MUE	1
CCS Clinical Classification	213 - Physical therapy exercises, manipulation, and other procedures

GP	Services delivered under an outpatient physical therapy plan of care
KX	Requirements specified in the medical policy have been met
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
CQ	Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
XS	Separate structure, a service that is distinct because it was performed on a separate organ/structure
GO	Services delivered under an outpatient occupational therapy plan of care
GA	Waiver of liability statement issued as required by payer policy, individual case
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service